The Dare of Genital Surgery

I had a hard time starting to consider genital surgery (AKA ‘lower surgery’). My brain would shutdown its thought process every time I pondered about it. It turns out that I had to change my relationship with my body before allowing myself to consider genital surgery. I also had to navigate my (unfounded) fears of prejudices. At the end I dealt with a number of hold-backs so I could dare consider genital surgery.

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This is the first of 3 very personal articles about my thought process and preparation for genital reconstruction. These articles are made in conjunction with a shorter, more concise version posted on the TransAvenue blog (en français). The inspiration came from a somewhat general question a friend posed to me: how to get a natural relationship with the neo-vagina (or neo-vulva in my case)?

In The Beginning – Before Considering Genital Surgery

Similar to what I’m sure is true for lots of trans individuals, I’d been preparing for surgery since day one. Growing up, imagining what my body would look like should my genitalia were different. But the reality was I didn’t begin considering surgery in earnest until sometime mid 2017 (my surgery was in November 2019). Before then I was not at all interested in changing my natural-bone genitalia.

Confused? Let me explain. I always (always) wondered what it would be like living as and having the body of a girl. On the other hand, none of this was in the cards until I actually considered changing my gender expression a few years ago. 2015 to be precise.

To give you some context, this is my timeline. I started HRT in late 2015, went full time in April 2016, had FFS in late 2016, and by mid 2017 I was making arrangements for my BA later that year. Before then I had always said that genital reconstruction was not for me. But while making arrangements for my BA something changed and I started wondering about my genitalia. At that point I had no urgency. Quite the opposite; I started by candidly questioning what would be different in my life if I were to have a vulvoplasty or maybe a vaginoplasty. At that moment surgery was not something I desired, it was something I started to become curious about.

Now, I think that naive curiosity, with no defined expectations nor a timeline – no urgency, helped me better appreciate my options without rushing into anything. It allowed me time to wrap my head around the concepts and really, really understand what I would be getting into and why.

My first step was to untether myself from my old ways of thinking.

Pretending to Say Goodbye to an Old Friend

This is where I want to get personal because not all trans people have the same relationship with their bodies, and particularly for this article, with their genitalia. So, when you read this, please consider that my experience may be very different from yours or from other trans and non-binary individuals.

I always had a good relationship with my natural genitalia. This means that I was ok with my penis and testes and really enjoyed them. As I said earlier, I didn’t seriously considered getting rid of them until well after living full time in my gender expression of choice. In fact, the first question I had for myself was if I was going to miss having a penis if I were to choose surgery. It was not only a question, it was more like an angst; the doubt of post-op regrets. It was time to find an answer to my first query to consider genital surgery.

Practice Peeing Sitting Down

To figure if I’d miss my natural genitalia I decided to push myself to act as if I already had genital surgery. Urinating without a penis was a big unknown. Before this point somewhere in 2017, for peeing I was still taking advantage, if you will, of having a penis. I had been tucking every time I wore women’s outfits long before going full time, but I was not always peeing sitting down. I did in most cases, but there were situations where it seemed more hygienic and safer to not sit or squat and pee standing up.

Starting in the second half of 2017 I forced myself to see if there were cases where I simply could not or would not pee squatting or sitting down. Think of it as a preparation to say good bye to my life long friend: my natural genitalia. Another way of putting it is a kind of dress rehearsal.

Now that I think of this, it seems so dumb! Just ask 50% of the population that peed sitting down all their lives. It’s possible and a fact of life for the vast majority of women. But for me it was an unknown that I needed to clear up before further considering surgery.

Doubts About Changing My Sexual Behaviours

Continuing with very personal disclosures, for the purposes of providing context, here are more intimate details. I’m not, and I’ve never been a very sexually active individual. While considering surgery, another apprehension I had was not knowing how my sexual behaviours would change. In particular I did not know if I would be able to indulge with a new anatomy.

Manipulating my natural sexual organs for pleasure never caused me dysphoria; if anything, it was quite the opposite. What I was not sure was how a different morphology would provide me sexual gratification. This was another question that I needed to explore before continuing with my decision process.

Opposite to forcing myself to pee sitting down, there was no way to practice or pretend having different genitalia when it came to sexual activities. To answer if changing my sexual habits would still provide me with gratification I had to relay on the experience of others and extrapolate based on my own past experiences. One valuable point of reference was the effects that HRT had on reducing my libido. That lower sex drive had already modified my sexual habits from the ‘quick-fireworks’ pre-HRT to a sloooow crescendo. With that past experience it felt as safe assumption that I would have no problem after surgery.

Another important and valuable source of feedback was discussing the surgical procedure with the surgeon himself. I was interested in learning about changes in sensation, amongst other things. I was able to have a private call with the doctor weeks before my surgery date. At that time he explained the generals of the procedure and how the glans would be rearranged, pretty much guaranteeing a very sensitive result.

At the end, prior to surgery I was not able to fully answer how my sexual behaviours would change. But I was satisfied that I had gather enough information about this topic and felt at ease without a clear answer.

My Genitals do Not Define me (Anymore)

As I write this I feel it may come across as contradictory or possibly incoherent, but I had to change how I viewed the significance or the importance of my genitalia. Before I never questioned my belief that to an extent my phallus defined me. When I started HRT and later went full time, since I had a good relationship with it, I still felt it delimited me. So the idea of getting a vulvoplasty and therefore a penectomy, at first simply did not make sense. Why would I remove something that was integral to me? That point of view prevented me from accepting genital reconstruction surgery.

