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Flesh of Your Flesh

Early on, in the first shell-shocked weeks after you found out, you imagined the distant day when she would have sex change surgery. That’s how you thought of it then – sex change surgery, the day they would take the knife to your daughter and make her male.

She was only fifteen then, and you imagined a day far into her future, beyond adolescence, beyond college, perhaps on the other side of thirty even, so far beyond the bounds of parental purview that none of it, thank God, would belong to you.

You imagined a hospital hallway in gray light, your child on a gurney, faceless and already woozy. You imagined the final goodbye, the last moment you would ever see your daughter. You imagined yourself bending over her, clinging to metal rails as they tore her from you. You imagined grief and loss.

* * * * * * *

            Surgery happened instead, on an early December day the fall Casey was eighteen, the fall she should have been away her first year at college, the fall she insisted on staying home instead. If you make me go to college now, you’ll be wasting your money, she had told you the previous spring, the two of you making your way along the cracked sidewalk toward your rental car at the edge of a New England university campus to which she had applied.

It was the fall that followed the spring of her first testosterone injection, the fall you watched as she changed before your eyes, head shaved, voice deepening, her presence intensifying. It was the fall you finally replaced the pink carpet in her room with slate blue, the fall you struggled to make yourself speak and think in male pronouns, the fall you hired a lawyer to erase from her birth certificate the name you had given her, Cassandra, the name you had claimed in childhood for the daughter you would one day have.

It was also the fall you threw yourself into your younger child’s new school, stepped up the horseback riding you had returned to in earnest, spent hours on the Internet researching small ships for a Caribbean escape you dreamed of taking with friends, but never did. It was the fall of your second dental crown in three months, the result, your dentist explained, of nocturnal teeth-clenching, stress-induced.

Sources had guided you to Dr. Fischer, a thirty-something plastic surgeon with a coast-to-coast following of female-to-male (FTM) transgender persons. Her office was two hours from your home in rural Maryland. You were used to driving long distances for professional help – the first therapist you took your daughter to, a woman neither of you could warm up to; the psychiatrist you found instead, a university-associated octogenarian who had pronounced her case “classic” and reassured you with his calm, gentle manner; the endocrinologist who prescribed her testosterone and taught her to inject it herself because you could not.

On your second phone call to Dr. Fischer’s office, the nurse had told you FTMs were their favorite patients. They are always so grateful, she said.

At your consultation visit, the staff was warm and kind, treating you and your child as if the surgery you were planning was as ordinary as a tummy tuck.  They showed you a scrapbook of headless before-and-after photos, one of which revealed a patient’s transformation from hairy, pendulous-breasted she-man to brawny-chested, nipple-pierced, tattooed motorcycle guy. Even though it wasn’t the look your child was going for, it was somehow reassuring.

You had liked Dr. Fischer immediately, the way she smiled and took her time with the two of you. You wanted to know how she got interested in FTM surgery, and she said she had once been overweight and cosmetic surgery had given her a new start, a life-changing confidence in herself. She said she could identify with the longing of FTMs for a different body, one that would match the person they knew themselves to be. You wanted to believe, then, that she understood what was at stake for your daughter, perhaps in a way you could not.

* * * * * * *

            When the word transgender had come into your life three years before, you were stunned and horrified, despite more than a decade of anxious concern over your daughter’s decidedly unfemale proclivities and, once puberty arrived, profound misery. In that terrible moment of truth and through the months that followed, you were saved from emotional devastation by an alter ego of sorts, what you came to think of as your good mother persona, who materialized forthwith, as if a button had been pushed summoning her to action. You imagined this persona the product of internalized lessons of self-sacrifice and rising to the occasion, lessons from the firm and disciplined hand of your own mother, though more than one therapist had suggested darker origins, perhaps the survival instincts of a three-year-old mind, learning early to block the unbearable.

