Foster Care to Transgender Surgery

Dr. Javad Sajan 00:00

Ever wonder what motivates people to get plastic surgery? Did they regret it? What can we learn from the stories of plastic surgery patients? We're here to explore those questions and get some answers today with my guest Gabriel on the plastic surgeon podcast.

Dr. Javad Sajan 00:31

Hello, my friends. Welcome back. And thanks to our listeners for the amazing feedback we have had so much fun so far, I look forward to more of your insights and suggestions. Please rate us and review us on Apple podcast to help us get you more awesome content. And the plastic surgeon podcast. We listened to real plastic surgery, stories of triumph and pain from real patients and providers to further understand the motivations of why they would risk their life under the knife. I'm Dr. Javad Sajan and my guest today is the wonderful, amazing Gabriel who had gender affirming surgery by me. We're here to talk to you about your journey, how we came to know each other, the procedure you underwent and how it helped affected you.

Gabriel Neuman 01:12

Thanks for having me on here today. I'm very excited to be here.

Dr. Javad Sajan 01:14

Thank you. So Gabriel is such an amazing patient. Someone who I've learned so much from, he came to me for gender affirming surgery and what we did was FTM top surgery, correct?

Gabriel Neuman 01:26

That is correct. Yeah.

Dr. Javad Sajan 01:28

And we're going to talk about that, how it went and how he got there. So, Gabriel, can you please tell us what's your gender identity?

Gabriel Neuman 01:34

My gender identity. I identify as a man. I'm a trans man.

Dr. Javad Sajan 01:39

How is gender identity different from something like gender assigned at birth?

Gabriel Neuman 01:44

So I would say that gender identity is how you relate to your place in the world. It's who you are. And I think that it's different from the way that you're assigned at birth, because when you're assigned with a sex at birth, it's based off of your bodily anatomy and with that you know, you're grown up and you're socialized in a certain way in accordance with your bodily anatomy and what you were born with. And oftentimes or sometimes that your personal expression and who you are on the inside and how you feel you are doesn't necessarily align with that. And that's where a trans folks come from.

Dr. Javad Sajan 02:25

Gabriel, how old are you now?

Gabriel Neuman 02:26

I'm 25.

Dr. Javad Sajan 02:28

When did you feel your gender assigned at birth wasn't your gender identity?

Gabriel Neuman 02:34

So the journey for me has been kind of an interesting one because I really started to have those internal thoughts and those internal conversations with myself in my adult life. Because, you know, when I was in high school and when I was a little bit younger I was going through a lot of tumultuous things with my own life. I spent, you know, four years of my high school life in foster care and so I was kind of dealing with a lot of that. And then once I moved out on my own at the age of 18, and I began going to school here in the city of Seattle and really I got the opportunity to step back and think about who am I in relation to the rest of the world. And it was that at that point where I kind of had that opportunity to breathe and really ground myself, that I realized that a lot of the things that I was doing putting on makeup, you know, doing my hair I felt like I was participating in kind of a performance.

Dr. Javad Sajan 03:39

And Gabriel, your gender assigned at birth, was it female?

Gabriel Neuman 03:43

It was female. Yeah. And I was, you know, I grew up socialized to think that I was a woman obviously, and I played that part and it wasn't until I managed to, you know, have a core friend group and feel stable with myself and stand on my own two feet that I realized that I didn't want to play that part anymore. And I wanted to be who I truly am. So you know, at the point where I graduated university and I started, you know, to start my career I realized that something needed to change. And so I really started to have those conversations.

Dr. Javad Sajan 04:24

Okay. And going back to your childhood, you were in foster care. Tell us about that.

Gabriel Neuman 04:30

Yeah. So I entered foster care the age of 14.

Dr. Javad Sajan 04:34

Why was that?

Gabriel Neuman 04:36

My mother was, so I lived with my single mother we moved up here from California when I was nine and you know, she had a lot of mental illness issues that was going on. And so my childhood was very tumultuous and abusive.

Dr. Javad Sajan 04:54

And Gabriel, I know a mental illness has a spectrum. Was it things like bipolar? Was it depression? Could you tell us a little bit?

Gabriel Neuman 05:02

Yeah. So you're absolutely right, Dr. So with her she had a lot of like psychosis issues and a lot of addiction issues that, you know, she became addicted because I think it was a form of self-medication for her, unfortunately.

Dr. Javad Sajan 05:22

What was she addicted to?

Gabriel Neuman 05:24

She was addicted to alcohol and Xanax.

Dr. Javad Sajan 05:27

Okay. How would you get the Xanax from doctors or

Gabriel Neuman 05:29

From doctors. Yeah. Yeah. So ultimately I-

Dr. Javad Sajan 05:35

Was she hitting you?

Gabriel Neuman 05:36

She was, yeah.

