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SRS Explained

 

My last post seemed to produce many more questions than I expected. Or different questions than I expected, at any rate. So I thought it might be a good idea to explain how my chosen form of surgery works when compared to others. Plus, it should have the added effect of calming me down.

To simplify things, there are three basic forms of vaginoplasty (the technical term for SRS) for trans women. I'll call them "Western Surgery", "Eastern Surgery" and "Colon Surgery", but to be fair, all forms can be found in any region of the world. They vary not only in cost and methods but also aesthetics and sensation results (those are fancy words for a realistic, orgasmic vagina). So I'll show you what's different about them and explain why I'm flying all the way to Thailand to get what's rightfully mine.

First things first, before you can even get the surgery there are several hoops you have to jump through first. You have to be of a consenting age in your country (18 in the States), one year of hormone therapy, one year of "real-life experience" and two letters from therapists (one of which must be have a PhD). Generally, to get those letters you need two years history with one of the therapists. You must also have a "demonstrable knowledge" of the ins and outs of surgery. Most interpret that to mean you must watch a video of the surgery take place and know about multiple surgeons. All of these are just the legal requirements. There's also physical requirements. Generally speaking, most surgeons won't work with HIV/AIDS infected patients and if they do they charge a lot more. You also need a full physical with blood work to demonstrate you're healthy enough to undergo anesthesia and most surgeons have a weight limit in the mid-200s mark. There's also the matter of hair removal in the "unmentionable" region so you don't have hair in your...well, moving on. Oh, and you need money. There's no payment program for this surgery. It's cash up front only.

I'll use Marci Bowers as an example of Western Surgery. When I first began to seriously research surgeons she was my first choice. Primarily because she's a fellow trans woman and a gynecologist. So I figured she would know better than most about what makes a good vagina. She practices what is commonly called "two-stage" surgery. The costs are astronomical, around 20K, which only rises when you consider travel, hotel, etc. Marci is famous, and her fee reflects that. As for the method, she has a variation on the original form of surgery. This is the inversion technique or the "turning the outie into an innie" procedure. To simplify, they take the birth defect, turn it inside out and place it into the pelvic region to create the vaginal canal. The clitoris is created by moving the most sensitive nerves and the outer vulva is created from scrotal tissue. It's been around for a long time and it works. The only problem is that's just the first step. In order to have labia and a clitoral hood you need to undergo "Labiaplasty". This bumps the cost up even more in order to have a realistic looking vagina. Here's an example of the results before labiaplasty. Her patients report positive sensation, which is really the most important aspect of the surgery in my opinion. After all, no vagina is perfect. But this traditional method places less sensation on the clitoris and labia and more in the vaginal canal. Which is a little less than accurate representation of a cissexual vagina.

Pros:
In the United States, less travel
Sympathetic surgeon
Good Sensation

Cons:
High cost
Two surgeries
Vaginal stimulation over clitoral

The least common and, quite frankly, least popular type of surgery is Colon Surgery, actually called Primary Colon Segment Vaginoplasty. The procedure is more or less the same as Western Surgery, however a segment of the Colon is used in order to achieve better depth rather than use skin grafts. This results in a self-lubricating vagina, which sounds like a great sales point until you learn self-lubricating means always lubricating. Sorry if that's TMI for you, it certainly wasn't a pleasant visual for me. The most prominent doctor who performs this type of surgery is Dr. Pichet Rodchareon of Thailand, though there are plenty of American and European surgeons who perform this same surgery. The cost with Pichet is around 10K, which is much cheaper than Bowers but can still require a second surgery for some patients. He's a hit-and-miss surgeon. A lot of girls love him and a lot of girls hate him. Personally, I don't like those odds. The fact that Pichet no longer allows pictures of his results is a pretty bad sign in my book.

