en English

 

Holly Lorka is an ICU nurse specialising in the post operative care of transgender patients following gender confirmation surgery. She is also a writer, storyteller and standup comedian. In this episode she talks to Dr Helen and Marianne about her work in Austin, Texas and how she still can’t quite believe how everything has come together, despite all of the challenges she faced growing up gender queer. 

Links:

 

Huffington Post: https://www.huffpost.com/entry/icu-nurse-gender-confirmation-surgery_n_5f33cae2c5b6960c066ecc88
Twitter: @hollylorka
Website: https://hollylorka.com
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The GenderGP Podcast

Why I love being a Nurse to gender surgery patients – Holly Lorka

 

Hello, this is Dr Helen Webberley. Welcome to our GenderGP Podcast, where we will be discussing some of the issues affecting the trans and non-binary community in the world today, together with my co-host Marianne Oakes, a trans woman herself, and our head of therapy.

 

Dr Helen Webberley:
Okay, welcome everybody to another edition of our podcast. I am Dr Helen Webberley here with Marianne Oakes. And another really, really, really, really, really exciting guest with us today. This guest caught our eye back in August 2020, when she wrote a lovely account of her work as a nurse in her hospital. And I’m not gonna say anything more about it because I reckon she’s going to tell us a load more and it’s going to be really exciting. So really, really, really lovely to have you, Holly, Holly Lorka. I’m going to hand it over to you now just for you to say hello and who you are and what you do and fill us with lots of lovely stories.

Holly Lorka:
So, hi, I’m Holly Lorka. I live in Austin, Texas, in the US. I am a nurse in a very small hospital here in Austin, and I work in the ICU to help recover patients after their bottom surgery. The final surgery in their gender transitions, gender confirmation surgeries. So my specialty is phalloplasty, which is a bottom surgery for females to males, where we make a phallus, using either part of the arm, or part of the leg, sometimes part of the lat muscle here. So I work with them in the ICU, and they’re here in the hospital for five or six days before they go home and get to get on with the rest of their lives. I fell into this. I was an open heart nurse. I worked recovering patients after open-heart surgery for 20-something years. And four years ago, this program came to my hospital. And so I was lucky enough to just be here. And I like to say it fell in my lap, as these things do. I don’t know, but I’ve gotten to know the team really well. They’re just a great group of folks who just want to help trans people to feel whole and be able to live their lives as the people that they really are. It’s a gift. I feel like I fell into this. I myself am genderqueer. I don’t like to label myself as non-binary, or I’d like to think hybrid is a good label for me. I probably, if this surgery was available 20 years ago, I would probably have it, but I know too much about the surgery. And I also know too much about myself. Not like I like who I am now, I’ve, I’ve grown into it. And so I had top surgery about two years ago was the best thing I ever did. I dabbled in hormones. I tried T for just a little bit, but I didn’t like how it made me feel. So I’m settling here kind of in the middle, but what a gift to be able to work with these folks after me, myself, going through this and feeling alone for most of my life to get, to meet this huge population of folks with whom I have so much in common. And to get to kind of laugh and cry and tell stories while I help them recover from bottom surgery, which is difficult. It’s a really difficult surgery. It’s very painful. It’s emotionally wrought. People have to lie in bed for days and days. So I feel like my presence there makes them feel like they have an ally during this really difficult procedure. And then I’ve stayed friends with a lot of them after surgery. So I get to hear more about their stories and how they’ve done with their, their kind of new and appropriate parts in the world. So that’s what I do. And then I write silly stories, too. I wrote the story for HuffPost. I’ve written a book that comes out next month. I can’t believe this gets to be my life, to use all these things that have caused me shame or to feel like I was a monster or would not get loved, or be able to love in the way that I wanted to. And it’s all come together in this very serendipitous magical mix of this gets to me be my big cartoon life now. And I dig it, and now I get to be on things like this podcast with y’all and reach people across the pond. It’s all very exciting to me.

Dr Helen Webberley:
Wow. Well, I don’t know. I’m brimming with excitement about what to talk about. But actually, I’m going to be really fair because I know Marianne will be too. And I always do lots of talking. Marianne, what would you like to say?

Marianne Oakes:
The first question, when I realize you were doing this podcast was in my mind, was what it is like being trans in Austin? You know, I know that in the UK, we’ve got, you know, a social climate that’s not always easiest to navigate if you’re trans and I’ve just remembered, you know, a hospital in Austin of all places and why Austin is a very liberal town or? What are your thoughts on that?

