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!
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
Congratulations! I hope you have a swift recovery and feel more at home in your body.
thank you! 💗
Congrats! I def need to get one for myself soon. Are you comfortable sharing the name of the surgeon/practice?
Congratulations, I hope you have a speedy recovery.
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!!
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 ❤️
Congratulations Dandelion, so happy for you 😊
thank youuuu 🥰
Ok, actual question time!
- How long was the waitlist, or the time between your consultation and the scheduled surgery date?
- Which PIV method did you get? I was looking at a specific method in the northeast and am trying to get an orchi ASAP with a request to preserve some tissue for a specific method, and am wondering if this is the same method. This seems like a VERY short time in the OR.
- Did you discuss personal priorities with your doctor? I have in mind the juxtaposition of sensation vs function vs aesthetics.
- Last one: how big was your grin when you woke up and realized everything was the way it should be?
How long was the waitlist, or the time between your consultation and the scheduled surgery date?
That’s a good question - I started HRT in December 2023, and I couldn’t have any surgeries until 1 year later (Dec. 2024). I knew I wanted an orchi, so during my first year of HRT I got a letter from a therapist for surgery, and then called up the hospital and scheduled a consultation, which happened probably sometime in the summer or fall of 2024 (sorry, details are a little fuzzy here).
Then I had the orchi scheduled with them for December and I started laser hair removal on the genital region a couple months before the orchi as I started to think a vaginoplasty would be a good idea.
Electrolysis for hair removal started ASAP after the orchi, so that was early February.
So overall the wait was like 6ish months since if I hadn’t been so dismissive of my bottom dysphoria and taken vaginoplasty more seriously, I might have done hair removal my whole first year of HRT and then had the vaginoplasty ASAP in December 2024 rather than waiting for June 2025.
Either way, I consider this a pretty short timeline, though I really wish I could have had my orchi when I started HRT in 2023, that insurance requirement to wait a year is blatant transphobia.
Which PIV method did you get? I was looking at a specific method in the northeast and am trying to get an orchi ASAP with a request to preserve some tissue for a specific method, and am wondering if this is the same method. This seems like a VERY short time in the OR.
Honestly I have no idea - I tend to think about getting the best surgeon and then getting whatever method they are best at. Since this surgeon is best at PIV that’s what I went with. I wish I had more details about it, because I’ve never heard of a full-depth vaginoplasty being done in 2 - 3 hours, that’s just insane.
Did you discuss personal priorities with your doctor? I have in mind the juxtaposition of sensation vs function vs aesthetics.
In visits before the operation I did ask the PA and nurses about what to expect in terms of sensation, function, etc. I didn’t give a lot of input on aesthetics, but that’s partially because I’ve seen his work before and it matches what I would like.
Last one: how big was your grin when you woke up and realized everything was the way it should be?
Leading up to the surgery was so nervous I was making a mistake and scared that it would look awful and I would immediately feel regret. Once I was in my own room and could look at it more closely, despite being the first day I felt this immense relief - like I had just shed a mountain of burden. I was shocked to find that I was so extremely happy with the results, and that led to some happy sobbing.
I’ve had intrusive thoughts about cutting off my penis since I was a teenager, and my scrotum has always seemed extremely gross to me - I just coped by not taking those feelings seriously, and so in a real way I didn’t understand my own bottom dysphoria or how severe it was. Right now at least I just feel so much relief and happiness - and I can’t explain why, it just is that way despite not expecting it to be like this at all.
Either way, I consider this a pretty short timeline, though I really wish I could have had my orchi when I started HRT in 2023, that insurance requirement to wait a year is blatant transphobia.
That is a short timeline! I’m happy that you were able to move this fast!
In visits before the operation I did ask the PA and nurses about what to expect in terms of sensation, function, etc.
This has always been a thing that worries me. I’m mostly concerned with functionality, though obviously we would all like like have all 3 be perfect. I’m glad you were able to find the procedure you were hoping for!
I was shocked to find that I was so extremely happy with the results, and that led to some happy sobbing.
Joy really is the end goal, isn’t it?
This surgeon seems pretty decent on all three measures, aesthetic seems ideal as well as function and sensitivity.
Here are some photos of the surgeon’s work:
NSFW
3 month post-op:
different person, 1 year post-op (this one is shallow-depth / vulvoplasty):
same vulvoplasty person but 6 months post-op:
a different person 4 days post-op:
and yeah, joy is the end-goal I guess, for me it’s more like harm reduction driving things than joy, but I’m happily surprised when the joy comes anyway, lol
I have a hard time connecting with my feelings around dysphoria, I’ve coped really well and part of the way I cope is by dismissing and ignoring my feelings around gender.
Congratulations !
thank you 😊
Happy to hear it went well! Hope it continues to do so and that other awesome things do as well :)
As a surgical tech in the process of switching over to nursing:
How was your healthcare team? What did they do that stood out as good / is there anything they could have done better?
