Future advancements

[JumpingPancakeFrog]

What do you guys think will the future hold in terms of FtM buttom surgery? I'm currently procrastinating my transition, 'cause once I start, I would need buttom surgery sooner or later. And not offend anybody, this is just me, I respect anyone who's doing well without, I wish I could, but I just have a lot of buttom dysphoria and once I'm on T it would become unbearable at some point. I'm not pleased with the current options. Meta is too small for me. Phallo can look very good, but I'm in a transgender support group, and those guys have all sorts of health problems, even tho they had it done by well respected surgeons. So, I read a lot of stuff, from lab-grown penises to 3D printing. But what are realistic expectations for the next decade?

[SeptagonScars]

I can't make do without getting bottom surgery either, so I totally get where you're coming from, however I'm satisfied enough with what the meta procedure can offer. But, in terms of future improvements of bottom surgery options, from what I've heard around, there's quite some focus on improving meta so that it will give a bigger result. I heard about a new method that extends the cl*t by somehow "pulling forward" the internal parts of it, which can make it even a couple of inches longer in some cases (but largely depends on original size and other things too). One issue I've heard coming with it is risk of losing ability to get natural erections though. From what I've heard one or few surgeons have started using that technique in Iran (or another country in that area) and it looks to me like that, or something similar, could be more available on the market in a not too far distant future. The method is called "Extensive Metoidioplasty". I have a link to a study, but not sure if that's okay for me to post, cause it does contain nsfw pictures.

Other than that, I've also heard about lab-grown penises and 3D-printing, but that those are not as far developed yet. Oh, and I've heard of some having gotten a type of phalloplasty where the outer labia have been used for the phallus as/instead of a graft. I've only seen one result online and it looked really good, and seemingly that method has fewer complications that are associated with the graft cause of using tissue from the same area and not further away on the body/different type of skin tissue, but that method I know very little about. But that could quite likely become a more available option in a not too distant future as well.

So, I think realistic expectations are improvements on the already established surgery option of phallo and meta, and that 3D-printing and lab-grown penises will take much longer to become developed enough to be properly implemented into practice. But of course I'm no scientist and can only speculate.

[JumpingPancakeFrog]

Yeah, I already thought they should look for ways to make Meto better, since the clit basically is a penis, just underdeveloped. Something that could increase it's growth to a common penis size. I heard about the phallo made from existing tissue, it's Dr. Ting who does that. He is just holding back info on what he'd exactly doing, 'cause he wants to perfect the method first. Especially with those things I think it would suck to get phallo, and then a better method becomes available but you already have needed material removed. With all those more fancy kinda stuff, stem cells, 3D... well, the increased visibility could speed things a bit up. Most doctors and scientist don't care about us, we can at least count on that they care about our money, tho.

[Elis]

I have had heard of something recently called mini phalloplasty, which is available here in the UK; but not a well known procedure. They take I think only 2 inches of skin from your body to use as a skin graft; then somehow attach that to the dick you already have. It's still small enough that you don't need  a erectile device inserted. I imagine this procedure will have less complications from phalloplasty.

With metoidoiplasty you can opt for a mons reduction. So the surgeon uses liposuction to take out some of the fat from the the front pubic area; so the dick won't be buried and will appear bigger.

I think with any type of bottom surgery complications are just part of the package and something you have to expect. Most are easily fixable now with revisions anyhow.

And new techniques like growing your own skin in a lab or 3d printing are decades away. It'll take time for these methods to become cheap enough to be widely available and for surgeons/doctors to be trained how to use new methods. I'd rather not wait until I'm 50 or so to get these new type of bottom surgeries

[JumpingPancakeFrog]

Actually what I hear from some people really scares me. One guy had had his first phallo dying from necrosis and with the second ongoing infections for about 2 years. And he didn't go to some butcher surgeon, it was one of the big names. It's really like 50/50, one half is all fine and happier than ever, and the other half go through hell. Which make me thing it's a bit like playing the lottery.

