Hi! I'm 23 months post-op GCS with Meltzer & Ley in Scottsdale, AZ. I am 50. I am in reasonably good athletic shape; I do circuit training 1x-2x/week, run 2x-3x/week, and yoga and sometimes pilates 1x/week.
I have had significant erogenous stimulation loss post-op, so much so that I have come nowhere close to orgasming since that surgery. I have friends who have been able to orgasm practically from the moment they finished GCS - including Meltzer, Suporn, et.al. I also have friends who took 24 months post-op GCS (including Meltzer, Suporn,
et.al.) before their first orgasm.
While I am disappointed, I am also hopeful though not with much basis.
Prior to GCS (February 2017), I had good physiological results and amazing erogenous results with HRT (begun March 2015 using exclusively injectable estradiol, and no progesterone or antiandrogen). [With estradiol alone, my T crashed to the teens.] As HRT progressed, I developed small A-cup breast tissue (along with other desired secondary effects, including some improvement in my hip-to-waist ratio, although as expected given my age little or nothing in the way of hip development). The breast tissue was exquisitely sensitive around the nipples, and became a source of incredibly pleasurable erogenous stimulation. My penis and gonads shrank. My ability to ejaculate disappeared (thankfully). But I began to experience a different, wave-like, whole-body shaking, warm-feeling orgasm. Amazingly, the area at the base of the penis became significantly more erogenous. I thought to myself that I had finally begun to experience something much closer to true female orgasm.
Unfortunately, my experience with sex following GCS fell way short of what I had hoped might be even better and more in line with my hopes.
The vaginaplasty surgery went well, with one scare over a urinary catheter blockage. I had perineal ripping that took something like 8-12 weeks to finally heal. And I had mild but persistent granulation that took something like 8 months to finally heal up with silver nitrate. My labiaplasty surgery went somewhat better. Again, some granulation. I should also mention that I had breast implants done during the same operation as my vaginaplasty. None of this stuff is unusual. And I believe my recoveries went reasonably well.
Following my vaginaplasty and breast augmentation, my endocrinologist switched me from 1ml/week <dosage removed> estradiol injections prior to GCS to <dosage removed> estradiol pills post GCS to reflect the removal of my testes. My endo also felt that at about age 50, my estrogen levels should reflect my age being that of a post-menopausal woman. He worried that estrogen would raise my risks of cancer, based on recent studies and nothing specific to me. My estrogen levels dropped to 22, which is very low even for post-menopausal women (something like 32 is normal, it was explained to me). And this massive estrogen drop-off occurred at the outset of my healing process, which I fear may have affected my neuronal reconstruction and healing. (That said, I am no scientist, so my surmise may be nothing more than uninformed.)
Since GCS and BA, I have sensation in the vulva and breast regions – touch, pressure, and temperature. My mons pubis provides some pleasurable stimulation. My clitoris is somewhat stimulatable. I even seem to have some good feeling emanating from the classic G-spot area in the vaginal canal, particularly when I am moving a dildo back and forth not very deep. When my spouse presses her hand between my clothed thighs into my crotch, I even feel something tantalizingly but fleetingly wild and erogenous, but even when it carries over into sex, it never climaxes with a proverbial happy ending. Unfortunately, since BA, my nipples and aureolas no longer cause any sort of arousal or even something anticipatory.
Essentially, since GCS, both masturbation by myself and stimulation by my partner have failed to bring me anywhere close to orgasm. I have tried self-touch (slow to fast), dildo and vibrator. I have tried to stimulate orgasm focusing on clitoris, vagina, and both. (Even post-GCS, I don't enjoy anal penetration, so it's really not an option for me.) I have viewed soft pornography (nude pictures of men, nude pictures of women, man-and-woman intercourse, woman-and-woman intercourse). I have tried mindful meditation in conjunction with masturbation. I have read books and articles and watched videos (e.g., Kinsey Institute) on lesbian sex and masturbation. I have made sure to be very patient, sometimes spending up to 2 hours alone. I have made repeated efforts, to no avail at least thus far.
Inability to orgasm and talks with other trans women and therapists led me to conclude that my endo was being overly cautious. I found a new endo who believes that 2 years of an effective dose of estrogen is way too short. She thinks I should have at least 7-10 years of estrogen at levels in line with pre-menopausal women (100-200). (Some of my trans friends think even all the way up to 300 is warranted.) So, for the last 4 months, I have been on weekly estradiol valerate injections at <dosage removed>. And my estrogen levels are well into the recommended range. But to date with this new hormonal regimen, I haven't come anywhere close to higher erogenous stimulation, let alone orgasm.
My Questions for the Forum Participants: I wonder if my endo should add progesterone. Or should she add a light dose of testosterone (suggested as a last alternative by my GCS surgeons)? Should I consider the highly experimental Platelet Rich Plasma injections into the clitoris and vaginal canal, which reportedly materially improves erogenous sensation for cis women? I wonder if erogenous hypnosis works. Does sex therapy work? I am not yet ready to throw the towel, but I am indeed very concerned as I approach the 2-year anniversary of my GCS and BA.
That all said, please know:I would NEVER CHANGE MY MIND about undergoing GCS even if my condition turns out to be permanent. I have ridiculously greater peace of mind despite the hurdles and trauma I have endured - and despite my inability to become highly erogenously stimulated, let alone orgasm.
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