University reunions. What’s the first thing that comes to mind when you think of that?

The last one I remember clearly was in 2006, six years after I had graduated from a private university. A friend called the day before and asked if I was going. I hadn’t even heard there was a reunion, but did not have any plans for the evening, so… why not?

I threw on a black business suit and a crisp shirt, no tie, figuring it would be a smart-casual kind of night. At the entrance, I bought my ticket and noticed the fine print: “Dress code: Black tie”.

Now, I did own a tuxedo. A pretty nice one, actually, from a French designer, which I’d splurged on for nearly €2,000 (if I remember right). But that tux was hanging in my parents’ house, about 45 minutes away. I’d worn it out for Christmas, my mom had offered to get it dry cleaned, and I just never brought it back to my apartment.

That left me with two choices: drive 45 minutes to fetch it, change, drive 45 minutes back, and show up nearly two hours late, or just walk in as I was, very aware of my fashion faux-pas. But then again, these were my former classmates. Surely they’d be more excited to see me than to inspect my lapels… right?

Well — not exactly. The first person to notice me was one of our investment bankers, of course suited in a tux. He gave me a quick once-over and, without so much as a hello, dropped this gem: “Gosh, can’t you even afford a tux anymore?”

That set the tone. The rest of the evening went like a live roast of my outfit, followed by the ritual display of status: who earned how much, which car they’d just bought, which house they’d snapped up. If that didn’t clinch the point, they’d top it off by announcing their girlfriend’s or wife’s salary, the prestige of their new wife’s job, and the family dynasty she came from.

By the end of the night I’d had enough. I decided then and there to skip future reunions, and also to cut ties with most of those people altogether.

“Dear fellow alumni,

The year 2025 is fast approaching, and with it our 25th university graduation anniversary. I — and many others I’ve spoken with over the past few months — think that’s a great reason to meet up again and look back on the last quarter century! […]”

When the alumni email landed in my old inbox I felt… conflicted. Did I really want to see any of them again? The 2006 memory still stung. And yet: this would probably be the only chance in twenty-five years to show up as myself and run into so many people I’d once studied with. The event was on the rooftop bar of a hotel, so I hatched a plan I liked: Book a room, pop into the gathering, and if the mood turned sour I could escape to my bed and just watch TV within thirty minutes.

There was an afternoon meet, too, but schlepping to campus and then driving back downtown to change for the evening felt like too much effort. I checked the evening dress code: Cocktail. I do own a number of dresses for work, but I seldomly go out on Cocktail nights, and the two dresses I own that are for special occasions would be way over the top for a “Cocktail” dresscode. I remembered that 4,300 USD Dolce & Gabbana dress I’d seen in a magazine: A dream in silk, painterly red and rose blooms on black, long, billowing sleeves and a cinched waist. It was unmistakably designer — elegant, airy, quietly luxurious — but it didn’t scream its label with flashy logos or prints, subtle enough to keep people guessing. This was confidence in silk, not a billboard. Exactly the kind of thing that would let me walk in feeling a little taller. Take that, Mr. Investment Banker.

I realized that going there was as much about seeing everybody as it was about wanting to heal a piece of myself that had been left open since 2006.

It took me quite a while to make the decision, but once I did, I confirmed my attendence, bought that dress on net-a-porter and booked a hotel room for one night.

In the months that followed, reminder emails were sent, showing the growing list of participants with their first and last name. Among them now showing “Sarah [last name]”. My LinkedIn suddenly lit up with profile views from people I hadn’t heard from in years; many of my former classmates had noticed the change.

When I arrived at the hotel about an hour late due to a traffic jam, it turned out that their parking garage only had space for approximately five cars, all spots which had been taken, so I had to park at a public parking garage that was close (about 700 yards) and just walk to the hotel with my suitcase, beauty case, garment bag for the dress, and an umbrella, as rain was expected the next day.

Three former classmates were smoking at the hotel entrance. They did recognize me, cheered and hugged me like no time had passed. After a brief check-in, heading to my room and changing into my dress, I went up to the 7th floor and entered the rooftop bar.

Nearly 60 people had gathered from all corners of the globe, some coming in from as far as the USA and China. Most had already met up at the afternoon event and were sporting little name stickers on their blazers or somewhere easy to spot. I was scanning the room for someone in particular when a former classmate — a woman who had already congratulated me on my transition via LinkedIn — spotted me first. She made a beeline across the room and gave me a huge hug. That was definitely a world away from how things felt back in 2006.

Looking around at my former classmates, I was fascinated by how much (or in some cases, how little) people had changed. Everyone was still recognizable, but some had aged so dramatically they looked at least a decade older. Then there were those who, clearly, had formed a very close relationship with their local bakeries. Let’s just say, several waistlines had flourished impressively since graduation.

The job-related boasting that had dominated the 2006 reunion had given way to a more grounded perspective: people seemed more attuned to what really matters in life, and a little wiser about the realities of office politics. I’ll admit, most of my conversations ended up focusing on my transition rather than diving into what was going on in the other person’s world. Still, almost everyone I spoke with was genuinely positive and supportive. Of course, there were a few I only exchanged quick hellos with, and whether by coincidence or their own choosing, those were the ones who didn’t end up talking to me that night.

As it turned out, while plenty of people had Googled me ahead of time and knew what to expect, the real fun came from those classmates who showed up completely clueless about my transition and who I wasn’t that close to during my time at university. Since I wasn’t wearing a name tag, I found myself in the same conversation more than once:

• Classmate: I’m really sorry, but I just can’t place you. What’s your name again?
• Me: Sarah [last name]
• Classmate: (thinking hard) Hmm, I only remember a [deadname] [last name] from our year. Are you his sister, by any chance?
• Me: No, [deadname] was the name you knew me by back then.
• Classmate: (momentarily freezes in a blue screen of death) Wait, you’re joking, right?
• Me: I promise, I am not. That’s really me.

That honestly surprised me: even I hadn’t expected it. The classmates outside the entrance had recognized me right away, which had left me feeling like I must not be very “passable” at all. But as it turned out, for those I wasn’t particularly close to during my studies, i.e. people who hadn’t really memorized my face, I did pass. That was a revelation.

I am glad that I made the decision to attend, as it was a genuinely lovely evening. I didn’t leave for my room until 3:40 a.m., probably the latest I’ve stayed up in the past twenty years.

We all agreed that waiting another 25 years would be a bit much, so we made a pact to meet up again in about five.

The next morning, over a relaxed breakfast with those that had also stayed overnight, we swapped a few more stories, shared some laughs, and then, one by one, everyone drifted back into their everyday lives. The farewell was casual, but it felt lighter than any reunion I remembered: A quiet, reassuring reminder that sometimes it’s worth giving the past another chance.

Driving home, I realized I was carrying something different with me this time: not just memories of the night, but a bit more peace with my own story. Maybe reunions aren’t really about reliving the past or quietly comparing careers, but about witnessing the hand that life has dealt each of us: Family, kids, the curveballs, the joys and losses, all those stories that never fit on a résumé. Maybe, if we’re lucky, these moments help us feel a little more at home with who we’ve become, shaped by everything beyond the titles and dress codes. Tuxedo or not.

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I’m out to the world now: at work, on LinkedIn, to all of my friends (well, some of them are former friends now), and on social media. Everyone knows — except for my parents.

I first tried to transition in my mid-twenties, but my parents didn’t take it well. My father already had a history of stomach problems, and when he found out, the stress triggered a severe gastrointestinal bleed. The doctors made it clear: stress could very well kill him. So I made the impossible decision to stop hormones and eventually detransition.
Since then, my parents have never brought up the subject again. Not once in those 20 years since I detransitioned in 2005.

When I restarted my transition, my strategy was simple: don’t tell my parents unless they notice something. Don’t bring it up proactively. Don’t mention surgeries until they’re already done. I kept visiting them in boymode (still do), wearing compression shirts to hide any visible breast growth. I figured: the less they knew, the less they’d have to react to. Maybe we could all just quietly pretend nothing was changing.

Since I still wear a wig, this whole strategy has worked surprisingly well for over two years. Though my features gradually softened, I could still “pass” as a guy without makeup or the wig, so my parents never really noticed anything.
When I had my rhinoplasty in London, I came up with a cover story: I told them I had a work-related meeting, slipped on a staircase, and ”unfortunately” had to undergo emergency rhinoplasty.
By sheer coincidence (wink, wink), the surgery just happened to be performed by one of the top rhinoplasty surgeons in one of London’s most exclusive private hospitals. I honestly thought the story was pretty flimsy. But my parents? They bought it without question.

For my facial feminization surgery in L.A., I spun another story . This time it would be a big Google event I’d been invited to. But this one felt riskier. I was having a scalp advancement, which meant I’d come out of surgery with a long incision running right across my forehead, along the “hairline”. Or whatever you’d call a hairline that’s barely there to begin with. I was pretty sure that once my parents saw me after that, the charade would finally fall apart.

It was early July 2025, and Germany was caught in the middle of a brutal heatwave. My mom, who is currently being treated for breast cancer, had scheduled a full checkup at a private clinic near where I live. She and my dad decided to drive down from Frankfurt, leave their car in my parking garage, and have me take them to the clinic, which is located uphill in the Black Forest.

They made the trip on a Sunday, with temperatures well into the mid-90s, in their old 2006 Jaguar with a broken air conditioning. As expected, there was a traffic jam. Someone had thrown a lit cigarette out of their window and managed to set the median strip of the Autobahn on fire. Traffic came to a complete stop while firefighters worked to get it under control. My parents were stuck for over an hour, trapped in the heat with no relief. By the time they arrived at my place, they were completely exhausted and soaked in sweat.

I had switched back to boymode, but this time without a compression shirt. I didn’t want to shock them outright, but was prepared to come out. I figured they’d see the incision line on my forehead anyway and eventually ask what had happened.

When they arrived, it was obvious how drained they were. They got into the elevator, both of them red-faced from the heat, their t-shirts clinging to them like they had just walked out of a wet t-shirt contest. They sat down at my dining table, gratefully drank some water, and we chatted a bit about the drive. Still, nothing. They looked me straight in the face — and nothing.

My mom wanted to freshen up in the bathroom. I have an over-the-door hook rack where my bras hang, and a shelf packed with makeup. All very much on display, thanks to the lighting strips I installed on each shelf of the cabinet. There’s no way you can walk in there and not notice it.
She steps into the bathroom (I follow her), stops right in front of the makeup shelf, takes a look, and simply says, “Oh, you’ve got a lot of stuff here.”
And that was it. I had braced myself for a flood of questions — but there were none.

Later, I even gave her a fresh t-shirt to change into, a women’s shirt with a print you wouldn’t mistake for anything else. Her only comment? “Oh, that’s really nice!”

Things quickly descended into full slapstick mode once my parents got into my car for the ride to the clinic. We had moved all their stuff — a large suitcase, a few smaller bags, and random items — into the trunk. My mom settled into the back seat, and my dad took the front passenger seat.

I drive a hybrid BMW, which has the charming (read: annoying) feature of greeting you with cheerful animations and a personalized “Welcome, Sarah” message, complete with a photo of yourself, right on the center console.

