SRS FAQ

These are some questions that people have wondered, so I thought I'd start a post to answer these and more. If you're wondering anything, feel free to ask about it below.

- "What the hell do you do all day?"

Well, mostly I lie in bed naked and stick things in my vagina.

[It's not as exciting as it should be.]

I lie in bed because it hurts to sit without my invalid ring and even then it's generally uncomfortable after awhile (fortunately the toilet isn't painful at all).

I'm naked because air drying is generally recommended, my mom doesn't care, and pants/underwear are kind of uncomfortable while I'm still swollen in general. (The swelling is supposed to subside within the first four months, so I won't know what the "finished product" looks like for quite some time).

I dilate four times a day. Take two Sitz baths (put some soap in water and soak for ~10 minutes). Douche twice. Eat. Sleep. Repeat.

- "What the hell's dilation?"

Dilation is where I put plastic rods in my vagina and hold them there. One of the "unique features" of the trans vagina is that you're creating a space of nothing where something used to be. As such, the body wants to heal upon itself in the space. If you don't artificially keep it open by dilating, the vagina will close up which, you know, would be bad (in addition to kind of defeating the point of the whole 'surgery' thing).

Dilating, fortunately, isn't uncomfortable for me most of the time. It's difficult at first; the muscles get tense, so the dilators don't go all the way in easily. I have to really focus upon relaxing and maneuvering to get them as far as they'll go (about 4.25"-4.5," which is a bit below the average for the surgery but because I highly doubt I'll need to accommodate anything aside from fingers and the dilators' more fun-loving second cousins, I'm not too concerned). The maneuvering is frustrating and uncomfortable, but once they're in it's just a matter of listening to something until I need to switch to the larger rod or stop.

Overall, it takes about 45 minutes to an hour including setup, cleanup, and positioning. The frequency is what's most obnoxious: I'll get one done, eat a meal, and it's practically time for another. Fortunately, the frequency gradually decreases the further you get from surgery (schedule is here), but I will be required to dilate once a week for the rest of my life or risk it closing. So, you know, that's fun. (Penetrative vaginal intercourse can count, though. Which will make for an awesome pickup line: "Hey baby. My vagina's about to collapse and only you can save it. Wanna be my heroine for the night?")

- "Why Montreal?"

So, the penile-inversion technique means that, contrary to popular belief, the penis is not "chopped off" but instead inverted using the scrotum for much of the vagina. This can require a skin graft for some trans women whose penises are not large enough (and, regardless of initial size, after years on antiandrogens/estrogen and possibly no erections, this might be a real possibility).

Unfortunately, scrotums be hairy, yo. Most American doctors recommend.require genital electrolysis to remove the hairs. Dr. Brassard in Montreal removes them himself by cautherizing them. The American doctors advice electrolysis because it's the only way to be absolutely sure. But I've had really poor results with electrolysis and I didn't know how to find someone in Knoxville to do the genital version so Montreal seemed a lot easier. So too, the Montreal clinic has reputable aftercare and since I was going alone I thought that'd be an asset. [Thailand is the country that does the most in the world, but I didn't want to be that far from home alone and I also didn't want to be that far from the surgeon in case I needed to go back for some reason].

The cost and, honestly, the distance was pretty comparable to most of the other top places in America.

- "Can you orgasm?"

Hopefully! I mean, I wouldn't want to let your mom down now, would I? With the penile-inversion technique, the surgeon keeps the nerve endings from part of the glans in the penis intact and essentially creates a clitoris. Most women, barring complications, are able to orgasm post-op although it may take some time before full sensation returns to the area (and, of course, degrees of pre-op sensitivity differ too).

Hell, there's even some degree of lubrication for some women from the urethra, depending upon how much lubrication the penis tended to create before.

But for now, I just have to wait and see. (Not gonna lie: I'm pretty excited. Since, you know, I can't get unexcited. Since, like, it... anyway, next question)

- "How did you pay for SRS?"


