So I emailed Dr. Brassard about the problems I've been having dilating 2 years post-op.  The nurse asked me when my last gynecologist exam was, and I've never had one because I didn't know I needed regular check-ups.  She told me to go get checked out and let them know the results and we would go from there.

Since I live in a smallish southern town, I'm going to assume any doctor I go to will not have examined a post-op transsexual.  My question is, if they don't know what they are looking for, how are they going to know if something is wrong?  What have been your experiences at the gynecologist?

Thanks,
Amy

I've only been to one when I was a few months post op for width reasons.  When my GP referred me, she stated in the letter I was MTF.  I went a long time ago and all went well.

They really need to know your are post op though, if not I'm sure they would find out pretty quickly - just through normal questioning if nothing else. 

You shouldn't need regular gyno checkups, as long as everything is going normally. 

Are you telling the gyno what the problem is?

Well, they're the most experienced at examining vaginas, so they'll notice if something is *different* from the expected range. At which point you can at least pass along that information to Dr. Brassard's office, and if need be they can do the interpreting of the symptoms/issues part.

You won't need a regular Pap smear - you don't have a cervix to test - so you don't have the main reason that they recommend women get yearly gyn check-ups. I'm not sure if that means you need one anyway or not, but at the very least, it wasn't silly at all for you to assume you didn't.  (I was born with a vagina and haven't been to a gyn in about 15 years; I get my Pap smear and general exam done by a nurse practitioner. Depending on who you ask, gynecologists are specialists who can be called in to handle unusual situations [pregnancy, illness, etc.] and the basic Pap can be done by anybody who knows what they're looking at.)

For the record, my wife went to our GP to get checked at 4 months post-op and he did a 2-minute speculum exam and said she had a ring of scar tissue right at the entrance to the vagina - this is apparently classic of Brassard's technique, based on the operations report that the doc requested and Brassard's office sent him  - that was interfering with dilation and making it painful, and she needed to stretch and massage that daily. I'm not saying that's the issue for you, because obviously I'm just some random person on the internet. But it certainly was the case that someone with experience doing this sort of exam only needed literally minutes to spot a difference from the standard vaginal geography. A gyn would presumably be even better.

I guess I should have been clearer.  I definitely intend to tell the doctor that I am a post-op transsexual, and fully explain the problem to her.  (Yes, it's a her.  I made the appointment today.)  I would fully expect a gynecologist to be able to tell immediately that something was amiss.  My concern is that she wouldn't know to help because she's never encountered a neovagina before, kind of like taking a Moped to a Harley specialist... close, but not quite.

Quote from: blueconstancy on February 18, 2013, 10:14:49 AM...said she had a ring of scar tissue right at the entrance to the vagina

This is what I'm guessing the problem is, not at the entrance but at the end of the vaginal canal.  Throw in the fact that this problem started happening sometime after I started having sex with a guy who regularly reached the end of said canal.

Quote from: blueconstancy on February 18, 2013, 10:14:49 AM...because obviously I'm just some random person on the internet.

Nice.  I like you already 

I'm flattered.

With any luck, you won't need her to help per se, just to identify the problem/symptoms so that you can contact Brassard's nurses and *they* can help. Like taking the moped in and having the Harley specialist tell you that something's wrong with the spark plugs, and then you do a phone consult with the moped specialist, if you don't mind me mangling your analogy. Plus, you might be surprised; cis women damage their vaginas too (especially in childbirth) so it may not actually be something she's never seen before.

I remember I attended gynecologist about 10years ago, he knew I was trans and never encountered a neovagina before, but after my examination he said only on very close examination he would never have known the difference, he thought my vagina looked very natural and realistic, it was a real confidance booster for me at the time, maybe he was being super sweet, I had worried about it so much before I attended him and felt awsome afterwards, a very understanding guy.

So I had my gynecologist appointment this afternoon.  The doctor was pretty awesome... late 30's Indian woman obviously born in the US, very laid back.  I told her I was a post-op transsexual (which she didn't blink at) and explained my problem.  After some pretty lengthy discussion I said it sounded like she has some experience with this sort of thing and she said she didn't, but she had read a lot and seen pictures.  Then she did an examination with a tool, then an exam with her hands.  In the middle of the exam she looked barely over the sheet and said, "Whoever did the reconstruction is a genius!  It looks absolutely fantastic."

So the diagnosis... she said that everything looked good, that the "reconstruction" looked completely intact, even at the very end of the vagina, and she didn't see any scar tissue.  She thought that perhaps after becoming sexually active several months ago that the angle of the vagina had become even more natural and suggested dilating in a position that would better fit the new position.  But her bottom line was that if I called back to their office Monday I could get a printout of her notes that I could send to Brassard, since he's the expert.

With the problems I've had, I dilated on Saturday, Monday, & again last night.  Last night was a little easier, but not much.  Although it seemed I could get better depth it still took me between an hour and a half to two hours.

-Amy

So I sent the gynecologist report and my thoughts to Dr. Brassard's staff.  I am somewhat offended and very disappointed in the response.  Dr. Belanger's response was that to fix the problem is to take your time and relax when you do your dilations.  I'm two years post-op and had no problems dilating for over a year and a half, and in that time achieved more depth than they even expected.  To insinuate that it's just me and I need to relax?

I already had a regular check-up scheduled with my endo for the end of March.  I moved it up to this Friday, so I'll see what she says.  She's has quite a few TS patients and is a very smart cookie!

Amy, welcome to the world of male doctors dismissing the concerns of their women patients as it being 'all in your head.'  Sucks.  Though you'd think Brassard would have more compassion and a better bedside manner.  However, he is a surgeon, and surgeons have that reputation of having bad bedside manner.  Your gyno's notes (surgeon is a genius!) probably stroked his ego a bit too much.

But don't feel bad about sticking up for yourself!


Jay

Quote from: sneakersjay on March 14, 2013, 06:45:22 PM
Amy, welcome to the world of male doctors dismissing the concerns of their women patients as it being 'all in your head.'  Sucks.  Though you'd think Brassard would have more compassion and a better bedside manner.  However, he is a surgeon, and surgeons have that reputation of having bad bedside manner.  Your gyno's notes (surgeon is a genius!) probably stroked his ego a bit too much.

But don't feel bad about sticking up for yourself!

Jay

Well, it wasn't Brassard who responded, but rather his protege Dr. Belanger.  I met her while I was there and she was very nice.  I liked her a lot.

Since my last post I saw my "smart cookie" endo and explained my problem.  She said she thought the skin inside was constricting, and as she often gives estradiol cream to her post-menopausal genetic females, she wanted me to try that 3X a week to try and condition the skin a bit.  I applied it Monday, Wednesday, & Friday night, then dilated this morning.  It might have been a little easier, but it definitely didn't take as long.  Instead of the 2 hours it's been taking it was only just over an hour.  Hopefully within a month or two I'll be back to normal

Thanks,
Amy