Choices, an overview

[Mr.X]

In a couple of months I will have to make a decision about either going for a phallo or a meta. I know this has been a topic of discussion before, but I just can't decide. There are so many pros and cons on both surgeries that it is hard to decide. I tried to make a brief overview of what I know about both surgeries:



I have been reading up on both surgeries and also discussed them with my therapist. Of course, I would love to go for the phallo as it gets me a normal sized schlong. But the complication rate of phallos are crazy. My therapist and surgeon told me that the risk of complications is a little over 50%, so the chance you get a complication is bigger than staying complication free. They also told me that the main problems lie with the urinary hook-up. If you leave that out meta and phallo surgery have about the same risk of complications. Thing is, I do want the hook-up.

So meta surgery is the safe bet, less complications and less chances of it dying off so you end up with nothing, or something that looks worse than what's there now. But of course, meta gives you a so called micro-penis.

I did not involve costs because I live in Europe. Whatever surgery I would go for, it would be covered by my health insurance. Although I do have to add that the last stage of phallo (to get an erectile pump) would not be covered by insurance. That's why I added 'not functioning' to the phallo con.

So, my question is, is my list complete about the pros and cons or can you guys add stuff? I wish to make a fully informed decision on this. Also opinions about your personal choice would be appreciated. I know that a lot of you wish to wait to see what the future brings, but I wish to not do that. I'm too impatient for that, and live in the now, so if I can change things now, I'll go for it.

[Arch]

Are you sure that the risk of complications isn't inflated? And is the urethral lengthening with phallo really that much more risky than with meta? Where can we get actual stats about complications?

Also remember that some complications are minor. Can you get a breakdown on minor vs. major?

I'm in the same boat you are, except that my expected start date is somewhere between eighteen months and two and a half years away. It doesn't seem like nearly enough time to decide.

One issue for me to consider is how other gay men will perceive my equipment. I don't know whether I will ever have sex with someone else again, but if I do, the gay community is geared toward larger size. And since I frequent gay establishments, I would like typical-looking equipment because other men will be looking, maybe just out of curiosity and not because they find me attractive (I'll be pushing 55 by the time I start, I think--no Adonis).

[Mr.X]

Arch, thank you for replying.
I'm afraid I can't give you a breakdown of minor vs major complications right now.  I would have to ask my surgeon about that when I see him. What they did tell me was that fistulas and blockages of the urinary track are common. The risks of complications of meta and phallo are about the same if you do the urinary hook-up. Apparently, lengthening is risky business. Without the hook-up, meta has less complications. This is due to the fact that with a phallo, obviously, skin gets transplanted and the phallo can die off. Meta does not have these issues. Or so I have been told by both my surgeon and my therapist.

One issue for me to consider is how other gay men will perceive my equipment. I don't know whether I will ever have sex with someone else again, but if I do, the gay community is geared toward larger size.

Yes, yes! I could have written that. I also worry about my future, ending up alone because gay men won't want to be with me because my junk is small. I know, I shouldn't be with those kinds of men if they are that shallow, but I already have issues finding someone as it is. If I can fix my junk that will be just one less factor other men can turn me down for.

[aleon515]

I believe there are more problems with the UL in a phallo, not because it is inherently riskier, but just how much more length, there's just more likelihood of having problems. (Common complications for UL are strictures, fissures, and infection. I think infection risk might be higher, just because being catherterized is longer, I'm just guessing this though.)

--Jay

[Arch]

Yes, yes! I could have written that. I also worry about my future, ending up alone because gay men won't want to be with me because my junk is small. I know, I shouldn't be with those kinds of men if they are that shallow, but I already have issues finding someone as it is. If I can fix my junk that will be just one less factor other men can turn me down for.

I have a hard time labeling a man as superficial if he wants his partner to have genitals that look and behave like what is typical. We like what we like. Sure, we can often compensate for "shortcomings," but I think that we FTMs already have an uphill battle as it is. Our bodies tend to be distinctly different from cis male bodies, our junk does not behave as theirs does, and we can add on whatever other differences we have accrued as individuals.