Pros:
Lower cost
Self-lubricating
One-step (usually)
Cons:
More travel
Always lubricating
Mixed Results

My surgeon of choice is Dr. Chettawut Tulayaphanich (try saying that three times fast!) who's a great example of Eastern Surgery. I call this technique thus because it's much more common in Thailand and other Eastern countries. Dr. Chettawut's price is reasonable, around 10K not including travel and hotel expenses. And his method is much more accurate in terms of matching a cissexual vagina. Instead of using the birth defect to create the vaginal canal, the skin is used to create the clitoris and outer vulva areas, making these areas more sensitive. The vaginal canal is created by using scrotal tissue and, if needed, skin grafts. He also places the canal close to the pelvic bone and urethra, resulting in a g-spot (yes!) which most other surgeons cannot. Very rarely does he require a second surgery to fix the labia and he consistently has good results. I've yet to find a girl who was unsatisfied with her outcome. The results are some of the best I've seen. To top it all off, his staff cares for you at your hotel through the entire healing process and Thailand is a very accepting country when it comes to trans folk.

Pros:
Lower cost
Best sensation
Sympathetic staff
Consistent results
Cons:
More travel

The final step in all surgery is recovery. This involves "dilation", which is stretching the new vaginal canal out several times a day with a stent (a nice, medical word for dildo) for the first few weeks, slowly increasing the size of the stent and decreasing the frequency of dilation. Ultimately, the only dilation required after a year or so can be in the form of sex or masturbation once a week. This is one of my boyfriend's favorite "perks" of dating a trans girl. He'll get to use the line, "But honey, we have to have sex. It's prescribed by your doctor." Is he a lucky guy or what? There's also a need of douching once in a while. Like dilation this decreases in frequency over time. To add irony into the whole thing, I'll need maxi pads for the first few weeks until the bleeding and swelling go down. To quote Hedwig and the Angry Inch, "It's my first day as a woman, already it's that time of the month." And that plane ride back home will be enjoyed in a wheelchair and later on a donut pillow. Sounds like fun, right? But it's worth it.

Really, once I found Chettawut it was a no-brainer. My boyfriend and I are very excited about our upcoming trip, not to mention the fun we'll have after the fact. Hopefully that answered a lot of your questions but feel free to ask any more, I know I gave the super simplified version. Stay tuned for information about what my trip to Thailand and surgery might be like.

2012

December 21, 2012 is the end of the Mayan calendar and rumored to signal the end of the world as we know it. Personally, I think the Mayans said, "You know what, 2012 is ages from now. Let's just stop. I got more important shit to do. We can update it again in a thousand years or so." Doomsday doesn't concern me, but there are some big events coming next year in my life.

First of all, I should be graduating from Collin with my Associates in May. There's still a long way to go in my academic career, but this is the first milestone since I decided to change my life in 2010. With any luck I'll be off to SMU to finish my Bachelors with a scholarship (hopefully a full-ride) or UTD. It will be a departure from "the basics" and more focused on my passion.

But the event that looms in my mind, and has for years, will take place in Thailand in the last week of July. Here I will meet Dr. Chettawut Tulayapanich, the man who is going to correct my birth defect. The thought of going through sex-reassignment surgery both delights and terrifies me. It's something I want to do and yet also something I have to do. I'm not implying that all transsexuals must get SRS, but this is something I've known I had to do since I learned about it at the age of 12. But as happy as the thought of surgery makes me, the looming reality also scares the shit out of me. It's not just the fact that I've never had surgery, never left the country and only have one shot at getting it done right, but the fact that I'll achieve something I've wanted for so long. I will forever look back on this day as a new beginning. And yet, despite my optimism I worry about everything. Will I have enough money? Will I have complications? Will I be satisfied with the results? Will everything go according to plan? And there's no way for me to know the answers ahead of time. No matter how many testimonials I read and result pictures I look at, it doesn't tell me what my experience will be.

