SRS Introduction
Wiki Index
Surgeons
Surgeons by country, including photos.
Types of Surgery
This is MTF/AMABF surgery only. The index page contains a few links to FTM/AFAB surgery.
SRS
The main techniques, in approximate order of popularity
- Penile-inversion and its variations. The most common technique and is practiced by most surgeons.
- Non-penile inversion and its variations practiced in Thailand. Said by some to be superior to penile inversion.
- Colonvaginoplasty. Not much known about this compared to the other techniques and conflicting reports about it, ranging from significant problems to superior results.
- Peritoneal. Fairly new for trans surgery, but becomming quite popular.
- Penectomy. Removal of the penis.
- Nullification. Removing the genitals entirely.
- Penile Preservation Vaginoplasty. Surgery to get a vaginal while keeping the penis. This surgery is relativly recent.
There's lot of different names/acronyms for this, and I'm just using SRS out of long term habit. Also GRS, GCS, GAS.
reddit
Susans
YouTube
- Post-operative care and neovagina care by HIV-NAT Thailand - "Lectured by Worapon Ratanalert, MD, Department of Surgery, Faculty of Medicine, Chulalongkorn University and Thai Red Cross AIDS Research Centre Bangkok, Thailand in 22nd Bangkok International Symposium on HIV Medicine 2020 on January 15-17, 2020 at BITEC, Bangkok, Thailand". At 6:34 there's a video comparison of internals of a cis-vagina, skin graft, colonic flap, and peritoneal flap. See also reddit post Jan 2020 lecture by Thai Surgeon showing internals of 4 types of SRS by HiddenStill in 2020
Long Term Results
reddit
YouTube
Keeping Testicles After Surgery
As in taking them home in jar, not still attached to your body (that's elsewhere here).
reddit
YouTube
Other
Papers
- Testicular Seminoma in a Transgender Woman: A Case Report by Elizabeth J Kvach, Jennifer S Hyer, John C Carey, Marci Bowers - "As per the findings in our patient, we recommend that all transgender women who choose to undergo bilateral orchiectomy (alone or as part of a vaginoplasty procedure) for gender transition should have testes routinely sent for pathology evaluation to rule out the presence of undetected testicular cancer"
Surgical Videos
reddit
YouTube
- What to Expect: Robotic Peritoneal Flap Vaginoplasty at NYU Langone by NYU Langone Health in 2024 - Animation of PPT vaginoplasty procedure done by Dr. Rachel Bluebond-Langner and Dr. Lee C. Zhao at NYU
- Male To Female | GRS Surgery Video | JaneMED SURGICAL INDIA by Janemed Surgical in 2023
- VAGINOPLASTY - Vaginoplastie by andrologie lyon sud in 2021 - surgery by Morel-Journel and Neuville Carnicelli
- Peritoneal pull through technique of Laparoscopic Vaginoplasty in absent uterus & Rt pelvic kidney by Dr.Pragnesh & Dr.Parulben in 2020 - this is on a cis women
- Revision of Transgender Surgery by Prof. Dr. Serdar Nasır in 2020
- Gender change Surgery male to female without Vaginoplasty. by Derma Touch India in 2020
- Bilateral orchiectomy; surgical removal of both testicles by Institute for Cancer Genetics and Informatics in 2020
- Post-operative care and neovagina care by HIV-NAT Thailand - Not a video of the surgery itself, but a lecture by a Thai surgeon with lots of surgical photos, "Lectured by Worapon Ratanalert, MD, Department of Surgery, Faculty of Medicine, Chulalongkorn University and Thai Red Cross AIDS Research Centre Bangkok, Thailand in 22nd Bangkok International Symposium on HIV Medicine 2020 on January 15-17, 2020 at BITEC, Bangkok, Thailand"
- LAPAROSCOPIC NEO-VAGINOPLASTY by Dr.Sandesh Kade in 2019 - "NEW TECNIQUE HARVESTING PERITONEUM BIGHIND THE MIDLINE BAND" - this is an MRKH patient
- Sex Reassignment Surgery and Post-Op Care - Poonpissamai Suwajo by Virology Education in 2019. This is a presentation at "The International Workshop on HIV & Transgender People" in Mexico City, 20 July 2019. This video includes a piece on peritoneal vaginoplasty.
- Male to female confirmation surgery - Sex change Operation by Dott. Patrizio Vicini Andrologo Urologo Roma in 2019
- reassignment surgery tilapia skin by Leonardo Bezerra in 2019
- Total Penectomy - Wide local Excision - bilateral inguinal lymph node dissection by Harris Qureshi in 2019 - this is for cancer, so not trans related
- Lipoinjection for labiaplasty in a transgender female by Prof. Palma in 2019
- Management of post vaginoplasty prolapse in transgender patientPOP by Prof. Palma in 2019
- male to female,erkekten kadına cinsiyet değistirme ameliyatı by abdulmuttalip şimşek in 2018 (in Turkish)
- GURSL Vaginoplasty by GURSL in 2018. Morel-Journel in France
- PriyaMED presents... Sugar's PPV GRS SRS GCS transgender by PriyaMED.com in 2018, in India - This is a brief introduction video a new form of gender reassignment surgery called PPV (peritoneum pull-through vaginoplasty)
- Robot assisted penile inversion vaginoplasty by Urology Times in 2017 - "Vaginoplasty uses penile and scrotal skin for male-to-female transgender patients who desire genital reconstruction. However, short vaginal length, vaginal stenosis, or complications in the perineal dissection are limitations of current open techniques in vaginoplasty. Lee Zhao, MD, MS, "
- Simple orchiectomy for transgender patients by Urology Times in 2017. Geolani Dy, MD, Wayne Brisbane, MD, and Thomas Walsh, MD, discuss surgical technique for performing a simple orchiectomy for transgender patients.
- Male to female gender reassignment surgery. This animation of the penile inversion technique originally from the University of Tuebingen, as can be seen from this paper Surgical Reconstruction for Male-to-Female Sex Reassignment in 2012. There's many copies of the video on YouTube.
- post-op unpacking srs/grs// operation was Jan 26/2013 by Gabreiella Janice Wissell in 2013
- Surgical Reconstruction for Male-to-Female Sex Reassignment by surgeryinmotion in 2013
- GRS by princessnovapoppy in 2010 - this shows Marci Bowers performing surgery in 2007, in Trinidad.
- Genitoplastia Femenizante Transexual Femenino by Guillermo MacMillan in Chile.
Susans
Penile Inversion
https://www.susans.org/wiki/Penile_inversion
Returning to Work
reddit
YouTube
Non-Penile Inversion
Suporn, Chettawut, probably others in Thailand.
Colonvaginoplasty
Sometimes used after an initial SRS has failed or depth is not sufficient. Has more restricted BMI requirements than other SRS techniques (eg Chettawut less than BMI 28 vs 35, age less than 45, weight less 80kg).
Olmec in India have a variation on this technique.
https://www.susans.org/wiki/Colovaginoplasty
reddit
Susans
YouTube
realself
- Surprisingly Wonderful Experience by bellaspet in 2019 - this is a revision with colon vaginoplasty by Dr Kamol Pansritum in Thailand after SRS in the USA "I had my SRS in early summer 2014 with a doctor in Pennsylvania"
- SRS Colon technique by sonata33 in 2018 - you can see the scar in these photos
Chapter 18, "Surgery in Complications: Colon Vaginoplasty" by Paolo Verze, Davide Arcaniolo, Marco Franco, Roberto La Rocca, and Vincenzo Mirone
Peritoneal Vaginoplasty
Surgeons who (probably) do this procedure, PPT, or a variation include
- Australia
- Europe
- Mexico
- Carlos Daniel Guerra Castañon
- Thailand
- Kamol Pansritum
- Poonpissamai Suwajo
- Worapon Ratanalert - presented at a conference showing the results of Peritoneal Vaginoplasty in 2020, but its not clear who did it
- Teerapong Poonyakariyagorn
- USA
- Marci Bowers
- Jess Ting
- Bella Avanessian
- Rachel Bluebond-Langner
- Heidi Wittenberg
- John Patrick Selph
- Gabriel Del Corra
- Sidhbh Gallagher
- Adam Bonnington
- Min Jun
- Shubham Gupta
- Joshua David Roth
- John T Stranix
- India
This started getting a lot of attention after Jess Ting did an article in Wired Magazine in 2017
reddit
Susans
YouTube
Research
Other
Peritoneal Pull-Through Vaginoplasty
reddit
YouTube
Other
Buccal Graft
reddit
Tunica Vaginalis Graft
reddit
YouTube
Other
- https://supornclinic.com/suporns-non-penile-inversion-srs-technique - "he Suporn Technique also harvests tunica vaginalis from the testes. Tunica vaginalis derived from the abdominal peritoneum is a serous membrane that covers the testes. Because the testes per se are not used in the creation of the female genitalia, the tunica vaginalis offers an easily harvested and useful addition – where necessary – to line the vaginal cavity. This – along with urethra mucosa – is dramatically less invasive than a peritoneal pull-through technique."
Orchiectomy
https://en.wikipedia.org/wiki/Orchiectomy
See the SRS wiki pages for surgeons.
Related reddit subs
- r/M2E - "If you are considering transitioning from male to eunuch, this forum is here to support you from A to Z."
- r/castration - "Some of the entires are lightly fictionalized, and this sub is inclusive of kink, fetish, fantasy AND fact."
- r/Castrations - "A place to talk about the fantasy or seek advice"
- r/CastratedShemales - porn sub
- r/eunuchs
- r/neutered - "This subreddit is a safe space for trans people, and anyone else who may seek to be, or find interest in, being neutered."
- r/emptysacks - "A place for eunuchs, trans people, and the like who have been castrated."
- r/emptysackshemales
- r/orchiectomy - "Support for those who have had, or wish to have an orchiectomy (medically necessarily or electively). Otherwise known as removal of one (or both) testicles. Removal of both testicles is also called castration. People of all gender walks are welcome here."
- r/stirringcastration - seems to be diy castration
reddit
- *Graphic be advised* Orchiectomy parts removed. by MissBoofsAlot in 2023
- I learned the hard way that you can get testicular torsion post-orchiectomy by Fisguard in 2023 - "13 years ago I had a bilateral orchiectomy with Dr. Tuan Njuyen in Lake Oswego, Oregon. The procedure went normally and healed well. Everything else is intact, I never ended up having GCS. I was grateful to never have to feel testicular pain ever again, but I was wrong! A couple of weeks ago I did yoga for the first time in years and ended up thinking I pulled a muscle in my groin area... I was admitted to the hospital the following day, skipping me ahead of a bunch of people because of the whimpering and clawing at my seat in the lobby... The searing agony came back in just a time for them to put me on heavy medication and kept me overnight. Once they had the MRI they found that one of my spermatic cords had gotten tangled in the inguinal canal and seemingly pinched with an artery. It then got swollen and stuck there... They said they'd perform surgery if it comes back. If I did have surgery, the surgeon would have made an incision in the pelvic region a couple inches above the swelling and snipped the spermatic cord higher up so it could never tangle again. So... if you're thinking about getting an orchi it couldn't hurt to ask your surgeon to snip a little higher, right? lol"
- 36 Hours Post Orchi - 36 Years Old - 5"7 120 lbs by staykinky in 2023, see also YouTube video Transgender Orchiectomy Consultation - Before & After Trans Journey [LetsGetSRS 38] by Transcaping in 2023
- Six Months Post Orchiectomy, Some Anecdotal Experiences by juniperliketheberry in 2022
- The dissection report of my balls, Or what HRT really does to testis, Feel free to ask anything about my Orchi! by Katlynashe in 2022
- Orchiectomy 8 years ago - My vaginoplasty is scheduled for October with Dr. Whitehead! by floridaeunuch in 2022
- Spermatic cord pain 2 years post orchiectomy. by PrincessNakeyDance in 2022
- reply to Internal swelling after orchi? by D0esANyoneREadTHese - "If they used a long halflife dissolving suture like heavy Vicryl it might be that it's finally dissolving enough to come loose... if you have the nylon ligature clips that might just be something you end up having to live with unless they migrated, everyone I know who's had clips instead of suture ligations, either for orchiectomy or for scalpel vasectomy, complains about occasional bouts of moderate pain/swelling in the inguinal area as the clips occasionally move around. I actually specifically ASKED my surgeon which kind of ligations he'd use before my orchi cause I didn't want to get stuck with clips, you'd have to call them up and ask what they used."
- 2 days post-op penile inversion vaginoplasty + tunica vaginalis graft (peritoneum) with Dr. Jess Ting - AMA! by SpicyHotShura in 2021 - "Dr. Ting uses the tunica vaginalis, which is analogous to the peritoneum. Its a newer technique that does not require robots, like the peritoneal pull through method that has been around much longer... That's the tunica vaginalis! Which is usually discarded in all other bottom surgeries, including orchiectomy, unless you have it done radically (through the inguinal ring rather than the scrotum) like I did when I had my orchi."
- Orchiectomy question. by internalgirl in 2021 - "I had a bilateral orchi three weeks ago and it feels like the end of the cord has healed and fused to the inside of the scrotum and is pulling it upward toward where I used to tuck my testicles."
- Orchiectomy experience, before and after bulge profile by UniqueMeat in 2021
- Wear underwear while sleeping after orchiectomy or be naked? by Robinothoodie in 2021
- Simple vs Radical Orchiectomy by KennaCinae in 2021
- Sex life after orchiectomy ? by raiventhegirl in 2020
- Questions for anyone who has had an orchiectomy by Mundane-Yesterday-18 in 2020
- Benefits of an orchiectomy by Nikki22_ in 2020
- Are your spermatic cords 'sticking out' after simple orchi? /Clarifying anatomy, etc by portlandiandro in 2020
- I had a bilateral orchiectomy today with Dr. McClung. I was only at the hospital for 3 hours and the pain hasn't been very bad. Most pain was during the first few hours post op and in my lower abdomen. If anyone has questions feel free to ask. by carar33 in 2020
- Orchiectomy before vaginoplasty? by needSRS in 2020
- Orchiectomy before SRS by MirriLiu in 2020
- [Orchiectomy Complications] Spermatic Cord seems to be fused to my incision, has anyone else experienced this before? by PrincessNakeyDance in 2020
- Pinching 2 Weeks After Orchi by TheGeometrist in 2020
- Those who have had an orchiectomy without general anesthesia, how much did it cost? And how did it go? by PrincessNakeyDance in 2020
- Received devastating new from Suporn (due to my previous orchi) by _Caracal_ in 2019
- Mexico? by ballboy83 in 2019
- Horrific scarring after orchiectomy. 2 months post op is this permanent? I feel the stitches were left in too long that's y it looks like this. by elektrikkiss in 2019
- Orchiectomy questions by AleksLife in 2019
- DEVASTATED by loss of libido after orchiectomy. by Nlwile3f in 2019
- I had a orchietomy with scrotectomy on 7/31. I wanted this as my final surgery. I don’t want to the “full” surgery, I never had much dysphoria about my penis. I knew I wanted my testes removed. I hope it is good enough angle. Ask me any thing. by Darbyprof in 2019, photo here
- Day 5 after my scrotectony. by Darbyprof in 2019
- Orchiectomy 7 months post-op recovery album by wantingmisa in 2019, photos here
- Orchiectomy Today! AMA by EdmundPaine in 2019
- Post-Orchie Changes by TenFootTiger in 2019
- I gave up my balls to become a girl by LewdRabbit in 2018
- Orchi long-term post-op photos? by lunabeieli in 2018
- had an orchiectomy last Thursday w/Dr. Smith @ UCSF. AMA. by ninabooboo in 2018
- I had an elective surgical castration, AMA by HaileyHeartless in 2018
- Just had an orchiectomy yesterday AMA, photos here, by transgenderbeepboop in 2018
- I got my name legally changed last week, Orchiectomy yesterday! AMA! by FionaV14 around 2017
- I had my simple bilateral orchiectomy this morning. AMA! by meatbeagle around 2015, photos here and here
Susans
YouTube
Discord
Other
lesswrong.com
Papers
Scrotectomy
Removal of the entire scrotum, including testicles. Best not do this if you plan on having SRS in the future as the tissue it useful.
reddit
Orchiectomy with Labiaplasty
Not really sure what to call this.
reddit
Zero/Low/Minimal Depth, Cosmetic SRS
reddit
Susans
YouTube
TransPulse
Journal of Sexual Medicine
Adding Depth
reddit
- reply to 6 weeks postop srs AMA | minimal depth | combined method | Dr. Morath | Munich , Germany by galjer10n in 2021 - "I agree - zero depth for me was a fairly quick recovery! When having my canal added later that alone seemed to take longer - even though all the exterior and clitoris was already done and in tact. ... Just because I could have mine added after the fact, it was super difficult to get! I had issue with insurance and other things....it very well could have cost me out of pocket had my surgeon not been so involved. He was also a bit hesitant on doing it, and now I have a permanent scar across my lowe abdomen, so bathing suits are gonna be a bit difficult to find the right one and such. Also I had to go through two medical leaves (12 weeks total) but I was fortunate to ha e a good position with a caring company - so that wasn't too much of an issue. ...Just be 100% sure you want to go zero depth! Its not easy and its not always possible (per my surgeon) to have it added later. "
- Almost 5 months postop - skin grafted canal addition from original zero depth vaginoplasty 10 months prior by galjer10n in 2021
- Zero depth after thoughts and whats next by galjer10n in 2021 - "I had zero depth GCS on 8/4/2020. I went this route mainly due to major dysphoria and I was only interested in aesthetics. However, this surgery did something major for me - my dysphoria is all but non existent anymore! I'm sure coming out and getting name changed and all played a big part there. What I notice now is I love who I am, and I feel very good about myself- something I have NEVER felt. This has also made me realize something else -while zero depth wasn't a regrettable choice, I now feel there is more to life, things I was never interested in prior as they never gave me any thoughts, now, probably because I feel so damn good, I see as options! I wont go into details there. ...While I have no regret going this route as I have the aesthetics I wanted, I do wish I'd have felt about myself how I feel now back then as I would have made another decision."
Non-binary Surgery
This refers to the surgery itself, rather than a person who's non-binary having a traditional surgery. For that, look under Real Life Experience.
While this section is for AMAB, it's also possible for AFAB to have simular results. See reddit users nonbinaryphallo and bonusdickboi.
Related reddit subs
- r/NonBinary - "This is a subreddit for people of every stripe who feel that they don't fit into our culture's gender-binary."
- r/salmacian - "A subreddit for people who desire a mixed genital set (for example, a penis and a vagina)."
