Questions! That's great, I love answering questions actually. It makes me feel useful and like maybe my journey has some purpose if I can help others in some way.
I decided not to pursue urethral lengthening. When I prioritize my lower surgery needs they were (in order of priority): no vaginal opening, male appearing genitalia (including a fused, hanging scrotum), natural erections, and standing to pee. When looking into surgeons and such, and evaluating cost, the fourth priority was the only one I was willing to compromise on. My insurance didn't cover any of my surgeries so this would be completely out of my own pocket. I was also not sure my short term disability insurance through my employer would protect my income during my recovery (thankfully, they did end up covering it). Adding urethral lengthening would have added 1/2 cost to my surgical expenses, increased my recovery time, and opened me up for additional potential complications. While my wife has been nothing but supportive and supported whatever I needed in this surgery, I couldn't in good conscience jeopardize my family financially in that way for something that, while nice, wasn't critical to my masculinity. Are there times I wish I could pee standing up, yes, absolutely. But it's not something that has bothered me to the point of dysphoria. For that reason, I decided to not pursue the lengthening. I still have a flat male perineum post surgery, it just has a small hole so I can continue to urinate while sitting.
I pursued the vaginectomy because much of my lower dysphoria came down to having female appearing genitals and wetness (particularly when aroused). Because of that dysphoria, my vaginal opening was not something I've used for sexual pleasure and caused me nothing but emotional pain. So it was my personal preference vs something my doctor recommended. I'd had a hysterectomy and oophorectomy previously so closing up that hole was the last thing that remained of those structures/organs. Post surgery, that has been an immense relief. As has having male appearing genitals. I had a lot to work with so even without the implants in my scrotum, I have significant size to my scrotum and it doesn't look anything like female genitals.
My second stage is scheduled for 4/26/19. I'll have the monsplasty and buried penis repair which will give me as much length as possible for my anatomy and give me the flat male pubic area. The scar tissue issue will be fixed at that same time as well. Lastly I'll also have testicular implants put in my healed scrotum. I had to wait at least 6 months for the second stage so the new scrotum can heal totally before putting the implants in. My original surgery was 6/15/18.
Even with those couple things remaining to be done, I'm immensely happy with my surgery results so far. It's been supremely freeing. The biggest area I've had improvement in is in being intimate with my wife. I no longer experience a mental break between the moment and my body and I'm finally fully enjoying sex for the first time in my life. My sensation has been fantastic, and I could go on and on with specific examples of what's different and how different it feels. Being able to more fully connect to my body has bled over into every part of my life and I'm finally beginning to feel "whole". Which is pretty amazing [emoji4]
