Why do transgender women have to dilate?

[JamesV]

Hi ladies, cis male here. So I've been reading up on transgender people and I generally understand most things except for dilating. While I was googling I found this site and decided to sign up and ask. I've come across 1 or 2 other sites. 1 of them was called gender trender or something like that but the information seemed very biased so I disregarded it. Hopefully this isn't too much of an invasive question.

Okay so, I understand that if a post operation trans woman doesn't dilate that the volume in her vagina will decrease, what causes that? Most places just explain that it happens but it doesn't explain why. I've heard that it's the (PC?) muscles trying to move themselves back into place, is that true? and if so, why is it so hard to open back up if she hasn't dilated in a while?

[Jen72]

While I am pre everything this is how it works. The surgery creates the vaginal space but as the body is healing it wants to close that space so you have to stretch it to maintain its shape or it will shrink. Much like any wound it will shrink or close to heal.

I could be wrong but this does make sense and I have no real experience what so ever either.

[Cindy]

Hello James and welcome to Susan's

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Many women, both cis and trans need to dilate at some time of their life. For non-trans sexual women this is often after a prolapse or surgery to  her vagina.

For post-op trans sexual women it is to achieve width and depth of her vagina and to prevent closure.

[Jen72]

Thanks cindy tbh just a good common sense guess on my part:)

[JamesV]

Thank you both for answering  but I'm afraid I'm even more confused now. What do you mean when you say "wound" do you mean while the surgery is healing? Or are you referring to the vagina as a wound? If so, can you expand? I thought a wound was injured flesh and from what I've read the skin in a "neo-vagina"(hope I used that correctly) is very much like the skin in a natal vagina?

[Cindy]

I would not refer to a neo-vagina as a wound at all.

[JamesV]

I would not refer to a neo-vagina as a wound at all.

So what mechanism causes the closing? I think that's the main thing I want to find out.

[Jen72]

Sorry bad choice of word to call it a wound. Truthfully best way might be calling it a something new to the body and it want to revert to a previous state. That isn't totally accurate either but all I have.

Thanks for pointing out the error of my wording no ill intent was intended.

[JamesV]

Sorry bad choice of word to call it a wound. Truthfully best way might be calling it a something new to the body and it want to revert to a previous state. That isn't totally accurate either but all I have.

Thanks for pointing out the error of my wording no ill intent was intended.

Lol I'm just thankful you're trying to explain lol. It's all new to me. I've never actually met a trans person before(to my knowledge) but I was looking at this show called Orange is the new black on Netflix and the transgender actor Laverne Cox was not all what I was expecting from what I was lead to believe so I started my research 2 weeks or so ago because I figured I was very ignorant on the subject. Any help is greatly appreciated.

[Cindy]

Why wasn't she what you expected?

I am a very normal woman, as are all trans sexual women

[Rejennyrated]

Good Morning James,

Well first of all its incorrect to say that ALL transwomen have to dilate. All do have to dilate while the healing process is taking place to avoid stenosis - but after a time, which varies from one woman to another dilation becomes somewhat optional. I'm over 30 years post-operative and I havent dilated in many many decades, yet I still have my full depth and capacity.

As a medical student I can answer your question as to why... the neovagina is created surgically from a pouch in the body, by extensive skin grafting. This means that there is a lot of healing being activated - and the tendency with healing is for the body to fill a cavity which is not yet lined with endothelial tissue... so until the cells of the graft undergo metaplastic change and become a psuedo-epithelium the cavity will tend to close over. Another problem is that in the early days the graft tissue may become hypertrophic and odematous - that is swollen - the pressure of the dilator helps to reverse this, and thus aids healthy healing.

However over time the body will learn that this cavity is permissable, and thus the dilation process - with frequent stretching and pressure eventually the whole structure settles and further dilation becomes unnecessary because the normal sexual activities that the woman is engaged in are more than sufficient to do the job.

I am not overly sexualy active, but even the occasional activity that I enjoy is more than sufficient to maintain everything and thus dilation is not a requirement.

[JamesV]

Why wasn't she what you expected?

I am a very normal woman, as are all trans sexual women

I know that now but the media depicts trans women very 2 dimensionally I feel like in how they dress and how they act and so on and so forth. I think Laverne's character was the first I've seen which actually breathed life into a trans character and it made me think of a lot of things I wasn't thinking before.

I don't like being "that" person since I'm a minority myself and I personally understand how ignorance can affect people so I went online and read a bunch of her interviews and then I went over to YouTube to find some trans vloggers. I then went on to research gender dysphoria and I believe I have a firm understanding of how that works and why I don't feel my gender as a cis person. Hopefully I can meet some trans individuals offline because there's only so much you can understand about actual people from reading info online.

[JamesV]

Good Morning James,

Well first of all its incorrect to say that ALL transwomen have to dilate. All do have to dilate while the healing process is taking place to avoid stenosis - but after a time, which varies from one woman to another dilation becomes somewhat optional. I'm over 30 years post-operative and I havent dilated in many many decades, yet I still have my full depth and capacity.

As a medical student I can answer your question as to why... the neovagina is created surgically from a pouch in the body, by extensive skin grafting. This means that there is a lot of healing being activated - and the tendency with healing is for the body to fill a cavity which is not yet lined with endothelial tissue... so until the cells of the graft undergo metaplastic change and become a psuedo-epithelium the cavity will tend to close over. Another problem is that in the early days the graft tissue may become hypertrophic and odematous - that is swollen - the pressure of the dilator helps to reverse this, and thus aids healthy healing.

