Born in Murray, UT as one of five kids, Dr. Nicholas K. Howland was raised in the LDS church. After receiving his Doctorate of Medicine at The University of Texas Medical Branch at Galveston, he now practices in Draper, UT as a board-certified plastic surgeon.
He specializes in plastic and reconstructive surgery and aesthetic services, developing personalized surgical and nonsurgical treatment plans to help patients achieve their aesthetic and medical goals. He is one of the few (if not, only) plastic surgeon(s) in the SLC area to treat patients who identify as transgender.
A proficient Russian speaker, Dr. Howland’s global perspective was broadened by a two-year church mission in St. Petersburg, Russia, prior to his collegiate studies. Outside the operating room, he cherishes time with his two children, whether it’s at the lake or in the mountains. His hobbies include playing the piano, golfing, water and snow skiing, and he enjoys the intellectual challenge of the New York Times crossword puzzles.
Connect with Dr. Howland here:
https://howlandplasticsurgery.com/dr-nicholas-howland
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Hey everyone, welcome to today’s episode of Living Beyond the Shadow of Doubt. I am so thrilled and honored to have my friend Dr. Nick in the house. Nick and I were on the island this past summer.
Hey!
And we’re fellow authors. We’ve been in the same mastermind this year and it’s been so awesome to get to know you and you have such a… I don’t know how to term your story. It is a bittersweet, complex, full of lots of opportunities for compassion, grace, moving on and moving up upward. So I appreciate you being willing to share with my audience. As you know, this is at the intersection of conservative faith background, as well as often it includes LGBTQ plus individuals or those that are connected to the LGBTQ plus community in some way, whether that means their parent, sibling, an ally, and I know that includes you as well. So I want to give you the opportunity to introduce yourself to our audience. Just share whatever you feel comfortable sharing. I know you said you’re an open book, but about your family, your background, your upbringing, your profession, the things that really have contributed to where you are at today.
Yeah, we can dive as deep into this as you want to go. so as an introduction, my name’s Nicholas Howland. I am a plastic surgeon by trade. I work in Draper, Utah, which is a suburb of Salt Lake, just a little south of Salt Lake City. Most of my practice is cosmetic surgery head to toe. I do operate on trans patients and consider myself an advocate for trans patients. I do not do any bottom surgery mostly because I’m in private practice and for bottom surgery, full sex change operations, you need a large university setting clinical space that has a big team that can do that.
So the surgeries that I focus on within the trans community are typically top surgeries, whether we’re going male to female, female to male, and then a lot of facial work, whether that’s hair transplants, facial feminization, jaw restructuring. I will apologize to your audience. I actually just had my own surgery a week ago. They went in, this is actually something I do for my trans patients from time to time, and they go in, we go in through the mouth and make an incision, and then they cut the chin bone in half and then pull it forward and then put a plate on to give me a little bit more of a more masculine jawline. My chin was kind of like angled, I had no chin, I looked like a Bob’s Burgers character for years.
You great. You look just fine.
And it’s the one thing that always kind of I didn’t really like and if I could change I would and so I did and here we are. So if I’m talking a little funny, if like my lower lip is not moving, that is why. Thank you. So for me, what I will say, people often, you know, it’s hard to summarize what is your story in a nutshell.
Yeah, 60 minutes doesn’t really…
No, it doesn’t cut it. it also like, it’s ongoing, right? We’re constantly changing and we’re constantly evolving. I am, you know, my book that I wrote while you and I were on the island together is very much a memoir. And so it encompasses my story. I grew up very LDS. I was born to an LDS family, or Mormon family here in Salt Lake City. My parents divorced when I was 16 years old, but that was like the biggest trauma in my life that I could have imagined was my parents divorcing. I ended up serving an LDS mission for two years, and when I came back from that mission I was…
I met a girl and was dating a girl and we wanted to get married. But we were breaking the law of chastity and sleeping with each other before marriage when we weren’t supposed to. Naughty us. And I got excommunicated. And so before we got married, we said, hey, we’re going do this the right way. And so I went in and kind of confessed all my own things. And they said, hey, you’ve served a mission, you’ve taken temple covenants out, like we’re gonna hold you to a higher standard than somebody who hasn’t done those things. And so we feel like the best choice is to excommunicate you at this time.