It's been difficult to explain this apprehension to most people I know. My boyfriend is too excited to really understand (who can blame him?) I don't talk about "trans things" with my mom or sister, although my sister will be there during the surgery so I'm sure something will come up between us soon enough. Other trans girls I know are either jealous (because they're still saving for surgery) or dismissive (because they've already had surgery). And most other people I know either happy for me or want to know the technical details. It's odd having such mixed emotions about what will no doubt be one of the happiest days of my life. This is on par with my wedding day or bringing my first child home. The enormity of the event itself scares me. And still, I work toward it each day. I think about it multiple times a day and generally, the thoughts are happy. It's just something I have to push through, because the thought of not having surgery scares me even more.

Game On

When people ask me how I began my transition, I tend to give several different answers depending on my mood. Did my transition begin when I came out as transsexual on my 22nd birthday? I'd say much sooner. What about when I came out as gay before that and began exploring my gender expression before dealing with my gender identity? Close, but still not quite there. Was it the moment in my early twenties when I decided if I was a pervert I might as well learn to live with it? We're getting closer. But the true beginning of my long, painful, beautiful transition to womanhood all starts with video games.

I've mentioned previously that Lara Croft was my first female protagonist in a video game. But that was a much bigger step than I usually give credit. Not only did she open to door to feminist discussions between my mom and me, but she also gave me an excuse to identify as a woman. You see, even if I was given the choice to choose a character's gender (which only ever happened in RPGs back then) I pressured myself into believing I had to pick a male character. Otherwise, people would suspect my gender even more. But with Tomb Raider, I didn't choose to be a woman. I simply was. And that began my exploration of identifying as a woman without feeling guilt or shame. It even gave me to courage to dress like a woman outside my room for the first time, briefly. At the age of 10 I would jump from tree limbs to playground equipment in my backyard while wearing cut-off shorts and a tank top with my stepbrother's cap guns holstered through my belt loops. I'm sure it was quite a sight.




There were plenty of kick-ass females in my life: my mom, Tifa Lockhart, Leia Organa, Daria Morgendorffer and Selina Kyle, to name a few. But I also suffered from the messages that all women are exposed to, telling me being a female was inferior, something unfortunate brought about by birth. It was MMORPGs (Massive, multi-player online roleplaying games) that gave me the courage to identify as a woman again. And feel power from that identity. It all started with a game of Guild Wars my roommate talked me into. I enjoyed gaming with friends, but it was the late-night sessions that kept me coming back. I rolled a female mage in secret and began a new game on my own. It wasn't long before a got a "private message" from a guy asking me to dance naked for money. So I did. I was a new character, broke and titillated at the thought of turning a man on, albeit with a virtual avatar. It wasn't long before my character became a stripper primarily and a mage after the fact. Boys would pay me extra to cyber while I did it, so I earned even more. But pretty soon they were asking for voice chat and pictures and that's when I got scared, the harassment that hounded me prevented me from actually enjoying the game and so I pulled the plug. I still had my male characters, but I lost all interest.







When I found a new online game, City of Heroes, I told myself to take things differently. As much as I enjoyed exploring my sexuality, I learned it was not safe for a woman to do so openly. So I focused on the game itself. I was The Green Mistress, a bow-and-arrow expert who could stalk her villains and snipe them from a distance. I joined a super team that roleplayed in character. I became good friends with Super Mama, a girl who was my age and had a toddler. There was also She-Witch and Tina Trix, who were sisters in college. We would generally play on our own unless a bigger mission required bringing in the boys. This was my first time feeling accepted by other women as myself. We bitched about men, talked about our lives, shared our secrets...but there was always one thing I didn't tell them for fear of losing that acceptance. To complicate matters even more, one of the boys, El Tigre, developed a crush on me. We began playing together once the others went to bed, then one night he asked if I wanted to cyber. I'm sure he was just joking, but I was horny and wanted the sexual acceptance of a male again. So I did it. Things progressed as they had before, he asked for pictures, voice chat and web cams. And this time I gave in. I think I was curious to see how far either of us would go. It almost became a game of chicken, waiting for the other to flinch. But he ultimately won when he began asking if we could meet up and have sex in RL (real life). Once again, I ran.

