GCS outcomes for trans girls who did not have dysphoria pre-puberty?

[Carrie Liz]

Basically, I'm still deciding on SRS, and I'm in the stage where I'm trying to glean absolutely every possible data point I can get.

There's lots of information out there about SRS, but most of it seems to be written by trans girls who follow the typical "knew since the age of 5, remember crossdressing as a kid" group of the trans community.

I didn't know as a kid. Although I was always effeminate, I identified as a boy when I was a kid, I had no idea I'd develop gender dysphoria, and I didn't even ever think about it. Then puberty hit me like a ton of bricks and I found myself every bit as dysphoric about my body as a pre-puberty-onset transsexual.

I guess mainly I'm just scared because really there's no way for me to know if the physical "phantom" sensation I've been feeling ever since puberty, and the umpteen amount of times that every single time something sexual happens to me I find myself mentally experiencing those things with an imaginary vulva that I don't have, are actually what it's like in real life. Basically, I'm scared that I'm wrong, and that because I didn't seem to have any problems with it as a kid that it's just some mental pathology that won't actually be cured with surgery, or it won't actually fix the body comfort problem that I'm expecting it to fix, or that somehow because I haven't even figured out what my sexual orientation is yet that I'm not qualified to make such a life-altering decision, and am more likely to be wrong about it.

Thoughts?

What I'm looking for is to see stories from people who are like me, who didn't start consciously desiring to be female until puberty or later, with either a lesbian, bisexual, or not-sure sexual orientation, who have had SRS... what was the experience like for you mentally? Was it the right decision? Did it really make your body and sexual experiences more congruent with the self-image in your fantasies?

No studies that really single out this group and compare its outcomes to those of the always-knew attracted-to-men group seem to exist. I'm just scared that I'm more likely to be wrong. I haven't come up with a single concrete reason why it would be wrong, but I'm just scared of being wrong because it's permanent and I'd be living with the consequences for 50+ years if for some reason I am.

[mfox]

I don't think genital dysphoria in childhood is a requirement or even as common as we tend to think.

As a heterosexual woman, I sometimes think I coped with genital dysphoria early on by being somewhat sexually attracted to what I had.  It didn't last forever, and it probably (sadly) prolonged my MtF diagnosis, but it meant I wasn't conscious of my dysphoria until later on.

[AnonyMs]

I've never heard of your history having any effect on SRS outcomes. If it made a difference I think we're all know by now.

But even so everyone's different, and from what I've followed of your journey I'd expect it would help you a lot. Speaking as a non-medical person of course.

[Jenna Marie]

This "knowing since you're a kid" narrative is toxic in a lot of ways for those of us who don't fit it...  this is a way I hadn't considered, but I guess I'm adding it to the list.

I believe that I genuinely was a cis man for years, and I didn't figure out that that had changed until I was 31. I'm not exactly sure *when* it changed, but it was definitely after 25, never mind right after puberty! I was bisexual before transition and am still bi after, though I like men a bit more than I used to. And I had GRS when I was 34, only three years after determining that I wanted to transition and a little over two years of living full-time. Yes, it made my body match my mental map and my fantasies, and yes, it made sex more satisfying - and possible, because after a while I could never bear to think of that thing while having sex. It was *different* than I'd imagined it would be, because having a vagina and vulva is going to come with surprises when you've never actually lived with it before (oh, God, the moment when I first stood up and felt lube sliding out of me...!) but not in a bad way and never in ways that made me wish I had the old equipment back.

I've never regretted it for an instant. I knew by about a year on HRT that I couldn't stand living with a body that was perfectly aligned with my mind/gender except in this ONE way, and although I was scared to death and had some doubts (because it was a huge scary surgery and a major change), I was convinced I'd be happier afterward, and I was. I think you know yourself well enough by now to be sure that this is what you need, and there's absolutely no reason to think you might be mistaken just because other people have a different and more dominant story.  You seem pretty convinced that this is what you need, and while a lot of the medical community (and sometimes the trans community) seems devoted to making us second-guess ourselves, those sorts of externally-provoked second thoughts are not a sign that you might regret this.

[kittenpower]

You should probably postpone SRS until all doubt is removed; there are stories of people who go through with the surgery even though they have some doubt, and are completely happy with their decision afterwards, however, there are also stories of people who go through with the surgery even though they have some doubt, and their lives become a living hell filled with misery and regret.

