Facial Hair Information- Tips and Tricks on How to Shave (HRT)
Frequently Asked Questions about Phalloplasty - My [personal] Experiences
How can one ejaculate after phalloplasty procedure? -ask answered.
Common Phalloplasty Misconceptions- Article
Male Mannerisms- help to know male gestures, wording, and attitude- (ask)
Testosterone Experiences That Caught Me Off Guard - (Ask)
Safe Binding and Packing - Articles Purchase Sites Also
Staying Stealth During Surgeries, Explaing Scarring - advice (ask)
Top Surgery (both ftm & mtf), procedures, and approximate costs.
Can I have top surgery and be overweight?
Keyhole Top Surgery Procdure- Outline and what qualifies you as a potential candidate
Finding a Top Surgeron in North America
So You Just Had Surgery (Top)- Advice on the best way to heal after surgery/ minimize scarring.
Is more time on the operating table really better? Operating time and infection information.
Metoidioplasty FAQ
My Personal Surgeon and Their Clinic
Interview with Dr. Chen about Bottom Surgery
Penile/ Phalloplasty Erectile Devices
Expectations- Personal Advice on Setting Expectations
Urethra lengthening Procedure Information- Self written article.
Importance of Uriologist
Phalloplasty Website - Includes Parents Guide
Urethra Lengthening Procedure
General Surgical Risks
Plus Sized Surgery Risks
List of Phalloplasty Surgerons in the USA
Vaginal-Perservering Phalloplasty Procedure
Graft SiteCare for Forearm -Free Flap Phalloplasty
What Happens if Erectile Device Breaks?
Image of My Phalloplasty (wearing underwear) Educational Purposes Only
Phalloplasty Procedure Outline by GRS Montreal - (Link to Webpage)
First Ever Phalloplasty Procedure - Surgeon
Michael Dillon- Trans Pioneer (First phalloplasty patient)
How to Find Proper Sources of Information in a World of False Information/ Online Safety
Why certain terms can be hurtful. Please respect my/others views.
Tattooing over your forearm skin graft -ask
Testosterone and Hair Loss Information
If there are any other posts/ other topics I should add to this directory, please send me an ask. I will never post your username without your expressed consent in the ask.
Hey! I was wondering who your surgeon was? Your experience with phallo sounds so amazing.
Hello!
My surgeons name are Dr. Belanger and Brassard at GRS Montreal.
I have had a great experience with my phallo, I was lucky enough to have minimal and minor complications after each surgery.
It's a long road, and it's painful, but when you're done you feel more whole.
The first time they checked the blood flow, you could hear it like a baby's heartbeat during an ultrasound, and it's the most amazing feeling that washed over me. I felt my body/outside was complete.
Thank you for your question, I apologize for rambling.
Phalloplasty Procedure Full Outline Offical (Radical Free Flap Procedure)
What is phalloplasty/ phallo?
Phalloplasty - "includes several surgical procedures that aim to construct male genitalia that looks as natural as possible. The surgery is divided into several steps that may vary from patient to patient. Generally, they are the three following steps" (Source1) . We aren't going to count if the prerequisite of hysterectomy. Since my surgical procedure, they have removed the requisite of an oophorectomy, that procedure is now optional thanks to the always advancing technology.
The first step:
a surgery that consists of creating a penis from a skin flap from a specific area of your body (most common areas are forearm and lower back) of the body that you would chat about with the surgeon(s) and that specific skin will be grafted to the genital area.
The second step:
Here, surgeons construct the urethra that will llow urination. This is known as Urethra Lengthening (often referred to UL) (Urethra Lengthening Procedure Post)
The third step:
At this stage, you will receive testicular and erectile implants that will allow for penetrative sex. Note: this is not the only type of phalloplasty sugerical options.
The first surgical step consists of:
the creation of a penis or phallus from a skin flap and fatty tissue of the donorn site involving the removal of blood vessels (to create a blood supply) and nerves (this is where nerves are disconnected and reconnected, which can take some time to gain full tactile function or feeling. This skin will be grafted to the genital area where a penis would naturally sit on your body. The next part of the procedure is:
"the burial of the clitoris at the base of the phallus;
the creation of the penile urethra within the phallus;
the lengthening of the biological urethra;
the creation of the glans;
the creation of the scrotum;
the closing of the vaginal cavity; and
the removal of a layer of skin from the thigh to compensate for tissue loss
on the donor arm." - (Source1) Some of these things are not the same for every surgeon, be sure to ask about if your clitoris could be not buried for example, or different pumping systems, varying styles in surgerical procedures from clinic to clinic, even surgeon to surgeon.
The second step consists of the construction of the urethra:
This procedure connects the penile urethra so the part of the urethra inside the phallus itself to your biological urethra that was elongated in the first step of the phalloplasty surgical procedure. The connection of the urethra is made by creating a tube from the skin of the scrotum between the openings of both parts of the urethra.
