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I only know of one that I happened across once. I thought it was odd honestly but to each their own. As I understood it - he had to attempt to transition then detransition after getting the operation. Also, he needs to take testosterone for the rest of his life now instead of producing it naturally.
I know of several such cases in Thailand. It’s no big deal there. You still need a letter from a psychologist but there are some (e.g. Dr Graham Peveller) who will write the letter.
It definitely can be done.
Hey there! Just want to clear up many of the things I am reading in the comments on this post.
Gender is very complex and some people (like myself) experience dysphoria only about their genitals and no other aspects of their lives. The reactions I am seeing from a lot of people in the comments are VERY invalidating to non-binary identities when there is actually a community of individuals who feel this way. Please have your friend reach out to me or take a look at some of the things on our subreddit for AMAB people with genital dysphoria (linked below). While most of the members have a major focus on genital dysphoria, some do experience other forms of dysphoria and anyone who would like to read more are welcome to learn about our experience. Just please be respectful!
https://www.reddit.com/r/AMABwGD/
Also, I do not want to downplay the seriousness of surgery, as I have surgery in a couple of months and I know it is NOT going to be a fun experience. But I would talk to your friend and see if they have been suffering from dysphoria for their entire life and thought there was no hope because society says they have to have a binary transition in order to have bottom surgery. Once I learned that is not true, I have been able to find REPUTABLE surgeons who would operate on me. The updated WPATH standards include nonbinary identities and do not absolutely require hormones or a binary social transition. Please tell them that the opinions expressed in these comments are anecdotal and not absolute. Do not get me wrong, some surgeons may police trans identities more, but times are changing as our understanding of gender is expanding as we evolve as a society.
Please have them reach out to me or the other moderator in the group and we can help them figure out what they need!
I am the other moderator of the aforementioned subreddit and I fully endorse this message! Non-binary transgender people exist and we deserve to be recognized without the toxicity of gatekeeping by other transgender people, and the greater global community.
I added your sub to the wiki here
https://www.reddit.com/r/TransSurgeriesWiki/wiki/srs/introduction#wiki_non-binary_surgery
Thanks! Can you credit segremores as well cause he created the subreddit and added me as the other mod.
There’s no credits for subs. The text I gave was just taken from the sub itself so people could get an idea what it’s about before clicking.
I can't seem to comment in your sub. I was going to show you this
https://www.reddit.com/r/TransWiki/wiki/hrt/implants#wiki_testosterone_implants
The sub is restricted as we have to more closely monitor what's being posted. If you request access one of us can approve you, though. :)
Can you add me then? I'm a mod here.
This is good pushback, my apologies. From the OP, I had assumed that the friend was cis, but you're correct that that's not explicitly stated. I've had a hard enough time - still ongoing - with getting my insurance to cover PI even with meeting all the WPATH guidelines. I'm glad to hear that you and others have had success with obtaining surgery from reputable surgeons while having transition goals that are non-binary and/or don't fit the binary transfeminine profile.
in many ways this is one of the most painful and uncomfortable and messy and awkward thinkgs a person can go through. also we kind of have to be crazy to undergo the risks involved, which are uncommon, but really serious. how satisfied anyone will be depends on how important it is to go through the liquid diet, the relearning to poop and piss (yes they competely stop the bowels for surgery) the pain being upright for a few weeks, the risk of pulling stitches with simple movements, for methods providing vaginal depth, there is the intensive and clinical dilating (like a dildo but the fun is replaced with intense discomfort and occasional bleeding for a while) and douching routine (iodine stains everything btw) and a possibility of needing revision surgery or developing a hole through to the bowel ..
alright, i'll stop. but make sure that these things are not glossed over. anyone considering this really has to make a thoroughly informed decision. almost nobody gets vaginoplasty for 'fun' but even less would stay sane through all of it if it wasn't needed for them.
Tbh I don't see a problem with it. There are tons of transmen who are happy with their vaginas, they are still men obviously. I would just make sure they understand the cost, upkeep, consequences of it. But equating gender to genitals is wild on a transgender forum tbh haha.