Dr. Javad Sajan 05:38

Was it just physical? Was it burning? Was it belt? Tell us.

Gabriel Neuman 05:42

Yeah, so it was physical. It was belts. It was with her you know, it was just physical as well. So it, you know, it wasn't the best, but-

Dr. Javad Sajan 05:57

And when that happened, was it because you acted up or she just became mad and started taking it out on you for no reason?

Gabriel Neuman 06:03

It was for no reason. She you know, that was kind of her, I think, way of control, because I don't think that she had a lot of control over herself in the other parts of her life. And I think that that was the way that she was able to regain that, unfortunately.

Dr. Javad Sajan 06:19

So at home for no reason she would just get up and start meeting you.

Gabriel Neuman 06:24

Yeah.

Dr. Javad Sajan 06:25

Do you remember how old you were when this started?

Gabriel Neuman 06:27

Oh, it started when I was very, very young. Yeah. Like, I don't remember when that didn't happen.

Dr. Javad Sajan 06:35

Now, would you say this was like a spanking or was it more intense than that is so like, could you tell us a little bit?

Gabriel Neuman 06:41

Yeah, it was definitely more intense than that. It was more like hair pulling, stuff like that.

Dr. Javad Sajan 06:49

Okay. Did she ever burn you?

Gabriel Neuman 06:52

No.

New Gabriel Neuman 06:53

Was she hit you with the belt and other objects?

Gabriel Neuman 06:55

Yes.

Dr. Javad Sajan 06:56

And then, so that went on for how many years?

Gabriel Neuman 06:59

Until the age of 14 when Iit just got to the point where I think like somehow it got on CPS radar and they eventually just took me away. And I ended up living with one foster family for the duration of my stay in foster care, which is a very rare occurrence for foster youth. Most of them traveled between numerous homes throughout their stay.

Dr. Javad Sajan 07:28

So, did you say you didn't call CPS, was it a family or friend, or you have no idea how it got there?

Gabriel Neuman 07:33

So I didn't call CPS. She actually got to this, went through this phase where she would like call the cops on me for doing literally anything, you know, for like leaving a paper towel on the counter or something. And so I kind of leaned into that a little bit and you know, I just didn't listen to her. And because I knew at that point that I wanted to enter foster care. Like I knew that I needed to kind of get out of that situation. And this was the only way for me to do that. And so you know, when she would do that, when she would call the cops, I would explain to them what was going on. And eventually they took heat and separated me from her.

Dr. Javad Sajan 08:12

And your first foster family was one year, you said?

Gabriel Neuman 08:16

No. So they I stayed with them for all four years.

Dr. Javad Sajan 08:19

Oh, wow.

Gabriel Neuman 08:20

Yeah. Yeah.

Dr. Javad Sajan 08:21

How were they?

Gabriel Neuman 08:22

They were great. They were very supportive of me. They were a very kind of just stable, traditional household.

Dr. Javad Sajan 08:32

Did they have their own biological children?

Gabriel Neuman 08:35

They did. They were all grown up. But they were come and visit occasionally and I had a good relationship with them and then I was their first foster child. So it was definitely kind of a learning experience for the both of us. Yeah.

Dr. Javad Sajan 08:47

Why did that family foster?

Gabriel Neuman 08:49

They fostered because my foster mother her mother was not a foster mom, but she was kind of the mother hen of the neighborhood. And she would have a lot of neighborhood kids over who, you know, couldn't afford dinner, you know, or needed a place to stay during tumultuous times in their life. And she just really wanted to play forward and provide that for youth as well.

Dr. Javad Sajan 09:11

Did you feel a part of the family or did you ever feel a strange?

Gabriel Neuman 09:15

I did feel part of the family. Yeah, I think there were a couple of instances in which we both had to learn from each other and we both had to kind of settle into each other's needs and lives because we did live different lives, you know? But we made it work.

Dr. Javad Sajan 09:33

Could you give me an example if you're not comfortable? It's okay.

Gabriel Neuman 09:35

Yeah, no, certainly. I think that one thing is that my mother was very she was very liberal. She was very kind of as free spirit vibe and they were very you know, traditional American Christian family a little bit more on the conservative side and so kind of just generally adjusting into the nuclear family environment for me was not something I'd experienced before. It was something that I watched on TV. So kind of adjusting into that environment was you know, it was hard and like going to, you know, going to church and stuff was like a very new experience. But you know, we both wanted to make it work, so-

Dr. Javad Sajan 10:19

That's awesome.

Gabriel Neuman 10:19

Yeah.

Dr. Javad Sajan 10:20

Was there any abuse there?

Gabriel Neuman 10:22

No.

Dr. Javad Sajan 10:23

Those four years, do you find there were, I don't want to use the word better, but more comfortable for you than the other years.