Note that the anatomical makeup of the phallus is composed of only skin, fatty tissue, blood vessels, and nerves.
It does not contain any muscles or a sphincter (a muscle that opens and closes like your butt does aka "the breakwall"), which means that after the second step, you may have to empty your urine either temporarily or permanently manually from the portion of the phallus by applying pressure to the phallus. (UL Article)
A minimum of a six month waiting period is necessary between this and the next stage planning.
Permanent hair removal from the area that will be used to construct the urethra is also required to avoid complications (unless during the consult the doctor states otherwise). Note that it is impossible to determine in advance which area will be depilated since it must be evaluated after Step one. It is at this time that you will receive information about hair removal,
The third step:
Involves insertion of implants (erectile device and testicular implants).
This procedure will allow you to be able to get an erection in your penis (phallus) and now you have the ability of penetrative sex. Erectile Devcies Post
You will have to wait a minimum of three to six months after the second step (healing and surgeon(s) pending) and have no urinary problems before planning the third step. If complications do come up, they will have to be completely treated and healed before the implant surgery can be performed.
"Depending on the surgeon's assessment, the second and third steps may be reversed." (Source1)
Everyone has to decide whether to undergo one, two, or all three steps. Meaning you can stop after any phase/step of the three)
This choice is super personal and must be made according to what you need, your expectations of the outcome, and the impact it has on your daily life.
There are a few factors that may influence your decisions, such as wanting to urinate while standing, the desire to have penetrative sex, having more masculine genitalia, etc.
The estimated time to complete all three stages of phalloplasty can vary from two to three years, including the waiting I'm between surgeries.
These results may vary according to the age, weight, quality, and elasticity of the skin at the donor site, the scarring process, lifestyle habits and the overall health of the patients, healing, how well you take care of yourself, etc. The radial forearm free-flap technique is shown to produce the best results from bottom masculinizing surgery options.
Mandatory Prerequisites for Phalloplasty:
Hysterectomy with removal of the cervix done minimum six months before the phalloplasty procedure. *There are two options for this: removing the uterus only (called "total hysterectomy"), or option two removing the uterus, fallopian tubes, and the ovaries, also called "total hysterectomy with salpingo-oophorectomy"*
Permanent hair removal (second step when recommended to start). The recommended options are laser hair removal or electrolysis, which may be more beneficial for results. from the area of the phallus donor site to prevent complications with hair growth (fistuals), which can cause issues such as infection and even surgerical intervention to fix the issue area(s). Surgeons typically like to see the graft site not have any hair growth for a minimum of three months.
Talk to your primary physician and/or gynecologist to help you make an informed decision about your choice on the type of hysterectomy you get.
And talk to your surgeon and your primary doctor about which option of hair removal is better suited if one is not insisted on you using it.
A vaginectomy can be removed since only 2 cm will be used for the phallus.
Body Mass Index (BMI)
Before phalloplasty can be performed, it is important to know that you must have a healthy weight or have a BMI under 30, and you can not have excessive fat accumulation in your abdominal area.
"Being overweight and abdominal fat can compromise the connection of blood vessels during the procedure and lead to significant surgical complications.
If your BMI is 31 or higher you be most likely required to lose weight before the surgeon will perform the procedure.
Patients with a high BMI also have a decreased potential for healing and decreased satisfaction with surgical results." - (Source1)
Source List:
Source1 -GRS Montreal,Quebec, Canada - downloadable PDF -used as the direct quotes and most of the information
John Hopkins Hospital - used for an information source. -https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/phalloplasty-for-gender-affirmation
Cleveland Clinic -an information source (I barely used this)- https://my.clevelandclinic.org/health/treatments/21585-phalloplasty
Article- Self written on Urethra Lengthening Procedure
Article- Self Written - Erectile Devices Available
Normal questions for phallo (my personal experience, and facts)
"Do you feel anything?" - yes, I feel everything from touch, stroking, temperature, pain, pressure, pleasure, gusts of cold air. They do disconnect and reconnect nerves, so it does take time (years) depending on how you heal to have complete sensation. But you always have sensation there even after the initial procedure. I found the Urethral Lengthening Procedure and the Implants (erectile device and prothetic testicle). It took probably 3 years after all of the procedures for me to have what is called "complete tactile function".
"How do you get erect?" - it's a pump, after they create the scrotum (they use the labia for this), you get your pump installed into your main hand side (ex. My pump is on the right testie), and the other testie is just an implant. I squeeze my pump (or my partner), and then saline water is pumped from the testicle into two tubes (one on each side on my penis). Creating a natural looking erection besides having to pump. It only takes about six pumps for me. Doesn't take much effort. I have a three part inflatable device.
