Here are some basic facts:
- method was penile inversion
- I opted for full-depth rather than a vulvoplasty
- surgery took 3 hours, though recovery took another hour
- I went under general anaesthesia and had to be intubated and put on a ventilator
- I’m currently admitted in the hospital and bed bound, discharge is scheduled for Friday
- so far pain is between 1 and 3 for me, most of the time it’s between a 0 and 1.
Ask me anything!
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aw, thank you! And not as far as I know or remember - I’m pretty sober and alert when I wake up from anaesthesia - I also usually have no headaches or confusion like can be common for others, and that was true this time too.
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no questions just a hells yeah
thanks 😊
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Thank you for even thinking about these questions! Remember that trans patients are patients, and while some things can be due to medical transition, not everything is. Unless it’s specifically transition-related care, most of us are just there for a stomach bug, or a headache, or the same procedures everyone else is getting. Ask our pronouns, ask our preferred names, make us feel like all of your other patients. This goes such a long way to making it a good experience. When it does come down to gender expression or transition-related things, ask about preferences and goals. Not everyone is binary. Even the binary among us have different options and plans. And sometimes, we can change our minds about things! Don’t stop being an inquisitive person. Learning gives you options and understanding and empathy, and those are the best tools you can have as a caregiver. Thank you for doing what you do!
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Feel free to send DMs if you want to have a longer chat about this. I’m headed for general anesthesia tomorrow for an unrelated procedure (see, we have normal human things like everyone else!) so I’m sure I’ll be meeting another nice surgical technician like you before I go under. I’ve been through a whirlwind lately, and my post history isn’t even half of it, so I am sure there’s much to discuss. Thanks again for remembering the human part of healthcare!
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Well, the hospital I am going to has a whole trans healthcare wing essentially, though they don’t call it that. It’s a subsection of the plastic surgery group, but my surgeon in particular works with lots of trans patients.
What I’ve noticed is that they make a standard practice of asking for name and pronouns, and then sharing their own. I personally don’t like this, but I get how it would help with non-binary folks or people who use neopronouns - so I tolerate it 😅 Mostly it feels stigmatizing to me, and when I work with people who know I’m trans it’s a different experience than people who don’t know I’m trans and who just see a woman. Since I just wish I were a cis woman, I prefer working with the nurses that don’t know I’m trans and thus don’t try to treat me differently (even as accommodating or being nice) based on my transness. I don’t want to be trans or treated differently for being trans.
The healthcare team was pretty responsive to my questions through the online portal, and in general seem competent.
My surgeon has awful bed-side manner, despite his excellent skills in the operating room - each time I interact with him I come away thinking he could really work on his delivery, lol - for example, when he saw me right before wheeling into the OR for my orchiectomy, he looked at my thighs and said “you need to lose 20 lbs” - it’s true losing weight can improve recovery, esp. for a vaginoplasty, but the way he put it was so direct and rude. (And tbh a bit hurtful, I struggle enough with my body and weight, and it just felt like a confirmation of my negative self image.)
Right before my surgery yesterday, the surgeon said that if the orchiectomy left a scar that makes it too difficult to him to use the scrotum as a graft, he will just do a vulvoplasty / shallow-depth vaginoplasty and then I would have to come back in 6 months to get full-depth (presumably with peritoneal pull through). For context, we specifically asked about whether the orchi he did would interfere with the vaginoplasty, and he said no - so learning it could right before being wheeled into the OR was anxiety producing since I suddenly didn’t know if I would wake up with a full-depth vaginoplasty like we had agreed on.
Other staff had trouble communicating clearly - like they would mumble or speak too quickly for me to understand what they were saying, but these are more like personality issues.
If you want to know how to work with trans patients I would just think the most important thing is to think of them as their gender - if you have a trans woman patient, just think and treat her as a woman and all is well. Ditto for trans man, and for non-binary patients it’s not that different. Knowing and respecting pronouns, and doing what you can to put in your mind that they are the gender they say they are is probably the best advice I could give.
Relatedly, there are lots of intersex people who are trans, so also not making too many assumptions could be good - sometimes anatomy will be different than you thought for a trans person, i.e. a trans woman might be intersex and not even realize they have an intersex condition which might mean they have anatomy they don’t realize they have, etc.
And when you’re working with trans patients I would say it’s important to just treat them like any other patient - when I looked very trans and wasn’t passing, I often would get this overly nice treatment that felt more like pity than respect or support.
Let me know if you have specific questions I didn’t cover!
