MTF SRS, Devastated by results (No clitoral glans)

[winter_girl]

I don't honestly even know what to feel right now. 4 months post op, one-step penile inversion with Dr. Brassard. Surgery was funded by the canadian federal gov't (because I'm not a millionare), so there wasn't any other choice of surgeon, and I was not made aware of what the result would look like, because Brassard forces everyone who gets surgery with him to sign a gag-order, banning them (myself included) from ever sharing photos of the results online. Even the one single case that I saw online of Brassard's work, which was only 1 year before my surgery, looked absolutely nothing like my results. Other one-step penile inversion results also do not lack the clitoris glans. And on top of all this, photos of surgery results from any surgeon have recently become extremely scarce and difficult to find online.

BTW, when I say none, I mean absolutely no clitoral glans whatsoever. There's a hole where the clitoral glans should be, and a completely stationary, separate flat wall at the end where the nerve bundle resides. The hole can move around, while the wall/nerve bundle remains stationary behind the hole (imagine a flashlight moving across a tree trunk). The nerve bundle is sensate, though too sensitive to touch directly.

Today I went to the nurse for my last post-op exam and was told it was "normal" to have a "flat" "clitoris" after this type of surgery (it's funny because even the nurse usually calls it "the clitoral area" since it's not even recognizable as a clitoris). I don't know what she's talking about, I have never, ever, ever, ever seen a vaginoplasty that completely lacks a clitoris glans, but it seems like the message is I'm not going to get any help from Brassard. I mean it's one thing to try and accept aesthetic shortcomings, such as the virtually inexistant labia minora, but this is like the second most significant structural component in female genitals, after the hole!

I don't know what to do, I don't know where to go from here, I don't even know what to ask. I just don't know how I can handle this kind of freakish outcome for the rest of my life. Even intersex people have a clitoris.

[Jenna Marie]

(I didn't have to sign a gag order, so that's a new and worrisome development.)

At 4 months, there is still a chance that this is not the final outcome. From the description, it's at least possible that you are describing the clitoral hood (the skin forming "the hole"), and the clitoris is deeply recessed but does exist. It took more like six months before I could retract my clitoral hood enough to see what was under it, because of swelling; Brassard says four months is when the general outline of the final result should be visible, but it wasn't for me, and there's still time for fine details to emerge in any case.

If it is any consolation, the nerve bundle is the critically important part of the clitoris; if that is missing, there's no way to restore or replace it and no chance of sexual sensation from that area. So if it's a purely cosmetic issue where the nerves are intact but the visible portion of the clitoris is absent, that should be fixable in a fairly quick follow-up surgery to shape a glans.

[AnonyMs]

I've seen people mention the NDA for I guess the last 2 years. It could be longer, but I don't know.

I did manage to find a few photos of SRS results, but it took a lot of searching.

[TinaVane]

wtf at a gag order and if you speak bout it ? i am guessing one will be sued eh ?

[Jenna Marie]

Technically, it sounds like the NDA is a ban on photos, not discussion. Still sucks, but I can't imagine he could actually track down anyone who shared photos privately (and GRS pictures are banned on this site except possibly through DM, so it's moot here).

I have a friend who went to him at the end of August and I just asked her today and she says she didn't sign an NDA, though, so I'm still confused.

[winter_girl]

It was an NDA on photos only, yes. I didn't ask why I had to sign it, some others on ->-bleeped-<- have said they had to sign one.

@Jenna Marie: I guess it's more worrisome because I've been told by all the nurses and doctors that I healed incredibly fast, and the nurse doing my aftercare exams told me the external swelling is completely gone, i.e. what I have now is the final outcome, and also that having a "flat" clitoris is to be expected. It's literally flat, like the nurse said, and remains completely stationary, like an independent, disconnected structure inside, with absolutely no protruding member.

I'll wait and see how it is after the full year, but as long as it's possible to get it fixed, since the nerve bundle is intact and sensate, that's at least a massive relief.

[Jenna Marie]

I should have added that I don't doubt you at all that you *did* have to sign it; I'm more wondering why he picks on some people and not others.

