Susan's Place Transgender Resources

Hello!  This is my first post!  I am a mom to a 17 year old trans girl and we are starting to look into surgeons.  Right now the short list is Bowers, McGinn and Ting.   My daughter has been on puberty blockers since the start of puberty and estrogen since she was 15.  Because my daughter's puberty was suppressed she has very little material to work with.  I recently heard of a procedure that has been used for cis women born without vaginas that uses a portion of the peritoneal lining in the abdominal cavity to create a vaginal canal.   Dr. Ting of Mt. Sinai and Dr. Bowers may be offering this option.

Does anyone have any experience or information about Dr. Ting and or the peritoneal graft?  Any info you could offer would be greatly appreciated.   Thank you so much!

Welcome to Susan's Place. I am not up to date on all the current surgical procedures however members tend to contact several surgeons with specific questions about their surgery and normally get detailed responses from the surgeons. I haven't seen this procedure discussed on the forum and normally a skin graft is used but there are other options depending on what the surgeon has to work with. I have move the thread to the GCS section of the site were it's more likely to be seen by member more knowledgable about this topic.

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From some quick research, it appears to be a procedure done more commonly on women with missing or partial vaginas, with or without a vulva, complete or otherwise.

Based on the quick reading I did, it appears that results are more than satisfactory, even over the long term. I'm not sure, though, how applicable this surgery is to trans women.

Dr Suporn in Thailand gets excellent results in this situation. He's retiring soon, but is training a couple of surgeons to take over.

Hi Betsy,

I recommend contacting Dr. Ting directly to also inquire about his peritoneal technique. Dr. Ting's email address is at http://www.mountsinai.org/profiles/jess-ting.

Quote from: caitlynjconklin on August 27, 2017, 01:57:14 PM
Hi Betsy,

I recommend contacting Dr. Ting directly to also inquire about his peritoneal technique. Dr. Ting's email address is at http://www.mountsinai.org/profiles/jess-ting.

Thank you!  We are waiting for to get an appointment with him.  We just met with the nurse practitioner at the Mt. Sinai Center for Transgender Medicine and Surgery.   Dr. Ting is the next step in the process.  I was interested if anyone had heard if there were any other doctors that serve the transgender community that are adding this to their practices.

Quote from: kelly_aus on August 26, 2017, 08:28:57 PM
From some quick research, it appears to be a procedure done more commonly on women with missing or partial vaginas, with or without a vulva, complete or otherwise.

Based on the quick reading I did, it appears that results are more than satisfactory, even over the long term. I'm not sure, though, how applicable this surgery is to trans women.

From what I read it seems like a good option, especially for someone like my daughter who doesn't have much to work with.  Appreciate you input!

Quote from: AnonyMs on August 27, 2017, 07:15:20 AM
Dr Suporn in Thailand gets excellent results in this situation. He's retiring soon, but is training a couple of surgeons to take over.

Thank you. I heard Dr Suporn is easing into retirement and that he is amazing.  I don't think he is using the Peritoneal Graft method, but I heard his results are good as well.

Skin grafts have been used for many years for vaginoplasty for individuals with inadequate penile skin. The donated skin may be full thickness or partial thickness. The skin may usually come from the lower abdomen or upper, inner thigh. There will be a visible scar where the donated skin was.

Sometimes a small section of the colon will be separated from the bowel and used for the vaginoplasty. The colon is reattached to itself to create two separate structures within the abdomen.

Using the peritoneal lining for a GCS vaginoplasty is a relatively new procedure. In the past, the peritoneal lining was used for small repairs of various structures in the abdomen. I do not know of any other surgeons who will do a complete vaginoplasty from peritoneal lining other than Dr. Ting.

When ever a surgeon suggests a graft of any type, they need to specify where the donated material will come from. They also need to specify what are the known long term complications of that procedure.

The peritoneal graft sounds like an experimental surgical technique to me. It may prove effective in the future, but I would not take the risk. Skin grafts are a proven effective technique to achieve a good depth in people like your child. Suporn technique is great, and there are also many other doctors practicing its variation all delivering great results.