So, SRS is expensive. Well, let me qualify that: SRS that in Canada or the USA with reputable doctors is expensive. After travel costs and paying for therapists to judge me insane enough to qualify for letters, I paid about $20,000. For someone who's never made over $13,000 a year, that's a substantial amount of money.

For better or worse, instead of going to a private college with a $40,000/year tuition, I went instate to the University of Tennessee which paid me to go. However, as my grandparents and mother had saved up some money to help me pay for college as I was growing up, they charitably gave me that money anyway. This, combined with spending very little money on much of anything and working pretty consistently throughout college, left me with a fair surplus once I graduated. 


So instead of going to a highly-regarded private school and leaving with a fair amount of debt, I went to UT and got a vagina. Worth the tradeoff? Meh. But it does let me say that my vagina was partially subsidized by the state of Tennessee.

If you have other questions, about the surgery or being trans or anything, please don't be afraid to ask in the comments below!

A Prurient Proof

So, funny story: a week or so before flying to Montreal, I start talking to a young woman online who lives in Atlanta. She's smart, pretty, showed me glimpses of her *huge* diction... I'll spare you the graphic details. Anyway, it just so happened that, to save money, I was already scheduled to take a bus to fly out of Atlanta. And we figured that, since I was going to be there anyway, we ought to do lunch before my flight.

So we did. Her train was delayed so I got there first, and she surprised me by walking out of the subway tunnel with a bouquet of yellow roses. Not gonna lie: I swooned. She didn't know the area well, so we kind of wandered around until we found a sub place (for lack of anything else). She made some flimsy excuse for buying me lunch. We ate. We were both sleep-deprived, so it was somewhat awkward. But it was a nice diversion from thinking OMG SURGERY OMG SURGERY like a stock ticker in my head.

When our time was getting short, I suavely and subtly said, “I wish I could just pull you into a corner and make out with you.”
She said, “Yeah, that would be nice.”
Heartened, I took the classy route: “Well, the bathroom is a single room.”
She promptly responded “Well, I'm finished eating,” dropped her sandwich, and started walking. I, as you might imagine, swiftly followed.

Lovely, lovely makeouts commenced. It happened so fast it was almost unreal; I'm not used to other people taking the lead in matters of the sexy and sordid. Anyway, lurid details might prove superfluous, but suffice it to say I had somehow gone through life never being thrown against a wall and furiously kissed and now I have.

Eventually, as you might imagine, someone tries the handle outside and finds it locked. We start to compose ourselves when I discover that I have a huge erection.

Like, a huge one. Bulging against my jeans for all the metropolitan area to see, no doubt no way no how. And I realize that I honestly cannot recall a time where this iconic happening-to-penis-havers has been a problem. Two days before the surgery, and I'm going to have to walk to the subway station in downtown Atlanta beside a really hot girl with a giant hard-on. The poetry of the divine, indeed.

So I do what any sensible person would do and awkwardly angle my bag to cover the front of my pants as I walk down the street and wait for the subway.  Someone fortunately gives me their seat on the subway (on account of my luggage) and, aside from my date's amused grin, I escape major embarrassment.. Soon she gets to her stop and kisses me goodbye (*sigh*). And, as she's gone and I can finally stop being turned on, I think to my penis, resting smugly and far-too-snugly in my jeans, “Q.E.D., motherfucker. Q.E.D.”

It might be an understatement to say that I had the last laugh.

On Crying Alone

On the night after the surgery, my hospital roommate (call her “Kate”) phoned her mother. Kate had been in significant pain all day. Whereas I was fortunate enough to merely have the motion sickness-esque nausea and headache that usually accompany my forays into anesthesia, she hurt terribly. And as time went on, the pain worsened.

Pain medication provided temporary relief but only fleetingly. And, of course, that's cause for even more distress: the gradually dawning knowledge that modern medicine can only do so much to save you from the mysteriously individual agonies of the body.

So, in unrelenting pain, no end in sight, she did what many of us would do: she called her mommy.

