Transfem
A community for transfeminine people and experiences.
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Some helpful links:
- The Gender Dysphoria Bible // In depth explanation of the different types of gender dysphoria.
- Trans Voice Help // A community here on blahaj.zone for voice training.
- LGBTQ+ Healthcare Directory // A directory of LGBTQ+ accepting Healthcare providers.
- Trans Resistance Network // A US-based mutual aid organization to help trans people facing state violence and legal discrimination.
- TLDEF's Trans Health Project // Advice about insurance claims for gender affirming healthcare and procedures.
- TransLifeLine's ID change Library // A comprehensive guide to changing your name on any US legal document.
- Rainbow Railroad // A non-profit international humans rights organization helping at risk LGBTQ+ people relocate to safety.
Support Hotlines:
- The Trevor Project // Web chat, phone call, and text message LGBTQ+ support hotline.
- TransLifeLine // A US/Canada LGBTQ+ phone support hotline service. The US line has Spanish support.
- LGBT Youthline.ca // A Canadian LGBT hotline support service with phone call and web chat support. (4pm - 9:30pm EST)
- 988lifeline // A US only Crisis hotline with phone call, text and web chat support. Dedicated staff for LGBTQIA+ youth 24/7 on phone service, 3pm to 2am EST for text and web chat.
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What technique did you get, where, with which doctor, how much did it cost?
How long did it take to heal after surgery until you could use it? Does it look good and function well?
Have you needed to dilate a lot/kept the full depth?
Penile Inversion, using scrotal skin for the graft. I had to undergo months of laser & electrolysis on the scrotum.
I try not to doxx myself, but in the US, in the southeast in particular. The surgeon no longer practices at that hospital, and the hospital has since shuttered their gender-affirming surgery wing. I anticipated this and was very intentional about fast-tracking my surgery as I saw the window of opportunity closing. It was really upsetting to see my predictions come true.
I don't have exact figures on me. Insurance covered most of it, I think total costs were like $125,000. I probably paid $1 - 3k out of pocket, and then of course you have to include the costs of the hotel for your caregiver the week you are in-patient, and the hotel costs for the week you are out-patient but have to stay close to the hospital. Those costs were in the thousands, and probably more than the out-of-pocket I paid to the hospital. Overall the surgery was very expensive (esp. compared to my orchi, which was out-patient).
Depends on what you mean by this. I was technically approved for penetrative sex around the 6 month mark. But I was using a dilator from the beginning, and able to receive sexual pleasure from dilation from around 1 week post-op (they taught me how to dilate after pulling the gauze out of the canal at the end of my 1 week of strict bed rest in the hospital). I also had clitoral sensation and pleasure pretty much immediately (from 1 week post-op and on). I seem to remember orgasming from dilation in the first 3 months (I forget when exactly, it might have been in the first month), and I was actually a bit afraid of some of those early orgasms because I wasn't really "cleared" for it yet and I didn't want to injure myself or ruin the recovery.
This is hard to answer ... the quick answer is yes and yes.
On the one hand the feedback I get is that it looks good. It obviously functions well, I'm able to receive penetrative sex and it feels great. But I'm very particular and sensitive, and it's easy for me to find ways to feel insecure about my genitals anyway. Particularly because of my weight, the surgeon was not able to form distinct inner labia, and my outer labia remind me too much of my scrotum sometimes. But when not scrutinizing or putting myself into weird positions to make my labia look weird, in general just walking around it looks better than I could have imagined or hoped for.
All this said, I have to remember the standard I operate by is whether it improved dysphoria and improved sexual functioning, and those are both obviously demonstrated. I basically couldn't have sex without dissociating before surgery, and now I actually have moments of feeling sexy and able to connect with feeling sexually desired by others, etc. that I couldn't feel before. I still dissociate sometimes, but it is much less. I still have bottom dysphoria, but it is much less. The surgery is obviously clinically beneficial and worth it.
EDIT:
here are some pictures of results very similar to mine, from a patient of the same surgeon (warning, NSFW images):
nsfw
Yes, until my 1 year post-op, I had to dilate at least once a day. The schedule was 3 times a day and eventually 2 times a day (around 6 months post-op), and eventually once a day (around the 9 month post-op mark?). After 1 year, it's dilating 3 times a week. Eventually it's just as-needed, so I'm probably going to test reducing frequency every 3 months and see how it goes until I'm dilating around once a month.