My personal opinion is that you should listen to those who have had actual first hand experience with this technique. In theory this sounds great in that peritoneal tissue is like the inside of your mouth and would be far superior to donated tissue from the back, buttock or inner thigh. It is similar to the lining if the colon in that it is moist and avoids the potential side-effects of colonovaginoplasty. I had that procedure roughly 30 years ago and continue to be very pleased  with the results.

Quote from: reborn on September 02, 2017, 11:54:13 AM
The peritoneal graft sounds like an experimental surgical technique to me. It may prove effective in the future, but I would not take the risk. Skin grafts are a proven effective technique to achieve a good depth in people like your child. Suporn technique is great, and there are also many other doctors practicing its variation all delivering great results.

Not experimental at all, just not usually done on trans women, but it is quite common in vaginal agenesis repairs. So I suppose, it being done on a trans woman is somewhat experimental..

As regards the OP; was peritoneal used for the vaginal canal?

Dr. Bowers team at Mount Sini has done 12 peritoneal graphs ( it is only done at Mount Sini). Dr. Tieg is on her team. She spends 15% of her time at Mt. Sini teaching doctors GCS techniques. She is activating her license in Colorado to teach a doctor GCS techniques. 

The peritoneal procedure is for trans woman that do not have sufficient material for GCS. One advantage is it can transfer moisture through its membrane. Also, the need to dilation is greatly reduced because the lubrication eliminated the vaginal canal tendency to "stick" together and close.

Dr. Tieg is on Dr. Bowers team and do contact him. The waiting list for Dr. Bowers to do the surgery is 4 years.

I just moderated Doctor Bowers presentation at the PTHC in Philly. This is one topic she briefly covered.

I hope this helps and sheds some light on the subject you inquired about, where to go and who to contact.

Dr. Bowers has on her website the 5 doctors she endorses for GCS. She cautions transwoman and showed us why she only endorses 5 doctors for GCS. She showed examples

I went to Dr. McGinn for GCS. I had a very different GCS procedure. I am intersexed and am having my GCS being done over 3 steps. I had no penile tissue. Penile tissue (pink tissue)  is used to go from the citreous to the vaginal canal. It is erectile tissue and when rubbed can produce engorgement and a pleasure response. I did not have penile tissue so I do not have that feature. I have a very good looking area( for lack of better words) between my citreous and vaginal canal. My whole glands penis was left in place. Later I have labiaplasty and my top was closed up and a clitoral hood made. My bottom gets closed up November 20th. This is a different procedure than you inquired about. If interested PM me and I will give you the name of the procedure, which s my last name. If you want I will send you pics. Keep in mind my bottom part of my vagina is not done yet. I can have a clitoral orgasm and well as a prostate orgasm and back of vagina orgasm. usually all three locations are stimulated.

I understand your concern for your daughter. I hope she has a wonderful experience with whomever she goes to. I cherish the memory and how empowering and satisfying it had enabled me to be.

Is this what we were talking about?


http://www.pinknews.co.uk/2017/09/13/transgender-woman-gets-revolutionary-new-vaginal-surgery-she-helped-to-create/

Yes, Dr. Ting is part of Dr. Bowers team. They have done 12 of that type surgerie as of last Saturday as per Dr. Bowers. She was speaking at the trans health conference in Philly and I was the room monitor.

I think this is great news.l had colonovaginoplasty 35  years ago and it made  a huge difference in my love life.  No more dilation or lube.Now you have all that w/o all the potential side effects.

Is it a peritoneum surgery like that: http://www.beverlyhillsurogyn.com/vaginal-surgical-procedures-beverly-hills/laparoscopic-neovagina/

Quote from: Complete on September 04, 2017, 11:14:27 AM
As regards the OP; was peritoneal used for the vaginal canal?

Yes.  A segment of the peritoneal lining is used to make the vaginal canal.

Quote from: Complete on September 13, 2017, 09:43:40 PM
Is this what we were talking about?


http://www.pinknews.co.uk/2017/09/13/transgender-woman-gets-revolutionary-new-vaginal-surgery-she-helped-to-create/

Yes!  That is it!

what is rhe dilation schedule like?

Quote from: amandam on September 19, 2017, 12:24:08 PM
what is rhe dilation schedule like?