Whatever her source, the good mother was strong and adept, a pro at numbing herself to loss, enabling you to draw your daughter close, kiss her forehead, and tell her it would be all right, you loved her no matter what and you would figure this out together, whatever it took. And then you had soldiered on, stoic and determined, busying yourself with counseling appointments and medical questions, phone calls and Internet research, the finer points of health insurance and legal maneuverings, feeling your way along but not feeling, one foot in front of the other, trudging the bizarre and unfathomable path that had brought you to the doorstep of Dr. Fischer.

By now you knew the official terminology, the crisp, sanitizing words Dr. Fischer would use in the letter she would provide, gender reassignment surgery, the words that would pass muster with the court when your lawyer petitioned for a legal change of gender so your daughter could be issued a new birth certificate, as if you had never held your infant daughter to your chest in the hours after her birth, marveling at the miracle of this tiny female being, the connection that had stunned you with its immediacy, a daughter. You knew the informal terms as well, the words the transgender community used: bottom surgery, the results of which were apparently so unsatisfactory that most FTMs opted out and focused instead on top surgery, the term preferred over double mastectomy.

Although it would not be the grisly procedure you had once foreseen, you shuddered when Dr. Fischer described the details of the surgery: how the fat would be liposuctioned from your daughter’s breasts, how her nipples would be removed and repositioned (otherwise, they would lie too low on her flattened chest), how she would leave the office with drainage tubes inserted in the twin incisions on either side of her torso, how it would be up to you to empty them once home, to clean and dress the wounds until you returned a week later.

You had never seen your daughter’s breasts, at least not in their developed form. The last time she’d let you near them, she was in fifth grade. You were standing at the stove making dinner when she came into the kitchen complaining her chest hurt.

Your chest hurts? You had asked. What do you mean? How does it hurt?

            She shrugged. It just feels sore.

            What are you doing in PE these days? Maybe the muscles are sore from some exercise you’re not used to.


            Show me where it hurts.

She put her hands up to the knots forming beneath her nipples.


You covered her small fingers with yours and felt gently.

Oh, sweetie. These are your breasts.

She looked up at you for a split second, face stricken, then her eyes fell and she walked out of the room without a word.

Years later, after you knew the truth, she told you her childhood self had often stood before the bathroom mirror studying her smooth, flat chest, dreading the day it would have breasts. She had resisted the bra you offered when they became noticeable beneath her shirts, agreeing at first to only plain cotton tanks, the kind that resembled men’s sleeveless undershirts. Eventually, she settled on tight sports bras that compressed and flattened her.

* * * * * * *

            Shuffling through the folder of forms Dr. Fischer’s nurse gave you and your child to read, you caught a glimpse of the photos they had taken of her chest. You paused for the briefest moment, the first and last time you would ever see your daughter’s developed breasts. They were a lot like your own – small and round, but a little fuller, pale skin and rosy nipples. You wanted to linger over the images, take them in and hold them inside of yourself, as if you could secretly save them, these sacred mounds of flesh that connected her to you in the most elemental way.

But you made yourself continue through the pages, knowing how much she hated her breasts, how embarrassed she would be if you looked, the good mother protecting her child. You couldn’t see then that the good mother was also protecting you, knowing that if you dwelled on these breasts, flesh of your own flesh, you would come to face the truth you were not ready to accept: that they were as repulsive to her as a dangling appendage between your legs would be to you, that there was no female connection, that there never had been and never would be. You wanted to cling still to the innocence and sweetness of that little girl you thought you had raised. You had to look away.

* * * * * * *

            I had wept for that lost little girl –heaving sobs that had come only once and then subsided, possibly for good. They had risen up late one evening the previous spring as I sat at my computer, composing an email to Beth, the one person in my world who understood what I was going through.

