a personal, out non-binary transition blog

epochryphal’s transition blog. tmi! primarily: vaginectomy, estrogen blockers, complete hysterectomy with unilateral oophorectomy, & double mastectomy with no nipple grafts. #nipplefree

[thirdsexmanifesto]

Hello from the Inauguration of Eunuch Pride Day!

To start: what the crap am I even talking about?

"Eunuch" is a specific third sex identity for people of any gender, defined as: a sex that is neither male nor female, nor a combination of the two. Such people seek out medical care to make their gonads non-functional or have surgery to acquire a sexless appearance.

"Why haven't I heard of them before?" you might ask. That's because they're a microscopic minority, less than one million (like, only a few thousand) in the United States, so it's unlikely you'll randomly bump into one...but there are two groups of people who have been aware of eunuchs for years: Transmeds and Truscums, because bigots always need a new minority to harass, and the anti-trans hysteria in the country has reached the point where I'm even seeing eunuchs used as the bricolage of propaganda.

So for this pride day I will dispel the misinformation I've seen. In general, the arguments used against third sexes are the same as those used against non-binary genders.

FALSE: people are eunuchs because they want to fetishize intersex people.

TRUTH: intersex is a mixture of both sexes; eunuchs want to be neither sex. Furthermore, intersex people can also want to be eunuchs.

FALSE: eunuchs are just fetishizing trans people.

TRUTH: trans people can also be sexless, such as agender people who have dysphoria around having a sexed body.

FALSE: eunuchs are just failed trans women who can't pass.

TRUTH: most eunuchs aren't women, so they are under no pressure to pass as one. Furthermore, cis women can also be eunuchs, so, again, they have no need to pass.

FALSE: the surgeries eunuchs want are just mutilation.

TRUTH: trans women have the exact same surgeries, but don't consider themselves to have been "mutilated." Transmeds/truscums consider anything that isn't binary male or binary female (even if the results look exactly the same) to be "mutilation."

FALSE: eunuchs can't orgasm after surgery.

TRUTH: most third sex people can, same with post-op trans women.

FALSE: people only want to be eunuchs as a response to sexual abuse.

TRUTH: eunuchs are just as likely to be abused as anyone else-more so in cultures that stigmatize queerness, but no, there is no correlation between the two.

FALSE: affirming eunuchs will be the downfall of transgender!

TRUTH: this is part of the conspiracy theory that non-binary genders and altersex folk will "steal" hormones and surgeries by flooding endocrinologists and surgeons with appointments, which will force "real" trans people onto decades-long waiting lists. There are so few eunuchs in the world there is no way they can clog the system.

FALSE: eunuchs just need to see a good psychiatrist to be cured of their sick desires.

TRUTH: conversion therapy is just as ineffective on third sex people as it is on binary trans people.

FALSE: only altersex people claim third sexes existed in the past as historical revisionism to justify their existence.

TRUTH: hundreds of cultures have mentioned having three or more categories of persons since written history began.

FALSE: third sexes were invented by European colonists as a means to dehumanize B.I.P.O.C. gay people.

TRUTH: indigenous nations already had a third sex option; it's white people who keep confusing them with gay people.

FALSE: eunuchs are used to erase the history of trans women.

TRUTH: historic cultures had distinct vocabulary for men-who-live-as-women and men-who-are-not-male (intersex, sterile, sexually submissive with other men in some cases); again it's white people who can't understand the lingo.

FALSE: B.I.P.O.C. only identify as a third sex due to internalized racism.

TRUTH: indigenous nations are reviving their traditional beliefs about sex and gender to remove the shackles of colonial cisheteronormativity.

FALSE: if only B.I.P.O.C. were properly educated on the difference between social function and gender they wouldn't believe in all this third sex hooey and finally have progressive attitudes on sexuality like white people.

TRUTH: the racism and colonialism have come full circle. Indigenous people are well aware that social function and gender aren't the same thing, but in some cultures the two can be inextricably linked in some situations, and in others new sexualities and genders are manifesting, requiring the creation of new terminology-so no, they don't need white saviors whitesplaining things.

FALSE: only people in brainwashing cults want to become eunuchs.

TRUTH: it's true that there have been religious cults throughout history that have required sterilization of some sort to join, but most eunuchs don't get surgery for religious reasons, anymore than trans women do.

FALSE: wanting to be a eunuch is body integrity dysphoria.

