Getting Fixed

Mx is at work today and They get up first while i stretch lazily out across the full bed. i’m off work until Thursday, and the tiredness in my bones and the bloated feeling in my belly tells me i’m still healing and still need it, but i feel better. i last took painkillers at 2pm yesterday, and last took the good painkillers at 11pm the day before, and nothing hurts. i roll from my back to my side to my back again and it still feels okay, though i don’t think lying on my stomach would be a great idea just yet. It’s day five, and we’re getting there.

i sleep a little more and then potter through to the bathroom. The dressings are peeling at the edges, and they told me after five days i could take them off if that happened, so i peel. There are two incisions, one inside my belly button that i can’t even see, and one running along my pubic hairline. That one i can see and it’s tiny, less than two centimetres and closed with two neat stitches. It doesn’t look as healed as i’d expected, and it’s jarring to see that fragile line. It feels like without the stitches it’d open right up and the thought makes me feel queasy. But it looks healthy, no inflammation, no infection.

For the first time since the operation i dress in my own clothes instead of Mx’s baggy jogging bottoms, i put my hair up, and when i look in the mirror i look much more like myself. Still dark under the eyes and pale in the lips, but not as translucent grey as i’ve been. i might do some things today – things like write, make a video, and help with the washing up. Probably not things like go outside or do the laundry, but you know, baby steps.

i’ve known i didn’t want children since i was five years old and saw my first body horror movie. It was a video of a sheep giving birth, and i don’t think my reaction to it was the one intended, but it was the worst thing i’d ever seen. i was fascinated too, and body horror is one of my favourite genres but just as i do not want to take the Substance, i do not want a slime covered living creature to slither bloody and wriggling out of my insides. As i got older perhaps my fear of the process wouldn’t have been enough to put me off if i wanted the rest of it – but the rest never appealed. i don’t think everyone is suited to be a parent, and i know all too well what happens when someone who isn’t equipped to love a child and prioritise their needs has one. Was i scared of becoming either or both of my parents? To an extent, yeah, but i’m self aware enough to know that the more likely outcome would have been a catastrophic overcorrection where i isolated the poor kid from the world out of fear. There’s a thousand ways to fuck the whole thing up and i knew the mistakes i’d make would be new and awful. And, at the same time, to raise a child in the way i thought best and to protect them in the (likely very excessive) way i thought was necessary, i would have to make huge sacrifices to my lifestyle which i was not motivated to make.

Mostly as i’ve got older people have come to accept that i don’t want children and that at this point i’m not likely to change my mind, but saying that i wanted to get sterilised still tended to raise eyebrows. Not so much – on this side of thirty – because of its generally irreversible nature, but because it seems so drastic, painful, risky and invasive with all the other options out there.

The other options are not great options for me. If they were, maybe i’d be more open to sticking with them to ride out the next decade or so before the whole thing shuts itself down for business, but that’s not gonna work. i was put on the pill the first time when i was fourteen – not for contraception but for acne. It was not an informed choice, and wasn’t even really my choice at all. In hindsight my acne was pretty mild, and it bothered me but only to the same extent my entire existence bothered me as a self-conscious awkward teenage weirdo. But it bothered my mother. It bothered her a lot. And when she was bothered, my life tended to be much worse. So when the pill was presented as a magic fix to both my skin and my home life, of course i took it, with the leaflet of side effects discarded in the bin along with the creams and potions and supplements and light therapy machine and assorted nonsense i’d been trying so far. My skin cleared. My mental health got worse. i gained weight, which turned out to be just as much of a bother as my acne. If i took the placebo week i bled constantly and if i skipped it i spotted at random with no warning. i got a little older and started having sex and discovered that i was practically numb from the waist down – perhaps not entirely from the pill, but it wasn’t helping, and i came off it.