[Jenna Marie]

Kittenpower : That's better advice for people who are *capable* of achieving a state of no doubt, though. I doubt myself about what to have for breakfast, much less decisions like this; not everyone can ever be that certain about anything. So the trick is to know oneself well enough to know if this is the kind of doubt that's a red flag versus "typical worrying." That can be hard to do with the rest of the world weighing in to say that there's only one true way to feel, mind you...

Or put another way, if someone is already suffering, it's not useful advice to tell them that a decision might cause different suffering - the pain of living in limbo is also a variable to weigh when considering whether to make a change.

[Carrie Liz]

Kittenpower : That's better advice for people who are *capable* of achieving a state of no doubt, though. I doubt myself about what to have for breakfast, much less decisions like this; not everyone can ever be that certain about anything. So the trick is to know oneself well enough to know if this is the kind of doubt that's a red flag versus "typical worrying." That can be hard to do with the rest of the world weighing in to say that there's only one true way to feel, mind you...

Or put another way, if someone is already suffering, it's not useful advice to tell them that a decision might cause different suffering - the pain of living in limbo is also a variable to weigh when considering whether to make a change.

Yeah, that's the thing, is that I don't know that I am capable of no doubt. I have anxiety. Which means, well, I overthink everything and second-guess myself on everything. And, well, I had these same "OMG do I REALLY know what the hell I'm doing? ME? Really legally a girl? PERMANENTLY?" freakouts right before going full-time and legally changing my name too. (To a lesser extent, though, since unlike surgery a name-change is reversible.) That's why I'm being a complete and total maven about this, looking for as much reassurance as I can find.

Right now I'm at about 85% sure, but I'm not sure that my mind's even capable of moving that statistic any higher.

And that's the thing, is that it's not because of any concrete reason that I have... it's more a case of me constantly thinking "what if I'm wrong?" and being terrified of that possibility, or "what if somehow in some way, even if I have yet to think of a single reason that I'd ever want to be male again, I'm still wrong, and after surgery I look back and miss that part that I hate right now because somehow I was wrong about why I hate it and why I want surgery and somehow there's some mythical self-acceptance method that I just haven't thought of yet that would make me be comfortable with it even though I can't see any right now? Maybe I'm wrong, maybe my mind isn't programmed to have one, maybe once the surgery is over somehow I'll want straight sex even though I've never wanted it before and my only experiences of it are me wishing I had a vulva the whole time."

That's just kind of how my mind works.

So again, I don't know if I'm even capable of 100% certainty. Which is why I'm looking for the experiences of others in my same place in terms of trans* feelings and sexual orientation, but who didn't have anxiety getting in the way of their decision-making.

[Jenna Marie]

Carrie : Yeah, I thought I remembered that you were a lot like me that way. If it helps, I knew that about myself enough to be able to say "well, this is as certain as I get about anything." (My wife actually said she'd never seen me be MORE certain about anything before, and that's what convinced her that I did want to transition.) If 85% is as good as it ever gets for you about major life decisions, then congratulations, you *are* sure.

The other thing is that we all grow and change, all the time. If we made all of our decisions based on whether or not we might one day change our minds after more years of living and changing... we'd never do a single thing. We'd be paralyzed by indecision until we starved to death or something. I know I'm being a little silly, but that's how I really think about this stuff : that the best I can ever do, personally, is say "I'm sure this is what I want right now, with all the evidence I have now, and if it turns out my future self changes her mind, well, I'll deal with that then." Who knows, I really might say something different when I'm 25 years post-op instead of 3, but I can't live my life NOW based on how I might feel then.

I'm not sure how old you are, but how many years post-puberty have you wanted this so far? I think that's a good sign that this, of all things, is something you've been pretty firm on until the rest of the world tried to convince you to doubt yourself (and for those of us already prone to do so, it's an especially nasty catch-22 when people try to make us question ourselves and then use the fact that it *worked* to invalidate our choices).

[Dena]

Thought I was somewhat feminine in my younger years, puberty hit me like a ton of bricks. I was uncomfortable with life but not so much uncomfortable with my body other than I wanted a few changes. The important deciding factors for me was in my second year of RLE I had live the life of a women long enough that I knew I would never return to the male role. If surgery wasn't available to me, I would continue living as I was. As for out comes, I am 33 years post surgical and have never had a moment of regret in those 33 years. Did I have doubts before surgery? Right up to the moment the lights went out. My first thought after surgery was I made the right decision.

