David Thomas ’s transgender diary

One moment I was lying on the trolley, pulse racing, preparing for the anaesthetist to start administering the intravenous dope. And the next thing I saw was the blurry face of my surgeon, Christopher Inglefield telling me that my four-and-a-half hour facial feminisation surgery had all gone brilliantly.

I blacked out again, and when I awoke from that, it was 10pm at night and I was in my hospital room, looking like a cross between an Egyptian mummy and the Phantom of the Opera.

The top of my head was swathed in a thick compression bandage, over which went a supportive, elastifor cated ‘face-bra’, resembling a fleshcoloured version of those white, flame-retardant hoods that racing drivers wear. On top of all that came a semi-transparent face mask, through which chilled water was pumped to cool my swollen skin.

Various tubes were taking fluid away from my head, putting saline into my system and pumping jets of water into the anti-deep Vein Thrombosis devices that were wrapped around my calves.

It was a long, sleepless night: hardly surprising, given the nature of the operation and the fact I’d already been out cold for several hours. But things were about to look up.

A friend of mine, Annie Tomkins, is a former surgical nurse at St Bart’s

Hospital. She now lives a few miles from the hospital in Hertfordshire where I had the operation. In another of the acts of above-and-beyond kindness with which I have recently been blessed, Annie offered to look after me for the week after my op. This took a huge weight off my mind, given the nerve-racking prospect of getting all the way back from Herts to my home on the south coast, then being alone in a topfloor flat.

Instead, Annie has provided the expert reassurance of knowing exactly what to look for when examining the various stitches across my forehead and around my ears and the plastic splint plastered to my nose. She has monitored the 24 pills (antibiotics, anti-inflammatories and painkillers) I have to take every day. And she’s an absolute genius at providing scrummy fruit smoothies and pulped food me to consume when chewing is out of the question, because the back of my mouth is laced with stitches too.

Amidst all this pampering I have hardly felt any pain, just an occasional tugging behind my ears, where the stitches are being pulled by skin that wants to go back to where it was before. I have to sleep sitting up, which takes a bit of getting used to, but over four nights at Annie’s I have taken my kip-count from two, to five, to six hours, which is not much less than I get normally.

The bandages around my head came off at 48 hours, post-op – what a relief that was! But I’m still using a portable version of the cooling-mask machine for several hours a day, to help reduce the swelling.

I only had to feel my face to know that it must look like an over-inflated barrage balloon, or a sausage waiting to burst, so I studiously avoided mirrors for the first three days. I’d lived with my old face for so long, could I cope with the shock of a new one?

Eventually, the contortions I had to make in order to wash without catching my reflection in the bathroom mirror became too absurd to sustain. I stood before that unforgiving glass, opened my eyes and gazed upon my newly acquired countenance.

It was not a pretty sight. My face was horribly swollen, the skin tight, waxy and a jaundiced yellow; a vivid scar across my forehead; bruises around and under my eyes the colour of crushed raspberries and blackcurrants; a massive plaster stretching from one distended cheek to another, holding the nasal splint in place.

But I didn’t despair, and for this, too, I thank Annie.

When she first walked into my hospital room, she took a long careful look at me and said, ‘Those lips are amazing. I can’t believe how much difference they make. They’re so feminine. It’s a much gentler mouth, like a lipstick advert.’

Mr Inglefield also visited me the morning after the op. ‘You will look spectacular…’ he said. He paused, then added, ‘eventually’.

Now the outlines of my new appearance are gradually emerging from the fog of inflammation. And every tiny, positive change I see in the mirror takes me closer to that day.

After the operation, I avoided mirrors. I’d lived with my old face for so long, could I cope with a new one?