Musings of a Singaporean Transgender

My trip to pursue FFS in Paris with Dr Quentin Qassemyar was finally here. Flying off on 6 Oct 2026, surgery on 8 Oct 2026. It's strange how time works; 1 year ago I was feeling the intense urgency to get FFS done, live life with a lot less brainworms and the wait time felt very difficult to get through. The curveball of being rejected by the US clinic last year made it feel like I had to postpone living life. And suddenly, here I am about to go for surgery and feeling very unprepared for it. Even though FFS in the US didn't pan out, being Isabelle the entire trip gave me the confidence boost I desperately needed to start going out more. I think the extra year was actually a blessing in disguise; it gave myself the time I needed to regain a footing and feel a lot less brainwormed about my appearance. The time also allowed me to better reflect on whether surgery was something I truly wanted (answer: yes). In being more confident to present as a woman, it allowed me to come out to more old friends and a few work colleagues (as a prelude to surgery plans, since coming back looking different was going to be hard to explain). The time also allowed everyone, especially my wife and parents, to ease in to the changes to come. It was an incredibly eventful 1 year, which I am grateful for.

My flight was at midnight, so I had a work day to get thru. Working at 110% efficiency, I managed to settle most things, but there was no mental bandwidth for anything else until the work day ended. I went home to do last minute packing, followed by dinner with my parents, wife and kid. It was nice; my dad steamed crab and blanched slices of the fish he bought from the market, which was always a treat. 

Going into the night, I felt incredibly emotional. I remember hugging the pet cat after work alone at home and breaking down a bit on the sofa, telling her that I wasn't ready to leave people behind, almost like a dereliction of duty. In the post-dinner drive back with my wife, I told her I was grateful for her support so far, knowing that it has been a difficult journey for her, as well as be the solo-parent while I recovered overseas. I felt emotional as I hugged my parents at the departure gates, Mum showing love the way she knew how, passing me her rosary telling me that as a Mum, she couldn't be there to recover with me, so in her stead she asked Mother Mary to keep watch over me. As I sat inside Terminal 3 sipping a drink, waiting for my flight, tears kept streaming down my face as my kid and I exchanged text and audio nessages. It wasn't the end of the transition, but pursuing FFS was a big step, something that I had wanted for years. And coming back I would socially transition, something that I had been mentally prepping myself for but always felt very scary.

Flight into Paris was uneventful. I got lucky and didn't have anyone seated behind me, so I could fully recline and got a reasonably decent sleep the entire flight. Which is really important because the day ended up so long.

My room for most of the trip. Quite nice

My accommodation was a villa in the outskirts of Paris that had link-up with the clinic, with 4 rooms for patients and a common living area. They had a driver who picked me from the airport and was also responsible for sending me (along with the other women) to and from pre/actual/post-op surgery appointments. I was quite happy I secured a space, because it was good value for the price, conveniencr and I would be recovering with other transwomen (and their partners), which would make the experience a lot better. Within the first 2 days I made friends with a German transgal and her partner going for the same extensive surgery as me 1 day before, who were really great company and also helped me out because I was there alone.

So much supplies. Also I'm sure the painkillers with Opium gave me some trippy dreams

We drove into Paris at 1pm and the first step was to get prescriptions, since the doctor's appointment was at 5.30pm (which became 8pm as he overran like crazy as usual). The amount of medicinal supplies i needed post-recovery seemed a bit insane, filling up the entire jumbo plastic bag. We kind of just hung around Paris until the pre-consult with the doctor, where I recapped on the things I wanted for each of the degments. I was glad that I had 1 free day before surgery, which allowed me to eat some yummy french food and buy things for people back in Singapore before surgery day.

Being in Paris with adult money is so much different that as a student

The driver arrived at the villa at 7am on surgery day, in anticipation of the terrible traffic. I was already awake at 5am that day, getting ready, messaging people and attempting video calls with people back home. The emotions were a complicated cocktail mix, anxiety about surgery, uncertainty if all will be ok without post-op complications, worries about how things will play out when I get back home. Maybe there was also a sense of loss, thinking that today is the last day this will be my face, mixed in with grief and catastrophising, that if I were to die, I leave all these people behind. In general, during the drive to Paris, bringing into focus thoughts about family and the people I love made tears stream down my face. 

After 1.5 hours of bad morning traffic, we finally reached the Clinique Eiffel Paris. The lobby is quite over the top looking, with the gold, mirrors, marble(?) and questionable artwork. But I suppose that's how plastic surgery hospitals are supposed to look...expensive. I sorted out the final payments, admin forms and i was brought to a room to change into the surgery outfit. This was when things started to feel real. Like a few years of anticipation and hope culminating in this moment...and then they made me wait an extra 2 hours cos the earlier surgery had a delay. Dr Qassemyar came into the waiting to do a pre-check on me, before I was lead by the nurse into the surgery room. It was really cold, so I was thankful for the warm air bed I was lying down in. The anaesthetist waltzed into the theatre, said some reassuring words, gave me an IV injection and the room started to spin. I remembered my final thoughts being "please wake up alive", before I closed my eyes and in the next monent I was awake again. Surgery was over!

One of my primary struggles with gender dysphoria have been about desperately wanting to see a woman reflected in the mirror. With makeup and the right outfit, I could see that. But my bare-faced self looked androgynous to me on good days and male on bad ones. Being regularly gendered male by random strangers further confirmed that perspective to me, causing a lot of internal turmoil, with swirling emotions of anger, disappointment, envy, resentment and resignation. I felt that FFS was necessary for me, chiseling bone to carve out a feminine appearance. But I also struggled with the shame of so intensely desiring FFS, instead of working to accept myself as I am. Friends and my wife have said that I conflated passing with beauty. But the line between wanting surgery to look less masculine versus becoming conventionally beautiful was blurry; the latter to me was an added bonus, as long as I didn't keep pursuing surgery after the initial FFS.

