Susan's Place Transgender Resources

Last night, I was reading a bunch of studies on outcomes of SRS, and the following quote from a study in particular REALLY intrigued me.

QuoteSampling and methods: We investigated 23 preoperative (16 male-to-female and 7 female-to-male transsexual patients) and 22 postoperative (14 male-to-female and 8 female-to-male) transsexual patients using a validated psychological measure for body image variables.

Results: We found that preoperative transsexual patients were insecure and felt unattractive because of concerns about their body image. However, postoperative transsexual patients scored high on attractiveness and self-confidence. Furthermore, postoperative transsexual patients showed low scores for insecurity and concerns about their body.

This kind of blew my mind. Is this really true? Can having SRS really have such a significant effect on someone feeling attractive and self-confident? I'd assumed that all it did was cure one's genital dysphoria.



I myself am currently having a LOT of issues with feeling unattractive, insecure about my gender, and especially a fear of somehow not being "female enough."

Basically, I'm still VERY insecure about my appearance. Despite 2.25 years on hormones, a year into being full-time, and having passed completely for 9+ months straight, I'm still constantly needing to look in the mirror to remind myself that I really do look enough like a girl to not worry about people not accepting me as one. I still hold myself off at a distance around other women, mainly because I'm afraid that somehow I don't deserve to be in their comfortable social space, I still have the internalized mindset that I'm a threat to them, not an equal, afraid that I still have the "male gaze" somehow. I'm constantly worried about certain body features invalidating my femininity, and constantly worried about being clocked, even though I'm stealth and completely accepted. I still constantly have these negative self-images going through my head where I'm afraid that my face is too mannish, or my body is too hunched-over and linebackery, or my shoulders are too wide, etc, etc, etc. Basically I don't feel like a woman yet. I still just feel like someone who needs to "pass" as a woman, or someone who wishes very deeply that I could be a woman but isn't actually one, I'm still an "other." I have a hard time accepting compliments, and a REALLY hard time feeling pretty, feeling attractive, or feeling like I actually deserve the acceptance I get.

I assumed that this all had nothing to do with my genital dysphoria, that SRS would solve that one thing and that one thing only. But after reading this article, now I'm wondering, might my insecurity with my other body features and passability partly be because I lack that feeling that I AM a woman due to my genitals? I do harbor VERY negative thoughts about my genital anatomy in the background, even though I'm usually not actively thinking about them while I'm having appearance-related dysphoric freakouts.

But after reading this study, maybe it is? I also read an article snippet from a trans guy who had top surgery, who said that pre-top-surgery he felt like his body was still fundamentally female, while post-surgery he said "once you have a flat chest, you're not just dressing as a guy anymore, you ARE a guy."



That's why I'm asking all of you, specifically girls, but guys too if they want to chime in, if gender-confirming surgery really did improve your self-esteem about other parts of your body as well? Does your experience confirm this study or not? Did you finally get a sense that you actually WERE the gender you identify as rather than just dressing as it and "passing" as it? Did you worry about your other facial and body features less? Were you more able to accept compliments, more able to feel attractive, and more able to feel accepted as an actual member of your identity gender?

I'm still planning on getting the surgery either way, it's just a matter of me having been stuck debating on whether I should get SRS/FFS first because of my issues with my appearance, and now I'm wondering if it's possible that my appearance-dysphoria might lessen after SRS and make FFS not as much of a need anymore.

I don't think so. But I'm not typical. I never hated my male parts, I just hated not having female parts, if that makes any sense. I wish I could have kept the male parts, but we all know it's an either or, and I'd much rather have what I have now.

All that being said, I really like my body (my face, not so much...) and that did seem to happen post-op, so maybe there's something to this. Never would have had the nerve to wear something like this swimsuit (https://www.susans.org/forums/index.php/topic,179354.msg1634945.html#msg1634945) a year ago.

Well its an interesting question... I didn't see where it mentioned whether or not the pre and post op women were at the same amount of time in transition.... In my mind it could just be because the post op women have more experience living as a woman, longer on HRT, just farther along in transition...

I can't say what SRS did for me yet but I can tell you that VFS and FFS have done a lot for my confidence and peace of mind.... Im not saying my way is the way for anyone else but I can describe my rational for taking the approach I have and what I feel its done for me....

First Im very grateful to have the money to do this in whatever order I want to.... I could see someone not so fortunate wanting SRS as soon as the $$$ was there and probably much farther into transition time wise than I am due to not having it... Anyway Id do it tomorrow if I could but I still have one more letter for Brassard to get before I can set my surgery date...

