Seven things I learned after my gender confirmation surgery

Rachel Saunders
5 min readJul 16, 2023

Many people ask what it is like having gender confirmation surgery (GCS) and what the impact on your life is years down the line. I had my surgery in Thailand in 2008, an interesting point in world history where to be trans was to be a more or less accepted part of the world, but also where being trans was a mystery to many. Here I want to share seven things I have learned about myself and being post op over the last fifteen years.

1) My recovery was stupidly easy

Compared to many people, it would appear that my personal recovery was about as easy as it comes. I had been advised pre-surgery to keep fit, cut down on alcohol and lose weight. In addition, I was told to eat everything they gave me in hospital regardless of whether I enjoyed the taste. While you cannot eat solids, the Thai nurses provided me with plenty of soup which helped keep me hydrated and nourished over the four days of nil solids. When it came time to leave hospital I walked out without any help, and by the time I flew home three weeks later I was able to pretty much get on with life.

My caveat with sharing this is that not everyone has the same recovery process, and each body is unique. My biggest piece of advice is to get into as fit a shape as possible pre-op and stay nourished throughout your stay in hospital. These things are not easy, but in my opinion greatly helped my recovery.

2) Sex and intimacy are intense and beautiful in my post-op body

It is hard to describe just how much an effect oestrogen had on my body when it comes to touch, being touched, and all round sensitivity. I had plenty of sex pre-op, and one of the biggest differences was that post-op I felt completely at ease with my body without the worry that my partner would see me as weird. I enjoy the frission that comes with this body of mine, and while it took a few months to get used to, it quickly became normal. I rarely have penetrative sex with men, but when I have it has felt right, with no inhibitions or neural disconnect. Sex with femme bodies is on a whole other level, and has a quintessence all of its own.

3) I had dreams about having a penis for many years post-op

This is not something widely talked about, but for years after the operation I would wake realising I had dreamed I still had a penis and was doing things with it. These dissipated after about eight years, but it was as if it took my body a long time to realise and reorientate itself. Not that I was worried, yet it is not something that is discussed in the wider post-op community.

4) Having a vagina does not magically make all the problems go away

When you chase the rabbit for so long and catch it, what to make of the world after? Post-op I went through eight years of trying to build a life for myself before going back to university. My personality was often at the heart of many of the issues I face, and while my gender was squared away, the rest of my life is still very much a work in progress. I have zero regrets about the surgery, and it resolved a festering hole at the heart of me, but reality has a way of not caring about such things unless you make an effort to attend to the rest of your life.

5) I understand the privilege of being able to have the surgery in the first place

Over the last decade the waiting times to access even basic trans healthcare has increased exponentially, and as such I hit the sweet spot for trans care when I did. I also got very lucky in that my then partner loaned me the money to pay for the surgery. I chose to go to Thailand because the quality of the outcomes and the recovery period far outweighed anything available in the UK at the time. For those who cannot access the pathways I did due to country, money, or societal pressure I have all the empathy. It is part of the reason I am discrete about my personal situation, as I do not want to appear to be bragging about my good fortune.

6) Pain is not always part of the process

After I woke up from the GCS I was likely high on the morphine, as it was the most blissed out I have ever felt. There was no pain for much of my hospital stay. However, the real pain started with dilation. It took a good six months for me to go down to one dilation a week, and then a year to go with none. My vagina does not ache, does not hurt, and is simply just a part of me. Yes, some people do have complications, but for me there have been zero. When anti-trans folk talk about butchery, I can honestly point to myself as a hundred percent success story.

7) It all feels so normal

Fifteen years on it all feels so normal. I honestly cannot remember what my pre-op genitals felt like, as this body of mine just feels right. Gender euphoria does not describe it, more like there is no part of me which I wish to change, no fundamental error of biology that I am clawing at to resolve. In many respects I feel like the middle age woman I am becoming, the person I hoped I would grow into. This is the greatest privilege, to grow old and achy as the woman I blossomed into in my youth. GCS was not the end of the path, but merely the gate that opened up a whole new life for me.