At 19, Soren Aldaco found herself alone in an emergency room for 8 hours, with doctors reopening the wounds from the double mastectomy she had undergone just two weeks earlier.
Inserting a Q-tip in the hole they had to cut open, doctors aggressively knocked out blood clots, sewed surgical drains into her body, and removed over three cups of blood that had pooled in her chest.
“At the time, I thought I was going to die,” Soren told Independent Women’s Forum. “I just remember being on zero pain meds at the time.”
Soren began identifying as transgender at 11. She started hormone replacement therapy at 17, and two years later underwent surgery to remove her healthy breasts.
Now 21, Soren looks back on her medical transition with regret. Her traumatic medical complications opened her eyes to the ills of so-called “gender-affirming care,” which she said enabled her to believe hormones and surgery could provide her with the sense of self she craved growing up. Detransitioned and now working to heal from her ordeal through mindfulness, Soren has become a vocal critic of the “enabling” she sees happening within the gender medical industry.
“Nobody will understand the complications that come with these procedures and these treatments until they experience them,” she said. “I know I didn’t, and reality caught up with me.”
‘Dead Daughter or Living Son’
Soren’s mother raised her alone for the first four years of her life until meeting her stepfather, who became severely disabled while they were dating. Soren describes her mother and stepfather as both “loving and caring,” but the family dynamic left Soren to mostly raise herself.
At age six, Soren was diagnosed with ADHD and put on stimulant medication. Though she was thriving academically, Soren said she was too much for her parents and teachers to handle. Looking back, Soren now believes this early rush to medicalization contributed to her later mental health issues and primed her to accept pharmaceutical intervention.
After hitting puberty at a young age, Soren began to get unwanted attention for her weight and for being “well-endowed.” Seeking respite from these comments, Soren began to disassociate from her younger self.
When she discovered that feelings of “wrongness” with being a girl had a name, “it was very attractive to me,” Soren said.
“I felt understood for the first time in my life,” she said.
So at just 11, with her 14-year-old girlfriend she had met online, Soren began casually identifying as a boy.
Over the next few years, Soren continued exploring her self-expression, engaging in niche LGBTQ+ subculture groups online. It “pushed me further into having to fight for how I identified,” she says now. But because her mother had not been receptive to her previous attempts at disclosing her LGBTQ+ identity, Soren didn’t see medicalization as a possibility—not until adulthood, at least.
Then, at 15, Soren found her biological father online and met him for the first time. A month later, she suffered a mental health breakdown that landed her in a psychiatric ward. The episode entailed Soren crying for hours, pacing relentlessly, and telling her mother that she didn’t feel safe.
At the hospital, Soren encountered a psychiatrist who Soren said deduced she was exploring a transgender identity based on her nickname and records. The psychiatrist, Soren said, offered her the idea of “gender transition” as a legitimate form of treatment for her psychological distress.
At that point, Soren didn’t have plans to share her trans identity with her family. Medicalization still felt like a distant possibility. But the psychiatrist disclosed her trans identity to her mother.
Now with a professional validating her trans identity as legitimate in a medical context, and having been outed to her family, Soren felt pressured to prove to herself and those around her that her identity as a boy was real. She stopped wearing dresses and makeup, gave up on her dream of playing collegiate softball, began binding her chest full-time, insisted that her family call her by her “boy name,” and viewed the possibility of hormones and surgery more like a legitimate possibility.
Knowing that her daughter had been previously diagnosed with a slew of mental health issues, including depression, OCD, and autism, her mother resisted the psychiatrist’s advice to affirm Soren’s identity as a boy.
But Soren’s newly reacquainted father and stepmother decided that supporting Soren in her “gender transition” was the best thing they could do.
“We hear a lot, ‘Would you rather have a dead daughter or living son?’ And that was the sort of mindset that they were exposed to and they acted from,” Soren said.
Despite her mother’s reservations, Soren began attending a transgender support group with her father and stepmother. The group was run by trans-identified adults. As part of that support group, Soren attended a subgroup for youth who identified as transgender, where teenagers of all ages would frequently discuss, as if it was the next big trend, “who was starting hormones next, who was getting the next surgery, what big relationship mishaps had happened that week, [and] who was struggling with self-harm.”
Soren described relating to these peers and feeling “envy” towards those who were getting procedures and modes of affirmation that she was not.
