Hi VickiI can share my perspective or experience to a certain degree. Others here may have more current details, especially on specific surgeons and countries. You mentioned:
Quote from: VickiSDL on Yesterday at 04:05:40 PMI will likely go out of country to have the surgery because I do not have health insurance and will be paying cash. Does anyone have specific recommendations for countries/hospitals/surgeons outside the USA?
Thailand is often one of the first places people mention. I have a friend going there soon and from what I have read it has become much more common than it was years ago. In my time it was very rare for someone to travel overseas for surgery, but now it seems more common and in some circles even preferred. That said, it really depends on who you talk to, what technique you want, your budget, your health needs and how comfortable you are being away from home for surgery and early recovery.
This is probably a question other members can answer better than I can, since people may have more current and direct experience with different countries, hospitals and surgeons.
You also asked:
Quote from: VickiSDL on Yesterday at 04:05:40 PMWhat is lived experience related to the difference between inversion method and peritoneum?
I had PIV, penile inversion vaginoplasty, so that is the method I can personally speak to. It is also the more established and commonly used technique. PIV techniques have been refined, but are still basically the same 37 years later.
For me I never bothered with the details, never questioned what was going to happen to me. I literally jumped on to the operating table and my lived experience is just a normal life as a female.
In general, common risks with PIV can include bleeding, infection, wound separation, urinary issues, loss of depth, stenosis, granulation tissue, pain, scarring, need for revision and ongoing dilation. Those are general risks people should discuss carefully with a qualified surgeon. At the same time, there are lots of us who have had surgery down there and have had no problems.
A figure of 99.7% satisfaction comes from one study in Plastic and Reconstructive Surgery [1] while other studies report satisfaction rates in the 90% range. Yet we often only hear about the problems or the negativity. Regret values have been reported as ranging from 0.6% to 6% [2]. People who are happy and simply getting on with life may not post as often.
PPT, peritoneal pull-through, is not a new surgical concept. It generally dates back to the 1970s and 1980s in gynecological surgery, but its wider use in MTF surgery appears to have started much more recently, around 2019. It may be attractive to some people because it uses peritoneal tissue, but because it involves abdominal or laparoscopic work there can be additional risks. These may include abdominal complications, bowel or bladder injury, hernia, stenosis, pain, scarring, need for revision and less long-term history for MTF patients compared with PIV.
So in very general terms, PIV is more established in MTF surgery. PPT may have potential advantages for some people, but it is newer in the MTF context and does not yet have the same long term data for transgender patients. A surgeon's experience with the specific method matters a great deal.
Yes, it is completely understandable to have concerns, and there is nothing wrong with that:
Quote from: VickiSDL on Yesterday at 04:05:40 PMAs a person over 50, I have some concerns about my recovery and whether or not the whole process is really worth the risk/hassle. My wife accepts me the way I am. She would prolly prefer me to be congruent but is not pushy about it. I hesitate to put my body thru such a violation of its tissue and organization.
Recovery depends on many factors: age, general health, fitness, weight, circulation, surgical technique, surgeon skill, aftercare, support at home, pain tolerance, mental resilience and whether complications occur. Any major surgery is a major physical disruption to the body.
That said, I can only speak for myself. For me, it did not feel like a disruption. Not even a minor one. I was 32 years old when I had my surgery done and it was the PIV technique. From my perspective, I have never regretted it and I am happy with how it turned out.
The "worth it" question is deeply personal. For some people, the relief and sense of congruence are worth everything. For others, the risks, cost, recovery and maintenance may feel like too much. Having a wife who accepts you for who you are is a wonderful thing to hold onto. However, the decision still has to come from you and what you need for your own body and peace of mind.
To me the "worth it" of having the surgery was that I was finally able to function just like any other female in society.
Take care and all the best for the future and your journey.
Best Wishes AlwaysSarah BGlobal Moderator@VickiSDL[1] OHSU Transgender Health Program "Regret and Request for Reversal" Workgroup. (2023). Regret after gender-affirming surgery: A multidisciplinary approach to a multifaceted patient experience. Plastic and Reconstructive Surgery, 152(1), 206–214.
https://doi.org/10.1097/PRS.0000000000010243 🔗[2] Wiepjes, C. M., Nota, N. M., de Blok, C. J. M., Klaver, M., de Vries, A. L. C., Wensing-Kruger, S. A., de Jongh, R. T., Bouman, M. B., Steensma, T. D., Cohen-Kettenis, P., Gooren, L. J. G., Kreukels, B. P. C., & den Heijer, M. (2018). The Amsterdam Cohort of Gender Dysphoria Study (1972-2015): Trends in prevalence, treatment, and regrets. The Journal of Sexual Medicine, 15(4), 582–590.
https://doi.org/10.1016/j.jsxm.2018.01.016 🔗