Dilation was challenging and painful for maybe the first 6 months and then became suddenly much easier as my wounds were no longer healing and thus tightening as much. I had wound separation complications, which made dilation more challenging.
I was shocked at how easy dilation was during the first few weeks or so - before you have had significant healing, and when you're dilating with a smaller dilator for shorter durations, it's not bad at all. It was only after significant healing was causing tightness that it became more painful for me (I don't remember exactly, but definitely by month 2 - 3, I was having more challenging dilation sessions).
Experiences vary significantly, but most people hate dilation. I wouldn't say I hate it, but dilating 3 times a day was very difficult in terms of having a life outside of dilation - working full time around that dilation schedule felt impossible at times. I don't know how most people do it, tbh and I often read of people dilating once in the morning, once after work when they get home (8 hours apart or more), and then once before bed - but then that defeats the point of more frequent dilations, which should be every 3 - 4 hours or so during that time.
Because of pain and tightness it also took me a long time to dilate in those first 6 months, a single dilation session could take me 60 - 90 minutes because it took so long for me to work up to the largest dilator and get it to full depth, I spent most of the time getting the dilator in (a minority of my dilation session was actually spent holding it in place at full-depth, which is for 15 minutes).
Now, it takes me like maybe 5 - 10 minutes to fit the largest (orange, 1.5" / 3.8 cm diameter soul source) dilator in to full-depth, and then it's 15 minutes holding it in at full-depth, so I often can fit a dilation in a 30 minute window. (And I don't have to take any meds for the pain; it can still feel uncomfortable at first, but after I get it all the way in, it usually feels good and there is no discomfort at that point).
Wow. Please don't mind me saying, but you're a beautiful specimen of a human being and you'll find plenty of opportunities showing off for money.
Hi! I'm a cis-het man, so I'm a guest in this space, and have already gone back and forth 100 times on whether to post anything at all, but eventually decided to. I just wanted to say I've encountered cis-het vulvas that look exactly like those pictured, so if your outcome looks anything like those then you're in amazing company.
In my limited experience, feeling self-conscious about characteristics your vagina either has or doesn't have, or has too much of or not enough of, is unfortunately pretty common amongst cis women, so you may be in a place to "level-up" your dysphoria into common internalized misogyny! Yay... 😅
If any of this has come across as creepy or inappropriate or hurtful in any way, I obviously can't take it back, but please let me know and I'll delete this comment as soon as I see, or if I don't see soon enough please get a mod to blow it all away. It's a sensitive area, and tone is hard to judge over text, and also maybe none of it was a good idea. kthnxluvyoubye!
you are welcome here!
Thanks for your affirming words. 💖
I do think my vagina could "pass as cis" in many contexts (which brings me immense relief as headlines increase about women being targeted and harassed in bathrooms, and about new TSA policies that prohibit women officers from doing pat-downs for trans women), but I think a gynecologist would probably be able to tell my vagina is not natal (from the lack of inner labia, and the location / placement of my urethra and vaginal opening - which are a bit lower than they "should" be for a natal vagina).
That said, you're right that at some point my dysphoria becomes sort of closer to the nit-picking and insecurity that cis women express ... it's confusing, though, because there is research on this difference - clinically speaking, trans women like me do actually see benefits from cosmetic surgeries that feminize the face or labiaplasties to make a neo-vagina more typical of a natal vagina, etc. whereas cis women who are insecure about their face or labia almost never see clinical benefits from the same cosmetic surgeries. Body dysmorphia can't be fixed with surgeries, but gender dysphoria can.
So, I assume while it may look the same, probably it isn't the same. My sensitivities are just higher and I see and live with all the ways I fall short of the woman I feel I should be (and in ways surgery will never fix - like the size and shape of my shoulders, my forearms, my hands, etc.).
Thank you for being so kind and considerate, and for bringing up such affirming and supportive points 🫶
Oh wow, that result is amazing. I'm also hoping for a similar result.
