“I knew even at a very young age that I liked women and I felt like a guy on the inside,” he said. “I always envisioned myself as a dad or a husband.”
As an adult, he took steps to bring his outer image in line with his inner sense of self, with a name change, clothing and hormone treatments.
And recently, in an operating room at Spectrum Health Butterworth Hospital, he took a big step in his transition from female to male. He underwent transgender top surgery — a double mastectomy designed to transform a feminine chest into a masculine one.
“When you’re a transgender person, you feel like you’re stuck in between and not complete,” he said.
But after the surgery, he felt transformed.
“I don’t even have words for it,” he said. “I can definitely say my insides are matching my outsides more and more.”
VanSolkema, a 34-year-old West Michigan resident, said the decision to have the surgery was an easy one. But to reach that point involved an often painful journey, one in which he had to rise above bullying and stigma that shook his sense of self-worth.
Now, he shares his story in an effort to promote understanding and acceptance of the transgender population.
From Sarah to Beau
VanSolkema came into the world on a fall day of 1983 as a baby girl named Sarah Elaine VanSolkema. Growing up, he embraced the girly stuff.
“My mom definitely spoiled me with Barbies,” he said. “I had tons of Barbie dolls. My dad built me an awesome dollhouse.”
In high school, he wore his hair long. He went to formal dances, proudly wearing beautiful dresses made by his mom.
“I was born Sarah,” he said. “I’m not going to change those moments, nor would I try.”
But looking back, he recalls that at least by age 7, he felt he was a boy. And he embraced boy stuff, too.
“I was definitely a tomboy. I was rollerblading and playing with boys and fighting with them,” he said.
By 19, he identified as a lesbian. Often a target for bullies at school, he dropped out of high school and went to work.
He excelled on the job, where his work ethic and leadership skills led him to supervisory positions.
But he struggled with depression. For years — from age 7-18 — he cut himself, carving the word “worthless” into the skin of his thigh. At 25, he attempted suicide.
It was at that point he sought counseling. He went back to school, got his GED and started taking college courses to become a social worker.
Outgoing and outspoken, he evolved into a student leader on campus at Grand Rapids Community College and Grand Valley State University. He became well known as an advocate for LGBTQ rights and volunteered with social service organizations that help people who are disabled or in need.
Through therapy and advocacy work, and through the supportive community and connections he made at GRCC, he came to realize he was transgender.
“I didn’t know much about the trans spectrum and transitioning until a few years ago at age 32,” he said. “I knew I was different, for sure. But I didn’t have a lot of education in LGBT stuff.”
Describing the disconnect between his inner and outer life was difficult, he said. He felt “forced into a shell that didn’t align with my thoughts, feelings and soul.”
Before beginning the transition from female to male, he told his mother about his decision. It was December 2015, and she was fighting the uterine cancer that would claim her life a month later. He told her he had chosen a new name for himself: Beau.
He and his mother had always been close. And she responded to his announcement with love. In their conversation, the message that came through to him was: “No matter what you do in this world and your life, I’m always going to love you.”
VanSolkema began testosterone injections. He grew facial hair. He wore a binder to make his chest appear more masculine.
And he researched options for transgender top surgery, looking at programs in Ohio and Florida.
“It’s about matching your inside to the outside,” he said. “I’m a 38 triple-D, so it’s hard to hide.”
To his surprise, he learned the surgery had recently become available close to home.
Reaching transgender patients
The service at Spectrum Health came about with encouragement from Jennie Mills, the practice manager for advanced breast care, who also leads the Healthy Pride Inclusion Resource Group at Spectrum Health.
She asked surgical oncologists if they would consider performing mastectomies for transgender people.
“We have a lot of transgender patients in the community, and they either weren’t getting this treatment or they were leaving the state (for surgery),” she said. “I know a couple of people who left the country.”
Dr. Paul Wright agreed to perform the operations after he researched the technical aspects involved.
“I realized it’s not that much different from a traditional mastectomy for breast cancer,” he said. “There are some subtle technical differences, but those are only minor tweaks from my usual practice.”
Since he arrived at Spectrum Health in June 2017, Wright has performed about a dozen transgender top surgeries.
“The main focus of my career is on cancer surgery and will always be that, I’m sure,” he said. “But it has been tremendously rewarding to be part of these surgeries (for transgender patients). It’s really life-changing for them. It’s something a lot of these patients have been struggling with, in how they view their body and their self-esteem, for a long time.”
Before surgery, patients receive counseling for gender dysphoria — a term that encompasses the distress they feel over the mismatch between their identities and their bodies. They obtain letters of support from mental health professionals.
Ready for change
On a winter morning, VanSolkema arrived at Butterworth Hospital for his operation. He was excited, he said. And not a bit nervous.
“I just want them gone,” he said cheerfully.
In the four-hour procedure, Wright removed breast tissue. At several points in the operation, he had VanSolkema raised to a seated position, as he does with all mastectomy patients, to see if he needed to remove more tissue or skin.
“Once the surgery is done, it gives the best cosmetic outcome,” the doctor said.
Wright could leave in place tissue he might have removed in a patient with breast cancer. He didn’t remove the fascia, the connective tissue that forms a sheath over the muscle.
A boost in confidence
It didn’t take long for VanSolkema to appreciate the change in his appearance.
“I’m really happy,” he said as he recovered from the surgery. “There’s definitely a smile on my face that has lasted for days. For the first time in my life, I can exhale — not just breathe to live, but to really let it out, because my autonomy in many ways is complete. I’m not just breathing and existing in a body I never requested.”
He likes the look of his chest. He looks forward to the day he can walk bare-chested on a summer day.
His back feels better, with his chest 6 pounds lighter.
“I feel more comfortable,” he said. “There’s a little difference in confidence I’ve noticed. I definitely feel more like Beau and the man I know I was born to be.”
This article first appeared on spectrumhealthbeat.org.