Through that group, Soren met a nurse practitioner whose child also identified as transgender. At his recommendation, Soren booked an appointment with him to begin the medicalization process. During that very first, brief appointment in January 2020, the nurse practitioner prescribed Soren testosterone and estrogen blockers without ever conducting psychological evaluations for such treatments. At that appointment, Soren was accompanied by her then-girlfriend, who had just received her own prescription for testosterone.
“It’s interesting, both of these major points in my transition—the beginning of my social transition and the beginning of my medical transition—involved me being in a relationship with another trans person,” Soren said. “We were able to transition together.”
A few months later, the COVID-19 pandemic swept the country, and Soren was on her own, administering testosterone injections once a week. She developed a deeper voice, masculine hair growth and body fat redistribution, acne, an increased sex drive, and constant mood swings, but the lockdowns meant few people were around to witness these profound changes. Soon, Soren’s relationship with her girlfriend began deteriorating, and they broke up. By January 2021, after just over a year of being on hormones while still socially isolated due to the pandemic, she decided to proceed with “top surgery”—better known as a double mastectomy.
“This was during a pretty traumatic point in my life,” Soren said. “Right off the back of the pandemic, right off the back of a pretty tumultuous relationship.”
‘Ethical Gray Areas’
Soren described getting approved for a double mastectomy as an easy process, where the surgeon only required a $200 consultation.
To get the surgery covered by insurance, however, Soren needed a recommendation letter from a therapist. To obtain this, Soren said her surgeon “spoon-fed” to her everything she needed the letter to say, including recommended language and the names of therapists who could write it.
Ultimately, Soren received the recommendation letter from a therapist she had been seeing for the past seven months, a woman who had a trans-identified ex-partner. Notably, this therapist had not been treating Soren for gender dysmorphia, but for other issues.
According to Soren, when discussing this letter and her surgery, she had disclosed to this therapist that she had some reservations about fully embracing a male identity, and had also begun exploring the possibility of taking on a “non-binary” gender identity. Despite this, the therapist wrote Soren the letter endorsing her for surgery in February 2021.
“I have been working as a private therapist for over a year and a half, and previously as a substance abuse counselor for four years,” the therapist wrote. “In that time I have counseled clients at various stages of transition. As well, my ex-spouse underwent transition during the time we were together, so I witnessed all of the stages leading up to that decision. I am fully versed on this process and endorse Mr. [Soren] Aldaco’s decision for top surgery.”
The letter also claimed that Soren “has completed a minimum of 12 continuous months of living in a gender role that is congruent with his gender identity across a wide range of life experience and events that may have occurred throughout the last year.”
But with the pandemic and ensuing lockdowns, Soren said this was clearly false.
“I was in a house locked up [with] no way for me to actually navigate the world as a boy or as a man on these hormones,” she said. “Just a lot of ethical gray area.”
Soren said she still paid out-of-pocket more than $5,000 for the surgery, which she covered using money she had received from COVID relief funds. The rest of the surgery, costing more than $20,000, was covered by insurance.
‘This Was Not Normal’
Soren began noticing concerning side effects immediately following the double mastectomy. She expressed these concerns to her medical providers, even sharing photos of her bruised chest that was so swollen, it began looking like she once again had breasts. After seeing the photos, her surgeons dismissed Soren’s concerns, claiming that her recovery appeared normal and that there was no need for her to see a doctor.
“[My surgeons] didn’t think it was that big of a deal,” Soren said. “But at the same time, I knew that I had been gaslit; this was not normal. I, as a 19-year-old, should not have been going through that.”
On June 23, 2021, two weeks after the initial surgery, Soren checked herself into the closest emergency room she could find with an in-house “top surgeon.” The pain had become unbearable, and she knew something was wrong.
The “top surgery” team from that hospital refused to see her, but the breast oncology unit diagnosed her with “massive bilateral hematomas” that required emergency removal of blood clots and the insertion of temporary drains that Soren had to manually remove blood and puss from multiple times a day, for a week. Her right nipple graft also began to visibly lift, all of which required Soren to see a specialist team and bind foam blocks to her chest for the next few weeks.
After recovering from the complications, Soren continued to identify as transgender and take testosterone injections. But now, she was experiencing increasingly severe medical complications in other areas of her body, including vaginal atrophy, hormone fluctuations, joint pain, and gastroenterological issues.