And at the time I very much believed in the church. I was a very strong advocate for the church and it was everything. So for me, this was the worst thing that could have happened in my life. you know, being told that my eternal blessings were being taken away was awful. And the first thing I did is I went straight to Deseret Book. Deseret Book is a Mormon-owned bookstore. And there are several of them here in Salt Lake City. You might have to drive away if you’re in Texas or somewhere else.
Yeah, well there’s some that are doing business under a different name. I think they’re connected though.
Interesting. And so I went there and I thought, you know, there’s got to be something. There’s got to be a book or something, some guidebook, somebody who’s been through this to tell me how to get back into the church. And there was nothing. And I had this moment in the bookstore where I was like, my gosh, this is… this is what God wants me to do. I am supposed to write a book on my own experience on coming back from excommunication and getting back in and all of my feelings. my gosh. And so I literally thought that was my calling in life. And I started all of the steps. I even have notes on this first book years ago that I took as I was kind of coming back into it.
They don’t just re-baptize you. You have to go through a significant period of slowly coming back into the church and slowly re-professing your faith and your belief and your willingness to follow the commandments and the covenants and all of that. When I finally got re-baptized, was almost a year after we got married. It might have been two years after we got married. It a long process. And I have a letter still. A little letter is like, you’ve been re-baptized, you’re a member of the church once again, and your blessings have been restored. Yeah, I have that letter. And said, you can re-apply for temple covenants in one year. So you get rebaptized and then you still have to wait at least a year for reapplication for temple covenants. I think it’s still the same time frame. But we did that and…
My daughter Isabelle was born right before that year mark hit and so we got sealed as a family together in March of 2003. Wait. March of 2004. no wait, sorry. I’m getting my dates confused here, Megan. We got sealed in March of 2007. We actually got married in 2004. And it was funny, I include this story in the book, mostly because it’s kind of funny and sad and all the things at the same time.
When we were getting sealed, know, Hillary and I, that’s my ex-wife, we were kneeling across from each other on the altar. all in our temple clothes and everybody around us is in their temple clothes and they wheel Isabel in and she is weeks old and she’s got this beautiful like onesie dress that her mom has picked out for her and they wheel her in in like a pioneer era pram into the sealing room. It’s very interesting, right? You’re in a sealing room with an altar and everybody is in temple gear. And so everybody’s sitting in chairs that kind of circle the room. And the sealer is there with you and your spouse. It’s not often to have kids, but you know, when they have families sealed, they’ll bring the kids in and they’re part of it. It’s pretty special. And it was very special to us.
And so they wheel her in in this pram and they pull her out and put her on the altar in between Hillary and I and she immediately projectile vomits all over everything. All over her dress, her mom, sealer, the altar, everything. And it’s kind of funny because people are laughing but people are also sort of like… Is this a sign? Should we be reading deeper into this? And so then the fact that, you know, seven, eight years later, we were separated and going through a divorce and I was getting excommunicated a second time. It’s hilarious. It’s sad. It’s all of those things at once.
So I just have to pause you just for a minute. I appreciate your story so much and I am having this visceral reaction even though I’ve heard you share it with me before. Hate is a really strong word but that is how I feel about the word excommunicated. You know, not really understanding that word in my youth or I’ll just say previous years the way that I do now. This is hard to hear. And you are going to shake things up by sharing this story. And that’s a good thing. I’m saying this out loud because I think that’s a good thing.