Regardless of how fast you healed, it's possible to have some areas still lagging behind the others, and I'd be shocked if anyone could be fully healed in 4 months. Brassard's nurses stressed the need to wait a year over and over again when I was there, so maybe this one is also not explaining things well or something - some of them are clearer than others.

But yes, the "protruding member" part is basically just skin cloaking the nerve bundle. (Well, in some cases, there is preserved erectile tissue as well, but some cis women have a visible/palpable clitoral erection and some don't, so even if you lack that, it's not going to be outside of the cis norms. I do have some erectile tissue, mind you, so I can attest that Brassard does provide it in at least some surgeries... and that means you might as well.) I'm glad to offer at least some reassurance, because if it does turn out to be absent, I don't blame you at all for being upset. Hopefully it'd be a very minor revision, since there's already skin there and everything; shaping a very small clitoris (that is, typical cis size) shouldn't take much. He does offer free revisions for the first year, plus you have it covered by insurance, so maybe you can explain that you understand that they think this is normal (!), but you would like a more visible clitoris for your own personal preference, and see if he'll do it.

I should also add that I am completely baffled by what this nurse is telling you, and she's demonstrably wrong. I've spoken to dozens of Brassard patients by now - and seen the results in person in a handful of cases besides my own - and they ALL had a raised clitoris with a glans that could be seen and felt. Either she's confused (or you are, I guess, since, as I said, some of them can be a little shaky on communication) or she's insisting on something truly bizarre.

[Jacqueline]

Winter Girl,

I am sorry how disappointed you are by your results. It is good you are seeing an upside to it.

I also want to share some links with you. They are mostly welcome information and the rules that govern the site. If you have not had a chance to look through them, please take a moment to:

Things that you should read

• Site Terms of Service and rules to live by
  
• Standard Terms and Definitions
  
• Post Ranks (including when you can upload an avatar)
  
• Reputation rules
  
• News posting & quoting guidelines
  
• Photo, avatars, and signature images policy
  

Once again, welcome to Susan's. Look around, ask questions and join in.

With warmth,

Joanna

[winter_girl]

Just an update, it appears it was in fact just a failure of communication. I'm still not sure why that nurse chose to call it a "flat clitoris", but it was definitely not true. After some time to heal more and some time to be active, as well as some more digging online, it was actually not at all an issue with the shape of the clitoral tissue, but the clitoral hood. Some women have problems with a clitoral hood that doesn't retract, which is what was actually going on. After becoming active (and possibly due to healing) the clitoral hood has become more flexible, allowing full exposure of the clitoris which is definitely raised and has a perfectly normal shape. As for the colour, well that's another problem for another day

(I know it's an old topic but I thought it might be helpful for anyone who experiences the same issue)

[KayXo]

I also have an issue in this area with clitoris not protruding at all. It's there and working fine, just not looking the way it should. I will be meeting with my surgeon shortly to see what can be done.

[patrick1967]

The one thing to keep in mind is that many cis women (or trans men before hrt) have clits that are fully hooded and virtually impossible to see, even when fully aroused. The look can likely be revised if you do not like the result, but there is a wide variety in general, just as biological penis size can vary as can the growth when erect it is the same with the female anatomy

[KayXo]

The one thing to keep in mind is that many cis women (or trans men before hrt) have clits that are fully hooded and virtually impossible to see, even when fully aroused.

This is not my case. My clitoris just lays underneath the skin. I need to press hard on the skin around it to make it protrude and even then, it barely comes out.

[patrick1967]

As much as I am "removed" from my female genitals, even after 4 months on T mine does not extend at all from the hood, even when I try and pull the surrounding skin back, it is barely there, before hrt it was nonexistant other than nerve sensation. See your DR if you aren't satisfied with the result, but there is no real "norm" on the anatomy of that body part

[divineintervention]

Had my surgery in 2014 June and same issue - you need to go to another surgeon to get a revision.

Dr. Brassard did not want to assist even though I went all the way up to Montreal to see him (from Asia) again.

I would not recommend him. Please see my other posts. Also, there will always be other comments that soften the blow - but you need to realise everyone has their own prejudices.

[jujubes1986]

i didnt sign anything... in regards to posting my pics online...