However over time the body will learn that this cavity is permissable, and thus the dilation process - with frequent stretching and pressure eventually the whole structure settles and further dilation becomes unnecessary because the normal sexual activities that the woman is engaged in are more than sufficient to do the job.

I am not overly sexualy active, but even the occasional activity that I enjoy is more than sufficient to maintain everything and thus dilation is not a requirement.

Wow, thank you! This answered all my questions. You've been a great help.

[Cindy]

Sadly, the media just likes to sensationalise everything.

Transgender people, be they females or males, have identified as the gender they were not assigned as. It is a crippling condition that can include hatred of how your body looks. How you are perceived, how you are treated by society.

As a child I was expected to be a boy. I wasn't and could not be one. For transmen they were expected to be girls, but never were.

If you can imagine the horror of you, a cismale, waking up and seeing your body as female. How would that affect you?

It is the same for transgender women. Everyday seeing a male body, but knowing you are female.

Being transgender is a very hard cross to carry. That we are made fun of, insulted and decried makes it so much worse.

I'm a woman. I was born one. My body didn't match. That really is what it is like.

[JamesV]

Sadly, the media just likes to sensationalise everything.

Transgender people, be they females or males, have identified as the gender they were not assigned as. It is a crippling condition that can include hatred of how your body looks. How you are perceived, how you are treated by society.

As a child I was expected to be a boy. I wasn't and could not be one. For transmen they were expected to be girls, but never were.

If you can imagine the horror of you, a cismale, waking up and seeing your body as female. How would that affect you?

It is the same for transgender women. Everyday seeing a male body, but knowing you are female.

Being transgender is a very hard cross to carry. That we are made fun of, insulted and decried makes it so much worse.

I'm a woman. I was born one. My body didn't match. That really is what it is like.

I don't think I could even begin to imagine what that's like but I'm sure it's a very odd feeling. While I was educating myself on trans issues I became aware of a new level of insensitivity and hate with some of the hate blogs I'd run into. It was simply disgusting and even though I'm not trans it sort of made me very angry in a way that there are people out here dedicating so much time to putting so much hate and falsehood into the air. Their antics seem a bit desperate and I can tell they have some sort of agenda. It's sad but from what I see things are getting a bit better for you guys and I'm glad for that.

[Rejennyrated]

Hopefully I can meet some trans individuals offline because there's only so much you can understand about actual people from reading info online.

Well thats the thing James - you probably already did without realising it.

Its only in the media, and in TV dramas, that all transwomen are readily identified as such. Most of us don't go around with a sign on our knecks saying "Transwoman please pass".

While most transpeople do not have the luxury that a few of us (for example me) had of at least partial childhood transition they learn pretty quickly. In the short term it means that they have to learn, as an adult, the things most of us learn as teens - and that means that for a very short while they may be more visible. However in the longerterm most of them do learn and then just blend in and fade from view. So those that you will notice are usually the ones who are still in the "early" stages and are not yet the "finished article" so to speak.

For example if you were to come to my hospital I might well treat you and you would be none the wiser that I was anything other than a slightly older than usual medical student. I also doubt if you would spot Cindy or many others like her in a crowd.

So your chance of meeting someone trans is good, your chance of actually knowing that you met him or her, unless they choose to tell you, or they are in the very early stages, is considerably less.

I hope that heps a little - and now I must leave you and return to my life. Take care.

[Cindy]

Thank you and I do appreciate you being sensitive to us.

As rejennyrated said you wouldn't pick most transgender people. You have probably met many.

But we get comments like this; that I did yesterday.

'You make a really good woman, if I didn't know you were a bloke I would never who have known'.

It was cruel and heartless and so normal.

[JamesV]

Well thats the thing James - you probably already did without realising it.

Its only in the media, and in TV dramas, that all transwomen are readily identified as such. Most of us don't go around with a sign on our knecks saying "Transwoman please pass".

While most transpeople do not have the luxury that a few of us (for example me) had of at least partial childhood transition they learn pretty quickly. In the short term it means that they have to learn, as an adult, the things most of us learn as teens - and that means that for a very short while they may be more visible. However in the longerterm most of them do learn and then just blend in and fade from view. So those that you will notice are usually the ones who are still in the "early" stages and are not yet the "finished article" so to speak.

For example if you were to come to my hospital I might well treat you and you would be none the wiser that I was anything other than a slightly older than usual medical student. I also doubt if you would spot Cindy or many others like her in a crowd.

So your chance of meeting someone trans is good, your chance of actually knowing that you met him or her, unless they choose to tell you, or they are in the very early stages, is considerably less.

I hope that heps a little - and now I must leave you and return to my life. Take care.

That's very true. Now that you mention it, I live in a big city so it's unlikely that I haven't met a trans person once lol. In any case, have a nice day Jenny.

[JamesV]

Thank you and I do appreciate you being sensitive to us.

As rejennyrated said you wouldn't pick most transgender people. You have probably met many.

But we get comments like this; that I did yesterday.

'You make a really good woman, if I didn't know you were a bloke I would never who have known'.

It was cruel and heartless and so normal.

I can see how that can be insensitive. You'd think it would be common sense not to say things like that but apparently not.

[Laura_7]

Well concerning education you could have a look here:
https://www.susans.org/forums/index.php/topic,190724.msg1699110.html#msg1699110

Concerning high emotions there is all kinds of info to be found on the internet...
its possible to keep to sane and trustworthy sources...

and concerning meeting... well there are lgbt centers, with various activities...


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