Gender confirming surgery - thoughts

[Cindy]

I suppose I am in a bit of a unique situation. I'm sort of well known both here and in society in Australia.

I've had some difficult conversations recently with women who have had surgery. Two very extensive and multiple, Goddess so brave.

All of them, and none are members BTW, are struggling with quite severe post surgical depression. It hit me that we have to be aware and to offer support for this. all of them are extremely embarrassed. This was their dream!

And the dream is a bit of a nightmare at the moment.
They all said that they would never mention their issues to other women in case they frightened them off from what they wanted to do. They also I think feel some 'shame' for stupid reasons.

Let us be aware of this and please, ladies who need support here, just ask.

There is nothing wrong in being depressed!

Cindy

[suzifrommd]

I need to emphasize what Cindy said. I'm usually a cheerful sort, not prone to depression, but I got hit hard for a couple of months. Largely past it, thank heaven, but pretty bad for someone who thought it wouldn't happen to me.

If this is happening to you, please reach out.

[Eveline]

Cindy, I sometimes wonder if it's OK to ask more about why folks are depressed. Does it make it worse to ask about the "why", or should we limit ourselves to just being emotionally supportive?

Like for GCS, someone might be depressed because of one or more of the following:

• after effects of general anesthesia, which can get worse as we age
• general trauma of a major surgery, and feeling like crap for a long time afterward
• fear that the new parts won't be attractive or functional when they are healed
• panic that maybe they just made a huge mistake
• emotional letdown that many people get after achieving a big goal ("so now what?")

It seems like the conversation might go differently for each of the above. Also, some of these are potentially triggering for other readers, so I suppose a trigger warning would be appropriate?

Maybe I'm just analyzing this way too much...

[suzifrommd]

Cindy, I sometimes wonder if it's OK to ask more about why folks are depressed. Does it make it worse to ask about the "why", or should we limit ourselves to just being emotionally supportive?

For me it was a combination of things. Mostly that I'd put my issues on hold because there was so much involved in making the surgery happen and in the early aftercare, that once I'd put the nasty stuff behind me, I suddenly had to deal with the reality of my separation, isolation, etc. Plus the surgery totally changed my sexual orientation and I needed to figure out what that meant for me.

None of it had to do with the physical effects of surgery or concern about my new body parts (which are wonderful).

[Muffinheart]

I'm trying to pinpoint my depression causes, and the best I can come up with is that I have nothing else to aim for. I think of the items in my checklist:
Come out - check
Divorce and buy new house - check
Change name, drivers licence - check
Electrolysis - check
Tracheal shave - check
Find a job - check
Come out at church - check
Find a partner willing to put up with me lol - check
GRS - check
Change name on birth certificate and remaining documents - check

What motivated me in 2007 through last year was "just one more step", but I have no more steps. No motivation.
It's way too easy to say just live life.
My mindset is always to be striving towards a goal.

Ugh

[sam1234]

Ladies, please correct me if I'm wrong because I'm looking at this from the F to M side. There can be a lot of swelling after surgery that is not only uncomfortable but makes the "new parts" look a bit warped. If someone is expecting to come out of surgery looking like the pictures of others they have studied, it would be a let down.

There is also the fact that as much as the surgery is good, there can be a lot of pain post op. People have very different reactions to pain and varying tolerances too it. If someone has spent months going from one surgery to the next, all of which were painful post op, I could easily see how depression would be the result.

With easy access to the net and before and after photos available, its hard not to have expectations of what someone will look like. Different surgeons have their own way of doing things not to mention we all have unique bodies to begin with. A couple of years ago, I looked at before and after photos of F to Ms and saw how realistic they looked compared to me. That sparked some pretty deep disappointment and depression.

Another factor may be the support the individual has from close friends and family. If the family had a bad reaction to the news, then the individual probably had to go through all those surgeries alone and feeling guilty because their family won't accept them. We like to think our parents will love us regardless of who we are, but sadly, that isn't always the case. The same goes for friends. Having close friends that leave you just because you transitioned, ignoring the fact that you are the same person inside can be devestating.