I just wanted some advice because if I don’t come with some convincing facts he will go through with it
My comment about equating gender and genitals wasn't pointed at you. More the rest of the girls who almost seem scandalized at the idea of a man wanting a vagina. You just seem like a concerned friend.
I am concerned lol I support whatever they decide 100% but I want them to know all the facts first. I mean I get his point with not having any fictional need for a penis since he isn’t interested in marriage or having kids and when it comes to sex he’s a bottom so I don’t blame him for coming to that conclusion but I want to get the facts from people who have done the procedure
I dont have anything to add but the ppl in the comments using he/him pronouns for your friend when you used they/them :( Good luck to your friend
I edited my comment to be on the safe side. OP did use he/him for the friend in several replies. But you're correct that OP did not do that in the original post, and that I extrapolated too much from the word "male". My apologies.
Gender is a spectrum; queer, enby, and gender non-conforming people do exist and it's important we don't try to negate that very real experience.
Edit: others have noted that WPATH guidelines allow for those with non-binary transition goals, and some surgeons will respect that. I wrote the below assuming that OP's friend is cis, though that might not be the case.
Almost no reputable surgeon will do this. They will require a year on feminizing HRT, and a year living as some form of transfeminine gender. Per WPATH guidelines. And you do not want to go to a non-reputable surgeon.
Your friend should work with a therapist experienced in working on gender issues. They seem to think that women have "easier" sex lives, which to be honest is straight-up incel bullshit. Go ask on /r/AskWomen about how simple, easy, fun, and safe their sex lives are. I'll wait.
Your friend, assuming they're not transgender and in deep denial, will experience massive dysphoria from hormones and/or surgery. This is exactly what we trans people transition to deal with. Your friend really needs to work on examining their thoughts and feelings that are leading them to believe that vaginoplasty is something that they want.
True. He’s been through A LOT of sexual trauma as a kid and that might be playing a part in it now that I think about it
Also I appreciate the advice friends :)
No judgement but I'm just wondering, why does your friend want such an invasive life changing surgery if they don't want to transition?
Once you have this surgery, you're bound to hormones for life, its not something you'd do lightly, please make your friend aware of this
See I mentioned how life changing and important a decision it is but by their reasoning they don’t want to be married or have children and feels doing this makes more sense and would give them a better sex life. In their own words “I’m not going to use it so why not” I didn’t really have an argument for that so here I am
Honestly, I'm not here to shit on your friends parade, they should do whatever makes them happy, but any bottom surgery is a huge commitment,
Once you have SRS, you must have a hormone in youe body whether that be Estrogen or Testosterone, and I'm not sure how T would impact a vaginoplasty, so in a way, your friend would be forced to transition anyways, as their female secondary sex characteristics would start developing from the estrogen. Without any sex hormones in their body, your friend would be at risk of several health complications such as osteoporosis and accelerated ageing process.
I hope this helps 💜
I’m not really in the “know” about transitioning tbh so excuse me if some of my questions seem obvious. So like say he gets it done and is put on estrogen. What would be the changes he’d experience and like how pronounced would they be? For example I’m assuming his voice would change and some breast development
Thats okay, you're bound to have questions 💜.
So, all changes depend on his genetic coding and his own estrogen receptors, and everybody's different, but estrogen can: Grow breast tissue Soften skin Redistribute fat Diminish hair growth Cause you to be more emotional Change your natural scent Change your body odour smell
Those are the main ones I can think of, but it really is a lottery as to the the extent of feminisation
Voice Change on estrogen isn't really a thing unfortunately, that's where voice training/speech therapy comes in handy 💜
Ok I see. I’m just trying to get a full scope so o can actually give him somethings to think about because I know for a fact that being on estrogen never crossed his mind. I’m bi myself and lean more towards guys so in a way I can understand where he’s coming from in a way but also the profound effects it would have I can’t in good conscience let him go ahead without FULLY thinking it through. Also how would sex be? I know it’s made with depth and as close as a natural vagina as possible but I’ve heard some trans women say they have self lubricated when aroused some say you can’t also since his wouldn’t naturally open like cis women is he limited to like a certain “size”?