TRUTH: body integrity dysphoria is the obsession with becoming severely disabled by removing limbs and even vital organs (such as one's bladder). Being sterile or not having genitals isn't disabling, and wanting to be a eunuch is now recognized as a form of gender incongruence/dysphoria.

FALSE: wanting to be a eunuch is body dysmorphic disorder.

TRUTH: body dysmorphia is an obsessive-compulsive disorder with high suicide rates because sufferers often enter a death spiral of self-loathing over a body part that is perceived as too small or too large. It's easily treatable with anti-depressants and therapy, unlike wanting to be a third sex, which arises from an innate sense of self regarding one's body. As with trans people in general, eunuchs can experience dysphoria acute enough to engage in self-harm, which is now recognized as distinct from obsessive-compulsive problems.

FALSE: eunuchs are a weird new thing concocted by gender extremists.

TRUTH: surgeries to sterilize people or make them sexless in some way have existed for thousands of years. In recent centuries these practices have been suppressed due to changes in cultural norms, forcing third sex people to seek care in criminal underworlds. But now we are coming out of hiding, demanding legal recognition and equal access to healthcare, so hopefully this will all change.

This is all the garbage I could find, and I was surprised by how racist it got, betraying an anxiety over black and brown bodies being transgressors of gender norms, and the persistence of European colonial biases against indigenous customs. When the bigot was a trans woman, I noticed unacknowledged internalized misogyny and cissexism. With anti-trans conspiracists, there was the usual aftertaste of heterosexism, coupled with the pathologization of sex changes as insanity or as part of a paraphilia.

Stayed tuned next month for Eunuch Awareness Week where I'll be posting educational articles from a positive paradigm.

Sources consulted in writing this article:

"Islamic Shari'a Law, Neotraditionalist Muslim Scholars and Transgender Sex-reassignment Surgery: A Case Study of Ayatollah Khomeini's and Sheikh al-Tantawi's Fatwas," Mehroad Alipoor, International Journal of Transgenderism v. 18, #1, pp. 91-103, 2016

"Native Hawaiian Mahu are Reclaiming Their History," Matthew Dekneef, 11/21/22, them.us

"Identities of a Single Root: The Triad of the Khuntha, Mukhannath, and Khanith," Saqer Almarri, Women & Language, v. 41, #1, 10/1/18

"LGBTI+ Language and Understanding in Nepal: Creating Spaces and Forging Identities," Patrick Sonnenberg, Independent Study Project Collection 3180

[genderkoolaid]

i wish people didn't make it seem like your options for medically transitioning as a nb/gq person are "do nothing" or "the binary opposite of whatever you started with"

[genderkoolaid]

#genuinely curious though: what are your other options?#there is no androgynizing hormone#it is just T or E#if you're talking about surgeries you are correct though

There is no "third hormone" but there are ways of going on HRT that are not the typical binary way.

Microdosing, for one, as well as going on HRT for a certain amount of time before stopping, which can leave you with certain effects but not others, or effects to a lesser degree. There's also a certain class of medications (SERMs I believe?) which are popular with NB/GQs who have a naturally T-dominant body, because they block some of the effects of estrogen like breast growth (there may be something similar with testosterone but if there is I can't remember it).

[dancerfelix-deactivated20260109]

You can take e without taking t blockers. You can use monoxidil for hair growth and not take t. You can take t and finasteride (which blocks dht and so prevents things like bottom growth and baldness). You can maybe use t cream (cream! not gel) applied locally to get bottom growth but less of the other effects of t. You can take t and get laser hair removal on your face if you dont like facial hair. You can get top surgery without taking t at all. You can get electrolysis and not do feminizing hrt at all.

[nekomimihell-deactivated2025092]

With surgeries there are also a lot of options. You can get a radical reduction instead of a full double mastectomy, you can choose whether or not you keep your nipples, you can get nipples tattooed on, you can have your nipples shaped into a heart or something. The placement of the nipples can also be different to cause a more feminizing or masculinizing effect. It's possible to get double mastectomies if you don't like your breast growth and implants put in if you want bigger ones.

You can get penile preserving vaginoplasty, you can get vulvoplasty without getting a vagina. And you can get phalloplasty or metoidioplasty while keeping your vagina. You can choose whether or not you want testicles. You can also get metoidioplasty first then get phalloplasty if you decide you want a bigger phallus. Phalloplasty and metoidioplasty can be done with or without routing your urethra through the phallus. You can get nullification surgery meaning everything is just smoothed out down there aside from your anus and urethra hole.

