“Oh my gosh, you look amazing,” said Kimberly Texley-Quigg, NP, certified obstetrics and gynecology nurse practitioner at Corewell Health’s Spectrum Health Cancer Center at Lemmon-Holton Cancer Pavilion.

She was meeting with a patient who had just undergone gender-affirming top surgery.

Top surgery is a procedure that removes or augments breast tissue and reshapes the chest to create a more masculine or feminine appearance for transgender and nonbinary people.

“I heal very well,” said 24-year-old River Raine, who received a double mastectomy a few weeks prior.

Raine uses he/they pronouns and has looked forward to this surgery for years.

“Your incisions are healing beautifully,” Quigg said as she removed the bandages.

“I still need to get comfortable correcting people on pronouns,” Raine said.

A large blue button is pinned to their chest with pronouns displayed for all to see.

“He/They” it reads.

“It shouldn’t hurt when the drains come out,” Quigg explained. “The hole will close within two hours, and you’ll be all set.”

She explained that he will receive a scar massage in a few weeks and demonstrated some exercises to increase range of motion to the upper body and arms.

“You’ll sit close to the wall and almost climb it while sitting,” she said. “And there is also the scapula squeeze where you try to squeeze by pushing your shoulders back once or twice a day.”

Three months of testosterone was also prescribed that will help deepen Raine’s voice, shape his face and support facial hair growth.

Rising to challenges

Rewind just one week and Raine was healing at Corewell Health’s Butterworth Hospital in bed after surgery.

One of his favorite stuffed animals sat on their lap.

“This one’s name is Einstein,” he said, introducing another.

Raine is visually impaired, and walks with a white cane, but gets around very well and tries hard to be independent.

And when asked about his body, he had a simple way of explaining it.

“Imagine being born in the wrong body,” he said.

Honoring emotions

When asked what motivates them, he will tell you pure spite.

“Don’t get me wrong, I have my moments of feeling sad,” he said. “But I also try not to worry about stuff.”

For, example, his vision.

“I was tired of the pain from the same eye procedure over and over, so I decided to have it removed,” he said.

They can see lights, outlines and movement, but it is starting to fade out of their remaining eye which will eventually be removed too.

“I don’t like thinking of myself as visually impaired,” he said.

Heading home to heal

A nurse stopped in to check the drains on Raine’s incisions as he finished up breakfast.

“I should be discharging in just a few hours,” he said. “And these sausages are really good.”

Raine worked with LGBTQIA+ patient navigator Zoey O’Brien at Corewell Health to get connected with the services he needed

O’Brien helped connect Raine with Dr. Erica Wrubel’s team who performed his surgery.

“Dr. Wrubel was very hands on which I needed,” Raine said. “Her office was very nice … they were friendly in general and made me feel comfortable along the way.”

Dr. Wrubel even corrected a few people in the operating room during surgery on Raine’s pronouns.

Raine started testosterone injections this week and looks forward to what’s next.

“I feel like a human pincushion at times,” he joked.

A connected homebody

When they are not shuttling back and forth to doctors’ appointments, he spends a lot of time at home with his cat Artemis.

Raine gravitates to the kitchen, often baking treats for friends.

He recently made a homemade lemon pound cake with icing on his own with no help from roommates.

“Try to help me and I will walk away from you,” he said. “I refuse help unless I can’t do it myself.”

Raine has two partners living in Australia, and he connect regularly via phone and text message.

He has a device that helps them communicate electronically with others, much like a text message, using a braille keyboard.

He has been knitting for years and is working on getting back into it with hopes of creating some scarves to give away at Christmastime.

He also hopes for a keyboard to get back into singing and releasing music.

“Here’s one song that was done a while back that I genuinely don’t hate,” he said.

Raine sang along and harmonized to Ocean Eyes by Billie Eilish.

“So, I’ll need to redo it after T. I plan to release these again someday. They’ll likely be sang with a slightly different (deeper) voice,” he said.