- r/salmacianporn
- r/AMABwGD - "This is a support group for all those AMAB folks out there who suffer from bottom dysphoria, but who also don't want to seek a binary gender transition."
Non-binary wiki
Facebook
- Non-Binary Surgery - "This group is for discussing genital surgery that falls outside the sex binary. You don't have to be non-binary to join, in fact many binary transgender people desire non-binary surgical options."
Doctors who offer penile preserving SRS include
- Heidi Wittenberg in Californina, USA
- Thomas Satterwhite in California, USA
- Dev N Gurjalam, USA
- The Crane Center in Texas, USA
- Maybe Ivan Aguilar in Guadalajara, Mexico (see here)
- Keelee MacPhee in USA, according to SRS Requirement Dilemma by Brittnee65 in 2021
- Geolani Widjaja Dy in Oregon, USA (see this post in 2021)
- Daniel Dugi in Oregon, USA (see this post in 2021)
- Adam Bonnington, USA
- Marin Health (Marin and Napa counties, CA, USA) - https://www.mymarinhealth.org/programs-services/surgery-procedures/surgical-specialties/gender-affirmation-surgery/nonbinary-gender-affirming-surgery
- Praful Ramineni in USA
The following is only a sample of the posts on this surgery for each surgeon. Check the surgeons entries for more.
reddit - Androgynoplasty
reddit - Optional_Joystick
reddit
Yozakura Kurage (Penile preserving vaginoplasty)
tumblr
Susans
Non-Binary Porn (may be AFAB)
https://twitter.com/410goneallopen and https://twitter.com/410goneallin with Dr Satterwhite, quoting a bit "So taking tally of everything, I have a penis, a vagina, and 'inner' labia."
There's one non-binary surgery by James Bellringer (UK) - see the post on transbucket
Heidi Wittenberg in the USA offers non-binary surgery - We understand that some patients will not be looking specifically for transfeminine or transmasculine surgeries. For these patients, we offer individualized surgical options. Examples include penile preservation vaginoplasty and vaginal preservation phalloplasty.
Pornhub. There's a lot of fairly standard trans porn on Pornhub, however I'm not sure these two links can be classified as transgender related. Some of the others I saw are even further afield and I've not included them here.
YouTube
Vice
Other
Nullification & Penectomy
I've not seen what's in here, but judging by the rest of the site I expect its extremly graphic.
Surgeons who (probably) do this procedure include
- Peter Davis (USA) - "For his gender non-conforming patients, Dr. Davis also performs gender nullification, also known as male to eunuch or “smoothie” procedures. The procedure includes a complete penectomy, orchiectomy, a reduction of the scrotal sac, and shortening of the urethra. The goal is to leave the area as a smooth unbroken transition from the abdomen to the groin. Although, an inconspicuous midline scar and shortened urethra will still be present. Dr. Davis does also offer the option of retaining the highly sedate distal penile tissue (which normally makes up the clitoris in a typical gender reassignment procedure), which he “buries” in the deep tissue of the lower mons above the urethra, akin to a “hidden” clitoris." https://www.davisplasticsurgery.com/services/gender-nullification
- Wittenberg and Bonnington (San Francisco, USA) - https://www.mozaiccare.net/nullification
- Crane, DeLeon, Jun, Lee, Mundinger, Safir, and Santucci (San Francisco & Austin, USA) - https://cranects.com/non-binary-surgery
- Chris McClung (Columbus, OH, USA) - https://www.cmreconstructiveurology.com/specialties/transgender-gender-affirmation-care
- Satterwhite, Gurjala, and Rodriguez (San Francisco, USA) - https://www.alignsurgical.com/non-binary/nullification
- Marin Health (Marin and Napa counties, CA, USA) - https://www.mymarinhealth.org/programs-services/surgery-procedures/surgical-specialties/gender-affirmation-surgery/nonbinary-gender-affirming-surgery
- Praful Ramineni (Washington D.C., USA)
- Marc Arnkoff (USA)
reddit
r/nullo - "A place to talk about and share images of nullos and nullification, whether fantasy or in practice."
r/anatomicalpenectomy - "A de-fetishized, anatomical look at severed male genitals."
Nullification pictures from my surgery by bethkamolski in 2024
Reconstructive SRS after total penectomy by Deep-Ad9635 in 2022
Nullo by split6 in 2024
- Going on 16 weeks by split6 in 2022
- 6 weeks after my Nullification by split6 in 2022
- Me after Penectomy and Castration by split6 in 2022
- 4 weeks post Nullification surgery by split6 in 2022
- reply to Recommendations for Vaginoplasty Surgeons in the US? by split6 in 2022 - "Though I wanted to be Nullified, I was coded under vaginoplasty with the hospital and insurance. My surgeon said it's the same surgery except for the things I didn't want like the labia and pocket for penetration. He even created a "clit" as he calls it. I tell people it's a button, because people associate a clit with a vagina. I've had a a very good experience with him, he's very direct and easy to work with, and answers questions completely. He responded to email very quickly, even on his surgery days. The people I know who have had the vaginoplasty are taking testosterone, and live as a male socially, as I continue to do, now with no genitals. The fact that this surgeon will help people transition MtF, those who want a "mangina" (their own term, not mine) and Male to Nullo shows he's very flexible. I highly recommend him. My own therapist retired during the pandemic, and my letters were too old for the insurance to accept, but he even recommended a therapist that works with him and it made things so easy."
- My orchiectomy and scrotum removal. I want to be gender nullified. Urologist consultation in February scheduled by split6 in 2021 - "I had Nullification surgery 4.5 weeks ago by Dr Praful Ramenini with District Plastic surgery."
- I'm ready to take the next step. Time to become a Nullo by split6 in 2021
Urethrostomy by CTEunuchSlave in 2021
Mexico? by ballboy83 in 2019
I'm a trans woman who had nullification surgery 5 days ago in Guadalajara. AMA. by JanaSophiaSherine in 2019
YouTube
Vice
A cis-male had penectoctomy due to cancer
AMAB-to-neutrois GRS by fluffy in 2018
See Dr Arnkoff (USA).
Adam Curlykale
Pornhub
Papers
Other
Virtual Penectomy
This involves injection of local anesthetic into the nerves of the penis to remove sensation. It's supposed to be temporary, but can apparently result in a permanent loss of sensation. If you were to have SRS later on I'd assume you would continue to have no sensation. It seems like a really bad idea.
Genital Surgery without Social Transition
There's more on this in other parts of this page, I've not yet moved it here.
Surgeons
- Praful Ramineni, Washington D.C., USA
- Toby Meltzer, Arizona, USA
reddit
- My Vaginoplasty (one-year post-op by Dr. Meltzer) by segremores in 2024
- reply to Recommendations for Vaginoplasty Surgeons in the US? by split6 in 2022 - "The people I know who have had the vaginoplasty are taking testosterone, and live as a male socially, as I continue to do, now with no genitals. The fact that this surgeon will help people transition MtF, those who want a "mangina" (their own term, not mine) and Male to Nullo shows he's very flexible. I highly recommend him. My own therapist retired during the pandemic, and my letters were too old for the insurance to accept, but he even recommended a therapist that works with him and it made things so easy."
Transplant
http://wombtransplantuk.org/
reddit
John Hopkins Medicine
- First-Ever Penis and Scrotum Transplant Makes History at Johns Hopkins in 2018 - "Two weeks after the penis surgery, the patient received bone marrow infusions from the donor. The procedure, pioneered by the same Johns Hopkins team, modulates the immune response that causes patients to reject transplanted organs, so the patient needs only one low-dose maintenance immunosuppression medication per day."*
reuters
Healio Endocrine Today
Advocate
Papers
- 2021 - The Montreal Criteria and uterine transplants in transgender women by Jacques Balayla, Pauline Pounds, Ariane Lasry, Alexander Volodarsky-Perel, Yaron Gil
- 2019 - Human uterine transplantation: a review of outcomes from the first 45 cases by BP Jones, S Saso, T Bracewell-Milnes, M-Y Thum, J Nicopoullos, C Diaz-Garcia, P Friend, S Ghaem-Maghami, G Testa, L Johannesson, I Quiroga, J Yazbek, JR Smith - "The number of cases being performed is increasing exponentially, with detailed outcomes from 45 cases, including nine live births, now available. In light of the data presented herein, including detailed surgical, immunosuppressive and obstetric outcomes, the feasibility of uterine transplantation is now difficult to refute. However, it is associated with significant risk with more than one-quarter of grafts removed because of complications, and one in ten donors suffering complications requiring surgical repair."
- 2018 - Uterine transplantation in transgender women: medical, legal and ethical considerations by BP Jones, NJ Williams, S Saso, M-Y Thum, I Quiroga, J Yazbek, S Wilkinson, S Ghaem-Maghami, P Thomas, JR Smith
- 2018 - Uterine transplantation in transgender women by BP Jones, NJ Williams, S Saso, M‐Y Thum, I Quiroga, J Yazbek, S Wilkinson, S Ghaem‐Maghami, P Thomas, JR Smith
- 2015 - Livebirth after uterus transplantation by Mats Brännström, Liza Johannesson, Hans Bokström, Niclas Kvarnström, Johan Mölne, Pernilla Dahm-Kähler, Anders Enskog, Milan Milenkovic, Jana Ekberg, Cesar Diaz-Garcia, Markus Gäbel, Ash Hanafy, Henrik Hagberg, Michael Olausson, Lars Nilsson - "We describe the first livebirth after uterus transplantation. This report is a proof-of-concept for uterus transplantation as a treatment for uterine factor infertility. Furthermore, the results show the feasibility of live uterus donation, even from a postmenopausal donor."
Other Techniques
Keeping Testicles
Keeping them attached rather than taking them home. That's elsewhere on this page.
A post on Susans says that keeping testicles after SRS (by moving to the abdomen) has been done in the past, that it was common in the 1950's, started by Elmer Belt, and that a Tess Cowen had done it.
reddit
- Had PIV without Orchi 2wks post-op AMA by SimpleArtist3795 in 2023 - "Hi! Two weeks ago I (33nb/amab [he/they]) had a Penile Inversion Vaginoplasty without Orchiectomy (testes retained). My surgeon was Dr. Dany Hanna out of Texas. The procedure was pretty standard overall. More scrotal tissue had to be left attached to house my testes externally in the outer labia and he anchored them in place. I have a clit and possibly inner labia. I'm still very swollen so time will tell with aesthetics. Visually the results are consistent with Dr Hanna's work. I have almost 3" of depth, that's as much as I could get with all things factored in. I'm looking forward to finishing healing. Dr Hanna and team were awesome and he was VERY realistic with me every step of the way. He definitely delivered despite my having a rare request. He does recommend I get my testes examined every couple of year to ensure things are still good down there. I am not on hormones and do not require them."
- Got a response back from a Mexican surgeon ( not telling you who) about my desire to have both a vagina and a penis. It's a positive response. Read my detailed answer if you want. by Kekmantlin in 2019
YouTube
- Julia grs surgery by lapuagurl78 in 2013 - "They allowed me to keep my testicles so I gave them to my ex-wife", surgeon is Marci Bowers
Susans
webarchive
- Vaginoplasty Results: Dr. Toby Meltzer - "This patient wanted to keep her testicles as an aid to preserving her sexual responsiveness, and Dr. Meltzer was persuaded to comply with her request. He positioned the testes between the skin and the muscles of the abdominal wall to permit examination by the patient and her physicians. In this view, "n" indicates the patient's navel, and "(t)" the testes, with the patient's fingers on either side. For more information about this remarkable technique -- and the remarkable woman who requested it -- I recommend reading J. J. Allen's "Meet Tess -- A New Dance of Scalpel and Soul" in Transgender Tapestry, Summer 1998, pp. 56-57." - links to
- Meet Tess: A New Dance of Scalpel and Soul by By J. J. Allen, first published in Transgender Tapestry #83, Summer 1998. - "After much consideration and some consultation, Tess underwent a unique medical procedure. While penile inversion was performed, the testes were not removed. Instead, the surgeon relocated them superior and anterior to the inguinal canals, approximating the location of the ovaries in a genetic female. While men with undescended testicles face an increased risk of testicular cancer, no studies have been done on the risks posed by the surgical re-ascension of the testicles. In Dr. Cowell's case, the testes lie just below the dermis, so that they can be palpated to a certain degree for examination. A full examination, though, requires the use of a modern radioimaging device, a procedure which Tess will undergo at regular intervals for the rest of her life." - note the trans patient is Dr Tess Cowell.
Undescended testicles have a higher risk of cancer than normal, and are often removed. This suggests that not removing testcles during SRS would increase the risk of cancer, but I'm not aware of any studies (and there probably aren't any due to the small numbers doing this)
Other
Papers
Tilapia Skin
See Dr. Alvaro Rodriguez on the Wiki page for SRS in South America
reddit
New York Post
YouTube
Mirror
Other
Papers in the Journal of Minimally Invasive Gynecology
- 2020 - Male-to-Female Gender-Affirming Surgery Using Nile Tilapia Fish Skin as a Biocompatible Graft by Álvaro Hernán Rodríguez, Edmar Maciel Lima Júnior, Manoel Odorico de Moraes Filho, Bruno Almeida Costa, Zenilda Vieira Bruno, Marcelo Praxedes Monteiro Filho, Maria Elisabete Amaral de Moraes, Felipe Augusto Rocha Rodrigues, Carlos Roberto Koscky Paier, Leonardo Robson Pinheiro Sobreira Bezerra
- 2019 - Tilapia Skin for Neovaginoplasty after Sex Reassignment Surgery by Helena Slongo, Cassio L.Z. Riccetto, Marcos M. Junior, Luiz G.O. Brito, Leonardo R.P.S. Bezerra
- 2019 - Tilapia fish skin as a new biologic graft for neovaginoplasty in Mayer-Rokitansky-Kuster-Hauser syndrome: a video case report by Maria Tereza Pinto Medeiros Dias, Edmar Maciel Lima Júnior, Ana Paula Negreiros Nunes Alves, Andreisa Paiva Monteiro Bilhar, Livia Cunha Rios, Bruno Almeida Costa, Eduarda Syhara Rocha Matos, Ana Cecília Venancio, Zenilda Vieira Bruno, Manoel Odorico de Moraes Filho, Leonardo Robson Pinheiro Sobreira Bezerra
Preventing Errections
reddit
- BCCL to stop erections part three: pain management and healing so far by j3553k in 2024 - "Currently, my penis does still extend a bit during an "erection", but it doesn't go up at all, just extends. When I get an "erection", I'd say it's about half the length of an erection pre-op. I imagine that as the severed corpora cavernosa tissues atrophy, the amount of extension will go down. However, since there's no blood in the corpora cavernosa, it's very squishy. It's quite a different feeling than erections pre-op. You can kinda see what I mean by getting hard and squishing your glans into your corpora cavernosa (or maybe by pinching below your glans and squishing it into your fingers). One thing to note - I was a grower pre-op (rather than a shower), so that might have an impact on "erections" post-op due to the difference in tissues. I didn't have extreme dysphoria over erections (I did have some), but I definitely have euphoria now that they're gone! In my experience, dysphoria/euphoria are very personal things, so I couldn't say for sure how you would react."
- Not attracted to what I am getting "down there" by aidenhartxxx in 2021 - "I recently had an orchiectomy and what's called a cavernosal artery dilation/destruction (basically, I can't get hard anymore)."
Papers
Perineal Urethrostomy/Urethral Reroute
reddit
BME
Other
Detroit Metro Times
- How to re-route a pee hole by Dan Savage in 2014 - "“Most urologists aren’t qualified to do this, let alone piercers — although I know that there are aggressive ‘body modifiers’ out there. I wind up cleaning up their messes,” says Dr. Keith D. Newman, a urologist and a fellow of the American College of Surgeons. “So my main piece of advice for SITTERS is to have a urologist do this, preferably someone who has experience with this surgery... “It’s one of the numerous steps involved in total gender-reassignment surgery, should the full male-to-female conversion ever be opted for,” says Dr. Newman. “As such, doing this one thing probably won’t preclude further anatomical reassignment in the future. On the other hand, SITTERS has to consider that there are potential complications and consequences that will arise from this altered anatomy.””" - this article is on many other sites
Papers
Revision
Revisions to fix problems with the original surgery, or sometimes just cosmetic improvements.
reddit
Susans
Hanna Simpson - Surgery by Kathy Rumer, Revision by Marci Bowers
realself
- Surprisingly Wonderful Experience by bellaspet in 2019 - this is a revision with colon vaginoplasty by Dr Kamol Pansritum in Thailand after SRS in the USA "I had my SRS in early summer 2014 with a doctor in Pennsylvania"
YouTube
TV show Botched Season 1 Episode 3 with Kimber James
Papers
Surgery before 18
reddit
Susans
Emily Tressa had SRS with Jess Ting in USA at 17
New York Times
- The New Girl in School: Transgender Surgery at 18 by Anemona Hartocollis in 2015 - "Kat’s surgeon, Dr. Christine McGinn, estimated that she had done more than 30 operations on children under 18, about half of them vaginoplasties for biological boys becoming girls, and the other half double mastectomies for girls becoming boys.". Note that this article quotes the notorious anti-trans psychiatrist Paul McHugh
Older Age
reddit
DIY Surgery
It should go without saying, but this is exceptionally dangerous.