I so. think one of the… One of the things I really want people to understand with my story, Megan, is… Yeah, so seven years later, you know, I went through an excommunication again. We got divorced. And when I got excommunicated the second time, even then, I was still convinced that this was sort of true. I went and I still went back to church the following Sunday. And so at that point, my wife and I had separated. She had moved with the two kids from Texas back to Utah. I had two years of residency training program left. And so I had to stay in Texas.
And you know, I went through this excommunication process a second time and I went back to church and I’m alone and I sat down next to a family that we had been friends with for years. And I looked at them and I smiled and the husband and wife kind of whispered something to each other and they got up and got their kids and they moved to another pew. And… I knew I wasn’t welcome. And I waited. I think I waited for the song to be done because, you know, God forbid I’m disrespectful. And I walked out to my car and I just, I think I cried in my car for a solid hour.
No, it’s okay. I’m getting to a major point that I want to emphasize. I cried for an hour and I got really angry. And I cursed the family and I cursed my ex-wife and I cursed God. Everybody but me who had put myself in this situation in the first place. And I stayed in that anger for a long, time. About seven years. Not really believing in God, not really believing in a higher power and just feeling abandoned and feeling alone. And the anger for a long time helped, right? I could at least hold onto that and not have to face this singular aloneness that had been thrust upon me from excommunication, from divorce, from all of the things.
And so it served me for a while. But the major point that I wanna make on the podcast with my book is at the end of the day, those excommunications were the best thing that could have ever happened to me. They were the right thing. And I would not be this version of me today that has grown and has healed and has become who I am were it not for those like kicks in the teeth and the excommunications. as bad as they were, as horrible as they can be, as harmful as they can be to some people. For me, I’m like, thanks God, I guess. And so I’m very, very moved past the anger around it because it served me for a while, but God, it feels so much better to just look back and say, man, I’m really grateful for those things because they shaped who I am. And so at the end of the day, it doesn’t matter what my belief is in God, he or she or they or whatever God is, got it right. And this was what was supposed to happen.
Yeah, we’ve had this conversation, I remember having it on the island with you, when God, this idea of a supreme creator, divine being, spirit source, is connected to religion that I believe is dangerous if we’re not able to separate. And for a long time I didn’t see that until I did. And it was having a queer kiddo that really forced me to sit back and realize there were ways that I could find God outside of the walls of a building, which I had experienced prior to that. But this was putting me in new shoes, in a new situation. And I’m not saying that people should or should not be a part of a religion. I just learned that for me it aligned and resonated to know that I could connect with that higher power wherever and that it didn’t need to be tied to a religion because it affected, you know, the way—I’ll just say this broadly—it affects the way our queer siblings and loved ones and friends feel about that relationship with the divine.
Yeah, think that’s… When you can find beauty in really any way that people connect with God, I think that you can really heal from your own struggles with how you connect with God. Does that make sense? for me, I have, you know… I’m no longer part of any religion. I would consider myself agnostic. I long time thought I was atheist. But I have two kids who are exploring spirituality and trying to figure out how they connect to God. And both of my children are being raised here in Utah, which is a very LDS predominant, LDS dominated culture and so that’s what they have the most exposure to.
Most of their friends are LDS. And so both of my children independent of each other have come to me and said hey what? My daughter said what if I marry a Mormon kid in the temple and my son said what if I choose to go on a mission and My response to them is Number one, I will always tell you what I believe, that’s just me as your dad, I’m gonna tell you what my own thoughts are. But number two, I very strongly believe that their choice in how they connect with God is one of the most individual gifts that they have that has nothing to do with me. And so, if they come to me and say, dad, I’ve read this thing, this Book of Mormon thing, and I really believe it, I would say, awesome. Love that for you. If my daughter was like, hey, I really like this Wiccan stuff, I’m like, okay, are you being a good person? Treating people well, yes, cool.
But I think the way we get so caught up in how people connect to God that we miss the whole point. It shouldn’t matter. everybody should be able to connect to God in the way that they choose to. And I think we’re seeing firsthand the dangers of trying to force people how to connect to God. And I think this is, I’m not trying to make this political at all, but I think we are seeing a blurring of the separation between church and state, which feels a lot like telling people how they have to connect with God. And when that happens, I think violence is a very common reaction.
