Monday, June 4, 2012

Surgery - keeping it real

My last blog had unexpected results, namely a spew of parting TG rhetoric. To quote:

"I guess some of you cut off your dicks to spite yourselves - self loathing is a separate illness from gender dysphoria. A faux or neo vag is the same cock you had to start with, only mutilated, if you enjoy sensations post-op it is because your cock nerves are getting you there."

We were also asked to consider the transsexual priestesses of antiquity, specifically the status of their surgery.

So. a blog on surgery.

How good is it, really? how wrong can it go? what does it change?

I suppose i could do some research. In keeping with the spirit of this blog, though, i'll keep it personal. There's enough personal accounts available out there for anybody with a serious interest to hear many sides of the story without me needing to paraphrase the vocies of others and twist them to my own purposes.

How good is surgery? Its rubbish. it really is. I suppose it is the best it has ever been, yet, for me, no matter how realistic or sexually functional a neo-vagina may turn out, surgery still fails in its most important aspect. I'm sterile. I cannot carry children and i have to take hrt for the rest of my life.

It gets worse!

In my case, i opted for Colon-Transfer surgery. Over the years i had developed an increasing hatred for my boy bits. I really did not want them, nor did i want to retain the memory of them in flesh... In retrospect this was a little foolish, as the surgeons can do amazing things with the various bits and pieces. Biologically, the male and female systems develop from the same base of cells, so there's not a huge difference between them either. But. that is where i was at, so penile-inversion was out.

I couldn't get a place with my preferred NZ surgeon, so i headed out to thailand, to a well known and respected Thai surgeon, Sanguan Kunaporn. Unfortunately, he wasn't very experienced at CT at the time, a small detail he neglected to mention. So he made a bunch of mistakes. When you join flesh, you get scar tissue. Scar tissue does not stretch. So, when joining two tubes (say, the colon and the entrance of the vagina) it is important to join them with a zig-zag. that way, when the tube needs to stretch, the zig zag can straighten out. Needless to say, that's not what i got. He also chopped out rather too much of my ascending colon (12", instead of 4"), severely compromising my digestive system. He then went and put it in upside down, so instead of the smooth muscles and blood supply being arranged to push stuff out, they pulled stuff in. And he failed to remove all the erectile tissue, meaning that when i was aroused, a small nub of tissue effectively blocked my vagina. Nice work, and about the biggest nightmare any woman born TS could hope for.

By the time i became aware of this i was newly single, without a job and and more than a little stressed. I was in the bath and out popped a thumb sized ball of grey stinky horror. It was to become a regular thing. I called them my clay babies. They were a consequence of all the fuck-ups my dear surgeon made. So. My newly minted body disgusted and revolted me. It required constant maintenance to keep it clean and would regularly remind me just how bad things were. Plus, i was broke with no means to get it fixed.

Still want surgery, anyone? It can go wrong....

Seriously, its probably worth having a few extra grand in the bank just in case. And not going into a relationship meltdown during the recovery phase would help too. It is impossible to quantify how important a stable relationship is to your mental health during recovery. Watching mine crash and burn was uniquely terrifying.

It took me 5 years to get things fixed. that's a lot of my youth missing, unable to really share with anyone else because i felt untouchable. A lot of time to learn how to become unapproachable. I used to get told i was proud and aloof. I wasn't. i was terrified and self-hating. I'm still realistic. No matter how many boyfriends care to tell me how things are fine down there, i'm not stupid, nor am i deluded.

Nowadays, after more surgery, things work as they should. I imagine for most operations, the kind of nightmare i had to live through is not that common, but who knows? It has taken me a fair bit of nerves to talk about what happened to me. It is a mental health issue. When dealing with traumatic stuff, we like to tell positive stories, and not dwell on the unchangeable horrors. How many of my TS sisters have secret horror stories, and how many are completely happy? Also, to be out like this is to risk giving ammunition to the haters. It has taken some time to feel strong enough to not care.

We like to think that our 'neo' vaginas are similar to the real thing, but they are not really (in my opinion). I've come across a few natal vaginas in my time, and i don't think i'd be mistaking what i have with one of them. Perhaps i was really unlucky? I doubt it, though. That's why, IMO, that parting gift from the last blog has the power to irritate us. There is, unfortunately, an element of truth.