"How do you "deflate"/ go down after an erection" -on the testie that is the pump, there is a small button above it, it is actually kind of a small box with a button on it. I hold the button for about 15 seconds and just let my erection naturally go down.
"How many surgeries does it take?" - well, I guess four in total. You have your hysterectomy (which included for me a complete oophorectomy as well, recent advancements in this procedure have made it so an oophorectomy is now optional), then your phalloplasty the building and attaching of the phallis and vaginectomy only at this part. The next surgery was to connect my urethral, called urethra lengthening. The last surgery was to install the penile pump and testicular implant.
"What are the chances it will fall off?" - less than 1% in the hands of a skilled surgeon. (My surgeon told me this information as the source) - note post operative care is the most important part of healing properly.
"Where did they take the skin?" - they took the skin for my phallis from my forearm and used a thin layer of the skin on my upper thigh to cover the tissue left exposed on my arm.
"Do you have any issues today?" - No issues, I've been finished for quite a bit now. I enjoy sex, it feels good. It looks good. I've never been clocked even naked in a locker room. I do dribble sometimes if I hurry while urinating, and I have to use a special technique to ensure 100% emptiness, but I can pee just fine. I found the installation of the pump helps me urinate easier than without.
"Can you ejaculate?" - Yup! I can, at least. I also have pre-ejaculate. I ejaculate almost everytime I orgasm. (With this said, the ability to ejaculate, amount of, and frequency of are all variable factors that can depend on person to person) EDIT: My ejaculate is not semen, it is a fluid secreted from your skenes glands. Your Skene's glands are two small glands on either side of your urethra.
"Is the orgasm different?" -yes! It feels better to me. It could be comfort, but ejaculating does feel good when you orgasm. Ejaculating can vary from person to person. This ejacuate is not like cis men's, it is a clear fluid from the Skenes Glands.
"Did you have any major issues?" - not really, I did have to see a wound clinic for my implant surgery. I had wounds that needed care. I got a bladder infection with the catheter during the healing stage of urethral lengthening and had it removed after just over two weeks (it was supposed to be in for six weeks), as a reference though one of my urine bags broke and I had a plastic baggie to try to repair it until I could get a replacement (i had to wait hours), I also have a compromised immune system. For my arm, I wore my compression sleeve 100% of the time, and my arm healed extremely well and flat. You just need to listen to the rules and be sure not to break them.
"Do you have to do anything (e.g weekly)?" - sorta, I have to make sure I pump fully once a week.
"Any issues urinating?" - nope, takes some getting used to, though (standing). I find that I dribble, but it's only when I'm rushing when I shake. I still sit most of the time, it's even very common in cis men as an FYI. (I asked a large group of cismen)
"Does it look real?" -Yes, my wife said she never would have known I was trans until I told her. All penises look different. Even getting an erection looks natural.
"Did you have any corrective surgeries?" -No, I got pretty great results the first time. I do plan on going to closer, regular plastic surgeon to put in a larger implant as my left testicle (non-pumping side).
Have any of your own questions? Send me an ask, I'll be happy to answer!
This was not a decision I took lightly at all, I did some heavy listing of pros and cons and the stress. But with the amount of anti-transition propaganda, I decided my community was more important than myself.
Due to lack of outside resources for people transitioning and lack of support for transsexuals and transmasculine people.
I thought there were other reliable blogs for information, sadly I was wrong.
I am a very strong advocate for the transsexual and trans masculine community, and people wanting to identify as male. Of course anyone supportive is welcome.
Recently I have seen an uptake in posts spreading fear mongering, spreading detransition/transition propaganda. I did not think again, that with all the talk of inclusivity I would still need to continue this blog.
This blog may not be as active, but you are welcome to ask questions still and ask for information you want or need to make a correct and informed decision on which direction your transition will go.
I refuse to allow my people continuing to be pushed around and pushed towards not transitioning if that is your goal.
Anyone who spreads fear, or tells you any form of detransition propaganda, block them, they are not your ally.
We need to be strong as a community and if we need to break off, we will try to make that happen.
For those of you on hormones replacement treatment (HRT) Testosterone;
a shaving kit makes a great and natural way to store and travel (where legal) with your testosterone. Going to a friend's house? Bam, it's natural to have a shaving kit. Or I found emptying out the hard case of a set of old hair clippers. If you carry needles and you are stowing your needles, I recommend using a hard case of some sort. I've had the airline break my syringes/ needles before, and when you have to ask a pharmacy that doesn't know, they may be hesitant to give you any needles without knowing the medication you are on.
Do research on where you are going if leaving the country, make sure you have what you need (if you can) to be able to have legal possession in that country and any other country where you may stop or another potential area to explore.
Keep yourself safe, it's always good to keep a note from the doctor and your prescription history.