Well, I asked myself that question and thought hard about it. Doing so lead me to yet another question: why would my penis define me while I’m very curious about a vulvoplasty? Again, I get candid here. The answer I found was that male organs for me were some sort of source or symbol of strength and determination. On a lighter note, after living full time, it was also an intriguing secret and differentiator from other women. Now a days those answers sound so stupid to me, especially the part where I felt it to be a symbol of power. Pff!! I guess this says a lot about how I was raised and the conservative, patriarchal environment I grew up in.

But when I started to consider genital surgery, these thoughts were in my mind and were contradictory to the idea of seeking female genitalia. The curiosity of aligning my physiognomy more to one that would be congruent with my gender presentation was much stronger than my archaic beliefs. It was at that point when I truly challenged my original misinterpretation of my genitals defining me.

Understanding my Misconception

I started by trying to justify my misbelief of a source of strength and determination. The only logical answer I found was that, yes, testosterone provided some physical strength and aggression, but had nothing to do with my determination. Even more, I had been on HRT for close to 2 years and neither my moral stamina nor my resoluteness had been affected by the lack of testosterone. Another actuality was that very few people had ever seen me naked so it made no sense that something invisible defined me. In effect I saw that after living full time and a number of gender affirming surgeries, my male genitalia had little worth to me. Once I had that mental breakthrough, plus the positive experiences I had thus far practicing as if I had no penis, meant to me that I could in fact live worry free with female-looking genitalia.

I Wanted Congruent Physiology With My Gender Expression

The realization that my genitalia did not define me was probably my most impactful liberator. Before, every time I thought of the possibility of surgery, I had what felt like a heavy anchor questioning, how would I change something that identified me? It shifted my mindset from being complacent with what I had and knew, to the allure of what I could gain. A large boost in confidence in my chosen gender expression was something I would attain. At that point my genitalia not only stopped representing me but they became worthless, even having negative value. That new, wider perspective truly allowed me to seriously consider having surgery. That was when the breaks came off.

Avoiding The Judgement of Others

This is yet another mental gravitational pull that dragged me down while considering surgery. It was the idea that others would criticize my decision. Yet again, as I think about this I shake my head and makes me angry. It now drives me mad that I worried what others may think. It’s that microaggression when someone questions your plans with the undertone of making you doubt yourself. This is, I guess, yet another remanence of the environment in where and how I grew up.

To be completely honest with you, I did not fully resolved this issue with myself until months after surgery and recovery. In the meantime I put a lid on this worry and I did not tell almost anyone that I was going to have surgery. The few people I told that were not part of my medical care team were my immediate family.

Telling my Mum

The decision to have surgery came to me after I had my second surgical assessment. Opposite to deciding to have surgery and then going through the assessment protocol, I went the other way around. To make an informed decision without discussing it with others outside of my care team, I did all the surgical preparedness assessments. It was until I made an informed decision that I opened up to my mum about it.

She first made a negative comment. But once I discussed it with her she was supportive of my decision. This was another point where I felt free to move at my discretion. Even thought it wasn’t asking for her permission, just by letting out my plans to her relieved me from wondering if and how she would judge me. I felt lighter, relieved, and more at ease with my decision to have surgery. By answering the question of how she’d react, and more importantly, the feeling I wasn’t hiding anything from my mum, untethered me.

Not Telling Others About Genital Surgery

The thought that others may question my plans for surgery was a distraction. I did not want any external influence when deciding to have surgery and which surgery. For my decision-making process I was not interested in hearing about the experience of others who already had a similar procedure. From other trans people that hadn’t had genital reconstruction I did not want their thought process to influence mine. And from any cisgender person I was absolutely not interested in hearing their questions and opinions about the surgery.

I postponed resolving this nagging gravitational pull until I wrote my first article for TransAvenue and its accompanying post on my own blog. When I was writing the TransAvenue post I felt extremely exposed and vulnerable. But it was until I wrote Opening Up About Why I Chose a Vulvoplasty that I truly realized how insignificant my fear of judgement was. Nevertheless, I was at peace with myself by not sharing my surgical plans with others. In fact I felt empowered by keeping such an important event to myself.

The Dare of Surgery

Once I had an understanding of my hold-backs then I could dare to consider surgery. My vulvoplasty was different from other surgeries because I first gather detailed information about the whole process before deciding. For FFS, for example, it was an iterative process. I decided to have FFS long before getting all the details. My breast augmentation was similar. For example, I didn’t decided on the kind and size of implants until the pre-op consultation. Before deciding on genital surgery I had to have a clear picture of the process and what to expect, including recovery. Once I allowed myself to consider genital surgery it was time to gather as much knowledge as I could.

The next step was to get very intimate with the details of the surgery. Back to my friend’s question, I’m sure all the learning and understanding that followed helped me develop a natural relationship with my neo-vulva.

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P.S. I’ve always disliked the term ‘lower surgery’. I find it imprecise at best. I’m sure my ESL roots play a role. I think ‘lower surgery’ and my literal mind thinks podiatric surgery or ‘surgery of the feet’. That’s the reason why I don’t use what I feel is a misleading term.

P.P.S. The header image was taken at the beach in the summer of 2017. That was roughly the time I started to dare considering genital surgery.