[RedSoxMichael]

What do you guys think will the future hold in terms of FtM buttom surgery? I'm currently procrastinating my transition, 'cause once I start, I would need buttom surgery sooner or later. And not offend anybody, this is just me, I respect anyone who's doing well without, I wish I could, but I just have a lot of buttom dysphoria and once I'm on T it would become unbearable at some point. I'm not pleased with the current options. Meta is too small for me. Phallo can look very good, but I'm in a transgender support group, and those guys have all sorts of health problems, even tho they had it done by well respected surgeons. So, I read a lot of stuff, from lab-grown penises to 3D printing. But what are realistic expectations for the next decade?

My bottom dysphoria is terrible and in fact it was part of the reason that I put off transitioning for two decades. In retrospect, it was a really dumb reason. (I had some other, less dumb reasons as well.)

I've found that on T I feel less knee jerk bottom dysphoria. It's still there and it's still pretty crippling but I did get a smidgen more comfortable with my anatomy somehow? Dunno how to describe it. I sure as hell don't like to look at it, though.

My social dysphoria messed up my life SO MUCH that if I had to do it over, I would take the painful genital dysphoria being in my face over COMPLETELY MESSING* MY LIFE UP because I was on the wrong hormones and getting misgendered daily.

*original wording may have been stronger

I was abused as a child so my normal meter has never been "right". I convinced myself that being misgendered and suffering all day every day was just fine and I could take it. I was right, I could take it, but I never made anything of my life--I was just existing. I was just grinding through each day and constantly sabotaging myself and shying away from actually accomplishing anything. I also stayed in an abusive relationship for over a decade because I thought that's what I deserved.

Please. Transition. It takes enough time that there will be years to plan your bottom surgery anyway.

[RedSoxMichael]

Most doctors and scientist don't care about us, we can at least count on that they care about our money, tho.

The problem is that transgender surgeries are kind of a niche thing. If you have a disease like diabetes with millions of patients that's what gets Big Pharma/Big Medical Device's mouth watering.

[JumpingPancakeFrog]

Actually here in Germany, if you do it the right way, you get all your stuff done pretty quickly. Being diagnosed with no doubts left, full-aged, having a good talk to your insurance and the guts to give your body into the hands of the doctors can easily from you from HRT to buttom surgery within two years. Of course you are allowed to take as much time as needed, but that's not a good idea for me, 'cause I'm a procrastination master, if I don't do things as soon as I can, I delay it for ever.

[SeptagonScars]

I'm not German so I have limited knowledge about how it is there, but my ex who is also ftm and lives in Germany certainly didn't have an easy ride transitioning there. Constantly ran into therapists and doctors who didn't do a good job or drew out on time for no good reason. Also, the average time going from first contact with gender therapist to getting to bottom surgery where I live in Sweden is 2-3 years. (The system works differently here though). But here I am 8 years after my first appointment, still not having gotten my bottom surgery. So it is very individual regardless of country. But either way, I do wish for smooth transitions for anyone who want/need to pursue it.

I don't mean to be snarky, just saying you can't know before hand how short or long time your transition might take, and I think it's an important thing to be aware of. Cause I did get my hopes up when I just started out and got nearly devastated by how much longer it was taking, compared to every other trans person I knew at the time. They all started after me and had reached their points of being "done" while I was still waiting to start hrt. (Well, that's also a reason I'm not gonna sit around and wait a second longer than absolutely necessary to get SRS, but that's just me. I'm not saying it should be rushed at all though.)

[JumpingPancakeFrog]

Yeah of course! It also heavily depends on the individuals' history. I might be lucky in that case, since my children's doctor already vocalized concerns about my gender identity. My parents just didn't do anything about it as trans was hardly heard of back then. But I have been on and off therapy since a little kid, so my insurance already knows there must be something going wrong all my life. What could leave me waiting is my mental condition. I hardly even make it to the dentist. Maybe it's time to start with those small thing right now!