While these games didn't give me the healthiest beginnings, they did teach me valuable lessons about being a woman in a man's world. It taught me female sexuality is a powerful and sometimes frightening thing when pushed against male entitlement. It taught me about gender discrimination in a way I'd never experienced before. It gave me to power to change my gender in some small way without completely altering my life before I was ready. I like to think of it as my transition training wheels. The first step in a long journey. I'm grateful for the chance those games gave me and wonder how it might help other girls and boys out there struggling to figure out who they are.

Bad Questions

As you may or may not know, I'm going crazy this week trying to get all my homework done as well as set up everything for Transgender Week here on campus. I've just spent the last 4 hours working on definitions, history and explanations of transgender people. I think this last piece I've put together is both informative and kind of funny. It's also been requested by some of the youth I volunteer with at YFT that I post snappy answers to stupid questions. This should kill two birds with one stone. Enjoy, and let me know what you think.

I know this is a bad question, but…
If you know it’s offensive or inappropriate to ask a certain question, then don’t ask it! Imagine it this way, would you ask the same question of your mother or father? If not, then it’s probably inappropriate.

What made you transgender?
What made you cisgender? No one really knows how gender identity is formed but it’s believed to be a combination of nature and nurture. A person can’t be “tricked” or “confused” into being transgender through therapy, peer pressure, upbringing or anything else. Gender identity is innate and unchangeable.

What is your “real” name?
If a transgender person has changed their name, do not ask about their birth name. This is disrespectful and implies they are being dishonest by presenting their preferred and/or legal name.

Can I see a “before” picture?
Would you want to show someone a picture of you at your fattest, your least attractive, your most depressed? This is how many transgender people feel about older pictures. By asking to see a picture of a transgender person before they came out or transitioned, you’re implying their gender presentation now is less genuine than their gender presentation before.

Have you had “The Surgery”?
Asking anyone about their genitals is completely rude and offensive. While many transgender people do receive sex-reassignment surgery, this is not true for all. A person’s “surgery status” does not validate their gender identity and is nobody’s business.

How do you really know you’re transgender?
How do you really know what your gender is? Is it only because someone told you from birth or is it an innate sense of belonging? If you magically woke up with different genitals would you blindly change gender or try to correct your body? The same is true for transgender people.

How do you have sex?
This is not an appropriate question to ask a cisgender person, so it is not appropriate to ask a transgender person either. Regardless of what you may or may not know about their genital status, unless you’re in a sexual relationship with that person, it’s none of your business.

Aren’t you really just gay?
Sexual orientation and gender expression are not linked together. If a transgender person identifies as a woman and dates men, she dates heterosexual men. If a transgender person identifies as a man and dates men, he dates homosexual men. Ignore the fact that this person is transgender and you can answer your own question.

Are you a man or a woman?
If a transgender person has shared their personal history with you, you should already know how they identify. If you’re still not sure, use their gender expression and other cues. As a last resort, politely ask what gender pronoun they would prefer. Anything else, such as birth sex, is none of your business.

I really do think of you as a man/woman.
Is this something you would say to your cisgender friends? Of course not! While you may think you’re being encouraging, you’re actually “othering” the transgender person and saying their gender expression is less genuine.

You pass so well, you look just like a real man/woman!
Many transgender people consider “passing” to be offensive because it implies their gender expression is somehow deceitful. The reason why they “look like” their gender is because they are that gender. While you may think you’re being supportive you’re actually claiming their gender expression is “almost” as good as a cisgender person’s.

Is (insert secondary-sex characteristic here) real?
Asking a trans woman if her breasts are real is extremely offensive. Asking a trans man if his goatee is real is also extremely offensive. Would you be asking this question if you didn’t know they were transgender? Of course not! So don’t ask.

