Susan's Place Transgender Resources

i am preparing for my gender reassignment surgery, however im completly unsure of where to start, who to contact and how much i will need to save. I will be in contact with my insurance company today to find out information about that. But after ensuring i can afford it. I have a decent job as well. Where do i go, and what do i do?

It depends on your insurance and what they do and don't cover. Then depending on the surgeon that your going to use and if they accept that insurance or not. So the cost could go from hundreds of dollars to thousands of dollars. On top of that, you have the cost of traveling and the hotel, and food in the city your going to be having surgery in. Sorry that I couldn't give you a more exact response. Hugs
Mariah

I recenly read the insurance company coverage that my company uses which would include grs, breast augmentation, even some of facial hair removal can be claimed as medically necessary, just need to find out if my company has chosen those as a part of their ppo network.. This is my first time getting health insurance so i am very confused about a lot of it.. As i read my plan dictates that my maximum deductible is $700 and my maximum outta pocket is 6k in network and 12k out of network. I will have 15-20 grand for my portion by the time i figure out who what where and when, i just dont know how to start

There's quite a few different surgeons, but a few big names. Personally I think its important to look at the quality of their work. You can find a fair number of photo's online, just not as many as you'd like. You might also like to consider how often problems occur, how serious they are, and how responsive the surgeons is to looking after you post-op.

There's a fair bit of variation in price and in wait list time. Some surgeons have a wait list of a few months, others 2+ years.

You could spend a lot of time reading this site, and searching with generally google. There's a huge amount of information out there.

Work out what is important to you. Perhaps you don't want to travel, have a financial limitation, health issues, want it done now, etc.

Someone wrote up their experience going to one of the Thai surgeons, and it might give you some idea of what to consider.

https://www.the-ress.net/files/SRS-With-Dr-Suporn-2015.pdf

Where are you? There are some insurance improvements in usa from aca obamacare - most cities have lgbt support meetings to direct you to endo, electrolysis, surgeons - thailand has 'big 3' surgeon clinics (chettawut, pai, suporn) - find what is yours.

Hiya
My 2 pence.
I live in UK & am recently postop.
I could have had surgery free on the NHS but went private because most surgeons use non genital skin grafts to add depth to the vagina & this is where issues with necrosis &, shrinkage begins.

Start with the outcome you want.
Then look into the 2 types if GRS: penile inversion or sigmoid colon Vaginoplasty.
Decide which one suits you best.

My recovery time was 1 week. I had a penile inversion with NO skin grafts. Later I plan on getting the colon Vaginoplasty & this way recovery should be 10 days appx.

I travelled to Dr Narendra Kaushik in Delhi who innovated a 2 stage GRS. He's the premier surgeon to all Hijras in India for a reason: he's a genius.

Anyway my depth with dilation is average so I could stick with what I have. But I still want long term functionality so will return in about 6 months.

Just a few thoughts.

Oh yes there's an academic review online comparing health outcomes between the 2 types of SRS. Well worth a read.

Kindness to all
Victoria xx

Re: Prices

Yes sorry forgot to mention.

In India you could do the whole procedure in a single visit. I simply preferred to divide the work. This way allows for revisions too.

In USD Dr Kaushik's fees are roughly $6000 including 10 days in a private room. Medicines/DiagnosticTests & food on top. Expect another 1 - 2k USD.

PS
The biggest cause of complications is smoking. It affects blood supply. So if you smoke beg borrow steal but figure out how to quit!!

Victoria x

Quote from: MasterSifuVictoria on June 05, 2016, 02:07:28 AM
Oh yes there's an academic review online comparing health outcomes between the 2 types of SRS. Well worth a read.

Do you have a link?

Hiya. The link is here

http://www.ncbi.nlm.nih.gov/pubmed/25817066

The review will surprise many. Given how fast I recovered & I'm no Marvel comics super hero, I was up & fine in 1 week not bedridden for 4 - 12 weeks, I can only add my experience to say the skin graft addition is done as a matter of routine but borders on malpractice due to the pain levels, skin failure, utility & long term dilation needs.