Im just doing things in my order of whats bothering me the most.... So I started laser/electrolysis before I even went on HRT... That was next, every permanent step has increased my confidence and well being and made me more sure of the next... Then it was my voice that was really giving me trouble so I had a similar procedure to the one Yeson in Korea does by a doc in NY... Well that really helped me when I stopped worrying so much about my voice, in person but especially on the phone... 

Next was FFS, 6 weeks post op from full FFS with Dr Speigel I can say this has been a huge help for me... Im finding I can go out more and more without make up if Im in a hurry to do something or just don't feel like it... Im not sure if its just my improved confidence and being more at ease or just the results of the surgery (which I do love) or likely both... But I notice even without make up at all I never seem to get read and when I do make the effort now people, men especially give me a lot more positive attention :D   Maybe I could have done that before but I was just too self conscious of being read....

Neither one has anything to do with downstairs but they have had a huge psychological impact and greatly improved my self image....

Im still not happy with my body at all after a year on HRT but I am slowly starting to see a woman in the mirror now... Im not sure I ever will be happy with it either but more and more the external world is giving me validation that Im at least seen as a woman (a pretty one too I guess ;D ) even though Im unfortunately not all the way there in my mind yet...

Im actually not in so much of a hurry as I was to get everything lined up and done, jump through all the hoops and have SRS even though the $$$ is there.... Im still seeing the wonderful feminizing effects from the HRT and just enjoying the ride and the results of my surgeries more and more...

In my mind though it wont be long before I confidently set up my date and hopefully have a good result... By then about a year or more from now and well into recovery I hope that I'll be able to say that yes SRS did improve my self image...  In the meantime I just try to overlook that junk and I know that its days are numbered ;)

I do feel like SRS wont change who I am inside but I can see how it could really improve my self image as woman with a good result ;) Im thinking that by the time summer is over and I have to try to hide that junk all through it I'll be more than ready to get on with it even though the surgery and recovery scare the hell out me....

Just my perspective...

 

Quote from: Carrie Liz on April 07, 2015, 11:57:52 AM
Last night, I was reading a bunch of studies on outcomes of SRS, and the following quote from a study in particular REALLY intrigued me.
................................

I'm still planning on getting the surgery either way, it's just a matter of me having been stuck debating on whether I should get SRS/FFS first because of my issues with my appearance, and now I'm wondering if it's possible that my appearance-dysphoria might lessen after SRS and make FFS not as much of a need anymore.

Carrie given your history you will continue to question your validity as a woman no matter how much feminizing surgery you get.  You must first find a way to unconditionally accept yourself as being female.

Probably there are far greater individual variations to draw any general conclusion.

barbie~~

Quote from: Eva on April 07, 2015, 03:45:05 PM
First Im very grateful to have the money to do this in whatever order I want to.... I could see someone not so fortunate wanting SRS as soon as the $$$ was there and probably much farther into transition time wise than I am due to not having it... Anyway Id do it tomorrow if I could but I still have one more letter for Brassard to get before I can set my surgery date...

Im just doing things in my order of whats bothering me the most....

That is EXACTLY my issue. I've been on HRT for 2.25 years now, full-time for a whole year, and even with saving money as fast as I can, I'm still 1.5 years or more away from being able to afford either SRS or FFS. And having one means that I can't have the other for probably another 3ish years after that because I'll be back to square one in terms of savings.

The FFS experience is definitely appreciated. Again, that's my issue, is trying to figure out which will have the greatest benefit to my overall well-being and my issues with self-confidence, worrying about passability, and feeling comfortable in my own body.

If I had the money, I'd do the whole trifecta in an instant. But I don't, so I need to figure this out.

You're now the 4th person who's told me that FFS mostly alleviated your passing concerns. I've heard from a few people here that SRS ended their dysphoria, but I'm just looking for more opinions on both, trying to figure out which I should seek out given my limited financial resources.

Quote from: Carrie Liz on April 07, 2015, 11:57:52 AMCan having SRS really have such a significant effect on someone feeling attractive and self-confident?

OMFG YES!!!

I had dysphoria from early childhood. By my teens, I couldn't pass as 'a straight male' and by 20 I couldn't pass for male at all.

I started HRT at age 17 and had SRS at 24. I never had any 'therapy' or any other surgeries.

After SRS I just fell straight into stealth and nobody ever suspected I had not been born 'normal female'. I was attractive and very outgoing, very much a flirt and a social butterfly - dramatic opposite to what I had been before. Self-confidence went from -10 to +10

Quote from: Northern Jane on April 07, 2015, 06:12:51 PM
OMFG YES!!!

I had dysphoria from early childhood. By my teens, I couldn't pass as 'a straight male' and by 20 I couldn't pass for male at all.

