Susan's Place Transgender Resources

For those of you who have been researching the anatomical details of which tissue which SRS surgeon puts where and why, here is an interesting piece of information I have obtained from dr. Marci Bowers:

Q: Which tissue do you use as the inner side of labia minora? (mucosal inner side of penile foreskin / lining of penile urethra / skin?)
A: The inner labia are lined with urethral mucosa. Why this makes sense and is the most natal is to look at Hypospadias conditions which, when severe, look most like natal female vulva.

This is in contrast to dr. Suporn (taken from his website):
"Labia Minora (Inner Surface) - From prepuce of penile skin or penile skin with intact sensory nerves and vessels"
(To my knowledge it is the inner pink side of prepuce when not circumcised).
Dr. Suporn elsewhere also claims that this tissue choice is the most natal-like one (in contrast to dr. Bower's opinion).
Dr. Schaff in Munich, Germany also says the same thing.

So it is interesting to see top surgeons disagree on what is the penile homologue of the inner side of labia minora.

Perhaps the disagreement might stem from the fact that in natal females, there probably is not a clear boundary between the urethral and vestibular lining cell types. So then all of the mentioned surgeons have a part of the truth.

Well , in US and Canada almost nobody has any penile foreskin left (stupidest thing of all stupidest things), so they needed to develop a technique which will result in a decent inner labia, accordingly to that. While this is problem caused because of mutilation of the little innocent babies, it is not the same thing elsewhere. Elsewhere only muslims and jews do this kind of things to their children... If there is enough penile foreskin, it is only smart to use it for inner labia minora. Well, not everybody would agree, obviously... but I do think that Thailand approach like dr. Suporn's makes the most sense where to use it, IF it is available. I'm not shure what they use in case of circumcised foreskin though....

Suport practices scrotal resection. Bowers practices penile inversion. Two totally different techniques, so not surprising that they don't use the same tissues for the same construction. In fact would be surprising if they did.

It may also depend on whether a surgeon is concerned with form, appearance, or function... whether a given tissue is homologous to the location may matter more to one surgeon than another, versus whether the tissue will look or behave "homologously" there. (Or in other words, the inner side of the inner labia on a cis woman is both [often] pink and [always] mucosal tissue, so using urethral lining will give the closest look and function to a cis vulva but is not necessarily the best homologous tissue. Which matters more to a given *patient* differs, too, and probably could affect surgeon choice.)

I wasn't aware of this until my sister opted not to do this to her son, but there are medical benefits to having it done. For that reason alone, I'm glad I had it done.

Quote from: mmmmm on April 06, 2015, 07:50:16 AM
Well , in US and Canada almost nobody has any penile foreskin left (stupidest thing of all stupidest things), so they needed to develop a technique which will result in a decent inner labia, accordingly to that. While this is problem caused because of mutilation of the little innocent babies, it is not the same thing elsewhere. Elsewhere only muslims and jews do this kind of things to their children... If there is enough penile foreskin, it is only smart to use it for inner labia minora. Well, not everybody would agree, obviously... but I do think that Thailand approach like dr. Suporn's makes the most sense where to use it, IF it is available. I'm not shure what they use in case of circumcised foreskin though....

Quote from: awilliams1701 on April 06, 2015, 12:42:40 PM
.... but there are medical benefits to having it done. For that reason alone, I'm glad I had it done.

There are no medical benefits for this mutilation. You (citizens of USA) were brainwashed (and mutilated) for decades

There is much greater risk of infection. I had no idea and neither did my sister. Her husband was aware of it though. The doctor complimented on how well she had been taking care of that part of him at one point and she was like what the heck are you talking about? He explained this to her. I wasn't aware of it until this and I'm glad its something I don't have to worry about.

Quote from: mmmmm on April 06, 2015, 12:56:46 PM
There are no medical benefits for this mutilation. You (citizens of USA) were brainwashed (and mutilated) for decades

Well, yeah.. it's an area you need to keep clean, obviously. It's part of a thing called daily hygiene, right? Probably not for no reason...

Quote from: mmmmm on April 06, 2015, 12:56:46 PM
There are no medical benefits for this mutilation. You (citizens of USA) were brainwashed (and mutilated) for decades

I do not live in the USA. I was not circumcised when an infant, but at age 7 I got an infection and could no longer urinate. The only solution was circumcision as the infection was under foreskin and caused the glans to inflame horribly. Perhaps antibiotics would have worked but I do not recall being given any.