A year ago, I decided to book a consult with a surgeon in the US. Popular doctors in the US have long wait times stretching years, so I knew I needed to get my foot in the door, even though I was still early in my transition. This involved waking up at 5am to call the clinic due to timezone differences and jumping through a few hoops because the clinic thought my call was spam and blocked my number initially. But I eventually secured an appointment for a consult about 1 year ahead (it has gotten worse for this doctor. Currently waitlists are almost 2.5 years).

"Why US?", many have asked. Taiwan, Thailand and Korea were nearer, cheaper, and had surgeons familiar with Asian faces. The waitlists were also much shorter, with prelim consults done using photos sent over to the clinic. While that was true, being unable to properly research a surgeon's credentials based on reviews, having a language barrier and a tendency for surgeons to be aggressive in the amount they corrected that resulted in unnatural results was something that bothered me. I wanted my post-surgery look to be natural. Korea had an added problem of "ghost doctors", where the person doing the surgery isn't the person that you signed up with. Patients usually have no idea of the bait-and-switch until something goes terribly wrong. It was my face and I couldn't bear the thought of living with a less desirable or failed result, after significant financial expense and enduring the long recovery process. Knowing myself, I would regret, hate and shame myself forever. I needed to go for something with assurance of success.

Finally after what felt like an eternity of waiting, it was time to fly to the US. It was 16 hours of flight time, with a 2 hour layover in Japan. By the time I rented a car and drove to my accomodation, I had travelled for a full day. As I lay down on the bed exhausted, I wondered what the f*** I was doing travelling this far. Maybe Asia was a better choice. I missed my family, I had to tell my kid and my parents I was on a "work trip", and felt like I didn't have anyone to lean on in this trip. I didn't do much research so I booked an accomodation near the hiking spots and premium outlet mall. Which turned out to be so far from the city, there was no way I could partake in the queer nightlife. So my exploration as Isabelle was mainly shopping 😅

The consult took place on Day 4 of my trip. I parked in the medical building at 8.30am, to go for a CT Scan of my facial bone structure before my doctor's consult at 10am. The purpose of such a scan is for the doctor to have a clear understanding of the facial bones, where and the extent to which they can shave down the bone to obtain a more desirable structure. After paying for the scan, a technician led me to lie down on a flat bed, which moved me back and forth into a donut shaped scanner. This process was fast, taking only about 5 minutes.

I returned to the clinic to wait for my doctor's appointment. I had been feeling anxious before the trip even started, so this morning was no different; this was the consult I had been looking forward for so long, an expensive but necessary step forward in my transition. I sipped on my coffee and ran through my notes on the questions and issues to bring up to the doctor. Soon enough, a nurse called my name and gave me an elastic cloth to hold back my hair for the consult. 

The doctor was a young, confident man who spoke with a reassuring voice (important for doctors). After exchanging pleasantries, he asked me about my personal history, past surgeries, my medical and social transition journey. He was quite amazed that I took a 16 hour flight to the US just for this consult and also asked me why I didn't go to Asia. As his specialty was in brow and nose work, and because I was paying out of pocket, he suggested that for any chin and jaw work, it would be much cheaper for me to do it in Korea, adding that he would provide me with recommendation of a clinic in Korea.

 

He started the consult by asking me the parts of my face that bothered me and wanted to change. In descending order of dysphoria causing parts, I told him that I wanted to advance my hairline, smooth out my browbones, reduce the size and bulbosity of my nose and sharpen my jaw and chin a bit to give it a slightly sharper V-angle. I told him that I liked my cheekbones, even though they protruded outwards a bit and another Taiwanese clinic had recommended for zygoma reduction. He listened to me before giving his opinion on what he felt should be done, limits and risks. He touched the skin of my forehead and said that it was quite tight, so he would only be able to advance my hairline to 70% of where he would have liked it, with the difference easily made up with a future hair transplant. He felt the texture of my nose to determine if it was skin or cartilage, to get a sense of how challenging the rhinoplasty would be. Based on the number of surgeries recommended, he estimated that it would take 6 hours, which was just at the self-imposed limit that he doesn't exceed. For those who are curious, the doctor's notes are shown below:

It would have been a happy day, if not for a curveball during the consultation. In the medical history form, I had indicated that I have a heart issue, where some general anesthetic drugs are not recommended, due to the potential to increase the risk of ventricular arrhythmias, which could lead to cardiac arrest. Unfortunately for me, the drug not recommended for use was exactly the one used in the clinic. And no surgeon wants to have a risk of their patient going into cardiac arrest midway through what some might consider elective surgery. He told me that there was a low chance that he would be my doctor, but he would like to get my medical records and run them through his anesthesiologists to see if alternatives were possible.

I felt time stop and my heart drop so hard I nearly broke down in the clinic. It was a terrible feeling, to feel like there was another road block to my transition. I had been looking forward to this surgery consult for more than a year and this was a huge wrench in my plans. One step forward, two steps back. If this doctor didn't go through with my surgery, I needed to go back to sourcing for another doctor that I could trust, wait even longer for a surgery date and delay my transition further. I could feel the anguish building in my chest, which I shoved back down with my well-practiced skill of suppression. On hindsight, perhaps I should have just let myself cry in the clinic.

The doctor could see the disappointment on my face and tried to reassure me that there could still be a chance for the surgery to proceed. We moved on to taking photographs as part of records for consultation, before moving on for the final chat with his assistant, who explained logistical details about the cost, post-care needed, payments, how to go about booking the next surgery date (April 2026 was the earliest) and other details. With that, it was the end of the consultation. The main objective of my trip to the US was done, albeit with a new, unexpected detour.