Yeah, I agree with you. Yeah. This podcast interview is taking place just days literally after… it’s in the news, it’s common knowledge. The LDS church filed an amicus curiae brief. I probably butchered that. In two Supreme Court cases and part of this brief is evaluating whether transgender status should be classified as a quote, quasi-suspect class requiring transgender protections for gender. And they’re asserting in the brief that this is an imposition of religious freedom and that’s all I’m gonna say about it. Yeah, there’s no Jesus in that. And that is extremely, extremely harmful for someone who identifies in this unique way to have something like that go to the Supreme Court. That’s when religion is doing the opposite of what they’re purporting to do, which is bring souls unto Christ, unto God, unto the divine being, however you term it. And I acknowledge there’s lots of ways that people will address that.
And I don’t want to focus on that because I heard a skip in your step, so to speak. I heard it in your voice when you talked about how you actually are choosing to believe now that excommunication was the best thing for you, that you are now on this other side. And that is the kind of the new layer I’ve added to my podcast this year is focusing on that joy that comes on the other side of stepping into so much unknown, so much uncertain, so much messy, often painful, sometimes very cloudy, not clear, but there’s a lot of living to be had on that other side. And I’d love for you to share, I mean, you kind of hinted at it, how you have experienced that as you have chosen on purpose your path.
Well, it didn’t come easy. Like I said, post divorce, post second excommunication, I went pretty dark for a while. I found out with my divorce that I am a depressive eater. And so, rather than starve myself, I will eat my feelings. And so those last couple years of residency, think it put on probably about 50, 60 pounds. And stayed there for a long, long time. And… You know, I moved back to Utah, and it’s not like, you know, none of this happens in linear succession, right? It’s not like, I had these horrible things happen, and then I just suddenly started to get better and better. Like, there were, from the outside looking in, you wouldn’t really know that deep down I was still pretty miserable. I moved back to Utah, I started working as a plastic surgeon here, I was finally making money, I was reunited with my kids.
Life didn’t seem all that bad from the outside looking in, but the truth was I was pretty miserable. I was not really living up to the ideals of being a man of integrity. I was drinking way too much. you know, never on the job, obviously, but I… That was an easy thing to escape feelings and escape where I was really at. I just wasn’t happy. And I would… You know, post divorce, I developed this pattern where any girl I was dating, I would make sure that I always had at least three or four lines in the water or other options. Because I didn’t ever want to go back through the pain that divorce had been and that feeling of being alone. And it’s a shitty defense mechanism and it’s a shitty way to treat people, but… In retrospect, I can look back at it and say, okay, I understand, I get it. It doesn’t justify it, it doesn’t excuse it. They’re people that I hurt with my actions. But I understand why I was there.
And around my 40th birthday, had a kind of an eye-opening weekend trip. I had been living with this girl for three years, we were engaged, and I knew I was kind of not super happy. But I was not gonna rock the boat. I was not gonna put my kids through another breakup with another person. I didn’t wanna hurt her, I didn’t wanna hurt her kids. And so I was just, okay, will just, this is life. I’m not gonna, I’m not gonna, you know. I consciously sat with myself and said, I am miserable, I don’t care. I will just live like this. And you know, the thing that surprised me and still surprises me is I didn’t think that anybody else could see it.
And so we went on this big trip to Napa with a bunch of couple friends of ours. And that entire weekend, we were just fighting. That was just our MO. We were the awful couple to go out with that is fighting the whole time. And you’re like, my God, why are we hanging out with these people? They’re just fighting the whole time. And the theme of the trip, though, was interesting. Most people on that trip, not most, every couple on that trip, independently like would pull me aside at some point by myself. It started with my sister and it just said, hey you just you don’t seem like you buddy like you don’t seem happy and seem very you know you’re drinking a lot your weight’s going up you just don’t seem real happy and all of them on the trip are like hey you don’t have to marry this person like maybe pump the brakes.
