Considering MtF Surgeries

[Guest Emily H]

Hello all. I've got some questions and thoughts that I really need some perspective on.

I've been living as a woman full-time for...about two years? That is to say, 24/7, no more male identity, no more male name, no more male clothes, everyone knows me, refers to me, and addresses me as Emily. It's my legal name, and (at least as far as New York State seems concerned) my legal sex.

Life is pretty good, not counting the normal hardships that a 20 year old with college debt and no clue what to do with her life has. I'm in a very liberal area, I have a lot of supportive friends, a very supportive and LGBTQ workplace, and 90% of my family, including my really loving parents, are totally on my side. I am VERY lucky and VERY thankful for where I am.

However, I am looking toward the future, and considering surgery.

I've been on hormones since high school, but I've gone off of them... for way too long. Like, 6 months. I stopped because the original plan was to get some sperm banked, then get my testicles removed so that I could get off of the t-blockers and let the estrogen do its job better. But given that I want kids, preferably biological ones, sperm banking was in order, therefor, stopping hormones temporarily.

However, given that the fertility center is over an hour away, I have a full time job, no car (yet), and I need to go back 3-4 times to make deposits, I'm not done with the procedure yet, and haven't resumed the hormones. Anyway, so that's all explained.

The idea of being a full-blown woman really appeals to me. However, the idea of sharp objects near my body, let alone making cuts, incisions, etc. is extremely scary to me. My whole life I've been really afraid of medical procedures, even minor ones. After spending a lot of time with my Gender Therapist and my endocrinologist on the subject, I came to a logical choice that if I had sperm in the bank (enough for 6 pregnancy attempts is the standard), and I'm CERTAIN that I don't want testosterone effecting my body (which I am), then the testicles are pretty much useless. I can dig that, I really can.

Now, going further with bottom surgeries, I'm really unsure what I want. If I could shell out a ton of cash to get an honest-to-god, fully-functional vagina, I'd probably pick up a few extra jobs and work non-stop until I could afford it. But I know that, currently, that's not possible.

So what's the reality of what I'd be getting, and is that reality something I would want? Am I capable of getting over my fear of surgery?

That's what I really have to figure out... I also have two major questions, that I'm sure everybody always asks.

-Is it REALLY a vagina? I mean, TECHNICALLY, I know its not... Pardon my extreme ignorance/bluntness here- but will it amount to more than just an inside-out penis that's been sliced up a bit?

-Related to the above... can I self gratification with it? Can I have sex with it? Will it feel good? I mean... self gratification with what I have now feels REALLY good. But other than those brief moments, I really don't use my penis or have any desire to use it the way it was intended, but I would REALLY love to have sex using a vagina (that's really weird wording).

For the record, I haven't really been doing ANYTHING related to my transition in a long while, not even seeing my therapist. I WILL resume that, and continue moving forward in transitioning, once I get my driver's license and can actually get to where I need to go. Not having transportation is just awful...

Anyway, thanks in advance for all answers and responses.

[VickySGV]

Short answers now since I have an emergency dental appointment that I have to leave for in a short time.

Your fear of surgery etc. is something You Alone or with a therapist must handle. If the surgery is important enough to you it can help you to overcome the fear. Surgical teams and recovery teams can and will help with the fears medically, and the first drug given to me in the OR was just a sedative that got me going. I had excellent post-op pain management, but it was quite the experience.

As for your Neo-Vagina, while I have not had vaginal sex with a male partner, my neo-vagina is nearly 7 inches deep and is an inch and a half in diameter, so in theory I can be penetrated and have a male climax inside of the NV. With some surgeons, you will have a degree of self lubrication. It took me a little over a year for my vulva to become fully sensitive to erotic stimulation, but it is there now. For self gratification, first, you can play with the dilators you will be given, and many girls do get some satisfaction and pleasure when they try to do it. For the first 6 months of healing other types of toys are discouraged, but not forbidden except the first 6 weeks to 2 months. I am happy I did it, and with how I have healed.

[Guest]

Well, first it depends on what your most important priority is: aesthetics, depth, or sensation. Unfortunately it doesn't seem you can get the best of all three at the moment...you kinda have to pick and choose. More like pick one to be great, and the other two to be adequate - good.

No personal experience, but I'd say the top of the line surgeons get you somewhere halfway in between a penis turned inside out and a fully realistic vagina...although they say some gynecologists have been fooled. Its not going to be as sensitive, or necessarily sensate in the same places as a natal one, but most these days say they're able to orgasm, it won't be all that self lubricating though maybe a little, and the transition from clitoris to inner labia at the front doesn't quite look the same in shape or color - it ends up more like a separate structure inside, hard to explain - I suggest going to the various surgeons websites for (the few) pics they have available- though that being said there's great variance in the genetic population as well - it's not like it looks completely different and your results may vary.

And the techniques are constantly evolving. A neo-vagina you get this year will be different than one just five years ago. And heck a decade ago, one of the top tier surgeons, Dr. Bowers, wasn't even doing the surgery. So a lot might change. Results also depend on if you're circumcised or uncircumcised. Dr. Chettuwutt in Thailand does amazing things aesthetically for those who haven't been cut.

With current tech you do have to dilate for the rest of your life, which is probably the current biggest difference outside of self-lubrication between a natal and neo vagina. And no periods of course. :- )

[KathrynJulia]

Emily

Getting this surgery is well worth it. I was the first post op my gynecologist had ever examined. She was nervous at first, then amazed at my results. If you walked in here and hadn't informed us you were post op, I would have thought I was looking at a regular woman's vagina who had had a hysterectomy. This is amazIng.