Like me, ask yourself one question, what would it take to make me return to the male role. If you can't find anything, the surgery may be your best answer.

[Carrie Liz]

I'm not sure how old you are, but how many years post-puberty have you wanted this so far? I think that's a good sign that this, of all things, is something you've been pretty firm on until the rest of the world tried to convince you to doubt yourself (and for those of us already prone to do so, it's an especially nasty catch-22 when people try to make us question ourselves and then use the fact that it *worked* to invalidate our choices).

I'm 29 years old. (30 next week.)

I started experiencing genital dysphoria pretty much as soon as puberty started, between ages 13-14, I had it SEVERELY bad for 5 years in a row, so badly that I tried to freeze it off in ice once. I became a Christian and started trying to pray away these desires when I was 20, and it did indeed lessen the amount of time that I dwelled on it, but I still kept experiencing genital dysphoria bad enough that I'd tuck myself with duct tape, and even tried to find a way that I could pee while tucked so that I could leave it on longer. And being with a girlfriend for the first time in my life at that age didn't calm these feelings, in fact they exacerbated them because being close to her body made me want it myself that much more. Once I started transition the desire got even stronger, and I had emotional breakdowns early in transition because the surgery was barred from me due to the full-time barrier. The thing is, though, even though I still badly wanted SRS, being on hormones has allowed me to actually enjoy my sexuality for the first time in my life. I used to hate every minute of it because I felt like a slave. Where now it's something I really enjoy, even if I do still wish the shape was different.

It's only very recently, after I'd been transitioning for 2 years or so, and was finally passable and full-time and past the phase where I was constantly on high alert constantly looking around to see whether people were staring at me or talking about me, that I started having any serious doubts. Mainly because it wasn't just a fantasy anymore, it was REAL. With REAL life-altering repercussions. Nonetheless, this has been a persistent desire for 16 years straight now, without a single gap where I would have said "no, I don't want it."

The only thing that makes me scared is that, well, testosterone did weird things to my mind sexually. There were a few other body-altering desires that I had for several years in a row which I'm REALLY glad I didn't follow through on, because they would have handicapped me for life. Those other obsessions went away once I started HRT, while the SRS desires didn't, but it still makes me scared that somehow I'm wrong, and that this is just an autoerotic fantasy that I shouldn't follow through on like all the anti-trans articles say, and that it's not really going to make me happier.

[Carrie Liz]

Like me, ask yourself one question, what would it take to make me return to the male role. If you can't find anything, the surgery may be your best answer.

NOTHING. I was just looking at old videos last night, seeing what I used to look and sound like for the first time in several months, and it was hard to watch because I just couldn't bear thinking that I used to not only look like that, but was trapped like that. I gave myself a big hug and was just overcome with joy that I get to be me, because I love my soft huggable feminine body so much.

I wouldn't de-transition even if I was paid a million dollars, let alone by my own free will.

So yeah, I already know for sure I'm going to be transitioned, and be on HRT, forever. It's basically just now down to a matter of which genitals I want in that female body. I'm afraid of risking my sexuality, something that does indeed give me pleasure even though I always spend the whole time wishing I had a vulva instead, on something that I have no idea what will feel like in real life, I only have my own fantasies to go off of, and how can I possibly know if they're right or not?

[Dena]

So yeah, I already know for sure I'm going to be transitioned, and be on HRT, forever. It's basically just now down to a matter of which genitals I want in that female body. I'm afraid of risking my sexuality, something that does indeed give me pleasure even though I always spend the whole time wishing I had a vulva instead, on something that I have no idea what will feel like in real life, I only have my own fantasies to go off of, and how can I possibly know if they're right or not?

Sorry I can't help you much on that one because mine remains untested in combat. I do know what you will feel will be different than what you feel now and the little bit I know, I think it will be better. It is also hard for me to judge because your surgery would be so much more advanced than mine. Exactly what it will feel like you will need to learn from some of the other girls with more current surgery.

[Carrie Liz]

Sorry I can't help you much on that one because mine remains untested in combat. I do know what you will feel will be different than what you feel now and the little bit I know, I think it will be better. It is also hard for me to judge because your surgery would be so much more advanced than mine. Exactly what it will feel like you will need to learn from some of the other girls with more current surgery.