I suppose that if you can meet and get to know someone on character and mental compatibility and not sheer sex, he is more likely to be into YOU and not just your junk. However, anyone less than a real soul mate might not be able to adjust his expectations.

That's my take on it, anyway.

[sam1234]

I would tend to agree with Arch. There is always going to be some risk when it comes to the urethral lengthening, whether it is small or long simply because the tissue is manipulated in a way that is un natural for the body. Length of the meta is individual and depends on how your body responded to the T.

If the finished penis is going to be too short to properly guide the urine to the bowl or urinal, then standing doesn't seem worth it. I will say though that the skin surrounding the tube in a phalloplasty can stricture down. I never had the hookup, but my surgeon left me a hollow tube running up the middle in case I decided to change my mind later. The distal opening stayed the same, but the opening at the base or the penis has strictured down over the years, and if I wanted a hook up now, it would have to be dilated somehow.

I guess the question comes down to which is more important to you. size or standing urination. That is an individual choice that only you can make, and talking to surgeon who have done both is a good idea. That way you have the true risks and long term prognosis for both.

sam1234

[Arch]

I want size and standing urination. I've spent my adult life in relationships with men, and I can't imagine not looking and functioning as much like them as I can. I would rather take the less harrowing route of meta, but I don't see myself happy that way.

Of course, I won't be particularly happy if I do run into complications with phallo. I guess I'll have to do some serious recon with the surgeon of my choice and hear what he has to say about the process.

[Jake25]

Are you sure that the risk of complications isn't inflated? And is the urethral lengthening with phallo really that much more risky than with meta? Where can we get actual stats about complications?

Also remember that some complications are minor. Can you get a breakdown on minor vs. major?

I'm in the same boat you are, except that my expected start date is somewhere between eighteen months and two and a half years away. It doesn't seem like nearly enough time to decide.

One issue for me to consider is how other gay men will perceive my equipment. I don't know whether I will ever have sex with someone else again, but if I do, the gay community is geared toward larger size. And since I frequent gay establishments, I would like typical-looking equipment because other men will be looking, maybe just out of curiosity and not because they find me attractive (I'll be pushing 55 by the time I start, I think--no Adonis).

I'm going to have metoidioplasty when its time for me, which will be a long time. I'll be one of the eunuchs in the gay community. How hard do you suppose it will be to find a date for that, Arch?

[Jake25]

Arch, thank you for replying.
I'm afraid I can't give you a breakdown of minor vs major complications right now.  I would have to ask my surgeon about that when I see him. What they did tell me was that fistulas and blockages of the urinary track are common. The risks of complications of meta and phallo are about the same if you do the urinary hook-up. Apparently, lengthening is risky business. Without the hook-up, meta has less complications. This is due to the fact that with a phallo, obviously, skin gets transplanted and the phallo can die off. Meta does not have these issues. Or so I have been told by both my surgeon and my therapist.

Yes, yes! I could have written that. I also worry about my future, ending up alone because gay men won't want to be with me because my junk is small. I know, I shouldn't be with those kinds of men if they are that shallow, but I already have issues finding someone as it is. If I can fix my junk that will be just one less factor other men can turn me down for.

I wouldn't want a man that wasn't another gentle eunuch of a man. I'm also not afraid to be alone. I may prefer it if I can't find the right guy...I always like having my space.

[Arch]

Hi, Jake. Since I am "stealth" in the gay community, I get to hear the unvarnished truth whenever the discussion turns to trans men--and cis men who are not well endowed. I can't say that I've heard it all, but I've heard enough to realize that many--probably most--gay men of mature age would not be happy with a trans man who has had a meta. Frankly, I think that most would not be thrilled with a full-size penis that doesn't levitate on its own and ejaculate and all of the bells and whistles, but I have little information about this particular topic.