For the kind of money involved, we deserve better than lazy GRS surgery IMHO.

Yours kindly

Victoria x

Re: Independent Research Sources

Hi Everyone

Also for those unfamiliar with a wonderful scholarship tool I highly commend Google Scholar be added to your arsenal.

There's a lot of misinformation out there & to help cut through the chatter to get to the hard peer-reviewed science one can start here.

You can check out all the university level research for SRS/GRS options and make an informed decision based on your health & personal goals.


https://scholar.google.lu/scholar?q=penile+inversion+colon+Vaginoplasty&hl=en&as_sdt=0,5

With all kindnesses
Victoria x

Quote from: MasterSifuVictoria on June 05, 2016, 03:38:12 AM
Hiya. The link is here

http://www.ncbi.nlm.nih.gov/pubmed/25817066

The review will surprise many. Given how fast I recovered & I'm no Marvel comics super hero, I was up & fine in 1 week not bedridden for 4 - 12 weeks, I can only add my experience to say the skin graft addition is done as a matter of routine but borders on malpractice due to the pain levels, skin failure, utility & long term dilation needs.

For the kind of money involved, we deserve better than lazy GRS surgery IMHO.

I found the PDF here

https://www.researchgate.net/profile/Sophie_Horbach/publication/274140536_Outcome_of_Vaginoplasty_in_Male-to-Female_Transgenders_A_Systematic_Review_of_Surgical_Techniques_Systematic_Review_Vaginoplasty_in_MtF_Transgenders/links/55f563db08ae6a34f6613fd6.pdf

Its from VU University Medical Center in The Netherlands, a place that as far as I know is not any kind of leader in trans medicine. I've seen papers from them before, and not been very impressed. I guess they get some kind of academic credit for publishing. Regarding this one, I've only skimmed it, but it doesn't seem to have anything interesting to say. As far as I can tell these results are all from surgeons none of us would have ever heard of.

Quote from: AnonyMs on June 05, 2016, 04:31:09 AM
I found the PDF here

https://www.researchgate.net/profile/Sophie_Horbach/publication/274140536_Outcome_of_Vaginoplasty_in_Male-to-Female_Transgenders_A_Systematic_Review_of_Surgical_Techniques_Systematic_Review_Vaginoplasty_in_MtF_Transgenders/links/55f563db08ae6a34f6613fd6.pdf

Its from VU University Medical Center in The Netherlands, a place that as far as I know is not any kind of leader in trans medicine. I've seen papers from them before, and not been very impressed. I guess they get some kind of academic credit for publishing. Regarding this one, I've only skimmed it, but it doesn't seem to have anything interesting to say. As far as I can tell these results are all from surgeons none of us would have ever heard of.

;D Seriously?

Big LOL

This is a standard meta review from "The International Society for Sexual Medicine"

And just because the names of surgeons are new to you in no way negates the quality of work.

This is the entire reason why there's the "Peer Review" system in science!! To avoid the fallacy of popularity.

Just because some surgeons are well-known to our community does not - from a scientific point of view - mean these celebrities are actually superior. Not by a long margin!

Too funny :)

Kindly
Victoria x

Quote from: MasterSifuVictoria on June 05, 2016, 04:48:10 AM
Just because some surgeons are well-known to our community does not - from a scientific point of view - mean these celebrities are actually superior. Not by a long margin!

What relevance does it have if none of us would ever go to these surgeons? Especially when it doesn't compare them to the ones we would go to.

Quote from: AnonyMs on June 05, 2016, 04:55:04 AM
What relevance does it have if none of us would ever go to these surgeons? Especially when it doesn't compare them to the ones we would go to.

Dear AnonyMs

Personally I select a surgeon based on reputation among other surgeons in their field not based on the flashiness of their website or Google AdWords marketing.

The way to look passed the marketing fuzziness is scientific journals & to find the best among the peer group.

