Crucial Caregiving

Finding the Right Help, From the Right People

September 2021

Editor’s Note: This is the sixth installment of “The Transchick Chronicles,” an on-going series of essays written by newly-out transgender journalist Stephanie Haskins, as she chronicles her transition. Parts one and two can be found here. Parts three and four can be found here. And click here for part five.





As I write this, my facial feminization surgery is a few weeks past.

It was/is wonderfully affirming. Like my breast augmentation five months ago, my new face is quite wondrous. Not much has changed, but enough to convince my dysphoric soul that, yes, I am indeed a female, and all I have to do is look in the mirror to confirm it.

Yes, I love mirrors now. I really like the image staring back at me.

My hairline is lower. My forehead is smooth. SO fucking smooth. In fact, I was convinced it was actually covered in plastic for the first few days. But no—that’s my real skin pulled tighter than I could have ever imagined possible. My whole face feels like it was shrink wrapped. Tight. Firm. Smooooooth.

My jaw is smaller and my chin is, too.

And my nose. Oh. My. God. Finally looking like I’ve wanted it to, for my entire life. But it’s still swollen, and really itchy. And I’m really hoping it’ll deflate a bit. I want it to look like Jennifer Lawrence’s.

A chick can dream, right?

My face was stitched across my hairline, on my forehead and around both sides of my head, past my ears. I also have two three-inch-long incisions inside both sides of my mouth below my lower teeth as part of the procedure to reduce my jaw and chin size. I was bandaged like a live mummy.

I always wanted to be a mommy, but a mummy is close enough, I guess.

Stephanie Haskins in June 2021

Stephanie Haskins after her facial feminization surgery in July 2021

Stephanie Haskins in September 2021


Not much pain, believe it or not, but I had a tough time breathing because my nose was packed with dressing and splints. In addition to the itching I couldn’t scratch, I wasn’t able to blow it for a month either, because both nostrils were filled with dried blood, mucous, and God knows what else. So much scabbing. So much swelling. So bloody uncomfortable.

Still, It was reshaped and restaged on my face in ways I can’t yet fully comprehend. It now has a gentle slope from my forehead to its tip. Even though It’s still swollen a bit, I can tell that it’s going to be a vast improvement over my last one.

Then in August, I had a heavy-duty laser procedure on my chest, back, shoulders and legs to get rid of sun damage and spots caused by baking in the sun around swimming pools decades ago. That’s when I thought a deep tan would help me lure handsome young men into my very empty waterbed.

But it didn’t work at all. I had to settle for women, who were fine—in a pinch.

OK, I know that might sounds awful—like a completely clueless anti-feminine mindset. And it was. But after all, I was a closeted gay guy at the time (or so I thought) with few options. I’m terribly ashamed of how my attitude diminished women, but that’s how I felt at the time.

You see, I still had no sense of my feminine soul. So many clues. But so little discernment.

In truth, I sucked at luring anyone into my sexual web and when it did happen, it didn’t often end well. At 23, I wound up paying for an abortion and getting a major STD from a sad and desperate young woman. She also had a sweet little two-year-old boy (not mine) who peed on my carpet. Sort of a sexual and ethical nightmare. (I promise to explore all of this in a later “Transchick Chronicles” entry.)

At any rate, as I said, the laser process will hopefully eliminate a lot of the imperfections that were incubated during my time as a sun-baby. Didn’t hurt much, just little popping noises that sort of stung a bit. Won’t be able to tell for a while if I can ever wear strapless dresses or summer tops. I hope I can. I do SO want to be pretty.

Even if it’s for just a bit.


Steve Haskins, sunbathing in the 1980s

Stephanie Haskins, sunbathing today


And now, I’ve started electrolysis to get rid of facial hair and ALL of the hair on my genitals and pubic area. And I have to tell you, dear readers, it’s probably the single most painful thing I’ve ever gone through in my entire life. I’ve even had kidney stone attacks, that put me in the hospital a few times, that were less painful.

