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Clitoris questions (trans man)

Started by Wendighost, September 10, 2015, 01:55:41 AM

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Wendighost

Hello! I'm a new user here, but I've been glancing around this site for a long time.

I'm a twenty year old trans man. I am asexual/aromantic and, currently, undergoing a lot of pressure from my therapist (a post op trans woman) regarding hormone therapy. She doesn't seem to understand why I am so uncomfortable going on T due to the potential enlargement of the clitoris. I've explained this to her many times.

I have very extreme dysphoria regarding my lowermost sexual organs. I pack almost constantly. I do not masturbate, feel sexual arousal, find sex/masturbation pleasing, et cetera to that effect. (I have had sexual experiences and enjoyed none of them and have not encountered sexual abuse/harassment.) I am aware that, if I do begin testosterone, there is the very likely possibility my clitoris will increase in size. I am very, very uncomfortable with this. It is the major reason I have refused the idea of T for many years despite desperately wanting to surgically transition and wanting a phallo in the future.

To my understanding, from what research I've been able to do, it is considered genital mutilation to remove a clitoris in a non-intersex patient unless their well being depends on it. I understand that clitoridectomies are done as hatecrimes to non consenting women, as well as further mutilation.
I'm coming here for some advice on whether or not anyone thinks there is an option regarding a complete removal of the clitoris for me pre-testosterone. I have an average clitoris and no deformed or non typical vaginal portions. This is inhibiting my ability to fully medically transition in a way that will relieve the majority of my dysphoria and general body image discomforts.

As well, I'd like to know if anyone is aware of any doctors that will perform a phalloplasty on a trans man patient who has not undergone HRT? I'm having my top surgery here in America (in Maryland with a Doctor Fischer) by October next year, though, once I finish healing well enough to comfortably and safely travel, I will be moving in with a family member in New Zealand. She has job opportunities in the Netherlands (close to Amsterdam) and we may be relocating there within the next four-five years depending on how the business and housing go. Is anyone aware of any surgeons in America, NZ, or the Netherlands/surrounding Europe that would perform a phalloplasty without a patient having taken testosterone for a certain amount of time...?

As a concluding note, I intend to begin T taking Androgel rather than injections. From what I've been able to learn, gels can have a very similar effect to injections depending on the dosages and the patient themselves. Would gels have a different effect on the growth of the clitoris than injections?

Thanks so much! I really appreciate the great community here.
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suzifrommd

Hi Wendighost. Welcome to Susan's.  :icon_wave:

Here are some links to site policies and other helpful information:


I'm concerned that your therapist is putting pressure on you. The choice to undergo hormone treatment is a very personal one, and should not be subject to pressure.
Have you read my short story The Eve of Triumph?
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Laura_7

Well you might try to think a bit about the reasons...

an orgasm can be seen as a source of pleasure and love...
an experience kind of detached from body parts might be possible...
and entertaining fantasies meanwhile...

it can be a spiritual like experience, of love and letting go...

you might try to get rid of any kind of judgement or whatever, and just see it as a source of pleasure...
its everyones right to use it...
if used with a loving intention (and self love is included imo) there should be no reasons against it.. religion or whatever...
its even healthy, its a source for endorphines and other products...

you might look into tools like magic wands or smart wands...
they are designed to stimulate a whole area...
as said phantasies are well possible...
some people even use it when being together with a partner...
I have to say all at your own risk because they are really powerful...
some use a piece of cloth in between...

You might talk with a counselor about possible reasons, or ask here if you feel you have more restraints...
its all natural and should be talked about...

and sometimes there are meds who make orgasms more difficult... meds against depression for example...
they might be switched to other ones...

so you could try to see it as a source of pleasure... and maybe love...


There are surgeons who do not require hrt, you might ask them.. or look on susans, there might be some hints to requirements, for example one letter of a therapist...

growth is individual... you might ask an endo knowledgable on the subject on different forms of application...


hugs
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Isabelle

Tell your therapist is she likes testosterone so much,  maybe she should go on it.
You don't need to be on hrt to get SRS under the current standards of care, as long as there's reasons, and you have reasons.
I would consider getting a new therapist.