I've been getting the impression that folks in the under-thirty group are more flexible. This impression is, however secondhand because my gay friends are in the over-forty crowd.

Mr. X, I have been thinking about where exactly my current mini-phallus will wind up if I have phallo. I've heard that I have the option of leaving it exposed just under the neophallus or having it buried within the neophallus. I don't know whether this information is accurate, but I thought it might give you some food for thought. At first, I thought I wanted the thing buried so that I would look as natural as possible. Now I'm thinking that I might have trouble achieving orgasm that way. But if I leave the thing exposed, I will look less typical, and I might continue to experience dysphoria about having an exposed remnant of my original anatomy.

Is this choice consistent with what you know about phallo? And if so, does it have any bearing on your own decision?

[Cindy]

Can I just make a comment?

Obviously I went the other way in surgery. But my surgeon also detailed all of the things that could go wrong, from vaginal-anal fistulas requiring a colostomy etc. It was quite frightening. At the end of the 20 or so complications I may suffer I asked him how many complications had occurred in his practice. He smiled and said none, but he had to warn me of the possibility. So be aware that good surgeons tend to be quite brutal in listing complications over any surgery.

I have a close friend who had phalloplasty at the Belgrade unit. It went horribly wrong and he suffered terrible infection. He was hospitalized for weeks after he got back. He is now fine and healthy. He had to have some corrective surgery but it was successful, his wife (sorry for the girl talk (we do talk!) ) told me so.

[mm]

Arch,  I understand your concerns on how to handle your present mini-phallus when ones has a full phallo surgery,  I have thought about that situation several times for I hope to get to that point some day.  It is somewhat assuring that you would it available if you left it exposed but there is the dysphoria effect of having it is still there.  I also read the that the nerves in your mini-phallos when buried can be connect to the your new phallopenis and you could have feeling someday all the way through it, which would best of all cases.  We just have to read and study what will be best for each one of us and hope for the best.   

[Jake25]

Hi, Jake. Since I am "stealth" in the gay community, I get to hear the unvarnished truth whenever the discussion turns to trans men--and cis men who are not well endowed. I can't say that I've heard it all, but I've heard enough to realize that many--probably most--gay men of mature age would not be happy with a trans man who has had a meta. Frankly, I think that most would not be thrilled with a full-size penis that doesn't levitate on its own and ejaculate and all of the bells and whistles, but I have little information about this particular topic.

I've been getting the impression that folks in the under-thirty group are more flexible. This impression is, however secondhand because my gay friends are in the over-forty crowd.

Mr. X, I have been thinking about where exactly my current mini-phallus will wind up if I have phallo. I've heard that I have the option of leaving it exposed just under the neophallus or having it buried within the neophallus. I don't know whether this information is accurate, but I thought it might give you some food for thought. At first, I thought I wanted the thing buried so that I would look as natural as possible. Now I'm thinking that I might have trouble achieving orgasm that way. But if I leave the thing exposed, I will look less typical, and I might continue to experience dysphoria about having an exposed remnant of my original anatomy.

Is this choice consistent with what you know about phallo? And if so, does it have any bearing on your own decision?

I'm also not worried about ending up alone, or with another trans man. I am asexual- so I prefer to live without sex.

[GnomeKid]

I'm going with the phallo.. Each to his own, but if meta was the only option I don't even think that I'd do it. 

[Arch]

GnomeKid, I would probably do meta if it were my only option. The dysphoria has been rising in the last couple of years, although some of it is due to my internal organs. I guess I would just tell myself that some cis guys have small equipment...as long as I could pee standing up, I would likely go for meta rather than leave things as they were.

Sometimes, I actually wish I didn't have a choice.

[CaptainAFAB]

You guys heard about this?

http://www.cbsnews.com/news/first-successful-penis-transplant/

First successful penis transplant. Obviously transmen will have to wait who knows how long, if this becomes available for transmen at all.

Whole new meaning to "organ donor."