Soren’s nurse practitioner continued her testosterone prescription as if her symptoms were all unrelated, instead referring her to various outside specialists to treat the individual complications as they arose.
By one point, she was on 11 different prescription medications to address the various other psychological and physical issues she was experiencing.
Looking back, Soren said she’s struck by the fact that all of these medications, including her cross-sex hormones, were being maintained by the same nurse practitioner who prescribed her hormones.
“Not even a doctor,” she said, “but a nurse practitioner.”
One specialist she saw, a rheumatologist, warned Soren against continuing her use of testosterone, citing it as a likely cause of her medical complications. Soren discounted that provider’s advice, instead trusting her nurse practitioner’s assurance that the hormones weren’t causing her medical distress. Now, when looking back, Soren regrets trusting the nurse practitioner.
But soon, the medical complications became “too much,” and her questions about the entire concept of “gender identity” became too heavy. Despite already making the permanent decision to surgically remove her breasts, Soren decided to stop her testosterone prescription and estrogen blockers.
‘A Key to Unlocking Me’
In January 2022, Soren moved to Austin, Texas, and enrolled in the first in-person class she’d taken in years.
The class, Intro to Sociology, taught Soren how humans develop a sense of self.
“We actually develop a sense of self, primarily, through taking on the role of ‘other,’” she said. “Through role models.”
Learning this caused Soren to take a step back and think of her younger sister, whom she had met a few years earlier when reconnecting with her father.
“I thought, what if she came up to me and said the things that I say to myself? What if she told me that she felt her body was wrong when I know for a fact that she is perfect, that there is not a single thing about her that she needs to change?” Soren asked. “It’s so hard to talk about her. I love her so much.”
For the first time in her life, Soren said she felt like she had a key to unlocking herself.
“To maybe healing some of those parts of me that I thought were going to be broken for the rest of my life,” she said. “I gave myself the chance to accept myself for who I was without the drugs, without the obsessive need to police myself.”
Today, Soren is a sociable 21-year-old who enjoys playing guitar, caring for her two cats, researching how to make classrooms more accessible as an undergrad at the University of Texas at Austin, and interacting with customers through her work as a barista at a local coffee shop. After spending so much of her life on social media, she’s learned the value of working with her hands and interacting in-person.
Soren has a girlfriend but resists using labels to identify herself, as she’s discovered that a “two-dimensional label fitting a three-dimensional human being—it doesn’t always work out.”
And despite not knowing the full extent of her side effects from surgery and years of cross-sex hormones, including the status of her fertility, Soren has come to terms with her circumstances.
“In mindfulness, you’re taught to accept painful feelings as they arise, to ride the wave instead of swimming against the current,” she explained. “And now when I feel a negative emotion like depression or anxiety or dysphoria, I lean into it a little bit. I say, ‘This is really hard.’ And I give myself that compassion that I craved growing up, that I thought I was getting from being affirmed in my gender identity.”
While she’s learned to accept the pain associated with her own set of circumstances, Soren doesn’t accept the notion that what happened to her should be allowed to happen to anyone else—especially not minors, like her younger sister.
She’s taken that message to the Texas state legislature, where she testified against “gender-affirming care.”
“Children deserve better than plastic surgery and hormones,” she told the state lawmakers. “The gender-affirming care I experienced in adolescence was an elaborate placebo.”
By sharing her experience, Soren hopes to correct a medical system that she believes “prioritizes ease and conformity over health.” But in order to do this, she believes that expanded access to high-quality, mindfulness-based therapy programs is an integral component.
In the future, Soren predicts that detransitioners might lead the next #MeToo-style movement, where they expose the medical harms that gender-confused children and adolescents have suffered at the hands of adults.
In the case of the nurse practitioner who started her on testosterone and continued prescribing it despite her declining health, Soren believes he was trying to help.
“But at the end of the day, you need to be able to discern between enabling and helping,” Soren said. “That you giving me access to certain drugs, that you just giving me referrals to whomever I asked for, didn’t actually help me heal. It affirmed me in my delusion. It made it easier for me to believe and prove to other people that something was wrong with me.”
“Sometimes,” Soren added, “the compassionate response is one which sets firm boundaries.”