Mother’s Support Guides Transgender Man Through Gender Affirmation Surgery

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Melissa Gonzalez with her son Izek

Melissa Gonzalez watches with pride as the daughter she gave birth to two decades ago becomes a man.

A mother’s love, the transgender community’s support and University Hospitals’ expertise will help Izek Gonzalez realize his full potential – and happiness – when he becomes one of the first transgender men in Ohio to complete a three-stage gender affirmation surgery, transitioning from a woman to a man.

“I always knew he wasn’t happy with who he was and assumed he would grow up to be different,” says Melissa, who recalls the toddler who threw tantrums over dresses and hair ribbons and began dressing and identifying as male early in his life. When he came out as a transgender teen, she was not surprised, and she readily accepted that he chose the path of a full physical transformation. “It was a shock at first, knowing that everything he did was going to be permanent.

“Ultimately, at the end of the day, you want your child to be happy as they’re progressing in life.”

Yearning to express himself

Izek identified with males as far back as he can remember. As a little girl, he refused to play with traditionally female toys like dolls, instead favoring tools and sports. By Kindergarten he avoided dresses and preferred basketball shorts. He would wait until he arrived at school to tear out ribbons and doff the dress for attire he found more appealing.

“As soon as I was able to start expressing myself, even looking back at pictures, I had no interest in following the females,” says Izek. “I identified with the males.”

At the age of 12, he had his first relationship with a girl and at 14 told his parents, coming out as transgender. In high school, he cut his hair, adopted a more masculine look and started meeting other transgender males. By 18, he officially changed his name and happily started hormone injections to begin his more permanent physical transformation.

Melissa, who works as a certified medical assistant in a physician’s office, provided information to Izek about the comprehensive LGBTQ & Gender Care Services at University Hospitals, including Shubham Gupta, MD, and Tobias Long, MD, the reconstructive surgery duo that performs phalloplasty surgery.

“I told him, ‘I support you and love you either way. As long as you’re happy, I’m happy,’” said Melissa, adding that Izek’s older brother and younger sister are also supportive.

A three-stage surgical transformation

Two years ago, Izek began meeting with a mental health therapist for clearance to undergo this major life-changing surgery. He began 12 months of hormone therapy, which is required before consideration for surgery.

Last spring, Izek went to Dr. Long, a plastic surgeon, for his “top surgery,” a double mastectomy that moved him further along the path toward becoming a man.

“Dr. Long supervised my healing,” says Izek. “He is very down to earth, he takes very good care of his patients.”

Izek consulted with Dr. Gupta, a reconstructive urologist, for “bottom surgery,” which will be a series of surgeries over 12-15 months. This summer, Izek underwent the first phase, where tissue was removed from his forearm to create the phallus and connect the new organ to arteries and nerves in his groin.

“This surgery allows the brain to rewire so this tissue gets the sensation feedback and erogenous sensation,” says Dr. Long, adding that 90 percent of patients will be able to achieve orgasm after all three stages are complete. “Izek is an awesome patient who really advocates for others.”

Izek is planning for Stage 2 in December, which in his case includes a full hysterectomy, though patients sometimes have this surgery done separately. Stage 2 typically includes a vaginectomy to remove the mucous membranes and close up the opening of the vagina, scrotoplasty to pull labia tissue forward to form the scrotum, testicular implants to give his new anatomy more shape and glansplasty to form the tip of the penis.

Six months later, Izek will choose the optional Stage 3, which are erectile implants to make sexual intercourse more pleasurable. Izek was thrilled to learn that he did not need to leave Ohio to complete his transition.

“I was looking at surgeons out of state until Dr. Gupta came to UH,” Izek says of the reconstructive urologist who now serves as Director of the Surgical Gender Affirmation Program for the UH Urology Institute. “They’re the only bottom surgery team in Ohio that offer phalloplasty.”

Advocating for others

Izek currently works in a dementia care unit at a health care facility and is going to school to become a nurse anesthetist, inspired to be the kind of caregiver he’s watched both his mother, his surgeons and the rest of his care team has been for him. Melissa believes her son’s bravery and determination will make him an excellent nurse.

“We have a growing generation of young adults who are afraid to be who they are for fear of what society says and even more fearful of their own family and friends,” says Melissa. “From the beginning, Izek has been the type of leader who will push for his beliefs and advocate for others.

“I’m proud of him for being so young – and in a society that is not always so accepting of transgender people – to say, ‘I’m going to be here and rally for the people just like me.’”

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