The electrologist uses a needle, through which an electric current is run, to kill each hair follicle on my scrotum—where my little soft-serve testicles reside. My first treatment lasted an hour and ten minutes, and I must admit I was whimpering like a baby for most of the time—with some of the pin-pricks causing excruciating and just hellacious pain. Whimpering then became wailing. The only thing that deadens the pain a little is a slathering of 5 percent lidocaine ointment on my quivering little dick a few hours before my treatments.

I encase it in Saran Wrap to keep it out of my G-string, and then hop a train from Sacramento to the San Francisco Bay area (where my preferred electrologist works). It’s an hour and a half ride during which I silently endure the sloshing goop.

So, why am I putting myself through this torture?

Because, when surgeons eventually repurpose my sad little penis and desiccated (dried out) scrotal tissue to craft a neo vagina and clitoris (aka bottom surgery), there can’t be any hair follicles left in that skin. At all. Not a great idea to have hair growing inside one’s new vagina. Every single follicle has to be electrocuted, and after two treatments, it looks like I’ll have to endure another one, or possibly two. I had two prior laser treatments in the same area three months ago, which were also quite uncomfortable, but NOTHING compared to electrolysis.

Still, I want to get it done as quickly as I can, so I can get on the waiting list for bottom surgery—which I hope can happen sometime in the next six months. Qualified surgeons always have a long list of prospective patients—once those patients are deemed psychologically ready and sufficiently hairless.

One good thing about all of this hair removal stuff is that neither I nor my trans sisters will ever have to suffer the indignities of a Brazilian bikini wax.


All of my surgeries and procedures are important parts of my extraordinary journey to becoming a fully actuated human female person. I’ve learned so much about myself and humanity in general as I’ve watched my body morph from sort-of male to neo-female. I’ve sensed my brain rewire itself, and I’ve felt my soul slowly crank itself open to a joy I had no idea would have been possible two years ago.

I’ve finally found a home for my soul.

During this process, I’ve come to know some extraordinary queer and transgender people who are truly angels among us. One of those persons is a 39-year old trans masculine man by the name of oliver flowers. (He chooses not to capitalize the first letters of his first and last name.)

This gentle, but strong-as-steel Louisianan took care of me right after my facial feminization surgery in early July. I didn’t want a straight or cisgender caregiver to look after me, for reasons I’ll get into later. After a long search, I found an absolutely groundbreaking company in the United States called T4T Caregiving. That acronym stands for Trans For Trans. oliver is one of its founders and also  works as a caregiver.

After my gender therapist told me about T4T Caregivers, I checked out their website and then contacted them for more info. Then I interviewed oliver and the manager of T4T Caregiving via Zoom, and I was impressed by our long and thorough conversation. My connection to them and their company was immediate and unbelievably strong. And I hired them on the spot. Naive? Foolish? Perhaps a bit careless? Yes, yes, and yes. But it turned out to be one of the best decisions I’ve ever made.

When I was wheeled out to my car the day after my surgery at the Kaiser Permanente Hospital in San Leandro, California, oliver was waiting for me. I had never seen him before, except for his photo on the T4T Caregiving website. I felt dizzy and weak and a bit pensive. But as soon as he helped me into my seat, and buckled me in, I knew I’d be safe. I liked him immediately. Slim, trim, lightly muscled, with a soft southern accent. He’s a strong, confident, kind, masculine presence. I knew everything would work out. And it did.

I believe that T4T Caregiving is the beginning of a health care revolution for queer people, and especially for transgender people, who choose to surgically transition in many different ways and who, like me, want to be cared for by “our kind.”


A T4T Caregiving logo; T4T stands for “Trans for Trans.”


“Boy, talk about an absolutely exclusionary sensibility,” I can hear you muttering out there, dear reader.

And all I can say to that is, “Fuck yeah!”

And then I hear you snickering, “So, you queer people think you’re too good to have straight people take care of you?”

No—not too good, exactly. But we are different. WAY different.