Also, im from NZ, there are currently no surgeons performing any gender surgeries. You may possibly find someone that can do Top surgery but beyond that, there's nothing. New Zealand is a black hole when it comes to trans health care.
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Wendighost

Quote from: suzifrommd on September 10, 2015, 05:45:49 AM
Hi Wendighost. Welcome to Susan's.  :icon_wave:

Here are some links to site policies and other helpful information:


I'm concerned that your therapist is putting pressure on you. The choice to undergo hormone treatment is a very personal one, and should not be subject to pressure.

Thanks for the resources!

I'm not very easily swayed by outside opinions, especially in the mental health industry when I know my body better than someone not living in it, so I'm not very worried about her pressure in terms of my health. I do have my letter for my top surgery already, but... I'm very worried that she's going to hinder further portions of my transition due to not wanting to go on T. She's an incredible therapist and the only gender therapist local to me in my state - even if she gatekeeps, I don't know if it's worth giving her up in the end. That's my real fear.
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Wendighost

Quote from: Laura_7 on September 10, 2015, 06:13:54 AM
Well you might try to think a bit about the reasons...

an orgasm can be seen as a source of pleasure and love...
an experience kind of detached from body parts might be possible...
and entertaining fantasies meanwhile...

it can be a spiritual like experience, of love and letting go...

you might try to get rid of any kind of judgement or whatever, and just see it as a source of pleasure...
its everyones right to use it...
if used with a loving intention (and self love is included imo) there should be no reasons against it.. religion or whatever...
its even healthy, its a source for endorphines and other products...

you might look into tools like magic wands or smart wands...
they are designed to stimulate a whole area...
as said phantasies are well possible...
some people even use it when being together with a partner...
I have to say all at your own risk because they are really powerful...
some use a piece of cloth in between...

You might talk with a counselor about possible reasons, or ask here if you feel you have more restraints...
its all natural and should be talked about...

and sometimes there are meds who make orgasms more difficult... meds against depression for example...
they might be switched to other ones...

so you could try to see it as a source of pleasure... and maybe love...


There are surgeons who do not require hrt, you might ask them.. or look on susans, there might be some hints to requirements, for example one letter of a therapist...

growth is individual... you might ask an endo knowledgable on the subject on different forms of application...


hugs

Hello - I don't think you fully understand the context of my post nor asexuality. I'm not broken, traumatised, religious/spiritual, celibate, anti-sex/masturbation/pleasure, or anything similar. I physically do not experience these things for natural reasons and they aren't a problem, they don't reduce my life quality or cause any mental distress, and I don't want to change my sexuality. (If you would like further reading on asexuality and our visibility, this is a great resource: http://www.asexuality.org/home/ )

I want to remove my clitoris not for sexual reasons, but because everything vaginal makes me very distressed and uncomfortable. Having something down there more pronounced would be what sent me into a spiral of bad mental health and a feeling of being broken and needing to be fixed. I would like to be on T before having a phallo, but I'm having difficulty finding surgeons who will perform a phalloplasty without a patient taking hormones (that does a final job I'm satisfied with) or a surgeon who will perform a clitoridectomy or similar on me so I can start taking hormones.

Thanks for your time!
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Wendighost

Quote from: Isabelle on September 10, 2015, 07:50:44 AM
Tell your therapist is she likes testosterone so much,  maybe she should go on it.
You don't need to be on hrt to get SRS under the current standards of care, as long as there's reasons, and you have reasons.
I would consider getting a new therapist.

Also, im from NZ, there are currently no surgeons performing any gender surgeries. You may possibly find someone that can do Top surgery but beyond that, there's nothing. New Zealand is a black hole when it comes to trans health care.

Unfortunately, my current therapist is the only gender therapist within a two hour reach of me and I'm not financially secure enough to take public transportation or spend much gas money. I've considered switching, but it took me a very long time just to locate this one.

Thanks for the information on SRS! I wasn't positive how far those standards would apply, but it's a great relief to know that they would cover my reasons.

It would be so convenient if NZ had a surgeon around just looking for a job to do within the next handful of years, but it's never that easy, is it? I'll have to look into the affordability of traveling somewhere for phalloplasty once I'm moved in there, since my income will be substantially more secure and the bills will be lighter... Traveling through Europe is a lot cheaper than traveling there from NA, so I'm hoping it's doable.
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Isabelle

Is there anywhere in Europe where you can claim to have converted to Islam, and get a doctor to remove it for you?
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Laura_7

Quote from: Wendighost on September 10, 2015, 08:34:21 AM

Having something down there more pronounced would be what sent me into a spiral of bad mental health and a feeling of being broken and needing to be fixed. I would like to be on T before having a phallo, but I'm having difficulty finding surgeons who will perform a phalloplasty without a patient taking hormones (that does a final job I'm satisfied with) ...

