Two weeks after undergoing a double mastectomy, the first of many gender reassignment surgeries, JEREMY FARMER looks back on a day full of anticipation and trepidation in our exclusive blog

PRE-SURGERY The sun was shining on a beautiful September morning as I left home for my first gender reassignment surgery. Other than thinking 'good it isn’t raining' I didn’t notice anything else.

My guts were full of butterflies and I could think of a million and one other things I would be rather be doing. In April this day had seemed so far away, now everything felt suddenly very real. It was pre-med day.

The journey down to Brighton was uneventful and the trains quiet, giving me thinking space. Mentally, I was geared for a negative outcome to the day regarding the medical side of transition because that was what nearly always happens.

Sipping my water I was glad to be alone for a while. I was meeting up with a friend between the two appointments, and I would need the support - whatever happened.

Walking out of Brighton station I began to feel the nervous nausea, but found a cab and within minutes was pulling up outside the Nuffield Hospital. I sucked hard on my sugar free mint, but really a mint is no substitute for a cigarette. Oh well, no point in hanging about I went in to the snazzy reception area and tried to appear calm. No doubt I failed.

I didn’t have to wait long before a nurse came to fetch me and started the pre-med formalities of health history, blood tests, MRSA tests, ECG and blood and heart observations.

For once my pulse was playing the game and she found it at the first go.

She then looked at me and I thought: “Here we go she’s going to tell me something is wrong,” but no, all was good to go.

My mate was outside waiting in the reception, he stayed with me while we waited for the consultant. I can’t remember what we talked about; everything and nothing probably. Whatever, it worked; I felt calmer. Then I was called in to see the consultant.

He started talking about the surgery, the risks and things that could go wrong. He took pictures then drew a rough diagram (he’s no artist) of a breast and how he would remove it. Yes, he said “remove it” at which point it all sank in. I came out of his office on a cloud.

For so many years my breasts have made me feel nothing but the self-hate that has pushed me into the pits of dark depression – in ten days they would be gone. I was walking on air. I was so grateful my mate had taken me back to the station. I am not sure I would have made it without him to keep me grounded.

THE OPERATION Travelling down to Hastings was event free, the conversation easy and nicely distracting from what was going to happen the next day. We stopped at Cobham Services for coffee and sinful donuts. Donuts are a very rare treat for me so they always taste awesome.

It was getting dark by the time we drove from Kent to East Sussex with the aroma of hops teasing our noses. I had forgotten the utter deliciousness of that. I must have drifted into my memories a bit, as the next thing I knew was a glorious reflection of the full moon shimmering on the English Channel and we were nearing the end of the journey.

My friend dropped me off with the friend I was staying with. Again easy conversation and a chilled out atmosphere.

I was too calm, I knew I was too calm. I would be having surgery the next day and I was not even feeling the slightest sense of nervousness - just an amazing sense of calm, that life was beginning to go the way it should.

We watched the lunar eclipse. The darkness of the sky made so many more stars visible and the colour of the moon was a deep blood red; a true blood moon, and prophetic to a Pagan like me. Blood moons are omens of an end and a change in life. I wasn’t going to watch it as I knew it would set my mind thinking.

Thinking, oh yes, the thoughts started coming thick and fast. I went back to bed for another nap before leaving for the hospital – sleep wasn’t going to happen quickly. So I let the thoughts come. Not once did I think, “Have I made a mistake?”

The pretence of being content in a female body had come to end. For a new beginning, something had to end. There was no going back.

THE BIG DAY To be honest I don’t remember that much. It was still dark when my friend and I left for the hospital and the roads were peaceful. It was just as well, as we were both tired from the previous night.

On arrival I checked in and was taken to my room for the next 24 hours or so. A flurry of people came in. I can’t remember a thing they said. I ordered food for later in the day, undoubtedly vegetarian as I don’t eat meat that much, and probably a bucket of coffee. I hadn’t had any coffee since the day before. I would have been as edgy as a cat on a hot tin roof.

We were told, so my friend tells me, I would be going to theatre at 9.30am but didn’t go until noon. I was back by 2.30pm judging by his post on Facebook.

I must have dozed off as they woke me up to give me the anaesthetic. The next thing I remember, I was talking to my mate and it was all done. I felt like I had been hit by a wrecking ball but was too groggy to make much sense of anything. The night was one of interrupted sleep. The nurse had to do regular checks on my sugar levels as I am a diabetic and give me painkillers when needed.

The procedure can be found here transurgery.com/chest-reconstruction/double-incision-technique

Mr Yelland, the surgeon, made the cool dude list on Tuesday morning when he came in to sign me out. His tie was superb. Anyone who knows me will know that meant I was back to my normal self even though I physically felt like I had been demolished. So it was home for a week of rest and healing before the post op appointment.

POST-OP A week of not so quiet and restful healing later, I was back in Brighton for my post op. Had it worked? Everything was healing as it should. Staples came out from the nipples. I was glad I had taken codeine beforehand, so it wasn’t that painful. No more itchy dressings, and I only needed to wear a binder if I went out to protect myself.

I looked in the mirror and I looked a bit battered.

But I can look at myself now and not hate what I see to the point of spiralling into dysphoria.

For the first time ever I can do that. I still have a lot of healing to do but it is one huge step in the right direction.

For the last two weeks my emotions have been shot to hell. I don’t have the words to sum up how I feel, and yes that is frustrating me to bits – I am a writer and not knowing the words to express my emotions is unheard of for me.

Happy? No it is beyond that, way beyond that. I am out of the cage now and it is awesome. That is the best I can do to sum it up.

MY THANKS It is only proper that I stop at this point and thank all those who have supported me this far. My deepest thanks go to Mr Yelland and his team at Nuffield Health who made it possible. Also to Jenny, Misty and Lisa for getting me there and back for the operation and to Andy for being there for the post op. My boys for being my boys and keeping me going. Alf for being a real bro and staying with me until I woke up. Kayto for being the best friend a guy could have at 4.30am. Finally to Caz for being my Caz and making me smile when I wanted to cry.

I’m not easy to live with and you hung in there for me.