If you don't want to take testosterone to get a deeper voice you can get your vocal folds surgically thickened, you can also get your vocal folds thinned to achieve a higher voice. Body hair can be removed in several ways if you decide you don't want it and there are many options to preserve your head hair so long as you catch balding early. You can get plugs of hair taken out and put on the balding parts of your head, like Bosley if you're old enough to remember those infomercials.

[blockers-and-ectomies]

You can get unilateral oophectomy to have lower, still-present endogenous estrogen. You can take estrogen blockers as an endogenously E-dominant person (the meds are usually used for cancer), though osteoporosis concerns mean doctors don’t recommend it long term at a young age as meds to prevent/treat osteoporosis have side effects. You can probably alternate between T and E (especially since they metabolize into each other at high amounts).

You can get partial nullification to smooth away the wrinkly bits and keep the erectile bits, which can also be kept semi-recessed without metoidioplasty if applicable and desired while still smoothing below that. Conversely, you can remove the erectile organ and leave the rest. You can get urethral lengthening/relocation to put the urethra hole higher up/move it without metoidioplasty or phalloplasty or penectomy. Eunuch communities have been doing creative things with gonads, hormones, and genitals for a long time in all sorts of ways!

Generally you can add and/or remove things independently - the exceptions I'm aware of are: you can't have vaginectomy and keep menstruating internally; you probably can't have phalloplasty and keep original erectile tissue separately for double phalli; and current technology hasn't been able to create gonads or uteri.

(To folks who mention "you can keep your vagina and get a dick; you can get everything removed," I gently ask you also make clear "you can remove a vagina without getting a dick" as this is not actually self-evident! While nullification has been around in community for a while, the word vaginectomy has only recently started appearing in trans literature as separate from phallo/meta/scrotoplasty and nullification, and the words vulvectomy and labiectomy still don't appear - plus vulvectomy is also a bit vague as to whether it involves removal of the erectile organ ala total nullification, even under the insurance code for "vulvectomy, simple and complete.")

[thirdsexmanifesto]

Diversity of Eunuchs

I recently found a community of queer eunuch men and in celebration of newfound brotherhood I made variants of the eunuch flag for the different types.

Angonadal eunuchs. These have their gonads and connecting tubey-stuff removed.

A variant of angonadal for people who also have their scrotums/labia flattened and smoothed out.

Aphallic eunuchs who only want the erectile organ removed.

Angenital eunuchs, called "nullos" by the community, these people have all external and internal sex organs removed for a completely blank groin like Daffy Duck. However, this does not mean they are incapable of sex: nerve clusters in the pubis can allow orgasm through pubic rubbing. As with anyone else, there's no way to tell if a person is asexual without asking (unless they have a pride flag).

Medical castration eunuchs, these folks don't want surgery, only taking drugs to switch the gonads off.

[blockers-and-ectomies]

I love this!! Deeply heartened to see the second flag/type especially. It sounds like there isn’t a simple word for the external smoothing without also removing all erectile tissue, but it’s still wonderful to hear it’s a recognized experience.

May I ask, do you know if there is a similar neutral-valence word to aphallic for removing all internal sex organs?

I’m also very interested in how alarms about osteoporosis create obstacles, and what workarounds folks have found, particularly below age 50 or so. (I’ve been discouraged from going fully angonadal without HRT and told that the only medications available to prevent osteoporosis have too severe side effects but would be necessary at my age.)

[aropride]

saw a tweet the other day that was like "outlawing diy hrt would kill trans people" which, yes, i agree. however it is already illegal for trans men. which is something i feel like people just ignore in discussions about diyhrt. i've also seen tweets along the lines of "it's easy to access and dose and it's not explicitly illegal so if you're concerned about us anti trans laws you're being stupid". which, the first part is completely untrue when it comes to testosterone, and the second part shows a mindblowingly uncompassionate view on anti trans legislation and is a genuinely bafflingly horrible thing to say to people who are scared for their lives and their futures

[blockers-and-ectomies]

yeah, while community resources like Mad Gender Science have some great perspectives on lesser-known nonbinarizing medications and some thoughts on naturally occurring substances, it’s all highly experimental and needs blood test monitoring, and there’s no “masculinizing” pharmaceutical option aside from testosterone

[genderkoolaid]

the reason a lot of transmascs experience some level of regret/depression after medical transitioning is, imo, the exact reverse of the reason TERFs think we transition in the first place.