Gabriel Neuman 10:31

They were certainly. Yeah. And I think that as it relates to my trans experience you know, I spent those four years just learning how to be a person in general and kind of playing catch up in a way and just readjusting. And so that, I think is part of why it took me until you know, my adulthood to figure out kind of the trans element as well,

Dr. Javad Sajan 10:58

During those four years you completed high school, correct?

Gabriel Neuman 11:00

I did it. Yeah.

Dr. Javad Sajan 11:01

How was that journey?

Gabriel Neuman 11:02

It was good. I always knew that, you know, I wanted to go to high school. I wanted to go to college. And, you know, I really kind of dove into academics before, prior to going to high school and prior to living with my foster family despite knowing that I wanted to go to college, it was just difficult for me to pay attention and to really engage in school because of everything else that was going on. So when I lived in with my foster family, I was able to do that and I was able to you know, participate in extracurriculars. And I really found my love of joining the debate team. And I've been in the debate community for like 13 years now.

Dr. Javad Sajan 11:43

That's awesome.

Gabriel Neuman 11:44

Yeah.

Dr. Javad Sajan 11:45

Did you play sports at all?

Gabriel Neuman 11:47

I didn't play sports. It actually took me until transitioning and being comfortable, with my body to realize that I actually do enjoy physical activity. But before that, I did not.

Dr. Javad Sajan 11:59

Did you build a group of friends in high school?

Gabriel Neuman 12:02

I did actually. Yeah, one of my best friends from middle school and high school continues to be in my life now. And they have also come out as a non-binary trans mask and they're also on their way to getting top surgery as well.

Dr. Javad Sajan 12:17

So, Gabriel, when you say your friend was non-binary trans mask, that sort of doesn't seem to come together. Can you explain to me what you mean by that?

Gabriel Neuman 12:26

Certainly. So a non-binary trans mask basically is the idea that they don't identify with the label male or female, but they identify outside of that binary, however, despite being born assigned female at birth. So with a female at birth anatomy they lean more masculine, so they feel better taking testosterone and, you know, reaping the benefits of the transition that way. And they feel more, they feel better with, you know, or will feel better with a masculine chest. So their body is aligned more masculine. However, they don't feel that the, the gender label of a man suits them either.

Dr. Javad Sajan 13:11

How did high school finished for you?

Gabriel Neuman 13:13

High school finished well, I graduated with honors. I ended up you know, getting accepted into Seattle university with a full scholarship, so-

Dr. Javad Sajan 13:21

That's awesome. Congrats on that.

Gabriel Neuman 13:23

Thank you.

Dr. Javad Sajan 13:24

What was your major?

Gabriel Neuman 13:25

I had two majors. I majored in political science and public affairs.

Dr. Javad Sajan 13:29

What did you want to do when you were in high school for your career? What were you thinking?

Gabriel Neuman 13:34

I wanted to get into politics. I wanted to you know, become an attorney and get involved in the legislative process that way and I really wanted to advocate for child welfare because of my experience in foster care.

Dr. Javad Sajan 13:49

When you do start feeling that being female, wasn't your gender identity? Was it in high school?

Gabriel Neuman 13:56

So it was a very slow kind of trajectory for me a lot of people realize they're trans at a very young age and a lot of people don't. For me it was kind of like putting the pieces of a puzzle together where one of the earliest signs of trans folks call their in congruency with their body dysphoria. And the first instance of dysphoria I felt was that I was just not comfortable with my breasts and I was not comfortable with getting my period. And I know-

Dr. Javad Sajan 14:30

When was this?

Gabriel Neuman 14:31

That was when I was in high school but I didn't know why, because in health class and in conversations with people, no one talked about the trans experience. You know, I really only knew of, of trans men, like from Chaz Bono, you know? And so I just, I had this feeling, but I didn't know what it was and it wasn't until-

Dr. Javad Sajan 14:54

Did you have any gender affirming education in high school?

Gabriel Neuman 14:57

No. None at all.

Dr. Javad Sajan 14:58

Anybody transitioning into high school that you knew of?

Gabriel Neuman 15:03

No.

Dr. Javad Sajan 15:05

Do you mind sharing what those, which high school it was?

Gabriel Neuman 15:07

North Kitsap high school.

Dr. Javad Sajan 15:08

Okay.

