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Surgery

A Reader Comments...

Hi Melanie.

I'm sorry to trouble you, but it's possible you could help me a lot, if it's not too much of an imposition. I've been reading all your stuff on the web and finding it really useful, particularly the account of your experiences and all the useful links your pages give.

I'm due to have surgery in the middle of September but I'm just not sure I'm ready.I need more time to do research, and the deadline is getting closer and closer. I'm terrified for example, that I may not have chosen the best surgeon. Over here (the UK) it seems to be in the nature of surgeons that they regard you as lucky to have found them and that you should damn well be grateful. As a result I have only the sketchiest knowledge of his techniques (a V-plasty) but I have no idea as to how it compares with other methods available around the world. I wonder if you know of a comprehensible but detailed description of all the various techniques which are available? If you can point me to such a source I would be really grateful.

I really want as good a result as I can and I can't seem to get the answers to my questions: Does a V-plasty give natural looking labia, positioning, clitoris etc? I just don't know. And how about the others? Does bilateral W-plasty give a better result? How about a Z-plasty? How about functionality? Will my vagina be deep enough? Will hair in the vagina be a problem?

Also, because I never had children it bothers me that I will be sterile. I've been trying to find an organization which will store sperm (so that if I ever have a relationship with a woman (I'm bi), we would still have the chance of children. The trouble is that there seems to be very little over here.

Do people discuss all this sort of stuff anywhere? I've only got a few weeks left and if I don't get some advice soon, it'll be too late.

I've lived the way I live now (job, friends house etc) for 17 years, so I'm well integrated.What stopped me was that the only man I ever really loved, the one who was going to stand by me through all the difficult times left me for my best friend. I haven't been able to go either back or forwards since then.

If there is anything you can do to help me I would be very, very grateful. I'm not part of a community and I just don't know where to turn.

Very best wishes,

Cathy

Melanie Replies...

Hi, Cathy. Wow, it seems like you have so little time to find so much information. First, before I offer what I can give you, I suggest you sign up with America Online. From there use keyword GENDER. This will take you to the Transgender Community Forum. The TCF is a group I founded in 1991, but retired from in 1994. It has now grown into the premiere electronic information and support sight for the gender community. You will be able to post your questions and concerns and have them read by hundreds of other folk such as yourself, some of whom will be able to answer all your questions. Also, the TCF has a web site now (though I don't have the URL) but you can easily find all the information you need on the web by doing a simple search for either transsexual, transgender, or sex change. I've done such a search and it turns up scores of web sites, jam packed with all kinds of information for the community.

What I can offer is this: I went to Dr. Biber. He (and Dr. Schrang)   are the two best-known "local" surgeons at the moment. They both use the same technique. It is a two-stage procedure. First is the actual internal surgery, then later a "labiaplasty" which improves the cosmetic look. I don't know much about the "v" plasty, "w" plasty, or "z" plasty, but it is my understanding that the original procedure is a "v" plasty (because of the shape of the incision). The labiaplasty I know for a fact is a "w" plasty. "z" plasties (I thought) were only used for other kinds of procedures.

The technique is as follows... An incision is made down the length of one side of the penis. The skin is peeled back so that it is only connected at the base. Most of the internal penile tissue is removed. A small portion of erectile tissue is left. A small slit is cut near the base of the penis. the erectile tissue is pulled through the slit so that it forms a clitoris. Then, the skin that was peeled but is still connected at the base is turned inside out and stitched up so that it forms a closed tube with what used to be the outside skin of the penis now on the inside of the tube. The tissue inside the abdomen is pulled away and the tube is inserted inside and temporarily anchored in place with a small wire that goes from the outside of the abdomen into the abdomen, around the pelvic bone, and back out again. This is removed by simply cutting the loop of wire and quickly pulling it through (painless but weird) about a week after surgery.

General anesthetic causes the bowels to stop as a side effect. It sometimes takes 3 to 4 days for them to begin again. Often an industrial strength enema is required. You will be on a catheter for urine for the first week. It may be hard to urinate after it is removed. Even after you are released, it may take another couple of weeks to even approach normal, non-painful urination. At first, the pain is significant, by the time you leave the hospital it should be less. After a week or so from being home, it is only a soreness, and continues to improve until things should be back to normal in a few weeks.

If done right, and if you have remained sexually active through self-stimulation, you brain will remember what orgasm feels like and you will likely be able to achieve that after surgery. If you have not been sexually active, do you darndest to get things going now, and keep on going as many times a day as you can right up to the morning before surgery. This will give you the best chance of maintaining pleasure after. It may be two to four weeks after surgery before you start to feel sexual sensation again. Keep trying.