TERF beliefs are generally that transmascs dysphoria is actually a natural uncomfortableness with how misogynistic society defines women, and that our transition is an attempt to conform to the idea that being nonfeminine means you aren't a "real" woman, instead of realizing that we only hate ourselves because society tells us women like us shouldn't exist, and actually radical feminism is the real liberation.

but for example: when i first starting on T, every change was 100% pure joy. i was so ecstatic, everything was amazing and wonderful. i truly loved everything.

but then the longer I was on it, the more transandrophobia I encountered because I was on T. I started feeling more and more ashamed of having hair on my arms, my thin facial hair, my "tranny voice". Things that made me really excited before starting making me a little bit uncomfortable because of how society treated it. It was literally like Rapid Onset Gender Dysphoria but exactly the opposite.

Now this wasn't and isn't as strong as the gender euphoria T has brought me, and it hasn't caused me a lot of real "oh no do I regret this" distress because I have been able to immediately recognize that I am only uncomfortable because of how people started treating me differently. But especially for transmascs without support systems, without understanding our own internalized transphobia, can very easily feel a lot of trauma associated with transitioning because of the way that society treats trans men. when every change of your body is met with mockery and scorn and disgust, its natural to get affected.

and this is why its so fucked up when other trans people share stuff about how "soo many trans men are gonna regret T because they're all stupid little girls who think T is gonna make them sexy yaoi boys, since they all have no idea what it's like to really be men and just fetishize gayness!" because you are literally the reason. People mock and shame trans men, they make spaces hostile for anyone with a testosterone-dominant body, they act hostile to trans men and our experiences constantly. and then when trans men internalize that disgust and blame ourselves for how other people treat us because of our transition, those same people turn around and use that as a way to further mock us.

[epochryphal]

as an exobinary person who doesn’t id as transmasc, had top surgery over 10 years ago, took estrogen blockers for a year and had vaginectomy + unilateral oophectomy + hysto over 5 years ago, and this year started T, a few thoughts of agreement and elaboration and divergence:

1) it’s maddening how unseriously i’ve been taken (mainly by people in positions of authority, whether cis or not) for a decade and how rapidly that’s shifted to “oh shit a real trans” with T. walking around shirtless and nippleless did not change how i was gendered, T has. arghh. i especially hate how much it likely has to do fat distribution. it wasn’t facial hair on its own, and it doesn’t seem like it was facial hair plus voice either.

(also, replying “i don’t have that :)” about sex characteristics was met with awkward subject change and forgetting, and continuing to talk in cisnormative and transnormative binaries and archetypes. really hard to get people to think about someone not having a vagina or a penis. the semantic space just.. glitches out)

2. i’ve wanted trans voice, like this whole time. didn’t want anything else for its own sake. especially actively wanted to not need anything else to disrupt constant self-assured samey misgendering. so, it felt a) socially dysphoric to only take T because of other people’s infuriating misperceptions, and b) physically unwise to take T only for voice when other permanent effects would almost assuredly happen, and to plan to take it temporarily* when i might get attached to temporary side effects like fat redistribution. bonus: felt like fetishizing of or appropriating from my transmasc-id’d friends, yay

*(i don’t wanna be testosterone-dominant or estrogen-dominant. i don’t want to take sexed hormones the rest of my life, and doctors currently insist some amount is necessary for bone health and there’s no supplementing around that allowed, so fine i’ll keep a low endogenous estrogen production—but it also ain’t ~dominant~ and this is a language expansion i struggle with)

3. i’ve always been keenly aware that if i didn’t like having facial hair, i could do electrolysis. if i started balding, i could try remedies (perhaps less certainly - i was much more aware of trans-aimed and eunuch/neut-aimed care strats than men-aimed ones) or wear wigs or shave my head like my dad.

(still don’t understand why “electrolysis is an option” gets so lost when contemplating T. sure, it’s an extra step and expensive and painful and takes ages, but that’s transitioning in general in a lot of ways!)