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Not OP but I went through this in 2017
The good: staff was overall very helpful, seeing my friends was great
The bad: explaining to the chaplain every time he came in that I don’t necessarily care for religion (at least not xtianity)
my hospital is very pushy with the chaplain, but there was a way for me to kinda opt out by disallowing the staff from putting my surgery info on a whiteboard where the chaplain goes to find patients to prey on. This also meant my spouse wouldn’t get updates from that same board, but we agreed it was worth it to avoid the chaplain, lol
sorry you had to deal with that, I think there is a lot of transphobia still and it’s weird to me that chaplains are pushed so hard with gender-affirming surgeries 😬
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I actually opted out so the chaplain couldn’t find me and somehow they still ended up dropping by during my recovery. Luckily this chaplain was pretty chill, it could have been a lot worse - but it was still a stressful event for me and against my explicit wishes and choices.
I wonder - what do you think the purpose of a chaplain is - all of this has made me think more about chaplains and their role. I tend to be cynical and think the worst, that being that chaplains are basically there to try to convert people when they are vulnerable (after a surgery can be a traumatic time, and a significant number of religious conversions occur after a trauma). There is also the opportunity to convert before death, so that might be playing a role too. But I need to actually read up on the history and context, maybe my cynicism is misplaced here.
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Congrats! I hope someday I’ll be able to do the same. The idea of sex kinda sucks when it feels like your brain is looking for parts you don’t have.
yes, I didn’t think my bottom dysphoria was that bad, I would have described it as moderate - but after the surgery and looking down, I felt such a huge sense of relief I broke down crying - I clearly had big feelings I was dismissing the severity of.
T~T
Tbh, I’m starting to look into it myself, though I still have +6mo before insurance will cover it. However, considering how long I’ve heard the waiting period can be, maybe now is the best time to start thinking about it and looking for surgeons.
yes, wait times can be very long and this is a surgery that requires a lot of planning. 6 months isn’t even enough time to get your hair removal finished, generally I see recommendations to have 1 whole year of electrolysis and at least 3 full cycles of hair clearance. That alone is a huge amount of work and time - I had 1 hour electrolysis appointments once a week. When you add in the typical insurance requirements to have been on hormones under the supervision of a doctor for a year and the requirement to get two independent letters from psychologists, you are looking at a lot of appointments with endocrinologists, psychologists, and eventually with the surgery team. It’s a lot - so start now if you think you might even possibly want it.
When I socially transitioned I practically promised myself I wouldn’t get a vaginoplasty, I only wanted an orchi … and that position was fully reversed after 6 months of estrogen. I wish I had taken the possibility of a vaginoplasty more seriously, and that I had started hair removal for that much earlier.
Why is the hair removal so important? Is it for removing hair that will be on the internal parts?
The scrotum and phallus skin is removed and used as a skin graft and it becomes the lining of the neovagina. You don’t want hair in your neovagina. Besides the obvious discomfort with that, there have been cases where hair in the neovagina leads to infections.
Usually surgeons now will cauterize the follicles they find on the skin graft, but that only addresses the hairs growing in that cycle - you need to have removed the hairs over many cycles so new ones don’t come in after the surgery. That’s why it’s best to have cleared all the hair with electrolysis across several cycles - ideally over an entire year (even longer than that would be better because the following year you can kill any that were missed the first year).
I thought of a question.
What was your process like for picking a hospital / surgeon?
My doctor admonished me to think carefully and pick someone experienced that I can trust, but I have absolutely no idea how to judge a surgeon’s competence other than looking for other people’s reviews online and asking the surgeon directly about past experience, results and so on in the consult. I’m basically planning on going by gut feeling right now.
/r/Transgender_Surgeries and https://www.transbucket.com/ both have photos of results from specific surgeons, so I spent time on the internet researching who was recommended.
I also happen to live in the southeast, and people drive from all over the southeast to go to this surgeon (like driving 8+ hours from other states), and in my local trans community I knew several people who had this surgeon and had great results - so it was sorta my only option in a way - the surgeon was within driving distance, and otherwise I would have had to fly to go to a different surgeon (like those in Thailand).
But basically just reading every review of the surgeon and looking at their results, and then I had a consult and asked more questions to confirm.
Not a question, but rather a statement. I’m happy for you :)
thank you!! 💕
Woah, awesome <3 I’m so happy for you!
3 hours seems really quick. And discharge in less than a week? Did you find the speediest surgeon ever, or is my information out of date?
I’m failing to think of a question, so… how are you passing the time until you are up and about again?
The information I had generally was that a vaginoplasty takes between 4 - 6 hours here, and in the past could take 8+ hours to complete.
