What’s Life Like After Undergoing Gender Confirmation Surgery?

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Answer by Tamara Wiens, in transition since 2012:

I’ve answered some of this before in here, so I will focus on the differences physically, psychologically, and practically between the different sets of genitalia, from a fully transitioned perspective (i.e., I won’t be answering in the context of a man with a penis).

Physically, it’s quite different, as you would expect. The obvious things include:

Urination—although I was sitting to pee long before, doing that with a penis requires spread legs to let the urine flow, and holding things down to prevent reflexive jerking and splashing. You can also pull the toilet paper as you are peeing, hard to do when you have one hand holding things in place.

Washing—cleaning a penis and scrotum (I was circumcised) is very simple. You can get all of it without effort. With vulva and a vagina, it’s much more complicated, as the water doesn’t flow there naturally in the shower, and you need to either use a movable shower head that can spray up or cup water to splash it into the labia. Even then, cleaning the folds can be done, but you can’t get inside, even in the tub, without douching (which isn’t advised due to creating imbalances of the internal flora).

Dressing—there are a number of things here. First, I don’t need to tuck anymore. I was long enough that it required quite a bit of effort, and left my penis between my butt cheeks, which resulted in chafing on both parts in a surprisingly large number of circumstances. I tried gaffes, but they were terribly painful, even more than the chafing from tucking, so I stayed away from them. I also had to tuck my testicles—all of this was an intricate package that could be disturbed by wide-spread legs, or the “gallant reflex” (although hormones mostly took care of that). It also precluded some outfits (most swimsuits, any outfit that is sheer or tightfitting enough to require no underwear) or made them painful (tight jeans, pants that ride high in the crotch). None of those things is an issue any longer—I can wear any swimsuit (well, any one that flatters the rest of my shape!), pants, etc, and no motion is forbidden to me at the cost of rearrangement.

Sensation—I have heard that the vagina of cis women has no sensation, other than the first inch or so. It hasn’t come up in conversation since my surgery, so I don’t know if this is truly the case, but I can tell you that I do have sensation in my vagina. I have an occasional “itch” on my “penis shaft,” just below the “head” … or at least that’s how my brain interprets it. However, that spot is about 6 inches inside me now—thankfully, none of the itches has lasted long—and I can no longer just scratch at it!

Psychologically, it’s interesting—before the surgery, there was this sense of … not distaste so much as wrongness. I didn’t want to talk about it, or look at it, or do anything with it, other than what I had to. There was also quite a bit of fear that I associated with it, mostly associated with getting found out, in a public washroom or as part of a sexual assault. Fortunately, I haven’t yet been sexually assaulted, but I had a fear that, if a rapist attacked me and discovered that I wasn’t what he expected, an assault might quickly become a murder. Having that genetic defect corrected has been incredibly freeing—I have no sense of loss, just a sense of rightness. Frankly, most of the time, I have no sense of it at all—it just IS, and it is what it’s supposed to be!

Practically, it’s a pain. Trust me, staying with the penis and scrotum would have been so much more practical from a “care and feeding” perspective, but given that this is what I needed to fully address my gender dysphoria, it’s a price I’m happy to pay.

First, there’s the cost—for me, it was financial, and pain, and time, and more time, and more time and pain. Even for those that can get provincial funding (in Canada, but not all provinces), there is the cost of another set of practitioners poking their noses into your business, that shouldn’t require anyone to be allowed to judge you, or gate-keep you, but they do. Even then, that doesn’t bypass the time and pain—first, of the surgery, then the healing and recovery, and more recovery, and often enough, more surgery with the additional pain and time to recover.

Second is the lifetime commitment. If you are interested in having vaginal sex, you will need to dilate at least once a week for the rest of your life, and for the first year, it’s much more (I figured it out once, it’s close to 700 times in the 12 months after surgery, which is the same as what you will do over the next 14 years, altogether).

Last is all the lube! I am one of Costco’s most faithful purchasers of that famous personal lubricants, for both dilating (think sex without arousal or pumping), and eventually also for sex. We simply don’t self-lubricate to the extent that cis women do, so we will need to use a tube whenever we want to get in there. In my case, I comfort myself with the knowledge that alot of other women in their late 40s are in situations that require the same kind of supports … but still not practical!

For any preop trans woman who would like more details, feel free to message me, and we can discuss the ins and outs (no, the pun was not intended) of the whole procedure. If anyone else would like more information, feel free—I’m happy to educate in this area of my personal expertise!

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