Transfem

Microbiome experiments seem to be going great! I don't feel I have that much left to figure out or problem-solve on that front. I even figured out how to make a dilation lube that functions as a prebiotic gel by replacing store-bought aloe gel (which has preservatives) with home-made flax gel, which is less structured than xanthan gum and prevents the lube from creating too much of a "suction" effect when I dilate.

I would say dilation is a lot of work, and they sorta pushed me back into working full-time around that 3 months point, sooner than I was really ready - so I would have a plan for that. Part of that is because my dilation sessions took so long due to pain and slowly having to work up to the largest dilator. Under those conditions, dilating three times a day was not really compatible even with the amount of house work & self-care work I wanted to do (i.e. feeding myself 3 meals a day, showering once a day, cooking meals, cleaning up from those meals, doing laundry, etc.), let alone working full-time on top of that.

So, if at all possible, I would have someone else able to do the housework for you (and able to feed you, help you, etc.) - this is not a surgery you can do alone, you need help. And ideally, you are able to pause from work for longer than the minimal disability leave some employers offer - I think waiting until I was just dilating twice a day would have been ideal.

That said, there is only so much we can do - so, at some point you are just rolling with the punches.

I do wish I had advocated more strongly for myself during the one week of strict bed rest in the hospital - I needed to avoid sitting up at too much of an angle, that may have helped me avoid the wound separation. Likewise with using a bedpan, the nurses always sat me up at 90 degrees to use a bedpan, and I wish I hadn't just assumed they knew what was best for me, and instead found a way that avoided putting pressure on that area.

Self-advocacy is really hard in a hospital, it was so much harder than I expected.

Hopefully there are some people who've been through the surgery who can be a resource for you.

I would also make sure to have a trauma psychologist lined up for after your hospital stay, surgeries often create situations that can be psychologically challenging and it's worth having that extra support.

here is a long post about things I wish I knew about surgery before my surgery: https://lem.lemmy.blahaj.zone/post/27942310

and a post on the specific challenges I faced and how I dealt with them: https://lem.lemmy.blahaj.zone/post/27942310

hopefully those are helpful too!

Hi! Welcome to womanhood! 😁

How has transitioning as a whole been for you? Getting on hormones, wardrobe changes, socially, etc? I’m only out to my close friend circle, but already know my close family is cool with trans people.

I socially transitioned months before I was able to start hormones. That initial social transition wasn't particularly helpful to my mental well-being and was even destabilizing (creating a lot of stress, resulting in worse mood swings, intense nightmares and parasomnias, worsened suicidal ideation, etc.). Looking back, I could see an argument for taking estrogen for a year or so before socially transitioning. (I socially transitioned as soon as my egg cracked because I was afraid I would crawl back into the closet and never come back out - I had to find a way to force myself out.)

My experience with hormones was very positive - estrogen changed my life and my mental health significantly, and that was very clarifying. I realized I would want to take estrogen no matter whether I was "really" trans or "trans enough" or not - estrogen made me happy, made my brain function better, it lifted me from depression, alleviated anxiety, and gave me a life in which I felt "irrationally" life affirming. Estrogen is responsible for me no longer wanting to be dead, I had wanted to be unalived since I was maybe 11 - 13 years old (looking back, quite a coincidence that it was around when male puberty started, hmmmm), and when I started estrogen it was like going back to childhood. Estrogen mostly made me feel "normal", like I could see how life could feel bearable to other people.

Transition can be massively destabilizing, but I don't really see any alternative - transitioning (particularly medically) was like starting my life. The alternative isn't really living.

If you have any conservative/anti-trans people in your life, how have relationships been with them since you started? Have you cut ties, or hidden your transition, or anything else? I have some bigoted family that are otherwise decent people and that I’d like to stay connected with (for now, at least).

I had some transphobic in-laws I was close to who blocked me and refused to talk to me. They reacted worse than I expected.

I lost blood family too, unexpectedly.

Friendships with anti-trans people really changed, they stopped talking to me as much or treated me differently.

I wouldn't particularly advise you invest much in relationships with anti-trans bigots, it's just not a recipe for good outcomes (for you or them tbh).

That said, I understand the impulse, I was very accommodating of the anti-trans people in my life when I first transitioned.

How was surgery as a whole? What was pre-op like, any things you didn’t like about it, things you had to compromise on, etc? I’ve never had surgery in the first place, so this would be extremely foreign to me.

