Susan's Place Transgender Resources

So I've realized something: one of the biggest sources of dysphoria for me is the fact that I want female genitalia, but I'm terrified of surgery.

Part of it I guess is a fear of losing body integrity and having soft parts of my body cut open or away.  I can't say I fear genital surgery any more than any other type of surgery, but that fear is pretty intense in me (every time I thought I might need surgery I had panic attacks).  This could very likely be related to past trauma because I get squeamish seeing surgery being done on someone else, but I don't want to talk about the causes I suspect.

Another part is the fear that they'll mess something up.  I've met at least two girls who had their surgery botched; one had her vagina scar over and become useless, and another can barely be intimate with her husband and has trouble with her urethra.  I'm terrified that any doctor I can afford will be hit-or-miss like the doctors these girls saw (at least one of them went to Dr. Bowers who is in my insurance network), and I'm terrified that I'll need corrective surgery and I either won't be able to pay for it or I'll die or have a miserable life from complications. 

Another part of it is even though I feel awkward and wrong having male genitalia and I'm 100% bottom, I don't- I can't- know what it's like to have female genitalia.  I have no idea what to expect or if I'll actually enjoy having a vagina vs. a penis.  I've known at least one girl who had a psychotic break after surgery because it was too much for her, and her case isn't unique in the annals of medical history (https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0CCcQFjAB&url=http%3A%2F%2Flink.springer.com%2Fcontent%2Fpdf%2F10.1007%2FBF01579246.pdf&ei=4ibgU4SUNea_igKbxoCQBg&usg=AFQjCNG_-lDtwFvwyfd_fOUHlBzfzh0_LA&sig2=tFeUv9N6yvRHGoo2NPcGBg&bvm=bv.72389368,d.cGE), which doesn't help my confidence in post-op life.  I've also been reading that these studies that say that post-op regret is rare are deeply flawed (http://www.theguardian.com/society/2004/jul/30/health.mentalhealth) because they tend to omit the fact that they have an abysmally low rate of follow-ups over the course of 10 years and the fates of the majority of the patients (e.g. suicide) are unknown.

I don't know what to do.  I feel trapped and wrong in my body but I'm terrified of the solution.

Questions on if its right or wrong are what you need to work through with your therapist.

Regret after comes from going into surgery with a expectation that are not possible.

Yes a vagina is nothing the same as a penis.

Each holds the place but neither will bring piece if its not what is needed to remove the inner pain.

Also if you do not commit to the aftercare your results will be sub par no matter what surgeon you use.

GCS can be the cure for GD but not in every person. Should not be taken lightly or have unrealistic expectation.

Me it calmed my mind vs my body.

Walk softly on your path to where inside you know what is needed for your own happiness.

You can drive yourself insane with what if's. I mean, what if a truck hits you. What if your job goes bankrupt and you are out of work. Nothing is exempt from possibilities of failure. If you really feel like SRS will relieve your symptoms of Dysphoria you will just have to accept the risk. There is not one surgeon out there that will totally guarantee function, depth or aesthetics. The do have a tremendous amount of knowledge and skill compared to older days. Modern surgery is safer today than any other generation. That should give you some comfort and aid in your decision. You do have to accept however it turns out if you have SRS. It is a risk, but with your Therapist's help you should feel more comfortable about making the right decision for YOU. You MUST have a total dedication to aftercare. Do not get SRS if you cant follow the recovery instructions religiously.  🙂

I've been there, Rose. With fear, what you need to work through is whether it's "protective fear" that's keeping you from doing something that's wrong for you or "paralyzing fear" that's keeping you from doing something you need.

Only you will be able to answer that question, though I agree with Izzy that a therapist can be a great help.

Rose:

Mistakes happen in any kind of surgery. Even in life saving operations.
Things left in the body or wrong limbs are cut off.
I have had heart attack surgery and colon cancer surgery. Where do think I would be if I did not have those surgeries?

Where will you be if you need to have SRS to survive and be happy?

Eventually , you need to take the chance to make YOURSELF happy so you can be yourself.

Remember there is a saying which goes something like this . That we will regret not doing things when the opportunity presents itself to us. Something said connected to Mark Twain.