We all get in. I press the start button. WELCOME, SARAH.
My dad glances at the screen, pauses, then says, “Hmm. I’m not sure I brought my stuff — wallet, keys, that sort of thing. I think it’s still in the trunk. Can we check?”
So I turn the car off, we get out, open the trunk, rummage around. Of course, he had everything.
We get back in. Start the car. WELCOME, SARAH.
My mom, fumbling around in the back: “How do I buckle up in here? There’s no seat belt!”
Off goes the car again. I walk to the back, find the seat belt, and buckle her in like a toddler. Back to the driver’s seat. Start the car. WELCOME, SARAH.
Two seconds later, my mom again: “Oh my gosh, this air conditioning is so strong! It’s freezing back here. I need my cardigan. Could you grab it from the trunk, please?”
So off we go again.

All in all, that WELCOME, SARAH message flashed up four times. And not a single word was said about it.

Needless to say, the same thing happened all over again when I picked them up from the clinic a week later.

I had originally assumed their complete non-reaction might have been due to sheer exhaustion on the day they arrived. But after spending a full week at what was basically the equivalent of a five-star luxury resort, they were visibly relaxed, rested, and in good spirits.

We stopped by my apartment again before they drove home. Once more, they had plenty of time to look at me, take everything in, and also use the bathroom again with its very obviously lit-up makeup display. And once more, not a single word was said.

Did I miss a great opportunity to come out to them? Maybe.

But at the time, I already knew I had a kidney stone surgery coming up, and I expected to feel pretty awful in the days that followed. I just didn’t want to carry that additional emotional weight on top of everything else.

Now that the surgery is behind me and I’m more or less recovered, my mom has already asked if I could come visit soon. I haven’t been to their house since April. Maybe this time they’ll notice the incision along my hairline…

The thing is, I’m not sure if they genuinely don’t see what’s become pretty obvious, or if they’re consciously avoiding it — keeping their little world intact by pretending nothing has changed.

From my side, I already know what their reaction will be. If anything, their attitude toward LGBTQ people has gotten even worse in recent years. So no, I’m not exactly looking forward to that conversation.

At some point, though, it’ll probably become unavoidable, especially once I get my birth certificate changed. We’ll see.

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About six weeks after my facial feminization surgery, I developed a urinary tract infection. That awful, relentless urge to pee, and when you do, it burns. Doctors tried multiple antibiotics, but the infection wouldn’t go away. Eventually, they discovered a large kidney stone was blocking my left kidney. It needed to be removed urgently before the infection caused something worse.

After weeks of living with an infection that refused to quit, I finally had the stone removed this week. Catheter in place, lying in a patient gown in a sterile hospital room, a nurse asked me how I’d like to be addressed. And honestly? I didn’t care. I didn’t feel feminine. I didn’t feel masculine. I felt… nothing.

I showed her a photo of myself on my phone. Fully done up, in full-on Sarah mode, and from that moment on, she called me “ma’am.” She meant well. But without the wig, the makeup, the feminine outfit — without the things that usually hold the illusion together — I felt like a fraud. A ghost of a woman I’d been trying so hard to become. And maybe also, just someone who was tired of hurting.

When I scroll through forums and social media, the message is crystal clear: “It’s never too late.” People celebrate the idea that you can embrace your true self at any age: 50s, 60s, even later. The feeds are full of before-and-after photos. On the left: a sharp, unflattering shot of an unhappy man in his 40s, usually under bad lighting. On the right: a slightly blurry, perfectly lit image of a smiling woman in her 50s, radiant, with flawless makeup and glowing skin. Too radiant, maybe. And with filters so easily applied these days, I’ll be honest: I’ve lost a lot of trust in what I see online.

After more than two years of transitioning, I’ve learned the art of taking a good selfie, too. I know how to turn my head just right, how to angle the camera, how to catch that soft golden light when the sun is just right. Sometimes I scroll through my own photos and ask myself: Have I really changed that much? Or did I just get better at knowing what to hide?

Since my FFS, I’ve found myself staring into the mirror more often, asking a question that’s hard to shake: How many of the people shouting “It’s never too late” are actually in a place where passing doesn’t even matter anymore?

Maybe they’re retired, mortgage paid off, financially secure with a pension or savings cushion. Or maybe they’re still living a double life, presenting as “him” at work, and slipping into a dress at home when the door is closed. There’s nothing wrong with that. For some, it’s survival. But let’s not confuse that with living full-time.

Because here’s the truth: transitioning fully in your 50s or 60s isn’t just about identity. It’s also about biology. It’s about finances. About the society around you, your workplace, your aging skin, your health, or maybe a partner who doesn’t understand, or doesn’t want to. These aren’t just details. They’re thick, stubborn layers that don’t magically melt away the moment you decide to become yourself.

Mirrors are honest. They don’t care about intent, identity, or how brave you’ve been. They reflect what’s there. And the truth is, passability gets harder with every passing decade. Skin loses its elasticity. Facial fat shifts. Hormonal responses slow down. Transitioning later comes with limits, and not all of them can be fixed by throwing money on a surgeon’s table.

The wig you now wear every day might be a meager stand-in for the hair you once had. Sure, you get better at makeup. You learn your angles. But even with FFS, so much of what coded you as male doesn’t disappear. Some of it can be hidden with clever fashion, soft fabrics, or a carefully chosen silhouette. But the moment you strip it all back — jeans and a plain t-shirt, no wig, no makeup — you realize: the illusion is fragile. At 50+, most of us who transition can still pass just fine… as a guy.

I often wonder why that is, as I have seen people transition at age 40 that had way better results just by HRT than I did when I started shortly before my 48th birthday. 8 years difference. Does this really change that much?

Researchers at Stanford and elsewhere now show aging doesn’t just creep up — it surges in waves. Around 44 and again at 60, our bodies experience significant biomolecular shifts, affecting metabolism, immune response, skin, muscles, organ function… the list goes on.

… meaning that the difference in outcome between someone starting her transition at early 40 and at 50 can be massive. Keep that in mind when you’re excitedly popping your first estrogen pill, or quietly despairing over why, 12 months in, your results don’t look anything like the ones you see on Reddit. The glow-up stories with the slightly blurry pictures. The “trust the process” promises. Your mileage may vary. And for some of us, it varies a lot.

And sometimes I can’t help but wonder: How disconnected from reality are some of the people who post their triumphant “I just got my gender marker changed!” selfies at 60+, while wearing a teenage goth outfit?
You’ve probably seen the look. Black platform boots, fishnet tights, a micro mini skirt, corset, and a semi-sheer top stretched over a still-masculine frame. It’s loud. It’s proud. And honestly, it leaves me speechless. But not with admiration, but with a kind of quiet disbelief.

How many of them are financially and emotionally insulated? Retired, with steady pensions. No workplace stress. No boss misgendering them. No partner questioning their identity. No caregiving duties or fragile balancing acts to keep life functioning. It’s a privilege to stage a flamboyant reveal when your only audience is a handful of supportive friends and some festive online cheerleaders. When the stakes are low, the theatrics come easy.

But for those of us still entangled in the working world, still navigating fragile relationships or unpaid bills or quiet stares in the grocery store, it’s not that simple. Visibility comes with a cost. And not everyone can afford to be seen like that.

The reality, well, my reality, is a lot more down-to-earth.

Most evenings, I try to plan the next day’s outfit in advance so I’m not standing in front of the wardrobe in the morning, panicking about what matches or what feels “safe enough” to wear.

Technically, now that I’m living full-time as a woman, I should have all the fashion freedom in the world. Dresses, skirts, heels, jeans, whatever I want. But in practice? Some of the things I’d like to wear just don’t work. They make me look boxy. They emphasize my broad shoulders, my large hands, or they sit awkwardly on a body that still carries decades of testosterone’s imprint.

Sometimes I want to wear trousers, just because they’d be more comfortable or more “me” that day. But I often don’t. I reach for a dress instead. Not because I feel particularly feminine, but because I want to remove all doubt about which gender I’m trying to present.

It feels like I’ve gone from the limited, boring fashion options available to men, to the sheer, dazzling variety offered to women — only to discover that I can really wear just a fraction of it. The rest is off-limits if I want to stay within the narrow, unforgiving bounds of passability.

People love to say that surgery is the answer. That if you’re not passable, you just haven’t done enough yet. There’s always another procedure, another fix, another chance to finally look like the woman you are inside.

Hair transplants. Scalp advancement. Brow bossing removal. Eyebrow lift. Blepharoplasty. Cheek implants. Rhinoplasty. Lip lift. Lip flip. Sliding genioplasty. Jaw contouring. Trachea shave. Facelift. Neck lift. Shoulder reduction surgery. Breast augmentation. Tummy tuck. Brazilian butt lift. Gender confirmation surgery.

And that’s not even an exhaustive list.

This is a list I created without having to look anything up. I know all of the terms by heart, sometimes even already know which surgeon you should go to for one or the other procedure. Many of my readers who are trans will know these as well, though we aren’t surgeons. Go figure.

Chasing the female ideal at 50+ feels like chasing a carrot on a stick — always just one more surgery away, and never quite there. One more sacrifice. One more recovery. One more “investment”.

But the goalpost keeps moving.

And at some point, you have to ask yourself: How much of your retirement savings are you willing to spend chasing a dream you’ll never truly reach at this age?

Not because you’re not worthy. Not because you’re not valid. But because biology, time, and gravity don’t care what your soul says. They just are.

I chose the hourglass as my teaser image for a reason.

Three years ago, I was dangerously close to ending my life. I couldn’t see a future living as male. It felt like the remaining sand in my life’s hourglass was running out — and fast. And in that moment of raw clarity, I realized something: if I didn’t try to transition again, even at this late age, I would regret it more than anything.

There are still moments like the one in the hospital. Not just low points, but free falls. Moments where I question everything. Where I wonder if I made the right choice, even as I know in my bones that three years ago, there was no other choice.

And the truth is, my transition has gone well, by most standards. I didn’t lose many friends. I kept my job. I’ve been accepted and supported by my colleagues. I was able to work with one of the top surgeons for FFS. My recovery has been steady. No major complications. No disasters.

On paper, it’s a success. But the heart doesn’t always measure success the way a checklist does.

I don’t get that second glance very often anymore when I’m out and about. Men open doors for me. I get served first at restaurants. And interestingly enough, it often feels like I’m treated more kindly now, as a woman, than I ever was when I moved through the world as a man.

And yet… I’m not always sure what I’m being seen as. Do I truly pass? Or are people just being polite? Are they offering kindness — or pity?

That’s the thing about transitioning: you never really get to know what’s happening in someone else’s head. You can spend hours analyzing a glance, a smile, a shift in tone, and still not know if they saw a woman, or a trans woman. Or a man in a dress.

That uncertainty is exhausting. And it lingers.

I’ve come out to everyone. There’s no way back now, and I certainly don’t want one. I have more good days than I used to. I feel more aligned with who I am. But even with all that, I still carry the question: Do they see me as I see myself?

And that question doesn’t go away. It hums quietly beneath the surface, even on days when everything feels right. It chips away at your confidence when you least expect it.

I’m not saying don’t do it. I’m saying: do it with your eyes wide open.