4. general post-surgical depression is super a thing because metabolisms and isolation from people during physical recovery. and also because cw: Medical Trauma from the medical industrial complex. ucsf was abysmal at consent, misgendering, fluorescent lights, mismanaged/withheld psych meds i’d been on for years, letting a blocked caller through because ~family~, and more.

i regret them and their so-called “”center of excellence in transgender care.”” i regret the choice of surgeon, maurice garcia, now at ucla, who told me when i woke that he just Didn’t Do Part of what we’d extensively agreed, because “healthy tissue” (implied i’d want it for metoidioplasty or phalloplasty later). i regret going by ambulance to the ER later that week for blood loss-induced psychosis because they insisted on coding my body parts by what was literally removed and not there, for records and for insurance.

so yeah i was fucking depressed after. and haven’t been able yet to get a surgical revision because Trust.

and there’s a bunch of little things, like mm top surgeon wouldn’t believe i wasn’t eventually gonna go on T and work out so made me really flat, which has not filled out as i’ve gotten fatter and gives me a shape that’s difficult to find off-the-rack clothes or body rep for.

but one, it all comes back to bodily autonomy and being believed by the people able to do the surgery. being actually collaborated with as an individual person, not an exercise of technique where they know better. and being given the full breadth of options, including things like electrolysis for ameliorating possible effects you don’t want.

and two, it’s all been worth it. wish it wasn’t fucking traumatizing - the authorities and institutions and medical systems required to get any of it done! but the actual physical effects, including pain and recovery, all fine and well worth it.

so yeah, big ups to separating social from medical, and also separating medical system interaction regret from physical transition regret.

[blockers-and-ectomies]

linguistic dysphoria too strong to reblog anyone’s else gd posts about it but

finally making headway on like personally-neutral-feeling-enough body words, that highlight underlying origins and distance gendered, sexed, and medicalized language

easy: tubes. gettin tubes tied (or removed) be the same, and context immediately understood

ok: gonads. medicalish but not terribly upsetting. would still prefer not to have any without risking osteoporosis or being reliant on highly gendered-sexed-medicalized hormones

relatedly, hard: hormones. regulatory signal messengers? growth regulators, maybe?

easy: chest, chest tissue

easily confused: nipplefree (with “free the nipple”). hard to read: nippleless. decontextualized: ductless. feels too direct?: no nipples.

contentious: shaft. lots of baggage around size assumptions and sexualness. lack of clarity in “outtie bits.” no clear conclusion at this time

easy: urethra. medicalish but not too upsetting. harder: specifying location. can be ground-facing, forward-facing (eg via urethral lengthening moving the opening up the body), handleable (but at various points along), probably other location options.

hard: front hole. imo implies too much actual hole existence / room involved. also creates problems where “hole” becomes considered ambiguous outside of explicitly cis perisex men. don’t have any good ideas around this rn

challenging: incubator. pro’s: ok analogy for how it may keep trying to brood and can overheat itself, and how it can chill out if denied inputs. cons: still may imply a feasibility that may not be there, and still may feel too dysphoric, even in discussing removal/disabling.

most excited about: flaps. skin flaps. not necessarily dangly, wide variation in size and shape. probably provokes the most opinions on aesthetics.

most importantly to me, flaps makes accessible talking about Shouldn’t Be There where medical systems fail to code or use their own existing gendered-sexed words (labiectomy) by pointing out the ones they do use (orchiectomy) - and that connection is probably lacking because oh surely orchi’s parallel is oophectomy because gonads. but that is more about the insides of the structure than the structure itself; it’s just that in the orchi case one could want either removed but then probably needs to remove both.

anyway Petition for already trans-centric and intersex-friendly and trauma-informed clinicians to uhh shift toward degendered desexed demedicalized language more comprehensively please

[pizzaback]

so because this comes up every time someone on the internet mentions it: yes people can get surgery to get both a penis and a vulva. you can get this if you have a natal vulva or a natal penis. you can have a phalloplasty or metoidioplasty and no vaginectomy. you can have a vaginoplasty and/or a vulvoplasty with no penile inversion, penectomy or orchiectomy. transgender medicine is wonderful and magical and can give you both a penis and a vulva.

[pizzaback]

also because people don’t know this either, you can get procedures to completely remove all genitals and relevant organs to have just a urethra. this is called a nullification. it is possible!

[sewer-swan]

someone close to me had a depthless vulvaplasty, and it's really rare zie sees anything about hir type of body, even in like, erotic stuff made by trans ppl. just... really bad visibility on this stuff.

Maybe part of it is our general deadlocked misery wrt doctors closing us to possibility, and part of it is general ignorance. But I would like people to talk about it more!!! It can get lonely out there.