We do have to accept a poor-quality result; superficially functional but really a hack job. It is true that the nerves we feel with are the same nerves as before, the flesh, the same flesh.

Does it actually matter, though?

My boy bits were always an alien thing, strapped to my body. They didn't fit some undefined pattern of self that demanded a womb and a vagina instead. The sensations i gained from them were somehow disconnected from me, in the wrong place. Looking at things spiritually, are my astral and etheric bodies female? I'm fairly sure my etheric one is. I've had too many experiences which fit. Perhaps that is where my drive to re-configure my physical form came from. Where the knowledge that it was wrong; arose?

I'm meant to be keeping it real. I can't deny the reality of my spiritual experiences - indeed they seem more real than many of my manifest ones - however. Speculation is speculation.

Changed my mind. Let's speculate! The whole energy business seems incredibly important to me. Why else would so many of us, throughout history, feel the need to take such drastic action, knowing that the results we get are so far from perfect its almost tragic? Why are we willing to accept imperfect results that we know may cost us our careers, family, friends, health or life? Why else do we allow an otherwise perfect body to lay down on the surgeon's table, (not knowing if we will wake), and then be mutilated (albeit carefully and with great skill)?

We know that we will not be able to carry children. We know that the unique smell and taste and feel of a natural vagina is beyond the surgeon's skill. We know that we run a risk of dying, of having a bad result. We know that we may become unable to orgasm.

yet - despite all the risks and fails, we do it, because it is still better than the alternatives.

That's real. I think. I doubt any of us are deluded about what we are putting ourselves in for (unless, perhaps, we've drunk too deep of the TG Koolaid). I doubt many of us fail to recognize that yes, our bodies have been re-shuffled. Some of us have cervixes made from the tip of their penis, some have clitori made from the glans, with the nerves concertina'd to make it all fit. Some of us have labia constructed from other bits a pieces. It doesn't matter. We have to live with the inadequacies, live with the not-quite-rightness. We also get to live with the re-positioned flesh being in the RIGHT place, with the patterns of energy coinciding with the pattern of body. It allows us to claim full ownership of our manifest, physical form when we couldn't before. Our bodies become ours, in a way that was impossible before.

i guess.

ed. note.
Looking at the comments, it seems people have been reading me wrong. I'm not unhappy with my results, i was not surprised or let down, and i have no regrets. I needed surgery, and i tried to get the best i could, at the time. This blog is more about being honest about what can be achieved, recognising the limitations and looking a little at the strength of the motivation that leads (some) of us to chose a sub-optimal but still state-of-the-art SRS. I felt that i needed to acknowledge the truth of what is thrown at us, in order to transcend it (the mutilation bit), as i believe denial is unhealthy. Yes. i did mutilate a perfectly healthy body. Unfortunately it was my body, not someone else's, and fine as it was, it was not right for me. Had there been other options (body-swap, gene therapy, brain wipe, whatever) perhaps i'd have tried that instead. As it was, the main option i could see was suicide. Or perhaps mass-murder, to let god know how unhappy i was.
It boils down to this: Yep, those of you who hate me. I had pretty extreme things done to my body. Call it what you like, you are probably right. I don't CARE. I did what i needed to do and that's all any woman can do.


  1. Thanks for posting this personal experience. I admit I do agree about the comment re scar tissue. The limting factor for me with penetration is diameter. Cant take the big boys and yes it is that ring of scar tissue.

    For self assurance, I used to regually ask male sexual clients to comment and all said same. For me, as long as its not a big boy, its wonderful in all ways.

    As to smell and gooey bits, I have no problems. I douche after sex and perhaps once a fortnight.

    I havent taken mones for more than 2 years and am still alive and have noticed littled differance to when I was on progynova. Premarin was best for me.

    Thanks again for this blog Flow

    ps, I had penile inversion supposedly with Sanguan but then had issues not related to him and returned where he used my colon.
    He had a colon specialist come in to do it.
    I believe he refuses to do colon first up anyway these days.

  2. Flow. I am sorry that you have had such a tough time of it. It really shouldn't be all that complicated. Unfortunately, for many, it still is.

    I have heard that there is another surgeon in Thailand named Suporn that reportedly uses inverted scrotal tissue to provide the epithelial lining of the vagina. The operative words here are, "I have heard..." I have not heard first hand how well that works out.