Gabriel Neuman 15:08

Yeah. So our health class was very you know, abstinent based and CIS normative. So none of that. So it wasn't until actually that I graduated college and through college that that feeling in that in congruency just continued and continued. And I experimented a lot with my physical presentation in terms of what outfits I wore and you know, the types of activities I did, you know, to try and figure out what this feeling was ultimately and nothing really seemed to click until I spoke with my friend who I was in a group chat one day and I was talking about how I really liked wearing band shirts, you know, just normal t-shirts, but I don't like how my chest looked underneath them and my friend, who's a trans guy messaged me and he's like, "Hey, so I don't want to kind of step on your toes or anything, but I felt that same way too". You know, before my transition. And that sounds a lot like dysphoria. And I said, there's no way that's dysphoria. There's no way my experience is the same as yours. Like you're trans I'm not trans, you know? But that kind of planted the seed in my head. And over the months I realized like, wait a second, this is an option for me. And this is something that I am.

Dr. Javad Sajan 16:32

And before this, did you have relations with the opposite gender?

Gabriel Neuman 16:37

I did. Yeah. I was in a relationship with a straight man for six years.

Dr. Javad Sajan 16:43

And how was that?

Gabriel Neuman 16:44

It was wonderful. Yeah, he's great. He's still one of my best friends. And it was a really great, great relationship. Yeah.

Dr. Javad Sajan 16:54

Did you feel any in congruency then, or did you feel like something was wrong or not really?

Gabriel Neuman 16:59

I did. And I think that was one of the hardest things of coming out for me to where, you know, the entire duration of our relationship. And he even noticed this and brought it up independently to me. You know, I would always cover my chest. Like, I never felt comfortable with that. And more and more through the duration of our relationship. I loved him and I wanted to continue to be with him, but I felt this other calling that was telling me that in my heart you know, I'm a man and I needed to embrace that, you know, I'm in transition. And ultimately that meant leaving my relationship for six years. And we did so much work, you know, we went to therapy, we did all work to figure out a way for us to stay together, despite my feelings. And it wasn't that I came to him and said, you know, Hey, I'm trans, let's figure this out. It was, I feel this way. I feel this unease. I don't know what this means for a little while. I thought I was non binary, and you know, he walked with me down that path and eventually we decided the best thing to do was to just separate and be friends. That's amazing.

Dr. Javad Sajan 18:13

He was so supportive during your journey. I think a lot of people wouldn't find that.

Gabriel Neuman 18:17

Yeah, he is. I was texting him on my way here. He drove me to my top surgery, actually picked me up, you know, he's. Yeah, that's great.

Dr. Javad Sajan 18:23

That's great. You've had very supportive people in your life after a very rough road in the beginning.

Gabriel Neuman 18:28

I have, yeah.

Dr. Javad Sajan 18:29

Tell us what is dysphoria?

Gabriel Neuman 18:32

So dysphoria is just generally this idea that it's just this deep feeling that the way that your body is just is in congruent with how you feel. And it's a very specific feeling because a lot of people feel like I want to change this thing about my body. You know, that you're a plastic surgeon. They feel that I can't speak to how it feels for CIS people. But for me and for trans folks who feel a gender dysphoria, it's this feeling of almost like I, this thing is on me. In my instance, it was my breasts. Like these are on me and I need them off so badly. And it's just this like deep, deep feeling of just in congruency and just needing to change. And it's this, it's almost, it's so hard to translate and it's almost an unexplainable. But some folks, some trans folks don't feel dysphoria at all. And some feel immense dysphoria. It's a very kind of personal experience.

Dr. Javad Sajan 19:45

And in college, what a year were you when you started learning that you are a trans man?

Gabriel Neuman 19:51

So it was actually right after I graduated college actually that first year of 2017 was when I really started to kind of question who I am and what that means in relation to my sexuality and my gender presentation and then for a long time I thought I was just non-binary and that was what it was. But then over time I realized, and it really kicked up after I started taking testosterone that, you know, no, I'm just a man. And I had to unravel that first.

Dr. Javad Sajan 20:29

What is transitioning?

Gabriel Neuman 20:31

Transitioning looks different for a lot of different people. For me that meant changing you know, my taking different, or I meant hormonal transitioning. So I started to take testosterone actually October 1st of last year. And so now I'm one year on T and that was the biggest thing for me because my clothing and my everything else I kind of had already done, but you know, transitioning for other folks means it doesn't necessarily always mean hormonal or medically transitioning. It can mean just changing the way you dress or the way you present to the rest of the world.

Dr. Javad Sajan 21:11

Do you start with that socially transitioning first, or did you go straight to hormones?

Gabriel Neuman 21:17

I socially transitioned and then I started to dress and present a little bit more masculine beforehand. I had very long hair and I cut that about six months before I started medically transitioning and I felt that was very free. And so what that looks like for me was taking baby steps of I'm going to cut my hair and see how I feel, and I felt great. I'm going to start dressing exclusively masculine and see how I feel and that felt great. And then it turned into, I'm going to start taking testosterone and see how I feel, and that felt great. So, you know, it was kind of baby steps for me.

Dr. Javad Sajan 21:51

How did you decide to start testosterone?