If this happens to correspond with a celebrity surgeon all the better but celebrity as a criterion for putting a scalpel to my anaesthetised body ... Never going to happen.

As for those celebrity GRS surgeons I have a good number of friends who have paid shocking sums of money for less than adequate sometimes Frankenstein like results.

Which I feel blessed to have avoided by being lucky enough to find a different way.

I remain absolutely convinced we should use the hard research, locate the best surgeon according to the peer group of other surgeons and request their services.

I sincerely hope I've answered your questio.

With kindnesses
Victoria xx

I think you misunderstand me. Normally I'm all for scientific research, but I don't regard getting published as a good measure of quality. Far too much of it is rubbish.

I have little regard for flashy websites, etc. I actually like Suporn because he doesn't do any kind of advertising or marketing and is still a top ranked surgeon. His website is also very poor.

Quote from: AnonyMs on June 05, 2016, 05:38:42 AM
I think you misunderstand me. Normally I'm all for scientific research, but I don't regard getting published as a good measure of quality. Far too much of it is rubbish.

I have little regard for flashy websites, etc. I actually like Suporn because he doesn't do any kind of advertising or marketing and is still a top ranked surgeon. His website is also very poor.

Dear AnonyMs

I understood perfectly well hun.

But "publishing" in a scientific journal is not quite the same as slapping an article up on a blog. Peer review is a thorough process of vetting quality.

I'll add only this ... having consulted with Dr Suporn directly, I didn't select Suporn due to his GRS techniques of choice, differing beauty aesthetic, and the recovery experience of friends.

However he may be the surgeon for you and I wouldn't wish to dissuade you if he provides what you're seeking.

With kindnesses
Victoria xx

Quote from: AnonyMs on June 05, 2016, 04:31:09 AM
Its from VU University Medical Center in The Netherlands, a place that as far as I know is not any kind of leader in trans medicine.

I think your post reveals something of the trans-atlantic information divide - that is to say that from an American perspective I guess that statement makes sense, but here in Europe it is indeed well known in professional medical circles as a major eurpoean centre of expertise and excellence in transgender medicine. Many european advances in the field came from there and indeed the associated Vrije Universiteit in Amsterdam was the first medical research facility to appoint a Professor of Transgender medicine in the 1980's - which chair was held for many years by Professor Louis Gooren - who has done much to advance understanding of the condition and its management on this side of the pond.

Sadly his work in the 1980's was largely ignored in the USA because it pointed firmly to a purely biological and not psychiatric etiology for the condition, and at the time this did not sit well with the religious and indeed medico-finance vested interests in American society.

Anyway I just wanted to correct your impression that this was not a centre of expertise in the field. At my medical school in London UK you would find that VUMC is indeed regarded as exactly that.

Quote from: Rejennyrated on June 05, 2016, 06:27:57 AM
I think your post reveals something of the trans-atlantic information divide - that is to say that from an American perspective I guess that statement makes sense, but here in Europe it is indeed well known in professional medical circles as a major eurpoean centre of expertise and excellence in transgender medicine. Many european advances in the field came from there and indeed the associated Vrije Universiteit in Amsterdam was the first medical research facility to appoint a Professor of Transgender medicine in the 1980's - which chair was held for many years by Professor Louis Gooren - who has done much to advance understanding of the condition and its management on this side of the pond.

Sadly his work in the 1980's was largely ignored in the USA because it pointed firmly to a purely biological and not psychiatric etiology for the condition, and at the time this did not sit well with the religious and indeed medico-finance vested interests in American society.

Anyway I just wanted to correct your impression that this was not a centre of expertise in the field. At my medical school in London UK you would find that VUMC is indeed regarded as exactly that.

I can't respond to this properly since there's some things I don't discuss here.

I'm in Australia, and don't have a whole lot of respect for trans medicine anywhere. I believe there are a few bright spots, but on the whole its a neglected field.