Because so many of us were and are so happy with being able to transition and loving the fact that we are finally in the right body, its easy to forget that some people are having problems after surgery instead of euphoria. Thank you Cindy, for reminding us that there are people who need emotional support and encouragement.

sam1234

[Jerri]

I have yet to blessed with grs, but in one of the groups that I meet with a very dear friend was very depressed last year, after many hours of going through many issues that had been triggering her, it was very plain to see that for me that physically my grs next year will help the issues that are impacting my dysphoria with my body. My concern is that I have so many other things that have also created triggers of all sizes and places. social boundries that may be percieved or real, work relations in a facility of 600 with a 25 year history most of which I spent in an male role. physical limitations that are developing, new laws and standards yet to be imposed, the fact that more than half of my family has not spoken to me since I was re-born. so many things have changed in my life. I drove a car sober and straight for the first time three years ago. my views are a living thing as my life becomes clear or foggy they adjust. the days I am not distracted or depressed are truly a blessing and much more frequent than ever in my life but do they really ever just stop being like that. likely not for anyone I just hope that we can offer help when needed to each and everyone of us. regardless of we just starting on our journey or miles on our pathes. and tha everyone should feel that someone here could help if they take a moment to speak up and hold a hand out

Jerri

[cindianna_jones]

I think that there is a major factor that hasn't been mentioned. This is the biggest goal and objective of our lifetimes. For many of us it is all consuming. For that reason, no plans are made for after the final procedures. I know we don't think it, but we just don't go live happily ever after.

I think it is important to have a bucket list that includes all of your other interests besides the surgery goals. If you are working on those in tandem, you'll still have them after surgery.

I sort of ran into this after my surgery. I did have a job and went through a couple more until I lost my past, but other than work, I had lost my other interests in life. So after figuring out why I felt down, I did prepare a bucket list that should have lasted a lifetime. I finished in 2009. I must make a new one.

Chin up!
Cindi

[LoriLorenz]

Keeping depression bottled up is no good for the individual in question or your friends and family. Like Cindi mentions, post-surgical goals pale in comparison to the major events GCS are in our lives. Hiding how we feel is not going to help us find new goals, but family and friends who understand just might. I for one will be looking to my family, friends and martial arts community for help and new goals after any surgeries.

[Ms Grace]

All good points. Depression can rear it's head for many reasons.

Expectations can be a major component of disappointment, set them too high and the results will usually be a let down.

As for feeling deflated once a major goal has been achieved, I guess the thing is to realise that GRS can be a destination along the journey, not the final stop... life goes on afterwards so plan for it.

Don't be ashamed if depressed, please share and get support.

[chefskenzie]

I posted the following on my blog a while back.  I think some of it applies here.  This is only one side of the coin in regards to what you are talking about.  But something I personally (in my geographical location) see from the TS community:




There are many ways of offering support online in posting the truth to someone, giving a wake up call, offering hard advice (but the hard truth), and being supportive.

There are also those who post things that are unnecessary, hurtful, or trying to stir the pot. I am not sure if it is because of their own issues and insecurities, or because they are generally unhappy.

However there is no Cookie cutter transition. EACH individuals transition is different.

What may work for Girl A is different for Girl B, C, and D.

With that said, it worries me that so many girls (a few on the forums, but many on other groups) look at surgery as the "CURE ALL". Once they get the magic vagina everything will work right in your life.

SRS is a dream come true for anyone able to get it. However what worries me is that misconception that it will fix everything for you.

For example. Many would say that because I am pre-op that my relationship won't last. That I am with a "->-bleeped-<- ->-bleeped-<-". Or might say that statistically these types of relationships don't last. Others say it isn't right to have a Significant other until you are fully transitioned because you will always be "insert whatever here".

I think before getting the magic vagina that we first and foremost be happy with the person we are on the inside. That we love ourselves fully.

That doesn't mean you have to love your genitalia, but you need to accept that you have a journey you must go on, for whatever reason. If you are lucky it may be a short one, or it could be long. Regardless you are on a journey.