Look in the mirror and dare to ask, “Is the me I seek worth the cost?” Measure your expectations against biology’s blueprint, not Reddit’s glow-up threads. Run the numbers: how much are you willing to spend on your transition? Can you afford it, financially, emotionally, physically?

And don’t get lost in the ever-hugging online echo chambers. You know the ones. The ones that tell the freshly egg-cracked, still heavily beard-shadowed trans woman that she already passes, even when she doesn’t. Not yet. Maybe someday. But not today.

Drop the slogans. Let go of “never too late” and “trust the process” if they don’t speak to your reality. Step into your transition knowing that for you, it might be too late to ever fully pass. That the process might not work the way it did for someone ten or twenty years younger.

But do it anyway if your heart says you must.

Because even if the dream stays out of reach, life can still get better than before.

And maybe, just maybe… that’s what they really mean when they say:
“It’s never too late.”

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This article is likely only relevant for those planning to undergo Facial Feminization Surgery (FFS). It’s going to be very long, as I am trying to be specific enough so others may benefit from my experience.

Why I went to L.A. when I am located in Europe

You will probably remember that I had cancelled my FFS with FacialTeam, as I wasn’t sure what would happen if the supraorbital nerve would be cut. Or, to be exact, an auxiliary branch of the supraorbital nerve, which — according to both Dr. Capitán from FacialTeam and Dr. Mardirossian — would likely not cause any problems. The thing is: I am not a medical expert, and when preparing for such a surgery, I was trying to understand what might happen. Reading internet forums, discord chats, talking to doctors and patients. Honestly, I would have loved to go to FacialTeam. I still am convinced that they are among the top surgeons on this planet when it comes to FFS, both in terms of results, but also their aftercare. Also, they are just a 3 hour flight away from where I live and I can even use the close regional airport for my flight to Malaga.

Still, I had read accounts from pain clinics around the world where patients suffered permanent pain after an eyebrow lift, where the nerve had been severed. Given my nerve position, cutting that nerve seemed to be inevitable. There was this nagging insecurity of what could potentially happen, which is why I searched for a surgeon that would guarantee me to keep my nerve intact. After a few consultations, I found Dr. Keojampa, who told me that he could work up to the position of the nerve using the classic approach, and then do the — otherwise inacessible — rest via an endoscopic approach.

About Dr. Keojampa

Dr. Keojampa was trained by Dr. Spiegel, who is also very well known in the world of FFS surgeons. While most FFS surgeons primarily do surgeries on trans patients, Dr. Keojampas ratio of cis vs. trans patients is roughly 50:50. He often does extensive surgery around the jaw/chin for patients with deformities, but still has quite a lot of experience with overall facial feminization surgery. As with all top surgeons, his waiting list is quite long, with waiting times of over a year being common for a full FFS (brow bossing, nose, chin/jaw plus any additional procedures).

I was mentally prepared for another year of waiting, but given that I had already done my nose in London in August 2024, the surgeon now had one part of my face less to deal with, and with the shortened surgery time, availability for a short term date was much better. My date was set to May 7th, 2025, just about 7 months after my first consultation with him.

My procedures

I had signed up for the following:

• Feminizing forehead cranioplasty type III (hairline incision), with orbital shaping, eyebrow repositioning/brow lift
• Major scalp advancement (3–5 cm) to lower the hairline
• Jaw and mandible contouring with sliding genioplasty

I am not going to put the prices I paid here (don’t ask), as the individual quotes are considered confidential, which I want to honor. Let’s just say that, in general, U.S. surgeons are significantly more expensive than their European counterparts. You can also get FFS done at a budget price in Turkey or South America, but especially when it gets “ultra cheap”, you often get what you pay for.

The surgery date that was available in May would be located in Los Angeles, one of the two cities were Dr. Keojampa does practice (San Francisco and LA). To be exact, not really Los Angeles, as I learned that the Marina del Rey area is considered not a part of Los Angeles, but sort of its own city.

Bringing a friend and booking the hotel & nurse

You shouldn’t undergo FFS all by yourself, and as I had numerous accounts of people that really recommended bringing a friend for support, I had asked a friend and colleague from work, whether she would accompany me if I did pay for flights & hotel. To my surprise, she agreed (we both didn’t know what we would potentially be getting into), so I searched for cheap but reasonably good hotels in the Marina del Rey area that are not too distant from the surgery center. There are none. Then I started looking at four star hotels and still found reviews that showed either insects crawling around, bed bugs or other unpleasant creatures that you don’t want to meet or take home, so I settled for the Marriott, which was not really a cheap option at 480 USD per night per room at the time I booked (and yeah, rooms became cheaper later, but you don’t know that for certain upfront). People have asked me why I didn’t simply book an airbnb: Well… let’s assume your host wears a red MAGA cap and finds out you are doing gender affirming surgery, then your place to stay may vaporize before your eyes while you are there. No, thanks. Hotels take your money and don’t ask a lot of questions — definitely preferred. If you stay in the Marina del Rey area, I can confirm that the Marriott is a solid option. Not the greatest hotel, but solid. Patients do stay the first night after surgery in the “Marina del Rey hotel” normally. From what I have seen, that hotel also is pretty nice.

I also booked a nurse for 3 more days to stay with me. While a friend can run errands and get food, a nurse knows whether an incision gets infected or looks okay, and can clean sutures and change bandages. In retrospective, I am glad that I booked one, even though everything went smoothly.

The time prior to heading over to the US

Most surgeons require you to do get surgery clearance with a primary care physician no more than 30 days prior to surgery. As my GP doesn’t really have that much time, I booked a whole day checkup at a private clinic in Germany which basically took all blood values, checked my organs via ultrasound, captured an ECG and made sure everything was okay, and I was cleared for a 9 hour surgery.

I also got a new CT scan at one of the world’s highest resolution CT scanners, a so called “photon counting CT scanner”, which is a (relatively) new device. The image resolution and quality beats every CT scanner that normal clinics have, which is great if you want to plan an FFS. Learn more about photon counting CT scanners here and here. I sent the CT scan over to Dr. Keojampa, so he could use it upfront to print 3d models of my forehead and mandible.

Arriving in L.A. & the days leading up to surgery

Day -3: Sunday

We departed Frankfurt airport on a Saturday, with a ~ 12 hour flight to L.A. I had booked business class for both directions, as I wanted to be able to move my legs a bit during the flight to decrease the DVT (deep vein thrombosis) risk during and after surgery. Passing through the border control was absolutely hassle free, given that I was still traveling under my deadname and in boymode (but I had expected otherwise, given the social media frenzy). As I am 50 years old, have to wear wigs and keep my own hair relatively short, boymoding unfortunately isn’t a problem.

Once we had checked into the hotel and freshened up, we first went to a local supermarket (Ralph’s Fresh Fare map link here), where we got some water bottles, some food that didn’t require chewing (e.g. apple sauce) as well as everything else from meds to mouthwash. Prior to my flight, I had pre-ordered quite a few things via Amazon to the hotel, which had luckily arrived in time. The thing that we used a lot was a pull cart that we used to transport the items from the supermarket to the hotel.

Day -2 & -1: Monday & Tuesday

When it comes to a major surgery, it’s recommended to provide medical power of attorney to someone, so if something happens, that person can make a decision while you are unable to. As I also wanted to get two large printouts for Dr. Keojampa to put in his OR (with some guidance of what to pay attention to; I did the same for my rhinoplasty surgeon), I went to the nearby UPS store (map here), where you can also get that medical power of attorney document notarized for just 15 USD — with the same shop assistant that just made the printouts (something unheard of in Germany, where you pay hundreds of Euros for a notary service). I asked my friend to be my contact in case something would happen and brought a copy of that document to the surgery center at the day of my surgery.

We also picked up my prescribed meds at Ralphs Pharmacy (map here) near the surgery center:

• Ondansetron ODT 8 mg tablets — against nausea directly after surgery
• Amoxi-Clav 875–125 mg tablets — an antibiotic for 7 days post OP
• oxyCodone-Acetaminophen (Percocet) 5–325 mg tablets — an opioid based, very strong painkiller
• Bacitracin 500 unit/gm ointment — topical cream to be applied to the incision post surgery
• Chlorhexidine 0.12% rinse — mouthwash to avoid infection, as the incisions are placed inside of the mouth for chin/jaw surgery

Other than that, the two days were mainly spent for a bit of sightseeing and shopping (Griffith Observatory, Hollywood Boulevard, Dolby Theatre, Rodeo Drive) and walking along Venice Beach — though the temperatures were pretty cold for “sunshine state California”. Make sure you bring a sweater as it can get quite chilly.

On Tuesday afternoon, a nurse from the surgery center called me to provide instructions on when to stop drinking & eating (midnight), what things to bring / avoid (bring: shirts that can be buttoned in the front instead of having to pull them over your head, avoid: makeup, jewelry) and when to arrive (07:30 a.m.).

I often see people asking for tips on how to stay calm before surgery. Honestly, I might not be the best person to answer that because I wasn’t anxious at all. In fact, the night before my operation, my friend was much more nervous about something going wrong than I was.

I think my mind works in a fairly straightforward way: I had chosen a surgeon I trusted, someone I knew would take care to preserve my nerve function. That high-resolution CT scan was the best basis to plan the procedure and made everything more predictable both for me and the surgeon. I had also clearly communicated what I hoped to achieve, had a close friend with me who I trust completely, had arranged for a nurse to ensure good post-op care, and my hotel room looked like a pharmacy with all the medical supplies I had bought. I had done everything within my power to get ready. And once I felt fully prepared, there was simply nothing left to be anxious about.

Day 0: The day of surgery (Wednesday)

My friend an I met at the hotel lobby at around 7 a.m. and I called an Uber that took us to 4640 Admiralty Way, the location of the surgery center. The building looks like a regular office building from the early 70s (it was built in 1972 and they did a makeover in the 90s), so you wouldn’t necessarily expect surgeries to take place there. I drove up to the 7th floor where I rang the doorbell of the surgery suite. The nurse that I had spoken to on the phone opened the door and gave view to a very small room, basically just 2 seats and a small table where I got a lot of paperwork to sign. I never got copies, but it was similar to what I had signed prior to my rhinoplasty: Risks are that you never wake up, suffer brain damage, permanent nerve damage and all sorts of other things. Don’t undergo a surgery like this unless you’re prepared to sign papers like these.

After I had signed all documents, my friend stayed in that small anteroom, and I went into the prep room where two hospital beds were standing, one obviously waiting for me. I was asked to go into a changing room, where I could leave my belongings, and put all of the clothing I was wearing into a plastic bag. It felt a bit strange doing that — when I was in London, I had a hospital room that I could prepare for surgery, but where I would also stay after… so it didn’t feel like I would be putting my stuff into a bag that felt kind of “final”…

Anyway… after changing into one of the typical hospital gowns, I did lay down into the hospital bed and the nurse started prepping me, i.e. putting an intranveuous catheter in, connecting me to the typical measurement instruments and starting to ask me a few questions, e.g. how tall I am, how much my weight is, whether I had eaten something that morning, etc.