Maybe let’s check in with you and see where you’re at beforehand. I knew I was unhappy, but it shocked me that other people could see it as well. And so within a week of that trip, we were broken up. And it was not easy. This was like a rock bottom moment for me. That breakup kinda just forced me to look at all of the things I had been ignoring for so long. And I was, uh, like, on my way to a hotel, um, suicide plan in place, and I was ready to check out. And I remember just, I called a buddy, it was like subconsciously, and just said hey with so-and-so and I we broke up and I’m gonna let her stay at our house for a little while till she finds a place but I’ll probably need something month to month do you have anything and He said well absolutely like but where are you going tonight? I said, I’m just I’ll be fine by myself. I’m gonna stay in a hotel for a couple days and He said, that’s not happening. You’re gonna come down to my house. We’re gonna go to dinner. Our buddy Ben is in town and we’re gonna hang out the three of us tonight. And in those, in those 30 seconds, he saved my life.
And we had this great night. I got two buddies who just really like poured into me and loved me and spent the night just laughing crying with me and both of them were just… They said something they really had they said dude like This is what we see Why don’t you see it? and then talking about me. And my buddy Ben, I remember him telling me something that has always stuck with me. He said, you can’t fuck this up. And I looked at him, like, I’ve kind of fucked this whole thing up, dude. I don’t know what you’re talking about. And he says, Nick, I am not talking about your relationships, your family, your kids, anything, I am talking about you. At the end of the day, you can’t fuck you up. Like, you are worthy of unconditional love, always. You don’t have to do anything to be worthy of it. You don’t have to accomplish anything or earn anything. It is there. You gotta find it. You gotta remember it, but it is there and you can’t fuck it up.
And so I, you know, the night was great and but the next day I still went back to that hotel and all of those same thoughts and feelings were still there and I had to sit in front of a mirror and I had to look and say, okay, like what do these guys see and what do I want? What is… I can go down this path which is I will not survive this path. Or I can go down this path, which is even scarier in some ways, and figure me out for the first time. And thankfully that was the path I chose. And I just said, okay, we’re gonna spend the next long time just figuring this out. And there’s a whole, like, there’s a lot that we can go into there on the things that I did. But at the end of the day, I was able to find exactly what Ben meant when he told me, can’t fuck this up. And I was able to find enough and remember enough love for me that it just, everything changed.
And I think that is within all of us. don’t think you have… One of the problems we get into, and this was something that my ex-wife, my current wife, my current wife Haley helped me realize while we were on the island. You know, had a… When we on the island, we’d do the blessing of the body every morning, right? And go through this beautiful prayer that Kira does with us. This was on Thursday, so we’d already been on the island for a few days and I had gotten to know you and I had gotten to know a lot of the women and their stories and Kira’s doing this blessing of the body and she’s talking about God, she’s talking about Jesus and I all of sudden felt very disconnected because I recognized that all of, was surrounded by all of these very powerful women who I respected and loved and they had all found healing and peace through God and Jesus. This memoir I was writing and a lot of the trauma that I had experienced I felt like was directly from God and Jesus. And I was like, well, shit, how do I fit in now?
And I got very emotional. I was sobbing in this blessing of the body and I went to my room and I called Haley and I just kind of, you know, let it all out with Haley. was like, I don’t understand this because I’m not stuck in this still. Like I don’t, I don’t feel like God and Jesus did all this trauma to me and I can’t get out of it. I just, I found it another way and it feels like I’m questioning the way I found it. Did I do this the wrong way? And Haley said something to me that I’ll never forget. She goes, honey, we go to all this stuff. We go to this woo stuff. We go to the, we’ve done plant medicine, we’ve done journeys, we’ve done breath work sessions, we’ve been to churches and all the things. And we talk about self love all the time. And so many people continue to try to outsource self love. And at the end of the day, it’s the most individual thing there is. It’s self-love. You don’t need God or Jesus or Buddha or grandmother ayahuasca or mother earth or anything outside of this to find that self-love. And yeah, that was my biggest takeaway from being on that island was having my wife really give me that moment of clarity and understanding that brought it all together for me.