Personally I'm considering inversion too, though using my cheeks as well for the vaginal lining.
I'm curious what motivates using your cheeks for the vaginal lining?
(EDIT: also, hi there! :D)
hi there too! :D love seeing your texts and writings.
the vaginal lining is mostly important for me to get the right microbiome. I recall your experiment with the microbiome and dug a bit around.
Ultimately I want to optimise my chances for getting a uterine transplant, that is my dream. A few hundred have already been carried out with about half(?) having live births as a result. My hope is that I could do so too, and pave the way that Lili Elbe started.
Vascularity and microbiome imho may play a role in the uterine transplant succeeding. If you want the research, it's here.
Whether I'm too late or not I don't know, but good chances and nothing is better than bad chances and nothing, imho. If I can't, then at least I have made it easier for others to follow.
(For readers in the future, if that link ever no longer works, I have backed up its content as a PDF, just ask me.) Here's also a summary I wrote
aw, thank you - I like seeing you around too 🫶
so, the problem with buccal lining for mucus-production is that it won't produce the right kind of mucus for a vaginal microbiome (nor will it behave like vaginal epithelium in terms of managing pH), so while a buccal graft is closer to vaginal epithelium than a skin graft (like from a scrotum), afaik the mucus it will produce won't have the sugars in them to feed lactobacillus and won't sufficiently replace cervical mucus, and the buccal graft won't create an acidic environment to promote lactobacillus the way vaginal epithelium would.
That said, I don't think it's the worst logic that a buccal graft gets you that much closer to something like vaginal epithelium, so I don't blame you for wanting to try that, esp. if a uterus transplant could install a future cervix that does produce the mucus that would help feed lactobacillus.
Not that it matters too much, but I personally wouldn't want a mucosal graft because it would make it harder to go anywhere without panties and pantiliners, because as I understand it the graft constantly produces mucus and you basically constantly have discharge (unlike a natal vagina where is not constant and goes through cycles of more or less discharge). Another reason some women want these mucosal grafts is for "lubrication" during sex, which again I understand the desire to be closer to a natal vagina that way, but what I've read is that the mucus isn't enough to sufficiently lubricate, and in my experience because my surgeon retained my Cowper's glad, I get extremely wet when aroused and surprisingly that has been more than enough for some kinds of penetration (though it's still recommended to use lube whether you have penile-inversion, or a technique with a mucosal graft).
Since no successful uterine transplant has ever been performed on a trans woman, I tend to hold some skepticism that it will be an option in my lifetime - but I do see that they keep trying, and hopefully someday there will be a success (and more than that, that eventually they will find a way to perform uterine transplants in a way that isn't a huge risk and becomes routine, the way vaginoplasties have been developed over the past century to the point that risks are relatively low and outcomes relatively positive).
Regardless, I don't fault you for seeking a uterine transplant (if I thought it were possible, I would certainly consider it myself), just be careful and weigh those risks seriously. I also would look into what the requirements would be, such an experimental and new surgery they may have stricter requirements around age, health, etc.
Thanks for sharing that article, I'll read it more carefully when I have a chance.
Also thank you for alerting me to the reality of uterine transplants in cis women, I wasn't aware they were as far along as that - that's so exciting and gives me so much hope!
Hmm. Are there other places in the body that have a similar microbiome and 'feel' as the vaginal lining? I think there's the gut, but I'm not sure.
Actually, a uterine transplant has been done before on a trans woman (Lili Elbe), though she died from organ rejection in the 1930s - when immunosuppressors weren't really a thing yet. With modern technology, I think outcomes would be much better.
It def has advanced a lot in the past years! The first succesful modern uterine transplant pregnancy was iirc completed in 2014, but now it's picked up steam and that gives a lot of hope for those who want to undergo pregnancy but cannot.
unfortunately I don't know of any tissue that acts like vaginal epithelium in terms of how it alters pH, let alone something that acts like the cervix in producing mucus that feeds lactobacillus - maybe someday they could theoretically grow such tissues in a lab to be used for a graft?
I didn't include Lili Elbe because it was a failure, I don't know of any successful transplant - but it's a good point that the surgery was completed. Her story is so moving and tragic ...