(I don't think it's a "must have" for *everyone,* though... or at least I'm doing fine and self-lubricating well at 3 years post-op without using it, and so are quite a few people on this forum. It's a useful thing for people who need it, including cis women, but between the animals and the apparent "side effects" I think I'm grateful I don't need it. Enough expensive meds for me as it is, as someone just said. 🙂 )