Dilation?  What's that?  Oh, you mean when l get it on with my hunk of love husband? Gee....that would be as often as we're able.😃😆😀😃😃😃😄😉😈😇

Quote from: amandam on September 19, 2017, 12:24:08 PM
what is rhe dilation schedule like?

The nurse practitioner at Mt. Sinai said 2x's a day!  My daughter was thrilled to hear that!

Dr. Kathy Rumer also performs this surgery. Dr. Rumer performs 25-30 vaginoplasties per month in Philadelphia. Her wait list is approximately 2-1/2 months. Her email address is info@rumercosmetics.com and their phone number is 855-782-5665.

Quote from: Bestk on September 28, 2017, 09:16:51 AM
Dr. Kathy Rumer also performs this surgery. Dr. Rumer performs 25-30 vaginoplasties per month in Philadelphia. Her wait list is approximately 2-1/2 months. Her email address is info@rumercosmetics.com and their phone number is 855-782-5665.

Of the 300 or so grs surgeries that Dr. Ruler performs per year,  how many use peritoneal tissue and what are the VERIFIED results?

Hi I am a tranaexual women from Nepal. & I want to have vaginoplasty using peritoneal graft. Does Dr Jess Ting perform vaginoplasty using peritoneal graft ? How much does it cost?

Quote from: Bestk on September 28, 2017, 09:16:51 AM
Dr. Kathy Rumer also performs this surgery. Dr. Rumer performs 25-30 vaginoplasties per month in Philadelphia. Her wait list is approximately 2-1/2 months. Her email address is info@rumercosmetics.com and their phone number is 855-782-5665.

If you search you'll find a fair lot of negative reviews about her.

Quote from: Complete on September 16, 2017, 10:42:18 PM
I think this is great news.l had colonovaginoplasty 35  years ago and it made  a huge difference in my love life.  No more dilation or lube.Now you have all that w/o all the potential side effects.

So this new peritoneal gives the same length/depth as the colovaginaplasty?


Sent from my iPhone using Tapatalk

I would like to know this as well ^^

For anyone still following this thread, I have information to add. I too was very interested in this procedure based on all the previous posts here. I did a lot of other research, including reading the ->-bleeped-<- thread of the woman mentioned in the Pink News article. It sounded great, and Dr. Ting is in-network with my insurance.

I set up a appointments with Dr. Ting's team, including consultations with a social worker, a psychiatrist, and a member of his medical team. Communication was sparse, but when I went to New York everyone was friendly and extremely competent.

However, during the consultation with Dr. Zil Goldstein of the medical team, I found out that the peritoneal method we've been reading about isn't the be-all and end-all that the hype has led us to believe.

My appointment was in the middle of March, and I've been thinking about alternatives. To verify that I truly understood what I was told, I emailed Dr. Goldstein. Here's my message and her reply:

QuoteHello Zil,

Thank you again for our consultation on March 16th. I'd like to verify that I understand clearly the differences between using peritoneal tissue for vaginoplasty versus the standard inversion technique. There seems to be a lot of misinformation being spread, some from one of Doctor Ting's patients.

So, as I understand it from our consultation:

*   The peritoneum is taken from the inside of the scrotum, not from the abdomen lining.
*   The peritoneum is used only to supplement the scrotal skin as additional graft material, simply for additional depth.
*   There are no additional "self-cleaning" or lubrication advantages.
*   Post-op dilation schedules are similar with both methods.

The reports I've been reading online indicate that all the above are much better using peritoneal tissue. I'd just like to make sure that I fully understand the pros and cons. If you have anything to add, I would be much appreciative.

-------------------

It seems like you have a good understanding of the procedure. All of that is correct.



Zil Garner Goldstein, FNP-BC
Assistant Professor of Medical Education
Program Director
Center for Transgender Medicine and Surgery at Mount Sinai

It's very disappointing, but the only advantage I can see from the way they're doing it at Mt. Sinai (as opposed to the full Davydov method) is the added depth. I was told they can get 9 inches with the additional graft material. That isn't important to me. That, combined with not being able to even meet with Dr. Ting until September, no possibility of surgery before the 2nd quarter of 2019, and the high cost of having to stay in NYC for three weeks, has me looking elsewhere.

I hope somebody finds that information useful.

