Due to a lack of medical support in Ireland, Noah Halpin was forced to travel abroad for ‘top surgery’. He details a journey many in the community are unaware trans people have to undergo:

They say that ‘Sometimes the hardest things in life are the things most worth doing’. I don’t know who ‘they’ are, but in many ways, they’re right. I never decided to be transgender, however, I did decide to transition. It was and continues to be the hardest thing that I have ever done in my life, but also the best thing I have ever done for myself. The biggest act of self-love.

Although the best thing I have ever done for myself, the journey has been and continues to be hard. Throughout this piece, I want to be brutally honest. Most people only speak about the joys of the end result, I want to talk about the nitty-gritty. The things that not many people will tell you.

My four-year fight to obtain hormone treatment (HRT)was difficult, exhausting, and, for the most part, infuriating.

I’ve been on testosterone for over a year now and although so much happier, not yet ‘complete’. After binding my chest for five years, it brought pain, spinal problems and laboured breathing, but worst of all, a constant consciousness of these two large intruders that sat on my chest.

As my appearance began to change through HRT, I only became more conscious of them. If I danced in a club, my hands would always find their way to my chest to cover what I thought was obvious. The type of clothing I wore changed in an attempt to mask it. I began binding tighter. It began to affect me more and more socially, sexually, mentally and physically. Something had to be done.

The problem? The only surgeon providing ‘top surgery’ to trans people in Ireland, has now retired. There are no longer any options for us in this country. For me, a trans man, top surgery meant a double mastectomy with nipple grafts. Complete removal of both breasts with the removal, resizing and reattachment of the nipples. (Apologies if  you’re eating your breakfast!)

Another problem? I needed thousands of euro to travel abroad and have this procedure done privately. And I didn’t even have a hundred. My friends encouraged me to crowdfund on the internet but I resisted for a long time – “Who would donate to ME? Why would anyone do that?” My own self-esteem was the cause of delaying my own happiness.

GoFundMe Campaign with a goal of €5,200, shared it on my social media and went to bed embarrassed. Within 36 hours, my target was reached. Donations and beautiful messages of support from people I knew, and people I didn’t know at all, were flooding in. I bawled crying. I couldn’t believe it.

When the target was hit, I phoned one of my best friends, Will St Leger, and asked him to come with me to Poland for my top surgery. I would need a carer, I would need support and I would need someone I trusted wholeheartedly. He agreed, and I was relieved. I emailed Dr Lembas of Lux Med Hospital, Warsaw, Poland and booked my surgery for four months later.

Dr Lembas is known by the trans masculine community as one of the best top surgeons in Europe, and one of the most affordable. I was glad of the four-month wait because I was not expecting the amount of preparation work I had to do in the meantime – blood tests, ultrasounds, paperwork, arguments with the HSE and my own doctors followed. Additionally, trying to earn a little more money as I soon realised that €5,200 wasn’t going to cut it.

In the days before we left, I became very worried. Not for myself, but for Will. I became obsessed with the idea that something was going to go wrong, that I would die and he would be left in Poland by himself to deal with it. Crazy right? But this worry consumed me. It didn’t help that I was suffering from a chest infection that I was trying with all my might to hide from the hospital staff for fear of the surgery being cancelled.

We flew into the cheaper of Warsaw’s two airports – Modlin – a little further out, but about €200 less. And we booked the cheapest AirBnB that we could find in Warsaw City, about 30 minutes from the hospital. The apartment was in an old building, the outside walls still riddled with bullet holes from the war, but surprisingly grand and beautiful inside.

We met the surgeon for the first time the following morning. He had never seen my chest before and it didn’t fill me with confidence when the first thing he said was “Wow, okay, those are very large”. He warned me that he may not be able to remove all of the tissue. But we proceeded, and he scheduled my surgery for the next day.

I was very excited, but I was also very nervous thinking about every possible thing that could go wrong. But let me tell you, in a crisis or a time of worry, you want Will St Leger there. Ever calm, ever reassuring, ever-loving but also painfully practical.