She did not ask for much, after their brief salutations and Kate's preface regarding her pain. She said, merely, “Tell me a story.”

And though I can only hear Kate's side of the conversation, I can make a good guess what happened.

“I don't know any stories,” her mother replies.
“Surely daddy or Uncle Tommy's done something funny recently,” Kate says, almost begging.
“Nope.”
The subtext is clear. And Kate, uninhibited by pain, gingerly jumps to it: “Don't you love me anymore?”
“I don't even know who you are. You murdered my child. How can I love you?”

Kate, sincerely, pleading, “I didn't murder your child, mama. I'm right here. I'm still your child.”
“You aren't my child.”
“I may sound different and look different, but I'm still your child, mama.”
“You aren't my child. You promised me, you promised me that you would never go this far. You promised me. And here you've gone and made yourself into some kind of freak. You promised me.”

“Mama, I didn't know what I was saying! I didn't know it would mean that much to you, I was just trying to make it easier on you and I didn't really know what I wanted and I'm sorry mama.”
“You promised me.”
“Mama, I'm sorry. I love you, ok mama? No matter what happens, I'm still going to love you. And I just need you to love me, that's all. Right now, I just need you to love me.”

Silence
“Alright. Bye, mama.”

Kate was so calm. She wasn't angry, she wasn't hurt. She wasn't crying. At least that she showed, of course.

I was, though. And, tear-stained from across the room in the darkness, I choked out “That was so terrible.”

Kate made excuses for her mother. Said her mother is the “most selfish person I know.” Explained the gaps in the conversation I'd already guessed. Said “Daddy will take up for me, I know it.” And that was that.

So I cried for Kate. Cried the tears she couldn't, fueled the anger she didn't, felt the hurt she blocked. And I reaffirmed my commitment to keep working towards a world where this bullshit doesn't happen.

***

Later, though, I wondered: given Kate's obviously fraught relationship with her mother, why had she called her, of all people, that night?

I don't really know. It's not really my place to ask, and it's arguably not my place to tell the story.

But I wonder: who would I call?

The day I flew back, as a product of exhaustion and hormone fluctuations, I started sobbing for twenty minutes straight. There was no definite reason. I was just... overwhelmed. My mother was in the room when I started, and I tried to hide from her. She's great if there's a physical/medical problem, but, as mentioned, she has her own significant barriers to trust and intimacy. I did call a friend who has talked me out of killing myself an embarrassing number of times and can at least roll with the punches, even if  she lacks the emotional vulnerability to be comforting. But when she didn't pick up? No one. I cried alone, just as I went to Montreal alone, just as I've done most of the hardest parts of my suffering and changing alone.

In other words, I don't have anyone I can call who can make me feel better. Not a single person who will be able to make me feel understood and loved and safe and cared for.

The reasons are legion, of course. I don't need to revisit my childhood here, but it doesn't take an expert in object relations to tell you that alcoholism, abuse, paranoia, and deadened stoicism don't foster trust and openness in a child (or her parents, for that matter).

But being trans, pre-transition... how can you be truly intimate with someone? Intimacy is all about knowing someone better and better, but when you haven't transitioned the person someone else is getting to know isn't you. Not really. Not in the way that matters most. My first and only long-term relationship was with one of the sweetest, most affectionate people I know. But whenever she touched me, it was as if she was blocked by stone. The person she was trying to reach, the person she was attracted to, the person she loved was not who I really was. And that's an obstacle no one can surmount.

It's not just being trans, of course. It's anything that makes you feel like you need to keep essential parts of yourself hidden from others. I sometimes, in my pettier moments, start to roll my eyes at LGB people getting so torn up about being closeted because, you know, at least the world sees them as who they are even if they don't recognize who they love, right? But it's the same fundamental thing: hiding part of yourself makes it harder for others to get close to you. The bigger the hidden part, the more distance between you.