Stephanie

Well that is disappointing to read.  :(

I've seen a good number of medical papers published now on the "pull through laproscopic peritoneal vaginoplasty" using abdominal peritoneal tissues used on cis women with Mullerian Agenesis and CAIS. One study followed their patients from getting surgery done as teenagers through adulthood beginning in 2003. Earlier surgeries were done and published with more invasive methods in Russia in the 1990's.

What the papers I have read describe is benefits including:

self lubrication
secretions match pH of natal vaginal secretions
according to the "sex" survey-
no dialation with normal intercourse
secretions lubricate, "taste" like natal vaginal secretions
no excessive secretions in daily living

This procedure has been done by enough surgeons now that it baffles why SRS specializing doctors have not taken the time to get practice under those who have done it whenever possible.  :-\ ::)

Quote from: josie76 on April 30, 2018, 06:20:03 AM
Well that is disappointing to read.  :(

I've seen a good number of medical papers published now on the "pull through laproscopic peritoneal vaginoplasty" using abdominal peritoneal tissues used on cis women with Mullerian Agenesis and CAIS. One study followed their patients from getting surgery done as teenagers through adulthood beginning in 2003. Earlier surgeries were done and published with more invasive methods in Russia in the 1990's.

What the papers I have read describe is benefits including:

self lubrication
secretions match pH of natal vaginal secretions
according to the "sex" survey-
no dialation with normal intercourse
secretions lubricate, "taste" like natal vaginal secretions
no excessive secretions in daily living

This procedure has been done by enough surgeons now that it baffles why SRS specializing doctors have not taken the time to get practice under those who have done it whenever possible.  :-\ ::)

Exactly, Josie. "Disappointing" and "baffling" are exactly the right words. To think that such a method is known, and have to resort to the tried and true inversion technique is also "frustrating."

Stephanie

Quote from: Steph2.0 on April 30, 2018, 06:35:56 AM
Exactly, Josie. "Disappointing" and "baffling" are exactly the right words. To think that such a method is known, and have to resort to the tried and true inversion technique is also "frustrating."

Stephanie

I'm not financially in a position to get GCS done, so I suppose I have time to wait and see if thing progress. If cash was no object I'd have the zero depth done and after it heals go find one of those surgeons that have done the peritoneal to get the finished up part done. Maybe things will improve by the time I can get it done.

now i'm very confused.  i've read several articles that describe the surgeries being done by Ting as pull through peritoneal vaginoplasty.  using tissue from the scrotum is very different.  why is it being reported this way?

Quote from: josie76 on April 30, 2018, 06:20:03 AM
Well that is disappointing to read.  :(

I've seen a good number of medical papers published now on the "pull through laproscopic peritoneal vaginoplasty" using abdominal peritoneal tissues used on cis women with Mullerian Agenesis and CAIS. One study followed their patients from getting surgery done as teenagers through adulthood beginning in 2003. Earlier surgeries were done and published with more invasive methods in Russia in the 1990's.

What the papers I have read describe is benefits including:

self lubrication
secretions match pH of natal vaginal secretions
according to the "sex" survey-
no dialation with normal intercourse
secretions lubricate, "taste" like natal vaginal secretions
no excessive secretions in daily living

This procedure has been done by enough surgeons now that it baffles why SRS specializing doctors have not taken the time to get practice under those who have done it whenever possible.  :-\ ::)

I too have read these reports specifically because of some of my own symptoms.. So here's what baffles me personally.

I can't verify the taste of my vagina vs a natal female.. yuck lol. but.. I had reconstructive surgery back in 2001 with the equipment I possessed.  While mine didn't look precisely male, it was enough to label me as such from birth & thus needed correction.  I saw Dr. Kunaporn in Thailand in 2001 who utilized what I had to give me external female genitals & the vagina. 

What I don't get is my vagina IS self lubricating, has a more acidic ph balance.  I didn't have colon resegmentation.  Every time I kept hearing 'no it doesn't lubricate' I'm like.. .but mine does?  When I play with myself down there, I produce copious secretions after orgasm to make penetration / dilation easy.  It always baffled me why mine was so different than everyone elses.  Then again everything about me from the time I was spawned hasn't fit any pattern.
Its certainly not urine, and it lubricates the interior as well as the exterior of the vagina. 