When you go thru the surgery, please do whatever the doctor tells you to do. A former friend who later moved to another state preferred to bowl instead of dilating herself ,as a result she developed urinary tract problems and I do not know if she is alive or not.

I completely understand. If I could go to sleep tonight and wake up with a vagina in the morning I'd be the happiest girl alive. However the thought of surgery terrifies me. Hell I'm afraid of getting a bad haircut and that will grow back. I'm not sure I can get into the correct mindset for surgery.

 I am not on hormones or anything yet. At this point I am more focusing on just trying to look how I feel. I am far more dysphoric about my body then I am my little boy part lol. I know it is really early for me since im not on hrt, but Im not even sure if I want srs to be honest. I don't know if it would be right for me. I will just see if I get more dysphoric about it when I start to get less dysphoric about my image as a whole. I have a lot of time to consider it though so I am in no hurry to make that decision.

But since you know you want srs you should definitely go for it. I mean, we all have anxiety about certain parts of the transition. we just have to overcome our anxiety if we really want to be our true self.

You should fear surgery. It's major invasive surgery that will takes months to fully heal and requires constant vigilance during recovery periods. It also costs thousands of dollars. I was like you once, I feared it too but my gender dysphoria was so severe it was either get it done or chop the tumor off myself.

Quote from: suzifrommd on August 04, 2014, 08:27:54 PM
I've been there, Rose. With fear, what you need to work through is whether it's "protective fear" that's keeping you from doing something that's wrong for you or "paralyzing fear" that's keeping you from doing something you need.

Only you will be able to answer that question, though I agree with Izzy that a therapist can be a great help.

Can you recommend any thought exercises that might help me work this out?  That seems to be the crux of it all.

For what it's worth, I did suffer paralyzing fear before I started just about every phase of this transition so I'm sure that's part of my problem, but maybe there's some protective aspect there too?  What I've found with emotions is they're seldom just "one or the other" but a mix of things when you get down to them.

Quote from: janetcgtv on August 05, 2014, 06:25:23 PM
Where will you be if you need to have SRS to survive and be happy?

From where I stand: I think I could live that way but I can't say it would be all that great.

Then again, this whole process has been a progressive thing for me.  I thought I could be fine with being a gay man but then I realized I wasn't.  I thought I could live with being kind of androgynous but then I realized I wanted more. 

I guess another worry I have is that I might get the surgery only to find out I'm just the kind of person who's never satisfied with anything.  I've been told that by people before and it worries me.

We can only reply from our own viewpoints and experience. I am extremely fortunate to have three therapists who look after me. Both my lead psyche and my second opinion psyche I know both professionally, therapeutically wise and as work colleagues. My surgeon is also a personal friend.

All of them have said the same thing. When you are ready, if you are ready, that is the time. If you have doubts don't have it. Yes they also emphasised that if my fear was normal fear of invasive surgery then that is perfectly normal and indeed if I wasn't fearful of having major surgery of any kind then I would be 'odd'.

They also all have said that I am no more or no less of a woman if I have surgery or not.

I got my surgeon to go through every major and minor risk, and asked him about corrections he has done on his own work and on the work of others. The frequency and the cause of all complications.

At the end of all of that I am ready. Yes I have normal human fears. But I am ready.

I feared not waking up. I feared pain of peeing again. I feared the dilation frequency. I feared lack of sensation. But as Cindy said when the time is right you will know. I booked my surgery in march. I had a good Easter coming to terms with it. I remember the cold in my arm as the anaesthic went in. And I remember waking up groggy with surgeon saying it was a success and holding my right hand. And I have no regrets. I'm lucky though and was able to approach things positively and only after all tubes were removed and I showered did I feel the emotion role me over... In relief.
If it helps the thread is here
https://www.susans.org/forums/index.php?topic=169918.0
If the thread scares you then it is time to work more with a therapist to overcome them. Or not.