Gabriel Neuman 21:56

It was because I did all of those other things first where you know, I felt this you know, my hair is long it's incongruous with this feeling that I have of who I need to be. So I'm going to change that and see how I feel and it felt great. And so all of the steps that I took were just affirming this idea that I kind of had the seedling of in my head of, I need to change something.

Dr. Javad Sajan 22:21

Were you seeing a therapist this time?

Gabriel Neuman 22:23

I started seeing a therapist in a couple months before. Yeah.

Dr. Javad Sajan 22:31

What was the therapist telling you?

Gabriel Neuman 22:33

She was telling me that, that same thing. And you know, she, she helps to contextualize it a lot for me because she contextualize it cause a lot of people, like I said earlier, feel like, or know they're trans and in a much earlier age. And so I was having this doubt of like, am I really trans? You know, since my experience is different, from what people, other people experience and she said, you know, give yourself the benefit of a doubt. You know, you had to go to high school and you had to deal with you know, in foster care, kind of that big transition. And then, you know, you had to transition into living on your own and going to college for a little while. So my brain was preoccupied with a lot of that stuff growing up and then it took that kind of period of stability for my brain to kind of realize that there are additional things that I need to get my needs met. And so she really helped with that. Yeah.

Dr. Javad Sajan 23:28

How did taking testosterone make you feel?

Gabriel Neuman 23:31

And it made me feel great? Yeah, it's a lot of the changes I wanted, you know, I wanted a lower voice. I wanted the you know, fat redistribution facial hair, still working on that one. And so I wanted those things and then, you know, over time I got them and I felt better. I, you know, I knew what I wanted, but like the feeling of actually getting it just made me feel so much better than I really could have imagined and then even just, even a lot of the stuff I didn't really predict, feels good to, like now I like working out, never would have thought that.

Dr. Javad Sajan 24:09

That's awesome. When you just started thinking about surgery?

Gabriel Neuman 24:14

I started thinking about surgery a couple of years ago when my friend was asking me like, well, you have all these feelings about your breasts. Would you consider top surgery? And at first I was like, well, you know, I had a lot of hang-ups on it, but the thing about it for me is that the reason and my connection to my breasts was because I felt like I could only be like sexually appealing to people. You know, as a woman and with the kind of traditional, like precepts of what makes women attractive right. Is that and then I realized over time that like, well, that's not the only thing that matters. And I can be attractive to people as a man without having breasts and so kind of doing that personal work really kind of solidified it. And then yeah, I would say probably about a year and a half ago is when I really made the decision that I wanted to get top surgery.

Dr. Javad Sajan 25:25

Did you start binding first?

Gabriel Neuman 25:26

I did. Yeah.

Dr. Javad Sajan 25:27

How are you binding?

Gabriel Neuman 25:28

I used a binder that I bought online but before that, even like I stopped using, I stopped wearing bras, but I would wear like these little bando things and I would wear kind of other things to minimize the appearance of my chest as much as possible. But I you know, so I did that and I've been doing that honestly since I was 18, but I didn't realize that that was why I was doing. And I thought, I just didn't like bra you know, it was and then over time I kept doing it and then I started wearing a binder and I remember that first time of putting a binder on, I saw my chest and I was like, this is what I needed. Like, this is what I want, this looks so good. You know? Yeah, so I find it for about a year and a half or a year before.

Dr. Javad Sajan 26:16

Did binding hurt?

Gabriel Neuman 26:18

Yeah, it wasn't comfortable. It really restricted my lungs. And after a long day, you know, cause I worked full-time currently, and then I'm also a part-time student in law school. And so before COVID, you know, you go straight from your work to school and that's like a 16 hour day and I don't want to wear a binder the entire time cause that's very bad for you and you shouldn't do that but I also hated the feeling of taking my binder off mid day and not having that on anymore. So, yeah, it wasn't great.

Dr. Javad Sajan 26:51

How did you first start researching about top surgery?

Gabriel Neuman 26:54

My friend had top surgery and so hearing his experience was really good. And he's actually from Chicago and he knew about you in Seattle. You know, and he let me know. And then I had, I met another friend who got top surgery from you as well. And so just kind of talking to them and hearing their experiences and their successes of surgery. And then, you know, I think just hanging out on the Instagram.

Dr. Javad Sajan 27:26

That's cool. And how did your friend in Chicago hear about me?

Gabriel Neuman 27:30

The trans community like just nationally is very connected online, you know, information travels through word of mouth. There's a lot of Facebook groups, a lot of just chat rooms on the internet you know, and so I think he heard of you from word of mouth, just down the pipeline and that's just a name that keeps popping up when people ask what are the best top surgeons.

Dr. Javad Sajan 27:55

Oh, that's awesome.

Gabriel Neuman 27:55

Yeah.