Holly Lorka:
Austin is a very liberal town. However, this very liberal town exists in a very conservative state, unfortunately. So Austin in and of itself is great. And I believe trans folks are okay here in Austin, but you know, our governor—am I allowed to curse on this program?

Dr Helen Webberley:
Go for it.

Holly Lorka:
He’s an asshole, and he’s bigoted. And a few years ago we had the trans ba – He tried to pass the trans bathroom bill. I don’t know if you all have those in, in the UK. And just from my personal standpoint, I, you know, I’ve always been looked at funny in the women’s bathroom until I speak, you know, and then they realize, oh, I’m actually a girl. But suddenly the looks that I was getting in, in bathrooms, weren’t just confusion. You know, people checking the sign on the door to make sure they were in the right one. Suddenly I was getting hatred, you know, looks, people actually hating me. I’ve been called out in bathrooms. Now people have been very vocal about it, like, Hey, you’re in the wrong one. And they get very upset instead of just, you know, asking me. So I think that you know, a few years ago, it might’ve actually been easier and now there’s so much uprising against anything that’s, other than people, you know – they’ve tried to marginalize folks and, and, you know, make people afraid of anyone who’s genderqueer. And I think that they’re more vocal about that, whereas before they just didn’t understand. And now they’re polarizing folks against the trans community, and that’s unfortunate. But I think that there’s also the normalization of it as well because now we’re having stories like mine appeared on HuffPost and I got a lot of hate mail from the HuffPost. You know, they had to take it down the comment section, but people are seeing it. I want to keep driving this conversation. There are a lot of people in Austin that want to keep driving this conversation. We had a trans person run for the chamber of commerce. I believe in, and she didn’t win, but it’s starting, you know, and even in Texas, it’s starting, and that makes me happy. That’s why we have to keep doing this stuff.

Dr Helen Webberley:
Yeah. I so agree with you, Holly. I mean, it’s, it’s interesting. I’m not trans, but working with trans people makes me experience some of the hatred that you’ve just described. And, you know, I don’t understand it. Marianne and I have said, there are so many times on this podcast, we don’t understand why there’s a small proportion of people who have such hatred in their heart. But actually interesting, I was talking to Charlie Craggs recently. She’s a prominent trans activist in the UK. And she was saying, Helen, we’re never going to be able to change that, that sort of attention there. They’re the ones that want to do the hate, the ones they want to feel that way. They want to believe that way. She said, we need to be doing this work exactly how you just described it, Holly, and, you know, raising the bar, raising awareness, showing people, because there’s a whole middle ground of people who are like, I don’t know, I don’t know anything about it. So inform me. And that’s why you do what you do. And having people like you in on Huffington Post, whether they had to turn comments off or not, I think it’s so important for that. So, you know, well done and welcome, welcome to the team. It’s amazing. And I’m moving on to much happier things. I didn’t know we were going to talk about your identity, but you brought it up. So I’m going to ask you about it. If you don’t mind. Interestingly, just today, the team at GenderGP, we’re talking about—one of the people that have come through with who was nonbinary who had shared their story. And certain, many of us said, we don’t really understand it fully. It’s sometimes, it’s quite tricky to understand that as you called it the hybrid or in the middle you know, with some of the times, it’s different pronouns. And sometimes, you know, as you said, just had top surgery, but then the T didn’t suit, and that middle ground is quite confusing. I sometimes think people who haven’t experienced anyone like that before, where if I’m, if I may. So I’m really, really interested in your thoughts on that if you want to share it. Cause I know, Marianne, I learn every day from the people that we listened to. So the people listening to this would, I’m sure it would help them to understand.