I want to use an example. I have a local friend I will call "Tammy". Tammy is Pre-Op M2F. She refuses to be in a relationship because no man could EVERY love her as long as there is a penis between her legs. That she isn't yet good enough for a relationship. Once she has a Vagina, she will be perfect.

I see a problem with that. What is or isn't between a woman's legs should never matter. It is about you, the person. I find this journey beautiful. I honestly look in the mirror and love the person I see.

Sure I look at certain parts and hate what I see, but I know that ONE DAY. That will be complete.

I know that my fiance, loves ME. The person I am, my personality, my kindness, my jokes, my laugh, the feel of my skin, my smell, my long hair, my MORALS, my outlook on life.

Because I know he loves me, I know he also loves everything that is or is not between my legs. If I get the magic vagina, he will be happy, in love, and supportive.

If I don't get the magic vagina, he will be happy, in love, and supportive.

It isn't about the genitalia. It isn't about the "perception, or sexual/kink". It is about ME as a Person, on the inside.

I had to learn to love myself. And it was not a easy journey.

I lost my family, most of my friends, jobs, and previous loves al l because I was unhappy, and chasing these perception of wholeness.

It took having nothing and no one, to realize that I didn't need all of them, or the Magic Vagina to be happy. I had everything I needed within myself.

So I quit being the victim. I held my head high, and accepted the fact that I DESERVED respect, and to live MY life the way I saw fit.

That is when I started being perceived as others around me as a woman. This was pre hormones, and even with a BIT of stubble, but long hair I was being called ma'am, instead of the sir I was getting a few weeks before. What had changed? Nothing but my perception and attitude.

Now I don't worry if I pass. I KNOW I do. I don't worry about my nose being too large. I know other women who have larger ones. I don't freak about a BIT of stubble on the side of my face between appointments because I know a LOT of women who have the same thing that are Natural Born Women with the Magic Vagina already installed. I AM a woman. The presence or absence of the Magic Vagina doesn't really matter, because it is really already there.

I know who I am, I know where I am going in my life. I know who I am going there with.

I know that this is easier said than done. I am also not pointing the finger at anyone here. Just thought it helpful to share my personal insight.

I think that is the main reason I don't have to go to therapy. There were no milestones for me to meet, no one to "come out to". I had realized LONG ago my family could never be supportive, and that wasn't MY problem. It was there's. I quit caring what people thought of me, or wanted a long time ago, and have focused on ME for a while now.

I think that is another reason I love being in love. Because I now have someone to focus on, and do little things for to improve their day. And what is so amazing is I daily get that back. Unconditional love is truly amazing. Having someone see the REAL me, and not the work in progress, but someone who can see the insecurity, and imperfections, and yet still look at me and see perfection.

[barbie]

Yes. Our mind is too big, too complex, and too diverse to be determined by SRS. So many factors determine the happiness or depression of a person, and it varies with time and space.

barbie~~

[mrs izzy]

As someone who have been through the process. I have been by the side of many girls in this end process.

I find it is a struggle for some.

Expectations...... As with anything with transition some I fell rush way to fast to a end point. They really are not ready.

GCS is hard. It truly is a long, long period of time before you start feeling like a real person.

Some shorter then others can happen.

BUT you will just need to do the time.

Need to do the time as in anything in transition.

Stop looking for magic, none of transition is magic it is lots of therapy hours finding who you truly are to heal the person you where forced to suppress.

Expectations will kill us, living towards healing from transition is where we need the focus.

Neo vagina is not a magic fix but can be for some. GCS is a step in the process to wellbeing.

I hat to see others struggle but we can hold there hands after the fact. In the end it comes to the choices of how one walks there path in transition, some should not force anything.

Not force anything.

[Laura_7]

Hugs to all who need it...

Imo this could also be a hormonal thing. Men and women who have had operations on testes or ovaries report depressions, and also menopausal women.
A still high estrogen dose, combined with bioidentical progesterone and maybe even a low dose of testosterone might be an idea... topical or best via implants, oral might give a spike and a low some hours later... many menopausal women reported some relief, imo this should be talked through with the endo...