Dr. Javad Sajan 27:56

And so you did some research on different people in Seattle, I'm assuming.

Gabriel Neuman 27:59

Yeah.

Dr. Javad Sajan 28:00

And how did you decide to come to me for the consultation?

Gabriel Neuman 28:03

Truthfully one of my friends got top surgery from you four years ago and their chest looks amazing. And so I was like, all right, well, that's what I want. So-

Dr. Javad Sajan 28:15

How did you feel to take that step to schedule the consult and then come in?

Gabriel Neuman 28:19

It felt really good. Yeah. it was really scary because I wasn't really sure what to expect. And actually before you, I got a consult with a top surgeon through my insurance and his stuff mis-gendered me. And I went into the room to get my console and he's looking at my chest and he says, well, your breasts are shaped weird. So I'm not really sure what the incisions are going to look like until I get on the operating table. So we'll see how this goes. It's literally what he said. And so yeah, so I decided that, that wasn't what I wanted. And I wanted to go to a surgeon that specializes in top surgery and that puts the advertises that that is something that they do and that they're passionate about.

Dr. Javad Sajan29:10

Then you came for the consult. Did you feel my, and I want you to be honest here, did my office, mis-gender you? How was that experience?

Gabriel Neuman 29:16

No one mis-gendered me. It was a pretty seamless experience. I felt you know, your office was very professional and I think it was a pretty informational session and pretty straightforward yeah.

Dr. Javad Sajan 29:30

The consultation. I'm someone who mainly focuses on top surgery. That's my big thing. That's all I do really mostly what I do, not all I do. And so we try to really have patients understand this is their passion. This is their desire. And when you had the consultation, did you feel that.

Gabriel Neuman 29:49

I did. Yeah. I felt that you know, your office was very they answered all the questions that I had. And something else that I knew about you was that your scar treatment regime was very well-regarded among the trans community as well. And the fact that you have one and that you did the research to figure out what the best way for healing is for your patients. Also kind of indicated to me that, you know, you take your craft seriously,

Dr. Javad Sajan 30:15

Thank you. Yes. You know, for me, surgery is not an event. I really believe surgery is a process. And when you see it as an event of just doing something and saying goodbye to people, that's when I think you don't have the optimal results or have an optimal surgery, you need a team that is focused on the mission. And I believe what you believe. Although I like to think it's all me, it's not, right? From my pre-op nurse, who you met with to get you ready for surgery, to my surgical assistant, the day of, to my recovery nurse, anesthesia provider, everybody has to understand how we do what we do, why we do what we do and what are the best steps to make optimal care. And so one of the things I was realizing, what the scarring is, people are often putting their own things.

Dr. Javad Sajan 30:56

They were spending a lot of money for things that might not be as effective. So over the course of four or five years, we did a lot of research, a lot of testing. And we came up with our own formulation to give people an option it's not required, but if somebody wants something to get optimal results, that's what we offer them. And it's improved. And I think like you saw in your friend, if you look at a scar, one of my scars, two or three years out, I think it will be more faded than most people. And hopefully you've seen that.

Gabriel Neuman 31:21

I have. Yeah, certainly.

Dr. Javad Sajan 31:23

And the whole, and even that. And the other thing that we do for example, is ultrasound guided massage, all these little things that we do to make sure that not just the event, which is the day of surgery, which is a big deal, but the whole process sets you up for success.

Gabriel Neuman 31:35

Yeah, certainly.

Dr. Javad Sajan 31:36

So how will surgery day?

Gabriel Neuman 31:38

It was good. I was really excited. I kind of manically cleaned and readjusted my entire apartment in preparation. And then my friend came and stayed with me for I think four or five days afterwards to make sure that I got all my medication and everything. And Yeah.

Dr. Javad Sajan 31:56

And your caregiver, was it your person you were in a relationship with or somebody else?

Gabriel Neuman 32:00

I had a whole team, so it was my ex drove me and picked me up and took me home. And then my friend who lived in Chicago, who I spoke with or I spoke about previously who sent me that initial DM saying, "Hey, this sounds like dysphoria". He actually ended up moving out here to Seattle with some friends. And so he took care of me, post-op and it was really nice to have someone who had gone through the top surgery experience before there, you know, to help me.

Dr. Javad Sajan 32:30

During this time were you, or are you in a significant relationship with someone else?

Gabriel Neuman 32:35

No.

Dr. Javad Sajan 32:36

Have you had any since you've transitioned?

Gabriel Neuman 32:39

I have, yeah.

Dr. Javad Sajan 32:40

How has that felt different than before?