When i was nineteen, i got an IUD. i had to fight even for that – by then i’d already been laughed out of my GP’s office for asking about sterilisation. But they agreed. It was worse. i had a retail job where i worked four hour shifts with only one toilet break allowed, and i couldn’t do it without ending up bleeding through a tampon, a pad, and my clothes. i had it removed, and for the next decade i used condoms and nothing else. Enduring lectures from doctors and nurses and once even a receptionist at the sexual health clinic about how that wasn’t good enough and i was irresponsible and what if you get pregnant, obviously someone like you shouldn’t be having children which pissed me off enough it almost made me want to have one or two out of spite. i did not. And i’d be late and panic in the bathroom staring down at pregnancy tests and on first dates i’d ask “are you pro-choice?” and then i had a severe mental breakdown and got addicted to drugs and stopped having sex for more than four years and that was the first time i hadn’t had to deal with the whole shitshow. Despite the addiction, the withdrawal, and then the intense sexual shame that extended my celibacy, it was quite nice not to have to think about it.

It goes without saying that the people who were assigned male at birth who i dated and hooked up with in my teens and twenties were far less tortured by the shitty options on offer. If i was on contraception i might let them go without a condom and if i wasn’t then i wouldn’t and beyond that they were not inconvenienced at all. i was angry that it was all my problem and that it was a problem no matter what i did. i could make myself ill and bleed on everything i owned and kill my sex drive, or i could not do that and have to argue with every medical professional i encountered. i was refused a medication that i needed due to not being on a second method of contraception. i was dismissed when i started getting severe period pain and told the pill would fix it, and if i wouldn’t take it then i couldn’t expect them to help. It turned out i had a cyst the size of a grapefruit on one of my ovaries, which might have been the problem, but what do i know about the body i’m living in, right? Contraception – as well as physically not working well for me – also became in my head a symbol of medical misogyny and figuring out that i was nonbinary didn’t make me any less fucking furious at the way women’s healthcare is. Getting a cervix biopsy from a smiling doctor who told me i didn’t have any nerve endings there so wouldn’t feel it, and a few months later being sent home with three days antibiotics for a UTI that then got into my kidneys and had me pissing blood for a year, cemented it for me that i did not want my control over reproduction to be reliant on ongoing medical care.

And then… eh. Time had passed. i was older, more tired, with less energy for anger and resentment. i had got into a serious and mostly monogamous relationship and i’m going to be honest, i wanted to get filled up with cum. Is that a shocking thing to say in a post about getting a tubal ligation? It is, surely, the point? So i decided to try a different pill – progesterone only this time. The nurse told me it would stop my period. i googled it afterwards and found nothing but people saying the opposite. i gave it a go.

After bleeding continuously for a year, enough was enough, and i switched to the NuvaRing. That was at least a different experience – my insides started peeling off in strips and falling out. i got my body horror experience after all.

“What happened with the ring?” The nurse asks. She’s nice – i trust her, which takes a lot for me in a doctors’ office.

“There were chunks of meat coming out of my vagina,” i say, and she notes down something less graphic.

“We could try the implant?” She says. But it won’t be we crying on the phone begging someone to take it out when that goes wrong, it will be me – and i know that’s not always easy to arrange so it’ll probably be me who cuts it out in the bath too. i decline the injection for the same reason – if it gives me side effects there’s nothing i can do except wait. And, despite the “oh my god, I thought you were in your twenties” comments on tiktok i am actually getting old. i smoke like a chimney, and since my bladder started fucking with me again i spend a lot of my time sitting on my backside. Pumping hormones into a body that is already risking blood clots doesn’t seem smart.

“it’s probably a long shot, because i don’t have kids,” i say. “But i wanted to ask about sterilisation?”

“Well… it might not be that much of a long shot.” She glances over my notes. “Adverse reactions to multiple forms of contraception, you’re over thirty, and in a long term relationship, I think?”

“We’re engaged,” i say, and run my finger absentmindedly over the ring. “And we live together. That helps, right?”

“Definitely. i’m happy to refer you – but you might have a bit of a wait.”

So wait i do, and life moves on. The engagement ends, i slut around for a couple of months and then unexpectedly fall in love, hard. It’s been almost a year since that conversation with the nurse when me and Mx are standing in the kitchen at 1am after a stupid impulse decision. i’m ordering the morning after pill, and They hand me Their credit card.

“I did it to you,” They say.

“i told You to,” i point out, but i’m not gonna argue with free money and i tap in Their details.

“i’ll get on the pill,” i say. “Hopefully when i get my assessment they’ll say yes, and i won’t have to be on it too long.”