I also experience multiple orgasms shortly before my 5th month post op anniversary. It caught me completely by surprise, but it was so amazing to experience. I haven't experienced being penetrated by a man because I'm not attracted to men. But you can split hairs but mine is an honest to God vagina and it belongs right where it is. I have no desire to go back to having a penis.

It's your decision. That's what it always boils down to. A decision that you have to make. Good luck on making that right decision. Kathy

[Guest LizMarie]

Yes, it is a vagina. Vaginoplasty is vaginal reconstruction and it is done on natal females also. Women who have been in accidents, suffered from birth defects, and especially women who have received radiation therapy for various cancers can also experience severe tissue damage in the vaginal area necessitating vaginoplasty.

So the operation is not just for transwomen. It is for women and involves reconstruction of the vagina.

Further, examinations are revealing that often the skin used to create the neo-vagina acquires actual traits identical to a regular vagina. The bacterial ecology of a health neo-vagina (for a transwomen or a natal female) is identical to that of a regular vagina.

If you're asking about sensitivity and orgasmic capability, that will vary per person but generally the reports are that many transwomen are orgasmic. Further, Lynn Conway, noted public transwoman figure, once participated in a study in San Francisco back in the 1990s, and transwomen with a neo-vagina appear to orgasm almost identically to natal females (which is very different from male orgasms). The neuro-muscular responses down there are identical to those of natal females and the EEG brain patterns are identical as well, with the sole difference being that transwomen appear to experience those brain patterns originating in a slightly different area of the brain (and again not at all like male EEG experiences).

So, short answer, yes, it's a vagina.

But of more importance are your own personal issues and concerns related to surgery. No one here can alleviate those. I highly recommend you discuss this topic with your therapist.

[Guest Ripley]

Vaginoplasty is a distant possibility for me at this point. Hopefully the other ladies here can answer your questions about that. But, I do have recent experience with orchiectomy (standard and radical at the same time!). I've also been pretty scared of surgery or medical treatment (Scalpels ) my whole life and I've got to say it was nowhere near as bad as I was expecting. I was put under with general anesthesia, and the last thing I remember was being wheeled away. Then I woke up laying in the recovery room and it was over. Went home the same day. They gave me pain meds, but after two doses I stopped taking them. The side effects were much worse than the pain, and the standard scrotal incision was little more than a scratch. Regular advil was more than enough, and I only took that at night to help me sleep easier. The worst part of the whole thing was having the IV removed. They put so much tape on my arm, you'd think I was going to be dancing around with it in!

The inguinal incision was a little worse pain wise (the only real reason I took the advil), like a really bad bruise. But, that's usually not necessary. I recovered in about a week.

I'd also like to add that I'm squeamish, but neither incision was anything hard to look at. There was very little blood and everything was sewn and stitched together neatly with disolving stitches.

[Guest DesiB]

Surgery was very important to me. I didn't always know if I'd able to get there, but finally I did! But my life actually changed more after FFS, fulltime transition, and just being generally accepted to a high degree in daily life. Still, vaginoplasty was always an essential part of what I had to do, even though I've always known what it felt like to be female my whole life, internally. (Even with an outie, I always imagined it and felt it as an innie.) So my feelings post op were all good. The only things I needed patience for were waiting for appearances to hopefully improve as things healed and plans were made for revisions and even a follow up labiaplasty. (But you can read on my blog at this site why that didn't happen.) So what did I get? My gynecologist says it looks like I have two vaginas! She asked if I ever had my urethra dilated because it is so wide open. The only person I ever let touch me down there kept mistaking my urethra for my vagina even after I had explained my situation to her. That was always a painful mistake and an end to the mood! My urologist asked me if I had surgery down there as a little girl and told me I had a hump inside my urethra like a male has. (He was going in there to find a kidney stone.) The next time I went to his office he had a different intern who asked me if I had genital reconstructive surgery. My GCS surgeon, Dr. McGinn told me that my vagina itself (as opposed to the entire vulva, I suppose) was indistinguishable from any other woman's. But when recommending that I douche it once or twice a week because there is no concern over upsetting the bacterial balance since it is really no different from a deep belly button. And when I complained about the "W" shape of my mons pubis, she replied that it looks that way because I used to have testicles. So I guess the bottom line is that no, surgery will never give you the same experience of a perfectly healthy cis birth. But if you can accept some of these disappointments, you may still decide it is worth it.

[Drea]

I avoided responding figuring that there will be the usual responses.

The "oh it is definitely worth it" based on someone else's experience and needs of course.

Then the "it is exactly the same as with any woman, it is indistinguishable" despite some very glaring differences.

I haven't seen the "vast majority have trans woman who have SRS are happy with their decision" brought up to support having SRS. This is what I call the statistic argument and basing ones decisions on statistics is a great way to become one yourself.

In my view, it is a very personal decision.

I have very clear reasons in my mind why I made my choice. I will share those privately with anyone who wonders. No nebulous generalizations like "this makes me the same as any other woman" or just because women don't have peni or because its the "full package"

Obviously testosterone is a big concern for you, orchi or SRS will resolve that.

Do you dislike your current anatomy or just indifferent?

Are you prepared for the maintenance?

It is probably an easy decision for someone to decide to have SRS if they absolutely hate their existing anatomy.

Similarly easy to decide not to have SRS if one loves their existing anatomy.

People in the middle then other factors will decide.

And maybe look at it from the flip side, what causes some to regret SRS? Usually behind that is someone had very unreal expectations or that it was more trouble than it was worth with the typical complaint being the maintenance, the smell, etc.

The one thing I could relate to in what you said was fear of surgery, getting cut into by sharp objects. I experienced one differenced, that part down there never felt part of me so the idea of surgery there didn't carry with it the same fear of me being cut into. If that makes any sense.