I hardly ever get trans patients, but I want to make sure their experience is as good as I can make it.
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 better.
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.
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!
asking for name and pronouns, and then sharing their own.
Huh. We’ll ask during intake, but haven’t offered our own. Do you think that’s a good practice overall, or making it weird? You and a couple other posters have mentioned -and I agree- that trans patients are first and foremost patients who should be able to expect the same care as anyone else, to include not getting special treatment since that can be awkward for the recipient. I have noticed a couple nurses seem like they’re walking on eggshells - like they’ll get WAY apologetic if they fuck up a pronoun. It’s awkward just to see from the sidelines, lol.
My surgeon has awful bed-side manner / weight
Some surgeons are like that. Reeeaaaaally smart in their area of expertise; but dumb as rocks the second they set foot outside of that bubble, to include basic social skills. Med school really needs a course or two on “how to not be an asshole!” …often the side you see as the patient is the ‘nice’ side, too - once you go under, they crank the asshole up to 11 to the staff in the room.
But… we tolerate it. They’re good at providing healthcare, and if that wasn’t keeping them occupied, they’d probably be serial killers or some shit.
Hope your recovery is going well! Unsolicited advice: you’re only about 30% as good as you feel after surgery. It’s the drugs. When you start feeling good enough to return to your normal daily routine, NO YOU DON’T! Sit down, be lazy, and chill for a couple more days. And follow your post-op instructions to the T - the groin is a high infection rate area, so don’t cut any corners with whatever they told you to do for cleaning, dressing changes, etc.
Also, congrats!
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!
Thanks!! As a surg tech I don’t get much insight from my patients: they roll into the OR, I introduce myself, anesthesiologist knocks them out, and we get to work. And the times I do get to chat (case delay for whatever reason and the patient is just hanging out with us on the OR bed) I usually try to just keep them distracted with questions about their work or kids or music preference or shit like that. Anything to keep their focus away from the pile of what looks like medieval torture devices I’m assembling, or the alien environment that ORs are for anyone who doesn’t work there. …what I don’t do is grill them about the quality of care they’re receiving lol.
So, conversations like this one are the closest thing I get to direct feedback. So again, thanks!!
Once nursing school is finished up and I switch over to the dark side, there will be a lot more interaction with actual conscious patients, so the feedback I’m getting here is super helpful!
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!
Feel free to send DMs
Right back at you if you have any questions about the OR! Anything specific to the procedure you’re about to have, this late in the game I’d definitely stick with your healthcare team and not a random internet stranger, but anything that’s OR in general, I got you!
Bit 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 😬
it’s weird to me that chaplains are pushed so hard with gender-affirming surgeries
It’s weird that chaplains are pushed so hard, period. This has been driving me nuts in clinicals - they’ll just drop into a patient’s room completely unsolicited and start asking religious shit. Like… dude, did that patient request a chaplain? No? Then get the fuck out! I can see the value in having a chaplain available to patients who want one, but until that request is made, stay in your damn office!
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.
It’s part of a whole-health or holistic model of healthcare. It’s good in that it acknowledges that there’s more to a person than the specific issue(s) they’re checked in for. We have a tendency to become kinda desensitized and lose sight of the human vs the ‘lap chole in room 4’. Spiritual health is one of the pillars of that model, and that’s what chaplains are there to provide.
The problem is that “spiritual” is just assumed to be religious, and religious is just assumed to be Christian, at least here in the states.
The other problem is that chaplains assume they’re part of a patient’s healthcare team by default, so they tend to just waltz into patient rooms and start talking to them as though they’re automatically welcome. Many patients lean on their religion when they’re stressed, and if that makes them feel better, then fuck yeah that’s cheap medicine. Some of them are so distressed that they want to speak to a religious official - enter the chaplain. Ideally, the chaplain functions like part psychiatrist and part liaison, tackling whatever it is that’s causing the patient spiritual distress and then connecting them with the people or resources needed to put that at ease. In other words, it shouldn’t matter if you’re a Christian or Satanist or astrologist or Pastafarian or anything in between - the chaplain should be able to see to the needs of each with equal competence.
In actual practice? “…well that’s why Jesus di–” OMG SHUT THE FUCK UP!!
Even looking at them through the lens of “they’re healthcare providers” it’s still super fucked up that they just butt into the patient’s space unsolicited. Like, imagine if a urologist did that… “Hey it looks like you’re here for a lap chole? Nice, nice… anyway, you’re a human with a prostate, so don’t mind me, I’m just gonna… get… up… in there… Alrighty that’ll do it, have a nice day!”
…and given the state of healthcare in the US, that’ll probably come back as $1700 extra on your bill that your insurance won’t cover cuz that doc was out of network.
But yeah, imo the chaplain should stay in their office unless a patient specifically requests to see them. Not every patient feels empowered to say no when the fucker just drops in right next to them and asks if they want to talk about whatever god they’re trying to push.
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 😁
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?
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).
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.
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.
no questions just a hells yeah