We had met through a listserv for parents of transgender children soon after we’d both found out. Like me, Beth had birthed a daughter seventeen years before and then watched as that daughter, from the time she toddled on unsteady feet, spurned all things girl in favor of things boy: toys, clothes, games, play, hairstyles. Like me, she hadn’t cared that her daughter was a so-called tomboy, and she was proud of this girl-child who rejected the pink, the bows, the limitations, the narrow boundaries. But like me, instinct had gnawed at her gut and made her uneasy. Like me, she had waited for the day her child would grow into the kind of daughter other people had – the kind that wanted to shop in the girls’ department, liked glittery notebooks, giggled over boys. Like me, she had waited and watched for the day when she could release the breath she had been holding as she watched and waited.  Like me, that day had never come.

Separated by hundreds of miles, the two of us exchanged emails every day, sometimes two or three times a day, our mirrored stories unfolding. Checking for her messages was the first thing I did in the morning and the last thing I did at night. Little by little, the cautious, polite notes of our initial exchanges had become full-blown narratives, spilling the intimate details of our lives into each other’s Inbox. We had become so close that Beth had invited Casey and me to take a weekend detour from a college trip that March and visit her family outside Boston. She had welcomed us with a hug, pulling us both into the warmth of her home as if we had known each other for years.

Our children had been emailing as well, discovering similar interests. They’d even applied to some of the same colleges. Unlike Casey, Jesse had already begun the process of transitioning from female to male. Though he hadn’t had surgery yet, he was several months into testosterone injections, his voice low, his upper lip and chin spiked with stubble.  He was quiet and soft-spoken, instantly likable. But I had shuddered to myself at his appearance, struggling to contain the uneasiness it set off in me.

My email to Beth that spring night alone at my desk had begun like so many others, describing the details of my day – a mishap with the family’s pet iguana; my younger child’s interview at a new school; Casey’s decision, officially announced earlier in the evening, to delay college for a year to complete transition. I had gone on about these things, paragraph after paragraph, letting the words carry me where they would, fingers tapping the keys like footsteps moving blindly down an unseen trail, leading me to their destination, a place of dread – horror even – over the endocrinologist appointment two days away, when Casey would receive her first testosterone injection.

I think I have been avoiding facing up to that reality until now, and I don’t want to face it! I wrote. I cringe at the thought of my child growing whiskers. I realize that I am still hanging on to the female Casey, and I don’t want to let her go. I just want to run in the other direction as fast as I can. Without the hormones, I could always cling to some hope. With the hormones, all I can do is accept, and I guess I am not as ready as I thought I was.

As I typed, my throat thickened, and the weight of my loss rose up from the place where I had pushed it down with the heft of denial, where it had lain dormant, as if waiting for this moment, the beginning of what remained of my daughter as I knew her.  The familiar voice that would slowly lower, perhaps so imperceptibly that I wouldn’t even notice until it was gone forever. The smooth skin of her face that would grow coarse, foreign, and likely spotted with acne. Her curves hardening into muscle.

I clung to the one image I will hide in my heart for the rest of my life, her eight-year-old face captured in her third grade school photo. She is wearing a soft gray cotton jumper over a white puffed-sleeved blouse. A gift from her grandmother, the dress is dotted with tiny pastel flowers. It had hung, rejected and unworn in the back of her closet until that day when I had pulled it out, not for the photo, but for a special presentation she had been asked to participate in for state school officials. Please wear dress up clothes, the teacher’s note had specified.

In the photo, she smiles with the innocence of a child happy to be in the world. Her face is luminous, the contrast of short dark auburn hair and brown eyes against pale skin sprinkled with freckles. It is the same sweet face of other photographs through her childhood, but paired with the simple jumper, the image had allowed me to believe in the little girl I never really had.

I just want to go back to that place in time. I want that little face with the freckles and soft skin and little bowl haircut. How is a mother supposed to give all this up?

This was my moment of parting in the hospital hallway, falling to my knees as the gurney withdrew, taking my daughter away. This was the moment of release for the sob that had been lying in wait, as if the pattern of my fingers on the keyboard tapping their truth had awakened the grief my body had held in check for three years.