In between I asked her if my friend could also come in, which she did. Dr. Keojampa also arrived shortly after, and we started chatting about bone cuts and stuff, which is when my friend said she wasn’t feeling all too well with all that medical discussion happening, the smell of disinfectant and the whole hospital setting, and rather wanted to leave before she would faint… so we wished each other goodbye and she left. I was going through my surgery wishlist with Dr. Keojampa again, he did mark the line where he would do the incision along my hairline and I signed off on the placement (looking into a mirror). Once we had discussed everything, he left to change into the surgical gown. I am not sure anymore whether the anesthesiologist was there before Dr. Keojampas arrival or after, but I had also talked to him, basically answering the same questions about allergies, weight, height, etc.

I was asked at shortly before 9 a.m. to get up and walk to the operating room, which was just adjacent to the prep area. The surgery suite isn’t that large — it’s just a few rooms, and the prep room and the OR are just next to each other. I was asked to lay down on the bench on the operating room. I still remember the anesthesiologist talking to me. “Can you slide down a little? A bit more… perfect.”
Then he placed the oxygen mask over my mouth and said, “I’m going to slowly start the anesthesia now.”

Here’s the thing: for my rhinoplasty, the anesthesiologist had me count down from 10 to 0. I think I made it to 6 or maybe 5 before everything faded. Somehow, that countdown helped my brain register later that I had actually gone under general anesthesia.

This time, though, it was different. After waking up from general anesthesia after 8 hours and 39 minutes (according to the log that I got post surgery), I apparently asked the staff three times when they were going to start — even though I already had my head wrapped in bandages. Maybe it’s also just the long time that one is under that creates this loss of orientation.

The next few hours are very difficult to remember and are based largely on what my friend and the nurse told me, as I can only remember fragments. I do remember being on the hospital bed that I was on before surgery and being asked to switch over to a wheelchair that was standing next to the bed. I remember my legs being put on some foot-rests of that wheelchair, but I don’t really remember how we got out of the surgery suite and down to the lobby. There is one fragment where I remember that the pavement seemed uneven while being wheeled to a car, but I neither remembered the car, nor the drive to the hotel, or how we got to the hotel room. I had brought an IPC (Intermittent pneumatic compression) device with me to reduce the post-OP risk of deep vein thrombosis and even explained to my friend how to put them onto my legs — but I don’t remember a single bit of that.

This is one of my main points of criticism: In a hospital setting, you have access to proper medical-grade equipment — like multi-chamber IPC devices — without having to bring them yourself. You’re hooked up to monitors for blood pressure, heart rate, and oxygen levels, all of which sound an alarm the moment something goes wrong. In a hotel room, none of that exists. Sure, there’s a nurse who checks your vitals every hour or so, but that’s a far cry from the continuous monitoring and immediate response you’d get in a hospital. Still, that seems to be the “American way” of doing things, as I’ve heard it’s very similar with the other top surgeons.

My mind became clearer at around 11 p.m., when I asked the nurse to get some of the stuff I ordered as I wanted to put together my cooling system, so I could use my facial cooling mask, so swelling wouldn’t get too bad.

FacialTeam in Europe uses the Hilotherm cooling system, which cools all of the face in the night post surgery, which doesn’t yield a better result, but very effectively reduces swelling and pain, decreases healing time and increases patient comfort.

The pictures that you often see from American patients that are brutally swollen beyond recognition occur because none of the US surgeons seem to be using that cooling technology, although it would be readily available. But... probably not in a hotel room, unless you bring your own. As I didn’t want to bring a medical cooling device when entering the US, I simply put together a similar cooling device made of Amazon parts plus a cooling mask I had ordered from the manufacturer in Germany prior to my arrival.

At first, the pain wasn’t too bad. I still believed I could make it through the night with just 1,000 mg of Paracetamol (or Tylenol, as it’s called in the US). But as the night dragged on and 2 a.m. crept closer, the pain became unbearable. It felt similar to a tooth extraction — except not just one tooth, but more like twenty, and not just in one spot, but all over my face.

I really tried to avoid taking Oxycodone, but the pain was just too much. So I gave in and took a single pill. It didn’t take the pain away completely, but it made it bearable. Still, I wasn’t able to sleep that night.

Getting up to use the restroom on my own felt risky. I was unsteady on my feet and definitely needed help just to manage the few steps to the bathroom. I was still feeling pretty dizzy and also needed assistance getting back into bed. Could I have done it all by myself? Maybe. But honestly, you’d have to be out of your mind to take that kind of risk after a surgery like this. Falling just wasn’t an option.

Day 1: The day after surgery (Thursday)

In the morning, Dr. Keojampa came by my hotel room to remove the bandages, check the incision, and let me take a first look at my slightly changed, already swollen and bruised face. Also I noticed that my lower lip had cracked at several locations and had some bloody crust on it, despite using lip balm the days before surgery.

Afterward, he reapplied the bandages and we talked briefly about what to watch out for during recovery — most of which he had already outlined in the detailed information he gave me before surgery. He had given me his personal mobile number in case anything came up, which really shows how much he cares. He often works with just one patient at a time, and I truly felt that focused attention.

While I stayed in the room recovering, my nurse handled everything else. She checked me out of the hotel, packed up all my things, loaded them into her car, brought the wheelchair, wheeled me down to the entrance, got me into the car, and drove me to the Marriott hotel — all the way to my room where she would also stay with me full time on Thursday, and part time during Friday and Saturday. Honestly, I was in no state to do any of that myself. You just lack the energy. Getting up, walking, anything that requires some miniscule amount of energy is exhausting.

Thursday I spent mostly on my bed, exhausted, in pain, with bandages around my head. I didn’t want to swallow another Oxycodone, so I mainly used Paracetamol (Tylenol) throughout the day to keep me from crying because of the debilitating pain.

I already knew from many forum posts that chewing would be nearly impossible after jaw and chin work, so my go-to “food” during the first days was that “nutritionally complete ready-to-drink meal” Huel. I knew that trying to use a glass could be difficult due to (possible) numbness of the lower lip, and using a straw could lead to the internal sutures in one’s mouth opening up, so I used large syringes to pull the Huel from a cup, and then push it into my mouth with the syringe.

After having such a “meal”, I first rinsed my mouth with some mild Therabreath mouthwash, waited for half an hour, and then rinsed again with the Chlorhexidine mouthwash that actually kills most of the bacteria, so the internal incisions don’t get any inflammation.

The nurse stayed with me from around 9 a.m. to 4 p.m., and then left for the day. Some people had recommended to get Vick’s NyQuil to be able to sleep, and I also found that this does help — not necessarily in the first nights, but later it does. For the first 3 nights I took an Oxycodone tablet and a cap of NyQuil, and often was able to at least get an hour or two of sleep before the pain would be bad enough again to wake me.

Despite all the cooling, swelling already started that day. The area below my left eye was quite swollen, and I was glad that I didn’t have rhinoplasty combined with the FFS, as that would probably have been even more hell to go through (I remember I also had swelling in that area from rhinoplasty). I did buy Thrombocid cream, which is on another level compared to Arnika cream when it comes to getting rid of bruising and swelling.

One thing that someone recommended was to bring small remotely controllable LED candles. I first laughed at that advice, but when I had ordered something from Amazon and was just missing 6 USD till I could get free shipping, I added some ultra-cheap LED candles for around 8 USD, got free shipping AND LED candles. Turned out that these were absolutely brilliant at nights. When you wake up, want to take another pill against pain, want to drink something, etc., you don’t have to turn out the bright hotel room lights, but just turn on those candles. Very nice.

Day 2: First shower after surgery (Friday)

As long as you don’t have a hair transplant, showering just a day after surgery is absolutely possible. I had brought my own towels from Germany, as I knew that those would be clean — really clean. As clean as hotel towels may be, I trust my own towels more. I had brought some special shampoo / body cleansing lotion from Germany that is often used in intensive care, which eliminates most bacteria after just one minute of application, including multi-resistant strains like MRSA. I used that for the first few days to make sure that hairline incision wouldn’t get an infection. After showering, I then rinsed my head with Prontosan wound irrigation (as tap water still contains bacteria and isn’t sterile. Prontosan binds to those bacteria and basically rinses them off). After that, I did spray a bit of Clinisept+ Skin cleansing antimicrobial Hypochlorus solution on my hairline incision. My UK surgeon had recommended that stuff for the rhinoplasty, so I used it for my FFS as well.

The nurse did change my bandage every day in the morning, cleaned the incision with 3% Hydrogen Peroxide solution, sprayed my head with the Clinisept+ solution, let it dry, then applied the Bacitracin ointment and wrapped me up again. A process that would take may 10–15 minutes max with her help.

Again, spent most of the day either on the couch, on my bed cooling my face, or on a chair “eating” some Huel.

Day 3: Lots of swelling & trying to eat some real food (Saturday)

Despite my cooling efforts, swelling increased even further on day 3. I am not going to post a picture here as it is just very gruesome to look at. Saturday was also the last day my nurse was there for me.

The post-op instructions state:

EXERCISE: Short walks following surgery are encouraged but please have an escort with you the first couple of trips. Please do not overexert yourself. It’s your time to rest, so you heal the best. Strenuous activity (causing sweating or rise in blood pressure) and light exercise should be avoided for at least 2 weeks.

The weather outside was nice, and I really did want to walk a bit. Staying in a hotel room for 3 days straight gets you down quite fast if the weather outside is nice and you are located just minutes away from Venice beach. So I asked the nurse if we could take a short walk. I dressed in a short sleeved button down shirt, jogging trousers and sneakers, and we slowly walked out of the hotel room. For someone who just got their face sliced open, I was pretty steady on my feet — at first.

We walked to the Marina del Rey Farmer’s market, where people were already packing up as it was in the late afternoon when we did take the walk. Even at that small distance, I felt how my energy was draining. I decided that we should go back to the hotel, and quite honestly, when we were back at the hotel, I was exhausted like I had been running a marathon. Still, every walk I could do would reduce my risk of a thrombosis, so I planned to do more walking in the next few days.

In the evening, I didn’t want any more Huel. Some people live with that stuff day in, day out — I can’t. I wanted something real, at the hotel restaurant. I figured that I might be able to bite small pieces of french fries with my frontal teeth (real chewing was not possible) and just swallow small pieces of fish.

I removed the deep fried crust of the fish and just swallowed little pieces of it. I could eat probably half of what you see on the picture before the pain in my mandible was enough to stop me from further trying more. Still, I was glad that I had something to eat that wasn’t in fluid form.

Day 4: Visiting the Venice canals (Sunday)

After that exhausting walk, I originally decided to take it slow again the next day. After the usual showering in the morning, changing bandages and especially cleaning the incision, checking whether it looked alright and applying the Bacitracin ointment was much more difficult without someone helping me. My friend had already told me before that she would be happy running errands for me, but that she wouldn’t be able to see any blood or incision lines (she had once fainted because of that), so I was on my own. I had bought a webcam, which I mounted on a portable stand and opened up an app on my laptop so I would get a live feed from the camera. This way, I would be able to work with both my hands on cleaning and checking the incision without having to hold a mirror.

While that method worked, I cannot really recommend it to anyone. Having someone with you that is able to help also when it comes to changing bandages and cleaning incision lines is just priceless.