reddit
- r/stirringcastration - seems to be a diy castration sub
- reply to People asking about vial coring so I wrote an article, see the articles Orchiectomy and Orchiectomy part 2
- A warning tale by IndividualExciting99 in 2023 - "I have tried several methods of self castration only one had any success??. about 18 weeks ago I injected both testicles with 3mm of hypretonic (30%) saline this was not painful at all and both testicles became swollen. this was about 3 inches in diamiter... All was well after a couple of days both testicles went down. Both were soft with no hard lumps or aparent internal structures. I was smiling inside finally I had done it, what a relief.. a couple of days later my left ball started to swell and was painful. fuck was it painful. codene and ibroprofen together failed to touch the pain. I walked into the local hospital and spoke to triage. at this point my testicle was about 7 inches long 2,5 inches diameter and so tender. triage called the uroligy consultant who felt prodded and poked then he said "this has to come off NOW" so i was admited and a emergengy op scheduled. when I came round it was not nice i reacted badly to the shit they gave to knock me out.. any way this left me wit no left testicle and a right testicle aboy the size of a single peanut... To anyone trying to kill their balls by injection all i can say is DONT"
- Jeez, trans woman prisoner who did her own orchiectomy is now denied estrogen, they'll only give her testosterone by _shagger_ in 2023
- Explaination to the doctor by Suspicious_Papaya_96 in 2022
- reply to Knowing if you're ready.. by ashleyjm in 2022
- reply to Knowing if you're ready.. by ashleyjm in 2022 - alcohol injections followed by surgeons orchi
- Absorption of EstroGel after home orchiectomy by AshlyBotex in 2020
- April 28 on the left, yesterday on the right, after eight stir sessions. Something looks a little different...can’t quite put my finger on it by stirrednuts in 2020 - there's plenty more in their post history, also look on r/M2E
- April 10th. Status on my journey to become an Eunuch. by Meetoo73 in 2020
- I self-performed orchiectomy (AMA; DO NOT CONCERN-POST!) by TsaritsaYevfimiya in 2020 - in r/transmaxxing
- I self-performed orchiectomy (AMA; DO NOT CONCERN-POST!) by TsaritsaYevfimiya in 2020 - in r/Boymode
- This is what it looks like with legs closed. On the previous picture my legs were spread. The random scar is from my self surgery and not the doctors fault. I talked to someone in the healthcare system, and they can remove the hair inside the vagina. So I feel a little better now. by stupidstories in 2020
- I self-performed orchiectomy (AMA; DO NOT CONCERN-POST!) by TsaritsaYevfimiya in 2020
- Alcohol injections by staygrateful123 in 2020
- {IM-hrt} Estrogen lv's Post-up and progesteron use Questions by barb32 in 2020, also see earlier posts here and here
- Considering CaCl2 injection... Any advice? in 2019
- In the hospital after almost bleeding out after having an unlicensed orchi. by empresskittycat in 2017 - "So, about a year ago I got into contact with someone who had her orchiectomy done by a man who used to do them on sheep and it was his fetish so he had done it on her... So, yesterday he came over to my apartment. The procedure I was completely awake for and it was horrible, horrible pain. My testicles kept going back inside my scrotum so he kept having to push them out. Then he got one off and the artery started bleeding. He sutured it (badly) and then got the other one out and off. By the end of it I had been screaming and writihing in pain, but he finished and I was so happy to have them gone. He left me and my partner for me to rest in bed. Well, about ten minutes later I heard what sounded like water being poured onto the bed and there was blood everywhere. It was just gushing. So, my partner called the paramedics. They came and got me into the ambulence which was hard because I live on the second floor and I could not stand up without possibly completely bleeding out. I got to the hospital and they put me into proper surgery. They reopened me up, cleaned me out, made sure to remove any debris the first guy left over and now I am still here, still in immense pain. The police were called by the hospital too and my unlicensed surgeon is now under investigation. I feel a little bad for him since he was such a nice guy, or seemed to be... The "Surgeon" was arrested last night so he will not be able to do his risky business again. While I feel kind of bad for him, after reading comments here I think it is probably for the best."
kitten den
YouTube
ABC News
gbtimes Chinese man sues after illegal transgender surgery in 2016
nbc4i
ABC7 Chicago
Roland Mery
The Daily Beast
PinkNews
The Baffler
Wikipedia
Papers
- Attempted self-castration with bilateral intratesticular injections of calcium chloride by Matthew S Correia in 2023
- 2022 - Choosing Castration: A Thematic Analysis of the Perceived Pros and Cons of Genital Injuries and Ablation by Men Who Voluntarily Sought Castration by Erik Wibowo, Samantha T S Wong, Richard J Wassersug, Thomas W Johnson
- 2022 - Male genital self-mutilation due to tomophobia - case report and review of literature by Jagadish Rao Padubidri, K S Akshath, Tanya Singh, Matthew Antony Manoj - "... we present the case of a 45-year-old man who was found deceased in his home in a pool of blood with a knife and a pair of scissors lying next to him. In addition to this, parts of the intestine were found next to the body. The patient was diagnosed with hydrocoele and had a known history of tomophobia which caused him to take matters into his own hands by incising his scrotum which led to his demise."
- 2022 - Genital self-amputation-its psychological urge by Srinath Ravichandran, Peter Mark Smith, Vincent Tang = "This case report highlights a rare case of self-inflicted bilateral testicular amputation and partial penile amputation in a patient who is a transwoman with a psychiatric history... The testes were not re-implanted as the patient refused and, after psychiatric discussion, was deemed to have capacity. She then re-presented within a week with self-inflicted partial amputation of penis. On both admissions, the patient had psychiatric evaluation but she was sectioned under the mental health act the second time." - this is in the UK
- 2022 - Genital Mutilation in Males by Carlos Toribio-Vázquez, Álvaro Yebes, José Quesada-Olarte, Andrea Rodriguez, María Alonso-Bartolomé, Héctor Ayllon, Luis Martinez-Piñeiro
- 2021 - Male Genital Self-Mutilation with Complete Exposure of Both Testes by Pedro Vila-Braña, Almudena Sabio-Bonilla, Alba Tamayo-Gómez, Ana Jiménez-Dominguez, M Ángeles Rosales-Muñoz, Elena Palenciano-Ruiz, Jorge Alcázar-Beltrán, Ignacio Puche-Sanz
- 2021 - Genital self-mutilation: A challenging pathology (Review) by Sorin Lupu, Ovidiu Gabriel Bratu, Delia Mirela Tit, Simona Bungau, Octavian Maghiar, Teodor Andrei Maghiar, Camelia C Scarneciu, Ioan Scarneciu
- 2020 - Presentation and resolution of gender dysphoria as a positive symptom in a young schizophrenic man who presented with self-emasculation: Frontiers of bioethics, psychiatry, and microsurgical genital reconstruction by Rand N Wilcox Vanden Berg, Christopher D Gaffney, Darius A Paduch - "Gender dysphoria can present as a positive symptom of schizophrenia. Completion of gender affirmation surgeries should not occur as a result of male genital self-mutilation via a deferral of emergent surgical reconstruction. Instead, gender affirmation should be considered after a full workup and assessment for resolution of any acute psychosis." - this is in the USA
- 2018 - Management of self-inflicted orchiectomy in psychiatric patient. Case report and non-systematic review of the literature by Marco Garofalo, Alessandro Colella, Paolo Sadini, Lorenzo Bianchi, Giacomo Saraceni, Eugenio Brunocilla, Giorgio Gentile, Fulvio Colombo
- 2014 - The hidden world of self-castration and testicular self-injury by Thomas W Johnson, Michael S Irwig
- 2014 - Voluntary genital ablations: contrasting the cutters and their clients by Robyn A Jackowich, Rachel Vale, Kayla Vale, Richard J Wassersug, Thomas W Johnson
- 2013 - Nonprescribed Hormone Use and Self-Performed Surgeries: “Do-It-Yourself” Transitions in Transgender Communities in Ontario, Canada by Nooshin Khobzi Rotondi, Greta R. Bauer, Kyle Scanlon, Matthias Kaay, Robb Travers, and Anna Travers
- 2012 - Self-castration by a transsexual woman: financial and psychological costs: a case report. by St Peter M, Trinidad A, Irwig MS
- 2012 - Three cases of penile self-mutilation by Suguru Yoneda, Takanori Kinjo, Takeshi Oida, Kentaro Takezawa, Hironori Nomura, Norihide Tei, Shingo Takada, Kiyomi Matsumiya
- 2007 - Male genital self-amputation in the Middle East. A simple repair by anterior urethrostomy by
Samir S Shirodkar, Fayez T Hammad, Naseem A Qureshi
- 2006 - Traumatic luxation of the testis due to self-mutilation: a case report by Yuji Ishibiki, Tsutomu Matsumura
- 2003 - An American hijra: a report of a case of genital self-mutilation to become India's "third sex". by Master V, Santucci R.
- 2002 - A case of complete self-mutilation of penis by Masayuki Tomita, Shigetaka Maeda, Takahiro Kimura, Isao Ikemoto, Yukihiko Oishi
- 2002 - Successful penile replantation following autoamputation: twice! by B G Volkmer, S Maier
- 1999 - Psychiatric and surgical management of male genital self-mutilation by Y Suraya, K C Saw
- 1996 - On background factors of male genital self-mutilation by M Nakaya
- 1995 - Self-castration in a transsexual. by S J McGovern
- 1991 - Psychiatric aspects of male genital self-mutilation by T Martin, W F Gattaz
- 1982 - Self-performed bilateral orchiectomy in transsexuals. by Krieger MJ, McAninch JW, Weimer SR
- 1980 - Genital Self-Surgery by J Money
- 1979 - Genital and Abdominal Self-surgery A Case Report by Ned H. Kalin
- 1979 - Male genital self-mutilation by H Greilsheimer, J E Groves
- 1976 - Three Cases of Genital Self-Surgery and Their Relationship to Transexualism by J Money, M De Priest
Female Genital Anatomy
Research
- 2018 - Measurements of a ‘normal vulva’ in women aged 15–84: a cross‐sectional prospective single‐centre study by A Kreklau, I Vâz, F Oehme, F Strub, R Brechbühl, C Christmann, A Günthert
- 2005 - [Female genital appearance: ‘normality’ unfolds] (https://doi.org/10.1111/j.1471-0528.2004.00517.x) by Jillian Lloyd, Naomi S. Crouch, Catherine L. Minto, Lih‐Mei Liao, Sarah M. Creighton
- 2000 - Comparison of Vaginal Shapes in Afro-American, Caucasian and Hispanic Women as Seen with Vinyl Polysiloxane Casting by Pendergrass P.B. · Reeves C.A. · Belovicz M.W. · Molter D.J. · White J.H.
Some cis-women have labiaplasty to alter their labia minora.
Porn is obvioulsy not representative of the average vagina/vulva.
Papers
- Measurements of a ‘normal vulva’ in women aged 15–84: a cross‐sectional prospective single‐centre study in 2018, by A Kreklau, I Vâz, F Oehme, F Strub, R Brechbühl, C Christmann, A Günthert - "From August 2015 to April 2017, we included 657 women in our gynaecological and uro‐gynaecological outpatient clinic of the Cantonal Hospital Lucerne."
- Female genital appearance: ‘normality’ unfolds in 2005, by Jillian Lloyd, Naomi S. Crouch, Catherine L. Minto, Lih‐Mei Liao, Sarah M. Creighton
Post-Op Anatomy
I'll collect a few results here to illustrate various points of post-op results. I find it helpful to look wth legs closed, open, and internally/labia apart as different things can be seen in each. Sometimes what looks very good with legs closed is not so good with legs apart or labia spread. In particular look closely at the labia majora, labia minora, anterior commissure, posteriour commissure, inside vulva. Some problems of SRS, eg assymetry of labia, can be fixed or improved by revision, but I don't know how that varies among surgeons.
In porn its quite common to obscure the view with hands or toys, and presumably its intentionally as sometimes you'll never find a photo without that.
Mia Fever (see Brassard) at first glance appears to have an excellent result, except that its misleading as you can actually see very little.
Inner labia that that don't go all the way down are a common feature/complaint in post-op results - few surgeons are good at it. It does exist in cis-women, as shown here, here, and here, but the different is also quite clear.
Comparison to Natal Vagina
reddit
Susans
Surgery Overviews
Overviews of the entire surgery process.
YouTube
Pre-Op
Choosing a surgeon
Moved to the Surgery Introduction page.
Surgeon Consulation
reddit
Preparing for Surgery
reddit
YouTube
Fertility
If you want to go off HRT to get a last sperm sample, search for Clomid in Dr Will Powers sub.
reddit
YouTube
Stopping HRT Before Surgery
Most surgeons require HRT to be stopped before surgery. The main exception appears to be implants/pellets for which you would time the surgery for when estrogen levels are low.
WPATH 8 Standards of Care (2022) say stopping estrogen before surgery is no longer necessary.
reddit
Other links
http://marcibowers.com/transfem/resources/faq/#discontinue-my-hormones - "The time-honored dogma for patients undergoing vaginoplasty is that estrogens increase the risk for blood clots and that all hormones must be discontinued. This suspension of hormones leaves patients moody, depressed, achy and overall not feeling well around the time of surgery. On the other hand, we do not stop hormones or birth control pills in natal women undergoing gynecologic surgery. My feeling is that those same rules can apply for our patient population so long as we drop doses as low as possible. Such has been our philosophy since 2003 without incident. We do not interfere with those who have already discontinued their HRT on the advice of their home physicians or specialists. Dropping the dose as low as possible 4 weeks prior to surgery is our current advice except in patients with higher risk."
https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy - "There is no evidence to suggest that transgender women who lack specific risk factors (smoking, personal or family history, excessive doses or use of synthetic estrogens) must cease estrogen therapy before and after surgical procedures, in particular with appropriate use of prophylaxis and an informed consent discussion of the pros and cons of discontinuing hormone therapy during this time. Possible alternatives include using a lower dose of estrogen, and/or changing to a transdermal route if not already in use."
Research
- 2022 - Continuing perioperative estrogen therapy does not increase venous thromboembolic events in transgender patients: a systematic review and meta-analysis by J Badreddine, M H Lee, K Mishra, R Pope, J Y Kim, S H Hong, S Gupta, J M Song, J I Shin, R A Ghayda - "" Perioperative estrogen therapy does not increase VTE risk on male to female gender-affirming surgery. Therefore, estrogen therapy may be continued perioperatively in vaginoplasty. More prospective studies are needed.
- 2021 - No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender-Affirming Surgery by Aki Kozato, G W Conner Fox, Patrick C Yong, Sangyoon J Shin, Bella K Avanessian, Jess Ting, Yiwei Ling, Subha Karim, Joshua D Safer, John Henry Pang
- 2019 - Association of Surgical Risk With Exogenous Hormone Use in Transgender Patients: A Systematic Review by Elizabeth R Boskey, Amir H Taghinia, Oren Ganor - "Current evidence does not support routine discontinuation of all CSHT prior to surgery, particularly given the lack of information on risks associated with resuming these medications after they have been stopped. Evidence suggests there is no need to discontinue either testosterone or spironolactone, although their association with perioperative outcome quality has not been studied in depth. Most of the evidence that supports discontinuation of estrogen prior to surgery is based on oral estrogen regimens that are not typically used in transgender patients, and even with those formulations, there are conflicting reports on perioperative risk."
- 2004 - Postmenopausal hormone replacement and venous thromboembolism following hip and knee arthroplasty by Jason G Hurbanek, Amir K Jaffer, Nariman Morra, Matthew Karafa, Daniel J Brotman - "We found no association between perioperative hormone replacement and post-operative thrombosis in patients undergoing major orthopaedic surgery. Routine discontinuation of these medications preoperatively--and possibly in other situations predisposing to thrombosis, such as acute medical illness--may be unnecessary in patients receiving appropriate pharmacologic antithrombotic prophylaxis."
- 2001 - Hormone replacement therapy (HRT) and anaesthesia by D. Brighouse
Small Penis
Typically starting HRT early puberty or micropenis. Very few surgeons can do a good job in this case, and its critical to choose carefully.
https://en.wikipedia.org/wiki/Micropenis
reddit
- I (22F) think bottom surgery gave me PTSD by ehu_girl in 2023 - "3 years ago I had surgery with Dr. Bowers and I wasn’t prepared for the complications I had... 3 years later I still have nightmares a few times a week about how it felt having to hammer the dilator in there because of how terrified I was I’d lose depth (and I did but I think most do, I just wasn’t given much to start with bc I started blockers early). I also still have a problem with internal hair growth because Bowers had said I didn’t need to get electrolysis beforehand. "
- reply to not enough skin for srs? by SRSwithBanksy in 2022 - "I can vouch for Dr. Bank in this area. I didn't necessarily have a micropenis, but I started hormone blockers at 14 and had a small penis and scrotum. Still ended up with around 7.5 inches of depth and well defined labia minora made from penile skin. From what I can tell, my labia minora are on the smaller side for the Suporn clinic, but much more present than almost any other surgeon."
- Is Dr Marci Bowers transphobic? by HiddenStill in 2022
- Best GRS doctors for the…under-endowed among us? by noiselesspatient in 2022
Susans
GenderAnalysis
Deciding on surgery
reddit
Cancelling Surgery
reddit
Susans
The day before surgery and fear
reddit
YouTube
The Living Experiment
Surgery without General Anesthesia
reddit
YouTube
Hospital and Early Recovery
reddit
YouTube
Real Life Experience (RLE)
The WPATH Standards of Care version 7 require (page 106) one year of living in your preferred gender (and HRT) before genital surgery. The one year is known as RLE, or sometimes RLT (Real Life Test) as in you don't get your SRS without passing it. Note that the WPATH SOC is not a legal requirement, surgeons are not required to follow it, and it is open to some interpretation. See the wiki introduction page on Medical Guidelines for more. Note also that version 8 of the WPATH SOC has some updates in related to this.
Its possible, though rare, to get SRS without even presenting/identifying female or having any intention of socially transitioning. Lots of trans people don't believe this is possible (and some believe it shouldn't be allowed). You must take estrogen or testosterone afer removing the testicles otherwise you'll be at risk of osteoporosis (this is very bad) and other problems. As evidence its possible, and with reputable surgeons:
reddit subs
- r/AMABwGD - "This is a support group for all those AMAB folks out there who suffer from bottom dysphoria, but who also don't want to seek a binary gender transition."
reddit
- Masc Enby With A New Pussy by SignificantSport5771 in 2023 - surgeon is Loren Schechter in USA
- I am a Masc NB and had Vaginoplasty with Dr. Meltzer AMA! by segremores in 2023
- Penile Inversion surgery by sugarbaby_K in 2021
- Is it possible to live as a man but with a man made pussy? by cumiko in 2020
- Subreddit for people seeking surgery by AceDragonDaddy in 2020 - annoucning a new (private) sub r/AMABwGD "This is a support group for all those AMAB folks out there who suffer from bottom dysphoria, without necessarily wanting to go through a binary transition."
- reply to How much does surgeon choice matter? (Mtf vaginoplasty) by TronzAnon in 2020
- I am a male from birth with penis. But I wanna be male with vagina! What I have to do? Is it normal? by MaleWithPussy in 2020
- Anyone had GRS but remained androgynous? by galjer10n in 2020, and
- 9 month update - Dr. Bank @ Suporn Clinic by InevitableAmbition in 2020 - "I haven't socially transitioned yet, and feel no particular pressure to."