Holly Lorka:
So I think that the most important thing to understand is that we’re all on our own journeys with gender, with identity, you know, in general gender or non, like our lives are completely transforming all the time. We’re figuring out more about who we are. And I think that you know, with the insurgence of trans people being visible, that there has become like, well, okay, so if you’re not comfortable being female, then you must want to be male. And I really feel like that’s not at all who I am now. Like I have grown to dig my feminine side, you know, I don’t want to like grow my hair out and curl it and all that stuff. But you know, there are parts of me that are feminine. And I don’t want to get rid of those. Like I don’t want to masculinize my voice. I don’t want a big, you know, muscular body. I’m very happy where I am, and I don’t really know how to explain it any more than I’m glad I waited. I’m glad that these options weren’t available to me when I was young because I’ve gotten a chance to enjoy kind of being both. My therapist works with me a lot on getting rid of either or mentality and, you know, embracing both and mentality and everything in my life. And I feel like, for me, the male and the female go together within me, you know like I have a nickname, Steve. And when I fix something at home or if I, you know, have a good day at the gym, I might be Steve that day. I don’t know. It’s just a nickname, but I like having that. I like having the choice, and I don’t want to disappear into a male identity. I don’t. I like being in the middle. I like making people scratch their heads. I like driving this conversation. I feel like this is what I’ve been put here to do. And I don’t want to just pass as being male. Nothing against our, our male folks, but it’s just not me. It doesn’t feel right to me. So I guess that’s the only way I can explain is that it doesn’t, it doesn’t feel right within me to jump all the way over. Nor does it feel right for me to stay in, you know, feminineville and keep my breasts and my body, which I hated, but like having top surgery cured most of my body dysphoria. You know, the fact that I can go to Nordstrom and buy a really nice tight shirt and walk around in it. And even though people stare now or when I go to the pool, and I don’t wear a shirt, and people stare, I I’m so much more comfortable having them stare at me for that than if they were to stare at me for any other reason. So I’ve just found a comfort level here, and it may change. That’s another thing I’ve learned is my feelings might change. You know, I’m really happy that I tried T cause I feel that was a really good litmus for me to decide, you know, I don’t want to, this is not who I want to be. You, my voice dropped just a little bit. My libido increased, I got a lot more aggressive, and I know that those things kind of dissipate when you get through them, but I didn’t want to, I didn’t want to mess around with those things at all. That wasn’t comfortable for me.

Marianne Oakes:
I think Helen will agree with me. A lot of our patients, we take the approach that sometimes we’ve got to try hormones to know whether they’re right for us. I don’t think you can ever know without trying. And some, for some patients, it may be that it’s right, but it’s not the right time. And I say we can change as we get older. You know this idea that gender is fixed is as crazy as to suggest that it’s binary or unique. And if we did a bit of exploration, that we probably never get to the end of it. It just keeps evolving as we grow.

Holly Lorka:
I agree completely with that. And that was a big day for me, was to embrace the fact that this is a journey. This is there’s no endpoint to this. And to allow myself to be open to the possibility of changing my mind. Or if, you know things changing for me. And that was very freeing. You know, you spend so much of your life, and I don’t know if your experience was this, but you know, you, you, you go to bed at night, and you pray when you’re a child that you will wake up as the right thing. And you know, you’ll just, you’re just hoping, hoping that you can be okay. You’re hoping that you can be the way that you want to be, but do we ever really know the endpoint of who we want to be? And I think this is a great point. Um but I think it’s, it’s a scary point because then I don’t want people to use it as the argument as we should make children wait until, you know, we start hormones or hormone blockers or schedule surgeries. Because I think for some kids, they know 100% that they want to be male or they want to be female, and we should move 100% in that direction rapidly with these people. So I think it’s just, it’s careful, it’s a careful conversation to have, and I’m always very wary about having it because I don’t want to sway people from allowing children to do what they need to do.

Dr Helen Webberley:
But actually isn’t it that the important thing is that exploration and that journey. And the message is, you know, if you want to try the different hormone, the other hormone to the one that your body produces, we’ll try it. But if you don’t like it, if it’s not for you, we’ll stop it again. And then we’ll see what, see what the birth hormone feels like again. And then if in six months, a year, two years, 10 years, we want to try it again. There’s no problem with that. And I think the things that you have said, Holly, in the last 10 minutes or so things like feeling comfortable, feeling happy. And it doesn’t matter whether you’re CIS or trans or a hybrid or something in the middle or whatever, isn’t that what we all want to do? We want to feel comfortable in our hearts, in our families, in our bodies, in our loving relationships. And we want to be happy. That’s just what we want to do. Nevermind. I’m not actually we try and loads of different things to make ourselves happy, youngsters and older people to make ourselves happy. And that’s just everybody.

