Before long, from somewhere in my limbic system a semipredictable parade of emotions streams out in costume, each hiding among the throngs of other students to present unique challenges throughout the dream. For the next several hours I plod and scrape my way through some mundane setting that only I can see is a screaming hellscape. My voice comes out wrong. I drop things constantly, my thumbs don’t work right. Every third person I meet is actually three life-lessons in a trenchcoat come to drag me through a sidescrolling haunted house of childhood trauma. I wake up in a sweaty mess of anachronicity and confusion that lays like a thick fog atop the rest of my day.

Yet for transgender people, the consensus belief in our continual, uninterrupted existence is questioned constantly. When we share with the world who we are, the world decides if it is willing to accommodate the clear fact of existence, often independent of how such accommodation or lack thereof will affect us. Many of us have had someone tell us we are dead to them. Many of us have had to completely uproot our lives and come into fresh settings to start anew. We must constantly beg for the healthcare we need by offering substantial proof that its absence will kill us, and from people who deadpan tell us that they could wish for nothing else. Even in subtle, often benign ways such as by loved ones who hang pictures of us prior to transition in their homes.

This past month marked my third gender-affirming surgery. And while it was the third, it has certainly also been the most complex and the hardest recovery. It is also the first one where I experienced complications that had the potential to be severe, including life-threatening blood loss requiring blood transfusions, and with that has come an enormous amount of pain, far in excess of what I anticipated.

I write this at 4am on March 31st, what is internationally known as Trans Day of Visibility.

It is 12 hours after I emerged from my second gender-affirming surgery. Like a lot of people, my impulse to accelerate transition goals has escalated over the past year as a growing unease fills my body every day that one day, my body and the care it needs, will soon be outlawed— or as is more likely in states like Massachusetts, will no longer be covered under Massachusetts’ implementation of the Affordable Care Act.