[SeptagonScars]

Having other mental issues is definitely one of the things that can slow down the transition process, especially when trying to get from first contact with gender therapist to starting anything medical like hrt. I have aspergers and did struggle with mood swings, anxiety and such too at that time. And experienced slight psychotic tendencies long before but the gender therapists kept bringing it up as a huge concern of theirs. Doctors want you to be mentally stable and have other issues under control before starting medical transition, which is good but sometimes they mess up on that point and do more harm than helping. I hope you won't end up with that kind of hassle like I did though. Yes, starting with small steps in the right direction is always a good idea!

[JumpingPancakeFrog]

Yeah, absolutely. Looking back I'm 100% sure that my gender dysphoria started all my mental issues, however it's not so easy that transitioning would suddenly make it go away, 'cause when these issues remain unresolved for too long, they kinda develop a life on their own. What's also a huge deal breaker is that I would have no family support, and not because my family are transphobic, but because everyone has mild to severe mental issues, and German doctors see that as a high-risk factor, and unfortunately I have to agree with that mindset. They are for sure individuals strong enough to go through this alone, but I really feel I have to think twice if I have the strength to do all that on my own. The first thing what I'm gonna do is talking about it to my GP, just because he knows me since almost two decades and has insight into all my therapy records. I guess just talking about it for now will be helpful.

[SeptagonScars]

That is not uncommon, definitely. For me, I've had to deal with my other mental issues also while transitioning and that was very helpful for me. Some of my issues were related to me being trans while others not (especially my asperger was not, it's a lifetime thing I needed to manage on its own either way), but transitioning at the same time as doing other kinds of therapy was good for me cause it was easier when I was on the right track with getting my body aligned with my mind. However of course it's different what works for everyone individually. But thinking that just transitioning will fix all problems is a dangerous thought, I think. Talking about it can definitely be very helpful, so I approve of that!

[randomdude5]

This is something that actually quite bugged me. I am finally getting my phallo surgeries done after pretty much 7 years of waiting, but I often though of what if's regarding future improvements and if I'd regret getting the phallo when something better comes along that I can no longer have because the necessary skin/ parts are no longer there.

I hear about the 3D printing and lab grown penises and such, but as was mentioned, that is probably quite a long ways away. For me anyways, bottom surgery was important, and I was somewhat putting my life on hold in terms of relationships and things until I had this done. Now that I'm almost done with all the bottom surgery stages, I am glad I did it and don't regret anything even though I had some minor complications. This is just me though, but I just want to get on with my life and live normally for as much of my life as I can without having to worry about some parts not matching up to my identity or having to work around university for surgeries like I am doing now. (It's a pain in the butt. )

[JumpingPancakeFrog]

I know what you mean. It's such a two-sided thing. On one hand we want 100% the body we're supposed to be in, yet on the other hand we're damn lucky that there are possibilities AT ALL.

However, what really scares me are dude that had it done, and say that while a dick is still what they desire, phallo wasn't worth it. Reasons for this statement are reuccuring urethal issues and while still able to orgasm it became more difficult to achieve it.

And I'm super honest, I actually do have guilt issues with this. I have a healthy, proper functioning and actually quite asthetic body  - but I don't want it. I know, one should look at it as a disability. The classic phrase; "born in the wrong body". And in my case it has been sooooo onvious from early childhood that I'm male. Really the classic trans* story. No doubts. But I still find myself looking in the mirror, thinking to myself; "Am I insane?". Sorry, I sound like an idiot, but this whole thing really screws with my mind.

[Lady Lisandra]

Appart from the lab grown and 3D printed genitals, I must add that there's a way to turn ovaries into testicles and viceversa. Scientists have successfully done it in rats, and theoretically it's possible to be done in humans also (still investigating side effects). The new gonads are not fertile, but they do produce hormones in acceptable levels, so it might replace HRT.

As for when this will be available, I can't tell. Just like custom made genitalia, it could be 40 years, 10, or less. There's really no way to tell.