“I’m going to phone the GP next week,” Mx says. “I’m going to ask for a vasectomy.”

i nearly drop my phone.

“W/we’ve been together less than two months,” i squeak. “You can’t have major surgery for someone You’ve been dating for two months. That’s insane.”

“I don’t want children either,” They point out. “If W/we weren’t together it’s still a good idea. And it’s not major surgery.” In my opinion, all surgery is major surgery. i’m a little horrified but a lot touched. Whoever gets operated on here in the end, it’s clear i’m not in this alone.

They get referred around two weeks later, and i get a letter inviting me for an appointment at the hospital for the end of the month. i get on the pill too, with the same nice nurse. She suggests i try the combined again, it’s been almost twenty years and there are better ones now. It’s okay at first, my sex drive drops but these days it’s so high that all the pill does is reduce me to normal. i gain weight, but i don’t let the voice from my childhood rule me anymore and so i buy a bigger size of jeans and i enjoy eating cheese and the world doesn’t end. i learn a new, better relationship with my body and maybe gaining weight is exactly what i needed to do to heal that. i grow softer around the edges and i grow softer in my heart. i move to the wilderness with Mx, W/we walk in the woods and i sing in the kitchen. If the pill affects my mental health it’s hard to tell – i’m happier than ever and no chemical could take that away. When i wobble, it’s inevitable – i’m learning how i fit with someone new and old insecurities were always going to bleed in, but they don’t stain and Mx’s reassurance wipes them away.

My assessment at the hospital is only challenging in how long it takes – i spend two hours in the waiting room bored to death even with the endlessness of the internet in the palm of my hand. But then i’m in and they recap the information on my referral, nothings changed, except one thing. One big thing.

“And your partner supports your decision?” The nurse asks.

“Yes,” i say.

“You’ve been together a while?”

“W/we met in 2021,” i say. Which is true. They came over, made me bleed on my bedroom floor, and then W/we didn’t see each other again for two years, during which i got engaged to, and then broke up with, someone else. But if i miss out all of that then technically…

i’m on the waiting list. Just like that.

So i wait. They say six months. i phone up after five to check in, and they say it might be a little longer. i phone after eight, they say they’ll call me back and never do. i gain more weight, and i still remember how to love myself but my lower back and knees start to share some opinions about it and i go on a diet. i gain more weight. Ah, fuck. i get a migraine, and then another migraine, and then “one of my migraines” becomes a thing i say. i start bleeding at random. i gain more weight, and now i can’t kneel. It’s November 2024, it’s been ten months and i phone up again and they say it could be another four or five and i cry on the phone and a week later i have an appointment for my pre-op and a surgery date for the following month and i wonder if i should have tried crying earlier.

And then Mx gets a surgery date – for right after my pre-op.

Some people might wonder why i went ahead. By mid-February Mx will have had the test to check their vasectomy was successful and will almost definitely be permanently infertile. Their operation involved only one day off work, a local anaesthetic, and very mild pain. Why bother with the big, scary, invasive one?

For as long as i can remember i have had to struggle, fight, and overcome a variety of gross medical nightmares to control my ability to reproduce. i have relied on doctors and on partners and on abstinence but i have never lived in a body that would protect me on its own. Being sterilised felt important for me to have that control.

Practically, there are benefits too. W/we are mostly monogamous but not completely, Mx might not be the only person who ever fucks me for the rest of my life and although i’d probably use condoms with casual partners it’s nice for that to be an option for safety instead of a non-negotiable. And – look, i don’t expect me and Mx to break up. i definitely don’t want U/us to break up. But what would you be willing to bet on a fourteen month relationship? i’m all in and i’d bet a lot, but maybe not another decade of my life coming on and off every shitty contraception option going. That’s a lot to risk. If this doesn’t work out how i want it to, i don’t want to find myself back to square one having to wait another two years for a new surgery date. i’m protecting every possible future, not just the one i expect. And finally, vasectomies fail. It’s not common, and if it does the test should pick it up and Mx can try again, but that could be another year and if it fails again what then?

