Archive for the M-to-F surgery Category

Presurgical Hormone Crash

One to two weeks before MtF gender surgery (SRS), most surgeons want you to stop all estrogen. Within a couple of days, your system goes from a healthy level of estrogen — to nothing!

When that happened to me, I became irritable and depressed; I snapped at my boss. Even though I was excited about my surgery, I was just short of miserable. Someone told me I was experiencing PMS. I don’t know how similar it was to PMS, but my feelings were tangible and unpleasant.

If I had it to do over again, I would have let myself down a little more gently. Instead of stopping cold two weeks before surgery, I think I would have started early and cut the estrogen in half for a week before stopping totally. If you are coming up for surgery soon, you may wish to keep this in mind.

They Don’t Cut It Off

I wanted to avoid the P-word, so this post isn’t misclassified by some automated system, but when I wrote it that way, avoiding the word “penis” took so much circumlocution that I got lost.  I wrote the bulk of this post on Easter Sunday, 2010; it’s been simmering since then.

The surgeon doesn’t cut off the penis during vaginoplasty.  The testicles are cut off and discarded, but part of the penis remains.  That’s what I tried to say in my poem Transformation of the Genitals.

That’s right: they turn the penis into a vagina, but they don’t cut it off.  So in fact you sort of have both: a penis (which no longer looks like one) and a very vagina-looking vagina made from it.  Sure, they throw away most of the stuffing from the penis before they push it inside you, but it’s still the same penile tissue you had last week. That tissue used to be a penis, and now it’s shaped like a vagina. That’s why I say you sort of have both.

This is an important distinction if, like me, you had some ambiguous feelings about your penis before the vaginoplasty. I mean: even though the tissue is no longer shaped like a penis, it still feels like a penis from the inside, at least in some ways. Some parts of the vagina of an XX female contain erectile tissue; after vaginoplasty, some small pieces of erectile tissue from the penis perform the similar functions for an XY female.

That’s what I prayed over a lot during Holy Week, 2010. Even though my surgery was 13 months earlier, the emotional healing isn’t finished yet. When I become aroused, some swelling occurs. The emotional discomfort I had with a swelling penis comes back to me, even though that penis is now shaped like a vagina.

So, I continue to grow and to heal.  If you, too, have ambiguous feelings about your male equipment, you are well-advised to resolve those feelings before vaginoplasty, because the feelings may still be there afterwards.

Reiki Before and After Surgery

Reiki is a relaxation and healing therapy that can be beneficial both before and after surgery — any surgery.  I just had a session this afternoon, which would be about 4 days after the bladder surgery I mentioned the other day.  I also had a session the evening before that surgery.

My surgeon recommended it; I accepted her advice, but wasn’t motivated to make it happen at the time of my SRS.  My experience this time was of a qualitative improvement in healing; had I known at the time of my SRS how beneficial it can be, I would surely have found a way to have at least one reiki session.   I plan to do so with any future surgeries, of any kind.

You can use your favorite search engine to find a reiki practitioner near you, or near where your surgery will occur.  Some hospitals even have reiki or Healing Touch programs right in the hospital.

The D-Word

It’s been thirteen months since my surgery; I’m still dilating daily, for 30 minutes or more, and twice daily on Saturday, Sunday, and holidays.  Because of the prostate surgery, I still have an unusably small vagina — can’t use it, but I’ve at least got one!  I’m taking advice from my gynecologist and doing my best to deepen what I have.

Dilating is still painful, too, during the dilation and for a few hours after.  Owing to some complications from the cancer surgery, my clit frequently itches and frequently hurts; it rarely feels good at all.  It’s a good thing I didn’t have surgery for the sex!  Since I have no prostate, there’s nothing but the clit to stimulate.

Because I didn’t have surgery for the sex, I feel wonderful!  No kidding: I’m happy to be alive.  It is a joy just to be able to walk  down the street.  I can think of several things I would have done differently about the SRS had I known — but now I just enjoy what I’ve got.

Seriously, though, if you know someone who has had a prostatectomy and is now considering vaginoplasty, there are some things they could know that might make the journey a bit more pleasant.

Tax Law and SRS

I just came across this link today on Helen Boyd’s blog (thank you, Helen), and thought others might want to see it, too:

http://taxprof.typepad.com/taxprof_blog/2010/02/tax-court-gender.html

According to this law professor, the gender reassignment surgery is an eligible deduction, but not breast augmentation.  This appears to be what came out of tax court.

My surgery last year was self-pay, so this may mean I’m eligible for a big deduction.  If you, too, paid for your surgery yourself, and had your surgery a few years ago, I believe you can file an amended return. I think that’s good for up to 3 years, but check with your tax lawyer or accountant.  I don’t know if this ruling is retroactive, but if it is you might save a bundle of money!

For those of you who are planning surgery in the future, save this link!

Followup: Why I Chose to Have SRS

I have had Sex Reassignment Surgery (SRS, or Gender Reassignment Surgery, or Gender Confirmation Surgery) as I said a few weeks ago. In a few more weeks, I hope, I will have some corrective surgery for after-effects of a prostatectomy I had in 2001.