The whole area of the pubic triangle (just about the hair line) will likely be numb forever. The nerves to the skin in that area must be severed during the process, and only a few cases have enough regeneration to recover skin touch sensitivity there. The nerves UNDER the skin pick up some of the slack after a while, so it doesn't feel quite as numb as right after surgery.

You will be VERY tired. For the first few days, you won't even have the energy to turn over. But once you are first out of bed after a week, you will gain your energy back quickly - over the next two to three days.

You ask about hair inside... oooh, grody! Yes, some people get that. If there is hair on the outside, you'll likely have hair on the inside. The only cure is electrolysis there ahead of time, and you know how painful THAT can be! New techniques for hair removal using red lasers might be better there.

Saving sperm for later? Sure, of course you can. That is independent of the surgery. Just contact a sperm bank and make arrangements to store some. If you can't find one directly, start contacting hospitals, and again, surf the web. A simple search should turn up a page on the subject which will likely lead you to a local provider of this service in your area.

Now, as a parting thought, what it comes down to is what will make you happy. I can't relate to not being sure. Although I had no idea if this was the best thing for me, I made a commitment to myself to see it through. I determined that the one thing I regret on my deathbed was never finding out what it felt like to be female. To me, the rest of my life didn't matter. It was just that moment of waking up from surgery and knowing what it felt like. That one moment was worth the rest of my life. My only fear was that I wouldn't wake up. Sure, that kind of tragedy hardly EVER happens, but you can't help worrying. But to not do it? How could I not and find any meaning in life from then on?

Now that it is all over, I honestly can't say whether it was best for me or not. I can clearly see the pros and cons from here much better than on the other side. Nowadays I sometimes wonder what it would have been like bringing up my kids as Dad instead of "Mel". I wonder what it will be like NOT to be the one who takes my daughter down the aisle when she is married. But then again, I could always have the breast implants removed, cut my hair and go back to the old lifestyle. After all, how many people look in your pants on the average day?

The real key to the whole thing is that I don't miss the old equipment. What is between your legs and the lifestyle you choose to lead are two completely different things. For me, the physical stuff was always unimportant. It hardly makes a difference to me if I have male or female equipment, other than to have found out what the female equipment feels like. The rest is all about being myself, and from your letter, you've already been doing that for 17 years!

So, maybe for you the equipment is important. It is perfectly normal for ANYONE to want to live in a feminine role, yet be male underneath it. Try to separate the two aspects in your mind. Imagine how you would feel about the surgery if you were required to live as a man even after becoming physically female. I met someone once who chose to do just that. I'd even considered it myself.

Now, imagine how you would feel if you lived in the feminine role for the rest of your life, but being physically male underneath it.

Then try the other two combinations on for size: Being in a masculine role and physically male, and being in a feminine role and physically female.

You will probably find each one feels quite different, and at least one is very unpleasant.

Before I had surgery, being masculine and male was the worst! (Mainly because I hadn't experienced any of the others) Best was feminine and female. Masculine and female was easily number three, and feminine and male was the worst. So, for the two years before surgery, I lived the worst of the the four (for me) as the price I had to pay to get a shot at my choice of the best and second best. And, I was driven forward by the hatred of the worst (masculine/male).

Now that surgery is five years behind me, masculine/male is a LOT more attractive than it used to be. I kinda miss it. But not enough to give up what I've got - I'd just like to visit there again from time to time. These days, the worst is still feminine/male. The other three are about equal, barring any practical considerations.

In the end, what did I get out of it? Just want I wanted - to know what it felt like. Other than that, I don't think it has had many benefits. Mostly, it has led to frustrations, disappointments, and difficulties. But is was still worth it.

I have a friend who had agonizing pain in his legs. For years, the doctors tried everything, and it only got worse. The only solution was living with it or amputation of both legs. He had the surgery. Now he has all kinds of problems - money, mobility, other medical difficulties, and on and on. Sure, the price is high, and the problems are a constant source of misery. But at least he doesn't have the pain in his legs anymore. In fact, some years after the amputation, he went through the gender program, obtained sex reassignment surgery, and is now living as Denise. That pain is gone too.

That, I think, is the real thing that drives any of us to this. We start out by wanting it because we think it will make us happy. But we end up actually doing it to stop the pain. Then, once it is over, we find out it didn't make us any happier, but at least the pain is gone. The question then arises: "What now?" I'm still trying to answer THAT one.!

Hope this helps, best of luck, look before you leap, and don't go any faster than your heart pulls you.

Melanie

  

 

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