Gabriel Neuman 32:44

It's been good, it's it? So it was kind of an interesting experience dating as a man, because you, as you know, when you're socialized female, you kind of have, there is a, like societally constructed idea of the part that you play in a relationship. And so kind of reevaluating that and experiencing dating on the other side you know, has been very nice and affirming for me, but at the same time, I think because I've had that experience also you know, dating as a woman basically earliest, I thought it was just not, I've been very cognizant of not wanting to repeat the, I don't know, sometimes men are clueless and I don't want to be that way. So I've been, trying to be very cognizant about that.

Dr. Javad Sajan 33:39

Please forgive my ignorance here. But when you are looking to date or meet other people, do you look for people in the LGBTQI community or are you open to anyone?

Gabriel Neuman 33:51

Yeah, I mean, so I'm bisexual. So like personally for me I would date a woman, I would date a straight woman. And if she were to want to date a trans man you know, they don't have to be part of the LGBT community.

Dr. Javad Sajan 34:10

Would someone know that from the beginning, would you tell them, or how does that come out?

Gabriel Neuman 34:13

Yeah. I would tell them in the beginning. Yeah.

Dr. Javad Sajan 34:17

And when you're meeting people, I know during COVID things are different, but is it mainly online or is it through regular star friends, connections, parties stuff like that.

Gabriel Neuman 34:25

Yeah. So I think that online with dating apps, it's a lot easier to kind of have that I'm trans conversation. Cause you can just put it in your profile. And so you know, if I talk to a straight girl on Tinder and I have I'm trans in my profile, like I think she knows and, you know but for the most part I meet most of my friends, you know, just socially through other friends and parties and things like that. And at that point, most of my friends are in the community. And so we kind of don't really have to have that conversation, which is very nice. But yeah, I mean, I wouldn't date a straight man, obviously I would only date a buyer or a gay man. And same thing with that since in the profile, easy.

Dr. Javad Sajan 35:07

And an online apps. Do you find many SIS female assigned at birth women reaching out to you sometimes or not too much?

Gabriel Neuman 35:16

Yeah, I do. Yeah.

Dr. Javad Sajan 35:18

And how does that make you feel?

Gabriel Neuman 35:19

It's good. It feels very affirming. You know, it feels like I'm being seen for who I am. Yeah.

Dr. Javad Sajan35:25

So now I'm coming back to surgery day. We did your surgery and we did a FTM top surgery. How did that day go?

Gabriel Neuman 35:34

It was good. I was I was super nervous go rolling up. I was tired but I was excited and I just didn't really know what to expect because it'd been so long since I've had surgery. Truthfully, I was really worried about saying some weird things to my friends afterwards, I'm getting off the anesthesia. But your team was very comforting for me and helped to answer my questions and you know, I think that, your team and you helped to give me the best experience I could. They gave me a really warm blanket which was very nice at 6:00 AM. And I think it went pretty seamlessly. Yeah.

Dr. Javad Sajan 36:16

How did you feel different after surgery? Did you feel different than Ida?

Gabriel Neuman 36:20

I did. Yeah. I, Oh my gosh. I remember getting home and I slept until like seven at night and then, you know, I kind of crawled out of bed and I just felt so relieved. You know, it was, I really wanted to look at my chest and I knew I couldn't because I had the binder on. But I just knew, like, it was just like taking a breath and saying, Oh my gosh, this is finally done. You know, this is finally, I finally made it. And I, this is who I am, you know? And it was, it felt really good even the first night. You know,

Dr. Javad Sajan 36:53

How did you feel when you first looked at your chest?

Gabriel Neuman 36:56

Oh, I was elated. It was great. It was so cool. You know, it was, I've read online and I did a lot of research beforehand and a lot of people are saying, you know, there's like a period of mourning because you lost part of your body and it's just, it doesn't mean that you're you regret it or anything. It just means that you're kind of processing that. And I was ready and anticipating that. And I'm certain that happens for a lot of people and that's a very legitimate and a real process, but for me, I was just like, "heck yeah, like this is it. You know, I don't, I don't need to look back at all".

Dr. Javad Sajan 37:28

How is life different now since surgery?

Gabriel Neuman 37:30

I mean, it's great. It's been very nice to not have to bind anymore, to not have to wear that. You know, additional layer under my clothes. You know, I remember after a kind of a numbing of my chest wore off going from my first run was like a very interesting experience. Cause I didn't have it. Added weight there and drinking fluids. I can feel it go down my chest, which was not really something that I was expecting, but it's like, Oh, you know and it's just feels great to, to look at myself and feel like there's not a thing there that I don't want to be there anymore.

Dr. Javad Sajan 38:09

Now, that you've had top surgery and top surgeries, I create a chest that fits your vision for me, that could be a nonbinary chest. It could be a smaller quote-unquote female looking chest, or it could be a male chest like we did for you. Have you thought about getting more surgery or other surgeries?

Gabriel Neuman 38:28

No, I think I'm pretty fine.