[epochryphal]

it really can. there are even more possibilities, too:

- a vaginectomy is separate from a labiectomy, so that depthless vulva is available regardless of natal equipment

- a labiectomy does not require a scrotoplasty, nor does an orchiectomy require a vulvaplasty—smoothness below the nerve-bundle outtie-bit is a possibility

in california all of this is required to be covered by health insurance, though there are hoops such as doctor’s letters, and they still resort to existing billing codes (and don’t have one for labiectomy last i checked)

other useful keywords for community-finding are altersex and xenogenital (and xenogender in general)!

[blockers-and-ectomies]

be warned that a vaginectomy, even with urethral lengthening, is not understood by a surgeon to include labiectomy - even if talking about smoothing over the surgical site. be frustratingly explicit about it, and about not just the immediate surgical site but the overall region. probably wise to use majora and minora terms, dysphoric as they may be.

wonder what a vulvectomy would be understood to be and if it would necessarily include castration/clitoredectomy…

[epochryphal]

finally, after a series of shenanigans around But How Can You Take Half A Packet, That’s Not Discretely Measured and We Can’t Split The Box and But Prescribing One Box For Two Months Doesn’t Work For Reasons and insurance prior auths and we totally sent it to the other guy check again-

i have The TestosteroneTM*

*not actual AndroGel (better name: AndroidGel) because generics; titled Testosterone Gel 1%; 25mg T per 2.5g gel packet; apply approximately half a packet daily to upper body T-shirt area (no pun intended), wash hands immediately; let dry; avoid skin-to-skin contact with area for at least a few hours after application; yell at incredibly cissexist included instructions as well as the notion of showering daily before applying

[epochryphal]

low-dose T guides/discussion threads?

Oh Hey

considering doing low-dose T again for primarily voice change reasons because social dysphoria increasing Bad

(struggling a liiiittle with the “but on a desert island this would not be something i would even consider” but like hahaha society is not an island; and with “but i’ve tried so hard to be the no-ho yes-op nonbinary pathforger for other people, this would be giving up and decreasing representation :(” but lmao a life is not about Being A Representation)

–but i can’t find any hecking resources now, not that there were many before but there were a few individual accounts?  mostly friends of bad breakups tho lmao rip

what i Faintly Remember is that gel is better because you can microdose even better than injection, and maybe you can even localize its effects better (eg Throat Not Junk) but this is very faint maybe wishful thinking

referrals???

[blockers-and-ectomies]

Is it possible to get labiaplasty and a clitorectomy? As well as a mastectomy? This is my ideal look

it should be, yes!  it might be considered a type of nullification, although the assumptions around that word are orchiectomy + penectomy.  still, i think looking for surgeons/doctors that are open to nullo/nullification will give you better luck finding someone to do a clitorectomy, as most gender affirmation surgeons seem to have this weird focus on ~not removing healthy tissue (unless it matches a binary transition)~

(also sorry it took me a while to see this!  because this is a sideblog, i can get asks but sometimes don’t notice them - you can DM me at my main, which is epochryphal)

[blockers-and-ectomies]

surgery consult

heyyyy news

had a video remote consult today (that is so nice for a first meeting, oh my god, please make this a usual option, so much less stressful than Getting a place and Checking in and Waiting and trying to self-regulate and you’re on Their Turf and hhh and medical environments)

crane center with dr. michael safir, am going to also talk to dr. angela rodriguez

talked about my journey and experiences, was immediately asked why previous surgery experience was bad, saw notes being taken about the fluorescent lights and the meds denied because time of day wasn’t noted

was asked to describe what bothered me currently dysphoria-ways and was just UGHGHHG face/noises/gestures, right, about The Skin and the Way it IS, which got a heh yeah understandable sounds about right

talked also about lesser concerns, the little divot near the perineal area that can be hard to keep clean (and confuses sexual partners lmao), the minor urinary retention where it sometimes feels like even after voiding there is still a bit left (but never much more than a few seconds, and usually voidable with a little push), Symmetry

talked about Traditional Pathways and how for crane center most folks they give vaginectomies are also getting metoidioplasty or phalloplasty so again the not quite comparable results, and how most nullo/nullification surgery is for cis men who id as eunuchs and sometimes get a zero-depth vaginoplasty (didn’t know that part), and how dr. rodriguez mainly does plastic surgery after vaginoplasty for trans women, and how dr. safir does a lot of vaginectomies (again with metoidio or phallo) but his background is in doing both cis men and cis women urology and he’s done tons of labioplasty for cis women, so even though his title is urologist he has more experience probably (but he still recommended i talk to dr. rodriguez)