[Maegan]

This post has been very insightful and informative so far. IF all goes well, I plan to have GRS next year and it is nice to know about some of the pitfalls. I'll surely have to be careful seeing that I do suffer from depression.

Good to know that all the support is still here.

Huggs

Maegan

[cindianna_jones]

FWIW, the first thing I did when I got home was to put go shop for a bikini, a nice bright yellow one I found. I walked like a duck but no one noticed as far as I could tell. I got home to my apartment, put it on, and went out and lay by the pool for an hour. It was during work hours so no one was there. I did this every day and it felt MARVELOUS. There are things we've always dreamed of that you can do to keep yourself from getting into the doldrums.

When I went back to work, it was really tough. They had figured out what I had done and that was taboo as far as they were concerned. Between dilating in the restroom and facing down the president every day who wanted to fire me, it was indeed a serious challenge. But that yellow bikini waited for me every day and boy, did I get a lot of use out of it!

Cindi

[Cindy]

What great comments.

Two of the girls went against there therapists advice and went to Thailand and got signed off by the in-house psych. I've got a feeling that maybe good therapists should be listened too with a more open mind than - bloody gatekeepers.

When I went for my surgery my psych asked if I would like to come and see her 7 weeks after surgery (there was no requirement), I asked why and she said I like to see my transwomen about that time and my natal women who give birth at about the same interval because that is when depression can set in.

I think there are some other points and they have been raised. GRS is a dream for so many and it will make us 'right' but it doesn't take away all of the other baggage we may carry. That has to be dealt with.

Secondly, as my surgeon empathised continually, GRS will not make you more feminine or more of a woman. You are a woman now. Surgery is massive and recovery and maintenance a grind on your life. You have to be aware of that and to be ready for changes in your life and routine that will be foreign and probably more than you ever expected.

I do think that it is very important for post op women to stay on the site. If they are unhappy the support is here for them. There is no criticism that 'whoops' I may have made a mistake or any reason not to say, Hey I feel bad or sad and want to talk. Just as there is no issue with women who decide they do not want surgery for any reason whatsoever.

Indeed I think it is critical that both groups discuss issues so that women contemplating surgery have a full perspective that they may not get anywhere else.

[LoriLorenz]

I want to share some of what my experience with surgeries has been:

I have had surgery that I later regreted. There are many layers that can happen after. A quick run down:

As a college student who was both hard of hearing and in a music program, I thought I needed to improve my hearing to follow my dreams. So I had an implant attached to my skull that would anchor a hearing aid. Yes, the procedure and to this day I use the aid regularly. Had I the choice to do it again, I would have not had surgery, since it has now become for me a sybol of brokeness that I was told I was, but I now know I'm not.

I went through anger, sadness, worry, and other emotions all over a little 6 mm metal peg sticking out the side of my head.

I could have gone in and had them saw it off, returned to bilateral "typical" hearing aids, and lesser hearing. I chose not to for the simple fact that it's less hassle and pain and recovery to use what I have. I have been asked if I would do the other ear as well. Tha was a vehement NO. One is more than enough.

GCS is far more major than that, and in that light I understand the reasoning behind needing psychologists involved in such major surgery as GCS. I hesitate to call it elective surgery since so many of the trans community would (and have) committed suicide rather than not be able to fully transition. In that way it's life-threatening not to have the surgery. However, in the sense that not transitioning does not threaten the physical being's existence, it is elective, yet necesary for some. I have had life altering major surgery that was needed or else my lungs would have collapsed, crushed by the severity of my scoliotic curves. I do not regret it, despite the rather large amounts of pain it caused and causes.

In surgery my brother contracted a virus that weakend his heart, which in the end was what killed him. Of the many times he was "on the table" that was the last thing we expected. We expected him to have a shorter lifespan because he might only be able to survive on dialysis for so long. His heart - until he caught that damnable virus - was strong and was not at issue. His issues stemmed from a car accident that left him sterile and unable to relieve himself in the normal way. My brother had been operated on so many times that we lost count. In the end, he was simply to tired to carry on and the pacemaker couldn't revive him.