Less than two weeks from my own surgery I am far more at peace with the idea than I imagined I would be at this point in time. I'm even sleeping better than I have in ages. (maybe a side effect of stopping HRT.. ? )

I made the booking end of April and since then have been through quite a lot of emotions, mostly fear as it it happens but only fear of the surgery itself ie. those horrible minutes before they put you to sleep when you have all sorts of crazy thoughts running through your mind, fear of the way I'll feel when I wake up (I've already been through two long FFS surgeries and do not like that feeling at all...), fear of some sort of complication that will have me going back for more surgeries afterwards.

Like others, to the extent that  they are not paralyzing, these fears are actually perfectly rational and "normal" as they correspond to genuine risks that have to be factored into your decision making. As Cindy pointed out, not having such fears should actually be a subject of concern.

However, if I can accept these risks it is because I am totally at peace with the purpose of the surgery, having my body "fully" aligned with my female identity. Once you have reached this point, afterwards it is just a question of finding a surgeon you have enough confidence in to let them do the job ie. enough confidence to get your fears below your paralysis threshold...   

To help you do that, Susan's is probably as good a place as you will find as there are tons of testimonials from people regarding their experience with different surgeons. However, no matter how much research you do, this surgery, like any other major surgery, comes with significant risks so you really do need to be sure you want/need it before taking the leap.

For most of us, and I personally believe this is hugely important, living full time as woman for a significant period of time beforehand (1 to 2 years) is by far the best way of gaining the required  level of certainty. In my own case, I am close to two years in my private life, more than six months at work and to be honest, before I had done that, GRS was not a priority. However, the more I espoused my female identity the more I came to understand that this final step was necessary for me, both from a  very personal psychological point of view  and from a practical point of view.

Hope that helps you with your own thinking. 
Hugs
Donna

All I can say is I'm very very scared too. I think it's a completely normal reaction to a surgical procedure that is very extensive.

Quote from: Rose City Rose on August 07, 2014, 01:51:55 AM
Can you recommend any thought exercises that might help me work this out?  That seems to be the crux of it all.

It helped me to write out the pros and cons. Something like this:

https://www.susans.org/forums/index.php/topic,144907.0.html (https://www.susans.org/forums/index.php/topic,144907.0.html)

Well, a lot of those cons don't really apply to me.  The necrosis, infections, pain, and possibility of losing the ability to orgasm are definitely big "what ifs" for me though.

As far as pain thresholds, I do OK; I know how to keep pain from disrupting my life too bad.  I was able to pass all my classes with "A's" while slowly flushing an 11 mm kidney stone over the course of several months, so I have some point of reference at least.  But I have no idea what to reasonably expect.

I've been told that losing the ability to orgasm is such an ever-present possibility that you need to be ready and willing to lose that ability before submitting to surgery; on the other hand, I have heard that patients who remain sexual on HRT tend to do well post-op and I'm definitely doing fine in that respect (in fact it's better since I have much more erogenous response overall).

My only concern with the "pro's" is that only one or two apply to me.  I can still have sex that isn't too bad with my current body configuration, but what gets me about it is a feeling that I'm missing out by not getting SRS done.  I'm profoundly curious about how it will feel, whether it will be at all like I imagined, and whether or not I'll be able to orgasm but as far as my genitals I'm kind of indifferent to them really and I can't say I intend to use my penis any time soon except as a massive clitoris.

If I could find a doctor who could give me a better than 90% chance of being orgasmic and sensate and who produced good results consistently with few complications, I think I'd feel much better about going ahead.  I just don't know yet if the rewards will be worth the risks and I've made no progress over the last several years in making a decision.  I just want to be able to make a decision I can live with but I don't know what that might be.

As said by many here it is a very serious surgery with serious outcomes.

Everything changes.

What you knew about orgasm and how to get there is out the window.

It is a whole new learning curve.

Today most well know surgeons do a great job and if you look at the WPATH SOC the goal is to do the best to give the ability to orgasm.

Risk are a every day part of life.

What ever you do make sure you are 100% confident in your decision, complications, infections and more can happen.

Quote from: Rose City Rose on August 08, 2014, 05:00:10 AM
If I could find a doctor who could give me a better than 90% chance of being orgasmic and sensate and who produced good results consistently with few complications, I think I'd feel much better about going ahead. 