I thought I would never get a vagina when I first transitioned. I knew I wanted an orchi, but I thought I didn't have any bottom dysphoria. But then my dissociation and coping strategies sorta melted away, and I was left with increasing distress about my genitals, and sex became more and more complicated for me. I clearly had bottom dysphoria, even though I never had specific thoughts like "I hate my penis" or "I wish I had a vagina" - I never felt a direct desire for a vagina, which made it difficulty for me to decide to have a vaginoplasty. It was a lot of having to read between the lines about what would be good for me or not. I remember in a therapy session, my therapist asked me to imagine myself in 10 - 20 years, that I'm living as a woman, using the restroom, going to changing rooms, going swimming, etc. - what would I feel in 10 years? Would I wish I had done something? That was clarifying, I knew instantly that yeah, obviously I wanted to have a vagina, I would regret living with "male" genitals that long, with denying myself that. I thought because I could cope and live with a penis that I should, but that was foolish and didn't prioritize my well-being.

I have a long post about things I wish I knew about surgery before my surgery: https://lem.lemmy.blahaj.zone/post/27942310

another post on the specific challenges I faced and how I dealt with them: https://lem.lemmy.blahaj.zone/post/27942310

Overall, surgery was challenging, but I suspended judgement and acted on the assumption it would be worth it for a future-self, and I think I was right - it was completely and obviously worth it, and I wake up happy to have a vagina every morning.

If you don’t mind, what was dysmorphia like for you? I’ve wondered for a while before now what it’d be like to be a girl, and have especially felt it in the genital area. And on the occasion I’ve been “misgendered,” I always felt really good about it.

I don't think I even had that level of awareness that I would want to be like a girl in my genital region. I did have the experience of being accidentally misgendered as a teenager and feeling happy to be confused with a girl (though it was a complicated feeling for me, at least as bitter and upsetting as it was sweet - I didn't think I could be a girl then).

Dysphoria was hard to describe, often it was like shame or embarrassment, a lot of the time it was like my body became someone else's and I felt sexual pleasure through the sense of the body being a separate male body - like, the penis wasn't attractive as my penis, but it could be attractive if it were someone else's penis. Dissociation was hard for me to notice happening. I often lived vicariously through the women I dated

How have you learned to do feminine stuff? Like chest measurements, makeup/nails, other clothes stuff, etc? Just researching online, or do you ask cis friends, or something else?

A combination of everything! I actually went to a Sephora and got a makeup lesson from them. I was lucky enough to have women family members show me how they did their makeup. To be honest, I was always interested in clothes, fashion, and nails, so I already had some experience on that front. But then I researched body shapes and how to dress my body to feminize it, etc. online.

But most of my femininity is "natural" - it looked weird to people on my male body so I was assumed to be a gay man, but once I passed as a woman, I found myself living a gender-conforming life for the first time ... it was rather surreal to suddenly be "normal" that way. Transitioning made me so extremely normal, lol.

Are you doing any voice training? If so, anything you can recommend to help? I have a lower voice and a small range, so anything helps.

Yes, I highly recommend voice training. I saw a speech language pathologist who specialized and almost exclusively worked with trans patients on their voices. Voice training is admittedly challenging psychologically, but it's one of the things you theoretically have a lot of control over (unlike so much in transition), so I encourage everyone to get into voice training. It took me around 6 - 8 months of weekly SLP sessions and full-time voice training outside that to find a passing voice. I know people who have taken shorter or longer to find a passing voice.

Here's a clip of my voice you can listen to, to get a sense of my progress.

Here is a beginner's guide I put together for voice training: https://lem.lemmy.blahaj.zone/post/32117601/16502930

Any resources you can recommend me on this? Where to learn about treatment, advice on how to do this stuff?

Yes, I have so many recommendations, lol

checkout some comments I made with links and lists of resources I recommend:

• https://lem.lemmy.blahaj.zone/post/40610299/19859171
• https://lem.lemmy.blahaj.zone/post/23710814/13642552

also, checkout my tips for transition & improving dysphoria

Here's some recommended reading to get you started:

• Gender Dysphoria Bible
• Whipping Girl by Julia Serano (and Sexed Up as well)
• Yes, You Are Trans Enough by Mia Violet
• “What Does the Scholarly Research Say about the Effect of Gender Transition on Transgender Well-Being?”
• An Introduction to Hormone Therapy for Transfeminine People

Awesome! I’m about 7 months behind you, and dilating suuuuucks lmao.

Dilating really does suck, it can be really painful and take a long time, and it can be really debilitating and reduces how much time and energy you have for anything else in your life.

What depth did you achieve / want? Did you lose any, and were you able to regain it after time?

it's sorta hard for me to know how to best measure depth, but basically the last dot on the dilator is visible still, the other dots are hidden - I think the depth is around 5 inches?