Pain was still there, but became much more manageable. After three days of using Oxycodone (one tablet each night), I tried just to stick to Tylenol after that, probably at around 1,500 mg / day. You won’t be able to use NSAIDs (e.g. Ibuprofen, Aspirin, etc.) throughout the first weeks, as they can cause bleeding, which Tylenol doesn’t do.

In the afternoon, my friend started sending me a few pics of where she was heading. She had rented a mountain bike from the hotel and was doing a tour, while I was sitting in that hotel room. I needed to get out. Looking at the map, I decided to try walking to the Venice canal historic district, and should I get exhausted, just take an Uber back to the hotel.

That day turned out to be mother’s day. Imagine me standing on one of the bridges of the Venice Canal district, with my bandages around my head, and this sweet elderly woman walks past me, gives me the warmest smile, and cheerily says, “Happy Mother’s Day!”

To this day, I still wonder: is it common in the U.S. for women to say “Happy Mother’s Day” only to other women, or also to men? And more importantly… how did she read me in that moment?

I did walk a total of 2.1 miles (3.4 km) that day. Still a bit exhausted, but much better than the day before, probably because I took a lot of breaks every time it became a bit exhausting. I managed to get back to the hotel without using an Uber.

In the evening, I took a few progress snapshots, something I can only recommend you do if you have any kind of surgery. I usually put up my monopod and did take a few snapshots of my face (front, side, 3/4, etc.). On the picture I am showing here, you can see the incision very well, along with the metal staples that were put in to the left and right of my head. I also had a scalp advancement, basically trying to eliminate the area that was completely hairless at the front, and move whatever hair I had left further to the hairline. My plan is to get hair transplants next year to furthre fill that area and at some point be able to ditch the wig. What you can also see — and that is the amazing thing about FFS — is the complete lack of brow bossing. In my opinion, that forehead looks perfect !

And a bonus that I haven’t mentioned before: Dr. Keojampa managed to keep the nerve intact, so I do have full sensation in the forehead (not above the hairline, because nerves inevitably need to be cut, but below the hairline). I also had about 80% sensation in my lower lip right after surgery, which recovered to 100% in a matter of weeks.

Days 5–8: Sightseeing and getting my sutures removed (Thursday)

The next days followed pretty much the same routine: Showering, cleaning the incision and reapplying the bandages, discussing where we could head today and then (often) taking an Uber to drive to one of the places one should have seen in L.A. and walk around, do some shopping and eat a bit.

However when I write “eating” I mean more of swallowing whatever bits I could cut small enough so I wouldn’t need to chew. It would take another 1.5 months till I could open my mouth fully again, chew bits and not end up in pain after having had something to eat.

A place that was really nice in L.A. was the Farmer’s market at the Grove (map here), which was a good mix of shops and restaurants and just had it’s own flair, not being as busy as downtown L.A.

On Thursday, I went back to the surgery center to Dr. Keojampas office to get my sutures and metal staples removed. Dr. Keojampa did another CAT scan on my skull, so we could take a look at the “after” scans for both my forehead and mandible, and he explained to me what he had done in detail. After that, his assistant carefully removed the sutures and staples. I think I spent over an hour discussing things with him, getting the sutures removed and telling everyone in the office goodbye, as the chances were very low that I would return soon — simply because of the large distance between Germany and L.A. I can only say that he and his staff really do care about their patients, and — having looked at the in-surgery photos — I am amazed by his skill.

I also got the CAT scans delivered via a shared link, so I could compare them to my previous CT scans.

The weeks after returning back to Germany

With the sutures and staples out, I was cleared to fly back home. I had given Dr. Keojampa a few documents to sign, just to be on the safe side in case the airline would ask any medically related questions (my airline did have a “fit to fly” form that specifically stated in the fine print that you would NOT be allowed to fly with them for 6 weeks after a major surgery, which gave me a bit of a headache prior to boarding). Is FFS a major surgery? Yeah, very likely so.

So in order for no one to notice, I bought a light beanie cap to cover my still very visible incision line. Luckily, no one asked me to remove the cap, so I was able to avoid any problematic questions at the airport and when boarding the flight.

We flew back on Saturday late afternoon L.A. time and arrived in Germany on the following day at 1:40 p.m. German time (04:40 a.m. L.A. time). I had taken a few more days vacation from work to recover, so my total time “out of office” was 2 1/2 weeks from flying to L.A. to officially returning on day 15 after my FFS.

I cannot emphasize this enough:

For anyone undergoing FFS: Give yourself more time to recover. 3–4 weeks are recommended.

I don’t know exactly how it is at your workplace, but when you are back, people expect you to deliver 100%. I am working in a management position, so I was already booked back-to-back from morning till evening with meetings, and I noticed that I just didn’t have much energy left latest by 3–4 p.m. At least I was able to work from home, keep my wig off and leave the camera off for the first days (that I had agreed upon with my boss before), so I wouldn’t put any pressure on the incision. Still, if I were to do it again, I would probably take a week longer just to recover and get back to an acceptable energy level. You will “feel” your body healing at least for 4–6 weeks post FFS.

Once I was home, I started applying silicone scar gel twice a day to the incision line (Biocorneum see here) and used scar tape when wearing my wig to work.

When I returned to work roughly two weeks after my arrival early June, my chin was (and still is at the time of writing, albeit a bit less) so swollen that it looked like my chin before surgery. So… the only real change from the surgery that was visible was my forehead, and that primarily from a profile view.

People at work have known me for 5 years now. Some people at work have asked me whether I already had “that facial surgery” or when I would fly over to L.A. — kind of a bummer. So, based on the responses at work, it seemed I had just wasted a lot of money. You often see before/after pictures that are quite dramatic when it comes to FFS, but a) these pictures are often a year apart, so swelling has had much time to go down and b) many are just younger, so their skin can better readapt to the changed bone underneath. Personally, now at age 50, I do think that I will need a facelift in order to bring out the changes at my chin level to really make it visible, as my skin was slightly sagging before, and still is after that surgery.

What has changed though is how many double takes I get when I interact with people who haven’t seen me before: Close to none. Whereas I had maybe 1 out of 10 giving me that questioning look where you already know that they have either clocked you or are still processing the visual input, now that ratio has gone down to maybe 1 out of 100.

Personally, I had hoped for more dramatic changes, but when I look at my CT scans, there’s no denying that quite a lot has changed. I guess it’s the dysphoria speaking when I look into the mirror and think that not all too much has changed.

So I leave you, my avid reader, with the question: Do you think I pass?

Please follow me if you’d like to read more stories and stay updated on how things progress.

It’s been a while — sorry about that. The radio silence was intentional, but not something I truly wanted. It was a decision born out of fear.

After I had to cancel my facial feminization surgery (FFS) in Europe, I began looking for surgeons in the US — specifically someone experienced enough to work around my supraorbital nerve, which emerges in an unusually high position on my forehead. I won’t get into the details just yet, but by December 2024, I had found one of the best: a top-tier surgeon based in the US who felt confident about handling my case.

By a stroke of luck (and because I had already completed my rhinoplasty, which reduced the estimated surgery duration by three hours), I managed to secure a surgery date in May 2025. I paid a $10,000 deposit, booked flights for nearly $5,000, and reserved two hotel rooms — for myself and a close friend who would accompany me — for a total of around $12,000. That brought my initial, non-refundable investment to about $27,000. And that was just to get to the starting line.

I had already been anxious about the possibility of Trump winning the election and turning Project 2025 from a hypothetical threat into real-world policy. That’s why I decided not to update my name and gender marker on my official German documents just yet. I figured it would be safer to wait until after my return from the US — so I could still travel in “boymode.” (Given that I wear a wig anyway due to my receding hairline, that part wouldn’t be a big deal.)

To keep things simple, I applied for an ESTA (Electronic System for Travel Authorization) — the streamlined, visa-free entry process that allows citizens of certain countries to visit the US for up to 90 days for tourism or business. Back in December 2024, with those precautions in place, I still believed traveling to the US would be reasonably safe.

At the day of the inauguration as the 47th president of the US, Donald Trump issued a number of executive orders that made abundantly clear that he intended to start a war on trans. “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the federal government” was the first of many executive orders that would follow, and would target everything around trans. Even that very first executive order made me uneasy. Would the hospital where I was scheduled to have surgery still allow my surgeon access to their operating rooms? Or would they cut ties, fearing political backlash? I reached out to my surgeon, anxiously awaiting reassurance. The response came quickly: I was safe. The hospital would continue to host their surgeries, including mine.

But… you should never feel truly safe in a country that churns out executive orders faster than a newspaper rolls off an offset press. In my social media stream, videos of US immigration and customs enforcement (ICE) officers started popping up. Stories of tourists being detained by ICE entered my TikTok videos, and googling their stories didn’t make things better. While some of the stories were admittedly bizarre — like a professional tattoo artist bringing her full set of equipment into the US but insisting she had no intention of working — many others seemed like sheer bad luck. Just regular tourists who happened to be in the wrong place at the wrong time, and ended up detained in grim detention centers before finally being deported back to their home countries. A French scientist was denied entry to the US after his mobile phone was searched by immigration officers at a US airport, where they found messages that would express criticism of the Trump administration. More and more people posted videos claiming that it was unsafe to travel to the US as a tourist, but especially as a trans person.

How far would things go by May 2025? Would they start automatically matching social media posts and photos to people entering the country? Would it still be safe to travel to the US on an ESTA? I’d heard stories — even tourists with an ESTA getting into trouble. Should I have applied for a visa instead? After all, I was getting surgery. But then again, it was during my vacation, and I was paying for everything myself, upfront. Besides… I was making America great again, wasn’t I? Leaving behind a near six-figure sum in the name of freedom, femininity, and facial bones.

Well… I wasn’t so sure anymore. My Reddit chat list felt like a mirror of the growing fear under the new government. More and more entries had turned into [Deleted user] — until those outnumbered the actual conversations still left. I began scrubbing my online presence: deleting photos from social media, taking down some of my Medium posts, erasing older comments — just like so many other trans people who first went silent, then disappeared entirely from platforms like Reddit.

And I stopped posting on Medium. As much as I wanted to share updates about my FFS and everything that was unfolding, a deeper fear took over: if I didn’t make it past the border, I might never get the surgery. So I chose full radio silence.

Have you ever sent a joke about a politician to a friend? I’m guessing most of us have. I’ve shared jokes about the German party I voted for, the one I didn’t vote for, and even about parties I’d never dream of supporting. I’ve joked about former President Biden — and yes, about Trump too.

But at some point, the jokes about Trump stopped being funny. They started to reflect real fear — fear tied to my identity as a trans person. My messages began to show that. And then I wondered: what if a border officer ever checked those chats? Even if the messages were never meant to be threatening… I’d be toast.

I bought my iPhone back in 2018. I tend to hang on to a smartphone as long as two conditions are met: a) it doesn’t get painfully slow, and b) it still receives security updates. And while I was still perfectly content with my old device, I decided it was time for a fresh start. A brand-new iPhone — something untouched, clean, like a blank slate.

