Excerpt from Nice flat chests – March 9, 2007

So. Being BRCA + is very much connected with being a lesbian for me.

BRCA + means BReast CAncer gene mutation positive. There are 2 genes, and I carry a mutation to BRCA1.

My assumption, inherently wrong, I know, is that the lesbians would choose to go flat and the straight ladies would reconstruct. (Keep in mind that my mother had BPM 20 years ago and is not gay.)

I am not a girlie lesbian. I am a girl who was a clueless tomboy when I was a kid. I did not want to be a boy, only to dress like one, and to do the same things. I was a teen-aged feminist, angry that my dad gave my brother the inherited ball glove, even though I loved softball more than he loved baseball, and it was too big for him. I protested the disbanding of the girls swim team. The school eliminated it because of financial difficulties and laziness. Despite my shyness at the time, I went to the new principal’s office, and ended up crying. I swam with the boys and beat some of them, and could go underwater longer than all but two friends. 75 yards in a 25 yard pool.

I was skinny and flat in high school. I went off to college and found rugby in 1982, post butch femme and pre-transgender (another incorrect assumption) I got strong and fit and hung out with lesbians who loved motorcycles and who worked out and who dressed like boys. We cut our hair short, wore jeans, and devoted our time to an odd British sport (best played by New Zealanders, of course)

In medical school, I debated whether to wear my intertwined women’s symbols at the catholic hospital I was assigned to and did, and was rewarded by the most appreciative patient ever. A young gay man with AIDS, who appreciated that code signal, where he was stuck feeling more out of place than me.

In residency, I started in Milwaukee, 3 weeks before Jeffry Dahmer was discovered, and suddenly was one of the few out people on the gay community’s task force to evaluate police and gay/lesbian relations. I testified before the mayor’s commission and helped develop the police sensitivity training, and recruiting policies.

And then I moved back to my small home town, with my girlfriend at the time, who subsequently moved on.

Now, I am an out of shape lesbian, who does not feel at all girlie. I still dress like a boy. (No neckties) My patients get confused, despite my 42Ds. My partner hopes I can stay back in the closet a little, as her job may legitimately be at risk.

And as a physician, I know exactly what my risks are, and exactly what the trials that some of you have gone through to get healthy after cancer. And I intend to do all of the risk reduction surgeries.

And because I am a lesbian, who dresses like a boy, but does not want to be a man, I do not want reconstruction. And I probably won’t wear prostheses. Which means that whether I want to tell everyone in town or not, they will notice. (Ultimately, it turns out, people don’t notice.)

I will probably be more comfortable in my skin wrapped in flannel and jeans. I am tempted to buy a bow, and pose as a true Amazon (ambidextrous) probably with clothes on. (Alas, I have too many hobbies as it is. Will probably borrow the kid next door’s bow for the photo)

And my patients will be more confused. (My poor young OT almost fainted this week when a patient made a big deal about thinking I was a man. Patient just meant that her image in her head of Dr. Snow was male.) My partner will be more nervous. And it will be hard for some people who don’t know me to tell whether I am TG or just a lesbian who likes to dress like a boy and keep her hair short. (those who know there are such things as lesbians or transgender people)

I know that my ovaries will not always make me who I am and I know that my breasts will not always make me who I am, but they do define me, at 43, BRCA+ and wanting to do all I can to stay healthy.

I do want the chest of ROW’s friend Ed(Right On Woman from the FORCE chat room, who has a friend, Ed, who is a trans man with a great looking chest), and I will try to talk to my surgeon to get that. I will be scared to do so, because there is a mystique about this surgeon for my partner more so than me. I will worry that it will earn me a trip to the plastic surgeon, or an extra trip to my therapist, when I am in a hurry to get on with things, so I can play golf in July. I will worry that I will need to find a new surgeon, and that will slow things down, or mean that I have to have 2 surgeries instead of having it all done at once.

So, it is all very complex for me right now. I don’t know a lot about the TG community, and will enjoy learning more about it. I will need to learn to break down my prejudices, to the point that I don’t mind if someone mistakes me for one.

I do care what people think, in that I have to interact with lots every day, and my choices will have an impact on how my colleagues react to me, in how effective I can be as chief of the medical staff next year, and how well my patients can relate to me with the biases they bring into the room.

Thank you all for this challenging discussion and for allowing me to go on and process all of this. I welcome any input on the subject, and would be glad to talk on-line or off line about myself more. It seems very therapeutic to me.

Margaret, who is breathing a sigh of relief as I hit the submit button.

This post was a response to the thread Questions for flattops, with comments by 15 women, before and after this post, and my comments were greeted by a plethora of supportive comments.

FORCE administration and message board members have always been very supportive of me. I have been able to meet some amazing people representing flattops and the LGBT community informally on line and at the FORCE conference.

<https://www.facingourrisk.org/messageboard/viewtopic.php?f=3&t=18160&start=50&view=print>