I don't think I lost any depth, but I was very vigilant and prioritized dilation above all else. My concern was more with losing girth, but I managed to dilate up to orange for each dilation (after the initial work up to orange, which maybe took a couple weeks?)

I’m so excited to hear about it getting better at some point, it’s a bit painful at the moment. :(

For me it seemed to get easier rather suddenly, within a couple weeks span around that 6 month mark - I just noticed dilations didn't cause so much pain that I was having to take meds, and they started to not take as long. Eventually they got easier and easier. I kept a log of my dilations, but I failed to keep track of when I initially started inserting, so that limits some of the usefulness of the information once I was using just the orange dilator from the beginning (instead of working up to orange first with smaller dilators), so, sorry I don't have more fine-tuned answers

It’s so much better than having the parts I didn’t want! Congratulations!

That's a really good way to put it, lol. I think my vagina falls short of a natal vagina for me personally, but I still fully endorse having a neo-vagina over what was there before, and in general it has been very healthy for me to have made this change (in so so so many ways, even just the reduction in anxiety when using a public bathroom or going through TSA to fly).

Welcome back! I missed seeing you around here. I hope you’re doing well despite all the insanity.

aw, thank you - it's nice to see you around too 🫶 I'm definitely doing well all things considered, just a time of high stress, but I'm mostly on the other side of a lot of the worst parts.

You mentioned penetrative sex in some of your other comments in this thread. Was that something you knew you would be interested in before the surgery?

yes, I almost went with a vulvoplasty, but what convinced me to get the full canal was a repeated pattern going back to childhood of a desire to be penetrated in sex, so - it was just something I realized was important to me, and would be a part of my desired sexual function, and since that was true I didn't want to take that off the table with a vulvoplasty (despite the fact that a vulvoplasty has lower risks, easier recovery, and doesn't involve dilation). It was watching a youtube video in which a sexologist weighed in on advising going with a vaginoplasty over a vulvoplasty because as a sexologist they believed it was important to preserve sexual function - and even if at the time I wasn't sure if I were asexual (and certainly believed my desire to be penetrated in sex was a small, unimportant desire compared to the concrete and real pragmatic benefits of a vulvoplasty), I ultimately heeded that concern as a kind of compassion to a future self whose life I could not predict.

I'm quite glad I chose a vaginoplasty, and would suggest anyone who is sexually active and wants a vagina to opt for the full canal, as there are many cases of women who opt for a vulvoplasty and then require a second surgery later to get the canal when they realize (too late) that penetration is important to them. If you're entirely asexual (and it's not just dysphoria), that's a case where I see a safer argument for a vulvoplasty, and I do know an asexual trans woman IRL who had a vulvoplasty and years later is happy with it.

The same day I had my vaginoplasty, a friend of mine in the community also was getting a vulvoplasty, and she was scheduled for a vaginoplasty at first and changed her mind last second with the thought that she would come back later for the full vaginoplasty. I believe the surgeon ended up leaving the hospital before she was able to get the full vaginoplasty, and of course she had lost the option for using a scrotal graft in that future vaginoplasty. (I assume she would have to opt for a peritoneal pull-through, which was the other technique that surgeon specialized in.)

Are there other benefits to having a vagina over a vulva alone that I should be aware of when considering a potential future surgery? Thanks!

personally, I think I might have felt like a less "normal" woman for not having a canal, but not everyone is going to feel that way. I wish I had been born a cis woman, and having a full vagina helps me feel closer to that in unexpected ways. There is a kind of safety and security in feeling closer to "normal" in my genitals, and my dysphoria makes that hard enough.

That said, the pragmatic benefits of a vulvoplasty are pretty great - they have become quite popular; I believe my surgeon said that he performs more vulvoplasties than vaginoplasties now. I completely understand the motivations there, and I almost went that way myself.

aw, thank you!!

life has been challenging, but all moving in positive directions - I'm hoping to establish stability (hopefully I'm closer to that than it probably feels right now)

Hi there! It feels nice to be remembered. 😊

Did you surgeon make you stop HRT for a while before surgery?

luckily no! because I inject my estrogen, I didn't have to stop HRT. (They were only concerned with oral estrogen.)

I did start taking prog orally instead of rectally temporarily, since you can't insert anything into the rectum while recovering (I went back to rectal prog after a few weeks I think? Probably wise to just assume you can do that within a few months, and give wide latitude for healing.)

What technique did you get

Penile Inversion, using scrotal skin for the graft. I had to undergo months of laser & electrolysis on the scrotum.

where, with which doctor

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.

how much did it cost?

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).

How long did it take to heal after surgery until you could use it?

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.

Does it look good and function well?

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

Have you needed to dilate a lot/kept the full depth?

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).