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“I’ve always been Sasha, but I didn’t always know what that meant," he said. 

After three years of testosterone injections, Sasha Koch, 25, made the decision to get top surgery in Kansas City in November 2020. With the support of his boyfriend Noah Doolady, Sasha raised enough money for the operation, quit smoking in preparation and is currently in the healing process. "I’m so ready," he said. "I'm ready to be me."

Sasha’s boyfriend Noah Doolady hand-drew a calendar that notes surgery-payment due dates, a blood test, a COVID-19 test, and the couple’s five-month anniversary.

“I did not feel good about that,” Sasha said as he left a blood test in preparation for the surgery. “All of my life, my experiences with hospitals and doctors have been especially bad.”

“I usually fall asleep around two or three in the morning and wake up at five or six,” said Sasha who suffers from insomnia. “The night before the surgery I got an hour of sleep — if that.” 

Sasha and Noah raised $5,630 to pay for Sasha's top surgery. “Over the summer, I was complaining to Noah about how dysphoric I was,” Sasha said. “We started to talk about how the surgery was for him and then he started a GoFundMe. I didn’t really believe anything would happen.” 

“I don’t even know what would be 100 percent me,” Sasha said. “I don’t have that strong sense of identity I guess.” 

“The next time I’ll be here I’ll be healed,” Sasha said of his workplace MBS Textbook Exchange. Sasha was granted a six-week leave from work to accommodate his healing process.

“I’m feeling panicked,” Sasha said  while shopping for groceries with Noah. “My excitement is overshadowed by fear as the date gets closer.”

Sasha was shaking as he entered St. Lukes Hospital in Kansas City, Kansas for his surgery before sunrise. “It’s freezing,” he said to his mom. “I should have brought a jacket.”

Sasha was misgendered more than a dozen times while checking in for his surgery despite preemptive phone calls and emails to ensure the nurses were aware of his pronouns. “I anticipate being misgendered everywhere I go, but no matter how much I expect it and prepare for it, it’s a jolt every time,” he said. “I immediately feel defeated when it happens. I’m never going to be seen like I want to be seen.”

“When I woke up there was some pretty bad pain immediately,” Sasha said. “I felt surprisingly lucid but I was extremely exhausted.” The operation took approximately three hours.

“I was in a daze that whole day,” Sasha said. Due to COVID-19, none of his loved ones were allowed into the surgery or recovery room. 

Sasha rested in his hotel room with an icepack on his chest after surgery in his hotel room. Sasha, who said he was dehydrated for the remainder of the day due to intubation, drank water and apple juice through a straw.

“Noah has been a saint,” Sasha said. “He calls me at 5 a.m. for my medication dose.” Noah designed a physical schedule to help Sasha keep track of his medication.

“Loving something or someone involves wanting to look at every inch of it and examine it and memorize it,” Sasha said of his artwork of Noah.

“My surgeon explicitly warned me that if I smoked real cigarettes before my nipples were healed, they would fall off,” Sasha said. “I’ve been fantasizing about smoking cigarettes.” Here, he smokes an herbal cigarette before the surgery.

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