On top of that I have no prostate to provide said secretions.. one explanation many tried to give me.  I was born without one.  I've asked ob/gyn's and endocrinologists and they don't have any idea why I'm not 'standard'.  I sometimes have to wear a pad if I notice excessive secretion issues.. as well as I continue to have spotting bleeding for whatever stupid reason.  My dilation schedule? Pretty much whenever I get an inkling to do it which is maybe once a week... used to be once a year lol.  I still have relatively the same depth/width.  I'm a terrible example, and don't try this at home kids.

My question  is does anyone that went through SRS / GCS have secretion/lubrication naturally?  Or am I like the only one in a sea of individuals.  Does orgasm provide lubrication naturally inside?  I would actually like to know.

This is odd.  The story on wired.com discusses the use of peritonieal tissue from the abdomen.  I can't imagine getting much from the scrotum (yuck I hate even typing that word!)

This is confusing for certain??  ???

Doreen, I wonder if given your particular biology, if you have some of the "normal" female glands that in cis women lubricate the vulva and vaginal entrance? Since you weren't born with a prostate maybe that gland structure and what would be a cowplers gland formed the cis-female counterparts? I'm just throwing out guesses though.  ??? ::)

From other's reports of standard penile inversion, there is only minimal secretions from the skin. Then some surgeons will cut a strip of skin away before inversion and take the penile section of the urethra and stitch it in. The urethra has lubricating glands down its length. That is supposed to help with just keeping it naturally moist but not enough for lube.

TMI warning  ;D
I've wondered about that because where I have a split penile raphe and my urethra is basically only skin deep, I have natural moisture for lack of a better word. When I tuck, the area between becomes slightly slick. Even if I wasn't tucking, the bottom side of the penis has a slicker feeling on that area. This seems to have increased since on HRT. But then again the groin area skin sebaceous glands all seem to be more active. The skin in the legpits ?? (armpit of the leg ???) has darkened some.

Hi,

I didn't know that peritoneal tissue existed in the scrotum. I did come across this paper related to the subject at https://www.ncbi.nlm.nih.gov/pubmed/15756559. But there is no definitive link... 

I find Dr. Ting to be very approachable and responsive by email. I highly recommend emailing him to get further clarification about his peritoneal technique, if you haven't already. As you may know, his email address is at http://www.mountsinai.org/profiles/jess-ting

Full disclosure - Dr. Ting performed my vaginoplasty in October 2016 - can't believe it's almost going to be 2 years since then - using his form of the traditional penile inversion surgery. I'm pleased with the results of my surgery.

Quote from: josie76 on May 05, 2018, 06:46:56 AM
This is confusing for certain??  ???

Doreen, I wonder if given your particular biology, if you have some of the "normal" female glands that in cis women lubricate the vulva and vaginal entrance? Since you weren't born with a prostate maybe that gland structure and what would be a cowplers gland formed the cis-female counterparts? I'm just throwing out guesses though.  ??? ::)

From other's reports of standard penile inversion, there is only minimal secretions from the skin. Then some surgeons will cut a strip of skin away before inversion and take the penile section of the urethra and stitch it in. The urethra has lubricating glands down its length. That is supposed to help with just keeping it naturally moist but not enough for lube.

TMI warning  ;D
I've wondered about that because where I have a split penile raphe and my urethra is basically only skin deep, I have natural moisture for lack of a better word. When I tuck, the area between becomes slightly slick. Even if I wasn't tucking, the bottom side of the penis has a slicker feeling on that area. This seems to have increased since on HRT. But then again the groin area skin sebaceous glands all seem to be more active. The skin in the legpits ?? (armpit of the leg ???) has darkened some.

I do know that skin discoloration can occur on estrogen... Skin 'patches' are also seen in inviduals with xx xy mosaicism / chimera types.   That might also be a possibility, who knows.  Only way to find out is a complete genetic panel, and even then they don't always easily see the genetic cause.  I know the geneticist that I saw had that as one of his suspicions too... we'll see, its all pretty much guess work at this point.

In the end what I did was I never rule out anything until its ruled out :)  I've ruled out XXY Klinefelters so far, CAIS and Swyers obviously.. though not variants of that, because that fits me a lot closer.  If I were in your shoes I'd probably take a guess at PAIS possibility. 