Well, I'm not even talking about "combat," I'm just talking about my own personal alone time.

And I have talked to friends who have had it, but the problem is that almost every single post-op girl I know personally was an early-discoverer and is almost exclusively attracted to men, so in their own minds it was a lot less optional and they had a lot fewer self-doubts. They never enjoyed their sexuality at all because their dysphoria was so strong that they didn't even want to look at it. So not much help in really giving me a comparable experience.

I do have one friend who like me was a pubertal-discoverer, and isn't exclusively attracted to men, and she has a LOT of issues. She is sad a lot of the time, and she's always telling me "surgery doesn't fix your problems," and when I asked her about whether she regretted it or not, she wouldn't say no, rather she said "it's not even worth thinking about, because even if I did regret it, what good does saying that do for me? Either way, I can't change it." She makes me scared. To be fair, she has a LOT more issues than I do, she was a cutter, and has a history of depression and anger issues, so she's still struggling with those same depression and self-worth issues, but still, I worry.

[Dena]

Well, I'm not even talking about "combat," I'm just talking about my own personal alone time.

To me, that's the same thing

[Jenna Marie]

16 years of relentlessly wanting this, even when you tried desperately to find a way out of that. Close to two decades, and your entire adult life, of being dysphoric to a degree that never got better than "awful." I am not being flippant, but I think you have as strong a case as it's possible to have that you're likely to be happier without that thing down there. It's harder to see from inside it, but yeah, you've needed this for as long as you've known you're trans, and you've only started questioning once the rest of the chaos in your mind quieted enough for you to *have* the energy to second-guess yourself. I also think HRT tends to take the steam out of desires which were driven by libido, and as you've noted, those other desires went away but this one didn't (and is consistent with what many a trans woman does want),

I was 34 when I had GRS and had only wanted it for a year, year and a half. I hope that knowing that helps a little, and I'm happy to answer any questions you my have about functionality, as well. (I didn't want to get into TMI if you weren't asking for that, but I lost my virginity at 19 and had a happy and fulfilling sex life with a penis for ~12 years [I got married at 22, so it was a frequent occurrence, too]. I may be as good a comparison as you'll find of someone who was able to enjoy things that way for years and then got a chance to enjoy sex with a vulva and vagina - which is even about 1000x better. )

[stephaniec]

well, If you don't mind my 2.8 cents thrown in even though I'm still pre op. I'm at the point of being able to do it when I push the go button. I'm one of the ones that started at 4 , but was hit  by a train at puberty. Your imaginary vagina is exactly the same as me since puberty. I'm going through exactly what your going through right now. MY bigger problem is my age and whether it makes sense to do it. I constantly am thinking about this problem. I'm bisexual so that is another concern because that causes you to question the surgery. I find myself in a major mental war about this. In one sense it's easier for me because if I decide to not do it I have that much less time on earth to deal with this genetic mistake. I truly don't like what I have. My imaginary vagina has been part of me for so long I've gotten really good at imagining it. I've asked myself so many times now the past two and half years I've been in therapy for this on whether I would of actually have done the surgery when I was younger because of my interest in women and I honestly don't know. I know I be so much more proper with a vagina , but my sexual nature is causing a lot of conflict about it. I think were both in the same boat even though your stated at puberty and I started earlier.

[suzifrommd]

Carrie, I imagine you've heard my story, but in case not, I first thought I might be trans at age 50. I never crossdressed, never hated my body, never wanted girl's toys, felt like a cis guy pretty much all my life (though I wished I could have a woman's body).

Take a look at the poll in the thread I started last spring: https://www.susans.org/forums/index.php/topic,188956.0.html

There are all sorts of people who never wanted girl's toys, never hated their body, never thought they were anything other than cis. But the number one option that people checked was "I want/wanted surgery to bring my body in line with my identified gender". The need to restructure our bodies is much more widespread than all those other things.

FWIW, I'm glad I got the surgery. I'm p!$$ed that I can't seem to have O's any more and there's tenderness in a few places, but I get to be shaped the way I should, which makes it all (including $20+k out of pocket) worth it.

[JessieBirdie]

Responding to this not because I fit your profile (I knew since I was little, albeit I didn't cross dress often due engrained transphobia that somehow got pushed onto me at a very young age.  Also I'm really not sure of my sexuality, albeit pre-transition I was definitely aroused by women sometimes).  But because I literally had my vaginoplasty 5 DAYS AGO with McGinn and how I felt at the time right before I went under is still fresh in my mind.