Briefly looking at that paper and some in the past doesn't inspire much confidence. I don't mean to be rude, but nothing I've read online, and its a fair bit, makes me feel good about the state of trans medicine anywhere in Europe.

Normal inversion is the least hassle and if you had enough donor material that's fine, but all the best surgeons either have mandatory or optional scrotal graft use.

By the sounds of the OP they want it done locally for insurance.

Quote from: Serenation on June 05, 2016, 11:27:05 PM
Normal inversion is the least hassle and if you had enough donor material that's fine, but all the best surgeons either have mandatory or optional scrotal graft use.

By the sounds of the OP they want it done locally for insurance.

Hiya Serenation

Felt I best clarify. Scrotal skin graft isn't the type of skin that presents difficulties. In fact scrotal is ideal.

Unfortunately for trans women who've been on HRT for some time there's a lot of shrinkage. As a result to create depth in the vagina surgeons are using abdominal skin for example. This type of skin is in the main incompatible with genitalia & is too often subject to necrosis, low blood flow, shrinkage etc.

Kindly
Victoria xx

I was on hrt around 13 years before srs, had to have scrotal graft.

As far as I can say there is also another group of surgical techniques.  Suporn, Schaff and some others may have an advanced technique than pi or sc.  I choose one from these newer techniques because of the look and feel, depth without skin or colon graft, becoming wet when aroused....

Quote from: MasterSifuVictoria on June 05, 2016, 05:47:08 AM

I'll add only this ... having consulted with Dr Suporn directly, I didn't select Suporn due to his GRS techniques of choice, differing beauty aesthetic, and the recovery experience of friends.

Differing beauty aesthetic? Differing from what? What is it exactly that you didnt like about his results aesthetically?

Quote from: Lara1969 on June 06, 2016, 04:40:37 AM
As far as I can say there is also another group of surgical techniques.  Suporn, Schaff and some others may have an advanced technique than pi or sc.  I choose one from these newer techniques because of the look and feel, depth without skin or colon graft, becoming wet when aroused....

Suporn is scrotal graft and cowpers gland for self lube, not sure any surgeons don't do that.

Practically all Thai surgeons are starting to follow Dr. Suporns technique, Dr. Thiti, Dr. Chettawut, Dr. Kamol, Dr. Sanguan, Dr. Saran, even Dr. Sutin and Dr. Burin who do Preecha's penile inversion at PAI, do non-penile inversion in their own practice. They obviously don't do the same technique into details, as they all have their own variations, but basic principle is taken after Dr. Suporns technique: non-penile inversion using scrotal graft for vaginal lining, and use of penile tissue flaps for vulva a.k.a Chonburi flap.   

Quote from: mmmmm on June 06, 2016, 07:54:03 AM
Differing beauty aesthetic? Differing from what? What is it exactly that y rou didnt like about his results aesthetically?

He's a good surgeon. I mean only beauty re FFS. My own face shape and background is more India/Spanish than Nordic or Oriental.

So what he suggested wouldn't have suited me aesthetically.

Hope that makes sense.

Kindnesses
Victoria xx

Well, I thought you were talking about GRS aesthetics, as this is thread about GRS.   

Quote from: mmmmm on June 06, 2016, 11:42:43 AM
Well, I thought you were talking about GRS aesthetics, as this is thread about GRS. 

In terms of GRS I rejected all Thai surgeons because 3 of my close friends have had horrific recoveries.

One is at Charing Cross with bleeding 3 months post op from Suporn.

Me, I'm fine 3 weeks later, & was up & out after 10,days with my surgeon.

However everyone has preferences and what's not right for me may suit someone else perfectly.

All I know is I had FFS, GRS and now VFS and I'm doing Tai Chi every day with little scarring visible & no pain.

Kindnesses
Victoria xx

Quote from: MasterSifuVictoria on June 05, 2016, 03:38:12 AM
Given how fast I recovered & I'm no Marvel comics super hero, I was up & fine in 1 week not bedridden for 4 - 12 weeks

I was up and fine in 2 days with Dr. Brassard. Bedridden for 4-12 weeks?! Never heard of such a thing post-surgery.