I believe that automatic circumcision is wrong, but it can clearly have benefits as I found out.

Your teeth can get infected, really really seriously infected... really bad stuff... Should we pull-out perfectly healthy teeth, just in case, because you are not likely to clean them very often, and it can get seriously infected ?

Wow, this took a left turn... I'm only going to say that I was circumcised and am nevertheless 100% satisfied with my GRS results (and good grief, I don't WANT my clit to be any more sensitive, it's already too sensitive to be touched directly!). So all is not lost for women who don't have a foreskin, particularly as US surgeons and Brassard seem experienced at dealing with people who don't.

Quote from: mmmmm on April 06, 2015, 02:59:50 PM
Your teeth can get infected, really really seriously infected... really bad stuff... Should we pull-out perfectly healthy teeth, just in case, because you are not likely to clean them very often, and it can get seriously infected ?

That is exactly what people used to do so "In areas with high poverty, many people used to have all their upper or lower teeth taken out in one go and replaced with dentures. The procedure was sometimes presented to a young man as a 21st birthday present or as a dowry for a young woman before her wedding – the idea being that it would save money on dentistry in the future. "  http://qi.com/infocloud/false-teeth

However, the point I was making, which you neatly ignored, was that you claimed there are "There are no medical benefits for this mutilation. You (citizens of USA) were brainwashed (and mutilated) for decades" yet I and others like me clearly had a benefit.

Quote from: mmmmm on April 06, 2015, 02:59:50 PMdo you know that circumcision results in much less sensitive neoclitoris, estimated around 75% less sensitive?

Maybe you are right, maybe you are not, but I am where I am. What am I supposed to do? Complain?

Quote from: Jenna Marie on April 06, 2015, 03:02:26 PM
Wow, this took a left turn... I'm only going to say that I was circumcised and am nevertheless 100% satisfied with my GRS results (and good grief, I don't WANT my clit to be any more sensitive, it's already too sensitive to be touched directly!). So all is not lost for women who don't have a foreskin, particularly as US surgeons and Brassard seem experienced at dealing with people who don't.

Yeah my gut keeps telling me to go to Brassard for that reason honestly. Unless I train to get my foreskin back, I don't see the point in going to Suporn. I'm still on the fence though. I know I'll feel a lot better once I have the consultation with Brassard. I keep looking for more info online but I've looked at every possible blog, forum and site so there's not much else to do other than meeting with the surgeons themselves at this point. 

Quote from: awilliams1701 on April 06, 2015, 01:05:48 PM
There is much greater risk of infection. I had no idea and neither did my sister. Her husband was aware of it though. The doctor complimented on how well she had been taking care of that part of him at one point and she was like what the heck are you talking about? He explained this to her. I wasn't aware of it until this and I'm glad its something I don't have to worry about.

Funny how none of the guys I know who possess their foreskin have ever had an infection or any other issue with it. And infection prevention is really simple, takes maybe 20 seconds to retract the foreskin and ensure it is clean. In New Zealand, it's illegal unless medically required.

The claimed medical benefits, which only seem to have any traction in the US, are actually minimal and can be easily dealt with by other means. Reduced UTI's? Simple hygiene.  Reduced incidence of STI's? Why aren't you wearing a condom?

And, frankly, if you'd ever seen one done, you'd probably have a slightly different take on it.

Quote from: cpvwye on April 06, 2015, 03:11:30 PM
What am I supposed to do?

Please go and compare the numbers of infections and other possible complications caused by not being circumcised in relation to being circumcised, and enlighten us with some real numbers to support the claims of medical benefits....


That being said... I sincerely apologize for the offtopic caused to the OP and moderators and others. Moderators, I think I should be watched, this is not the first time... I'm telling you...

Since we're on the topic, I'm uncircumcised and looking at various surgeons right now but am leaning towards Dr. Brassard.  I was curious, if I go to Dr. Brassard, what does he do with the foreskin?

I can't answer DrummerGirl's question, but I'd like to ask similar question... what does dr. Suporn do with the penile urethra, if he uses the foreskin for lining the labia minora? Does he throw it away?

You can work on getting the foreskin back

http://www.wikihow.com/Regrow-Foreskin

There are devices and techniques out there for this.


Just got me thinking, I wonder if this would help with transmen as well