I started HRT at age 17 and had SRS at 24. I never had any 'therapy' or any other surgeries.

After SRS I just fell straight into stealth and nobody ever suspected I had not been born 'normal female'. I was attractive and very outgoing, very much a flirt and a social butterfly - dramatic opposite to what I had been before. Self-confidence went from -10 to +10

^^THIS - a million times. It actually strikes me as almost incredible that anyone would doubt this fact! :o

Similar story, similar result. As it happens I chose a non stealth path, but not by any means out of necessity, because I've proved on several occasions in the past that when I don't tell people they never guess. Therefore I choose to make the gift of being open because I feel that by so doing I'm helping to shift perceptions. (Plus its costs me nothing to do so.)

Oh and I would never have FFS because that would be cheating in my view. Personally I don't like that sort of "manufactured beauty" approach. My face is my face. It may not be perfect but then lots of women are plain Janes, so why should I be any different? So as long as I'm unequivocally read as female thats 100% good enough, but each to their own.

I wonder if they only included people who planned on having SRS in the 'pre-op' group. As a non-op person, I'm pretty content in my body and secure in my identity and I suspect that, for me, SRS would be a mistake. I have no plans for FFS either, but I admit there are 2 or 3 minor tweaks I'd like done - but these are fairly standard things that many cis women have.

Honestly, the sample size is way too small to draw any real conclusions. What were the participants ages, I wonder? The limited info leaves me with more questions than it answers.

Quote from: kelly_aus on April 07, 2015, 06:44:48 PM
I wonder if they only included people who planned on having SRS in the 'pre-op' group. As a non-op person, I'm pretty content in my body and secure in my identity and I suspect that, for me, SRS would be a mistake. I have no plans for FFS either, but I admit there are 2 or 3 minor tweaks I'd like done - but these are fairly standard things that many cis women have.

Honestly, the sample size is way too small to draw any real conclusions. What were the participants ages, I wonder? The limited info leaves me with more questions than it answers.

Now you mention it that is all very true... Clearly this isn't really a scientifically valid and well designed trial. In fact the words "confounding error" spring to mind, but I have to say my personal experience does still accord with the theory. The statistical power of such a small study, combined with the lack of a control group and no randomisation make it meaningless.

Interestingly back in the 1980's there was a group based at CXH in london under Dr Don Montgomery who were indeed trying to run an RCT on this very subject. Unfortunately they ran into practical difficulties because to run the trial they had to prevent a group from having surgery in order to gain comparitive data - and this proved somewhat impractical because most of their controls simply got fed up and went elsewhere to get their surgery. :P

Quote from: kelly_aus on April 07, 2015, 06:44:48 PM
I wonder if they only included people who planned on having SRS in the 'pre-op' group. As a non-op person, I'm pretty content in my body and secure in my identity and I suspect that, for me, SRS would be a mistake. I have no plans for FFS either, but I admit there are 2 or 3 minor tweaks I'd like done - but these are fairly standard things that many cis women have.

Honestly, the sample size is way too small to draw any real conclusions. What were the participants ages, I wonder? The limited info leaves me with more questions than it answers.

Since they said "preoperative," that to me seems to say "people who plan to have it but haven't yet."

I expect that if they did include non-operative trans people in that group, the self-esteem scores would be much higher.

But then again, I'm pre-operative myself, not non-op, and I'm dealing with the exact distress that they seemed to find, so it resonated with me.

I wasn't trying to say "this is some definitive scientific double-blind study that proves that SRS is effective," I just saw it as "a group of people in a similar situation to me were also under significant amounts of distress related to self-esteem and body image, while a group of people who've been through this procedure that I'm hoping to go through saw those problems significantly reduced. This is an interesting suggestive survey. I should ask some people who've actually been through it if they likewise experienced the same thing or not, to see if this possible conclusion is valid."

Quote from: Northern Jane on April 07, 2015, 06:12:51 PM
OMFG YES!!!

I had dysphoria from early childhood. By my teens, I couldn't pass as 'a straight male' and by 20 I couldn't pass for male at all.

I started HRT at age 17 and had SRS at 24. I never had any 'therapy' or any other surgeries.

After SRS I just fell straight into stealth and nobody ever suspected I had not been born 'normal female'. I was attractive and very outgoing, very much a flirt and a social butterfly - dramatic opposite to what I had been before. Self-confidence went from -10 to +10

So, presumably you had a period between HRT and SRS when you were living full-time but had not had the surgery yet... was there a significant difference in body image and self-esteem between that post-transition-but-pre-operative state, which is where I'm at right now, or are you just talking about a complete pre-everything vs. post-everything?