Thanks for your time!

Well you might try to mentally connect it with a different picture... like that of a penis... so it might be even pleasurable...
its kind of a mental reprogramming...

I'd prefer that from surgery...


well concerning phallo etc you might look here for example... there are others... look around, do your due diligence, and think about it... take your time... and you might simply ask... :
https://www.susans.org/forums/index.php/topic,169037.msg1478769.html#msg1478769
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Laura_7

Quote from: Isabelle on September 10, 2015, 08:50:26 AM
Is there anywhere in Europe where you can claim to have converted to Islam, and get a doctor to remove it for you?

Well I wouldn't advocate having it removed... it would be needed for a phallo...
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Isabelle

They'd only be taking the tip. Most of the clitoris is internal, like a wishbone. There would be plenty of nerves to use.
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Wendighost

Quote from: Laura_7 on September 10, 2015, 09:03:48 AM
Well I wouldn't advocate having it removed... it would be needed for a phallo...

I'm not sure there is anywhere I could claim I'd converted without some sort of documentation stating so (and it doesn't help I'm both a registered SGI Buddhist and was raised in a Jewish family), let alone a way to not face some sort of potential discrimination or scrutiny due to it. It's a possibility, but I'm not entirely sure how I'd even go about doing it if it was plausible.

As for the clitoris and phallo:
Insensate phallos do not include any parts of the clitoris and that's exactly what I'd like to have done. I don't care to have sexual sensation in my penis and due to wanting a forearm doner site, it's unlikely I'll need any more sensation than I'll naturally receive through the procedure anyway. A clitoris is not required for a phalloplasty, unlike a metoidioplasty (which I am, under no circumstances, having done)
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Wendighost

Quote from: Laura_7 on September 10, 2015, 09:01:49 AM
Well you might try to mentally connect it with a different picture... like that of a penis... so it might be even pleasurable...
its kind of a mental reprogramming...

I'd prefer that from surgery...


well concerning phallo etc you might look here for example... there are others... look around, do your due diligence, and think about it... take your time... and you might simply ask... :
https://www.susans.org/forums/index.php/topic,169037.msg1478769.html#msg1478769

I'm not doing anything to my body that I'm not going to be comfortable with or have to "reprogram" myself into being comfortable with. I have been identifying as transgender for ten+ years openly and have known for many of those years that what I wanted was a penis most closely resembling a cis male penis as I could obtain.

I think you misunderstood somewhere - I'm a pre operation transgender FtM, this board is only in relation to MtF surgeries and has been dead since 2014. Thank you for trying, though.
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Laura_7

Quote from: Wendighost on September 10, 2015, 09:26:40 AM
I'm not doing anything to my body that I'm not going to be comfortable with or have to "reprogram" myself into being comfortable with. I have been identifying as transgender for ten+ years openly and have known for many of those years that what I wanted was a penis most closely resembling a cis male penis as I could obtain.

I think you misunderstood somewhere - I'm a pre operation transgender FtM, this board is only in relation to MtF surgeries and has been dead since 2014. Thank you for trying, though.

There is a link there to a surgeon who is very active and offers ftm services.

Though they advise hrt for part of their service it might be asked if it could be made differently, or with a time lag.


Quote
I'm not doing anything to my body that I'm not going to be comfortable with or have to "reprogram" myself into being comfortable with.
Well a lot is perception, which might be altered. But its up to you.
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Wendighost

Quote from: Laura_7 on September 10, 2015, 09:32:54 AM
There is a link there to a surgeon who is very active and offers ftm services.

Though they advise hrt for part of their service it might be asked if it could be made differently, or with a time lag.

Well a lot is perception, which might be altered. But its up to you.

I will inquire accordingly, though the distance is farther than I believe I'd be able to reasonably travel.

