I Asked For This
We arrived at the hospital at 5:15 AM.
Looking back, the warning signs were already there in preop. The anesthesiologist was casual to the point of near indifference, which is never what you want from the person putting you under general anesthesia. Then the head nurse walked in with my paperwork. She had my procedure charted as a chin augmentation instead of a reduction. (No thanks, I don’t wanna look like Kirk Douglas.) Having to audit your own surgical chart from a gurney to make sure they do not do the exact opposite of what you planned to your face is unsettling. But you swallow the gut check. You tell yourself the system knows what it is doing.
The real problems started the second I woke up, still inside the operating room.
I have had gender-affirming surgeries before. Both times, I woke up in the quiet buffer of post-op. You are wrapped in warm blankets, someone is checking your vitals, and after my bottom surgery, my surgeon was standing right there with a smile to tell me how it went. This time, there was no smile. I woke up shivering on a metal table under fluorescent lights, listening to people talk over me. About me.
I get bits and pieces:
“…blood pressure spiked”
“…can’t move her”
“…the next team needs the room”
“…over 200.”
Nobody looked at me. Nobody said, Miranda, you are out of surgery and you are safe. A nurse did finally ask how I felt. I could barely get the words out past the swelling: “I can’t breathe. I’m freezing, but I’m hot. I’m scared.” They brought a second blanket, then a warming unit, then I heard muttering that they could not get my temperature up. The nurse said my pressure had spiked and they were trying to bring it down. But within seconds, voices were arguing over what to do with me. Post-op refused to take me because my vitals were unstable, while the next surgical team was outside waiting for the room. I was shivering, scared, and listening to two departments fight over who had to deal with me.
Then came the interrogation. Nurses started firing questions: Did I have a history of high blood pressure? Was I taking medication? Who was treating it? I had to explain three separate times that my blood pressure had been controlled for over a year through diet and lifestyle. My baseline reading from that morning in preop was 105 over 75, documented in the chart sitting five feet away. Yet across the room, I kept hearing the staff throw around the term “uncontrolled hypertension.” They were not treating my body’s acute shock. They were building a case to make it my fault.
Lying there in the cold, one thought kept looping through my head:
I asked for this.
They eventually rolled me out to post-op anyway, just to clear the OR. That was where I met my recovery nurse, Nurse Ratched.
She never gave me her actual name. In fact, she refused to look me in the eye. When the anesthesiologist handed off my chart, she barked at him over my body to “just tell the story.” When I told her the fighting was scaring me, she looked past me and said, “We’re not arguing, we’re discussing your condition.”
By that point, my bladder was bursting. From the moment I landed in that bay, I needed to go, but she told me there were no bathrooms and I would have to wait until I reached recovery. An hour went by while my pressure stayed dangerously high and my bladder screamed. Finally, she sighed. “I can tell you’re very uncomfortable. Would you like a bottle?”
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A urinal bottle.
I hesitated. “I don’t know.”
“What do you mean?”
“I’m a post-op transgender woman,” I said, trying to keep my voice steady. “I don’t know what I need.”
“Oh,” she said. “You were reversed down there?”
I asked for this.
In a major academic medical center in Philadelphia, you don’t expect to hear “reversed down there.” But, here we are.
A doctor finally stopped by, and while he asked the same checklist questions, he brought a pill that actually worked. My pressure came down enough to move me upstairs to step-down recovery.
The floor staff was kinder, but the institutional incompetence continued. During check-in, I elected for my post-procedure prescriptions to be sent to the hospital pharmacy. But now I was told sorry, the pharmacy closed at 8:00 PM.
“Wait, what? It was already past eight? What time is it? How long have I been here?”
And that was how I found out my estimated three-hour surgery had actually taken well over eight hours.
Nobody had told me. My surgeon never came to my bedside. Not in the OR, not in post-op, and not on the recovery floor. She never checked in to explain why a three-hour procedure took eight, or what happened on that table.
Eventually, they discharged me into the night with gauze wrapped around my head and assurances that my prescriptions would be routed elsewhere.
We got home, and my partner got me settled into bed, only to open the pharmacy bag and discover they had quietly omitted my pain medications without telling us.
At midnight, nineteen hours after we walked into that hospital at dawn, my partner started making phone calls. Exhausted, she had to spend an hour fighting hospital gatekeepers and transfer rules just to get a prescription sent to a 24-hour pharmacy so I would not spend the night suffering.
If you are a trans woman preparing for surgery, know this: the hardest part is not always the surgery, and it is not always the recovery. Sometimes the hardest part is surviving the indifference of the system itself.
Audit your charts. Speak up when something feels wrong, even when you are naked in a gown. And make sure you have someone in your corner who will fight for you when you are flat on your back, because when things go sideways, the institution will look right through you.
No matter what we chose to endure to become ourselves, none of us asked for that.