- Remaining as a male socially after having GCS(vaginoplasty)? by vsme in 2020
- SRS with Dr Suporn PDF 4th Edition by Suporn2015SRS in 2019, pages 228 and 240
- GRS still in boymode? by allisonmaybe in 2019
- Do trans people need to undergo Real Life Experience before getting approved for gender reassignment surgery? by MissDramaQueen in 2019
- Reply to SRS within a short notice by ArielBartlett in 2018
- Which lockers do I use? (It's complicated) by kiwiis in 2018
- reply to I regret GCS but not social transition. Can I get a meta? in 2018
- I am recovering from a non-standard vaginoplasty: I kept my penis. Ask me a couple things. (Serious, NSFW) by Androgynoplasty in 2018
- reply to Did you get/Do you want SRS for yourself, or did you get it/do you want it because you don't want to be harrassed in locker rooms, at swimming pools, in dating, etc? by Aprze in 2018, and reply to Is it transphobic if you can't see person as their preferred gender, despite respecting their pronouns and more? in 2020
- Well I guess it is set. Anyone else in Chonburi mid April - June 2019? by InevitableAmbition in 2018
- reply to SRS without social transition? in 2018
- SRS without changing gender around 2017
- reply to Any experience with Dr. Paul Daverio (SRS MtF) ? by LadyDuckloves
in 2017
- Has anyone else thought to just medically transition to get their body more feminine but not socially transition? around 2016
- I just had SRS and I'm in shock around 2016. This post is mostly deleted, but its about a male having SRS with Brassard. To quote a short piece "This guy I'm talking about was about 60 years old, plain white guy ... He was literally your stereotypical overweight trucker, full beard"
Susans
The Eunuch Archive
Wikipedia
- Gregory Hemingway - "Hemingway considered sex reassignment surgery as early as 1973. He had the surgery in 1995 and began using the name Gloria on occasion. Despite the surgery, Hemingway, presenting as a man, remarried Galliher in 1997 in Washington State."
Josef Kirchner
twitter
- https://twitter.com/ludaireirl - "Red panda cboy (he/him). Real life trans/NB cuntboy (AMAB) and sex aficionado. Mostly IRL lewds and nudes. NSFW/18+" - appears to be post-op AMAB who hasn't transitioned.
Papers
Psychs for SRS letters
SRS letters are usually written in accordance with the requirmenents the WPATH Standards Of Care and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
The WPATH SOC is a set of best practices for treating transgender people, while the DSM-5 contains the standard diagnostic criteria for being transgender.
Neither are laws nor are they absolutly required to get genital surgery, but its very difficult to find a surgeon/psych who doesn't follow them, or at least go through the motions. Insurance companies may make things even more difficult. Thailand does have laws on genital surgery that are not exactly the same as WPATH and requirements does vary somewhat between surgeons.
https://thegalap.org - "The GALAP Movement. We are a group of transgender, nonbinary, and allied mental health clinicians in the U.S. who believe in improving access to letters for clients who are seeking gender-affirming medical care. We resist the harmful practices of gatekeeping and believe in an informed consent model where clients can affirm their gender identity without the steep cost of sessions with mental health professionals and reductionist clinical practices. As such, we want to create a movement towards to providing free and low-cost letters for gender affirming access to medical care."
https://www.gendergp.com/help-centre/surgery-referral
reddit
I had to put this somewhere - this is a post by cis-women with MKRH talking about her experience, and its something many of us can relate to.
Informed Consent
There's very few surgeons who do informed consent for genital surgery. If this is of interest its generally more practical find a psych who will write you a letter without making a big deal of it. Informed consent is common for other trans surgeries.
Informed consent genital surgeons
- Marc Arnkoff (Michigan, USA) - Orchiectomy
- Ivan Mañero Vazquez (Barcelona, Spain) - SRS
- Jesús Lago Oliver (Madrid, Spain) - Orchiectomy
- Jorge Saenz de Cabezón (Barcelona, Spain) - Orchiectomy
- Melissa Belmonte (Mexico) - Orchiectomy
Online psychs for SRS letters
Personally, I'd check these psychs are accepted by your surgeon before using them.
I've heard of Graham L Peveller being accepted in Thailand, and he does letters for penectomy/nullification.
reddit
- reply to SRS surgery referrals for Suporn clinic by MooshroomMagic69 in 2023 - "I found Dr.Graham Peveller. He charges 260 USD for providing you a referral letter... I must say that Dr.Peveller's services have not met my expectations. Communication outside of the chat service has been slow, vague and infrequent... Since Peveller does not hold any degree related to psychology, he does not meet the WPATH criteria of being a licensed psychologist signee. Therefore, the letter must be endorsed by a second psychiatrist in-house at the clinic before surgery. The fee for this meeting is 2,000 THB. This will "upgrade" the referral to be WPATH compliant... I'd no longer recommend against using Dr.Graham Peveller's services. It is, however, important for me to inform anyone interested to lower your expectations of Peveller's communicative abilities. He suffered from a major injury, and probably has some ways to go with recovery. For those with >3 months time remaining, I'd shoot him an email well in advance."
- reply to What is the pathway to GRS? (MTF) by Tharivol616 in 2021 - using Dr Graham L Peveller for PAI in Thailand
- List with online gender therapists by Laura__333 in 2020
- How to find a PhD or MD psychiatrist for a letter by MeZooey in 2020
- reply to My insurance requires me to be "living as another gender" for a year before they'll sign off on something, what does that mean and what documentation is necessary? in 2019
- reply to Is it possible to have srs when you diy? by liszasthrowaway in 2019, for SRS with Sutin in Thailand. Also see Proof letter for srs in Thailand?
- My SRS experience with Dr. Chettawut (Oct 2017) by finallybeing in 2017, reccomends psychs Shawn McGill and Dr Lori Becker.
Susans
Other
Genital Hair Removal
See https://www.reddit.com/r/TransWiki/wiki/hair-removal
Penile Atrophy
reddit
Piercings
See also the Piercings section in the introduction page of this wiki.
reddit
Intersex
reddit
Susans
Scrotal Skin
There may be some advantage to having more scrotal skin rather than less.
reddit
- MTF SRS: learning, deciding, and everything before the actual surgery by 2d4d_data in 2021 - "Within 6 months of starting HRT my testicles were a fraction of the size they were before. In the years since without the constant weight and size my scrotal skin has shrunk. I have heard a few surgeons talking about stretching the skin before surgery. When this skin is used to construct the end of the vagina having more isn't a bad thing."
reddit subs
Jarod Johansen's Ball Stretching Guide
Vaginal Lining
reddit
Papers
Pre-existing Conditions
Acid Reflux
reddit
Anal Sex
reddit
BMI
Move to a separate page
https://www.reddit.com/r/TransWiki/wiki/weight-loss
Coeliac Disease
https://en.wikipedia.org/wiki/Coeliac_disease - "Coeliac disease (celiac disease in American English) is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye and barley. Classic symptoms include gastrointestinal problems such as chronic diarrhoea, abdominal distention, malabsorption, loss of appetite, and among children failure to grow normally."
reddit
- reply to Question about SRS + crohn's disease by Year_2038_Problem in 2022 - "I have Celiac, so my surgeon (Dr Mcginn) screened for Chronn's just to be safe. She said it wouldn't prevent me from getting the surgery, but she'd need to take precautions if I had it."
Careful with lubes, Dangerous Lilly in The Big Lube Guide warns against lubes containing Vitamin E and Oat Beta Glucan for Celiacs and those with extreme gluten-sensitivity.
Crohns
https://en.wikipedia.org/wiki/Crohn%27s_disease - "Crohn's disease is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract from the mouth to the anus."
reddit
r/CrohnsDisease
Cystic Fibrosis
https://en.wikipedia.org/wiki/Cystic_fibrosis - "Cystic fibrosis (CF) is a rare genetic disorder that affects mostly the lungs, but also the pancreas, liver, kidneys, and intestine. Long-term issues include difficulty breathing and coughing up mucus as a result of frequent lung infections"
YouTube
Ehlers-Danlos Syndrome
Also known as EDS.
Resources
reddit
- I tried to post this to the Ehlers-Danlos subreddit so that other people could be helped, but unfortunately, the mods there wont allow it. I'll post it here, and perhaps it will make it to those who need to see it and whom it could help. Basically, how I partially reversed my fiancé's EDS. by Drwillpowers in 2024
- worried about labiaplasty 5 days post op by Kara_Fox in 2023
- Gender dysphoria in adolescents with Ehlers–Danlos syndrome by fanciestVeggie in 2023 - references this paper
- Does anyone know any US (north-east) GI specialists with competency for patients with EDS? by pxumr1rj in 2023
- EDS & Transgender surgery by MalibuPuppy in 2023, also see cross post here.
- Ehlers Danlos Syndrome - medical literature vs medical culture vs patient culture in 2022 - don't post here without reading the rules of the sub as its for medical professionals and you may get banned
- EDS and vaginoplasty by MehToFemale in 2022 - surgeon Dr Burke at ECMC - "I have mild EDS classic type and had vaginoplasty about a year ago with Dr Burke at ECMC. I had massive swelling, apparently the most they'd seen, and a fair amount of dehissence (sutures popping). Because of this I have a fair amount of scar tissue around my vaginal opening which I'm trying to break up through dilating, it's been slow going. They tried to remove some scar tissue/open up the vaginal opening when I had a revision, but it mostly dehissed and scarred in again."
- Dr. Ley 6 months post op labiaplasty revision with EDS tissue by Throwsawayfortacos in 2022
- EDS experts talking about hormones and EDS on their Instagram stories today!! by Different-Eagle-612 in 2022 - not surgery
- Just wanted to say thank you! by yorkpeaches in 2022 - some of Dr Powers comments are about EDS - "At a side note, I'm pretty sure I have discovered some sort of genetic syndrome that I'm calling informally for now "the tetrad of trans". Autism, gender dysphoria, hypermobile joints, adhd. I have so many people in my practice that have all four of these simultaneously that it defies any denying it anymore. I can't ignore it. I look forward to further affordable whole genome sequencing so that we can start to sort out which genes are responsible for this."
- reply to I’m in the ER with an enormous Bartholin cyst, and I’m terrified that they’re not going to listen to me when I say local anesthetics don’t work for me. in 2022 - "... before I was diagnosed and learned about this issue, I had two dentists yell at me on separate occasions that there was "no way I could still feel them drilling." Now I always bring in literature about it from an EDS organization when I need dental work, and fillings have been painless ever since. Personally I need 2 to 3 times the typical dosage for effectiveness at the dentist."
- HRT made my Ehlers Danlos / HSD much worse - anyone have similar experiences? Did anything work? by GarfSaysTransRights in 2021 - not surgery related
- Do any FTM’s who have had top surgery also have ehlers-danlos or Marfans syndrome? by cassowarybrain - this is FTM top surgery
- SRS and Ehlers-Danlos Syndrome by MadGenderScientist in 2020
- HRT Options for Ehlers Danlos Syndrome by Mattpilf in 2020 - this is not about surgery
- 2 years 6 months post op results - Ehlers Danlos Syndrome/connective tissue disorder by edsftm around 2020 (this is FTM surgery)
- Any other trans zebras on here? I'm curious how EDS has impacted your transition. EDS impacted mine in a bunch of unexpected ways by mhpro90 in 2019
- EDS Story of an Aussie trans-girl by Fuckmylifuuuu in 2019 - not surgery related
YouTube
Research
- 2023 - Gender dysphoria in adolescents with Ehlers–Danlos syndrome by Jordan T. Jones, William R. Black, Christine N. Moser, Eric T. Rush, and Lindsey Malloy Walton
- 2023 - Orthognathic Surgery in Ehlers-Danlos Syndrome: Review of the Literature and Case Report by Anthony Deleonibus, Joseph Bogart, Bahar Gharb, Antonio Rampazzo
- 2021 - Ehlers-Danlos syndrome: prevalence and outcomes in gender affirming surgery - a single institution experience by Alireza Najafian, Isabel Cylinder, Breanna Jedrzejewski, Craig Sineath, Zbigniew Sikora1, Leigh H. Martin, Daniel Dugi, Geolani W. Dy, Jens Urs Berli - "The prevalence of EDS diagnosis in our patient population is 132 times the highest reported prevalence in the general population. Wound healing issues and the need for additional post-operative interventions in the group with EDS diagnosis were not significantly different from the control group. Our findings suggest that patients with a diagnosis of EDS undergoing GAS have comparable outcomes to patients without EDS. Concerns for post-operative complications should not be a barrier to offering GAS to patients presenting with an EDS diagnosis."
- 2022 - Gender dysphoria in adolescents with Ehlers–Danlos syndrome by Jordan T. Jones, William R. Black, Christine N. Moser, Eric T. Rush, and Lindsey Malloy Walton
- 2020 - The Relationship between Autism and Ehlers-Danlos Syndromes/Hypermobility Spectrum Disorders by Emily L. Casanova, Carolina Baeza-Velasco, Caroline B. Buchanan, and Manuel F. Casanova
- 2019 - Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery by Jane R. Schubart, Eric Schaefer, Piotr Janicki, Sanjib D. Adhikary, Amber Schilling, Alan J. Hakim, Rebecca Bascom, Clair A. Francomano, and Satish R. Raj - "EDS survey respondents reported nearly three times the rate of LA non-response compared to non-EDS respondents, suggesting that LAs were less effective in preventing their pain associated with routine office dental procedures.", where LA's refer to Local Anesthetics.
- 2014 - Recommendations for anesthesia and perioperative management in patients with Ehlers-Danlos syndrome(s) by Thomas Wiesmann, Marco Castori, Fransiska Malfait, and Hinnerk Wulf
Other
Factor V Leiden
https://en.wikipedia.org/wiki/Factor_V_Leiden - Blood clotting disorder
reddit
Fibromyalgia
https://en.wikipedia.org/wiki/Fibromyalgia - "Fibromyalgia (FM) is a medical condition defined by the presence of chronic widespread pain, fatigue, waking unrefreshed, cognitive symptoms, lower abdominal pain or cramps, and depression."
reddit
Foreskin
Papers
- 2007 - Fine-touch pressure thresholds in the adult penis by Morris L Sorrells, James L Snyder, Mark D Reiss, Christopher Eden, Marilyn F Milos, Norma Wilcox, Robert S Van Howe, "The glans of the circumcised penis is less sensitive to fine touch than the glans of the uncircumcised penis. The transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates the most sensitive parts of the penis."
Circumcision
reddit
reddit subs
Other
Phimosis
https://en.wikipedia.org/wiki/Phimosis - "Phimosis is a condition in which the foreskin of the penis cannot be pulled back past the glans."
An alternative (and better for SRS) treatment for phimosis is the Dorsal Slit - "Dorsal slit has a long history as a treatment for adult phimosis,since compared with circumcision it was relatively easy to perform, did not risk damage to the frenulum, and before the invention of antibiotics was less likely to become infected. However, the literature often indicates that despite being "a simple operation" it was "not liked by some" or refers to the "untidy apron-like appearance" it could produce. Dorsal slit is now rare in Western countries as a treatment for phimosis. Standard guidelines suggest conservative approaches first and, should those fail, either circumcision or preputioplasty to both retain the foreskin and relieve the phimosis."
reddit
Other
Hypospadias
https://en.wikipedia.org/wiki/Hypospadias - "Hypospadias is a common variation in fetal development of the penis in which the urethra does not open from its usual location in the head of the penis."
reddit
YouTube
Inguinal Hernia
reddit
Irritable Bowel Syndrome
reddit
Low Potassium
reddit
Peyronie's Disease
https://en.wikipedia.org/wiki/Peyronie%27s_disease - "Peyronie's disease is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis. Specifically, scar tissue forms in the tunica albuginea, the thick sheath of tissue surrounding the corpora cavernosa, causing pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening."
reddit
Prior Surgery
reddit
- Post-Op Transwoman with complications by TiffanyRichter in 2021 - "The surgery didn't take due to several reasons, I had bladder cancer eight years ago and lost my bladder from the disease, their was nothing for the surgeons to attach the colon to except for scar tissue from the cancer surgery performed. The other reason is that I was diagnosed with Marfan Syndrome and so the vaginal tissue stretched too much. I asked my surgeon about skin grafts, but he said that would not work in my case."
YouTube
Prostatectomy
https://en.wikipedia.org/wiki/Prostatectomy - "Prostatectomy ... as a medical term refers to the surgical removal of all or part of the prostate gland. This operation is done for benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the pelvis."
reddit
- Vaginoplasty after prostate removal. by Physical_Clock_2978 in 2022 - a surgeon replied "I do penile inversion vaginal plasty and I would certainly offer you that technique, but we both would need to understand that the risk of rectal injury, and the risk of total incontinence afterwards, is sky high. After even a well-done radical prostatectomy, the external sphincter is barely holding on for dear life. When you create the vaginal canal, it would dislocate some of its connections of the sphincter to the rectal area, possibly pushing you over into total incontinence. I see it as “doable” but “high risk”."
Psoriasis
https://en.wikipedia.org/wiki/Psoriasis - "Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin."
Youtube
- Truth About My Bottom Surgery (SRS) MtF Transition by Mathilda Hogberg in 2021 - see 12:00 - "I suffer from psoriasis which is an autoimmune skin disease however it was nothing like that it was really intense as well so i went to the OB-GYN she wasn't sure what it was all about I mean she saw that it was eczema but she didn't know what they were coming from so she told me that it would maybe go away after a while
and it didn't like spoiler alert it didn't go away it just got worse it was so painful it was not cute it was not pretty and i just wanted it to go away
i met with three OB-GYN during a pretty long period however the third OB-GYN he was the best OB-GYN that i've ever met he just like instantly recognized what it was all about and he asked me if I use lube and I am using lube because like when I'm dilating and stuff like that i need to use it so he told me that i was allergic to the lube that i was using and he asked me what kind of lube it was and i told him that it was water-based and he said that that is not really a good idea if I have psoriasis because it gets like dried out and stuff like that so it told me to switch to a lube that is silicone based instead and I did and everything just went away and no not a single OB-GYN that i met before him could tell me that I had these problems for maybe like three to four months and no one told me and he just like instantly recognized it he just like looked at it and he was like you're allergic you're having an allergic reaction"
Marfan Syndrome
https://en.wikipedia.org/wiki/Marfan_syndrome - Marfan syndrome (MFS) is a rare multi-systemic genetic disorder that affects the connective tissue.
reddit
Multiple Sclerosis
reddit
Transurethral Resection of the Prostate
https://en.wikipedia.org/wiki/Transurethral_resection_of_the_prostate - "Transurethral resection of the prostate (commonly known as a TURP, plural TURPs, and rarely as a transurethral prostatic resection, TUPR) is a urological operation. It is used to treat benign prostatic hyperplasia (BPH)."