In late March 2025, I bought a brand-new iPhone 16 Pro Max. I also got a new SIM card, set up a fresh email address, and created a new Apple account. I never installed any messenger apps on that phone — and no social media either. Instead, I carefully selected a handful of photos from my old device and transferred them via AirDrop. Each image was hand-picked to create a curated version of my life — one that looked safely bland, like that of an ordinary, plain vanilla cis person. No selfies. Nothing that pointed to Sarah. It felt like erasing everything that had happened over the past two years. But that phone? — That phone would be safe.

How about my laptop? Originally, I had planned to use my company-issued one. It was compact, lightweight — perfect for travel. But there was one problem: the login screen showed my name. Sarah. That would raise questions I wasn’t ready to answer. I needed a clean-slate laptop. I remembered I still had an old 2013 MacBook Pro sitting on a shelf, gathering dust. So I brought it back to life. First, I wiped the hard drive using a zero-fill method (yes, I know — it’s not ideal for SSDs, but this machine wasn’t in daily use anymore anyway). Then I did a fresh install of Windows 10, along with Microsoft Office and VMware.

For anyone unfamiliar, VMware is virtualization software — it lets you run a separate operating system inside your main one. I set up an encrypted virtual machine containing all my sensitive data: WhatsApp, Reddit, Discord, my passwords. Then I uploaded the entire virtual instance to my personal server in Germany.

When I’d enter the US, my laptop would be clean. I’d download the VM later — once I was safely past the border.

I learned that people were stopped at the border because they were bringing prescription drugs without the proper documentation from their doctor (in my case: blood pressure meds and hormones), so I asked my doctor to complete this form for me.

It did feel like overkill. Paranoid, even. But after everything I’d read and seen online, traveling to the US this way simply felt safer. Better to overprepare than to risk everything.

So… what was it really like?

It was… rather unspectacular. My friend and I stood in line until we reached a somewhat bored-looking officer who asked the usual questions. What was the purpose of my trip? (Vacation.) Then a few follow-ups with slightly more interest: What was I planning to see? (Griffith Observatory, Hollywood, the Walk of Fame, Santa Monica — which we all ended up seeing by the way). How much money had I brought? When would I be flying back? Where was I staying?

They took a photo of me and scanned all of my fingerprints. That was it. My friend? She wasn’t even asked what she planned to do. In and out in under two minutes.

But wait — surely there’d be additional customs officers stationed at the exit of the baggage claim area, right? Well… no. Not in my case, for whatever reason. No one asked about my luggage. And absolutely nobody inquired about prescription drugs. Which, for all Fox watching Trump readers that stumbled upon this post, is totally fine. My prescription drugs consisted of blood pressure meds and female hormones that I would only use for myself.

Returning to Germany two weeks later was similarly hassle-free. Well — mostly. At the airport, just after my FFS, something unexpected happened. I was traveling in boymode, wearing a sleek pair of black Lululemon pull-on pants — no zippers, no buttons, nothing even remotely metallic or bulky. But when I stepped into the TSA body scanner, a red alert box suddenly lit up over my groin area (something that seems to happen quite often to trans, see here). I was confused. There was literally nothing there to trigger that kind of warning. A TSA officer asked me to step aside for a pat-down. Without giving it much thought, I complied. The officer was female, but in the moment, I didn’t even register that detail — I was still puzzling over what had caused the alert in the first place. It was only afterward that my friend, who had been watching nearby, gave me a knowing, Cheshire Cat grin and said, “You do realize they just identified you as female, right?”

Would I say that traveling to the US is safe?

Statistically speaking, yes. Millions of travelers pass through US airport security every year without any issues at all. But if you’re trans — and if your appearance doesn’t match the gender marker on your ID — my answer becomes less certain. Honestly, I don’t know. I traveled in boymode. My ID still listed me as male. There was nothing outwardly that would have raised a red flag. And yet, despite that, I took precautions. I used a separate phone and a clean laptop, because… well, better be safe than sorry.

I’ll be sharing more about my FFS journey in the coming weeks. For now, I can say this much: it’s been the most painful post-op recovery I’ve ever gone through. But two weeks out, I still believe I made the right decision in choosing my surgeon. All of my nerves are intact. I still have full sensation in my forehead and lower lip — something that often takes months to return with other surgeons. That alone feels like a small miracle.

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First and foremost, I extend my warmest wishes for the new year to each of my readers. May 2025 bring you health, happiness, and success.

For those of you who have been following my journey, you’re aware that I’ve made the social role change at work and have been living full-time as Sarah. So — how has it been?

In some ways, it’s been business as usual. The relentless drive for sales targets and year-on-year growth rates that seem just out of reach, endless meetings that oscillate between productive and pointless, and projects that invariably take longer than planned. After five years at a medium-sized company, you establish a routine with the colleagues you interact with daily, occasionally, or hardly ever. However, perhaps due to my transition, it feels like I’ve engaged in small talk or had meaningful conversations with nearly everyone at our headquarters in the last 2 months.

Previously, when presenting as male, I was seldom asked about my feelings or well-being. Compliments on my choice of outfit, perfume, or the appearance of my skin were virtually non-existent. Reflecting on my 24 years in an office setting, I can confidently say I’ve received more compliments in the last two months as Sarah than in all those years combined.

One of my readers, Jas (hi there, and thanks for your comment!), pointed out that I am still in the early stages of my transition, likening me to a thirteen-year-old girl obsessing over her daily outfits. She speculated that I might look back and laugh at all this in five years. Maybe. Maybe not.

The truth is, I’ve always had a passion for fashion. It’s comparable to a chef meticulously preparing a meal — crafting the perfect ensemble involves a similar process of selecting and combining ingredients. From the tailoring to the choice of colors and the texture of the fabrics, fashion is an art form that fascinates me for hours on end, and my enthusiasm for it hasn’t waned.

At work, I am aware that not everyone sees me as Sarah yet. To many, I am still [deadname], the person they’ve known in a male role for over five years, who now seeks to be recognized as female. While many colleagues see me, not all interact with me directly. Therefore, my wardrobe becomes a powerful tool for communication. This is why I dedicate considerable effort to crafting outfits that strike the right balance — neither too formal nor too casual, femininely expressive without being excessive.

During a chat with a colleague from HR, she confided that she’s always eager to see what I wear next because “it always looks so nice.” She even mentioned that my style has inspired her to devote more attention to her own wardrobe. Such feedback not only affirms my choices but also tells me that I am in fact very visible to everybody. Sarah is very visible, [deadname] wasn’t.

Do discussions about fashion, makeup, skincare, and hair define my transition? Is this all there is to living as a woman? Such questions might imply that the essence of my transition is superficial, but the reality is far more profound.

In her compelling article, “I have reached the mountain top” the aforementioned Jas argued that our core selves remain unchanged by transition; we don’t morph into entirely new beings. She believes that transitioning doesn’t unlock a hidden feminine self; essentially, you are who you’ve always been. I do agree with her. I don’t anticipate becoming someone entirely different five years from now. Yet, there is undoubtedly some change occurring — not in my personality per se, but in how I express it outwardly. It’s about what I allow myself to express, the emotions I allow myself to experience, and how I savor each moment. This shift in expression also affects how others perceive and reflect happiness back to me.

Similar to Jas, I wouldn’t claim that I “feel like a woman,” but I can definitively say I never truly “felt like a man”. Transitioning has allowed me to freely express the feminine aspects of my personality. If this expression aligns with your core self, people will recognize it. Although my socialization as a man may occasionally reveal itself through certain idiosyncrasies, I believe these traits can be unlearned or adjusted. Ultimately, what matters most is your own sense of authenticity and well-being.

If transitioning is largely about the freedom of self-expression (just looking at that aspect for now), one might wonder, why not simply express oneself within a male role? This question is challenging to address. When perceived as male, societal expectations and interactions conform to that gender identity, often subconsciously ingrained by both genders. It’s only by standing on the other side that one truly experiences both the positive and negative aspects of such a shift.

And yes, so far, the journey has been overwhelmingly positive and fulfilling. Amidst the routine of work, this new normal can seem mundane until a moment of realization strikes. During a typical conference call, as I glanced at the video thumbnails of participants in the 4x3 matrix, I saw a woman with long blonde hair and a scarf. That woman was me. It’s these moments, when I recognize myself living the dream I once envisioned, that bring immense joy.

However, for those contemplating the start of HRT or transitioning, I must offer words of caution. I have been fortunate: I still have my job (knock on wood!), received tremendous support from colleagues, and possess the financial means for significant procedures like FFS.

But, alongside the joy, there have been setbacks. For instance, a well-meaning colleague commented, “I’m glad that you can live it out now,” implying my identity was like a role in a play, not my core self. Even more disheartening was a New Year’s greeting from a former colleague who not only wished me good health but explicitly stated he would omit any wishes for continued professional success from now on, as if to say my career ambitions were a closed chapter due to my transition.

Such remarks show that the majority of people don’t really understand why someone transitions. It is also a bit disheartening to read such a greeting from an ex-colleague on New Year’s eve.

Then there’s the ongoing, unresolved situation with my parents. I often joke with friends that my life feels like a scene from the German film “Goodbye Lenin,” where a son goes to creative lengths to protect his die-hard communist mother from the reality of Germany’s reunification after she wakes from a coma. Similarly, my parents are some of the last to know that I’ve transitioned to living as Sarah. Given that I have to wear a wig, it’s very easy for me to play that old [deadname] role when I visit them (using compression shirts that still seem to do the trick).

I’m planning to undergo facial feminization surgery (FFS) in May — more on that in an upcoming post — and I’m leaning towards not informing them about this surgery beforehand. The real challenge will be what to say after I return, as the changes will be impossible to overlook. But, as my old boss liked to say, “Let’s cross that bridge when we come to it.”

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From the perspective of someone just starting their transition, I’ve reached significant milestones: 20 months on HRT, a first — albeit minor — feminization surgery, coming out to friends and colleagues, and making the full social role change at work with mostly positive reactions from coworkers. Apart from my parents, I no longer need to switch between roles — I can live as Sarah in my day-to-day life. By all accounts, I should be happy.

Yet, alopecia has left me with little natural hair, so I rely on a wig every day. Without it, no one would ever mistake me for a woman. With my wig and makeup, I imagine I look very “trans” to those at work who knew me before, and perhaps somewhat passable to those meeting Sarah for the first time. My voice, however, still needs a lot of work. Or a surgery.

When I was in my twenties, all I wanted was to wake up, style my own hair, apply a bit of makeup, and be seen as a woman. Now, with that wig and having to do the whole shebang of makeup, I can’t shake the feeling of being a fraud.

There’s also a big difference between being a part-time trans woman — taking your time on weekends to do your makeup, pick your favorite dress, and enjoy some leisurely window shopping — and the daily reality of getting up 45 minutes earlier to meticulously apply makeup (no mistakes allowed, because you have to look your best to appear halfway passable). Every outfit is carefully chosen the night before to save precious time in the morning. What once felt like an enjoyable ritual now feels like a high-stakes performance, where every detail has to be perfect. Sometimes, as I stand in front of the mirror, my wig still off while I do my makeup, I catch myself thinking, Who are you trying to fool?