I so appreciate your raw vulnerability here. You know, I think words matter. I’ve had sometimes similar kind of thoughts. For me, it’s kind of summed up in, I think sometimes it’s vocabulary words. It’s just a different use of vocabulary words that you use to describe something that happened for you that maybe I use to describe in words that have meaning to me, to something that happened to me. And the same goes for those of other faiths, religions, creeds, cultures, whatever. That doesn’t need to be a problem, that we describe it or we use different words to understand what’s meaningful to us. The problem comes in when somebody’s putting themselves above another or saying that this is the only way, because that’s in effect canceling out the very real human experiences that others have had that are valid and that were, I believe, curated for them. How that happened, I don’t really know. But yeah, I have learned on such a different level how much the divine already rests. We’re taught that. mean, regardless of whether that’s a belief you continue to hold on to, I mean, that to me is kind of another word for that self-love. Love is the highest vibration that we can live by.
Yeah, I, listen, don’t get me wrong. I absolutely believe in a higher power. I just think it’s you. I think it’s me. I think it’s all of us. And I think that if you’re, I think one of the most, I have a very strong belief that one of the most important things we can do is turn inward and remember to love ourselves because once you do that… everything else around you changes. You then pour that into your children, you then pour that into your partner and your spouse, you then pour that into the rest of the world. it’s really the ultimate cheat code.
I told a buddy this on a podcast the other week where I just said, know, we spend all of our life chasing after external validation because it feels good and our brains are wired for that. you know, we get a like on a comment or somebody shares our post and that gives us a little hit of dopamine and it feels good. And we’re getting external validation from the world around us. like, all right, I’m doing something. But the most valuable thing in this world is internal validation. And it is so hard to achieve because it doesn’t give us that same feedback loop of dopamine hits. No. But there is a power and a peace to being able to just sit with yourself and know I’m good. me and all this other shit going on around me can’t faze me because this internal validation that I have makes everything just fine.
Nick, I needed your sermon today.
Hahaha! Anytime, girl. You got it.
I, so what are you, let me ask you a question, especially with, you know, with all the stuff that’s coming up with the church filing what they filed, with people getting shot here in Utah, with bombs or truck drivers shooting up Mormon churches. How do you respond? Like what, because, and this is something, this is a question I’ve had to sit with and ask myself over the last few weeks is what do I do with this?
You know, it’s really easy to feel helpless when things like that seem to be happening on such a grand scale. Unfortunately, I think what contributes to that feeling is that’s what gets the headlines, right?
That’s what gets the attention. It’s the loud, often negative, or divisive news. And I think the way I respond is by coming back to exactly what you just said: that internal validation. I have to remind myself that my peace and my connection to what is good and true doesn’t depend on what a large institution does or doesn’t do.
It’s painful, though. When you see a community you were once a part of, or that your family is still a part of, making decisions that feel—like I said—harmful or lacking in that basic Christ-like compassion, it stings. But I’ve learned that I can’t control the institution. I can only control how I show up. I can be a voice for those who feel silenced. I can be a space of safety for the people who are being affected by those briefs or those headlines.
And I think that’s why stories like yours are so important. They humanize the “suspect class.” They put a face and a heart and a journey of struggle and triumph behind a legal term. When we share our stories, we make it harder for people to just see a “status” or a “category.” They start to see a person—a friend, a surgeon, a father.
That’s how I respond. I keep talking. I keep listening. And I keep leaning into that love we talked about. Because at the end of the day, that’s the only thing that actually changes hearts. Legal briefs might change policies, but love changes people. And I’d rather be in the business of changing people.
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