[SeptagonScars]

I've also been conflicted between whether to wait for surgery techniques to improve or go with what's already available, especially while I was still busy with getting on T or getting top surgery. I'm actually glad that I waited those 3 years I did from after I got top surgery 2014 to last year when I decided to go with what's already available because my bottom dysphoria had become too crushing for me to deal with at that point. Cause during those 3 years I waited, mons resection had become an available option in my country which it wasn't really before, and also getting UL had become a far more common practice among the surgeons available here so they had gotten better at it. So 3 years ago those might not have been options for me, but pursuing bottom surgery now, they are. Now I'm on waiting list to get meta by the surgeon I chose, and unless more practical issues regarding the hospital or what not pop up, I'm finally gonna get it either this spring or summer, which I'm really excited about!

Living in a small (population-wise) country and not having the possibility to travel abroad for surgery, what's available in US or other bigger European countries usually takes a while to become equally available here. There are only a handful of SRS surgeons working here and they don't get nearly as much practice (not as many patients) due to the small population also means fewer trans people pursuing surgery. So they don't have the means to improve as quickly/effectively as surgeons in bigger countries. However I also couldn't wait even longer cause I realised that no matter when I'd go for having SRS there are always gonna come up new and better techniques in the future that would overshine the previous ones. So my own surgery results would be "overshined" at some point or another regardless. So I figured it would be better for me personally to not wait longer for that reason as it felt like chasing the unachievable. It's never gonna become "perfect" or "ideal" even if I could have waited until I'm 80 years old, but "decent" and "better than my current situation" can happen and is good enough for me. Meaning, I realised that it can always become even better no matter how good something already is.

I'm also actually more dysphoric about what I currently have rather than what I don't have but wish to have, which I think lowers my expectations somewhat. I too used to think that I should be grateful for having an attractive looking and well functioning, very healthy female body, but I realised that "it's a great looking body and I'd give it to someone else if I could but regardless of how good it looks the issue is its bio sex which I need to do something about either way, and also there's nothing that says I can't look great as a man after transitioning too, but then actually appreciate it" and eventually I stopped feeling guilty about making the changes I needed to. But I understand why you do.

I don't think you're insane, in fact I think it's a healthy thing to question one's own sanity every once in a while. It's people who never think they're insane that I'd worry about!

[JumpingPancakeFrog]

Thank you! Yeah, my doc also told me, as long as something is questioning his own sanity, it's a good sign that person is not insane. My doc was actually very encouraging. However, I have so much going on, I really doubt at this point, that will ever reach the required mental strength to transition. It might look completely diffrent in 1, 5 or even 10 years from now, but same as with science, no one can foretell. 

[Lady Lisandra]

And I'm super honest, I actually do have guilt issues with this. I have a healthy, proper functioning and actually quite asthetic body  - but I don't want it. I know, one should look at it as a disability. The classic phrase; "born in the wrong body". And in my case it has been sooooo onvious from early childhood that I'm male. Really the classic trans* story. No doubts. But I still find myself looking in the mirror, thinking to myself; "Am I insane?". Sorry, I sound like an idiot, but this whole thing really screws with my mind.

Who doesn't have guilt issues at some point? It's not only about surgeries and such. People tell you all the time that you have to be gratefull for what you have and use it... I've learned after some time that just because you can, doesn't mean you have to. Do you have a functional female body and are able to reproduce? Well, maybe you don't like that, and it's okay to give that up if you don't want it, that's a perfect reason. Do people find you attractive as a woman? well, maybe attracting others is not what matters most to you and you'll be happier as a man, regardless of how others find you.

[JumpingPancakeFrog]

Lady Lisandra: Oh yes, so you're so right. Even if I might not transition, I will NEVER get pregnant. If I would, my dysphoria would reach it's top and I would probably jump out of the window. And guess what one therapist once told me? She said to cure this "personality disorder" I should find a man, marry and get at least one child. How irresponsible.