Even if you were completely (or me) m2f that's nothing to be ashamed of either.   I suspect far too often people try to glom onto the intersexed tag because they feel internally its somehow better than being m2f.  Its funny how our brains rationalize.. because ultimately being m2f in my honest opinion is a mental version of intersexed in the first place, and certainly nothing shaming to it (Despite what families & society try to make us think).

Your specific physical symptoms you were describing, I've not really heard myself though that isn't terribly surprising. I suspect most doctors wouldn't know either unless they deal with intersexed people all the time either, or specialize in m2f anomalies.  That's a pretty narrow specific field to find for sure.

Quote from: Doreen on May 06, 2018, 01:29:26 PM
I do know that skin discoloration can occur on estrogen... Skin 'patches' are also seen in inviduals with xx xy mosaicism / chimera types.   That might also be a possibility, who knows.  Only way to find out is a complete genetic panel, and even then they don't always easily see the genetic cause.  I know the geneticist that I saw had that as one of his suspicions too... we'll see, its all pretty much guess work at this point.

In the end what I did was I never rule out anything until its ruled out :)  I've ruled out XXY Klinefelters so far, CAIS and Swyers obviously.. though not variants of that, because that fits me a lot closer.  If I were in your shoes I'd probably take a guess at PAIS possibility. 

Even if you were completely (or me) m2f that's nothing to be ashamed of either.   I suspect far too often people try to glom onto the intersexed tag because they feel internally its somehow better than being m2f.  Its funny how our brains rationalize.. because ultimately being m2f in my honest opinion is a mental version of intersexed in the first place, and certainly nothing shaming to it (Despite what families & society try to make us think).

Your specific physical symptoms you were describing, I've not really heard myself though that isn't terribly surprising. I suspect most doctors wouldn't know either unless they deal with intersexed people all the time either, or specialize in m2f anomalies.  That's a pretty narrow specific field to find for sure.

Well as far as my body anomolies, I know I have XY chromosomes and was able to produce viable sperm. I've had two doctors say MAIS is likely because if my skeletal shape. One my regular general doctor (internist) and one the urologist who just did my orchiedectomy. The MAIS would explain some the penile and perennial raphe as it would make those areas less responsive to DHT that normally completes the male changes there.

I guess I really meant in the last post is that with the penile raphe being just a skin layer over my urethra, that whatever glands are in the urethra seem to get through to outside of my skin there. Given a matching set of bumps in my skin just under the end, one doctor said it might show that I had a hypospadias stitched closed when I was born. If so it was done during the circumcision and they never said anything was unusual to my mom. The hospital records were destroyed about 30 years ago as in IL they only have to keep records for 10 years. Doctors all long gone as well so no actual record of anything for me to find.
For me the search was just to answer why I was different as a kid. When I finally came to terms with being transgender I started putting my life puzzle together. My body caused me distress growing up while trying to be a boy. I wanted to understand why. The more information I get and the more I learn the more I find any real answers are hard to come by.

Quote from: josie76 on May 07, 2018, 01:51:21 PM
Well as far as my body anomolies, I know I have XY chromosomes and was able to produce viable sperm. I've had two doctors say MAIS is likely because if my skeletal shape. One my regular general doctor (internist) and one the urologist who just did my orchiedectomy. The MAIS would explain some the penile and perennial raphe as it would make those areas less responsive to DHT that normally completes the male changes there.

I guess I really meant in the last post is that with the penile raphe being just a skin layer over my urethra, that whatever glands are in the urethra seem to get through to outside of my skin there. Given a matching set of bumps in my skin just under the end, one doctor said it might show that I had a hypospadias stitched closed when I was born. If so it was done during the circumcision and they never said anything was unusual to my mom. The hospital records were destroyed about 30 years ago as in IL they only have to keep records for 10 years. Doctors all long gone as well so no actual record of anything for me to find.
For me the search was just to answer why I was different as a kid. When I finally came to terms with being transgender I started putting my life puzzle together. My body caused me distress growing up while trying to be a boy. I wanted to understand why. The more information I get and the more I learn the more I find any real answers are hard to come by.