I have not had breast augmentation. I have not had facial feminization surgery. My Adam’s apple thankfully isn’t very prominent, so I haven’t had a trachial shave. I haven’t had rhinoplasty (a “nose job”) even though I’ve always thought my nose was a little large. On my boy self, it was large; on me, I think it goes beyond large.

My body, though, isn’t identical to me. It is an essential part of my essence, but it isn’t the whole thing. It goes back to loving my body.

When I don’t love my self, I fasten upon every detail, large or small, to prove that I am not lovable:

  • I have age spots on my hands and face.
  • I’m 63 years old; I don’t look 23…. or even 33.
  • My belly is too big.
  • My bust is too small.
  • My butt is too small; I wish I could worry that it’s too big.
  • My eyelids sag.
  • My brow ridge is too prominent.
  • My feet are too big.
  • My jaw is too large, and my chin too pointed.
  • Et cetera

Whether or not each one of those things is true, not one of them — not even all of them together — is reason for me not to love myself.  Since I do love myself, it doesn’t matter whether I have any of them fixed.

If SRS changed anything, it has reinforced my sense of identity as a woman; I am a person who has a vagina.  That vagina really is important to me.  I see now that I left this out of my earlier post.  For me a really good reason to have SRS was that I wanted a vagina.  Now that I have a vagina, and I love myself for being who and what I am — I don’t need anything else.

All the other things I could have fixed?  Well, maybe someday, if I win the lottery….

Why I Chose to Have SRS

Sex Reassignment Surgery (or Gender Reassignment Surgery, or Gender Confirmation Surgery) is not the inevitable end result of transsexualism.  Thousands of my my peers — both transmen and transwomen — cannot have surgery for financial reasons; thousands more cannot for political reasons (i.e., they live in a culture in which transsexualism is punishable by death); thousands more have medical conditions that prevent them from having surgery; still more thousands fear to do so for social reasons (i.e., family or friends will disown them).

Even when there are no external impediments, SRS may not be the best course for a specific transsexual person.  Choosing to have one’s genitals physically altered has spiritual, emotional, and rational components.  After discussing the alternatives with my partner, I chose to go ahead with SRS for these reasons:

  1. Surgical removal of my testicles would reduce my need for estrogen and other drugs, and would consequently lower my health risks for estrogen-related conditions
  2. Even in 2009, there remained in the United States legal situations in which a physical male could be subject to legal prosecution for some actions (e.g., entering a women’s restroom) in some jurisdictions; surgical alteration to remove the legal risks seemed wise
  3. When dealing with people, the approach of “least surprise” is safest.  That is, if I appear to be a woman with clothes on, it would be least surprising for someone to find that I appear to be a women with my clothes off (for whatever medical, emergency, or accident-related reason).

Well, those were the three reasons that clinched the decision for me. Living full time as Kathleen had already removed the depression which plagued me for so much of my life.  I had already come to accept my body as it was, and to love it.  I had already come to love myself as a transgendered person.  Had there been a medical impediment to SRS, I don’t believe I would have gone into depression, because I loved myself as I was.

So for those three reasons, I chose — and my partner concurred — that SRS was the course of action for me.  Those might be good reasons for you, too, or they might not.  SRS is just not the right course for every transgendered person.  But, you know, that’s part of the excitement!  Yet another advantage to being transgendered is that your choice of paths isn’t obvious.  You don’t have the luxury of doing what everyone else does; your challenge is to discover the right path for you.

One Terrifying Moment

On the 8th day after surgery, I went the surgeon’s office to remove the bandages and learn how to dilate.  I was sitting in a chair with stirrups, and my partner was holding onto my shoulders.  The doctor removed the packing and handed me a mirror.  I think I began to scream, but stifled it.  My partner assures me I didn’t scream, but I think the doctor said something like, “Is she [meaning me] always this excitable?”.  Between my legs was a very black hole, black as soot.  It looked as if the flames had just gone out.  It looked like one of the many gates of hell.

Thoughts of the devil began to weave through my consciousness.  Had I been drafted into the devil’s service?  Was this vagina-like thing a mark of the devil?

The doctor began explaining some more, and I realized that the black tissue I was seeing was partly dried blood and partly dead skin.  Yes, I was told, it is black, but that won’t last long.  Once I got past the black, I could see that a very complex female organ had been sculpted.

Over the next few days, I began to piece together what had been going on in my head:

  1. Yes, it looked like hell when the packing first came out; I hadn’t been prepared for that.
  2. In my mental preparation, I had imagined not having a male organ, but I had never pictured what I would look like with a female organ instead.

My corrective action was to talk to myself about integrating this new piece into my body.  After all, I told myself, none of it was foreign tissue: it was all me, just rearranged.  I wanted a vagina; now I had one.

I’ve gotten past that moment.  I feel very good now about my vagina, and about having a vagina, but there was a tense moment along the way.

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