Holly Lorka:
Yeah, I think that maybe if we could de-stigmatize or, you know, more normalize the fact that we’re just like, it’s not that big a deal. We’re just trying to feel happy. We’re just trying to find out what makes us feel good, just like everybody else’s with everything. I think that’s a really good way to look at this and it doesn’t have to have anything to do with the Bible, y’all.

Dr Helen Webberley:
Absolutely, there are so many different influences, aren’t there, Marianne?

Marianne Oakes:
I was going to say I do relate to that, you know, going to bed at night praying that something would happen, we would wake up different. And that’s a story that I hear all the time from –

Holly Lorka:
Universal 100%.

Marianne Oakes:
Across all generations, one of the things, and I was just listening to you, and it just brought it to my mind for anyone that’s not questioning their agenda. They can get up in the morning, they can go to their wardrobe, and they can pick a jumper or something that’s going to make them feel good about themselves that day without thinking about their gender. People who are questioning their gender to whatever degree we go to that wardrobe. And it’s a battle, and we’re pulling on a costume to get us through the day and survive the day. We’re not just being. And I think listening to you describe, I’m imagining that whether it’s Steve’s side of the wardrobe or Holly’s side, it doesn’t matter. You just have a wardrobe, and it will be right that day. And actually, isn’t that just a privilege that we should all be able to experience?

Holly Lorka:
Yeah. The fact that we even have to talk about it as it being, you know, something. Yeah just buy, whatever clothes you want, put on, whatever you want all the time.

Marianne Oakes:
I’ve got a theory I have to say, and I’m probably wrong. Then we’ll get shouted out when some people listen to this, but I genuinely think there are people out there that are jealous that some people are comfortable enough to have explored and got to that place where they are not wearing that facade. And because you know that a lot of the people around us are wearing a facade of some kind. And I do, you know, there is just a little part of me thinks know, why would you hate? Why is there so much bile in your tone? And I can only imagine it’s coming from a place. I don’t know, jealousy, envy.

Holly Lorka:
If you’re strong enough to do these things. I mean, imagine the other things that we’ve all had to deal with and thought about and handled, you know like this is the big major one, but I mean, I feel so free in all of my life now to be who I am, you know, that I can just get up on HuffPost and write this thing and have my name attached to it. And I don’t give a shit like this is – I’ve already done the hardest thing that I could possibly do, you know, which is – look at this. The rest of the stuff is not that it’s not that hard. So

Dr Helen Webberley:
Again, both of you that I’ve mentioned that word, bravery, isn’t it. And you know, it is very brave. And we see that a lot from people who come to GenderGP when they’re thinking about taking some steps to change their life in some way, change their social interactions, change their external presentation, change their internal chemistry. Those are very brave steps to take. So, you know, and, and both of you have there, separately, have mentioned that brave word and fighting to be happy or fighting to be accepted, fighting to feel comfortable. Even in the face of adversity is brave. And you know, we have to recognize that. So, so hats off and high five to all those people, who’ve been brave enough to step forward to find that comfort in the face of difficulty. But Holly, so I want to just say to you, because you, again, you both talked about the going to bed and praying that in the morning, something will be different. So you indeed in your job get the absolute delight of when somebody wakes up, they have that that their prayer has been answered and they have something different. And you know, I’m actually absolutely up for, I’ve gone goosey all over me. And like I was standing on my head because just the thought of all those people who were assigned female at birth, and the number of times we’ve heard, what did they ask for for Christmas? All they want is a willy, when is my willy going to grow? And, you know, to be part of that journey of somebody when their willy grows quite quickly in the course of that operation must be so exciting. Tell us about it.

Holly Lorka:
Oh, it really is exciting. I have had so many patients cry, you know, when I pull the covers because I always say, congratulations, do you want to see it? And I mean, it’s always yes. And a lot of the other nurses don’t do that. And I always want to say, don’t you understand what just happened? Like we just made a willy, whatever. But yeah, I always say congratulations and their faces and their whole beings light up, and they break down, and they’ve suddenly gotten the one thing that they wanted their entire lives. So then I say, do you want to measure it? And I go and get the tape measure out because who doesn’t want to measure their willy? It’s really moving. And I try not to let it get lost on me. I try not to let it get old because it’s new for each person like today we’re having a vaginoplasty come out of the OR, and so I I’m in charge today. I’m not taking care of patients, but I’m going to make it a point to go in there and make a big deal out of it. Because I think sometimes the nurses forget to do that or don’t do that. And it’s like their birthday, you know, they suddenly get what they want. And I can’t believe that I get to be at the end of this. It’s just this journey of my life, the way that it’s folded upon itself and, you know, come around full circle. Suddenly I get to help people with this and, and be there on the first day that they see their new parts is crazy. Yeah, it’s never lost on me.