talked about insurance coding language and how lyon-martin had called it a metoidioplasty (revision) and dr. safir was very like no that’s a major operation and this would be minor, we’d probably call it a labioplasty (me like aha altering the appearance..... Into Disappear) (buzzes about still wanting labiectomy to be The Word, Like, Obviously, It Is The Etymologyically Correct One, but considering if i’ll allocate the effort)

talked about the lack of results to look at (metoidios look hella different!  didn’t explicitly talk about, but my impression sure is that they can cinch skin closer underneath because T and release means it extends, whereas without means skin pocket right. god still toying with words there since nook is less good-feeling because of breaking up with homestuck, lol).  talked about the lack of ways to envision also?  but knowing the Not This and the Remove It and the symmetry, right.

probably need to talk more about the fantasy world Fully Rescindable, Looks Smooth And Then Arousal Means Little Emergence setup, in terms of truly designing as close as possible.  god should i be looking at lizards.  heh.

oh and they do need photos of the Surgical Site, hair is fine, don’t have to transmit them electronically (albeit through secure online portal and only to the One surgeon) if don’t want, can come in person and show photos on phone (they don’t even get a copy!), there is no in-person exam regardless (!!!!! holy shit)

very cool.  much less charisma-y bustle-y, hard to tell if that’s because yknow remote video consult is a very different environment, or because people involved.  but dr. safir was very like “i just want to get you taken care of, and we will take care of you” (between him and dr. rodriguez right) and felt much more Experienced and Chill and also Not About A Portfolio Or Technique Development and thank you

also i guess 85% of their patients are gender surgeries and they have their own site and staff, so the whole misgendering thing Should be better (we’ll see around being non-binary specifically, and around looking estrogen-dominant)

yeah!  they take Medi-Cal and i feel like i’ve heard about the crane center going way back, mostly about metoidios but such is the nature of presentations/workshops.  crossing fingers.

[blockers-and-ectomies]

Do you know if its enough to just not have a uterus but still have ovaries and still get a vaginectomy?

i do know and it is! one, two, or zero ovaries all work with a vaginectomy.

[blockers-and-ectomies]

Is there a way for afab non binary people to gender nullification surgery and not a hysterectomy and to not remove the ovaries? Just removal of labia and closing up the vagina

Hmm. The way my doctors spoke about it, a hysterectomy was necessary - although possibly a bilateral oophectomy instead would work - because the main concern is menstruating into a closed space. I would guess that if for some other reason, a person was not menstruating and could be reasonably expected not to ever menstruate, there wouldn’t be a need for hysto or oopho.

My expectation is that doctors would want to be Very Very Sure that menstruation would never happen, though, so they might be resistant even to a perisex person on testosterone HRT (or presumably effective blockers), because if ever the supply of/access to T(/blockers) became compromised, menstruation could occur and be very bad.

A quick search also shows me that fallopian tube tying or removal doesn’t affect menstruation, so it’s specifically the having a uterus that is triggered to shed its endometrial lining by hormonal changes regulated by the ovaries.

My search also shows me that endometrial ablation is a newly-developed surgery that is meant to damage or destroy the endometrial lining, preventing it from building up and shedding as menstruation. It looks like success rates vary and there is sometimes still light menstrual flow, which would still be an issue in the case of vaginectomy.

I don’t know of anything - but can theoretically imagine the existence of a procedure - that could close up the vagina and remove the labia but also create or leave a small passage for menstruation to exit from. Here I think there might be doctor resistance, and maybe some issues around wanting to use the vagina itself to continue being the passage - I don’t know if its walls have special properties necessary/helpful for menstrual flow, and I don’t know how difficult it would be to construct another passage (possibly very, given what I know of vaginoplasty requiring dilator use just to prevent closing up). Perhaps instead a procedure that could alter the vagina in some way (elasticity, size, certainly the opening) and remove/close the labia while redirecting the exit aperture? That might not be considered *closure/removal* of the vagina, but depending on your objectives, it might be an option.

Basically I would suggest looking into ways of stopping menstruation, or if it’s possible (if you’re okay with it) to create a way to menstruate through a different channel or in a way compatible with closing/removing the vagina and labia.