When I had a tummy tuck last November, I asked the care agency I hired if they had a queer person on staff to help me, and it was only at the VERY last minute that a young lesbian named Hannah was assigned to my case. Why did I ask for an LGBTQ person? Simple. I was just starting to transition, and I didn’t want to have to explain myself or defend myself or out myself to people who might not be sympathetic.

But Hannah was only with me eight hours a day. Two cis, straight women handled the other 16 hours each day, and they were fine, but totally clueless. They had no idea what to make of a trans person who still looked like a guy but wanted to be treated like the woman whom I felt breathing inside of me.

They just didn’t understand who or what a transgender person was, what I wanted or needed emotionally, or what to say to me. Not mean. Not hurtful. But not what I wanted or needed at that point. I was very fragile. Admittedly.

When my facial feminization surgery was scheduled, I knew I had to do something different. Something better.

The fact is that a lot of people in our heteronormative culture consider our various affirmation surgeries to be a sort of demented mutilation. They don’t get us or our imperatives.

No transgender person wants to deal with that sort of phobic shit. At any time. But especially not after major surgery.

It’s only been in the past 25 years or so that trans people who choose to undergo gender affirmation surgeries have been able to find reliable and extremely talented surgeons who specialize in the procedures.

The main two are vaginoplasty and phalloplasty: Constructing functional neo-vaginas or neo-phalluses out of existing genital tissue and skin from other areas on our bodies.

Think about what I just said. We’re talking miracles here.

Anyway, a few years ago, oliver determined that the trans community as a whole desperately needed compassionate post-op caregivers who had undergone the same kinds of surgeries and could use their own experience to care for and guide other recovering trans people.


oliver flowers (who prefers to not capitalize his name) is one of T4T Caregiving’s founders.


“I’ve been a caregiver for 18 years professionally, a number of years before my own transition began,” oliver tells me. “I started focusing solely on trans people five years ago after seeing my own community recovering alone—when they didn’t need to be alone,” he says.

T4T Caregiving recognizes and understands the special physical and emotional needs of transgender human beings who have almost always been underserved, marginalized, neglected or ignored by our health care system.

“Having someone with you who understands the process start-to-finish helps encourage healing and lowers anxiety as issues arise,” oliver explains. “I love caring for trans people. We understand each other better than any cis person ever could. And I love ushering through these epic rites of passage with the depth and care we deserve,” he says.

Specifically, it means FTM (female to male) people who’ve had their breasts removed are caring for other FTM people who’ve just had the same surgery. Or people who’ve undergone phalloplasty are taking care of other young men who’ve had the same kind of operation. You get the idea.

During my surgical recovery, I was completely comfortable having oliver hover over me, change my bandages, give me meds, ice my incisions, and tuck me into bed. A trans man taking care of a trans woman. Not awkward at all. It felt perfectly natural. And very, very right.

Trans caregivers at T4T know exactly what a newly constructed penis or neovagina looks like. Not their first rodeo. No questions. No leering. No disgust. Trans FOR Trans. T4T. We take care of our own.

Truth be told, we trans people often feel compelled to live mostly among, or in close proximity, to our own kind. Because after a while, we get really fucking sick and tired of having to out ourselves, or explain ourselves, or having to justify ourselves to cis (and usually straight) people who don’t understand us—or perhaps hate us—or might even want to kill us.

Think I’m exaggerating? The 44 trans people (many of color) who, according to Human RIghts Campaign, were murdered in the U.S. in 2020 might beg to differ. If they were still alive, that is. We in the trans community think that number is outrageously high. Most of the victims were Black trans women who hooked up with men who have fetishes about trans females (who might still have dicks attached). They have sex, but then the men suffer from some kind of demented “buyer’s remorse,” go into full-on “gay panic” and kill their dates, often in the most violent and despicable ways. It’s awful and it’s disgusting.

T4T Caregiving is managed by another young transmasculine man who lives in Atlanta. His name is Justin Coffman and in addition to keeping the trans trains running on time, he’s also a caregiver.