Marianne Oakes:
When I read the article, you were talking about it and how you, you know, you are with the patients. The one thing I can say, I’m going off my own experience. You know, when we go through this journey, those closest to us are actually in pain. We’re going through something, we’re gaining something, and they’re losing something that, Oh, that’s, that’s the perception. And I can only imagine there’s a lot of people waking up from that surgery that have got nobody to high five, nobody to celebrate with and to have a nurse there that say being congratulatory and, you know, making a big deal of it. I just think that’s invaluable. I’m sure there is a lot of loneliness waking up after the operation. So I thought that was fantastic.

Holly Lorka:
Thanks. And I think that also now with COVID we aren’t allowing visitors on our hospital, but also people are truly alone. When they wake up, and they’ll be alone, their entire hospitalization here. Yeah, I feel like I serendipitously get to offer a friendly face, an ally, someone to make them feel safe and seen. And I’m so happy that I get to be the one to be there.

Dr Helen Webberley:
I think you’ll, you still have, I’m imagining that there are some patients who are really, really happy to have a nurse like you. You you know, I’m a doctor I’ve worked with lots of nurses, and a good doctor or a good nurse is such a valuable commodity, isn’t it? And clearly, you have so much heart and passion for your patients.

Holly Lorka:
Well, and I’m stupid too. Like I just crack really bad jokes. And I mean, so when, when we first as a hospital found out that we’re going to do this, everybody got this real serious, like go this, we need to be very serious and very professional. And, you know, and you know, three weeks into it, we’re all cracking dick jokes. And it’s like, I’m ridiculous, but the laughter helps to calm people down, and it helps them to feel safe and to not feel afraid. And so I feel like me, and my ridiculousness has helped even more with this. I mean, regardless of my gender queerness you know, my being an ally for them, I’m also ridiculous and funny. And I feel like that just really helps. That’s been an invaluable tool in my entire nursing career, but specifically with this, because I can make the jokes, but somebody else won’t feel comfortable making, but that we get. We genderqueer folks get. And I just feel like that’s just, all of this has been such a gift to me.

Dr Helen Webberley:
Your patients are very, very lucky to have you. In terms of, you know, people, people who are still, let’s call them people who are still learning about gender and gender affirmation therapy, or hormones or surgery, sometimes they will say that that is such a big thing to do to your body. Your body wasn’t made that way. Why would you go through that and put yourself in those risks if this is irreversible? So you’ve seen those two people that you mentioned that you make, you go from, make friends with them and kept in touch. You know, how many times have you seen regrets or oops, or I shouldn’t have done that. What was that always the experience different to that?

Holly Lorka:
I have seen, the only regret I’ve seen is that people didn’t realize how painful or involved or frustrating the recovery is after this, but I’ve never heard anyone regret having it done, not even one time, not even when there was a complication when things didn’t go like they thought it was going to go. I, 100% of the time, have heard that they are very happy that they did it. I think by the time people get to this stage, I mean, they know that they’ll have no regrets, which is why they’re comfortable doing this. Um you know, I often say that it’s such an important surgery that people that’s all they think about, you know, once they find out that this is available, their entire lives become about it. I mean, that’s how important it is. So, of course, they’re not going to have regret. It’s like they have planned their entire lives to have this, you know? So I always say, I ask people, how long have you been planning this? And what I always mean is how long have you been trying to schedule it? But it’s always, however many years they’ve been alive is the answer to the question. I should not answer that. Ask that question anymore. I’m so no, no regrets. People know they want this, you know, it’s what, it’s what makes them correct human beings.

Marianne Oakes:
I always get a sense, you know, the lives have been leading up to this moment. You know, if, if by the time you lay on that trolley being wheeled down for surgery you haven’t gone through the process. You can, you know, they’d climb off it. Nobody’s going to put themselves through that surgery. If they’re not prepared for it, you just, you’re not strapping people to the trolley and forcing them down there, are you?