Papers
Post-Op
Reddit subs
- r/Healthyhooha - not trans related, but "This is a sub for safe, open discussion about the maintenance, habits, questions, and tips related to vaginal and vulvular health."
reddit
reddit
YouTube
HRT
You need to take adaquate estrogen (or testesterone) after surgery to avoid medical problems. The worst seems to be osteoporosis.
reddit
Susans
Low Testosterone
Some women need to take testosterone after SRS (or orchiectomy) as a result of too low testosterone.
This is also a problem for some cis-women.
reddit
Susans
YouTube
High Testesterone
Its not common, but the the adrenal glands produce testosterone and after SRS or orchiectomy they can in some cases increase production to compensate for sudden loss.
From a pdf about SRS with Suporn
The clinic’s ‘Post-Op Care’ book says that in about 10-15% of cases “unwanted male characteristics can return immediately post-operative” as the body attempts to make up for
the loss of testosterone and that the treatment is anti-androgens “for at least 3 months”. My doctor said much the same and prescribed low dose spironolactone (25mg) to allow my body to adjust. I took it for a few months, and as usual it fixed that problem.
What's it like? Life post-op
reddit
YouTube
Sex and Orgasm
reddit
YouTube
There's a reddit sub for sex toys
Susans
Splinter:
How I learned to orgasm after sex reassignment surgery in 2016
Vogue: Why One Trans Woman Wants to Discuss Sex After Surgery in 2016
Taste & Smell
reddit
Susans
YouTube
Depression
General anesthesia can cause post-op depression.
reddit
r/opiates has some interesting discussion on post op
YouTube
Depth
According to wikipedia a vagina ranges from 4.3" to 4.7" during sexual arousal, and the avergage errect penis length is 5.17". However the post-operative trans women's vagina does not stretch.
For complications in depth post-op see wiki entry Dilation and Depth
reddit
Susans
YouTube
Surgeon Statistics
Germany 11 cm (sample of 24)
Unknown surgeon, 330 sample, 6"
475 sample 0.6% (3 of 475)
Jurgen Schaff, 8.78 cm (sample 40)
Sweden (Karolinska University Hospital), 10.4cm (sample 80)
Suporn average 7.0 inches/17.8 cm, min/max is 6.0"/8.5", from 2010-2017
Chettawut, SRS with skin graft = 6.5-7 inches, SRS with colon graft = 8-9+++ inches
Cis-women's depth in a post on susans Re: Chettawut girls, are your vaginas working well? by Susan in 2015
References
I need to review these, I'm not sure which ones are related to depth.
Dilation
Assuming no complications
- Dilating is critical early post-op, and if you don't dilate you'll likley permanently lose depth. Permanent loss of depth can only be fixed with further surgery, possibly peritioneal or colon vaginolpasty. What early means is variable. It youre comtemplating stopping becuase its too painful I'd suggest looking into stronger painkillers, because repeating SRS is not going to be a great experience and you might face the same problems again. Not all doctors/surgeons are willing to provide stronger painkillers.
- Your body will tell you how often you need to dilate. If its easy you can expermient with dilating less often, but if it gets harder you need to dilate more. If you dilate less because its difficult it will get worse and worse.
If dilation is difficult you need to do it more, not less.
- Long term there's many reports of women not dilating for years with no permaent loss of depth. It can however take some effort to regain depth.
Note that some cis-women dilate
reddit
- Don't dilate like that, dilate like this. You're probably doing it wrong (Surgeons hate him! learn this one cool trick!) by Drwillpowers in 2023
- Dilating while standing up by Low-Island-2637 in 2023
- In the interest of Science: a Diagram showing my Progress with dilation after SRS. Ø4,5cm is a soft silicone dildo, not a dilator! by Torenga in 2023
- Quick question for anyone who’s had GCS. I’m flying home for the first time after GCS and my wife is worried about TSA and what they’ll ask about my dilators. I don’t want to check them, well because I’m worried they lose them. Any thoughts would be greatly appreciated! Thank you by raceinbk1980 in 2022
- I had issues dilating early on, so thought I would post what worked for me. I am beyond this difficult point now, but maybe it helps some others. by WRKaren in 2022
- Cannabis for dilation related pain by princessxha in 2022 - "... but I really was not fine in weeks 2-4. Dilation was uncharacteristically painful. More painful than most people report. Severe, sharp, burning pain on the inside... I found small quantities (0.2g combusted) of it before each dilation session (3x day) to be a godsend. Smoked pure, no tobacco of course. I would compare the type of pain relief to opiates. You still have the pain but you don’t feel it properly because you’re too fuzzy. It was as ‘mind-numbing’ as strong opiates but without the addiction/danger, constipation and extreme sedation."
- Extreme dilation pain by Emma Landing in 2022
- Lidocaine on vaginal dilator by Expensive-Can-5743 in 2022
- Guide to dilating by 2d4d_data in 2022
- PSA for dilators etc while flying by femessence in 2022
- A big bed desk has been the biggest help for dilating by far! by OdderlyNat in 2022
- 3D-printed dilator stand by TransSurgeryAlt4728 in 2021
- [MTF] How log were you sore after sizing up, and did you take breaks or power through with the new size? by _jenni4 in 2021
- How "tight" is your dilating? by RosyGlow in 2021
- How Do You Know You are Dilating Correctly? by LongBeachVero in 2020
- Dilating Width problems twelve days in by transinthesouthpod in 2020
- Was orange not enough for some women? by notyourdonut in 2020
- Is there life after dilation? by AnyaAnn in 2020
- Blood with dilation? by LaurenRossy1 in 2020
- Internal look through clear dilater 35 days post by CuteFoxers, video here
- Dilation after surgery. by allielizzie16 in 2020
- Would anyone else be willing to share their dilation routine as prescribed by their doc? by nuwutella in 2020
- Dilation- whats more important, frequency or duration? by 15thcateringwillow in 2020
- PSA don't forget to dilate or douche. I forgot. This is the result. Waxy skin cells and sweat etc :( I had to blast my vag with water and manually excavate this. by adventures_in_dysl in 2020
- [NSFW] Neovaginas and large insertions? by OwnsManyThighsocks in 2020
- Is the necessity of dilation a myth? by sg2k19 in 2020
- What to dilate on? by ZebraTank in 2020
- Clear acrylic dilators and a flashlight can be used as fiber optics to see inside yourself by MayScream in 2020
- Dilation: pain in leg by smilewithnose in 2019
- So I dilated for the first time in 2 months. Yikes. by voicethrowaway1337 in 2019
- I won! by transgendersquid in 2019
- blood after dilation at nearly 3 months op ? by WarriorFighter19 in 2019
- Dilator Stuck inside my Vagina: Urgent by pinkielotus in 2019
- Increasing depth in transgender women by using testosterone on dilators by 2d4d_data in 2019, discussing a comment by /u/Drwillpowers
- What’s dilation like, both post op recovery and long term? by mugiwara_girl in 2019
- Is it possible to regain my initial SRS depth? by egmtz in 2019
- Failed to dilate, vagina almost closed in 2018
- SRS with Dr Suporn PDF Update 2 by Suporn2015SRS in 2018
- Somebody should make a subreddit called "Dilation Station" where post op women can post entertaining things to watch and do while dilating. in 2018, see also https://www.reddit.com/r/dilationstation/
- GRS Dialation and more, 3 weeks after GRS by Alanis Martinez in 2019 - surgeon was Harold Reed in USA
- Suporn vs Chet Dilators in 2017
Susans
YouTube
Cis-women may dilate for various reasons - Vaginal dilation: When it’s indicated and tips on teaching it in OBG Manag. 2012 December;24(12):12-18, by Kristene E. Whitmore, and Susan Kellogg Spadt.
Sleepless Rants, Episode NaN in 2018, "Since I’m bed-ridden for a few months, I needed a decent desk in bed that would allow me to still be productive whilst mostly laying down."
Other
- 2020 - In Vietnam, old hand at transgender service opens up about job - "In her career, she witnessed one case of fatality following a gender affirmation surgery due to postoperative mishandling. It was a Filippino who came to Thailand for the operation. She died several days after getting back home. According to the ill-fated lady’s companions, she was mishandling the vaginal dilator. Her family members were not aware of her excessive bleeding, which caused her death."
Stents
A few surgeons use stents early on
reddit
- Placeholder after 2nd SRS by AeylaHearts in 2024 - "I just had my revision surgery/ 2nd stage surgery with Dr. Hess/Heß in Essen, Germany and now I am advised to wear a placeholder and not dilate for the following 2 weeks. This is to not irritate the inner stitches more than necessary. The placeholder/stent is made from Bandages wrapped up in a condom, which is common for Hess and The surgeries in Munich I think."
Dilators
Note that the Soul Source dilators are pretty much the standard dilators after SRS and are supplied by many SRS surgeons. The others are more likley intended for cis-women, and some may not be of sufficient length.
Firstly, a warning about cheap dilators and sex toys as found on Chinese sites, aliexpress, ebay, etc, by Dangerous Lilly
reddit
Suppliers
- Soul Source vaginal dilators and YouTube channel - these are standard in North America for post-SRS dilation.
- https://www.thepelvichub.com/shop/grs-vaginal-dilators - Australian reseller or Soul Source dilators
- Vagiwell Dilators here, discussed on susans here
- Radiation Products Design, Inc - 228 euros for the 35mm dilator, do not sell to the public
- https://www.vaginismus.com/products/vaginal-dilator-set/
- pelvision BV
- Femmax Vaginal Dilators available from various suppliers, YouTube video How To Use Your Femmax Dilators - Instructions & Advice by StressNoMore in 2012 (may not be suitable post-SRS)
- Amielle Comfort Instruction for Use - Video by Owen Mumford in 2017 (may not be suitable post-SRS), Amielle SM2100 Comfort Vaginal Dilators Set on Amazon UK.
- Syracuse Medical Devices Vaginal Dilators - https://www.smeincusa.com/sme/syracuse-medical-vaginal-dilators.html - some other info here, and also at CMT Mmedical
- https://vaginismus.com/products/vaginal-dilator-set
- https://middlesexmd.com/products/vaginal-dilators-set-of-7
- https://www.vuvatech.com
- https://www.millimedical.com - see post on susans An expanding electric dilator? in 2019, and reddit Expanding dilator - Made dilation faster and less painful in 2020, and reddit reply to Dilators by illyriarose in 2020
Soul Source now (2021) sell these https://www.soulsource.com/products/milli-expandable-dilator
- medesign I.C. GmbH Dilator Set 'Vivian'
- Passion Glass Sex Toys Glass Dilators GRS SRS
- Steris Charing Cross Dilators - sizes from 20-46mm
- https://www.intimaterose.com/collections/vaginal-dilators
- EPI-NO Delphine Plus - "Childbirth and Pelvic Floor Trainer used to prepare the perineum, and reduce the risk of tears, and episiotomy during a vaginal birth.", See YouTube video EPI.NO DIALATOR MTF TRANSGENDER IS IT WIRTH THE MONEY? by Stefabulous in 2020 - this is about the EPI-NO Delphine Plus
- https://theros.de/dilatoren/fms-dilator_1 - glas dilators, 150mm long, 12/14 to 48/60mm diameter
- https://www.cmtmedical.com/product-category/pelvic-pain/dilators/
- https://en.wikipedia.org/wiki/Hegar_dilators - "Hegar dilators are dilators used to treat vaginismus, induce cervical dilation, and for inflatable penile implant procedures... Typically, dilators are a set of metal rods of increasing diameters, from a few millimeters up to 26 millimeters." - there's lots of suppliers of these and they come on small size increments
- Sybian/Motorbunny - these are very expensive sex toys, see below for more on these as its not clear how useful they are.
- fuze dilators - "Complete Set of 5 Dilators. 100% Medical Grade Silicone. Insertable Dimensions ½”, ¾”, 1”, 1 ¼”, 1 ½”"
- She-ology 3-Piece Wearable Vaginal Dilator Set
- https://vwell.com/products/super-fit-xl-silicone-vaginal-dilator-set
Dilator size spreadsheet
Candles are known to have been used in Thailand as dilators until recently, but it goes back to at least 1898 (in the USA by the look of it), see the thesis Dilating Health, Healthcare, and Well-Being: Experiences of LGBTQ+ Thai People by by Sowapark, Montita in 2019 (and see also the original source New method of creating a vagina in a case of congenital absence by R. Abbe in 1898).
After Robert Abbe performed one of the earliest vaginoplasty procedures in 1898 for a patient with vaginal agenesis,345 he reported that: The gravitation of the abdominal contents tended to shorten the vaginal canal, and I saw that it would be necessary for her to wear a vaginal plug part of every day at least. Several varieties were tried, but nothing was so comfortable as a good-sized wax candle smoothed and rounded, and kept in by a T-bandage.
Markovsky (Germany) Meine GaOP – Die zweite und dritte Woche nach der OP – Pures Glück mit ein wenig Zwicken und Zwacken
reddit
Papers
TransgenderZone
YouTube
Research
- 2019 - Dilating Health, Healthcare, and Well-Being: Experiences of LGBTQ+ Thai People by Sowapark, Montita - "
Abstract. How can the epistemological tools and frameworks of biomedical engineering and critical gender studies be used to contest each other’s work, engender new collaborations, and broaden our conceptual horizons as to the limitations and potentials of each discipline? On one hand, this study asks how the Thai sex/gender system affects the health, healthcare, and well-being of LGBTQ. To answer this question, I conducted 32 in-depth semi-structured interviews with Thai LGBTQ+ patients and healthcare providers. By analyzing these themes using Michel Foucault’s theory of biopower..." - I don't know what any of that means, but this thesis has looks at the design of existing and new dilators. I'm not sure I understand this as the author seems to be of Thai herritage and yet the proposed dilator designed seems over engineered and far to costly for Thai market (it's a poor country).
Milli Medical
Note that its not clear how suitable these for post-op trans women, and they are expensive (US$250 in 2021). And also note that they are doing a fair amount of marketing for this. They are 10.5cm (4 inches) so not useful for depth. The diameter is 15 to 40mm so it could be useful for the scar near the vaginal entrance. It appears to be more suitable as an additional dilator to your exising set to solve specific problems.
reddit
reddit - in r/vaginismus
reddit
Susans
Papers
- 2021 - Vaginal Dilators: Issues and Answers by Marisa Liu, Mark Juravic, Genevieve Mazza, Michael L Krychman - "This article will summarize the current research on vaginal dilators and discuss needs for future research to maximize patients' compliance and success with this treatment. Much of the summary data regarding user behavior will come from the early survey data with Milli, a novel, patient-controlled electronic dilator that slowly expands 1 mm at a time from its smallest diameter, 15 mm to a maximum diameter of 40 mm. Milli is currently being used by more than 1,000 women, and 3-month follow-up data were recorded on 335 of those patients."
- 2020 - 056 The Milli™; the Only Patient Controlled Expanding Dilator: Follow Up Survey Experience by M. Krychman, S. Kellogg- Spadt, S. Prendergast, S. Kingsberg, A. Dweck, M. Jurvic
- 2018 - 085 Milli™ the ONLY Patient Controlled Expanding Dilator: Preliminary Soft Launch Experience by M. Krychman, M. Juravic - "The initial soft launch of 50 users of this novel dilator is reported here."
- 2018 - The Final Design: Milli; Introducing the Only Patient Controlled Expanding Dilator [39F] by Michael Krychman, Mark Juravic
- 2017 - 263 Milli™ A Novel Patient Controlled Expanding Dilator by M. Krychman, S. Kingsberg, S. Prendergast, M. Jurvic
Inflatable Plug
Dr Will Powers reccomends using an inflatable sex toy to help with difficult dilation problems.
reddit
reddit - in r/vaginismus
- Mixed Emotions (Cured self and gave self new small problem) in 2021 - "A long time ago, I bought an inflatable plug with the intention of inflating it and birthing it. ... Over time, I was able to get it in uninflated, but with no hope of getting it out equally uninflated. A few weeks ago, I decided to try again. I got it to a size that was probably as thick as a wrist, more or less, and pushed it out. I was very turned on and excited by being able to do this. It burnt just a tiny bit, but it was absolutely nothing in comparison to vaginismus at it's worst. The toy was a pain level I could enjoy as a sadomasochist, which was absoloutely never something I could say about vaginismus. But afterwards, I was touching myself, and I was just... in awe of how "loose" it was. I almost fisted myself, but not quite. I figured this was just in the moment and would snap back to the regular tightness, like how it does/did after dilating or sex, but... it didn't entirely. In the weeks following, I found myself putting a finger in with ease and being totally amazed. It was always difficult to get a finger in before, always, and now I could just do it anytime. I would do it just to prove to myself that it still worked. Whether I was masturbating or just sitting around by myself, I'd do it just to feel how easy it was. I wondered if this meant I was cured, if this is what a normal vagina feels like. ... So, the day before yesterday, I attempted sex without dilating first, and IT WORKED! It went in easily and naturally, with no preparation, like never before, and it felt GOOD! And at first, this is wonderful."
- Biggest dilator goes only halfway around 2015 - "I also got myself a small inflatable dildo (it’s the 6 inches inflatable dildo from Lovehoney, if anyone is interested). It’s a great tool, because it’s not as rigid as a plastic dilator, and you can gradually make it bigger when it is already inside of you. With the help of the dildo, I’m now at the point where I can insert the biggest dilator of my set (I have the Velvi kit)."
Sybian/Motorbunny
These are very expensive sex toys and are included due to a post on susans on their use for dilation.
https://en.wikipedia.org/wiki/Sybian - "A Sybian (/ˈsɪbiən/), or Sybian saddle, is a masturbation device. It consists of a hollow saddle-like seat containing two electric motors, motor speed controller boards, gearing, pulleys, and a platform on cranked axles such that a ridge on the top of the unit can be made to vibrate through a range of speeds as set using a wired external hand controller, and an upward-pointing shaft set on an angle through the ridge can be made to rotate at speeds of up to several hundred rpm, again by use of the wired remote control. Flexible molded attachments are supplied that fit over the vibrating ridge and shaft which mostly have integrated dildos on their top. In use, the rider inserts the dildo into a bodily cavity for internal stimulation while applying pressure on the vibrating ridge with their external erogenous parts."
