Labia Reduction for STP vs. Scrotoplasty

[AndrewL]

   I'm fairly reluctant to be posting this since I don't like my personal life to be so open, but I could use some advice.
   During my consult for the hysterectomy which I plan on doing asap the doctor mentioned that he could perform a labia reduction at the same time since I have extremely large labia. At first I was ecstatic. I recently got my peecock and I can't use it for STP because the labia are in the way. I've also had this problem with other STP's I've made on my own. This additional surgery could be performed during the hysterectomy at no cost to me.
   The problem is that the labia are what is used for a scrotoplasty. If I cut them off so I can STP with a device now I could be creating problems for future surgeries.
   The biggest frustration I'm having now is time. Ideally I want the hysterectomy done with last week. Now I have to make a decision in as little time as possible that will affect the entire course of my transition, looking at timescale that I can't fully compute.
   Right now I'm leaning toward doing the labia reduction. I know it could complicate GRS later, but I wasn't even 100% sure I wanted to do GRS. I'm still bouncing between the terms transgender, transsexual and genderqueer as I try to describe myself. I know I prefer living as a man and I want my documents to reflect that. But that is almost complete and will be complete after the hysterectomy regardless of what I do about the labia.
   Even if I do want GRS someday I see it as being 10-20 years down the road due to costs and time. I do know that I want to STP and the sooner the better. I just worry that I might have regrets if I do this surgery, or more if I don't and in 5 years I'm still frustrated I can't STP.
   Anyway I was wondering if anyone else had run into this conundrum and had advice. Or if someone wants to chime in with what they see I'd appreciate it. I'm a grad student who's applying for jobs and struggling to find time to deal with the medical stuff so anyone with resources and input would be a godsend.

[Adio]

It's possible that you could get the reduction now and use expanders later for the scrotoplasty.  Unless there was significant scar tissue, and even then, I don't see why that would be any different than someone with average size or smaller labia getting a scrotoplasty.  Not perfectly comparable, but some guys get a breast reduction before top surgery without issues.

Does your hysto surgeon know about your future transition/surgery plans?

[Sharky]

I think the labia majors are the ones they make the scrotum out of. Are you talking about thoes or the labia minor? I don't see how the majors could get in the way, but everyone's junk is different.

[Nygeel]

Labia minora is what's removed. Labia majora is used for scrotalplasty.

[Ender]

Seconding this: labia majora are used for scrotum construction.  Some surgeons use labia minora for urethral construction and/or penile shaft reconstruction (for a meta).  Buccal mucosa (from the inner cheek) can also be used for urethral lengthening.

If bottom surgery is at all on your radar, be careful.  I would personally consult a prospective bottom surgeon on this, but if you aren't looking at surgery until 10-20 years from now, well, techniques change... my philosophy for surgery would be to go in with the maximum amount of 'donor' tissue and a minimum of pre-existing scarring at the surgical site.

When I was using StPs (Mango or medicine-spoon type), I needed to use one hand to push the labia minora apart while using the other hand to place the receptacle.  If I didn't spread 'em, they would have been in the way of using the STP.  I don't think mine were small, but I don't think they were particularly large, either.

[Adio]

Just to throw this out there--the OP didn't specify labia majora or labia minora.  It's entirely possible that they are talking about the majora especially since they mention scrotoplasty.  I had a patient during my preceptorship that had a vulvectomy which included the removal (which was actually more like a reduction) of her labia majora.  So it is possible.

[Renate]

I'll preface this with the acknowledgement that I don't know anything about FTM procedures.

It's just that skin in general, and pubic skin specifically, is a precious commodity.
MTF's and FTM's should not be throwing away pieces of skin until they are clear what they are doing.

[AndrewL]

Wow I really don't know what I'm talking about. I feel stupid because I just had to look up what the different types of labia look like to try and clarify the question. I've avoided studying my groin before since I've felt disconnected to it and hated looking at it. Even now, as T's making it more comfortable to sexual I don't look at whats there I just use what I know feels good. Now I'm even less sure about my ability to make a decision, but better informed so posting this was useful.

To clarify I looked at the diagrams on Wikipedia and what the doctor showed me was a reduction of the labia minor. Up to this point I hadn't known the mounds to the side were the labia major, I'd assumed that was just flesh around the groin and the large flaps were the labia, oops. For reference my labia minor range from 1" long toward the back of the groin to up to 3" near the clitoral hood. Both sides are like this and its this extra skin that fills the STP making me spill every time. If I push them outside of the STP I can almost get it to work but I can't pack like that since my groin drys out and becomes itchy and oftentimes the peecock won't seal with them outside of it. This is getting extremely frustrating since STP is THE MOST important thing about transitioning to me at the point because I have having to sit down. Still I hadn't considered surgery an option to fix that until last week.

I am concerned that the doctor doesn't know what he's talking about. I like the endo that referred me to this gyno but the gyno doesn't have a background in transguys. At the same time I want the hysterectomy done last week so I don't want to wait a month to try and set up an appointment with another doctor who might know even less. I wish I had more time for research, but I can't put off the hysterectomy and I wouldn't be able to afford the reduction on its own. I'm in a do/don't situation where the longer I take is time taken away from when I can have the hysterectomy, fix my last identity documents and start scheduling things again without worrying about recovery time. I appreciate the help you've given...at least I now realize my concerns about the scrotoplasty are misplaced (due to operator confusion) and I can shift my research into looking at urethral construction and how a reduction might impact that.

Thanks!