    There is no doubt in my mind that less than perfect, (or even adequate), results can have a detrimental effect on self image and self esteem, if one does not have a full, clear and realistic understanding of just what are the actual potentials and limitations of available medical technology. As you, Dr. Benjamin and some of your readers noted in an earlier post, "Surgery CANNOT make you into a woman". The consequences of failing to understand that alone can be devastating.

    However, the alternative, living with a body that is not yours, and/or is not properly configured, is much, much worse. I guess I have been extremely fortunate. Despite a relatively difficult period of surgical recovery, and more than just a few rather trying periods in my life, I have never been happier or more congruent than I was the day I awoke to that reality of being who I am.

    Life, in and of itself, can be full of difficulties and uncertainties. That is our lot as mere mortals. My philosophy has always been to just simply enjoy the ride and help others along the way as best I can.

    On the other hand, I find it troubling that you allow yourself to be brought down by the rantings of such a damaged and angry individual such as the one that you quoted above. Just because your results were not perfect, or up to your standards does not mean that you were "mutilated". Thinking of your surgical reconfiguration in those terms cannot possibly help you accept yourself as how, and WHO you are.

    1. thanks hon! i don't feel 'mutilated', i do recognize that that is one way of looking at things, and i really don't like to reject ideas just because the words may seem pejorative.

      i'm happy with my decisions, and a less than perfect result that fits is better than none. I hope it came across in what i said that i feel that that is a decision that thousands of us have made through the centuries.

    2. As I've also mentioned before when that favorite transgender chestnut comes up, Benjamin's thinking was very much a product of his time (like Freud's was in the Victorian era). We know today that sex has a great deal to do with the human brain, and as such trying to attribute it to those older, more simplistic terms is to dumb down a complex situation.

      I've said before that all the surgery does is bring some congruence to somebody who was already a woman. In the process, it brings that person closer to what is considered female as a physiological whole rather than just in the head -- this, in turn, reaps psychological benefits for the brain that has to deal with such a thing.

      To call such a surgery 'mutilation' is something that transsexuals need to get the fuck off of already -- that's transgender thinking. Nobody calls breast implants mutilation, but those aren't natural. Or artificial hearts, or any other number of surgical interventions. This word is usually only seen with reference to sex reassignment surgery, and I'd say that enough is enough. When the transgender community (and friends) are finally going to go picket hospitals for 'mutilating' everybody, I'm willing to take that nonsense with any remote degree of seriousness.

    3. ok. term issue. i'd consider that breast implants, rhinoplasty, face lifts etc could be called "mutilation" if one was to take a 'my body is a temple' attitude. I know a lot of people who are into body modification (split tounges, implants, removed bits, added bits) and that's include able under the term too, for me.

      i hear where you are coming from, though. I just think that fighting against the term, for whatever reason, is to enter into a fight with no end.

      i forget the name of the psychological method. is it inter-personal self-psychology? the one where you enter into the world of the mad person (eg, the one saying "you are mutilating"), accept their basic reality, and then offer them tools or stories which are congruent with that reality. Its easier for them to take on board, as there is less they can reject. In the case of this blog, that was me saying "yes you are right, however, its my right and it made me feel better" the argument then becomes one of rights and not of terminology.

      I have a particular dislike for terminology debates as they go around and around in circles as there is no definitive language. The tower of babel saw to that!

    4. Flow. What bother to, " enter into the world of the mad person (eg, the one saying "you are mutilating"), (and), accept their basic reality"?

      That in itself is madness.

    5. The World Health Organization defines genital mutilation as, "all procedures that involve partial or total removal of the external genitalia, or other injury to the genital organs for non-medical reasons."

      So a non-medical purpose is what makes for mutilation. Using the word mutilate in reference to sex reassignment surgery thus implies that there is a) no valid medical reason for this surgery, b) it is harming and not healing in nature, and c) the body of a former transsexual was 'perfect' and is being rendered imperfect -- id est, that any perceived flaws are all in our delusional heads.

      This is the language of somebody who thinks transsexuality is a sham and transsexuals are big phonies who have no real necessity for this surgery. It's the language of somebody who wants to make sex reassignment unavailable again and put transsexuals back in our respective closets, since sex is somehow 'perfect' and nature never makes mistakes. That's thinking that hasn't changed since Benjamin's time.