I've included these due to some posts on susans
- Re: Extreme dilation pain by Rachel in 2021 - ... my graph died about 50%. At the 4 week mark dilation became painful. It became an extreme pain and would bring me to tears. I continued to dilate 30 minutes 5 times a day with 1-4 dilators. I had to have an operation to remove the scar tissue. I lost depth due to the operation. I was 3.5 inched deep post the second operation... I was going to get peritoneal GCS due to the depth issue. I was instructed by RBL to get a doctor the demonstrate pelvic floor exercises to increase depth. I did and it was my primary care doctor. They see thousands of trans. I then thought that a sybian would do the exercises for me. It did and I had orgasms too. My depth is between the 5th dot and horizontal slit with my labia at the slit. I was fully healed when I did this. I used motor bunny xl toys on the sybian.
- Re: Depth by Rachel in 2020 - "If I was to get another I would get a new Motor Bunny; it has more power and is 1/2 the price."
- Re: Longer Dilators by Rachel in 2020 - "I use a Sybian with ex large Sybian and Motor Bunny toys. I start with a small toy and have a long orgasm then switch to medium then extra large. The Sybian does automatic pelvic floor exercises. When I use the dilators there is no orgasm. When you are in the seated position and vibrating I can put a lot more force. I really like using the Sybian and I have a lot more sensation now.", also on susans
Porn
Lube
Be careful with lube in the first few months after surgery, use water based lubes as other chemicals can interfere with healing.
Ingredients of concern are
- Glycerin/glycerine/glycerol - yeast infections
- Propylene Glycol - vaginal irritation
- Chlorhexedine Gluconate - disinfectant and antiseptic (kills good bacteria), irritation. This is an ingredient in surgilube - "CHG products are generally safe to be used by most individuals. However, you should not use products that contain chlorhexidine gluconate if you are allergic to CHG, as there’s a possibility of serious allergic reaction."
- Nonoxynol-9 - spermicide, kills good bacteria
- Petroleum based ingredients, oily and won't wash out, can upset pH leading to infections (eg BV)
- Benzyl alcohol - irritation
- Citric acid - irritation
Dangerous Lilly
reddit
Susans
YouTube
Research
- 2021 - Clinical and Personal Lubricants Impact the Growth of Vaginal Lactobacillus Species and Colonization of Vaginal Epithelial Cells: An in Vitro Study by Paweł Łaniewski, Kimberley A Owen, Michael Khnanisho, Rebecca M Brotman, Melissa M Herbst-Kralovetz - "Lubricants containing chlorhexidine gluconate or nonoxynol-9 (N-9; Conceptrol, K-Y Jelly, and Surgilube) significantly inhibited Lactobacillus species growth... Chlorhexidine gluconate had a detrimental effect on Lactobacillus growth and exhibited stronger antimicrobial activity compared with methylparaben and propylparaben... This in vitro model indicates that select vaginal lubricants, particularly those with chlorhexidine gluconate, have potentially adverse effects on women's health by reducing growth and recolonization of vaginal Lactobacillus species."
Other
Dilation Long Term
reddit
- 9 years post-op: PI w/ scrotal grafts with Dr. Bowers by MuffzStuffz in 2023 - "... I had like "around 7" hairs growing inside. I tried my best to cope with it for the next year or so, plucking the hairs the best to my ability, but by 7 years post-op, I was just kind of sick of the upkeep of cleaning it, dilating, and trying to deal with the hair. I was going through a rough spot with chronic health conditions, declining mental health, and no partners/sexual desire so I just decided to stop the uncomfortable dilating sessions and deal with the consequences later. It was nice ignoring it for awhile, but by 8 years post-op I was starting to have some pelvic pain near the surgery site even though I wasn't using the neovag canal anymore. I ended up getting new, smaller dilators to see if that would help the pain, and I found out I have about 3 or so inches left in depth... So now I still have to dilate and clean it out to help reduce the pain and discomfort in the area, even though I don't really view it as a viable sexual organ anymore (especially the neovag canal)."
- reply to Questions for people who have gotten vaginoplasty and are fully healed by Strong_Suggestion503 in 2021
- reply to after SRS, will you need to dilate for the rest of your life? by KaySOS in 2020
Susans
YouTube
Hormones
reddit
Self-lubrication
See also colonvaginoplasty.
reddit
Dehiscence
https://en.wikipedia.org/wiki/Wound_dehiscence - "Wound dehiscence is a surgical complication in which a wound ruptures along a surgical incision."
reddit
Douching
Cleaning the vagina with water, etc. It seems to be required early post-op, but somewhat unlcear how often you need to douche in the long term. For cis-women its not reccomended
Marci Bowers (SRS surgeon) - http://marcibowers.com/mtf/wp-content/uploads/sites/3/2014/05/Discharge-instructions-for-GRS-edited-revisions-no-phone-number.pdf - "There will be some blood-tinged discharge on your pads for at least a few weeks This diminishes as healing advances. Odor will change from a somewhat foul‘healing odor’ to a more natural ‘feminine odor’ over 6-12 weeks. Douching during this period with warm water and capful of vinegar is acceptable. Beyond 12 weeks, douching is discouraged as it depletes the vagina of bacteria that maintain the normal vaginal health and well-being."
UCSF Center of Excellence for Transgender Health Vaginoplasty procedures, complications and aftercare by Toby Meltzer (SRS Surgeon) - "Initially the patient should douche daily during frequent dilation. Douching can be reduced to 2-3 times a week when dilation is less frequent."
reddit Having anosmia, how will I know when to use a vaginal shower after SRS? by miarella in 2018
- I went to Dr. Chettawut and he specified using one once a week for three months and then as needed thereafter. After the three month period I’ve used it only occasionally.
- once in 2.5 years
reddit Life after SRS question. (nsfw?) by KiaraCake in 2019
- Douche once a day? My surgeon said to stop at 2 months. Most people seem to stop once they get past the initial stages of healing... Dr. Sutin - PAI
- My surgeon was Brassard in Montreal, his instructions are to douche once a day forever to prevent dead cells from accumulating and causing infection.
- My gifriend had hers from brassard 3 years ago and she just douches once a week after her dilation. Even talking to her about it now shes pretty confused by it.
- Apparently others who have been to Brassard have stopped / reduced their douching without adverse effects, although Brassard's instructions indicate that you'll basically die if you skip it for any length of time.
- I've douched one time in two years, probably against medical advice. (Bowers)
- My girlfriend went to Brassard about 18 months ago and I don't think she's douched in like a year.
- I stopped douching about 3 months ago and I've had no problems.
reddit Post-vaginoplasty: do you douche? by stellaproiectura in 2018 - "I’m recovering from GRS with Dr. Brassard and their recovery booklet specifies to douche every single day for the rest of your life. This seems abnormal; for cis women, douching is generally ill advised ever, let alone once per day. I’ve spoken to former Brassard patients who were not informed to douche daily, and who haven’t douched at all in years. Others douche once a week. "
- I went to Bowers and she specifically states not to douche. I've never douched once and I'm perfectly healthy.
- I went to Brassard three years ago and my booklet specifically said not to.
- I haven't douched in 15 years.
reddit How do you clean cum out of post op vagina NSFW by transsurgery around 2017
- I had surgery with Chettawut, I asked him and he said I could douche after sex if I wanted to, but it's not required.
- I have never douched, surgeon said not to because they are self cleaning
- I see you went to Chet, I went to Suporn which is a very similar method. I was told not to worry about it, it'll clean itself.
reddit For those post-op, how's sex? by transthrowaway45345 around 2016
- Do you clean your vagina in the shower or do you need to douche everytime? Shower only. Haven't touched since like 3 months post-op.
- I very rarely douche anymore. Theres no weird discharge so I dont really worry about it. Just wash it down in the shower.
- I clean it like my first gf taught me. Get all the junk out of the folds, but don't wash inside. The insides take care of themselves.
- I wash my vulva in the shower. You shouldn't be cleaning the vagina out unless you have a yeast infection or when you're early in post op. The neo vagina cleans itself and douching damages it's internal flora which it uses to keep itself clean - although it takes a couple of months to reach this point.
- Just the shower. Don't douche hardly ever.
- Just clean in the shower.
- No, I use baby wipes to clean up any mess, then shower when appropriate.
- I douche when the dilator comes out stinky. Yes. I sniff it every time.
susans Do you girls douche? by kimbee777 in 2016
- I was instructed to do it after surgery but I haven't done it in many years.
- I went to Brassard, and he recommended douching for the first two months but not afterward "because it can disturb the normal balance of the vagina." I followed his instructions, and I've had no problems (I'm 4 years post-op now).
- Nope I never douche.
- I am almost 2 years post op and I douche every single day.
- No I do not and I am sexually active.
- I am 15 months post op... Dr B was my surgeon as well and I got the don't need to douche talk from her as well...
susans To douche or not to Douche? by Gail20 in 2018
- I haven't douched in eons ... like decades really.
- I never douched, not even once.
Susans Using a feminine douche? And general cleaning tips/tricks? by Blush in 2015
- I use a douche now and again - not by any means every week or indeed month - but as and when...
- My doc recommended it for the first few weeks and then "as needed" thereafter. I generally don't do it.
- Douching is important post-SRS...at least that's how Menard did it...We had to douche after dilating for a few months as I recall...then it was just douche when you feel you need it. Now so many years out, I only douche when I think about it, which is rarely.
Vaginoplasty: Male to Female Sex Reassignment Surgery, Historical notes, descriptions, photos, references and links. by Lynn Conway 2000-2006 - "The postop woman may need to douche occasionally, especially after intercourse, in order to keep her neovagina clean and odor-free."
Excercise
reddit
Susans
Gynaecological
YouTube
Piercings
reddit
Probiotics
reddit
Recovery
reddit
Recovery
Can be caused by internal hair and granulation (and probably many other things).
reddit
- Reoccurring Infection by transthrowaway7895 in 2022 - "I got the issue checked out by a doctor who works with post op patients. Turns out it wasn't a reoccurring infection but granular tissue at the apex. Dilation was irritating it and causing blood, the odor, and the weird discharge. I did seem to have had a BV infection but it either was taken care of by the initial antibiotics or switch to ph balanced lube after. The doctor I saw applied silver nitrate and the symptoms improved / disappeared immediately after."
Sensitivity
reddit
Sports
reddit
Urethra
reddit
Urinating
reddit
Susans
Porn
Papers
- 2021 - How Women and Men Pee: Assessing Gender-Specific Urination Practices for a Comfortable Toilet Experience by Vasco Schelbert, Lena Kriwanek, S. Ramesh Sakthivel, Lotte Kristoferitsch, Harald Gründl, Christoph Lüthi - this paper relates to squatting, not sitting - "We used infrared recordings to assess gender-specific urination practices... The results show that the minimum angle for females is around 7°, and the maximum exit angle is around 70°. Conversely, for men they are 5° and 45°, respectively, and thus, the range is smaller."
- 2020 - Urethral complications after gender reassignment surgery: a systematic review by N Nassiri, M Maas, M Basin, G E Cacciamani, L R Doumanian
- 2018 - Gender-Affirming Penile Inversion Vaginoplasty by Ali Salim and Melissa Poh - "Corpus spongiosum is then dissected off corpora cavernosa, and the attachment of the corpus spongiosum to the crus of the corpora cavernosa should be separated so the urethra can point in a downward position when the patient sits to urinate. Circumventing this step can result in an anteriorly directed stream, where the patient would complain of messy and non-hygienic voiding." - note that "anterior" means towards the front
- 2016 - Lower Urinary Tract Symptoms in Male-to-Female Transsexuals: Short Terms Results and Proposal of a New Questionnaire by Carlo Melloni, Guglielmo Melloni, Matteo Rossi, Luigi Rolle, Marco Carmisciano, Massimiliano Timpano, Marco Falcone, Bruno Frea, and Adriana Cordova
- 2005 - Impact of sex reassignment surgery on lower urinary tract function by Piet Hoebeke, Gennaro Selvaggi, Peter Ceulemans, Griet De Cuypere, Guy T'Sjoen, Steven Weyers, Karel Decaestecker, Stan Monstrey - "Results: In general, no change in voiding patterns was observed. Post-void dribbling was reported by 79% of the FTM transsexuals, and 16% of the MTF group reported some form of incontinence."
Vaginismus
https://en.wikipedia.org/wiki/Vaginismus - "Vaginismus is a condition in which involuntary muscle spasm interferes with vaginal intercourse or other penetration of the vagina. This often results in pain with attempts at sex."
reddit
Complications
Death or Brain Damage from Anaesthesia by Dr Jennifer Hares, in 2017 - "The risk of dying in the operating theatre under anaesthetic is extremely small. For a healthy person having planned surgery, around 1 person may die for every 100,000 general anaesthetics given. Brain damage as a result of having an anaesthetic is so rare that the risk has not been put into numbers."
Papers
The Netherlands, in Dutch
https://www.transvisie.nl/transitie/volwassenen/intimiteit/ - shows an very high rate of loss of sensation, google translated - "In the sex confirmation operations, the surgeon will do his/her utmost to make the sensitivity of the new genitals possible. However, not everyone will actually succeed. In transgender women, the Amsterdam UMC (VUmc) indicates that this works in 80% of all operations."
Onderzoek Transgenderzorg, Nederland, https://www.transvisie.nl/wp-content/uploads/2016/12/onderzoektransgenderzorgnederland.pdf, google translated - "Conclusion: 81% of the vaginoplastics in the VUmc lead to one or more recovery operations. On the basis of the prudent figures that are there, the data from Thailand / Germany / Ghent (B), the percentage of recovery operations in these countries seems significantly lower."
Many papers don't mention who the surgeon was. Got to wonder why.
Anal Fissure
https://en.wikipedia.org/wiki/Anal_fissure - "An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet paper and undergarments, or sometimes in the toilet. If acute they are painful after defecation, but with chronic fissures, pain intensity often reduces."
reddit
Botched Surgeries
I'm not not sure what else to call these. They can be quite disturbing to view. Take this as a warning to be very careful choosing a surgeon, and personally I'd assume they are bad until proven otherwise rather than the other way around.
I've only put a few here, but there are (many) more listed on the surgeons pages.
reddit
YouTube
Hannah Simpson
reddit subs
Bacterial Vaginosis (BV)
See also
- r/Healthyhooha - "This is a sub for safe, open discussion about the maintenance, habits, questions, and tips related to vaginal and vulvular health."
Not necessarily a complication of surgery.
Cowpers Cyst
reddit
- Experiences with "Cowper's Cyst"? by cyberpunk_trans in 2024 - " I'm a few years post-bottom surgery, and 1 year post-revision. I had my surgery performed at NYU by Dr. RBL. Shortly after my revision, I complained to my surgeon about some swelling in the area next to my urethra, on one side. It was swollen and slightly dark-colored. She suggested it may be a cyst, and prescribed some cream to see if it would resolve itself. It didn't resolve itself. The swelling remained and it was somewhat inconvenient and occasionally uncomfortable for a number of months. Finally, I flew to NY for a post-op visit, and the Dr was able to take a closer look. Her conclusion was that it was a "cowper's cyst" - a cyst formed from cowper's gland fluid, possibly from some blockage in the duct. She nicked it with some scissors and allowed it to drain. It's been a few days since then, and the swelling has gone down considerably. It's my hope that the cyst is resolved. If it comes back, I'll have to schedule a surgery in NY for a more through cyst excision. Notably, Dr. RBL mentioned that she does occasionally see this happen with some bottom surgery patients, but did not know why it occurs."
Death
See Death on the main surgery wiki page.
Dehiscence
Wound separation
reddit
Dilation and Depth
Depth or tightness.
reddit
- Extreme dilation pain by Emma Landing in 2022
- Starfish technique for neovaginal opening scar tissue restriction and lack of vaginal aperture width. by Drwillpowers in 2022
- Depth gaining progress by galjer10n in 2022, surgeon Chris McClung (USA)
- reply to Confused about vaginoplasty by Maybebaby57 in 2020
- Succesful Attempt at Gaining Depth by 9lexi in 2020 - "In the name of data compilation, I am very happy to report that I have gained approx 1.5-2" of depth, overall. The 6-inch mark on my dilator now sits flush with my labia minora. This was achieved simply by putting extra pressure on the dilator, as advised on the previous thread and by my surgical nurse when consulted. I occasionaly use coconut oil as a lubricant, which has had the added effect of softening the skin around my pelvic floor considerably."
- Dilation tips to maximise depth? by 9lexi in 2020 - "I'd been on blockers since early puberty, and I came out with just over 4 inches of vaginal depth - admittedly a good result for what I had to offer."
- reply to Succesful Attempt at Gaining Depth by darthemofan "this matches my experiences: it is possible to gain or regain depth, contrary to what the surgeons proclaim... I see from the other posts you had surgery 4 month ago. I do not think such results are replicable much further than than 4 month mark (1.5 to 2") but 0.5 to 1" might within 6 month to 1 year. I do not know if the effect can be cumulative... With Suporn, I gained about 1.5 inches in the first 2 months, to about 7.5 as measured with the L Due to serious disease, I could not dilate for a while at about 8 month post op. It was not SRS related but really bad and I didn't have my mind on that. It was about 2 month stop. Hard to remember, it's a bad experience I try to forget I lost about 1 inch, and have since regained / relost/ regained some of that. Currently, at least on the S, I'm at 6.5, on the L I used to be at 6 but working up Then a few month ago I have lost the M dilator (yeah my bad, don't do drugs kids) making it tough to work with just S and L so I'm back to 5.5 on the L while still at 6.5 on the S I will try to get soulsource or something with E3 oil to go back to at least 6.5 on L"
Susans
- Depth by Rachel in 2020 - 3.5/4.5" to 6" using a Sybian sex toy
YouTube
Vaginismus
Its not clear to me it this is relevant, but perhaps.
https://fertilitypedia.org/edu/therapies/pharmacotherapy-of-vaginismus - mentions topical lidocaine, botox injection, anxiolytics (anti-anxiety medication)
This non-trans reddit comment might have some relevance
- I bought a dildo to "break myself in" after having trouble with penetrative sex with past partners. - "When trying to have sex for the first time, it wouldn’t go in and the pain was unbearable. I thought it was because I needed to be “broken in” and kept trying but nothing changed. Had my first OBGYN appointment and all she did was prescribe me vaginal muscle relaxer ointment to put inside there. I applied it before sex and it was like magic. My muscles didn’t contract and was able to have sex and enjoy it. I only needed it 2-3 times after that and after those times I didn’t need it at all. Over a year later and my sex life is now pain free!!"
