Cavan Ó Raghallaigh is a father, a spouse, a political activist and a transgender man. He is currently going through a medical transition to make “the inside and the outside match” in order to create a more congruent self. The painting depicting Cavan shows him forty eight hours after his first surgery.

Cavan found answers to his gender struggles in his mid-fifties. He had distress due to his gender all his life, but couldn't identify it among the other issues he was dealing with. “I thought I was just a cis[gender] female with a lot of problems because I did go through a lot of stuff. Sexual abuse from the age of four and a half, repeated into my mid-twenties. I was a single parent. One thing after another.”

He dealt with his other issues through therapy, but still found himself in crisis. He was suicidal, and wasn't making progress. His partner was his last lifeline. “It's David's fault that I'm alive because he said, 'I can't promise it will get better, and I have no idea if it will get better, but I want you to stay with me.’ It still gets me. Not a lot of people are that fortunate to have someone that believes in them at that level.”

Around this time, Cavan started writing a book using different sides of his personality as characters. “It started out by being a story about a brother and a sister. Within a few months, I couldn't find anything for the sister to do. It was all the guy voice….I was starting to suspect I was not writing a novel, I was just finishing my therapy.” He said that the day after the dramatic tension left the novel, he woke up as himself. “I felt my guy voice move into my body.”

The world feels more vibrant to him now. He used to live vicariously through his dreams at night, but now that he’s discovered himself, “I don't have to live in technicolor dreams anymore. I can live every day…some of which I do now, some of which I hope to do, some of which are lost in adolescent dreams because old bodies don't do those things.”

Cavan's kids took the news very well, and so did his spouse, David. “We've only gotten happier. It wasn't too hard because the guy I married thought he was bisexual and turned out to be pansexual. So I had an unfair advantage. A lot of trans people don't have that with their partners."

When researching how to change his gender in the eyes of the state, Cavan discovered there was no system of information, or standard process on how to achieve this in Texas. “I had to pick it up in bits and pieces. A lot of it, word of mouth only.” This has caused Cavan to become an advocate with a variety of organizations working towards a standardized statutory process. “Even if they add to the number of documents required, at least you will know what to expect when you go in, and there will be a place where you can look it up.” In the current climate, he says you can “get one answer in one courtroom, and down the hall you get a different answer. Even if they are two judges hearing at the same moment.”

Hormones weren't any easier. In Austin, there are a lot more doctors with male to female hormone experience, than female to male. It took him almost two years to find a doctor who had worked with transgender men in his age group. “I had doctors who were willing to try, but had no experience. I feel like that is why I have heart failure. Because they pushed my [testosterone] up too fast for somebody my age.” Hormone therapy simulates puberty, and Cavan feels his doctor was using hormonal levels appropriate for a young adult instead of a middle aged man.

“But they were willing to try, and I needed something,” he says. “If I don't continuously work towards finishing the process, I start getting depressed again.” Cavan feels he needs to move quickly due to his age. His family has a history of medical issues, and shorter lives. “What I was going to need to do, I was going to need to do a little faster than somebody who had 40 years instead of 20.”

His first surgery was top surgery to remove his breast tissue and some reduction of hip fat. Cavan is a high-risk for cancer, and would normally be covered for a double mastectomy, but the fact that he is transgender “gave the insurance company something to hide behind. So it was not paid for, even though I had documentation for a diagnosis that would have qualified me, had [my gender identity] not been mentioned. But I was so happy to be me [that] I haven't hidden anything.”  

Cavan will undergo more surgeries soon for abdominal reconstruction to remove excess fat and loose skin before he can have bottom surgery. The bottom surgery he’s chosen is a metoidioplasty to, “help me be functional on a daily level without a prosthesis.” His advocacy sometimes takes him to spaces that are less than safe, and being able to hide his transgender status can be important. Cavan also believes that going through the document changes and surgeries that many transgender people are looking for helps him be a better advocate for what the transgender community needs.

His recovery has been slow. “My heart doesn't pump as much blood and oxygen around to heal things as other people's do, even at my age. So I'm likely going to take longer to heal.” The hardest part of recovering from surgery has been having his activities restricted because his gender awakening has made him a more active and vivacious person. “I don't like to be caged up any more. I used to think staying at home all day was a really great thing to do, but I hate it now.”

Still, his top surgery has already produced results for him. While shopping for clothes, he bought a polo shirt and realized, “I don't have to put an undershirt on under this? I can just, one layer? One?!” He has been used to chest binders under multiple layers of clothing, even in the Texas summer, until now.

More importantly, the surgery, “allowed me to hope that the rest could be done. Before that was done, I would not allow myself to hope that it would actually happen. Even though I've still got healing to do…what I have is hope that I didn't have before.”

And he says, “I would like to have it [transition] entirely completed in time for me to spend a few years as entirely who I feel I am. But I don't have any problem with dying tomorrow because I've already had, in the last two years and a month, more in those few weeks than I had in the previous half a century.”

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