Anxiety attacks, depressive downswings, dissociation, and extreme physical distress over what I am facing physically now are not perception and the knowledge that I have the choice between a surgery to alter what I am facing or completely remove it from my body in lieu of something I have been fighting to earn the right to have is, also, not a matter of perception. I really appreciate your contributions, but you're being extremely insistent regarding your own ideology over my knowledge of the body I am forced to live in (and you are not) and what I am comfortable with. Which is what I'm already facing with my therapist.
Again, thank you, I appreciate your time. I'm going to ask our conversational line stop here due to my own discomfort.
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captains

Hey, I'm an aromantic trans guy, and while I'm not ace (I'm bi), I do have a lot of sex repulsion due to dysphoria and trauma. While I personally am hopeful that clitoral growth from T will help alleviate some of my discomfort until a phallo is in the cards, I have to admit that I'm quite afraid that in actuality, it'll make the difference between my junk and a cis guy's more obvious and heighten my distress. So I empathize with your issue, here!

However, I wonder if maybe your perception of the changes are greater than the reality? I ask because after reading endlessly about people's growth, sex drive, etc, my understanding was sort of biased by the intensity of people's emotions. Like, everyone is hype for positive change, yknow, and for most trans guys, increased libido and clitoral size was the desired outcome. But truly, the changes are not great.

If this is the only reason you're opposed to T, I might try it becuase if you did begin to experience sexual side effects you were uncomfortable with, you could stop. Side effects in libido would go away immediately, and any potential growth could be handled surgically via a doctor who specializes in cliteromegaly. I know there are surgeons who consensually reduce clitoris size in cis women. Yes, some of them are intersex, but others were simply unhappy to have been born with a larger clitoris, or have experienced unwanted clitoral growth after athletics-driven steroid abuse.

Unfortunately, I don't think you'll find a reputable surgeon willing to remove the clitoris entirely because, like you said, of the history of female genital mutilation. And I don't know about T and phallo -- although I would like to know, because I also desperately want bottom surgery despite my hesitance re HRT.

(Also: Islam has nothing to do with clitorectomy.)

Hope that helped a little? Good luck, man.
- cameron
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Wendighost

Quote from: captains on September 10, 2015, 10:43:36 AM
Hey, I'm an aromantic trans guy, and while I'm not ace (I'm bi), I do have a lot of sex repulsion due to dysphoria and trauma. While I personally am hopeful that clitoral growth from T will help alleviate some of my discomfort until a phallo is in the cards, I have to admit that I'm quite afraid that in actuality, it'll make the difference between my junk and a cis guy's more obvious and heighten my distress. So I empathize with your issue, here!

However, I wonder if maybe your perception of the changes are greater than the reality? I ask because after reading endlessly about people's growth, sex drive, etc, my understanding was sort of biased by the intensity of people's emotions. Like, everyone is hype for positive change, yknow, and for most trans guys, increased libido and clitoral size was the desired outcome. But truly, the changes are not great.

If this is the only reason you're opposed to T, I might try it becuase if you did begin to experience sexual side effects you were uncomfortable with, you could stop. Side effects in libido would go away immediately, and any potential growth could be handled surgically via a doctor who specializes in cliteromegaly. I know there are surgeons who consensually reduce clitoris size in cis women. Yes, some of them are intersex, but others were simply unhappy to have been born with a larger clitoris, or have experienced unwanted clitoral growth after athletics-driven steroid abuse.

Unfortunately, I don't think you'll find a reputable surgeon willing to remove the clitoris entirely because, like you said, of the history of female genital mutilation. And I don't know about T and phallo -- although I would like to know, because I also desperately want bottom surgery despite my hesitance re HRT.

(Also: Islam has nothing to do with clitorectomy.)

Hope that helped a little? Good luck, man.

Thanks, and hello fellow aro friend!

I've really strongly considered a lot of the points you've brought up, but there are complications on my end. Once I start T, if I decide to stop it, my therapist is going to get even more pushy. She's going to doubt my gender, be more difficult to receive letters and referrals from, et cetera. She's convinced if I'm a trans man, then I want to be on T no matter what, and there aren't any therapists I could get to other than her.
Even if all of that wasn't an issue, the surgical regard comes right back around:
If I go on T, dislike the changes, and need a surgery to reduce them, I'm brought right back to where I am now but missing a few thousand dollars. I can't afford medical insurance and have been denied welfare due to unrelated complications. As is, I'm skipping three months' of groceries at a time to afford the top surgery, and with NZ being so void of trans healthcare... There's a huge risk of being stuck without the money and surgeons to fix something worse than what I'm experiencing now.