Papers
2017 - Advances in the Treatment of Chronic Pelvic Pain: A Multidisciplinary Approach to Treatment by Sarah K. Hwang - "Muscle relaxants are also commonly used for symptom relief when pelvic floor muscle spasm is contributing to the patient’s pain... Certain muscle relaxants, such as diazepam and baclofen can be made into a suppository or compounded cream and used intravaginally. Vaginal diazepam is generally well tolerated, with the major side effect being drowsiness. In a retrospective review by Carrico and Peters, 67% of women reported no adverse effects from the vaginal diazepam, while 33% of women reported some drowsiness."
Discharge
reddit
Erectile Tissue
reddit
YouTube
Susans
Excess Lubrication
reddit
YouTube
Granulation
Usually its a small matter to have it fixed, but occasionally its more of a problem.
https://en.wikipedia.org/wiki/Granulation_tissue
reddit
- Need help with first silver nitrate application yesterday by grsfollowupquestions in 2024
- months post-op Brassard by u5ern4me2 in 2024
- reply to Don't dilate like that, dilate like this. You're probably doing it wrong (Surgeons hate him! learn this one cool trick!) by Personal-Tutor5225
in 2023 - "I sourced this : Kenalog In Orabase (Triamcinolone Acetonide) - 0.1% (5g)" and Powers replies "That's the stuff I use. Basically the same thing + benzocaine. But topically on granulation tissue, it causes it to turn to non-granulation tissue extremely rapidly. Usually only one application is needed. It's quite effective."
- 7 Weeks Post PIV SRS (Dany Hanna) by Narrow-Selection3725 in 2023
- Dr Brassard inside cavity hyper granulation pics. I will post fully healed cavity pics when im done with the weekly treatment. Pictures taken at 4months post op. by Alexe1337 in 2023
- Is this Granulation? by ExpJustice in 2023
- 6 Weeks Post PIV. Red Areas Recently Appeared. by Narrow-Selection3725 in 2023
- Day 48 post SRS (I think). I'm still alive... I loosing hope for my vagina to look like one... I'm not posting because there is not much changes... The only thing is that now I'm using the big dilatator and it hurts so damn much. by Cut3LittleBunny in 2022
- Two things, one personal, and one a neat trick for post-op granulation tissue. by Drwillpowers in 2022 - "... Apparently I should have posted on this ages ago? Silver nitrate certainly works for granulation tissue, but I think it is absolutely not the best option for post-op trans people. It stains the tissue and can leave semi-permanent "tattoos" it tends to spread beyond where you want it to go and can atrophy other tissue a little bit, and its only somewhat effective. Steroid injections are also commonly used for overly prolific granulation tissue, but once again, hard to keep where you put them and its easy to overshoot and cause atrophy. What would be a lot better would be a topical steroid, but in a wet area, creams/ointments just spread around like mad. There exists "triamcinolone dental paste". The stuff is hydroscopic and was designed to be placed in the mouth on apthous ulcerations (canker sores). As a result, you can take a little dab of this paste, and push it onto the cancer sore, and it rapidly absorbs water from the surrounding tissues and glues itself in place, eluting the steroid directly at the site of application but minimal exposure to the surrounding areas. As a result, I can take this stuff, and basically place it on undesirable granulation tissue, and literally within days, it begins to regress backwards due to its impact on the vascular proliferation. Once the granulation tissue becomes a regular old wound bed again, you just stop using it and hopefully things heal over right. If not, and it starts to come back, you just bonk it again with another coating once a day until you get where you need to be. This is far less irritating, seems to be extremely effective, and is highly precise. I couldn't find any evidence when I searched of this drug in studies or elsewhere being used in this fashion, and its exceptionally effective and in my opinion superior to that of other options. Sorry I didn't post on this one before, sometimes I do stuff and not really think about it being a big deal, but I've had a few of these in a row lately and the patients commented on how much more convenient/effective it was and I realized I should prob post it up."
- Is this hyper granulation? Sorry for graphic pic by throwaway5523354 in 2022
- Silver Nitrate Discharge by Tylizle
in 2022
- Reoccurring Infection by transthrowaway7895 in 2022 - "I got the issue checked out by a doctor who works with post op patients. Turns out it wasn't a reoccurring infection but granular tissue at the apex. Dilation was irritating it and causing blood, the odor, and the weird discharge. I did seem to have had a BV infection but it either was taken care of by the initial antibiotics or switch to ph balanced lube after. The doctor I saw applied silver nitrate and the symptoms improved / disappeared immediately after."
- Persistent Granulation Tissue by SinAthena in 2022
- 4 month post op granulation tissue/bleeding by Vannaspite in 2022
- Feeling Suicidal After SRS by u1traviolette in 2022
- reply to Question on discharge postop - how long do you end up wearing pads for? by RxDotaValk in 2021 - "Once my surgeon used silver nitrate to burn away the granulation tissue (this happened at my 6 month follow up appointment), my daily amount of discharge decreased dramatically. It was night and day. I was getting really nervous because at 6 months and still having to wear pads or changing liners every few hours...it was causing a lot of anxiety for me. I was wondering if this was the new normal. If you have a lot of granulation tissue (the lumpy bright red tissue), make an appointment with your surgeon asap to get it removed. They cut off a piece when I was in the office but it didn't hurt at all, surprisingly. My surgeon also gave me a prescription for clobetasol that has helped clear up almost all of the remaining granulation tissue that didn't go away after the silver nitrate treatment."
- what should I expect from silver nitrate for granulation tissue? by IncognitoGirl81 in 2021
- Almost 5 months postop - skin grafted canal addition from original zero depth vaginoplasty 10 months prior by galjer10n in 2021
- Dilating after a silver nitrate treatment? by saoirse_floflo in 2021
- This treatment reduced my hypergranulation when silver nitrate didn't by RosyGlow in 2021
- Reoccurring granulation, post srs, any advise by Andsheshallnotnofear in 2021
- Silver Nitrate Use by LongBeachVero in 2021
- Discharge after GCS 6 months post-op by Melissa7d in 2020
- Has anyone had granulation on the clitoris? by notyourdonut in 2020
- Granulation at 10 months by throwawaymybut in 2020
- Douching & Granulation by 9lexi in 2020
- granulation help? by zFr0st in 2020
- Complications by ExLibrisMortis in 2020 - surgeons is Bowers in the USA
- SRS: granulation inside vagina by smilewithnose in 2020
- Steroid cream for granulated tissue. This work for anyone? by pile_drive_me in 2019
- Should I use silver nitrate by myself?? by lovelikeamelie in 2019
- reply to I need your help... because... I don't know how much longer I can keep going on this way. Please. Any help. I'm begging you. by EmmaLake in 2018 - an example of post-SRS granulation
Susans
YouTube
transpulse
Other
Hematoma
reddit
Incontinence
redd
Long Recovery
Some women have a long and difficult recovery
reddit
Hair Loss
See Hair Loss on main surgery wiki page.
Libedo
Anti-depressants, finasteride, low testosterone can all cause problems. For some bioidentical progesterone can help with libedo.
reddit
Medical Adhesive
- reply to First day in Bangkok by Allieh6935 in 2019 - "I was allergic to the glue they had on the bandages and the glue used like I have big scars from it "
Necrosis
https://en.wikipedia.org/wiki/Necrosis - "Necrosis (from Ancient Greek νέκρωσις, nékrōsis, "death") is a form of cell injury which results in the premature death of cells in living tissue by autolysis."
reddit
Neuropathy
https://en.wikipedia.org/wiki/Peripheral_neuropathy
reddit
Pain
Pain is common in the weeks/months after surgery. A small percentage of women have severe pain for longer.
Possible reasons for pain include
- Everyone recovers at a different rate and has different experiences of pain. Even when everything is normal some people will have significant levels of pain for months while others have very little even while still in hospital.
- Pain in the weeks after surgey is common, and would likley be treated with drugs, potentially quite strong.
- Standard painkillers do not work for some people and they need to try alternatives. This can happen in hospital as well as afterwards. Some doctors are very poor at prescribing good painkillers (because of potential for abuse).
- Granulation, especially if its in a senstitve spot. This can last a long time and worst case may need revision.
- Scar contraction. This can last a long time and worst case may need revision.
- Sutures can be sharp and poke in sensitive spots.
- UTI's can be horribly painful. These need medical treatment. Standard tests do not show up all possible UTI's so a negative test does not necessarily mean you do not have one. Some UTI's will need different antibiotics.
- Infection.
- Recreational drug use can give a very high tolerance for painkillers (opiates) to the point they don't work and doctors are too scared to give you more. Worse, you may also have an increases sensitivty to pain.
reddit
- reply to Is anyone just tired of dealing with surgeons and kinda shocked at how often they are blatantly bad people or just have horrible bedside manner? by TransexxedTransexual in 2024 - "I had a vaginectomy and part of a Johansson's urethroplasty with Dr. Dmitriy Nikolavsky in Syracuse, NY... I was in severe pain for the next week. I told this to the medical team but they couldn't have responded worse... I went in to get seen and check if there's an infection. There wasn't, I was just in pain because I had an intense surgery. The nurse coordinator there, Amy, initially said I can't be in pain. I continuously stated that I am definitely in severe pain. She then said that I can't be in that much pain, and when I said I am, she said that the pain must be from something else and can't be from surgery... The entire time they saw me I was in severe pain and completely unable to sit down at all. Sarah, the nurse practitioner there, made it seem like I was drug seeking and "refusing" to cooperate and essentially wrote the visit notes that way. She said they can only treat post op pain, not chronic pain (I literally just had surgery that week!!!)... He then went on a long speech about how he had a patient like me before and how his supervisor is supportive of him not operating on anyone he doesn't want to, etc. That was the last I had talked to him... He apparently has a habit of doing this. Since this happened to me, I've talked to/heard of at least 5 other people who were treated like this or dropped as patients by Nikolavsky... I would never recommend him to anyone. I regret seeing him and it permanently traumatized me. For months it was difficult to feel any sort of sensation in my penis because I was terrified it would turn into severe pain."
- Warning about Dmitry Nikolavsky in Syracuse, NY by warningDMSyrcacuse in 2023 - "He does not provide adequate pain meds for a lot of people. He gives tramadol, Tylenol, and celebrex for pain by default. No stringer opioids. Even if you think you'd find that to be enough for pain, I strongly, strongly, STRONGLY recommend you tell Nikolavsky that you don't do well with pain at your consult. That way, the office will make an appointment with their pain management clinic (which is like 15 to 20 minutes drive from the hospital) and THEY'LL have to give you/clear you for pain meds. Context: I had no fucking clue they'd do this and was left suffering, I was completely unable to do anything but cry and scream for a week and Nikolavsky's team did nothing about it but minimize my pain and gaslight me ... I have a medication listed in my allergies and his team came in while I was in the hospital and less than 24 hours post op to try and pressure me into taking that medication. During my post op visit, he came in with a resident and when I asked who he was and why he was there, the way he answered made it seem like I wasn't allowed to say no to him being there. "
- Update - painful dilation by JustSoBitter in 2023 - "I went to my GP who prescribed neuropathic painkillers. It totally fixed everything. I even introduced the next size up to my dilator routine and have been able to hit depth consistently. Dilation also takes about half the time it used to."
- Sharp pains in labia 3 weeks post SRS by JustSoBitter in 2023 - "I had PIV about three weeks ago... In the past couple of days, I've been having really intense sharp pains around my labia, specifically around the suture lines."
- Post GRS pain relief. What were you given ? by Icy-Yogurt-Leah in 2021
- Severe ongoing nerve pain after grs MTF in Thailand by overlycaucasian1 in 2021
- Does the pain ever stop? by Sorvena in 2020
- Struggling with post-op pain by Sorvena in 2020
- Bad experience with Dr. Wittenberg by RainbowPassage1 in 2020
- Post op girls. How much does it honestly hurt? by Shadow_Heart_ in 2020
- [NYT] “After surgery in Germany I wanted Vicodin, not herbal tea” in 2018. This is about the different attitudes to painkillers in Germany vs the USA after surgery.
YouTube
Susans
Postural Orthostatic Tachycardia Syndrome
https://en.wikipedia.org/wiki/Postural_orthostatic_tachycardia_syndrome - "Postural orthostatic tachycardia syndrome (POTS) is a condition characterized by an abnormally large increase in heart rate upon standing. POTS is a disorder of the autonomic nervous system that can lead the individual to experience a variety of symptoms. Symptoms may include lightheadedness, brain fog, blurred vision, weakness, fatigue, headaches, heart palpitations, exercise intolerance, nausea, diminished concentration, tremulousness (shaking), syncope (fainting), coldness or pain in the extremities, chest pain and shortness of breath. Other conditions associated with POTS include Ehlers–Danlos syndrome, mast cell activation syndrome, irritable bowel syndrome, insomnia, chronic headaches, chronic fatigue syndrome, fibromyalgia., and amplified musculoskeletal pain syndrome."
reddit
- Beware of POTS post-op by SoVeryBohemian
in 2023 - " It's when your pressure is naturally a bit down and when you get up your blood doesn't get to the head quickly enough so you might get dizzy, lose your vision for some seconds or outright faint. I'm a big case and it happens basically every day once or twice cause I'm dumb and don't take time to get up. You usually get some seconds of grace of your vision going black and can act quicky by bending down or if it's bad enough sit or lay down to avoid fainting. If it gets to the point of shaking uncontrollably you're most likely going down." - also see the reply "What youre describing in this comment is orthostatic hypotension not POTS."
Prolapse
reddit
YouTube
Papers
Recto-vaginal Fistula
See also Vesicovaginal Fistula.
reddit
YouTube
Sex Reassignment Surgery: When Things Go Wrong by Amy Hunter in 2010 (the surgeon is not named, but from the desciption its clearly Marci Bowers), see also “This Is So Hard:” Coping with Complications from Gender Affirmation Surgery in 2017
Statistics
- Europe 2.3% (25 of 1037)
- France 2.6% (sample 189)
- Germany 4.2% (1 of 24)
- Sweden 2% (4 of 205)
- Unknown surgeon, 330 sample, 0.9% (3 of 330)
- Preecha (Thailand) 0% (0 of 395)
- Suporn (Thailand) 0.08% (2 in 2500)
- Bellringer (UK) 0.75% (6 in 800)
- Tina Rashid (UK) 1 in 450 (see here)
- Wittenberg (USA) 2% (see here in 2021)
- McGinn (USA) 0.6% (see here in 2021)
Sources
Need to review these to find out where the data came from, some may be not relevant
Papers
Scarring
See also the section on scarring on the the Introduction page.
reddit
Sensation
It will likely take some time to regain the ability to orgasm after surgery, and permanent loss is rare. 3 months is far too early to worry, and it can take up to a year. Less common it takes longer than that. If you still have sensation to touch you're likley still ok.
Anti-depressants, finasteride, low testosterone can all cause problems. For some bioidentical progesterone can help with libedo.
reddit
- (update) antidepressants were actually worsening my post op depression by transthrowaway12121 in 2023 - "hi some time ago i was being sad here talking about regretting srs and sex being shit and stuff. i had been on lexapro and wellbutrin for many years but on a low dose, it was even on my doctor's radar i could get off it at some point as i had been doing well. ever since srs even without things going wrong i felt out of it, disconnected from my enotions and body and side effects like sexual dysfunction were reallt fucking me up. so since some weeks ago ive been off those meds and wow i instantly feel so much better and sex is so good. i instantly went from regretting surgery to suddenly just feeling peace and hope about life in a way i never have before...."
- Finally able to orgasm! (6 months post op) by heyImMissErin - "I was so discouraged for the past two months not being able to find any pleasure in masturbating but I finally managed to orgasm! Huge sigh of relief (literally and metaphorically!)."
- reply to Is anyone who had vaginoplasty unable to orgasm? by mtfanon999 in 2022 - "J.Bellringer, "Genital surgery", pages 209-219 in J.Barrett, "Transsexual and other disorders of gender identity: a practical guide to management", London, 2007, in the section on clitoroplasty, which focusses on techniques for creating a sensate neo cltoris, on page 214 concludes "only some 75% of patients are able to reach orgasm." In the concluding section on sexual function, on page 219 he stated - in the context of vaginal sexual stimulation - that "a reasonable estimate is that some 85% of patients are able to attain organsm after the operation. Gradual incremental improvement in surgical techniques over the last 15 years may account for the rise in the proportion of people reporting a sensate neo citoris from Bellringer's report of 75% in 2007, to Rashid's report of 85% in 2021."
- After GRS, my vaginal skin and surrounding area are completely numb. Any surgery or way to fix? by BeechHause in 2020
- How long until feeling comes back? by sharinganuser in 2020
- I just had an orgasm for the first time since bottom surgery. by bipolarSamanth0r in 2019 - "it's been 20 months and I thought I couldn't any more"
- loss clitoris sensation risk by Susaop in 2019
- Had SRS and my hands are numb. Anyone else deal with this? by Optishosh in 2019
YouTube
Other
Smell
reddit subs
- r/Healthyhooha - "This is a sub for safe, open discussion about the maintenance, habits, questions, and tips related to vaginal and vulvular health."
reddit
Urethral Stricture
YouTube
Urinary Tract Infection
https://en.wikipedia.org/wiki/Urinary_tract_infection - "A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidney infection (pyelonephritis).[10] Symptoms from a lower urinary tract infection include pain with urination, frequent urination, and feeling the need to urinate despite having an empty bladder. Symptoms of a kidney infection include fever and flank pain usually in addition to the symptoms of a lower UTI. Rarely the urine may appear bloody. In the very old and the very young, symptoms may be vague or non-specific."
reddit
- Blood when wiping after peeing and constant feeling of needing to pee. UTI? What does one do with this? by SoVeryBohemian in 2024
- AZO has changed my UTI ridden life forever in 2022 - this post is by a cis women, "No one knows the pain of a UTI unless they’ve had it themselves, and those who’ve experienced it can attest to the pain... I took the tablets. And my life changed forever. No running to the washroom, shivering on the toilet, crying and sobbing in pain waiting hours to see a doctor. I drove myself to my doctors appointment, took the urine sample, was scolded for ruining the test results due to the AZO dye, but I regret nothing. They can and will have a look at the urine at the lab LOL. Anyways, to anyone who experiences UTIs here and there, please get yourself some AZO." - this post refers to AZO® Urinary Pain Relief Maximum Strength Tablets, containing "99.5mg dose of active ingredient per tablet, Phenazopyridine Hydrochloride"
- Problems in Paradise by Sapphire-Sarazin in 2022
Vesicovaginal Fistula
See also Recto-vaginal Fistula.
https://en.wikipedia.org/wiki/Vesicovaginal_fistula - "Vesicovaginal fistula, or VVF, is an abnormal fistulous tract extending between the bladder (vesica) and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault."
reddit
Regret
Be aware that there are some hate subs targeting transgender people on reddit by misrepresenting surgery, regret, and detransition. I've not linked to them as the discussion there is very misleading and quite disturbing. If you're not sure if you're looking at a hate sub go to subredditstats.com and look at how the users of the sub overlap with known hate subs like gendercritical, itsafetish, lgbdropthet, detrans, etc (don't go looking at those subs, you'll only get upset).