[blockers-and-ectomies]

also was feeling a lot of despair around hormones as The Thing That Affects Gendering, and how like... people who start transitioning way later than i, leave me behind, and have very different experiences/narratives around mis/gendering and passing and privilege

like, oh. you get gendered differently? that quickly after doing something? that soon into your transition.

like, oh, you think of a transition as resulting in being seen differently.

even walking around naked and imo visibly blatantly nb/trans/my gender, i don’t get treated different, gendered different, than with my clothes on- just more awkward and pretending not to have noticed anything.

like, oh, i can’t think of anything that would affect how i’m gendered that wouldn’t be horrible for me.

like. oh. hormones sure are The Solution and Easy for most people, huh.

[blockers-and-ectomies]

update 9/10/19

officially seeking a surgical revision for Unsatisfactory bottom surgery

BEGONE, FLAP

also lmao my beloved wonderful pcp at lyon-martin like “yeah dr. garcia moved down to la.... for Reasons, I Think.” Word

getting a referral to a dr. chen who is PRIVATE NOT UCSF YAY.

they’re looking at wording because Insurance; their first instinct was “metoidioplasty revision” which i was like lmao it’s not tho, there was no release/meto part, and then my v good doctor was like oh yeah Hmm...

i talked about seeing the word labiectomy, and about having gotten urethral lengthening “to prevent infection and improve hygiene” and yet hygiene is still way impacted, and about mostly seeing it as vaginectomy. so they’ll try out some words/coding

i complained about my treatment and about the not having...done what i asked...with the surgery...because “healthy tissue” wtf..... and my wonderful doctor asked if i was unhappy with how the results looked and felt and i was so HONESTLY YEAH

for real, for all that the initial relief of No More Stuff was immense (and so was the Trauma)... as that’s worn off i’ve been increasingly like. Blugh. about the look, feel, everything. like :/// at best down to :((

and i had really written off surgery as a Never Again, Trauma. which had preempted considering anything. plus i thought nothing would be- valid, covered, medically necessary, Transition, anymore. would be plastic surgery, cosmetic, psh you’re unhappy with Looks.

but... i’m getting more support, now, and recovering too, and better at self-advocating and with senses of what to watch for and how to preempt. and it’s maybe- worth it. and yeah actually it’s- super related to gender and selfhood and dysphoria.

i still haven’t really found any- photos, models, descriptions even, of what i want? despite hearing about labiectomy. and now finding the word monsplasty(??). mostly i just- want there to NOT BE STUFF, below lil outtie bit, which i don’t want released or grown on T or anything, and i do want kinda as it is all recessed. so preserving the way it’s in a lil skin pocket, but smoothing the Fuck out of that shit below, no more of this Extraneous Painful Stupid Hardtoclean Intheway Imo-ugly-af-on-me Shouldn’t-be-there Skin

and i can’t really draw or envision it but. maybe i can be hopeful about it.

also apparently now they only ask for one therapist + one doctor (and they might even be able to cosign the same letter)! gasp! instead of Psych Phd + therapist + MD three separate letters

[blockers-and-ectomies]

as for nonlegal transition, oh my god i hate coming out at work, i inevitably Do and it Goes Unwell but i hate being (forcibly!) closeted more

body stuff is good, have been tinkering with the idea of investigating things but it’s not really motivated by dysphoria anymore? which is So Nice. it’s more like... playing with character customization. what if we imagined some stuff. no pressure.

i mean, i do Really Hate that people Can’t Just Tell that i don’t have a vagina, but then it’s largely because they a) assume i’m a cis woman and b) assume no visible penis = vagina, so idek how to solve that.

am mostly like NEVER TRUSTING A SURGEON AGAIN still so like, highly a theoretical thing to imagine. which is okay right now. it’s more like imagining an idealized model-version of what i have, anyway, the kind you make into a doll. also slightly alien-cyberpunk fantasy ideas, but yknow.

relatedly am kinda looking at words like altersex and xenogenital and aporine and outherine? but not strongly motivated. am pretty okay. would be real cool to happen upon a Perfect Word(s). has not happened yet. might not. s’okay.

mostly really into exobinary these days as a very loudly I SAID OutSIDE the BInary, ALL Of It, and the exoplanet analogy.

am, however, feeling Real Damn Unrepresented in my fandom smut consumption, despite a preponderance of alien, trans, and nb content. what the fuck.

also am seriously considering that i should Finally look into how to do a voice modulator over the phone. wanna do that.

[blockers-and-ectomies]

oh yeah also LANDLORDS are very relevant to legal gender markers on ID, though they again never seem to notice