The sobs came in waves, rolling through me. I let myself go, finally, head down on folded arms, allowing myself entry into that empty place, letting myself feel its damp walls, its hard floor under my feet, where I was, despite Beth’s supportive presence, utterly alone.

* * * * * * *

            Your child, no longer a minor, signed the papers. You saw her hesitate when she came to the part listing the risks of surgery, including possible death. You could tell she was surprised, shaken, and you knew she was thinking about the extra heartbeat her doctor had discovered the past spring, even though he said it was nothing to worry about. You did not think about the possibility of death, not because it was unbearable, but because it was already happening. The good mother rubbed her child’s back, reassured her this was standard language, she was in good hands, she was not going to die.

On the day of the surgery, your friend Emily came to sit beside you in Dr. Fischer’s waiting room, elegant in polished wood and shades of teal. After your daughter had changed into a hospital gown, they let you into the surgical suite, cheerful holiday music playing overhead. You pulled out the socks you had brought to keep her feet warm, red and green socks with a chip in them that played Jingle Bells. She rolled her eyes at your goofiness, but let you put them on her anyway. You could see she was anxious, so you did not allow yourself to feel. You held on, strong and steady and cheerful. You bent and kissed her, squeezed her hand. I love you, you said. Everything is going to be fine. I’ll see you in a few hours. You did not cry.

In the waiting room, Emily held your hand and kept talking so you wouldn’t think about what they were doing to your daughter’s breasts. At lunchtime, when the staff said it would still be another couple of hours, the two of you walked across the parking lot to a Mediterranean restaurant. You weren’t hungry, but you made yourself eat anyway, and you each had a glass of wine. You were surprised at how calm you felt, only later realizing that it was numbness.

When you got back, your daughter was out of surgery and they said you could see her. You didn’t realize how scared she had been until you bent, once again, to kiss her cheek and stroke her damp hair, and she asked in her woozy voice if she had died. Of course not, silly, you whispered. The doctor says your chest looks fantastic and you did great. It’s all over now, and Mommy’s here.

            Mommy’s here, you said, as if those words could return you to that time and place when mothering had felt so simple and uncomplicated, even when it had been hard, because all you had to do, it seemed, no matter what went wrong, was pick her solid little body up and hold her close, wrap your arms around her, rock her in the same chair where you had soothed her with your mother milk.

            Then you straightened beside your child, and the room quieted just for a moment, at least that’s how you remember it, just long enough for you to catch the strains of Musak overhead. The notes were familiar but unexpected, out of place. How odd, you thought. For the tune that met your ears that early December afternoon, the sweet, improbable notes that streamed through gray light as your child awakened, were those of Brahms Lullaby.

The music faded against the buzz of post-surgery activity, but it had been enough, stilling you to a sudden heightened consciousness, and you understood that this tender, long-loved lullaby was a gift meant for you.

Those brief, lilting measures awakened the primordial mother inside you, the child-mother unschooled in the ways of sacrifice, stoicism, false cheer. The music called you back to the memory of that moment, taking this child, your firstborn, in your arms for the first time, the wash of awe and relief and gratitude, the longing for what was to come.

You had not been awake for that birth, given general anesthesia for an emergency Caesarian as her heartbeat plummeted the moment you had started to push.  Waiting in your hospital room afterwards, it had seemed hours before they brought her to you, finally quiet and sleeping, exhausted from the trauma. They told you she had come out red-faced and screaming, as if furious at the tugging and pulling it took to free her from the birth canal where she was lodged.

You had missed her first breath, the chance to enfold her slick, naked body in your arms, quiet her screams with the warmth of your breast, the beat of your heart. You had grieved the loss of those moments and now you had another chance. Although this day was nothing you could have ever imagined, although it had come to you unexpected, unwelcome – here it was.









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