      So this is not a matter of a 'terminology debate', it's a matter of do you think such a position is bullshit or not. Obviously, we know how most radical feminists and transgender folks feel. You know how I feel.

    6. i know how you feel.

      you are having a terminology debate and failing to hear what i am trying to say. i've become an enemy to fight against, which is daft, given i am a happy post-op woman, who does not think she is mutilated and would not have made a different choice given the chance again (beyond choice of surgeon, perhaps).

      the difference is, if i meet a bigot who says that i have mutilated myself, i can deal with it with equanimity and calm.

      you'll get there, and be at peace, eventually.

    7. and ... reality check.

      perhaps it is my upbringing. I believe that there are many ways to look at the world, and each has its own validity. The only difference between the reality of an apparently sane person and that of a lunatic is the sane person is happy with theirs.

      The way i was born drove me to try and understand consciousness, manifest reality, what it is that we are. that has led me to a study of mind, and from there to a study of perception, belief etc.

      It is clear, to me, that my viewpoint is simply my viewpoint. The only thing that makes it better than anyone else's is that i am happy with it. If i cease to be happy, i pick it apart with analysis and see what's not working right.
      SRS was necessary because no amount of picking apart my mind could fix having the wrong body.

      So. why enter the world of a mad person? because in doing so you learn to understand them. In understanding you learn how to disarm. (or how to derail their attacks) You can help them, in other words, and you can help yourself. We do it every day, in every shared interaction. The inter-personal self-psychology is just an overt description and discipline for doing so consciously.

      In doing so, we also learn about the little non-conscious things that make us tick. This allows us to better accept ourselves.

      can everyone please stop fighting? this is getting a little distressing for me. I seem to be wearing a lot of stuff that doesn't belong to me and it feels like we are running around in circles. I consider you guys allies and it hurts.

    8. You're not 'an enemy' flow, and I'm not sure where you got that from my message (you also seem to have missed the last part, when I specified that this is not really a debate of terminology and pointed out that it is a discussion of the intent behind the terminology instead).

      I merely stated that to refer to sex reassignment surgery as 'mutilation' is the intention of those who *are* our enemies. 'Mutilation' connotes a harmful, non-medical lack of necessity to sex reassignment surgery. We shouldn't be using that word in like manner ourselves, and there shouldn't be any tolerance in any of us for those who do.

      Sorry if any of that disturbs you.

    9. I don't see any fighting. Certainly no reason to stress. All we have here is a simple difference of opinion based on understandably different experiences.

  3. I have tears in my eyes reading what you've been through. Wish I could come and give you a hug! Sorry I don't have any profound thoughts or experiences to add but I just wanted to let you know that you're loved.


  4. Dearest Flow,I embrace you to ward off that hateful rhetoric. You will never be alone . I still find it strange how some of us can be plagued by the same doubts both pre and post transition....and yet be inspired by self awareness and the wonderful possibilities for eventual self acceptability.

    Some people who know me think I am courageous but I don't think I would lay my heart open as you have done. What I will say is that at the time I was researching surgery options the only method available here was colon vaginoplasty and that by a surgical team with a less than inspiring history and reputation. There had been and I am led to believe continued to be some disastrous results. So I opted for Sanguan Kunaporn too and at first I was reasonably satisfied with my scrotal/penile vaginoplasty and now , years later it looks OK (Many women are dissatisfied with vagina appearance) works OK and smells like a vagina(not malodorous) Now I think it could have been better in some ways but I guess I am luckier than a lot of us.

    Would I do it all again? You bet your sweet life I would . Same surgeon? I dunno. Most of us only get one chance at SRS so will have no idea of what it would have been like by a different surgeon

    Do I feel mutilated? Hell no. I feel restored and content. My affliction has been treated and cured to the extent that I can live my life as a complete female person, unlike the deluded bigots who's hateful rhetoric prompted this posting by you. I admire you so very much ,please, never put yourself down.

  5. I'm so sorry to hear that you had such difficulty with your surgery. I agree that any of the surgeries are rubbish, but sometimes they come out reasonably well.