First and foremost, let me make it clear that I tend to take a rational approach unless confronted with tremendous stress.  So with that in mind, I don't believe it's worth talking about imaginary vaginas...I knew before surgery that I could not rationally imagine having a vagina.  It's just impossible because you can't "shape your genitals into a vulva" without cutting away lots of tissue in a non-reversible fashion.  However, when I looked at my junk the last time before surgery when changing into my OR gown...it was clear to me I have always been quite uncomfortable with what I had.

The moments before the surgery, what I was really thinking was: will there be complications, as well as, how will the pain be, and finally...what the hell will it feel like?  I actually sat there for about two minutes in the prep room when Heather (Mcginn's PA) went over the complications list, the final form I had to sign, as that is quite frankly how I function in situations like that.  I also made it super clear they should NOT sedate or "relax" me until I was being wheeled into the OR.  I decided it was worth the risk, and to use the metaphor i specifically told my therapist, I jumped off the cliff, because staying on it didn't seem reasonable.

Afterwards, I felt relief for two reasons: Primarily A: I had the weight of the decision off my back.  and also B: I was pretty sure I made the right one.  I will note in pure honesty though, there was a single time in recovery I've had doubt about this, and that was when I was in enormous GI pain my third night in the hospital.  I seriously felt like I was on the verge of death from bloating gas I was told I could not relieve as I was on super strict bed rest due to a minor hiccup in surgery (see my recent forum topic here), plus with no morphine to make it go away that night, with all my familial support back at the hotel, and not knowing what time it was in the middle of the night (I totally panicked, could not find my cell phone and the tv was off and out of reach), I'm guessing my survival instinct must've kicked in.  The doubt went away completely though once I got even minor relief from the pain from a little extra Vicodin after the nurses finally came in.  I probably should've just called them earlier (DO NOT BE AFRAID TO HIT THAT NURSE BUTTON EVEN IF YOU HAD NO LUCK WITH PREVIOUS ORDEALS WITH THE NURSES, which I did like 3X before that)...sigh.

Now, one more thing I can leave you with...you brought up imaginary vaginas.  I'm not going to talk about those, but given I'm still quite newly pre-op, I still think I'm qualified to compare my new vagina to having a penis because I had one less than a week ago and those memories are fresh in my mind.  Note: I have yet to see my vulva yet as its still under packing, but based on what I can feel from it, and based on Mcginn's stated technique.

A: (What I'm most sure of).  The vaginal canal has minimal sensation, but I do feel a sensation on my prostate from the packing at the moment and it definitely feels like there is pressure with something occupying a new hole between my legs.  Earlier during the first two days of recovery it felt like a watermelon was stuck up there, but now it feels semi-pleasant...albeit the level of pressure is going in and out and it gets uncomfortable at times. Relevant FYI/food for thought: McGinn orders a prostate exam in the pre-op physical.  That was super uncomfortable, but I can assure you this feels absolutely nothing like that.

B: I think I can feel the penis skin around skin/mons curvature level, albeit split, right around where my vaginal opening should be.  This part currently stings a little.

C: I can feel perineal skin around the floor of the packing.

D: I'm not sure about my clitoris atm, albeit I'm definitely feeling an intermittent sting from something that feels like it was once my glans penis, like the penile skin as well.

E: I believe she left some erectile tissue on the sides inside the vulva, because the pressure seems to increase in there when I get aroused, it's pleasant...yep, really!

So there's my current anecdote: take it as you may...

[AnonyMs]

Hi Carrie, perhaps another way of looking at this might help. What if you don't do it? How are you going to feel every day over the next 5 years, or 10, or 50+?

I'd guess probably not too great.

That's what's been pushing me. Not so much hope at what's in front, but knowing I can't live like I am right now. Chances are its the right thing to do, and if not, well I'm stuck no matter what I do so there's no point in worrying about it.

[Serenation]

85% seems like a pretty low number to go into it with, Like JessieBird said right before the moment of truth fear of complications can make you waver a little, so can post op pain, heaven forbid having complications.

Though I'm one of those always knew, hated sex has a bf types and I know what I am having for breakfast tomorrow so take my opinion with a spoon of sugar.