Or, coming to glorious, glorious terms with no longer having a penis.
Yeah, I said that.
In the Fall of 2022, I had gender affirming vulvoplasty surgery. It is the single best thing I have done. I have not regretted it at all. Not once.
Not even when I first sat on a toilet to pee (after getting the catheter removed) and realized I now peed straight down, making stealth peeing nearly impossible. I used to be a person who really liked not making peeing noises when I was actually peeing. It was embarrassing! Everyone could hear!
But no longer. Now, there is not ever a time when I can pee discretely. Tinkle is definitely a sound, it turns out! And I find myself—found myself that first time—just smiling and going with the flow (as it were). Now, I relish it, because it reminds me of just how fortunate I am to have figured this out, and to have been able to have this life-saving intervention.
But this is really a post about my vulvoplasty, not just about peeing. I’ve been meaning to write about it. I wrote about the decision to have the surgery, here: In which I use the word penis a lot
But I have not written about the surgery, not since I had it done. So let me do that.
Let me start with a few of the broader themes that have stuck with me. First, trans medicine and surgery is amazing, y’all. Mine was pretty simple, as they go. I did not have them construct a full vaginal canal (because penetrative sex is not something I am interested in), so it was less complicated than it could have been. (And, of course, I don’t have the perspective of a trans man, and it will be different.) But some of what they can accomplish now blows my mind.
Second, it took my ex/wife to remind me when my one year anniversary of the surgery came up. It feels that normal. I think about it that little. Twelve months later, it didn’t even register as a significant milestone. It is so absolutely clear that this is me, that “me” didn’t notice. I love that for me.
And third, my experience is not that of everyone. I came to this with a shit ton of privilege, and I leveraged it all over the place in order to get this done. I had really good insurance, and even so I paid about $5,000 out of pocket. I had a supportive community to help me through recovery.
My heart breaks for people who need these kinds of interventions and cannot access them. It’s bullshit, plain and simple. Maybe if we all do a small part, whatever we can do, we can make it better for the next person. I am doing what I can to make it less shitty for others (details unavailable), but I can’t make it not shitty. I am sorry for that.
The details
But, some of you are here for details. So, here are (some) details.
I got the surgery, yes. Getting to that point took some time, though. From the moment I began looking for a therapist, to the day of surgery, was 28 months. That is a long fucking time for something I knew on day one I wanted to do.
As part of that process, I saw one therapist for four sessions, then ghosted her because I was having to explain the trans experience to her, while I was simultaneously figuring out my trans experience. Ugh. Then I floundered, tried to get in to see a psychologist. That took four or five months to fail. Then I found a support group (where I lasted a couple of months, they were great, but left for my own reasons), and finally I got a recommendation for a therapist who I still see today.
I got my surgery done in a large midwestern city in the United States, where I am fortunate enough that they have options for getting this done. I went through a public hospital system, not a private doctor or clinic. But getting seen, getting approved (thanks, insurance-industrial-complex), and then getting a surgery date took more than a year. And this was a good experience, as they go!
I was seen by a team of surgeons, each with their own specialty: general surgery, plastic surgery, and urology. The surgeons were friendly, but I never really felt cared for by them, exactly. Luckily, their support staff were pretty great, including nurses, obgyns, and others who helped shepherd me through the process.
The surgery itself was… well, from my perspective it was very short. I was prepped by some nice nurses, I met my anesthesiologist for the day, they wheeled me out to go to the operating room and I… woke up after it was all over. Perceived time for the surgery? 30 seconds, maybe?
The procedure kept me in the hospital for… okay, honestly, I don’t remember exactly, it was at least two nights, but there were no complications. One of the surgeons stopped in, briefly, to tell me it all went great! and I haven’t seen any of them since. But the nurses on the recovery floor were really attentive, and when I eventually got up to take a lap around the hallway (suggested to help me get my feet back under me, accompanied on a tether by my catheter bag), I noticed that on the door to my room they had written my pronouns in very large letters.
I want to be sure to acknowledge here that my experience is not the experience of many people. I had no complications. I am a very compliant rule follower. I’m white, and older. I’m a people pleaser. Keeping that perspective in mind, I have nothing to complain about regarding the people who got me to—and then out of—surgery.
One of the most important parts of surgical procedures like this is what happens when you come home. I have to acknowledge here that the people who love me had to exist through that time, including the hours I was actually in surgery, and it was hard for some of them. I love them deeply for the love they showed for me. I could not have done it if not for them. It’s not all medicine and surgery, folks. But this, too, is a place where I was privileged to have a community, and a family, and a partner, that supported me.
Aftercare at home was a bitch. I had to poke needles into my stomach for several days. I had the much aforementioned catheter to carry around and sleep with and clean (and clean, and clean). I had meds to take and stool softeners to drink. I had instructions to do nothing, but honestly, for a while I spent a lot of time napping. And I had pain. Not, like, a really lot of pain, but yeah, pain.
And then, it was over. I went to a post-op appointment a week later, they removed the catheter, they said the surgical incisions looked great. They booked me an appointment with a physical therapist, and another post-op appointment, and sent me on my way.
I spent a month or so trying to remember not to lift heavy things. (But again, a vulvoplasty like I had has a much shorter recovery time than a vaginoplasty does.) Eventually I started doing normal things, and a bit later, I started exercising again. I threw out a bunch of underwear I did not need anymore, and bought new stuff. I went back to my life, I visited my therapist, I did the hard things and the fun things we all have to do.
And eventually, I forgot that I’d had the procedure.
Except when I pee.
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