I thought I had built a solid wardrobe over the past 20 years of dressing non-binary. But I quickly realized that my collection of chunky-heeled boots now feels far too chunky, or that many of my heels are simply too high for office wear. While I have a large collection of blouses I’d love to wear, they’re all too lightweight for our chilly office, where conference rooms are barely heated above 68 degrees Fahrenheit in the winter. To stay warm, I need more cardigans — but, of course, the ones that fit well, come in the right colors, and are good quality are completely sold out. The sweaters I already own aren’t figure-hugging enough to look feminine, and the chunky knits I’ve always adored now just look oversized and unflattering on me. I feel caught in an impossible situation. It’s not that I lack clothes — it’s that I just need many additional items to make those clothes that I already have work for office outfits. What I have doesn’t quite fit the person I want to present. “I don’t have anything to wear” might sound dramatic, but it’s not far from my current reality. What once brought me joy now feels like a constant battle to create outfits that look polished, keep me warm in the office, and still appear feminine.

Video calls. I never really considered that, of course, you also have to wear makeup at home to look the part on camera. It almost feels like a waste to go through the whole routine just to appear presentable for a video call. I’m holding out for Black Friday to buy better lighting and a new webcam, so the effort I put into my makeup actually shows in the video feed — something that’s currently quite disappointing.

Yes, I’ve received plenty of compliments. A colleague called me at the start of the week, and her first words were, “Oh my God, it’s 9:08 a.m. on a Monday, and you already look like a million bucks!” Another colleague passed me in the hallway at the office and later told me she initially thought I was a visitor from headquarters because I was dressed so sharply. I’ve been complimented on my clothing, hair, and makeup — even told I look better as Sarah than I ever did as (deadname).

But there’s this nagging feeling… shouldn’t all of this feel natural? Instead, it feels like constant hard work — and not just occasionally, but every single day. When I take off my wig after coming home or finishing the last video call, it feels as if I’ve just completed a grand performance.

The truth is, I feel better as Sarah — dressed up, made up, and presenting as myself. I don’t want to go back to being (deadname), and I’ve never felt like a man. I don’t doubt that I’m trans. But at the same time, I struggle to say out loud that I am a woman.

Although I’ve only been living this full social change at work for two weeks, many of my female coworkers have already opened up to me, which feels amazing. For example, we recently discussed how expensive it is to be a woman — something men can never truly understand. The conversation turned to women’s hygiene products and how these should be as freely available as toilet paper. At the very least, there should be a communal stash so you can grab a tampon in an emergency without the awkwardness of asking around. Inspired by that discussion, I bought a shelf for the restroom originally designated for people with disabilities (which is now used by me), and stocked it with women’s hygiene products for everyone to use.

Still, during that conversation, I also came to realize just how many aspects of being a cis woman I will never experience or fully relate to — so how can I claim to be one?

Maybe I just need more time. Maybe it will all fall into place eventually. But right now, after two weeks of living this social role change, I find myself wrestling with what can only be described as “imposter syndrome.”

There’s a tension I can’t ignore: the gap between how I feel internally and how I perceive myself externally. It’s not about meeting anyone else’s definition of womanhood — it’s about bridging that divide for myself, finding a balance between effort and ease, between performance and identity.

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Hair. Men often don’t think about hair that much. They often wear it short, some lose it over the course of a lifetime, and aren’t too bothered with that fact.

For a woman, losing hair can feel catastrophic. Cancer patients often start shedding their hair after the first run of chemo treatment, and I fully understand why many start to cry when they see their hair falling out.

Transitioning from male to female at 49 brings challenges — hair being one of them. I’ve lost a fair amount at the front and vertex (the crown area), so wigs have been essential. Hair transplants are possible but should wait until after forehead recontouring, which I plan to get. Returning to shorter hair after a transplant would be hard at work, where I can’t wear a wig during the initial healing.

So… could there be a better option than wearing a wig, prior to getting a hair transplant? Maybe yes: There are manufacturers of hair pieces that get attached to whatever is left of your own hair, and when adding extensions to the mix, you can go from “guy to girl” in a matter of about 4 hours — if your own hair is long enough to attach all of these items. I had grown my hair for about 1 1/2 years, so it had reached the minimum length to be able to attach the hair piece and extensions.

After having gone through various wigs over the last 2 years, I arrived at a slightly darker blonde color for my everyday look. I don’t know what got into me, but when I chose the color to get for my hair extensions and hair piece back in April 2024, I chose an ombre color look that went from dark blonde to light blonde. According to the hairdresser, the hair piece was custom made for me, which took 3 months to make.

Months in advance, I had made an appointment for October 22nd to get the hair piece and extensions attached. That date was around the 2 months post rhinoplasty mark, so I figured it would be enough time for the swelling go down, do the coming out at work, get the hair extensions and return — tada! — as Sarah to work.

The change

Getting all things attached was a matter of just 4 hours. First touching up the color of my own hair, then attaching 150 extensions with a length of around 18 inches each (with little attachment points where they are kind of “glued” onto your own hair), then attaching the hair piece, which is glued at the front and attached to one’s own hair with little metal micro rings further to the back. The hair of the hair piece is mounted on top of a grid-like structure, through which one’s own hair is pulled, so it mixes with the hair of the hair piece for a more “natural” look.

Finally, the hairdresser did cut the hair and put some curls in it for that “wow” effect.

You will notice that I am wearing a simple polo shirt on that picture. As my own hair got colored first, I didn’t want to risk any of my new blouses, so I went to the hairdresser with a very old polo shirt. Once I got the hair done, that male polo shirt looked absolutely out of place to the head with that absolutely female hairstyle I was looking at. It was kind of a funny experience.

The hair did look amazing, but when looking into the mirror, I immediately realized that this full blonde look isn’t exactly flattering for me. I did prefer my darker wig’s color, but couldn’t change it now.

As we had external guests visiting our company’s HQ the next day, and as I wasn’t all too sure whether my boss could cope with me coming to the office with full hair, makeup and in a dress or skirt, I opted for a no-makeup look, female Marlene trousers and a nice, but neutral blouse. I did not wash my hair that next morning, but just gave it a few brushes, as the curls from the day before were still there.

However what I noticed that morning was that the middle part of the hair looked quite unnatural. I have had my experience with cheaper made wigs, and what I was looking at was looking like a very cheaply made wig. You couldn’t see the skin of your head, which — if you look closely — normally is the case where the hair parts.

Also, the whole hair looked very flat. Like I had pressed it down with an iron or something. I did try to combat this in the days to come by using dry shampoo, hair spray, volumizing blow dry mist, curl volumizing foam, with a number of different techniques, e.g. drying the hair upside down, putting in rollers, or using a round brush. It would get a bit more volume for maybe 1–2 hours, but return to the ultra-flat state that I never saw in my wigs after that.

Women with long hair don’t wash their hair every day. It’s often washed on day 1, while day 2 and 3 (or even longer) are managed with dry shampoo, after which a regular washing is done again. I also found that it just wasn’t manageable to wash the hair every day: Shampoo & conditioner took around 20 minutes. Patting it dry with a towel and letting it air-dry a bit another 15 minutes. Blow drying to a still damp/moist state another 15 minutes. Then going from that state with slightly frizzy hair to smooth/sleek hair using a hair straightener (a tool similar to Dyson’s Airstrait) another 45 minutes. Spending over 1 1/2 hours each morning — not doable.

So when I did wash my hair, I would usually do it in the evening when I had time, and just hoped it wouldn’t be too messy in the morning. While it did still look okay the next day, achieving the glamorous salon look was unachievable, especially when you wanted to keep those nice curls.

The nice thing about the hair extensions and hair piece was that it was permanently attached. For someone with little hair before, now having this amazing, ample hair was just… priceless. If you pulled on an extension, you would pull on your own hair. It moved and felt like my own hair. It no longer felt like two personas, removing the wig in the evening — it felt very natural.

Still… it didn’t look right. Especially on day 2 and 3 after washing the hair, it started looking more and more like one of my 30 USD wigs, and not like the 5,000 USD hair extensions / hair piece system I had bought.

The beginning of the end

“Let me fix your hair in the back”, a female colleague offered when we walked into a conference room prior to a meeting. I asked her what was wrong. “Oh, some of the extension connections are visible, I just have to rearrange the hair a bit… there we go!”.

The thing with the hair piece is: It doesn’t cover the back of one’s head like a wig does. It is attached towards the front of the head, and some its hair will cover the back. But when the hair strands don’t all fall in place like they should — which unfortunately happens more often than one would wish — the extensions become visible. Even worse, as I don’t have much hair at my vertex it looks very bad. I tried to capture this with my smartphone by shooting a video and just pulling out a still from the video. Here’s how it looked like:

Once I saw that, I became very self aware. Were extensions showing? Was that vertex visible again? Did I just move in a way that would expose something?

It felt terrible. We are working in an open plan office, so someone will always look at the back of my head. I started checking the back of my head every 15–20 minutes or so. I chose the seat in a conference room based on whether my back would be visible to another person in that conference room, or through the glass of it (our building has a very “open” type architecture).

The amazing hair suddenly became a nightmare. I became increasingly frustrated, didn’t like how it looked, and just wanted it to come off. I didn’t want to become the laughing stock of the company, the trans that got that half-baked hair solution that just looked silly.

Two nights ago, I made the decision to take a look again at the back of my head, and if it would show the connection points and the blank vertex again, I would cut everything off. It did.

I took some scissors and first cut off the hair piece, followed by each individual extension, which were all attached pretty close to the scalp… which meant that afterwards, my head looked like a kid’s first try of cutting their own hair. Crying, I took my hair trimmer and shaved the rest of the hair off, now back to the length I started with when starting my transition in 2022… 10 millimetres or 0.4 inches.

After sending an email to my hairdresser, cancelling all future appointments, she just called me tonight. She said that I could have called her, that we might have worked on putting in additional extensions, trying a number of different things… she was a bit at a loss of words.

I guess it’s hard to understand for someone else how much pressure there is when you transition. There are people at work that don’t like what you do. There are people that would rather like to see you gone. I might have overreacted that night, could have explored more options, but then again, I knew that all of my hair insecurities would be kind of “solved” with the wig that I had gotten in London in September. Real human hair, great hair color, amazing volume, absolutely natural-looking. I put it on, and I feel safe. I had bought it back then in order to have a “Plan B”. I am going to be back in London soon, so I am going to buy two more of these wigs, just to have some backup wigs should something happen, but also to rotate them in order to have less wear & tear.

(picture removed for privacy reasons January 2025)

Looking at the mirror without a wig now, I feel sad and vulnerable. I hate that G.I. Jane look. I know that the hair piece will never provide me with the natural result I am looking for, and that even a hair transplant might not provide enough volume & density to go without a hair replacement system.

The only solace that I have is that my own hair will grow back. I just looked at pictures from June 2023, when I had a 5 mm buzz cut, and how fast it did grow after all. I might try that hair system again in 2 years from now, do a bit more research on hair pieces, see whether there are better systems, although I already went for the “Bentley” of hairpieces with the one I got.

For anyone trying such a hair piece, I would recommend that you take a week off from work after getting it. This way, you have more time to fix things that might not work for you, or even revert back to a wig based solution. Also, always have a plan B in place if that shouldn’t work out.

With the wig I now feel safe. If I run my fingers through the back of my head with it on, I feel supple, voluminous hair. If I look at the mirror, it looks like my own hair.