Quote from: AnonyMs on June 05, 2016, 06:51:00 AM
Briefly looking at that paper and some in the past doesn't inspire much confidence. I don't mean to be rude, but nothing I've read online, and its a fair bit, makes me feel good about the state of trans medicine anywhere in Europe.

I second this.

Quote from: Lara1969 on June 06, 2016, 04:40:37 AM
As far as I can say there is also another group of surgical techniques.  Suporn, Schaff and some others may have an advanced technique than pi or sc.  I choose one from these newer techniques because of the look and feel, depth without skin or colon graft, becoming wet when aroused....

I had PI and become wet when aroused, have decent depth and overall find the look to be fine. But, Suporn would have been my first choice if I had to redo things for even better results.

Quote from: MasterSifuVictoria on June 06, 2016, 12:10:44 PM
In terms of GRS I rejected all Thai surgeons because 3 of my close friends have had horrific recoveries.

One is at Charing Cross with bleeding 3 months post op from Suporn.

Me, I'm fine 3 weeks later, & was up & out after 10,days with my surgeon.

However everyone has preferences and what's not right for me may suit someone else perfectly.

All I know is I had FFS, GRS and now VFS and I'm doing Tai Chi every day with little scarring visible & no pain.

Kindnesses
Victoria xx

Did you go to Charing Cross itself?

Did you read the series by Juliette something or other in The Guardian? I thought it was great, and she really put people straight on Charing Cross and addressed the fear factor of the name.

It was a brilliant series of articles.

Quote from: alex82 on June 16, 2016, 03:06:13 PM
Did you go to Charing Cross itself?

Did you read the series by Juliette something or other in The Guardian? I thought it was great, and she really put people straight on Charing Cross and addressed the fear factor of the name.

It was a brilliant series of articles.

Please allow me to clarify:

1. "Charing Cross"My friend is (or was, she's discharged now) "at" Charing Cross to receive treatment because of Dr Suporn's work which has caused 3 month's of bleeding. I have 2 other friends who have gone to Thailand and both had similar issues, mainly with pain levels, long recovery times, and frequent dilation. There were also multiple surgeries required to revise the dead skin! Additional General Anesthetic is a serious risk and if this is typical of Thailand surgeons then it represents dubious work frankly.

PS By "bedridden" I mean Recovery. 2 hours of daily dilating does put one out of commission. And in the UK you are signed off from work for 3 months. This is how long recovery is expected to take.

So when I say mine took 10 days max. I meant it. I could bend, squat, move, dilate, and even light jog after 10 days. Why? I had ONLY penile skin used ... not one skin graft. This is the key to low dilation requirements, low pain, and fast recovery - no non penile skin grafts.

2. "Suporn Technique" Suporn's work is in substance modified penile inversion. He may be swapping penile skin for scrotal but the end result is the same. Plus he uses skin grafts, the same as standard inversion with the same results of long recovery and frequent dilation of length durations. As such one of the major drawbacks is the long (and forever) diliation requirements which are the same as standard penile inversion when skin grafts are added.

To restate, the major flaw with most methods of penile inversion as well as Suporn's revised version is the use of non-genital skin grafts. These skin grafts are what causes all the extra pain and needless hours of life spent on dilating or even years later the wound WILL close and no vagina! An avoidable nightmare.

3. "So-called Internet authorities." I appreciate that many believe that Sigmoid vaginoplasty is inferior and rely on surfing the internet blogosphere but the peer reviewed science absolutely favours the sigmoid solution.

Why because if you forget to dilate for weeks even years, your neovagina will NOT seal shut.

I encourage all to make use of Google Scholar. There are MANY science journal articles to support this conclusion. The belief that penile inversion or even the modified is superior in long term results is an absolute myth and needs to be dispelled with people relying only on hard data not the misinformation resulting from loyalty generated by "Buyer's bias" or pseudo-scientific "hearsay."