This certainly isn't the case for all trans people. But I wonder: now that my active transition is nearing its end (vagina dynamics aside, I mainly have to get electrolysis finished, and the rest will just be dilations/HRT for the rest of my life) and I'm finally reaching a point of relative emotional stability for the first time in my life, will I be able to get closer to others? Will I find myself in five, ten years in some emotional turmoil and be able to call someone who I know will help me feel comforted and loved on some essential level?

I don't know. But I think there's more reason now than ever to hope I will.

Two and a Half Weeks Out

Every day seems to follow the same pattern: I wake up feeling nasty and terrible, dried out and poorly rested, not to mention seeing spots on my bed/bed pad from discharge. I dilate. I take a shower and douche. I feel recharged and ok. I dither around for a few hours. I eat lunch. I dilate again. I sitz bath. I dither. I dilate again. I eat dinner.

And then I start to worry. I look at my vagina. I see this horrible white stuff that is most likely "fibrinous sloughing" or something. It creates constant discharge. I get pissed off that my bed pad is full of spots where I've sat, that I'll have to get more pads, that I'm wasting pads. I look at forums and google and everything trying to figure out if I need to do something. Because I can wait, that's fine. But needing to do something and not knowing about it is terrifying. I dilate again. I sitz bath. I douche. I try to go to sleep. I eventually do.

***

I emailed back the "follow-up" questionnaire my surgeon's office sent me yesterday. I got an auto-return email saying they'd be on vacation until August 22, effective that day. I'm furious that they'd just up and leave and not even warn us about it. I don't know what to do about the white stuff. I don't know what's normal.

I'm light-headed and my thoughts are foggy. My doctor here said that if I got light-headed, I needed to reduce my anti-androgen. I don't want to; I've already regressed so much from the month I had to stop hormones. I hate having dark facial hair again. I hate having greasy hair and rougher skin. I read a forum post about "adrenal fatigue" with the fogginess lasting years.

I don't know what normal is. And that's the problem. I don't have pain. I don't have that much bleeding, aside from the discharge. It just looks bad. And foreign. I want to lie naked in bed recovering, knowing that I'm doing everything right. I don't want to sit here terrified that my incompetence is going to produce lifelong sideeffects, botching this entire surgery. The only people who can really say are on vacation for six weeks. There's a metaphor in that somewhere.

***

This is easier than I thought. This is harder than I thought. This is so incredibly worth it. This might be a gamble turned disaster. I have so many people who support me. I'm, essentially, alone. I'm so looking forward to living. I wouldn't mind dying. I literally had a fainting fit of vertigo after I wrote that. I don't know what to do. I don't know if there's anything to be done. I need someone to tell me. I'll get someone who says "Wait and see." This isn't that hard. This is far too hard.

I want to be well.

The Way We Were

Ever since I was a child, I have wanted nothing other than a vagina. I would lie awake at night, fantasizing about its majestic curves, its mysterious crevices, its supple and moist texture. I could imagine nothing hotter than being penetrated by a hard, erect penis, feeling it pound against those beautiful walls deep inside me. I knew that I could not be whole, nay I could not be human without one.

But society was stacked against me. My parents hated it when I wore dresses. I was a boy, they insisted, and that meant I was supposed to play in the dirt with guns and sticks and foosballs or something. Of course I knew better: inside, there was a little girl howling to be let free. But it took me 23 years before I was finally able to build up the courage to say that yes, I truly wanted to be a Vagina American. 

I wanted to be a woman. And what's a woman without a vagina? A man, that's what. I wanted to be anything but a man. I wanted to let the woman trapped inside me out. And I knew that she could only escape through that glorious, flowing opening betwixt my legs. 

But first I had to convince everyone I was really serious. I dressed as a woman for an entire year. It was hard and all, but once my therapist saw I was serious she gave me papers saying that people shouldn't give me shit because I'm mentally ill and it's not my fault. Wearing makeup and a dress felt so freeing! Some people laughed and mocked me, and they still made me use the men's restroom at school. But I could kinda get that, though; I mean, I wasn't really a woman, not yet anyway. I was just some freak. I hadn't earned it.