I once said that SRS was everything I ever wanted, yet its the most over rated thing I've ever done.
For me, it meant I was able to wear what I wanted and not worry, I could sleep with someone without disclosing my past, I could go to the beach and not worry about something showing, I could look in the mirror and feel right.
These days, all these years on I don't think of it at all, I'm happy, I don't worry about it.
However, my body image is up & down, I hate photos of myself, I remember at uni I had to take a self portrait, I tried about 30 times before taking one I liked, my cousin saw the other 29 and said that I had nothing to worry about, but I could see male in all of them.
To this day, and I wrote about this on Tumblr that I hate photos of myself because I can see male features in my face.
SRS could never change that

I'd say that for the most part it only corrected my genital dysphoria, though it did also remove a whole set of low-level stresses that I'd mostly stopped noticing - fear in the bathroom, unwillingness to go swimming, etc.

I was comfortably finished with transition for at least two years before GRS, so I had largely resolved the "not feeling like a woman" aspect - um, not by any hard work or clever solution on my part, just by living as a woman long enough that I settled into the role and started to believe in myself - and at that point the only thing still glaringly wrong with my body *was* my genitals. I suspect that had I been able to afford GRS earlier, it actually would have come as a self-confidence booster in terms of knowing I could shut bigots up by dropping my pants (metaphorically more often than literally, I hope!), but I wasn't that lucky so I don't know for sure how it would have played out.

I will say, however, that my genitalia was a constant, ongoing reminder that I wasn't a "typical" woman, to put it politely. It was impossible for me to ever completely forget my situation as long as I had that reminder/dysphoria there muttering constantly in the back of my mind. It sounds as if the same may be true for you but it's causing you a lot more distress to keep thinking of yourself as having this major caveat to any attempt at womanhood... in which case, GRS might help a great deal. Or, to put it more concisely, don't underestimate the degree to which genital dysphoria can poison your peace of mind even when you don't notice/realize it's happening. I had no idea how much mental static that was causing me until it was gone, and I'd've sworn I was largely dysphoria-free for a year or so before GRS.

Quote from: Carrie Liz on April 07, 2015, 11:57:52 AM

This kind of blew my mind. Is this really true? Can having SRS really have such a significant effect on someone feeling attractive and self-confident? I'd assumed that all it did was cure one's genital dysphoria.

Hell yeah! It made a huge difference in my life. It wasn't just the having lady bits either. Being 100% girl really and truly solved my gender problem. Instead of wasting brain cells worrying about it, I just went about living a life. I had focus and purpose and just enjoyed my life for what it was. As I have said on here many many times I knew I should have been born a girl and my gender transition proved it to me. I love being a woman, it's totally me. Hope that helps!

I'm wondering if post-op can include FFS. For me I care more about GRS/SRS than anything else including passing. I HATE what I have. Fortunately HRT has silenced him 95% of the time. He might still be there, but I don't have to deal with him most of the time. So for me SRS would be huge as instead of rarely dealing with him, I would never have to deal with him.

On the other hand if you don't have disphoria about that part of your body or your disphoria about looking male is worse than obviously FFS is going to help with that a lot more than SRS would. So as I said I have to wonder if it included both.

Quote from: awilliams1701 on April 08, 2015, 03:17:46 PM
On the other hand if you don't have disphoria about that part of your body or your disphoria about looking male is worse than obviously FFS is going to help with that a lot more than SRS would. So as I said I have to wonder if it included both.

In this particular study, it included only SRS. There was another study done on people who'd had either FFS, SRS, or neither, and in the "neither" group, positive self-esteem was somewhere in the 35% range, in the post-operative group of people who'd had either FFS, SRS, or both, that number increased to somewhere around 55%.

To be fair, the average person in the "pre" group had only been on HRT for 1.5 years, while the average person in the "post" group had been on it for 3, so there's probably a later-in-transition bias that had nothing to do with surgery, as was mentioned as a possibility by Kelly, but it seems that both surgeries have about the same effect on self-esteem.

Quote from: Carrie Liz on April 08, 2015, 03:16:29 AM
So, presumably you had a period between HRT and SRS when you were living full-time but had not had the surgery yet... was there a significant difference in body image and self-esteem between that post-transition-but-pre-operative state, which is where I'm at right now, or are you just talking about a complete pre-everything vs. post-everything?

Actually I never did "full time". There was no legal basis (or protection) in those days (1960s and early 70s) - you WERE whatever your genitals and birth certificate said you were and I was just a kid living at home with un-supportive parents so my "full time" was just weekends when I could get away from home. When I went away to college (1969) I went "gender-less", even having all reference to gender withheld from my college records, and just letting people assume whatever they wanted. (Most assumed I was a girl.)