I should’ve known, I noticed (insert body flaw here)!
Listing off a transgender person’s body characteristics or flaws after they share their history with you is extremely hurtful. Everyone is self-conscious of their body to some degree and everyone has characteristics of both genders they may be uncomfortable about. Be respectful and think before you speak.

I’ve seen (insert movie or TV show here), so I know all about you.
You wouldn’t claim to know all about being a Native American after seeing Pocahontas, so don’t do the same to transgender people. While there are some respectful and informative shows out there, many are offensive and contain stereotypes or myths. Watching TV is no substitute for actual experience.

My (insert acquaintance here) is gay, so I totally understand.
Being gay and being transgender are completely different things. Being gay has to do with a person’s sexual orientation. Being transgender has to do with a person’s gender identity. Transgender people can be any sexual orientation just like cisgender people.

Some final thoughts:
Being friends with a transgender person is no different than being friends with a cisgender person. If you’re curious about a particular aspect of transition or transgender people, try to do some research on your own rather than assuming a transgender person has all the answers. Above all, be respectful, think before you speak and treat them the same way you would want to be treated.

What's the Verdict?

What the hell, these are fun from time to time. Call it a guilty pleasure.


RULE 1. You can only say Guilty or Innocent.

RULE 2. You are not allowed to explain anything unless someone messages you and asks!

 

1. Asked someone to marry you?

innocent

2. Kissed one of your Facebook friends?

guilty

3. Danced on a table in a bar?

innocent

4. Ever told a lie?

guilty

5. Had feelings for someone whom you can't have back?

guilty

6. Ever kissed someone of the same sex?

guilty

7. Kissed a picture?

innocent

8. Slept in until 5 PM?

innocent

9. Fallen asleep at work/school?

innocent

10. Held a snake?

guilty

11. Been suspended from school?

innocent

12. Worked at a fast food chain/restaurant?

innocent

13. Stolen something?

guilty

14. Been fired from a job?

guilty

15. Done something you regret?

guilty

16. Laughed until something you were drinking came out of your nose?

innocent

17. Caught a snowflake on your tongue?

guilty

18. Kissed in the rain?

guilty

19. Sat on a roof top?

guilty

20. Kissed someone you shouldn't?

guilty

21. Sang in the shower?

guilty

22. Been pushed into a pool with all your clothes on?

guilty

23. Shaved your head?

innocent

24. Slept naked?

guilty

25. Had a boxing membership?

guilty

26. Made a boyfriend/girlfriend cry?

guilty

27. Been in a band?

guilty

28. Shot a gun?

guilty

29. Donated Blood?

guilty

30. Eaten alligator meat?

guilty

31. Eaten cheesecake?

guilty

32. Still love someone you shouldn't?

innocent

33. Have/had a tattoo?

innocent

34. Liked someone, but will never tell who?

innocent

35. Been too honest?

guilty

36. Ruined a surprise?

guilty

37. Ate in a restaurant and got really bloated that you can't walk afterwards?

guilty

38. Erased someone in your friends list?

guilty

39. Dressed in a woman's clothes (if your a guy) or man's clothes (if your a girl)?

guilty (ha)

40. Joined a pageant?

innocent

41. Been told that you're handsome or beautiful by someone who totally meant what they said?

guilty

42. Still have communication w/ your ex?

guilty

43. Cheated on someone?

innocent.

44. Get totally drunk one night and you have an important exam tomorrow morning?

innocent

45. A total stranger treat you by paying your fare?

innocent

46. Get totally angry that you cried so hard?

guilty

47. Tried to stay away from someone for their own good?

guilty

48. Thought about suicide?

guilty

49. Thought about murder?

innocent

50. How about Mass Murder?

innocent

51. Rode in a stranger's vehicle?

guilty

52. Stalked someone?

innocent

53. Had a girlfriend/boyfriend

guilty