It was hard. It was really really hard. But that's the price of real womanhood, you know? Well, that and $20,000. I worked really hard to save that money: nothing was more important. And when I had finally saved enough, finally gone through all the tests and therapy, finally proven myself, I made my appointment. It was one of the happiest moments of my life.

As the time got closer, I was scared, sure. But I knew who I wanted to be: a woman. Not a drag queen or a he-she fag or a crossdresser. And that's what a vagina is, ya know? It separates the men from the girls!

Anyway, after so much time, I finally made it to Montreal. In just a few short hours, Dr. Brassard was able to work his magic. And when I woke up? It was like being reborn. I was a women. A real woman. And no one could ever take that away from me.

Now, I'm recovering. And it will certainly take awhile. But after that? I'm done! For all intents and purposes, I'll be just like any other normal woman. All of this “trans” business will be behind me. I can finally just be “me.” And that will be the sweetest thing of all. 

 *** 

In case you haven't already surmised from my subtle and urbane satirical narrative above, this is not going to be a conventional retrospective about Sexual Reassignment Surgery (SRS). If that is what you're seeking, one need only google the term to find countless videos and articles about SRS, most of which will be produced by cis people, for cis people (although the discerning searcher can find trans owned narratives with a bit of work).

As such, if one wants to write about SRS, it's impossible not engage that narrative. Indeed, the vast majority of cis people equate being transsexual to having Sexual Reassignment Surgery. It's a point of fascination, both morbid and mocking, for the culture at large. Increasingly, much of this is well-intentioned: progressive people, in particular, love to see marginalized people become happy with themselves and their identities. But this is undermined by the inordinate focus upon SRS even within these circles: never have I seen celebrations of name changes, of starting Hormone Replacement Therapy (HRT), of even simply coming out as trans that match the congratulatory and celebratory joy from cis people regarding a transsexual person's surgeries. It always has been and remains the most familiar and intriguing aspect of transsexual people's existence for cis people. And that creates a host of problems. 

Because SRS is not just about surgically altering one's genitals to be closer aligned to one's true sense of self. It's about legitimacy, legal, cultural, and social. It's about wealth. It's about those who don't or can't have SRS as much as those who can and do. It's about cis people's deepest fears and suspicions of trans* people. It's about definitions. It's about biology and culture. It's about relationships, sex, and love. It's about “real.” It's about verisimilitude. It's about impossible standards. It's about women, it's about men, and it's about everyone and anyone involved in that inherently limited binary.

I cannot write about this without writing about all of that. And if you think I am angry, then you are right. I am furious. And excited. And hopeful. And terrified. And thankful. And resentful. And a whole host of emotions complicated by the fact that I had quite invasive surgery two weeks ago that will take a year to really recover from.

These feelings, together, do not fit the conventional narrative. And, as such, this exploration is going to make you uncomfortable (and not just because I'm going to go all "nonlinear postmodern" on your beautiful butts). But I want to ask you to engage with that discomfort. Chances are, what you want, what most people want, is to read a story about how I was sad because I was a boy and then I became a girl and then I got surgery and then I became a real girl, and now I'm happy. You want to celebrate with me, unambiguously, to embrace unmitigated positivity. And believe me when I say I appreciate so much about that sentiment. And I will write about that. But I need to challenge it, too. Because the only way this story is coated in unmitigated, celebratory positivity is when we don't want to see anything else. And there is just too much else there.

Hopefully, I can find a way to show a bit of everything.*



[*Well. Almost everything. IF YOU KNOW WHAT I MEAN.**]

[[**I mean I'm not showing you my vagina. Which is kind of ironic, because that is what this is all about, right? And yet, you not seeing my vagina is also kind of the point. Isn't that deep? It'll be deeper after I dilate. *drops mic* GOODNIGHT EVERYBODY.]]