Transitioning! What a hassle, man. I wish there were more options for us regarding hormones. I'll dig deep wherever I can about getting phallos without HRT - any specific procedure you're interested in? Any information I can find over the next few days, I'll toss at you. I imagine I have a lot of emails to send and calls to make.
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Laura_7

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FTMax

Hi Wendighost,

No one can say for certain how T will affect everything downstairs. Some people experience a lot of growth, some people none or minimal amounts. It can also change the sensation as well. For me, my sensation has decreased significantly. I started on gel and switched to injections. When you do the math, there is no difference in concentration of testosterone despite the different delivery methods. In my personal experience, there was no difference between the two in terms of changes I got/speed of changes. Both were the same for me.

You could start at a low dose, but even that isn't certain to not cause changes to occur. If growth is the only concern you have, but you want phallo, I'm not really sure what the issue is? The neophallus is attached directly overtop of the clitoris. You would never have to see it again. You could hold off on starting HRT until you're about a year away from being ready for phallo, and that would give you the shortest window for dealing with it.

I haven't seen any doctors in the US that will do phalloplasty on someone who hasn't undergone HRT for at least a year, but I also haven't been looking. So it's not out of the realm of possibility. I watched a video the other day about someone else's research into bottom surgery and doctors are apparently a lot more willing to accommodate patient requests than I thought they would be. I know three of the surgeons I've looked at have required HRT for a year before phallo. I don't think there are any surgeons in New Zealand that perform phallo. The only way you'll be able to get a straight answer is to contact specific surgeons directly.

I went to Dr. Fischer for my top surgery and I'm very satisfied with my results. As Laura said, there are online therapists that you could speak with as well. That is how I got my referral for top surgery.
T: 12/5/2014 | Top: 4/21/2015 | Hysto: 2/6/2016 | Meta: 3/21/2017

I don't come here anymore, so if you need to get in touch send an email: maxdoeswork AT protonmail.com
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Wendighost

Quote from: ftmax on September 10, 2015, 01:09:58 PM
Hi Wendighost,

No one can say for certain how T will affect everything downstairs. Some people experience a lot of growth, some people none or minimal amounts. It can also change the sensation as well. For me, my sensation has decreased significantly. I started on gel and switched to injections. When you do the math, there is no difference in concentration of testosterone despite the different delivery methods. In my personal experience, there was no difference between the two in terms of changes I got/speed of changes. Both were the same for me.

You could start at a low dose, but even that isn't certain to not cause changes to occur. If growth is the only concern you have, but you want phallo, I'm not really sure what the issue is? The neophallus is attached directly overtop of the clitoris. You would never have to see it again. You could hold off on starting HRT until you're about a year away from being ready for phallo, and that would give you the shortest window for dealing with it.

I haven't seen any doctors in the US that will do phalloplasty on someone who hasn't undergone HRT for at least a year, but I also haven't been looking. So it's not out of the realm of possibility. I watched a video the other day about someone else's research into bottom surgery and doctors are apparently a lot more willing to accommodate patient requests than I thought they would be. I know three of the surgeons I've looked at have required HRT for a year before phallo. I don't think there are any surgeons in New Zealand that perform phallo. The only way you'll be able to get a straight answer is to contact specific surgeons directly.

I went to Dr. Fischer for my top surgery and I'm very satisfied with my results. As Laura said, there are online therapists that you could speak with as well. That is how I got my referral for top surgery.

Thanks so much for your response [and I love your icon]!

Finances would have to work out very perfectly for me to have a backlog large enough to pay off T as well as the phalloplasty - It's still a major potentiality and something I may have to make work. In a perfect world I would have my clitoris removed or know for certain I wouldn't experience growth and be able to start T now for all it's other benefits, but I'm so glad you'd pointed the HRT timeline to me. I hadn't realised there were surgeons that would perform the procedure in such a short period of time since starting T, which is a great relief.
More likely than not I'll have to see a surgeon somewhere in Europe rather than America and I've started looking into various surgeons' work over there already. I'll be contacting US doctors, too, to cross reference all my options.

Thank you for your feedback on doctor Fischer - I've heard very little negative things about her and seen few unsatisfactory results for her patients, so I'm very excited to be close enough to see her. I'll have to look into online therapy again, the last time I'd tried to make an online therapist work (almost two years ago, so there's been some time) my elder sister (a major contributor towards my transition+my caretaker) decided that wasn't "real" therapy and pushed me into finding one offline. I think she'd be more open to it now, so I'll look into that as well!

Again; thanks much for your time and information. I really appreciate it!
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