Regret is rare, but there are a few cases.
Review of the data
reddit
Hate on reddit
YouTube
Susans
David Reimer
- https://wikipedia.org/wiki/David_Reimer - David Peter Reimer (born Bruce Peter Reimer; 22 August 1965 – 4 May 2004) was a Canadian man born male but reassigned as a girl and raised female following medical advice and intervention after his penis was accidentally destroyed during a botched circumcision in infancy.
- https://en.m.wikipedia.org/wiki/John_Money - "During his professional life, Money was respected as an expert on sexual behavior, especially known for his views that gender was learned rather than innate. However, it was later revealed that his most famous case of David Reimer was fundamentally flawed. ... During subsequent appointments with Reimer and Reimer's twin brother Brian, Money forced the two to rehearse sexual acts, with David playing the bottom role as his brother "[pressed] his crotch against" David's buttocks. Money also forced the two children to strip for "genital inspections", occasionally taking photos. Money justified these criminal acts by claiming that "childhood 'sexual rehearsal play'" was important for a "healthy adult gender identity"."
- https://www.healthyplace.com/gender/inside-intersexuality/the-true-story-of-john-joan
Samantha Kane
Huffpost
Papers
- 2024 - A systematic review of patient regret after surgery- A common phenomenon in many specialties but rare within gender-affirmation surgery by Sarah M. Thornton, Armin Edalatpour, Katherine M. Gast - "A total of 55 articles examining regret after plastic surgery were included. The percentage of patients reporting regret ranged from 0 to 47.1 % in breast reconstruction, 5.1–9.1 % in breast augmentation, and 10.82–33.3 % in body contouring. In other surgical subspecialties, 30 % of patients experience regret following prostatectomy and up to 19.5 % following bariatric surgery. Rate of regret after GAS is approximately 1 %. Other life decisions, such as having children and getting a tattoo have regret rates of 7 % and 16.2 %, respectively.
When comparing regret after GAS to regret after other surgeries and major life decisions, the percentage of patients experiencing regret is extremely low."
- 2023 - “Regret after Gender Affirming Surgery – A Multidisciplinary Approach to a Multifaceted Patient Experience” by Breanna Y. Jedrzejewski, Mary C. Marsiglio, Jess Guerriero, Amy Penkin, Jens U. Berli - "A total of 1989 individual underwent GAS, 6 patients (0,3%) were encountered that either requested reversal surgery or transitioned back to their sex-assigned at birth."
- Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence by Bustos, Valeria P., Bustos, Samyd S., Mascaro, Andres, Del Corral, Gabriel, Forte, Antonio J., Ciudad, Pedro, Kim, Esther A., Langstein, Howard N., Manrique, Oscar J. - "A total of 27 studies, pooling 7928 transgender patients who underwent any type of GAS, were included. The pooled prevalence of regret after GAS was 1% ... Based on this review, there is an extremely low prevalence of regret in transgender patients after GAS."
- 2018 - Abstract: A Survey Study of Surgeons’ Experience with Regret and/or Reversal of Gender-Confirmation Surgeries by Sara Danker, Sasha K. Narayan, Rachel Bluebond-Langner, Loren S. Schechter, and Jens U. Berli
- 2017 - Regret in Surgical Decision Making: A Systematic Review of Patient and Physician Perspectives by Ana Wilson, Sean M Ronnekleiv-Kelly, Timothy M Pawlik - "Self-reported decisional regret was present in about 1 in 7 surgical patients. Factors associated with regret were both patient- and procedure related."
- The Journal of Sexual Medicine: The Amsterdam Cohort of Gender Dysphoria Study (1972–2015): Trends in Prevalence, Treatment, and Regrets in 2018 - Only 0.6% of transwomen and 0.3% of transmen who underwent gonadectomy were identified as experiencing regret.
- 2016 - Reversal Surgery in Regretful Male-to-Female Transsexuals After Sex Reassignment Surgery
- 2014 - An analysis of all applications for sex reassignment surgery in Sweden, 1960-2010: prevalence, incidence, and regrets. - There were 15 (5 MF and 10 MF) regret applications corresponding to a 2.2% regret rate for both sexes.
- 2007 - Excess mortality from suicide and other external causes of death among women with cosmetic breast implants - "An increased rate of suicide among women with cosmetic breast implants has been consistently reported in the epidemiologic literature... Among women with implants, we observed statistically significant 3-fold excesses of suicide... Thus, screening for pre-implant psychiatric morbidity and post-implant monitoring among women seeking cosmetic breast implants may be warranted."
PDF 3rd biennal EPATH Conference Inside Matters. On Law, Ethics and Religion, see page 118, "Detransition rates in a national UK Gender Identity Clinic"
Of the 3398 patients who had appointments during this period, 16 (0.47%) expressed transition-related regret or detransitioned. Of these 16, one patient expressed regret but was not considering detransitioning, two had expressed regret and were considering detransitioning, three had detransitioned, and ten had detransitioned temporarily. The reasons stated by patients for their regret or detransition included: social factors, reporting physical complications, and changing their mind about their gender identity and identifying as their gender assigned at birth. The 16 patients consisted of 11 trans women, two trans men, two cis men, and one person assigned male at birth who said their gender identity was “trans”.
Ignore the YouTube video on regret by the Russian propaganda channel "RT Documentary", for obvious reasons.
To put things in perspective
There's paper often cited by hate groups against SRS. The author made an AMA post on reddit around 2018 about it. Read her response here, in particular "The study was not designed to answer the question if gender-affirming surgery causes mortality suicide or criminality so it could not be used to say that gender-affirming surgery causes death. The study does not say that we should not treat transgender persons since they anyway commit suicide on the opposite it say that we need to improve health care for transgender people and that we need to reduce risk in both cardio vascular dead and suicide. Some people interpret that suicide or suicide is a sign of regret to gender-affirming treatment. The study does not say that. To my knowledge there is no study that had showed that suicide attempts in the transgender group is due to that they regret transition. However there are some studies showing an association with suicidality and minority stress"
Sutures
reddit
Papers
- 2007 - The effect of a hydrogen peroxide wound care regimen on tensile strength of suture by Raghu S Athre, Jesung Park, Joseph L Leach - " Analysis of the data showed a statistically significant decrease in tensile strength of fast-absorbing gut sutures treated with hydrogen peroxide compared with fast-absorbing gut suture control samples and fast-absorbing gut sutures treated with only water. ... Though no in vivo studies were performed, a logical extension of these results would be that premature degradation of fast-absorbing gut sutures secondary to use of hydrogen peroxide might lead to widened and/or hypertrophic scars. "
Miscellaneous
YouTube
Intersex
reddit
SRS for Intersex Women
Susans
Research
Papers
- 2021 - The Repairing of the Recto-Neovaginal Fistula in a Male-to-Female Transgender Through Perineal Graciloplasty by Nail Omarov, Sedat Tatar
- 2024 - Histological Features of Neovaginal Epithelium after Vaginoplasty in Mayer-Rokitansky-Küster-Hauser Syndrome by Massimo Candiani, Francesco Fedele, Alessandro Ferdinando Ruffolo, Simona Di Fatta, Stefano Salvatore, Fabio Parazzini
- 2023 - The long-term outcomes of vaginoplasty using acellular porcine small intestinal submucosa grafts in patients with Mayer–Rokitansky–Küster–Hauser syndrome: A case series by Zhi-yang Xu, Ling-xia Li, Xing-guo Wang, Meng-xin Wang, Gai-jing Cao, Bi-liang Chen, Shu-juan Liu
- 2023 - Creation of a decellularized vaginal matrix from healthy human vaginal tissue for potential vagina reconstruction: experimental studies by Jayson Sueters, Fangxin Xiao, Jan-Paul Roovers, Mark-Bram Bouman, Freek Groenman, Huub Maas, Judith Huirne, and Theo Smi
- 2022 - Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 2: Genital Reconstruction) by Norah Oles, Halley Darrach, Wilmina Landford, Matthew Garza, Claire Twose, Chanjun S. Park, Phuong Tran, Loren S. Schechter, Brandyn Lau, Devin Coon - "Objective: To perform the first systematic review of all available GAS publications across all procedures to assess outcomes reported in the literature and the methods used for outcome assessment."
- 2022 - Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 1: Breast/Chest, Face, and Voice) by by Norah Oles, Halley Darrach, Wilmina Landford, Matthew Garza, Claire Twose, Chanjun S. Park, Phuong Tran, Loren S. Schechter, Brandyn Lau, Devin Coon
- 2022 - The Effect of Gender-Affirming Medical Care on the Vaginal and Neovaginal Microbiomes of Transgender and Gender-Diverse People by Yonah Krakowsky, Emery Potter, Jason Hallarn, Bern Monari, Hannah Wilcox, Greta Bauer, Jacques Ravel, Jessica L. Prodger
- 2022 - Systematic Review: The Neovaginal Microbiome by Richard Mateo Mora, Preeya Mehta, Ryan Ziltzer, Mary K Samplaski
- 2022 - Coming Soon: Ability to Orgasm After Gender Affirming Vaginoplasty by Gaines Blasdel, Carmen Kloer, Augustus Parker, Elijah Castle, Rachel Bluebond-Langner, Lee C. Zhao
- 2022 - The Effect of Gender-Affirming Medical Care on the Vaginal and Neovaginal Microbiomes of Transgender and Gender-Diverse People by Yonah Krakowsky, Emery Potter, Jason Hallarn, Bern Monari, Hannah Wilcox, Greta Bauer, Jacques Ravel, and Jessica L. Prodger
- 2021 - Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence by Valeria P. Bustos, Samyd S. Bustos, Andres Mascaro, Gabriel Del Corral, Antonio J. Forte, Pedro Ciudad, Esther A. Kim, Howard N. Langstein, and Oscar J. Manrique
- 2020 - Pedicled Peritoneal Flap Vaginoplasty in Male-to-Female Gender Affirmation Surgery: A Case Report by Poonpissamai Suwajo, Worapon Ratanalert, Krerkrit Sooksatian, Ketchada Uerpairojkit, Navipa Dusitanond, Thiti Chaovanalikit, Sirachai Jindarak, Suthep Udomsawaengsup
- 2020 - The neovaginal microbiome of transgender women post-gender reassignment surgery
- 2019 - Evaluation of BMI as a Risk Factor for Complications following Gender-affirming Penile Inversion Vaginoplasty by Graham C. Ives, Lydia A. Fein, Lindsey Finch, Emily C. Sluiter, Megan Lane, William M. Kuzon, MD, Christopher J. Salgado
- 2019 - Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study by Richard Bränström, John E. Pachankis
- 2019 - Vaginoplasty Modifications to Improve Vulvar Aesthetics. by Watanyusakul Suporn
- 2018 - Abstract: Robotically Harvested Peritoneal Flaps As a Well-Vascularized Adjunct to Penile Inversion Vaginoplasty by Adam Jacoby, Samantha Maliha, Michael Granieri, Lee C. Zhao, and Rachel Bluebond-Langner
- 2018 - Autologous Buccal Micro-Mucosa Free Graft combined with Posterior Scrotal Flap Transfer for Vaginoplasty in Male-To-Female Transsexuals: A Pilot Study. by Wei SY, Li FY, Li Q, Li SK, Zhou CD, Zhou Y, Cao YJ, Zhang SY, Zhao Y
- 2018 - Symptomatic Neovaginal Candidiasis in Transgender Women After Penile Inversion Vaginoplasty: A Clinical Case Series of Five Consecutive Patients. full paper here.
- 2018 - Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development: an international, multicentre, retrospective study on surgical characteristics and outcomes.
- 2018 - Postoperative complications of male to female sex reassignment surgery: A 10-year French retrospective study.
- 2018 - Primary Sigmoid Vaginoplasty in Transwomen: Technique and Outcomes. by Salgado CJ, Nugent A, Kuhn J, Janette M, Bahna H
- 2018 - Creation of Clitoral Hood and Labia Minora in Penile Inversion Vaginoplasty in Circumcised and Uncircumcised Transwomen.
- 2018 - The evolution of transgender surgery.
- 2018 - Autologous Fibroblast-Seeded Amnion for Reconstruction of Neo-vagina in Male-to-Female Reassignment Surgery. by Kamal Seyed-Forootan, Hamid Karimi, Nazilla-Sadat Seyed-Forootan
- 2018 - Predictors of Patient Satisfaction and Postoperative Complications in Penile Inversion Vaginoplasty
- 2018 - Feminizing Genital Gender-Confirmation Surgery
- 2018 - Male-to-female vaginoplasty: Preecha's surgical technique.
- 2018 - Does Depth Matter? Factors Affecting Choice of Vulvoplasty Over Vaginoplasty as Gender-Affirming Genital Surgery for Transgender Women
- 2018 - Male-to-Female Sex Reassignment Surgery using the Combined Vaginoplasty Technique: Satisfaction of Transgender Patients with Aesthetic, Functional, and Sexual Outcomes
- 2017 - Cytology of the neovagina in transgender women and individuals with congenital or acquired absence of a natural vagina.
- 2017 - An Update on the Surgical Treatment for Transgender Patients
- 2017 - Factors Associated with Gender-Affirming Surgery and Age of Hormone Therapy Initiation Among Transgender Adults
- 2017 - The Combined Vaginoplasty Technique for Male-to-Female Sex Reassignment Surgery: Operative Approach and Outcomes
- 2016 - Revision Vaginoplasty: A Comparison of Surgical Outcomes of Laparoscopic Intestinal versus Perineal Full-Thickness Skin Graft Vaginoplasty.
- 2016 - Transwomen and the Metabolic Syndrome: Is Orchiectomy Protective? in 2016
- 2016 - Primary Total Laparoscopic Sigmoid Vaginoplasty in Transgender Women with Penoscrotal Hypoplasia: A Prospective Cohort Study of Surgical Outcomes and Follow-Up of 42 Patients.
- 2016 - An Update on the Surgical Treatment for Transgender Patients
- 2016 - Reversal Surgery in Regretful Male-to-Female Transsexuals After Sex Reassignment Surgery
- 2016 - Surgical Outcome after Penile Inversion Vaginoplasty: A Retrospective Study of 475 Transgender Women.
- 2016 - Sensate Vagina Pedicled-Spot for Male-to-Female Transsexuals: The Experience in the First 50 Patients. by Kanhai RC
- 2015 - Outcome of Vaginoplasty in Male‐to‐Female Transgenders: A Systematic Review of Surgical Techniques by Sophie E.R. Horbach, Mark-Bram Bouman, Jan Maerten Smit, Müjde Özer, Marlon E. Buncamper, Margriet G. Mullender
- 2015 - A Rare Case of Male‐to‐Eunuch Gender Dysphoria by Maria Hermann, Andreas Thorstenson
- 2014 - Voluntary genital ablations: contrasting the cutters and their clients. by Jackowich RA, Vale R, Vale K, Wassersug RJ, Johnson TW
- 2014 - The hidden world of self-castration and testicular self-injury. by Johnson TW, Irwig MS
- 2014 - Gender Dysphoria: The Role of Sex Reassignment Surgery
- 2014 - The use of cultured autologous oral epithelial cells for vaginoplasty in male-to-female transsexuals: a feasibility, safety, and advantageousness clinical pilot study.
- 2011 - Gender reassignment surgery - a 13 year review of surgical outcomes in 2011
- 2011 - Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden by Cecilia Dhejne, Paul Lichtenstein, Marcus Boman, Anna L. V. Johansson, Niklas Långström, and Mikael Landén
- 2010 - Gynaecological aspects of the treatment and follow-up of transsexual men and women in 2010
- 2010 - Vaginoplasty by using amnion graft in patients of vaginal agenesis associated with Mayor-Rokitansky-Kuster-Hauser syndrome. - this is on cis-women
- 2009 - Microflora of the penile skin-lined neovagina of transsexual women by Steven Weyers, Hans Verstraelen, Jan Gerris, Stan Monstrey, Guido dos Santos Lopes Santiago, Bart Saerens, Ellen De Backer, Geert Claeys, Mario Vaneechoutte, and Rita Verhelst
- 2007 - Do histologic changes in the skin-lined neovagina of male-to-female transsexuals really occur?
- 2005 - Female genital appearance: ‘normality’ unfolds (this is cis-women)
- 2004 - Radiological evaluation of vaginal width and depth in male-to-female transsexuals by the use of magnetic resonance imaging.
- 2001 - Sparing a testis during vaginoplasty in male-to-female transsexuals: does it benefit our patients? by Hage JJ, Karim RB, van Diest PJ
- 2000 - Vaginoplasty in male transsexuals using penile skin and a urethral flap.
- 1999 - The effects of topical vitamin E on the cosmetic appearance of scars.
Plos One
The Journal of Clinical Endocrinology & Metabolism
BMC Microbiology
Transformation génitale homme–femme (aïdoïopoïèse) by Marc Revol in 2014
Vaginoplasty with a Pudendal-Thigh Flap in Intersexuals by Yuzaburo Nambaa, Narushi Sugiyamaa, Shuji Yamashitaa, Kenjiro Hasegawaa,
Yoshihiro Kimataa, and Mikiya Nakatsukab in 2008
American Journal of Legal History
The British Journal of Psychiatry
Journal of Sex & Marital Therapy
Obstetrics & Gynecology
American Academy of Pediatrics
Hindawi
YouTube
ResearchGate
Transgender Health
Collection of links
There's a lot of academic papers listed in a spreadsheet here.
Books
Miscellaneous
reddit
Vaginoplasty: Male to Female Sex Reassignment Surgery (SRS) by Liz Conway, 2001-2006
Trans Road Map: Vaginoplasty surgeons and overviews
reddit
YouTube
Susans
Gender Reassignment Surgery: A Catholic Bioethical Analysis in 2018
A collection of photos (these are possibly quite old)
A collection on a French site including Suporn, Marc Revol, Stan Monstrey, Michael Sohn, Yvon Menard, Brassard
A collection including Brassard, Chettawut, Bowers, McGinn, and Suporn.
Post-op porn, generally its difficult or impossible to find out who the surgeons were
Wiki Index