Apparently this is a really good surgeon and hospital, I was shocked they got it done in 3 hours. I’m not sure how typical that is, but I heard from one of the staff that they had make major advancements in the past few years that enabled a much faster surgery. I would love to have more details, but I don’t yet unfortunately.
I’m not sure re passing time - I brought movies, audiobooks, and my laptop so I can mess around on Lemmy like right now 😉
So we’ll see, but right now it’s also really easy to just close my eyes and spend time drifting and coming in and out of sleep.
I’m super happy for you! Get some rest and I wish you a speedy recovery!
thank you 🥰
Congrats ! I hope you have a speedy recovery ! My question is: what exactly is the difference between a vaginoplasty and a vulvoplasty, and the part about full depth? I sort of can work out an idea from the names but I guess I’m wondering what’s the details that make it either/or?
Strictly speaking, a vaginoplasty normally includes a vulvoplasty, but the reverse isn’t always true. A vulvoplasty without a vaginoplasty means no vaginal canal, and so no depth.
Sometimes people will use vulvoplasty to mean a shallow-depth vaginoplasty, I was just specifying I had full-depth (which has a longer recovery time and more risks of complications. Basically with a vulvoplasty / shallow-depth you have labia, a clit, etc. but no vaginal canal. With a full-depth vaginoplasty you have all the things a vulvoplasty provides (labia, clit, etc.) as well as the vaginal canal (as Ada points out).
Hows it feel to not having a thing touching your inner thigh, constantly? Although i guess theres probably something there from the hospital 😅
post orchi not having testes was a huge benefit for that - but the empty scrotum would still slap the thighs and make me feel nauseated and upset whenever that happened.
I am on bed rest so I’m not allowed to walk or get out of bed until Friday, so I have no idea yet how walking feels - I am very much looking forward, though - that was one of the biggest sources of genital dysphoria and I can’t wait for it to be gone. I remember post-orchi saying “every step brings joy” because walking used to cause dysphoria and suddenly I could walk differently and feel so much better.
Wait until you lie on your tummy in bed for the first time!
Not OP, but i can say 2 years post op it feels weird to think I used to have something there lol
CONGRATS!
What non-sexytimes related thing are you most excited to do once you recover more?
lol, I have so much work to do once I’ve healed, but in terms of what a vaginoplasty unlocks for me, I definitely look forward to swimming and feeling right / fitting better in my clothes.
Oh gosh, I hear you on the swimming! I’m a trans guy and my first swim post-top surgery was so much fun. It was way too cold for me to be in that pool and I didn’t give a shit. I hope you have a blast at your body of water of choice!
ha, that’s awesome - I was always the kid that wore a shirt to go swimming because it felt wrong to go topless. Looking back, there might have been signs, lol
So glad you had that post-op joy, I look forward to joining you 😁
Congratulations Dandelion, so happy for you 😊
thank youuuu 🥰
Congrats!!
Questions:
- how long it has been since you made your mind for the op?
- does the public healthcare/private insurance cover the surgery and post op care?
- how do you plan to celebrate this awesome life milestone with your friends?
lots of love, girl :)
how long it has been since you made your mind for the op?
I was pretty sure I wouldn’t want a vaginoplasty when I socially transitioned in August 2023, but I knew I wanted an orchi.
It was probably around 6 months on estrogen when I realized I needed a vaginoplasty as well, so that was around a year before the surgery - maybe June 2024 (I started HRT in Dec. 2023).
does the public healthcare/private insurance cover the surgery and post op care?
I have insurance through my employer. The total cost of the surgery is $135,000 and insurance is paying for all but $1,400 of it which I have to pay.
how do you plan to celebrate this awesome life milestone with your friends?
I guess I haven’t thought of this at all, tbh - I’ll be moving in a few weeks to another state, so I won’t have time to celebrate (let alone recover!) so my life is just too busy for fun stuff 😅 Also, not sure most of my friends really grok the whole trans thing, so even if I had the time for it, I’m not sure what I would do to celebrate with them.
It’s a good idea, though - I’ll have to ponder this some more ❤️
yaay congrats! :^ i remember when i woke up i was so sad because i thought it was just a dream and i started to cry T_T
i got mine at the end of june 2020 and had an amazing view of the empire state building lit up for pride and i thought it was appropriate coming back from surgery and seeing that :3
Happy to hear it went well! Hope it continues to do so and that other awesome things do as well :)
thanks!! I’ll just be excited to be able to walk around again, being on strict bed rest is a lot more difficult than I expected, lol.