Here's a link to get everyone started.
http://scholar.google.co.uk/scholar?hl=en&q=sigmoid+vaginoplasty&btnG=&as_sdt=1%2C5&as_sdtp=

Kindnesses
Victoria xx

I've a few questions...

Quote from: MasterSifuVictoria on June 17, 2016, 03:50:42 AM
1. "Charing Cross"My friend is (or was, she's discharged now) "at" Charing Cross to receive treatment because of Dr Suporn's work which has caused 3 month's of bleeding.

PS By "bedridden" I mean Recovery. 2 hours of daily dilating does put one out of commission. And in the UK you are signed off from work for 3 months. This is how long recovery is expected to take.

Is this treatment at Charing Cross for granulation or something else? I've not heard many problems with Dr Suporn that are not directly related to the longer/difficult recovery process - I'm ok with that, not so much other things.

There's one women last year who had a really hard time of it; perhaps its similar.

https://www.youtube.com/user/NatalieLBG/videos

Quote from: MasterSifuVictoria on June 17, 2016, 03:50:42 AM
I have 2 other friends who have gone to Thailand and both had similar issues, mainly with pain levels, long recovery times, and frequent dilation. There were also multiple surgeries required to revise the dead skin! Additional General Anesthetic is a serious risk and if this is typical of Thailand surgeons then it represents dubious work frankly.

There's a very large difference between some Thai surgeons, and some are really cheap/bad. Who were these other two? Do you mean there was additional surgery under general anesthetic for these revisions?

Quote from: MasterSifuVictoria on June 17, 2016, 03:50:42 AM
PS By "bedridden" I mean Recovery. 2 hours of daily dilating does put one out of commission. And in the UK you are signed off from work for 3 months. This is how long recovery is expected to take.

So when I say mine took 10 days max. I meant it. I could bend, squat, move, dilate, and even light jog after 10 days. Why? I had ONLY penile skin used ... not one skin graft. This is the key to low dilation requirements, low pain, and fast recovery - no non penile skin grafts.

I could also bend, squat, move, dilate and even exert more effort if I wanted to, 10 days post-op. Low pain and fast recovery too but dilation and maintenance was time consuming the first couple of months.

Quote"Suporn Technique" Suporn's work is in substance modified penile inversion. He may be swapping penile skin for scrotal but the end result is the same.

I disagree. For instance, scrotal skin absorbs better so that post-op girls with Suporn can actually take hormones vaginally, if they wanted to and have good bio-availability. I also think the feel of it, inside, would be different, perhaps easier + more pleasurable during intercourse (?). You also state that using skin other than penile skin involves longer recovery.

QuotePlus he uses skin grafts, the same as standard inversion with the same results of long recovery and frequent dilation of length durations. As such one of the major drawbacks is the long (and forever) diliation requirements which are the same as standard penile inversion when skin grafts are added.

If scrotal skin were used, why would this lead to increased dilation requirements? Scrotal skin shrinks (closes) more easily?

QuoteTo restate, the major flaw with most methods of penile inversion as well as Suporn's revised version is the use of non-genital skin grafts. These skin grafts are what causes all the extra pain and needless hours of life spent on dilating or even years later the wound WILL close and no vagina! An avoidable nightmare.

My surgeon used scrotal skin graft (in addition to penile skin) and I did not experience much pain. Years later, after not dilating for YEARS, my vagina is still relatively deep (close to 4 inches and probably more, if I started dilating again) and has not closed. Scrotum is genital skin.

Quote"So-called Internet authorities." I appreciate that many believe that Sigmoid vaginoplasty is inferior and rely on surfing the internet blogosphere but the peer reviewed science absolutely favours the sigmoid solution.

If this is indeed the case, why do the vast majority of doctors not use this method?

QuoteWhy because if you forget to dilate for weeks even years, your neovagina will NOT seal shut.

