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The Ins And Outs Of The Future

Published: Dec 27 2018

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Operation: Me

I have been thinking about the future more. When I first started transition I didn't have a solid plan for what would happen. It was more of a "hey, this is making me happy; weird" thing. I mean I have this whole blog about it so it's a bit more complex than that but you get the idea. I continued one day at a time. Now it's been a couple years. Many things have changed since I began. Some fast as the HRT did it's work, most slow and agonizingly so. 

Since things have slowed down I can refocus on what I would like for the future. I don't have to worry anymore about coming out or how I will begin hair removal on my face. I can focus on things that require more planning. The biggest of which is reconstructive surgery.

Initially I was not concerned with the state of my genitals. I couldn't do anything about it and it didn't matter because HRT takes time anyways. Now that time has passed and I find myself much more concerned. If you want a comparison that you might relate to you can think of it as cleaning the bedroom. I can't vacuum until I pick up the clothes and big things. In a similar way, I had bigger things to take care of than my genitals initially. Now that those obstacles are gone I can see that there was something else that calls for attention. This is just me though. For some people their genitals cause them the most significant distress. The result may be the same but the prioritization is just a bit different is all.

One And Done

Now I have mentioned it's a priority for me. So then after surgery I am "done"? Well, no. There is no "done". I am always going to be trans. Afterwards I might end up focusing on something else I would like changed and plan towards that. This brings me to the next point. There is no one "the surgery".

I see it a lot that people ask (generally a huge faux pas to talk to a person about their genitals when you don't know them extremely well) if you will get "the surgery". Sometimes they even say something about getting "the surgery" to be a "real woman/man". It generally displays a lack of knowledge on the topic because there are multiple surgeries on multiple different areas. Do you mean facial feminization surgery (FFS), which is really a grouping of multiple surgeries like: rhinoplasty, brow reduction, jawline reconstruction, etc? Generally for trans women they are asking about vaginoplasty (bottom surgery, GCS). Even then though there are several options like depth or no depth or labioplasty or phalloplasty (for trans men). For trans men maybe top surgery (or double mastectomy) may be the more immediate concern. There is just too much wrong with the statement but the biggest issue to me is the idea that I am not already a woman. I am a woman whether I have a vagina or not. That is not up for any debate and if I am told this I will immediately consider it a negative strike against you. I won't cut off communication but it will set off a red flag that you may have a misconception either through ignorance or intention that I will need to consider.

As I mentioned I can't be "done" and another group of people take that and say that it's a never-ending cycle of surgery after surgery and I will never be happy. I don't believe that people truly believe this. At least not consistently and honestly. I don't see the same concern for every single person who has had any (reconstructive) surgery. All the people who have had a singular surgery are evidence that you can just be "done" when you are satisfied. If they were honest they would advocate to stop all elective surgeries for all because they will lead to a slippery slope of endless self-criticism and more surgery. No more breast augmentation, rhinoplasty, liposuction, or dental work.

As you can see it's a touchy subject and mostly because of people that are ignorant or intentionally malicious. So now that I go the ranting out of the way let's talk shop. 

Pros and Cons

The surgery I want is vaginoplasty, specifically with depth. There are pros and cons to all the specifics available. For example, there is a difference between how surgeons can form the vaginal canal to make depth and how that affects things. I will leave you to look up those on your own. Most of the surgeons I have seen do penile inversion at least in the US. The other option was depth or no-depth. I also want to have depth.

I will start with the cons. Specifically depth/no-depth. This affects recovery time as there is a lot more required to give depth than to just arrange the tissue. Imagine it like carving art into a pumpkin. If you want it on the exterior only you only need to put the art on the skin (reconstruct the tissue), but if you want to have it hollow with a candle inside you need to do more work and remove the insides (construct a canal). I will leave it at that since there is a lot more to it and very much more graphic than I think you want to know! So recovery will be a bit longer, about 4-6 weeks.

The next con is dilation. Since the tissue is not in the position it started with I will not have the muscles/tissue structure that would normally be there. This means I need to dilate to keep the canal open and pliable, initially a lot (3  times daily), but slowing down as time goes on. By the time I get to about a year it might be reduced to 1-2 times a week. and eventually maybe even once a month. I might be botching the timeline a bit but it's a process that will need to be done to maintain functionality.

Therapy. There is nothing inherently wrong with therapy. I will have to have it though and that is sort of part of the con list. There will likely be a full post about gatekeeping in the future to expand my thoughts on this.

The last con is cost. Obviously more involved surgery means more cost.

Now for some pros and also justifications. The first is depth. Firstly if I am going through the effort to have surgery I will go all out. I don't have any extraneous circumstances that require me to consider recovery time (which is a valid reason I considered for no-depth). I do want it to be function for intercourse/penetration (not everyone will be concerned with this and may not need the depth then). If I didn't get depth to start the amount of depth I can get (if any!) is reduced significantly so if I ever want depth I should start with it.

Another pro is that clothes will fit better. At least they won't have a bulge in any way because of excess tissue in the area. 

Cost. As I said it's a lot but insurance covers some of this. That is especially good because I really don't want cost factoring into a life-long, life-changing decision when looking at surgeons.

The last one is really weird but aesthetic. Going to the bathroom won't be a reminder of what I have. Taking a shower. Changing clothes. It will all not be a reminder that I have something where I would like nothing (external). 


There really isn't one. The topic is complex and unique for each person. As unsatisfying as that may be it was nice to get this all out there and put my thoughts into words. 

The only thing I have come to realize it that while I seem blasé about it all I am freaking out inside. Not about anything specific but just having it become closer to a reality is daunting and scary.

All the subjective questions that cannot be answered like: will I like the aesthetic? will it function the way I want? will I cry the first time I pee (because it sounds 'right')?

These can't be answered before, at least not with any precision, and that makes me nervous. Also excited. Hopefully there will be more to come as I get more information and things get into motion.


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