So, today I had my consultation with Dr. McGinn, and I would like to relay some of what we talked about.
Unfortunately, I was not able to take notes as Dr. McGinn went through a torrent of information very quickly, but I can recount a few comments. Any anatomical errors are mine, not hers. I had to do this from memory after a 400-mile road trip.
First of all, let me say I did not find Dr. McGinn brusque or impersonal. If anything, she impressed me with how much she truly cares about her patients and the transgender community. She is direct, yes, and very busy, but she was focused on me and wanted me to be as informed and prepared as possible for what SRS entailed.
I am listing these comments in no particular order:
1. Dr. McGinn made a point that she has very definite surgical objectives for both form and function of the neovagina. It's hard to separate the two, but I will first mention that she spent a significant amount of time explaining that this is not just plastic surgery. You are not done once she has constructed your new vagina. You will be taught not only how to take care of your vagina, but how your vagina should function, and how you can become orgasmic. You should be able to function as a woman, and that includes sexual relations with your partner. The hormone regimen is big part of it. She does believe in prescribing testosterone, and managing your hormone levels.
2. More on form. The Thai technique involves folding in the base of the scrotum inward, like the tongue of a shoe, to form part of the fourchette. She does not like this approach. For one, the fourchette does not come out shaped like a V but more like a U. Secondly, the entrance to the vulva is not as pink as it is in cisgender women when using this technique.
3. She does not find the "meshing" technique some Thai surgeons use to be a good thing. Tougher recovery. Much greater chance for scar tissue to form. Vaginal depth is *not* necessarily related to penis length. It has more to do with available space between the rectum and peritoneum.
4. Every surgical outcome is individual. She really hates that many SRS surgeons only post the best post-surgical results and not the pre-surgical pictures. She says the photos on her site are typical, not necessarily "the best".
5. Labia minora. Labia minora are made from urethral tissue. The amount of urethral tissue does *not* correlate with penis size. She said you can't tell until you dissect the penis. Some have less, and some have more. There are three advantages to using urethral tissue in her opinion. For one, it is pink in color, so closely resembles what cisgender women look like. Secondly, she said the urethral tissue is also erectile in nature, and this is not a bad thing. During arousal, you will feel a kind of tightness, a kind of responsiveness in your vagina when sexually aroused. Thirdly, the urethral tissue is secretory and aids in lubrication during arousal. BTW, she has professional differences of opinions with Dr. Meltzer about this technique. They have had direct conversations and they agree to disagree.
6. Penile inversion technique vs. non-penile inversion. She said this was a misnomer. The penis is not actually "inverted". She discards almost all "penile skin" - not penile tissue, but penile dermis. The corpus cavernosa is not used, but the glans and urethral tissue are used. The only thing from your penis that goes inside the neovagina is the nerve. Again, she pays particular attention to aesthetics. The insides of pussies are pink. Your pussy will be pink inside, not brown.
7. General comments. She doesn't like what she sees as the medical profession exploiting the transgender population. She said there are dozens of new SRS surgeons that have sprung up over the last few years because they see the demand outstripping the supply and the potential for creating a lucrative money stream. She does not say this because they are taking away business. She has more requests for her services than she can handle. She does over 100 SRS procedures a year, and has been doing it for ten years. She will come right out and tell you that the best SRS surgeons in North America are Meltzer, Bowers, Brassard, and herself, with Meltzer having more experience than anybody. She feels the newer surgeons cannot give adequate medical support in the event of complications. When things go right, everything is fine, but they simply don't have the experience to fix things when they go wrong. She runs what she describes as a "boutique" medical practice that specializes in transgender health care, not just plastic surgery, although she is a board-certified plastic surgeon.
8. I went with McGinn. I really liked her. I really trust her. My SRS date is August 8th.
Hope that helps answer some questions. Again, this was from memory, so any errors in details are mine alone.
With kindness,
Terri
EDIT: fixed several errors, with thanks to KayXo