I quit my 'full-time weekends' after college because it was just too painful having to go back to my former life after the weekend. I checked into hospital as a (presumed) male and left as a female and never looked back.

Times have changed LOL!

Quote from: Northern Jane on April 08, 2015, 08:22:24 PM
Actually I never did "full time". There was no legal basis (or protection) in those days (1960s and early 70s) - you WERE whatever your genitals and birth certificate said you were and I was just a kid living at home with un-supportive parents so my "full time" was just weekends when I could get away from home. When I went away to college (1969) I went "gender-less", even having all reference to gender withheld from my college records, and just letting people assume whatever they wanted. (Most assumed I was a girl.)

I quit my 'full-time weekends' after college because it was just too painful having to go back to my former life after the weekend. I checked into hospital as a (presumed) male and left as a female and never looked back.

Times have changed LOL!

Bother... well, times have changed indeed.

Although, frankly, I almost wish I could have had SRS right as I was entering RLE... it would have made things a lot less complicated.

Being stuck halfway is really not fun.

Quote from: Carrie Liz on April 08, 2015, 10:18:58 PM
Bother... well, times have changed indeed.

Although, frankly, I almost wish I could have had SRS right as I was entering RLE... it would have made things a lot less complicated.

Well, for me, as sure as I was (and I was awfully sure!) those years of living en femme, at least part time, were very important. It was the first time I began to see who "the other me" could be, the first glimpse of who I might be unbounded. It turned out to be a pale shadow of who I eventually became but at least I knew there was something there.

Quote from: Northern Jane on April 09, 2015, 11:46:31 AM
Well, for me, as sure as I was (and I was awfully sure!) those years of living en femme, at least part time, were very important. It was the first time I began to see who "the other me" could be, the first glimpse of who I might be unbounded. It turned out to be a pale shadow of who I eventually became but at least I knew there was something there.

Same experience... the times where I was on HRT and yet not full-time, just going out and being myself, gave me a bunch of perfect little glimpses into how great life could be when I was finally free to be myself. Those feelings were confirmed now that I've gone full-time and I'm accepted as my true self by everyone. I wouldn't trade my current social life for the world, and I love every moment that I'm out and accepted and just living my everyday life without having to think about my body.

Problem is, once I get home again and I'm just alone with myself, I'm still dealing with a crapton of body dysphoria. And frankly, it's not much better than it was pre-transition. And this body dysphoria occasionally still intrudes into my social life, where it makes me feel so depressed and so un-confident about my appearance that I have breakdowns where I start questioning myself because I can't believe that people accept me as the person they accept me as because I get so hung up on how not female my body seems to me.

Quote from: Carrie Liz on April 09, 2015, 01:19:26 PM
Same experience... the times where I was on HRT and yet not full-time, just going out and being myself, gave me a bunch of perfect little glimpses into how great life could be when I was finally free to be myself. Those feelings were confirmed now that I've gone full-time and I'm accepted as my true self by everyone. I wouldn't trade my current social life for the world, and I love every moment that I'm out and accepted and just living my everyday life without having to think about my body.

This is something I totally identify with!  The number of times I have come home from a social engagement and said to myself "Finally - and it feels so right!".  For the first time in my life I enjoy flirting with guys and receiving the attention, but that's when the discomfort kicks in:  while I'm not quite that spontaneous, right now, pre SRS I am careful not to flirt to the point where something might go further.  It's weird, because I didn't have much genital dysphoria before, but right now, both due to my upcoming SRS and my comparative success in flirting with guys, the dysphoria is much more noticeable.  It's a strong brake.

Julia

Quote from: Julia-Madrid on April 09, 2015, 02:21:41 PM
This is something I totally identify with!  The number of times I have come home from a social engagement and said to myself "Finally - and it feels so right!".  For the first time in my life I enjoy flirting with guys and receiving the attention, but that's when the discomfort kicks in:  while I'm not quite that spontaneous, right now, pre SRS I am careful not to flirt to the point where something might go further.  It's weird, because I didn't have much genital dysphoria before, but right now, both due to my upcoming SRS and my comparative success in flirting with guys, the dysphoria is much more noticeable.  It's a strong brake.

Julia

Julia,

Interesting.
Contrary to you, my dysphoria has been mild and very sporadic as I have never been on HRT.
Generally women tend to flirt with me rather than men, although I usually drink with men.

barbie~~

I can state that for me (who has had brushes with self-mutilation in the past) that SRS will be an immense relief and let me feel "whole" about myself, and therefore more confident about myself. So the results do not surprise me at all, at least from my perspective.