Gender reassignment surgery Q&A
There are plenty of questions and articles written about gender confirmation surgery. Namely, what is it like, how does it feel, what is the recovery period like, and does it hurt. This post is from my own personal experience, and hopefully answers some of those questions. This post is intended both for a trans and lay audience, and if you have any questions feel free to drop them in the comments.
This post aims to be gender neutral, and while I myself am an AMAB female, my intention is to be as broadly inclusive of the whole trans spectrum including non-binary identities. I make no judgement on you or the surgeries you wish to have, and hopefully what I put forward is general advice that can be applied across the board.
Bit of background first. I had my vaginoplasty gender confirmation surgery (GRS) in 2008 in Bangkok, Thailand, and spent four weeks in country before flying back and returning to work the Monday after. I spent eight years going through the UK’s NHS pathway (which has changed somewhat since my time) and decided to go private for better post-operative results. My experiences are very much my own, so take from this what you will.
Why have the surgery in the first place?
I underwent GRS because I believed it was the only way to align my inner gender identity with my external physiology. I transitioned at 17, having known I would from about age 9, and having waited 8 years to undergo the surgery I knew intrinsically it was the right thing for me.
Do you ever regret it?
No. Emphatically, it was the right thing for me, and I have not had a moment’s doubt about it since I woke up from the surgery.
Did it hurt?
The surgery and aftermath, no. Mainly because I had an epidural just before I went under and morphine as I was coming round, I had no surgical pain. Seriously, the most blissed out and at peace with myself I have ever felt was in the recovery room after the surgery. I cannot explain just how at peace and pain free I was.
However, dilating my new vagina was the hardest and most painful part. It was a chore, and not at all sexually pleasurable (despite what some sources may say). Even now if I am not comfortable and relaxed it aches whenever I insert anything, though this is typical of a lot of women.
How long did it take you to get back to work?
I was back at work, with a support cushion, four weeks after my surgery. At the time I was working in an office, so I had limited physical exertion and was able to get on with things.
Did anyone go with you?
No. I was alone by myself throughout the whole period, though nurses did take care of me both in the hospital and the hotel. I made friends with other women who were there for various procedures, which helped with the whole process. I am the sort of person who makes friends easily, and I was not phased about being by myself. However, I would always recommend either having someone familiar with you, or being the sort of person who is confident enough to connect with other people who are there. Being lonely in a foreign country is never a good thing, so take care of your mental health as a priority.
Did you have any complications?
No. Thankfully I had no complications and I healed without any noticeable issues. Indeed, if you did not know (prior to me loosing my hair) most people I have slept with or looked at my genitals could not tell the differences externally.
General stuff about the surgery:
Know intrinsically that it is the right thing for you. Having doubts is okay, but do not go into the surgery expecting it will fix everything in your life. One of the key lessons I learnt from the whole process is that any lingering issues I had with myself did not magically disappear the moment I woke up from the surgery. Sort out any mental health issues you may have during your transition, as your post-op life will be directly impacted by those issues. This is not meant to say mental health should be a barrier to surgery (quite the opposite), rather, being in a centred place within yourself makes the healing process go so much quicker.
Get fit and lose weight prior to surgery. Seriously. I am certain this is what enabled me to recovery so quickly and get back on my feet. You will lose weight when you are in hospital due to not being able to eat solids, so being in shape will help your body recover quicker than it would otherwise. I never smoked, rarely drank, and was not one for high sugar/salt foods, and I walk everywhere. If there is one piece of advice you take away from this it is be in shape for any surgery, as otherwise you really will feel it.
Being scared or worried is okay, any general anaesthetic is a big deal. I had been under four times prior to my GRS so I knew the procedures and risks involved, and I always approach any surgical procedure with the same mindset: accept that this may kill me, meditate to get my breathing down and park any anxiety, and have complete confidence in the surgeons operating on me. This may appear fatalistic, but for me there was no point in worrying about any outcome other than a successful one.
Surgery is not the final point in a gender journey, merely a steppingstone along the way. Yes, granted, it is a goal, but if you make your entire gender journey about one or two surgical outcomes you potentially miss the bigger scope of the process. Because I had to wait eight years (due to a multitude of NHS and personal reasons) I think it gave me a deeper perspective on myself and my gender. That is not to say my situation was ideal, but it helped me see surgery as a way marker than the end. In the twelve years since I have gone back to university, travelled the world, been in numerous relationships, and worked for some amazing organisations, as well as making many new friends who have lit up my path.
Do your homework on any surgeon, hospital, and procedure you wish to have done. If the cost appears cheap, as yourself why. If the surgeon does not show their results or provide testimonials as yourself why. If the procedure is the latest thing, get out result images, speak to patients who have had those procedures, and look at the complication rates. You only get one shot at GRS, and you must be confident that it is the right surgeon/technique for you. Don’t rush into it just because you can, as it could result in complications and long-term health issues that are hard or impossible to correct.
Finally, there is no right way to go about this whole gender path. Yes, there are surgical techniques that could give you better outcomes than others, and yes, I completely understand the desire to get things done. However, your journey is your own, and each trans person is a whole bundle of personal intersections that may mean your journey winds its way differently from other peoples. Surgery is a big deal, and having had two gender related surgeries, GRS and a tracheal shave, my best advice is to see these on your own terms, not on terms presented on the internet or forums. Trust me when I say that what people post online is only a sliver of the story, and while things may appear perfect, or not, the truth is always somewhere in-between.
If you are intending to have surgery, then best of luck, if you are caring or supporting someone who is, bon voyage, and if you are generally curious, I hope I have answered some of your questions.