Yup I had similar experiences in that Missouri also destroyed all the birth records, no records of my alleged 'allergy' shots, no records of the inguinal hernia op, etc..  My mother is a RN and she would know but she's incredibly close mouthed about my birth history.   When I presented the facts related to potential dandy walker syndrome (I have a very large cyst in my head too), she just said "Oh you just have a big head, just like your dad". 

Her continuous denial and downright lies over the years... she lied about SO many things in childhood and about my father.. that believing anything she says is suspect.  Of course she denies anything happened at birth.. then again I have umbilical internal lesions (scar tissue) from no surgery I ever heard of. 

Oh well, life goes on.  Sometimes the mysteries remain a mystery. 

From my source: Dr. Ting can collect the peritoneal tissue from the scrotum or abdomen.  Harvesting the peritoneal tissue from the scrotum is a recent development.

Quote from: mistyjensen on May 14, 2018, 04:16:38 PM
From my source: Dr. Ting can collect the peritoneal tissue from the scrotum or abdomen.  Harvesting the peritoneal tissue from the scrotum is a recent development.

Do you know why he would choose one over the other and if the outcomes in terms of lubrication, dilation schedule, or efficacy are different?

No, I don't.

Quote from: Brooke on May 14, 2018, 09:32:46 PM
Do you know why he would choose one over the other and if the outcomes in terms of lubrication, dilation schedule, or efficacy are different?

Any type of graft depends on how much donor tissue is available.

Some of us do not have enough scrotal tissue to construct a vagina of any size, so the surgeon must find the tissue elsewhere. Taking peritoneal tissue from the abdomen is a much more complicated procedure.

Quote from: Rachel on September 09, 2017, 03:00:32 PM
Dr. Bowers team at Mount Sini has done 12 peritoneal graphs ( it is only done at Mount Sini). Dr. Tieg is on her team. She spends 15% of her time at Mt. Sini teaching doctors GCS techniques. She is activating her license in Colorado to teach a doctor GCS techniques. 

The peritoneal procedure is for trans woman that do not have sufficient material for GCS. One advantage is it can transfer moisture through its membrane. Also, the need to dilation is greatly reduced because the lubrication eliminated the vaginal canal tendency to "stick" together and close.

Dr. Tieg is on Dr. Bowers team and do contact him. The waiting list for Dr. Bowers to do the surgery is 4 years.

I just moderated Doctor Bowers presentation at the PTHC in Philly. This is one topic she briefly covered.

I hope this helps and sheds some light on the subject you inquired about, where to go and who to contact.

Dr. Bowers has on her website the 5 doctors she endorses for GCS. She cautions transwoman and showed us why she only endorses 5 doctors for GCS. She showed examples

I went to Dr. McGinn for GCS. I had a very different GCS procedure. I am intersexed and am having my GCS being done over 3 steps. I had no penile tissue. Penile tissue (pink tissue)  is used to go from the citreous to the vaginal canal. It is erectile tissue and when rubbed can produce engorgement and a pleasure response. I did not have penile tissue so I do not have that feature. I have a very good looking area( for lack of better words) between my citreous and vaginal canal. My whole glands penis was left in place. Later I have labiaplasty and my top was closed up and a clitoral hood made. My bottom gets closed up November 20th. This is a different procedure than you inquired about. If interested PM me and I will give you the name of the procedure, which s my last name. If you want I will send you pics. Keep in mind my bottom part of my vagina is not done yet. I can have a clitoral orgasm and well as a prostate orgasm and back of vagina orgasm. usually all three locations are stimulated.

I understand your concern for your daughter. I hope she has a wonderful experience with whomever she goes to. I cherish the memory and how empowering and satisfying it had enabled me to be.

Where can I find this list, or what 5 surgeons are these?

Quote from: transgirl34 on June 03, 2018, 09:46:51 AM
Where can I find this list, or what 5 surgeons are these?

They are listed on Dr. Bowers' website.

Papillon Center – Dr. Christine McGinn, DO (Philadelphia)
Pierre Brassard, MD (Montreal)
The Suporn Clinic – Dr. Suporn Watanyusakul (Bangkok, Thailand)
Toby Meltzer, MD (Scottsdale, AZ) [ note: 2-stage surgeon]
Mt. Sinai-Beth Israel Hospital – Jess Ting, MD (New York, NY)

~Terri