Dr. Javad Sajan 38:31

Some people after their top surgery consider having other surgeries, like bottom surgery, one bottom surgery is something like phalloplasty where a penis is created. Why haven't you thought of that?

Gabriel Neuman 38:42

I the dysphoria that I feel I mean, I do have bottom dysphoria for sure, but I think that with the changes accrued through, you know, testosterone it does affect you, you know, you get what's called bottom growth. I feel sufficient there. And I feel like having additional surgery wouldn't necessarily kind of rectify any dysphoria that I currently have. And I feel like I'm pretty set where I am.

Dr. Javad Sajan 39:11

Some people talk about, you know, what many feel is a controversial topic, which is when people transitioned at an age and then they decide they want to de transition. What are your thoughts on that? And can you tell us what de transitioning is?

Gabriel Neuman 39:25

Yeah. gosh, I think de transitioning is a very personal thing. Some people stop taking testosterone and then they just kind of go back to, when you do that, your, your fat redistribution goes back to more of a traditional a fab feminine shape, hourglass shape or whatever. And then, you know, your voice kind of heightens a little bit, things like that. I mean, I think that some people just think that they want something and then they kind of get there and then they realize that actually doesn't help to rectify the incongruency that they feel with their bodies. And I think that's a very valid experience and however de transitioning only affects a very, very, very small portion of people. I think the statistics for top surgery, like I don't, I'm not Google, but I think it's like, like less than 1% of people end up regretting top surgery, and I don't ever, I don't think I'll ever get to that point, I think.

Dr. Javad Sajan 40:33

And de transitioning is when someone decides that transitioning was incorrect and they're likely going back to their gender assigned at birth, is that correct?

Gabriel Neuman 40:41

I think so. Yeah. It's that or for some people it's, you know, they consider themselves non-binary and they want to go back on their traditional hormone route for whatever reason or yeah, I mean, I think the most contemporary definition is just, you thought you were trans and then it turns out you're not, and that's fine for some people.

Dr. Javad Sajan 41:02

And when you started your journey, did you run into anyone who's done that or thought that.

Gabriel Neuman 41:07

No.

Dr. Javad Sajan 41:07

So now life's come a long way. You've had such an amazing journey, so many twists and turns and today tell us what you do now? You're in law school. Part-Time or full-time.

Gabriel Neuman 41:17

Yeah. So I worked for the GSBA the greater Seattle business association and we're the LGBTQ and allied chamber of commerce here in Washington. So I worked full time for GSBA and I really, really, really loved my job there. And then I am also a law student part-time at Seattle university school of law and the part-time program allowed me to work full-time. And so I kind of juggle both.

Dr. Javad Sajan 41:44

And full-time law school is three years. How long has part-time law school?

Gabriel Neuman41:48

It depends because you can take summer classes and all that. Typically it's four years. I might ended it in like three and a half.

Dr. Javad Sajan 41:58

And what kind of attorney do you want to become, or do you want to practice law?

Gabriel Neuman 42:03

Yeah, I really want to, I still want to focus on child welfare. I wanna focus on child welfare specifically with regards to the LGBT community, because there are a lot of areas of need for queer and trans youth. And I want to do my part and provide that representation and that support.

Dr. Javad Sajan 42:26

So in that spectrum, what is the most significant issue that you see?

Gabriel Neuman 42:32

I would say that in 40% of trans youth end up homeless and a lot of that is because trans youth they get kicked out of their homes for being trans. You know, a lot of their families just don't support their identity. And as a result, they end up on the streets a lot of times, or they end up in foster homes that might not embrace their identity. And in Washington state, if you're trans, you get placed in the foster home, that is for your assigned sex at birth. And so a lot of those youth end up getting put in situations where they're bullied or they're you know, faced with huge amounts of dysphoria. It was a result of that. And so I think that's finding, you know, finding housing solutions and support for those youth in a way that affirms their gender identity is very, very important.

Dr. Javad Sajan 43:28

That's amazing. Thank you so much for being our guest today Gabriel, I learned so much from you. Every person I have the privilege of talking to here shares a part of their life that helps me understand a part of my life better, your difficult childhood and the pain you went through, although nobody ever wants it or wants to go through with it. It seems to me, it's given you tremendous strength in your spirit and it's helped you mate, make some strong decisions. Do you think so?

Gabriel Neuman 43:55

I think so. Yeah.

Dr. Javad Sajan 43:57

I know your deal. We'll teach our listeners how and what to expect as they start their own journey through surgery. I appreciate your time and I'm honored to have you as my patient and my friend. Thanks for listening to the plastic surgeon podcast and please rate and review us on Apple podcast or hear more great content. From my live surgeries on Snapchat and my adventures throughout the week. Catch us on all social media @realdoctorseattle . See you next time.