I think it would be possible to do this but fairly difficult. If your friend is interested in this I would honestly suggest researching the procedure, the risks, the outcomes, what it entails. These are surgeries that are irreversible with significant risks. It sounds like your friend may benefit from talking to a therapist about this too.
I think people should do what they want but comments like, they've experienced a lot of sexual trauma, they don't want to consider fully transitioning because of family, makes me think that perhaps their thought process could benefit from professional help in understanding their desires.
That being said, while unlike others I don't think it would be impossible to get GRS without various other aspects of transition - it will make it, I think, significantly more challenging. I do know there are some surgeons that do informed consent vaginoplasty but they are pretty rare.
Without transition no reputable surgeon would preform this as WPATH requires you to be on HRT for a year and living full time plus 2 letters of recommendation from two qualified physicians. So yeah not gonna happen. How perhaps recommend to your friend seeing a qualified therapist and see if maybe they're actually trans and just not willing to admit it to themselves. But if they aren't this isn't an obtainable idea.
Social transition is not strictly necessary, and HRT is probably not either. The psych letters are.
I can confirm this - I had bottom surgery while still presenting as male to save my family and such (but I was on HRT for 1 year at that time) and I had no intent to transition socially, even though I really wanted to and deep down I knew I needed to but I was fooling myself thinking I could just not do it and be ok. I had three letters but they did have to state that I had gender dysphoria and that I was(am) trans gender, which is true. I read all the letters and honestly was surprised at how well each one continued to imply these two facts.
However after GCS I said "what the f%@$ am I doing?" I needed to transition from the start but I was not doing so to save my family and anything else that seemed to matter...after surgery I said truly none of this or nothing else matters if I cant be who I am...and then I fast tracked my transition. Turns out it didn't matter to my family one way or the other, but it mattered more than I ever knew to me.
How long after surgery did you socially transition?
Well I was on medical leave for 6 weeks - went back to work on week 7, and Friday of that week work announced my name and gender change, so once that announcement was made I was 100% in, and at that point I started dressing female and using female restroom.
Since then I've lived 100% female in every way and I am absolutely happy/glad that is the case.
Two referral letters from qualified mental health professionals, one in a purely evaluative role (see appendix); and
Persistent, well-documented gender dysphoria (see Appendix); and
Capacity to make a fully informed decision and to consent for treatment; and
Age 18 years and older; and
If significant medical or mental health concerns are present, they must be reasonably well controlled; and
Twelve months of continuous hormone therapy as appropriate to the member’s gender goals (unless the member has a medical contraindication or is otherwise unable or unwilling to take hormones); and
Twelve months of living in a gender role that is congruent with their gender identity (real life experience).
This came from AETNAs website for current standards of care. In order to avoid HRT you'd need to demonstrate a clear reason why in which case I'd imagine no surgeon wanting to approach this because of "unwilling" as the risk of someone suing for surgical regrets and malpractice being too high at that point.
That's one insurance company, and nice theory, but the evidence says differently
Here's the actual wpath link look in section 54.
Sure, I know that, but people do it anyway.
I'll tell you what if you can find me a surgeons website and an insurance company who openly state they will perform GRS without WPATH standards I'll take that as an actual source.
Did you look at the link I posted?
Reddit is not a source
Given that you don’t actually care, and I don’t care about convincing you, let’s just leave it.
Also same requirements I needed to get the letters from my PCP, my therapist, and I got an extra from another mental health specialist to get approval for my GRS with Mt Sinai and Blue Cross Blue Shield.
I’ve suggested fully transitioning but he would have to walk away from his family they are super not about that unfortunately
Can i ask if you can dm me because i wanted to ask how this works because i wanted to transition in the future but i have no clue where to start or how to start
Sure! I'll be happy to answer whatever questions you may need
Thank goodness. I thought I was the only one who just wanted the bottom surgery and was worried that it might not be possible. Did your friend still have to do hrt?
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