FWIW, my surgeon claimed she never had a patient who could orgasm before SRS but not after. Most decent surgeons have a low rate of major complications and the minor ones seem to clear up.

Still, I didn't allow myself to go ahead with the surgery until I could tell myself honestly for each of the possible complications that I could live with it if it happened.

Quote from: suzifrommd on August 08, 2014, 07:41:03 AM
FWIW, my surgeon claimed she never had a patient who could orgasm before SRS but not after. Most decent surgeons have a low rate of major complications and the minor ones seem to clear up.

That's encouraging.  The figures I was hearing were anything from 50% to 70% orgasmic but that info might be out of date.

I guess i'm in the minority for not caring about orgasms. I've never had sex in the male role and mine were never worth having anyway, so I guess I don't feel like I have anything to lose.
All I use my stuff for right now is peeing, so as long as I can pee and wear tight pants post op, i'll be happy.

Quote from: Rose City Rose on August 08, 2014, 05:00:10 AM
Well, a lot of those cons don't really apply to me.  The necrosis, infections, pain, and possibility of losing the ability to orgasm are definitely big "what ifs" for me though.

As far as pain thresholds, I do OK; I know how to keep pain from disrupting my life too bad.  I was able to pass all my classes with "A's" while slowly flushing an 11 mm kidney stone over the course of several months, so I have some point of reference at least.  But I have no idea what to reasonably expect.

I've been told that losing the ability to orgasm is such an ever-present possibility that you need to be ready and willing to lose that ability before submitting to surgery; on the other hand, I have heard that patients who remain sexual on HRT tend to do well post-op and I'm definitely doing fine in that respect (in fact it's better since I have much more erogenous response overall).

My only concern with the "pro's" is that only one or two apply to me.  I can still have sex that isn't too bad with my current body configuration, but what gets me about it is a feeling that I'm missing out by not getting SRS done.  I'm profoundly curious about how it will feel, whether it will be at all like I imagined, and whether or not I'll be able to orgasm but as far as my genitals I'm kind of indifferent to them really and I can't say I intend to use my penis any time soon except as a massive clitoris.

If I could find a doctor who could give me a better than 90% chance of being orgasmic and sensate and who produced good results consistently with few complications, I think I'd feel much better about going ahead.  I just don't know yet if the rewards will be worth the risks and I've made no progress over the last several years in making a decision.  I just want to be able to make a decision I can live with but I don't know what that might be.

Hi again,
I can't help but react again to what to me looks like an over emphasis on the sexual motivation for doing GRS. No doubt for many people it is the first thing that comes to their mind when they think about GRS but I'm not at all sure that it's the principal motivation of the majority of those who do finally take the leap. As it happens, this is probably very well reflected in the way the terminology has evolved over the years: sex change surgery, then gender reassignment surgery and today gender confirmation surgery.

I'm not particularly hung-up on terminolgy but would have to say that in my own case, GCS best corresponds to what I'm doing as it is only since I have gained real certainty about my comfort living as a woman that I have decided to do this final surgery. Sex may come into the equation at some stage but it was definitely not the main motivator and I'd actually be a bit concerned for anyone whose main emphasis was on that part of the question. 

In your case, since you seem to only just starting out on your transition, I'd suggest you initially try to think through all the reasons you are considering such a move and also that you actually start living as a woman well before you give any serious thought to GRS.  Just remember it is far the most radical transformation you can make and only worth seriously considering when you are certain you want to live the rest of your life as woman,  a choice that has implications that go way beyond how your orgasms as a woman will compare with those you experienced as a guy. 
Bon courage!
Donna

Quote from: Donna E on August 11, 2014, 05:02:43 PM

Hi again,
I can't help but react again to what to me looks like an over emphasis on the sexual motivation for doing GRS. No doubt for many people it is the first thing that comes to their mind when they think about GRS but I'm not at all sure that it's the principal motivation of the majority of those who do finally take the leap. As it happens, this is probably very well reflected in the way the terminology has evolved over the years: sex change surgery, then gender reassignment surgery and today gender confirmation surgery.