Holly Lorka:
No, we’re not. No. you know, this brings up something can, can I talk about something different that has surprised me is so being in the way that I am, like I wanted a willy my entire life as I’ve struggled with that, whatever, it’s still hard sometimes, but so taking care of the phalloplasties, the female and male patient piece of cake for me. Right. Get it. I understand. But when I started taking care of the vaginoplasties and find out that they had their willies, you know, not cut off but changed. And the, or I had to deal with some feelings about that, like to understand that it was as important for that population to take their willies off, basically as it was for the other population to get a willy. And that really surprised me. I had to really sit down and think, wow, Holly, you need to understand what’s happening here. So that was hugely educational for me. And I learned a whole lot about myself now. I got it. Now, now I would say, what if we could just all change parts? You know? Yeah.

Marianne Oakes:
It’s the same for me when I’m doing the surgery and referrals for top surgery, you know, to hear somebody’s utter disgust for the chest yeah. My craving, you know, to have a chest, it does flip everything on its head. The one thing I’ve learned is that as much as my dysphoria is driving me to want that chest, their dysphoria for them is driving them to be rid of it. And the feelings are very similar, and the significance of a chest art of, you know, vagina or a penis is massive to a trans person. And you can’t, you know, whichever direction you travel in, the parallels, are there the feelings that drivers to be searching out, the surgeries are equal. But yeah, I do sometimes recoil, thinking really?

Holly Lorka:
Right.

Marianne Oakes:
But then, you know, that’s what makes us unique. You know, we’ve got our own journeys to go our own explorations, and we all go as far or as not so far as we decide.

Holly Lorka:
Right.

Dr Helen Webberley:
I think for me, what you’ve been talking about there, Holly, what you were talking about a few minutes ago when you were describing, you know, addressing your own feelings about what the patients wanted. And that’s such an important thing, isn’t it? For any healthcare professional that might be listening to this podcast, you will all have personal feeling s and emotions about the patient in front of you, whether they are a heart patient or trans patient, you’re going to have feelings about it. And it’s never, never more important than with something like transgender identity, which, which that person might not understand about, to have a look inside at your own feelings. What are you feeling? What are your emotions? And do you need to take some time out to address those so that you can give your patient the best care? And I think that’s so important, isn’t it? And the other thing is that I wanted to say is, let’s go back to those assessments. You know, Marianne love your imagery of strapping the patient to the trolleys, going down to the operating theatre, forcing that into their arms and give them the anaesthetic and making them have the operation. It’s just not like that, is it? We see this kind of criteria. You must have two extremely detailed letters, which must contain this, that, and the other. And you have to convince me that this patient wants, then it’s like, hello, why didn’t you ask patients? Why don’t you sit down with a surgeon? Why don’t you sit down with this patient and ask them, how long have they been wanting the surgery? Yes, they are sure they’ve been thinking about it. As you say, since the minute they knew it was in existence, you know, so these we’ve talked Holly Marina, Marianne, and I was always talking about assessments and how in many ways degrading they are, but this is another one we haven’t talked about, you know, that the number of assessments and the detail that people have to go into to convince a surgeon to, to do what they, that patient is desperate to have done.

Holly Lorka:
Yeah. And, you know, with my top surgery, I don’t know that my surgeons had performed top surgery on someone who was not transitioning all the way, who was not changing, you know, identity markers not changing birth certificate. So I think that was a new one for them. I had to have one letter, no big deal. But yeah, I wish we could change that. Like why do we have to jump through so many hoops? Like, aren’t my own feelings enough to justify what I want to have done? And if you can’t trust me, the patient you’re working on, to tell you what I want done. Like, what are we saying about people’s own personal feelings? You know, why is a psychologist or psychiatrist more qualified to tell you how I feel about myself? And I am. Those are great questions.

Dr Helen Webberley:
And Marianne, You’re lucky enough that you get, because you have to have these letters. Marianne is really lucky because she does the assessments. So she gets to talk to the people who are on their way to your operating theatre. You know, I feel really lucky for Marianne, but she gets that pleasure and privilege. But not so much the patients. Marianne?