Any time one has surgery, the surgeons are cutting into one's body, one's being. This can have life altering effects (both the expected and unexpected). Please, my friends, please attend to thoughts of surgery with caution and knowing all the risks and effects that can come of it (at least all that we can reasonably know).

That said, particularly where those who do feel it's surgery or suicide, chose surgery. You life is worth having pain, and if that pain needs to be the after effects of surgery instead of the effects of depression, then let it be the pain of surgery, which fades in time and can be dealt with far easier than the other.

[Eva]

This may be one of or THE best threads Ive ever read here and Ive read a lot

My thoughts... Im only a bit more than a year "full time" in that time HRT has been very good to me considering Im 46... I have $$$, I was VERY good at making it as a man... For at least 30 years Ive dreamed of doing what Im doing NOW After what looks to be a very successful FFS and just being happier than Ive ever been I have no doubts SRS WILL HAPPEN for me .)

I have no doubt that second letter will be a formality and like I said its easier with money, it talks and makes the hoops easier to jump through...

I really liked chefskenzie post it echo's so much of the way I feel about this... Even pre op and with YEARS left to fully feminize I feel like you have to love yourself going in or shortly after.... Really no going back with the decision to embark on all this...  Ive had VFS and now FFS with one of the best docs you can pay... Yes its made a NICE difference for me but I feel like Ive laid down the fundamentals already that just make that icing on the cake 

Ive to my amazement found plenty of BF's and new cis friends and even much better relations with family since I made my decision, its not nirvana but considering the alternatives.....

Maybe its just the afterglow of successful FFS but I feel more certain than ever this is right for me

Its easy for me to consider successful SRS to be the end and Ive thought of it that way I must admit but Im beginning to see that its just another step and it wont "make me a woman"... I feel like Id better have that worked out first!!!!

Im starting to see it as just an admittedly HUGE step on the way It gets better every day here so far, even the bad days are valuable learning experiences

From what I know now about this kind of surgery its gonna be no picnic recovering and possibly the worst recovery I can imagine...

I think that one should just think of it as a medical procedure that's necessary to live but unlike FFS or VFS its easy to hide that compared to overall looks and manners VS SRS ...

BUT I donno yet just how it will all feel, I sincerely thank all of you that are way ahead of me for your perspective 

[Cindy]

Two things:

This from Eva:

Its easy for me to consider successful SRS to be the end and Ive thought of it that way I must admit but Im beginning to see that its just another step and it wont "make me a woman"... I feel like Id better have that worked out first!!!!

Unquote

When I was due for surgery I started to have doubts. I posted to some of my friends here going at about the same time. One of my friends replied, and I will not identify her and this is my personal take on the matter from what she said.

I'm 62 and gorgeous. I have suffered chronic depression all my life from my TG issues. The last three years have been the happiest of my life. I am alive. I am me. I love my life. I am happy.

Why then take a procedure that may make me unhappy? At 62 how many years will I continue to dilate and maintain? I will never have (adopted) children and a family, so why? (sorry just my dream not anyone elses). You need to balance that.

I am not gong to say what my decision was, my private parts are .... my private parts I got very upset at supportive work colleagues being interested in what I was going to do so I closed down both publicly and privately.

But we have to be very sure of what happiness and the future may bring.

This is not a process.

There is no path that says, OK for an MtF you get HRT, FFS, Trachea, VFS, GRS and a GPS so we know where you are (sorry). You do what YOU want. You are no more and no less a woman for it.

LoriLorenz raised a very good point. Some times we things fixed that maybe we don't need fixed, but we do from hope for something better. That sounds familiar.

He also raised the risk of serious surgery.

I also know the rates of success for GRS male to female surgery. We never see them reported here (legal reasons) OK the stats are ephemeral, just conversations,  yes I went to Dr X and yes I have 6 inch depth, as long as you want to be F by a pencil, was one. There was bitterness. Understandable.

We hear from girls on the ground going through surgery and their delight, pain and fortitude. Awesome girls.

When was the last time we had a 3 month post, a six month post etc?

I have to make sure that I am not knocking what many of us want, or have had but I do think this is a useful debate.

Cindy

(My comments in this thread are PO)