I'm not particularly hung-up on terminolgy but would have to say that in my own case, GCS best corresponds to what I'm doing as it is only since I have gained real certainty about my comfort living as a woman that I have decided to do this final surgery. Sex may come into the equation at some stage but it was definitely not the main motivator and I'd actually be a bit concerned for anyone whose main emphasis was on that part of the question. 

In your case, since you seem to only just starting out on your transition, I'd suggest you initially try to think through all the reasons you are considering such a move and also that you actually start living as a woman well before you give any serious thought to GRS.  Just remember it is far the most radical transformation you can make and only worth seriously considering when you are certain you want to live the rest of your life as woman,  a choice that has implications that go way beyond how your orgasms as a woman will compare with those you experienced as a guy. 
Bon courage!
Donna

Uh... I'm not "just starting out."

I've been living full-time as a woman for 8 months and I've been on HRT for about a year and a half.  I'm almost completely unable to get an erection now thanks to the meds, and I don't really care because the last thing I want is an erection.  I am comfortable in a female role and just the thought of being anything other than female terrifies me.  I don't think, emotionally speaking, I could or would de-transition if given the choice because that decision would be paramount to suicide in my case.

Sex is of some importance to me because I enjoy intimacy with my partner and I don't want to lose that for the rest of my life.  And yes, I do feel that being fully physically female would actually enhance that enjoyment because my body would be more in line with the role I've already begun living in my public life.  But that's normal, and I reject the pathologizing of the female libido.

Also, sex is not my only reason.  I hate not being able to tuck because of my varicocele.  I hate having to wear loose clothes to hide the obvious bulge.  I hate the pain I get from wearing panties and I feel like an orchiectomy would just leave me feeling too uncomfortably null-gender for my liking.  I hate being reminded that I was born male. 

I'm trying my best not to be offended by your remarks.  You really did make some assumptions about me that were unfounded.

Quote from: Rose City Rose on August 11, 2014, 08:38:25 PM
Uh... I'm not "just starting out."


I'm trying my best not to be offended by your remarks.  You really did make some assumptions about me that were unfounded.

My apologies as no offense whatsoever was intended. My remarks were based on the following phrase from your introductory post from last December:

"I'm still pretty early on in my transition, on hormones for several months but just starting to dip my toe in the water when it comes to presenting in public."


I understand that all things are relative in this world but to me, that sounded rather like someone who was just starting out... That being said, my own transition was probably particularly slow so I can understand that our perceptions on such a subject might be rather different.

Anyway, the intent was simply to explain that based on what I have read here and on my own experience, the reasons for doing GRS/GCS can evolve a lot once you are really living as a woman in all aspects of your life. If, as seems to be the case, you are already fulltime, it is something you may have already noticed but it didn't appear very much in your posts.
Wishing you all the best!
Donna

Quote from: Donna E on August 12, 2014, 12:23:47 AM
My apologies as no offense whatsoever was intended. My remarks were based on the following phrase from your introductory post from last December:

"I'm still pretty early on in my transition, on hormones for several months but just starting to dip my toe in the water when it comes to presenting in public."


I understand that all things are relative in this world but to me, that sounded rather like someone who was just starting out... That being said, my own transition was probably particularly slow so I can understand that our perceptions on such a subject might be rather different.

Anyway, the intent was simply to explain that based on what I have read here and on my own experience, the reasons for doing GRS/GCS can evolve a lot once you are really living as a woman in all aspects of your life. If, as seems to be the case, you are already fulltime, it is something you may have already noticed but it didn't appear very much in your posts.
Wishing you all the best!
Donna

I have been moving rather quickly, but only because I had to wait so long to begin.  I basically had to dive in headfirst because I was going too slow.  Truth be told, I was seeking treatment as far back as 2010 and "ready" to start hormones as far back as 2011 but I got delayed because getting treatment presented a problem.

I've definitely noticed my attitude toward surgery evolving.  When I first began seeking therapy, surgery was the last thing on my mind.  It took another two years before I thought "well, maybe, but I'll cross that bridge when I come to it."  For a while I put off thinking about it because of the issues listed here; I was afraid.  But now I feel like I need to face my fears and start putting my mind toward making a decision.

I have no problem with living the rest of my life as a woman.  It's the side effects of the surgery that worry me the most.