I repeat. I've had penile inversion, as you have (you state penile skin was used) and years of no dilation have not resulted in much depth loss and closure

I'm going with Dr Bowers.  She is the only ob/gyn that does this work that I am aware of.  Unlike many surgeons she is also covered by insurance, for me at least.  In terms of procedure, she is always refining it but uses single stage penile inversion with scrotal skin used too. 
Personally I would avoid anything with colon but as with all this stuff, we each have to make up our own minds. 

Quote from: KayXo on June 17, 2016, 09:42:11 AM
I could also bend, squat, move, dilate and even exert more effort if I wanted to, 10 days post-op. Low pain and fast recovery too but dilation and maintenance was time consuming the first couple of months.

I disagree. For instance, scrotal skin absorbs better so that post-op girls with Suporn can actually take hormones vaginally, if they wanted to and have good bio-availability. I also think the feel of it, inside, would be different, perhaps easier + more pleasurable during intercourse (?). You also state that using skin other than penile skin involves longer recovery.

If scrotal skin were used, why would this lead to increased dilation requirements? Scrotal skin shrinks (closes) more easily?

My surgeon used scrotal skin graft (in addition to penile skin) and I did not experience much pain. Years later, after not dilating for YEARS, my vagina is still relatively deep (close to 4 inches and probably more, if I started dilating again) and has not closed. Scrotum is genital skin.

If this is indeed the case, why do the vast majority of doctors not use this method?

I repeat. I've had penile inversion, as you have (you state penile skin was used) and years of no dilation have not resulted in much depth loss and closure

1. The "other skin" I refer to is not scrotal. I very much agree that using scrotal scrotal skin doesn't necessarily increase dilation - non genital skin does eg from abdomen. However, compared to sigmoid vaginoplasty however, overall there is significantly increased requirement for dilation yes.

2. 4 Inches is insufficient. Sounds like it closed. If it hasn't closed, why is the depth so shallow? If so why did the surgeon not provide adequate starting depth of 6 - 8 inches?

3. I disagree. whether scrotal skin is used for the cosmetic element - labia, minor etc or the penile, this is not innovative per se. Looks the same, feels the same, just as involving of a regimen to dilate as any other penile inversion, where's the unique benefit?

And yes according to his website "Vaginal Wall - From scrotal skin (and groin skin if necessary)" Suporn IS using extra non genital skin just like everybody else.

4. Years of dilation. Yes you had ONLY penile and scrotal skin. This is good! Like I did, though used for somewhat different cosmetic parts but fairly much the same. However, many many more people have added skin grafts, not just penile and scrotal, and this is where the short and long term problems start.

If we stick to "penile + scrotal = no problems" "penile+scrotal+graft = long recovery, long dilation, pain"

5. Why do surgeons choose penile inversion? It isn't safer as the multiple scientific journal papers show. I can only guess it has to do with Operating Theatre time and cost.

A penile inversion can be done in a few hours sometimes 2, but a sigmoid is typically an all day affair.

Money is the likely culprit. 2 surgeries per day versus one. 2 House in Malibu vs 1. 250K per year or half a million? I can think of no morally benevolent excuse.

Hope that all helps clarify my position further.

Kindnesses
Victoria xx

Quote from: MasterSifuVictoria on June 17, 2016, 10:24:49 AM4 Inches is insufficient. Sounds like it closed.

Closed is 0 inches. I'm far from closed and can have sexual intercourse, finger myself, clean the inside of my vagina, etc.

Quotewhy is the depth so shallow?

Because I stopped dilating years ago.

QuoteIf so why did the surgeon not provide adequate starting depth of 6 - 8 inches?

With his technique, starting depth was around 5 inches. It's fine with me (it appears average depth in ciswomen is 4.5 inches) but I admit more would have been even better.

QuoteI disagree. whether scrotal skin is used for the cosmetic element - labia, minor etc or the penile, this is not innovative per se. Looks the same, feels the same, just as involving of a regimen to dilate as any other penile inversion, where's the unique benefit?

Scrotal absorbs medications better and is not the same type of skin as penile.

Quotea sigmoid is typically an all day affair.