“I’m extremely passionate about our model of trans people caring for and providing for one another. We connect with each other in ways that no one else can,” Justin explains. “It’s deeply fulfilling to share the incredibly special and vulnerable experience of having gender affirming surgery with our clients and to guide and assist them through that life changing experience.”


Justin Coffman manages T4T Caregiving. 


Justin emphasizes that nearly all of T4T’s caregivers work other jobs to supplement their incomes. “We do this because we love our work,” he says.

I’ll tell you that I truly felt that love from oliver. He doted over me like a papa bear taking care a sickly little cub. I felt like shit, but oliver kept me cheery and totally antiseptic–clean as a whistle and absolutely germ and infection-free during my recovery.

He watched over me as I showered, ate, slept, and was totally delighted to debate my galloping phobia about almost all men (he IS a man, after all!), to discuss our mutual far-left wing feminist politics, and to engage in heartfelt chats about our lives as queer and transgender souls who know—intuitively—that we have to take care of each other, and more importantly, care ABOUT each other.

When my dearest friend in the world—also a transmasculine person—met oliver at the pool at my condo a couple of days after my surgery, I watched the two of them gab for hours about their similar paths to manhood. Similar, yes, but not even remotely close to being the same. They splashed and paddled around in the 113 degree heat in the cool water, trading stories about their journeys—journeys completely opposite to mine.
Because they are men. I am not.

So, as I sat in the shade wrapped like a broken vase waiting for the glue to set, I knew two things:

First, that I was enormously happy in that moment; I felt absolutely content and serene in my new life as an out transgender woman.

And second, that these two guys were the very best, most authentic men I have ever known. Who now love their lives.

As I do mine.

While oliver describes T4T Caregiving as a “small, private care service,” it’s barely surviving with its present business model and it needs financial support to grow—and to help more people who desperately need it.

The eight trans people who currently make up the T4T staff don’t work out of any facility. They live in all different parts of the country, and when they’re matched with a client, they fly to wherever the patient lives. Clients are expected to pick up air fares and any other transportation costs. oliver flew in from his home in rural Tennessee at a cost to me of about $350.

My entire bill for six days of oliver’s in-home day and night care, including the travel, was $1900. He stayed in my condo 24/7, slept in my bed (because I actually prefer my couch–VERY comfy) and I purchased the food we ate. Luckily, I had the means to pay for this invaluable service. But too many other trans individuals do not.

Consider this: T4T Caregiving charges a third of what traditional agencies charge—a maximum of $250 a day. That’s less than $10 an hour for round-the-clock care. And that’s the MOST they charge. But many clients can’t afford even that—and are charged on a sliding scale.

Yet as little as T4T Caregiving asks for remuneration, it eventually wants to provide services for free to people who simply can’t afford to pay for anything.

“It’s an unfortunate reality that much of our community can’t afford to pay for care—so we’ve created a Community Care Fund that aims to cover our services in full,” oliver says. “But this fund is new and small and needs sustaining donors who want to support the work we do, to allow trans people to receive care from their own community instead of recovering alone.”

“We have a number of grant applications and fundraising projects in the works, and we deeply hope that in time, we can make our Community Care Fund self-sustaining and use it to provide our services for many clients,” Justin says. “Eventually, our goal is to make our services completely free to all trans people, while also supporting the needs of our caregivers and compensating them well.”

I plan to have someone from T4T Caregiving watch over me again, when I recover from my upcoming vaginoplasty surgery in a few months. I can’t imagine anyone more qualified, equipped, or loving, to have by my side.

Caring for and about each other, as transgender human beings. It’s a must. Because if we don’t, there are no guarantees anyone else will.


You can donate to T4T Caregiving here: Email them for more information at . As for Stephanie Haskins, she’s hard at work on the next chapters of  “The Transchick Chronicles,” and we’ll bring them to you when they’re ready. Sign up for our e-newsletter here to be alerted when they’re published. Stephanie is a Board member of The Reporters Inc. and you can read more about her on our Team page. She can be reached at .



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