Mx went ahead too for, i imagine, many of the same reasons. And i will always appreciate that They were so willing, so comfortable with taking Their share of the responsibility. That They offered multiple times to go back to condoms during the wait so that i could have come off the pill as i started getting more side effects. That They supported whatever i wanted to do, listened when i got upset or stressed, and were always there. They say what They do should be the standard and don’t think it’s anything special, but the fact is that it’s not standard and They always had the option to ignore the issue and say it wasn’t Their problem, and because of who They are They never did.

My pre-op appointment comes, it’s quick and focused on the practical stuff, recording medications and medical history and doing routine tests to check i am surgery ready. There are no issues, until a letter arrives a few days later saying my operation has been rescheduled to January 30th – another six weeks. After almost two years that should be nothing but i still have a little breakdown. It feels like an eternity, but mostly i think it bothers me because it stirs up a lifetime of medical trauma of not being listened to, my wellbeing never feeling like it matters, and my suffering being something i should just endure because of the parts i was born with. i spiral, and Mx listens and doesn’t call me crazy but does, gently, help me recognise that’s how i’m acting. i calm down. Mx has Their operation and i fuss over Them and look after Them and envy a little how easy it all seems to be, already knowing i’ll be in for a rougher time.

i go into the Day Treatment Centre at the Freeman on January 30th 2025, exactly one year after my assessment and almost exactly two years after i was first referred by the nurse at my GP. By this point it doesn’t really feel real – all the ups and downs and anxiety and excitement have overloaded my brain and it has decided to dump all that and mainly focus on the fact that i’ll have a week off work and should be able to get some crochet and writing done. This will turn out to be a bit ambitious. i am most nervous about the amount of O/our dynamic that will have to be modified – i thrive with lots of rules and routines and strict discipline and me and Mx have looked over the rules and agreed most of it just won’t be doable during my recovery. The thought of Mx doing the cooking and cleaning feels icky.

Nerves start to kick in more once i am in my curtained off bay in the centre, my possessions in plastic bags, a cannula in my hand (on the first attempt, which is very impressive with my crap veins) and a nurse explaining to me about the risks of blood clots and how long to wear the compression stockings. It starts to seem like a much bigger, scarier operation than i’d boxed it off as in my head. The surgeon comes to see me and i anxiety at her for a few minutes and she calms me down. Yes, she confirms, it is considered major surgery because they’re opening up my abdomen, but no i’m not at high risk of blood clots even with my smoking and being on the pill and yes, i should be fully recovered in a week and feeling as if i never had surgery. By the time the anaesthetist comes to see me i am back to my relaxed state of sort of forgetting it’s real again. i talk about wanting to avoid taking opioids if possible, and he is supportive but cautions that i might need them.

“Some people barely have any pain, and some people have a lot, it’s hard to predict,” he says. i decide to live in the delusion that i will have barely any, and as the ice cold anaesthesia crawls up my arm from the cannula i am confident i’ll wake up feeling great.

And then i wake up. There is almost no pain – it feels like very mild period cramps. i am hungry and hope i’ll get the promised tea and toast soon, and decide i need to prove to the nurse looking after me that i am very fine and normal so i can leave the recovery room and get my toast and also my phone to let Mx know i am okay. i tell her i would like to go running topless in the woods. She says i am not allowed to do that. i realise i might be slightly high on whatever i’ve been given during surgery. i refuse painkillers confidently, i definitely don’t need them. My pain level is starting to increase a bit but nothing tea and toast won’t fix.

“What’s your pain out of ten?” The nurse asks. She frowns at my face, then the machines. “Your blood pressure has dropped a bit.”

“Maybe like a six or seven now,” i say “It’s fine. Pain’s just in my head. It’s not real.”

“Are you sure you don’t want to take anything?”

“Yes,” i say. No, what the fuck, says my head, where the pain is.

“I can take you through to discharge,” she says. “Your blood pressure doesn’t seem to be dropping anymore. Food might help.” She frowns again. “If you’re sure?”

They start to wheel me through and in less than thirty seconds everything changes. The machines surrounding me beep and chirp in agitation and when asked i find i can only slur and mumble “nine, now. Nine.” My vision blurs and i am being turned inside out, my spine feels like it is bending inward, outward, splitting and twisting. There is a fist in my guts twisting tighter and tighter and i think i should probably be screaming but my lips are cold and still and silent. i am being wheeled back the way we came.

