By Isabel Terrell
“I can’t express the feeling of finally being free,” says Mac Sulyok, 20.
Mac is sitting beside a big window in a hospital office as he speaks about his upper Transition Related Surgery (TRS). According to Mac, the double mastectomy allowed him to feel more at home in his body by eliminating the need for restricting binds around his chest.
A silver chain catches the natural light as it dangles over a relaxed grey t-shirt. Full-bearded and smiling, Mac comes across as cool, confident and relaxed in his skin. Anyone who meets him can tell he feels lucky to be him.
“I remember touching this part of my chest for the first time since I was little and I immediately started crying,” says Mac. “I looked up and said ‘I can finally breathe.’”
But what many might not realize is that Mac’s been on a long journey with his body, and accepting the need to feel comfortable in his skin.
Another milestone in Mac’s transition journey is set to take place this month at Michael Garron Hospital, Toronto East Health Network (MGH). He’s partaking in lower Transition Related Surgery in the form of a hysterectomy.
‘The scariest moment in my beginning life’
“I think the first time I identified as male was in junior kindergarten,” says Mac. “In senior kindergarten I had told the first girl that I loved her.”
Mac says that was one of the “scariest moments in (his) beginning life,” because when he saw the look on his school crush’s face, he knew his experience in his body felt different than a lot of his peers.
“I didn’t know what to do with myself. I couldn’t understand why she couldn’t see that another little boy liked her. But I wasn’t,” he says.
Mac’s relationship with gender has shifted over the years. Labelled female at birth, he says he spent most of his childhood and teenage years further closeting himself, even though his gender expression was like other boys his age. He experienced bullying in school, but had a fiery spirit and always maintained friends. He loved sports and played on the boys’ teams throughout early elementary school. In high school, Mac was restricted to the girls’ teams. He says that led to further bullying.
Later in life, Mac discovered he had a hormone imbalance which helped him along his transition. At 17, he came out as Transgender and started his physical transition.
'What I looked like never matched my card:' Mac's experience in healthcare
“There’s such little representation in medical care for people like me,” says Mac.
Mac was referred to Dr. Helena Frecker, MGH obstetrician and gynecologist, to complete his upcoming surgery. He says his experience with Dr. Frecker has been one of his favourites so far.
Dr. Frecker has extensively studied the healthcare needs of gender diverse individuals, and uses her platform to make OBGYN care as inclusive and comfortable as possible. She’s also educated healthcare professionals across the country, and has been heavily involved in research and gender inclusive policy making to decrease current barriers to healthcare for members of the LGBTQ+ community.
“Pretty much any gynecologist can perform a hysterectomy,” says Dr. Frecker.
“But a lot of people refer to me because I make the point of making myself competent to provide not just the surgical care, but all of the other stuff: the positive office environment and understanding certain ways to chat with people about their health that can be more affirming, or less gendering or triggering of gender dysphoria.”
Gender Dysphoria refers to “discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics),” according to Rainbow Health Ontario. Not all gender nonconforming individuals experience gender dysphoria.
TRS is covered by OHIP as of March 2016 to align with the World Professional Association for Transgender Health internationally-accepted standards of care for Gender Dysphoria. Individuals applying for surgery funding have to meet minimum requirements for supporting assessments and hormone therapy prior to submitting a request to the Health Ministry of Ontario.
Although there are a few standout experiences, Mac says the vast majority of his experiences in clinical settings have not been positive.
“Growing up, I was very accident prone. I turned heads when I went into the emergency room because what I looked like never matched my card,” says Mac. “People aren’t always the kindest when they don’t understand.”
In the first year of his transition, Mac began hormone therapy using Lupron Depot, a medication originally designed for treating cancer, but is also commonly used by trans youth due to its ability to slow puberty and create a “clean slate,” prior to estrogen or testosterone treatment. But even that first step in his transition was challenging. Mac visited over six doctors before one could teach him the proper use and injection technique.
In photos: Mac's physical transition
Lack of knowledge about specific needs for trans individuals is just one barrier Mac and many others experience. Outside of non-inclusive health forms, and providers that dance around questions about gender, he’s had countless professionals assume his specific concerns are related to his transition--even for ailments like broken bones and the common flu.
Mac says that the adversity he, and others, face makes them feel they have to be their own advocates in healthcare and otherwise.
'Truly starting to live'
“People always push and say that being trans is a choice. If they could feel the feeling of not belonging to yourself and feeling trapped because this is the only body you’re going to get, they’d know it’s not,” says Mac.
Mac says he “truly started living” after his first TRS. The lower TRS set to take place at MGH this month will mark the next big step on his journey to becoming him.
“It is so important to love yourself, because you have to be the first person to do it.”