Especially some of my female co-workers have already asked me why I have refrained from coming to work with makeup on and in a dress so far. The answer is two-fold: First, I wanted to give everyone around me a bit more time to get accustomed to the news that I am transitioning, especially my boss, who I think has a hard time accepting it. Second, the way the hair piece looked made me too insecure.

I think I’m finally ready to walk into the office as Sarah. My hair feels sorted (for now), I’m confident my makeup will be on point, and my dresses and skirts are just waiting to be worn.

A year from now, I hope I’ll look back and laugh about this whole thing.

Please follow me if you’d like to read more stories and stay updated on how things progress.

While I began coming out at work four weeks ago, I hesitated about sharing the experience publicly. I wasn’t entirely sure how much to disclose, especially since part of the process left me questioning if I truly have my team’s support — or if I might be job-hunting in a few months under the guise of an “unrelated reason.”

Still, here we are. You’re reading this post, so I’ve decided to share some of my experience. Rather than focusing on the exact words exchanged, I’ll paint a broader picture of what coming out at work can feel like.

At 49, I’m in the process of transitioning from male to female and am now nearly 19 months into HRT. The results so far include a beard that’s mostly gone due to epilation, small A-cup breasts, and an increasingly androgynous face, especially since my feminizing rhinoplasty in August. That said, without a wig, my physical gender markers still lean “male.” In other words, I could probably stay in “male mode” indefinitely at work. But with an October 22nd appointment booked for a permanently installed hairpiece and extensions — a true “wow” moment for a more feminine look — I decided to come out before suddenly showing up with the new hairstyle.

I’ve lost track of how many coming-out conversations I’ve had by now. Thirty? Maybe forty? You get practice. Each one involves explaining that this isn’t something recent — that I’ve felt this way for a long time, having first tried to transition two decades ago, and am now moving forward again. I’ll often show a few photos on my small iPad, which usually gets a “wow,” a “you look beautiful,” or an “is that really you?”. For this work-specific coming out, I prepared responses to questions I expected, like “Which restroom will you use?” or “When do you plan to let the rest of the company know?”

In the second week of October, I sat down with my boss, the CEO of the company, to come out to him personally. It was a long meeting — over two hours — and he listened intently while I shared my story. Normally, I can get through it without breaking down, but that day was different. I was already under stress, and when I touched on what happened 20 years ago, I lost my composure. He didn’t show much reaction or surprise; he simply listened. At the end, he formally promised “full support” — from himself and from everyone in the company.

I’ll leave out some of the details of what was said, but I couldn’t shake the sense that, despite his official stance, he might already be weighing non-transition-related reasons to let me go. I’ve met every profitability and project target they’ve set for me, including goals many called unrealistic just a year earlier, so now might not be the right time to act. But it wouldn’t surprise me if next year’s targets turn out to be conveniently unachievable, giving a tidy reason for termination. Perhaps I’m reading too much into things, misinterpreting micro-expressions or reading between the lines. Yet, his negative comments in the meeting were oddly pointed, and although I had asked the head of HR not to brief him beforehand, he didn’t seem surprised. It was clear he knew this was coming.

What struck me most wasn’t the lack of surprise, but a hint of contempt — a reaction that no one claiming to “support” you should display.

I left the meeting with mixed feelings. Some of the steps we take in transitioning are non-reversible. Like one of those one-way traffic speed bumps with spikes, where you will have a flat tire when you try to reverse. This meeting felt like either way I now had a flat tire, with the cat now out of the bag, never to be put back into it again.

A week later, I came out at the management meeting. It was one of the first items on the agenda. “Something personal from our CDO”, to which again I very briefly told my story in a 1-minute-elevator pitch, telling everyone if they wanted to know more, I was happy to meet for lunch. Again, the CEO told everyone that he expects “full support”, but also doesn’t want this “trans topic” to dominate all of the internal discussions, as we have to focus on the business. So far, I got one very sincere email of a colleague telling me that despite us often disagreeing on business things, he would fully support me. And another call by a collegue who wanted to know my story and asked quite a lot of questions. As far as the other colleagues are concerned… silence.

Same day, 2 hours later, I came out the exact way to my department. Same sort of non-reaction. Maybe everyone thinks I am crazy, or they don’t know what to ask. I do agree though with my boss: I don’t want to make this a topic that is all over the place. If someone wants to know, they can ask.

There was no official email yet, as personally, I wasn’t sure when I would make that official role change at work. Maybe once I got the hair extensions? That would depend on how well they would look like and how confident I would feel with them (sneak preview to my next post: they made me feel absolutely insecure about myself).

I knew that this information would spread in the office like a bush-fire anyway.

Normally, I wear compression tops to keep my breasts unnoticeable, but the day after coming out, I decided to wear a bra to work. I kept the look neutral with a slightly oversized sweater, so nothing was exactly on display — but it was undeniable that, suddenly, I had a shape where there had been none before. Still, no one said a word.

With nearly everyone only in the office on Tuesdays and Wednesdays, there wasn’t much time for people to notice any changes. But the following week promised to be more eventful. Not only would I have my hair extensions and a hairpiece installed, but we also had visitors from the UK scheduled. So, on day one of a more significant shift in my appearance, I’d be under close scrutiny, needing to look presentable enough for a business meeting with external partners. My (negative) experience with that hairpiece — let’s just say it deserves its own post.

If you ask how this felt: exhausting, plain and simple. Each day left me drained, as though I’d lifted a huge weight from my shoulders only to take on another.

Now there is a sharp awareness of every look, comment, or expression, even ones that might not mean anything. A smirk from a coworker, a casual comment from my boss — it all feels like it could hint at something bigger. I’m left on edge, wondering if each subtle sign could be the first step toward being pushed out.

Ask me again in twelve months if it was worth it — I’ll likely have a better answer by then, hopefully some peace of mind if things go well.

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Wednesday, October 9th will mark a pivotal moment — the day I come out as trans to my boss, the CEO of the company I work for. Surprisingly, I’m not too stressed about the conversation itself, having gone through similar talks many times before with friends and quite a few colleagues, and having prepared quite a few documents. What weighs on me more is the uncertainty about what happens next.

This question has been on my mind even more since watching Will & Harper on Netflix and having dinner with a trans friend yesterday. If you haven’t seen Will & Harper, it’s a touching documentary following Will Ferrell and his longtime friend Harper as they embark on a road trip. Harper, now in her 60s, recently announced her decision to transition from male to female. Watching her journey struck a deep chord with me, as someone also transitioning later in life. There were several moments in the film where I found myself in tears, as Harper’s experience felt painfully relatable.

One theme in the documentary that resonated deeply was the question of passability. Harper doesn’t pass in my book, and while she seems to have come to terms with that, it’s a question I still wrestle with. At 19 months on hormones, I had hoped for more significant changes by now, but at 49, it’s become clear that I have to manage my expectations. It is what it is.

I had dinner with a friend last night, someone who started HRT in her early 20s, had FFS, and effortlessly passes, even without makeup, in jeans and a hoodie. She’s beautiful, and being around her always makes me reflect on my own journey and what could have been if I transitioned 20 years back.

The first time we met, I was about seven months into HRT. She didn’t mince words back then, telling me, “You’d have to be delusional to think you’re passing at this stage.” It stung, but I appreciated her honesty. So, yesterday, I asked her again. She tried to soften the blow this time, joking, “Well, you’re definitely passing in the boob department.” It made me smile, but it wasn’t the answer I was really looking for. I value her opinion deeply, and I needed more.

“Do I make a fool of myself if I show up at the office as Sarah after coming out?” I asked, searching for something concrete. She paused, choosing her words carefully, as if she didn’t want to hurt me. She never outright said that I don’t pass, but she didn’t say I did either. “It’s not so much about what I think… how have people around you reacted?” she asked gently. We had spent the evening dissecting different aspects of plastic surgery, and at one point, she began to review my features. She complimented my nose, saying it was a huge improvement, but added that a brow bossing reduction would really open up my eyes. And that hair would be a big factor of course.

In the end, I never got a direct answer about whether I pass or not. Or maybe I did. Not passing.

I started reflecting on what she said when we first met… “you would have to be delusional…” Maybe she was right. Maybe I’ve spent the last 19 months going out as Sarah, receiving so little negative feedback, that I’ve convinced myself I’m passing — when, in reality, I’m not.

Like many others on overly positive trans forums, I’ve definitely mastered the art of taking good selfies. You know the ones I’m talking about: the “before” photo where the person stands in harsh light that accentuates every flaw — brow bossing, large nose — compared to the “after” shot, 6 months into HRT, soft light, head slightly tilted, smiling. Of course it looks better. But just because you look passable in a photo doesn’t mean you do in real life. Especially not in a conference room with harsh, unflattering lighting where the architect clearly didn’t think about anyone’s complexion.

On October 22nd, a Tuesday, I’m getting my hairpiece and extensions installed. They’ll be 17 inches long, and, hopefully, they’ll give me the feminine look I’m aiming for. Originally, I had planned to take a few days off after the installation to get used to styling and managing my new hair. But between my rhinoplasty in August and other transition-related appointments, I’ve already used up all my vacation days for the year. So… back to the office the very next day I go, with what I hope will be a striking new look.

And that’s where the real question comes in. Do I use this moment to socially transition at work? Should I show up as Sarah, complete with makeup, female clothes and my new hair, or wait until after I’ve had my full FFS? That could still be a year or two away, depending on the availability of a surgeon who can handle my specific needs.

This decision has been weighing on me more heavily lately. In Will & Harper, they talk about how transitioning is, in large part, about accepting oneself. And while I know that’s true, I’m not sure I could bear any ridicule at the office — snickering behind my back or, worse, someone outright laughing at me. I don’t want to be a spectacle. I just want to be seen as a woman, and I don’t think that people will see me that way right now.

Then there’s the issue of my parents. Once they see the hair extensions, the penny will finally drop, and they’ll realize what’s actually happening. And when that moment comes, all hell will break loose. That’s one of the main reasons I want to come out at work before I visit them again. I need at least one part of my life where I feel supported, and I’m hoping the workplace can be that safe space for me.

I’m also just so tired of living this double life — [deadname] at work and when visiting my parents, Sarah in my personal life. But even as I write this, I’m still questioning whether I can make the leap to being Sarah 24/7, with makeup and everything, in just a few weeks. It feels like such a huge shift, and I’m not sure I’m ready for it yet.

So far, reverting back to boymode has always been an option. Spending 40 minutes getting ready — makeup, hair, everything — just to run a 15-minute errand? Probably not. Boymode. That choice has been my fallback. But once I make the switch at the office, that fallback disappears. It’ll be makeup, hair, styling — all of it — every day. And I’ll be under a magnifying glass, probably even more so than the average woman in the office.

People often say you should move at your own pace, with what feels comfortable. But at some point, you have to take the leap if you ever want to get anywhere, right?

What I fear is that if I don’t make the jump now, I could delay my social transition by another 12 or even 24 months. But if I do it now, I worry that people might not accept me because I haven’t had my full FFS yet. Sigh. I honestly don’t know what to do next.

In a sense, I think Harper is stronger than I am.

Wish me luck. I am going to write another post once I came out on Wednesday.

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