Codeine comes first, but not long after i accept IV fentanyl. i’m brave to a point, but not stupid. The nurse talks to me about it before – about my recovery, about what i am afraid of, and it’s hard to explain because all i can think about is pain but i manage to communicate enough to confirm i want it. There is no pressure. My stubborn suffering ass is making everyone’s day worse and we all know it but no one pushes me to accept more drugs than i want. i accept that i need them, and as it turns out i need a lot of them. i wasn’t one of the lucky “barely any pain” people, it turns out. Right at the other end of the scale.

i get down to a three out of ten – which might actually have been a four or a five but i want that bastard toast – and it is over an hour after the time i should have been out of recovery, i know Mx will be worried out of Their mind. i am too familiar with immediately thinking people are dead if they don’t text back when expected, and if someone did that to me while in a hospital being cut open i would be demented. They are, but hide it as well as They can as W/we text and i eat my hospital toast. i am given information i can’t absorb in the fentanyl haze but luckily it goes in paper form into my bag with some painkillers and then i am dressed, on my feet, and shambling through to the waiting room where Mx is waiting. i am definitely not at a three out of ten, but i want to be home and in bed and keep a brave face on until W/we are across the road and then i cling to Mx’s arm and sob in the car park.

The rest of the first day is a blur – sleep, eat chocolate, smoke, take painkillers, sleep again. Make it to the couch. Order Chinese food, eat three pieces of chicken, smoke, sleep again. Wake in the night, take painkillers, stare at the ceiling, sleep again. It’s the second day and i nap on the couch, i eat leftovers, i smoke, i sleep again. The third day, i eat more, i take less painkillers, the colour starts to come slowly back in my face. i can walk around again, i sleep less. And then it’s the fourth day, the fifth, the dressings coming away and i’m looking at those small neat stitches. i say – “i think They made my belly button neater? Are they allowed to do that?” and Mx says it looks the same to Them but i am not trusting the opinion of the person who didn’t think i looked “that bloated” one day after the operation, thank you very much.

It still doesn’t feel real, i think. i still have to take the pill – just twice more in my whole life. Maybe when that last dose is done it’ll feel real. Maybe when i start ovulating again (“Are You prepared for Horny Week, Mx?” i ask, and They confirm that They are slightly afraid of what a higher sex drive looks like on me). Maybe when i’m fully healed and the stitches disappear and that thin pink line turns silver. But in the moments i remember it is real the relief is huge, the freedom and safety of it. my body is mine – well, no, it’s Mx’s. But that’s with my consent, the person i chose to give myself to. i don’t have to ask or argue or research options after options i simply exist in a body that protects and respects my choice for me, with no more medical intervention and no more buying medication on my phone in the kitchen. It feels good. It feels right. It feels like it’s been a long time coming.

Some of my medical trauma heals as the cuts in my belly do. It’s strange – this is by far the most painful medical experience i’ve had but it wasn’t traumatic at all. The kindness, understanding, and focus on my consent, my needs, and my autonomy throughout treatment was something i have not experienced before. The lack of judgement about my lifestyle – which had to be explained to head off a likely safeguarding referral once they saw me naked – and the incredible level of understanding of my gender identity and just every single interaction i had on the day of the operation was exceptional. Does that mean i won’t whine and drag my feet and kick up a giant fuss when Mx suggests i need to go to the GP about something? Probably not. i have some trust issues that won’t budge that easily. But knowing how much better things can be makes me less convinced that it will always be bad. If this post happens to be spotted by anyone involved in my care that day – thank you. If it’s spotted by anyone going into that clinic, you’re in damn good hands.

So what’s next? Another restful day. Likely a few more restful days – i’m back to work on Thursday but i’m not committing to much else just yet. Coming off the pill, exciting, and my birthday and Valentines very soon so i’m hoping i’m healed enough for some unhinged violence. And then the waiting game – will this have any downsides? In theory it shouldn’t effect hormones at all – nothings been removed, just clamped – but some people do experience hormonal changes. i would much rather navigate and manage that, though, than take medications that i can feel actively making me sicker with every dose. At least if there’s trouble, it’s trouble from my own body not something external. That feels like something i can take on.