We travelled by taxi to the hospital, and it sounds ridiculous now, but I was telling Will what I wanted if I died, giving him my debit card pin number, computer password (a good friend will always delete your browser history!).

But when we arrived in the hospital and I got checked into my room, a sense of calm came over me. I signed the final forms, had a shower, changed into surgical scrubs, met the surgeon, then the anaesthetist, and was given about five minutes before I was taken down to surgery.

It all happened so quickly, I didn’t have time to worry.

Will walked me to the theatre doors and we hugged before departing on the words: “Bye-bye titties!” I walked into the theatre and looked around at all the implements, machines and people before my surgeon beckoned me to jump up onto the table. Next thing I knew, they’re injecting the relaxant into my hand and as a feeling of cold spreads up my arm, Dr Lembas is trying to explain something to me, but I just keep laughing at him. I knew in my head that nothing was at all funny, but everything was hilarious.

Four hours later, I wake up in the intensive care unit (which is apparently standard over there). I’m told that the first thing I asked for was my phone (naturally). The preceding photos that were captured on my phone would show that the nurse did in fact, go retrieve it from Will and that a mini photoshoot in ICU ensued. I remembered none of it.

Jump forward an hour and I’m coming around again in my room and Will is there. I’d never been happier to see someone in my life and in my dream-like high, proceeded to sing “Rise and shine! There’s no more titties!”

What I wasn’t expecting, was that as I came out of the dream-like high, I became extremely irritated by everything and everyone. I only remember bits and pieces of this, but I became extremely rude and obsessed with the idea that I needed food and water and no amount of talking to me would change my mind. I wasn’t myself at all, and became so irate that I asked to be sedated for the night. And I’m sure that the nurses were as happy to have that happen as I was. It wasn’t my finest moment, and I still cringe, but a level of self-forgiveness is essential here.

The following morning, Will came back to visit me and in the afternoon, the surgeon came in to remove the drains. Drains are tubes inserted into either side of your chest during surgery that drain excess blood and fluid.

I won’t say that their removal was very painful, but it was uncomfortable. One of the strangest sensations I have ever felt. It was a relief when they were gone.

That evening when Will came back to collect me, I couldn’t have left quicker. But we were on our own now, or more to the point, Will was on his own now. I was on pain meds most of the time and I know that I wasn’t very much fun to be around. I wasn’t myself at all. I was still in a lot of pain and very irritable. Something that no one talks about online is the stomach bloating – pain meds commonly cause constipation and for over a week, it was highly uncomfortable.

Will played a blinder, keeping an eye on my dosages and timings, making food and bringing everything to me in bed, helping me get dressed, basically waiting on me hand and foot. As someone who has had to be fiercely independent for much of my life, I found it difficult to allow myself to rely on someone else for almost everything, and this sometimes caused friction.

We began to venture out the following day, but I had to be very careful in public. The slightest bump sent pain searing through my body. Will became somewhat of a bodyguard in public spaces.

Over the next week, I was in a lot of pain and my only saving grace were the painkillers I brought with me to Poland from my own GP.

Then it was time to see my surgeon again for a post-op check. I lay on the bed as the bandages were removed. But for some reason, I was terrified to look down at it. I refused to. I wanted it to be perfect and I was afraid to look in case it wasn’t. I didn’t expect to feel like that.

On the day of our departure back to Ireland, we were back with the surgeon. He removed the plasters and the stitches from my nipples and confirmed that everything was healing well.

It was then that I really got to see my new chest. And I cannot put the feeling into words. It was pure joy, pure satisfaction. It was perfect. It was everything that it was meant to be in the first place. And it was then that I thought “It has all been worth it”. I can now go swimming, I can have sex without constantly thinking about my chest, I can get changed in communal changing rooms, I can wear white t-shirts, I can dance shirtless in a club, I don’t have to bind anymore! I can be myself. Finally.

The only thing I do wish was different, was that I could have had this surgery at home, in my own country, without having to rely on just Will for help, and without having to ask my friends for money to do so.

I wish that Ireland didn’t force me abroad. I wish for those coming after me, that we can change this. For them.

This story was originally published in GCN Issue 360.