    Cells and tissue change over time. The inverted penis skin that is put inside those of us who had penile inversion surgery does not remain the same. Over time, while it does not quite become identical to vaginal mucosal tissue, it gets close. That's because transplanted tissue becomes similar to the surrounding tissue.

    Over time, it's really not an inverted penis at all. The flora improves. The smell improves. It might even start to self-lube. It no longer supports hair growth. It's really not the same tissue as was used for the surgery. I wish you had known that!

    If I had it to do over again, I would probably use the same method performed by the same surgeon.

    For the commenter above, the Suporn Method (his own technique) does indeed use scrotal skin for the vaginal lining and penile skin for the labia, the reverse of what is done in penile inversion. As far as I know, the results are good, especially for those who would not have had enough depth using penile skin alone. It requires much more suturing, and the healing time is longer, but Suporn is famous for good reason.

  6. I think it is counter productive to make such sweeping, all inclusive statements such as this one: "We do have to accept a poor-quality result; superficially functional but really a hack job."

    IMHO you are again buying into that hateful, denigrating TG put down of women of history who have what they do not. In short we have pussies. Yours may be lacking in your own estimation, but the fact that your male partners find it attractive speaks volumes to the contrary.

    My suggestion is for you to get out there and enjoy what you have worked so hard for. It should do wonders for your self image.

    I for one do NOT accept your assessment that "WE" have to accept a poor quality result. I certainly did not. I do not accept your including me in your "we".

    1. sorry hon. there seems to be a misunderstanding of what i was saying. I'm happy with what i have now. it isn't perfect, but its mine and it is functional for sex.

      I didn't think i had a self image problem. perhaps i do and don't know it. i think i'm hot, actually. sexy and fun in bed.

      The day that we can conceive is the day i'll agree that any result we can get is other than poor quality. sex is far from the be-all and end-all of being born with the wrong body.

      however, i understand that you may have a different opinion and i respect that. I;m glad you are completely happy.


  7. Surely you realized that sterility was just part of that huge price required to be paid for your life. That is just the limits of our current medical technology. Someday, maybe...and adoption is always an option.

    I am glad that you can accept my alternative perspective. I have no doubt that your perspective will continue to evolve as well, with the passage of time.

    1. absolutely. i do believe you have read me completely wrong.
      i have no regrets, and understood what i was getting myself in for. I knew i would be sterile, i knew there was a chance of failure, i knew the post-op risks and i knew what may happen to my life.

      that is entirely irrelevant to what i blogged about. Just because i knew i'd be sterile, does not make the fact the surgery cannot create a functioning womb any better. Just because i knew how my neo-vagina would function, does not make it any less of a compromise.

      recognize the pros and cons of a situation does not imply regret, or a bad self image, more an acceptance of reality.

      and yes, adoption is the one :)

    2. Almost nine million women have had hysterectomies in the United States alone, and seven million are infertile. Another 45,000 to 62,000 will be born with vaginal agenesis (an improperly developed vagina). About 90% of those have Mayer-von Rokitansky-Küster-Hauser's Syndrome: a possibly absent cervix, uterus, and vagina.

      So the cons of post-transsexuality coincide with the cons of those who were 'female born' with defects; transsexuals take on the same cons and risks they do to fix their own problems. That's why I commented in the other topic that we're not any different from them in the end result.

  8. Perhaps I did, and in that case I apologize. Thank you for being so open in your discussion of the potential drawbacks of SRS. I agree with you that it is extremely important that those thinking of this potentially life threatening/saving surgery as some sort of panacea, or "ticket to acceptance", understand the ramifications of their actions.

    And this of course is in addition to the potential effects on their immediate family.

    Courageous post.

  9. "....OK, a blog on surgery.

    How good is it, really? how wrong can it go? what does it change?"

    In a nutshell, a lot of things can go wrong. Not often. Not always. But...It can, and does happen.

    However, what seems to have been forgotten or overlooked, is that in the ovewhelmingly vast majority of cases, the results are absolutely fabulous and life saving for those of us that "had no other VIABLE choice".

    Can you imagine having your prayers answered beyond your wildest dreams? Unfortunately, for those trying to get to the truth, or understand the reality of the experience for the vast majority of of us that WERE CURED, we are not that readily available for comment. The vast majority of us are simply enjoying our exceedingly normal and mundane lives.


please be nice.