Being under general anesthesia for such a long time isn't safe at all and significantly increases risks.

Quote from: KayXo on June 17, 2016, 10:33:30 AM
Closed is 0 inches. I'm far from closed and can have sexual intercourse, finger myself, clean the inside of my vagina, etc.

Because I stopped dilating years ago.

With his technique, starting depth was around 5 inches. It's fine with me but I admit more would have been even better.

Scrotal absorbs medications better and is not the same type of skin as penile.

Being under general anesthesia for such a long time isn't safe at all and significantly increases risks.

GA isn't dangerous if you are healthy. Any GA for smokers certainly is. Besides a heart bypass takes 6 hours & these guys ain't in great shape & survive just fine. The length of time argument falls a bit flat sorry.

Why would you need to have a vagina that absorbs medicine? I've not seen Estradiol tabs for vaginas before? Is this a common way to consume HRT in Thailand?

Semantics. Closed is losing depth with a rate that risks losing all depth. Since you lost 1 or 2 inches by not dilating, when you're a senior in an old folks home, how much dilating will you do? Over a few years it would be 0 zero inches.

;)

Quote from: MasterSifuVictoria on June 17, 2016, 10:46:37 AM
Besides a heart bypass takes 6 hours & these guys ain't in great shape & survive just fine. The length of time argument falls a bit flat sorry.

Between 3-6 hours, based on several sources.

QuoteWhy would you need to have a vagina that absorbs medicine? I've not seen Estradiol tabs for vaginas before? Is this a common way to consume HRT in Thailand?

I live in Canada. Progesterone and estradiol tablets/capsules can be absorbed through vagina as well as suppositories and creams. Bio-availability is increased and first pass (liver) effect is avoided

QuoteSemantics. Closed is losing depth with a rate that risks losing all depth.

Closed is closed. 4 inches is far from closed. I've not dilated for 6-7 years and only lost 0.5-1 inches. Risk of closure appears to be quite low.

QuoteSince you lost 1 or 2 inches by not dilating, when you're a senior in an old folks home, how much dilating will you do? Over a few years it would be 0 zero inches.

0.5-1 inches over 6-7 years. One cannot assume that another 0.5-1 inches will be lost during the next 6-7 years. Besides, depth can often be recovered if dilation is restarted as some transsexual women can testify, even after 10-15 yrs of no dilation.

Quote from: KayXo on June 17, 2016, 11:06:31 AM
Between 3-6 hours, based on several sources.

I live in Canada. Progesterone and estradiol tablets/capsules can be absorbed through vagina as well as suppositories and creams. Bio-availability is increased and first pass (liver) effect is avoided

Closed is closed. 4 inches is far from closed. I've not dilated for 6-7 years and only lost 0.5-1 inches. Risk of closure appears to be quite low.

0.5-1 inches over 6-7 years. One cannot assume that another 0.5-1 inches will be lost during the next 6-7 years. Besides, depth can often be recovered if dilation is restarted as some transsexual women can testify, even after 10-15 yrs of no dilation.

Lol

I truly wish that were the case. The number of trans women who lose it due to lack of dilation is substantial.

You only need to read through the following thread:

https://www.susans.org/forums/index.php?topic=97349.0

OK I guess I could use the tabs as suppositories but .... Uhm I'm OK with injections and sublingual under the tongue really xx

PS Again, it's non genital skin that's the culprit & why you didn't lose inches at a fast rate over that period of time.

:)

Quote from: KayXo on June 17, 2016, 11:06:31 AM
I've not dilated for 6-7 years and only lost 0.5-1 inches. Risk of closure appears to be quite low.

Just curious, but how long did you dilate for before you stopped? My understanding is that its really critical early on, and not so much later. I'm unclear on where that boundary lies.

 :police:

Things are getting too personal. I will lock this up if need be.

More importantly, we have moved well away from PrincessLulu's original request. This is a confusing and frightening set of choices for people to make. This is not helping.

Sincerely,

Joanna