Marianne Oakes:
I was just going to say a little bit like you, Holly, when you come for an assessment or referral letter with me that this they’re always surprised how I just approach it. It’s all about rapport, getting them to talk. It’s a conversation, I pick up, a feeling from them. And I kind of make it clear. I’m not making this decision. You’re going to make this decision. I’m going to support your decision. That’s what this conversation is going to be about. And I think what rights does anybody have to tell you that they know you better than you know yourself? And I don’t know, I don’t make light of it. The weight of the responsibility is on my shoulders. Don’t miss on this, but I do not pass that way on to them. I try to make it as informal a conversation that they can have it. I just don’t, I’m humbled that they have to come to me and a bit, like Helen has said, yeah, it is a privilege that I have, which is, it’s a privilege I would forfeit to, if the surgeons would just believe them.

Holly Lorka:
Well, liabilities and such right. Lawyers, it’s all because of a lawyer.

Marianne Oakes:
Yeah. Yeah. I can’t, I also have to say, I have a little bit of empathy, you know, if I was a surgeon, I’m going to cut somebody off, and you know, do something that there is a little part of me thinks, can we be doubly sure? You know, because I’m going to be performing life changing surgery. So I kind of get it, but I think it’s, I think the—certainly, in the UK, some of the surgeons are just too, too, over the top with that.

Dr Helen Webberley:
And I think that, again, it’s the discrepancy between what happens to you if you’re an assistant, a person wanting chest surgery, or if you’re a transgender person wanting chest surgery and that inequality is just, it’s just not fair. And what we should be doing, I feel, is spending our time working with that patient on the rest of the journey, the journey after the surgery. How, what do you think it’s going to look like? Is your perception of what it’s going to look like anew in the world, will that change? Is it the same as reality or what us as professionals experience of other people who’ve been through that? Because that’s the knowledge that we have is so many people before, during and after surgery. And I wish that that’s the kind of thing that we were able to spend our time doing, rather than validating gender again, you know,

Marianne Oakes:
To be fair as well, Helen, we we know that actually, the emotional support is probably more important than the medical support at times. And there’s so much time, and effort put into looking after the medical side of it, that a lot of patients haven’t got the money then to support themselves with the emotional side. And certainly again, in the UK, you know, some of the services that they access that are private, so expensive, and it’s all about medical treatment that there’s very little money left to look after themselves emotionally. And that’s the shame. And what you said about staying friends with some of the patients. I think that’s great because that’s the emotional support that they need, isn’t it?

Holly Lorka:
Well, I don’t know how much emotional support I am again, but yeah, I think that all of the internet, like the groups and the that is incredibly helpful, the I mean, I have so many of my patients in message groups. And so they all know that I’m going to be at the other end when they wake up. Cause they’ve all been, you know, blogging and messaging and whatever. But I think that those things are hugely supportive. And yeah, if I can be a part of that, and especially if they see me as an ally, like putting things on Huffington Post or writing a book, then I feel like it, it just helps make the network even bigger for everyone, you know,

Marianne Oakes:
I’m going to go backwards a little bit here, so I apologize. But you said something before, and I recoiled a bit when you said it, cause you said when you went for your surgery, that it was an anomaly that the surgeons weren’t used to somebody that wasn’t going the full distance or, you know, fully transitioning. And I recoil because I just think that is full for you, isn’t it? That’s your journey. And it’s interesting how other people see that. But straight to, (unclear 35:30. That is your journey. That is full. If that is where you’re wanting to be, then, then there’s no other, there’s no continuation to the next station at this moment in time.

Holly Lorka:
You know, it was a little strange because my friends that I have at work, I’ve, we’ve all worked together for a very long time when the surgery has started happening here, all of a sudden they were looking to me and saying, you know, like, when are you having your surgery? And I had to say stop. And especially after I had my top surgery, then they’re like, well, when are you scheduling your bottom surgery? Well, let’s all take a minute here. And maybe we can have a talk about how this actually is versus what you have in your head. This is my thing, is I can charm people into talking to me or put myself in the right place at the right time to having these conversations. And I really, I feel like it’s just my job to help people understand that it’s not either, or it’s not, you don’t have to be one or the other, you know, you don’t have to pick. So even if I can help the surgeons that they’re better now, they got it. You know, they’re fast learners.

Dr Helen Webberley:
You’ve taught them. We’ve seen that happen. You’ll just have to listen, we’ll teach you. Tell us about your book, Holly. What did you want to write about?

Holly Lorka:
I have a book coming out next month called Handsome. I’ve been writing stories since I was young enough to hold a pencil and a piece of paper. And I finally put enough of these stories together to get a book together. And it all kind of came together right around the time when I started helping with these surgeries. And so the last few stories in the book are all about my gender journey and about how serendipitously it’s kind of come to pass here. So there are stories about me just not fitting in the world. I mean, I’ve been an awkward human, my entire life, gender, notwithstanding. And so it’s a book about trying to understand my place in the world with no, you know, we don’t get a map, we don’t get an instruction manual, and I grew up in the seventies. So there weren’t really even any talks about being genderqueer, having gender issues. So they’re just stories of me trying to figure out where I fit in and how I fit in. And they’re geared—I wanted to reach an audience that was not LGBTQ. I just, I wanted it to be for the general public. I kind of charmed people in by putting a few funny stories upfront before I start to launch into more of the serious stuff. And because I want people to know me as an entire human being. It’s not just my gender struggles that make me who I am. So that is my book. You know, it’s, my voice is strong and I talk about sex a lot. I feel like it’s important for us to be honest about sex. I talk about how we all learned about sex by reading like 50 shades of Grey, or Judy Bloom or things that weren’t correct. You know, romance, novels, those aren’t actual stories about what it’s like to discover your sex and your sexuality. It’s mostly awkward fumbling, feeling that you’re gross or you’re, you’re not right. You know, even cis folks. So I feel like it’s just an honest discussion about who I am in the world. And people have told me that they can relate to it because it makes them feel not alone that like everyone experiences, shame, self-loathing. And so it’s the story of how I came to love myself, kind of handling all of this. I feel like it’s really timely right now. It just is coming out at, at just the right time. So I’m really hopeful that it will drive this discussion of gender that it’s not, you know, black and white, there are all kinds of stories in the middle, and also it’s not scary. You know, if it doesn’t have to be scary to the general public, we’re all just folks who perhaps suffered a birth defect. I don’t know what everyone else’s thoughts are on that, but I think my hormones got messed up, you know? And so my biological presentation is not what it was supposed to have been or is it? I don’t know. I mean, was this program from the beginning for this to be my struggle, to have these conversations and write a book all of these questions. But I just want to, you know, let’s just normalize this. This is just a thing that happens, you know, it’s just a thing that happens that we’re all trying to handle and it doesn’t need to be scary or polarizing or against religion or, I mean, who thought that went up anyway?

Dr Helen Webberley:
Yeah, absolutely. Well, I’m very excited about reading your book, and certainly, we will put a link underneath the podcast.

Holly Lorka:
Thank you.

Dr Helen Webberley:
To help anybody who would love to learn, and that’s what it’s about. And, and I love the idea of just normalizing this. I don’t like the word defect because I don’t see you what I’m looking at here, a lovely image in front of me as defective in any way. But I am quite liking the idea that maybe, you know, this was the raison d’etre, this was for you to maybe help people. And that’s what health care professionals are here to do, you know, that’s our vacation. So if your gender has helped you as a nurse in your profession and in your, and as your work and your writing, as well—if you were put here to do that, then it sounds to me like you’ve done a really amazing job.

Holly Lorka:
I try. You know, I feel like I’ve been given this great bag of beautiful things. So I’m just trying to make the best of it right now. I’m just trying to maximize what I can do. And it makes me feel so good to feel like I’ve reached people. And when I’m, I’m having some advanced copies come back with reviews right now, and it’s always the same thing. I would never have picked this book up. It’s not something that I would gravitate toward reading, but God, I’m really glad I did because I kind of understand a little bit more about what this is about. And that by far is the best response that I could ever get.

Dr Helen Webberley:
Absolutely. Well, I want to thank you personally, from myself, from Marianne, from anybody listening here. Thank you so much for joining us from all the way over in Texas. It sounds like you’ve had an amazing career and thank you for sharing your own journey and, and those that you’ve, you’ve helped them with us today. And really, you know, all the best for everything that you do. And thank you for joining us today.

Holly Lorka:
Well, thank you. Thanks for having me. And I really appreciate the work that you all are doing as well. And I will continue to watch and listen to you guys over there across the pond. Now, if you’ll excuse me, I have to go see about a new vagina.

Dr Helen Webberley:
Lovely to speak with you. Thanks so much.

Marianne Oakes:
Bye-bye.

Holly Lorka:
Thank you. Bye-bye.

 

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