If you, for some reason do no longer have your testosterone, missing a dose or two will not cause any issues (I was told this by my family doctor).
Also, it's a good idea to perhaps take your vial and put it safely in a carry-on. They will not let you take your syringes (if they have needles attached, they will not let these on your carry-on).
It's good to have a hard case for long distance travels, otherwise a shaving bag works well. Find a more padded one if you can, and that closes securely.
I like to keep all my things together (Needles, testosterone, alcohol/alcohol wipes, and cotton balls/pads.) So that if you ever need to leave in a hurry you have to only go to one place and grab one thing.
I try to buy syringes with needles by the box. They cost me about $0.25 each and I get 100 in a box, all for $25.
It is also important to get a proper sharps disposal. You can usually ask the pharmacy and they will give you one. (In Canada I believe they are free).
About injection,
Unless instructed how to properly by a health care professional, I would not use your thigh for intermuscular injection. A great place, and the least painful I have found is in your gluteal muscles. It is important to rotate injection sites/sides. Give the muscles a break, especially if you need a dose weekly like I do.
Try to get air out before injection
Make sure you pull back the plunger to make sure you do not inject into a vein. If you pull the plunger and you see blood, do not inject. Find another location.
Do not use a needle more than once if possible (during a single injection, you can use attempt a few times), try to get it right the first poke, and it will hurt less.
The more a needle is used, the more it actually starts to spur at the tip, which means it's going to be harder to poke yourself, and it can be more painful
Do not share needles
Dispose of your needles properly by using a sharps container. Return it to the pharmacy when finished and they should give you a free exchange for a new one.
Do not throw needles out in the trash even with the cap on it can still be dangerous. I've personally seen (had) a needle peirce through the cap, have gotten stabbed.
Try to minimize air bubbles in the needle. But if you are scared of air bubbles. My cousin is a nurse practitioner, and she told me that it takes a lot more air than that empty syringe can hold to cause an embolism. But it is still important to minimize bubbles just to be easier on your body and help better absorption. So, a couple of tiny little bubbles are okay.
Make sure you are using a sterile area to place your things.
Make sure your hands are clean and sanitized.
Afterwards, press and slightly massage the injection site for at least 1 minute to help the testosterone absorb and to stop the bleeding.
The rule of thumb if you ever forget where to inject into your butox, upper and outer area of your gluteal muscle (so upper and outer buttcheeck).
Before you poke yourself, I find it helpful to press with your finger/alcohol pad and find a nice area, I usually do it as I apply the alcohol to sterilize the area. I find it helps me get it right the first time.
Any other questions? Let me know!
Do not inject yourself unless you have been properly taught how.
Do not fool around with your dose, more is NOT better
It may take a few years to fall into the safe/average hormone levels areas or what arrangement you have discussed with your prescribing physician.
Be careful! I am not a physican, always listen to the professional and be safe!
Hi! Thank you for being a great resource and advocate.
Question: How did you bring up bottom surgery to your doctor? How did they respond, and do you have any tips for people who might be anxious about bringing it up?
I have been wanting to bring it up to a doctor, but I've been too afraid. I'm worried they'll say no, or act like I shouldn't want it for whatever reason (ex. the unfortunately common misperception that transmascs don't get/need bottom surgery). I don't know anyone else irl getting phalloplasty, and I still struggle with feeling ashamed about how bad I want/need it.
Thank you, and no pressure to answer this if you don't feel up to it, for any reason.
Hello and thank you :),
When talking to your doctor bring it up less as a question. Say "I have been researching this and looking into studies and I have been doing the work and I am serious, this is something I have been thinking about for awhile and need to be happy with myself in my skin". Ask them what steps they can help you with to get you going in the right path. This helps the doctor feel you are a lot more serious, they know at this point you need it, it's less a conversation of persuasion and more of a conversation of information.
I was very straight forward with my doctor, I came at him like an information tornado, and also I remember trying to explain my disconnect between my brain and body. I actually had to teach my family doctor about it. (With that don't be surprised if your family doctor does not know much, they are general practitioners, so they may know it in a very general term).
Pro Tip: email a clinic about generic information on the procedures and bring that information with you, it's proof you have put thought into it, and that you are serious about pursuing your transformation.
This is big and brave and I am proud of you. Just take some deep breaths, maybe try to talk to a trusted person and work out the kinks in your speech prior to the appointment.
It's better to be fully prepared, sound confident, and show you have knowledge about things like how you know it will be painful, mentally taxing, and it's a huge procedure. Be realistic with your expectations.
So it's less of your asking them if you can have the procedures, and more "I need them, to be okay in my skin".
Thank you for your ask, and the appreciation 😊.
You got this! I have faith in you.
Love,
-Zestual 💙 🩷
P.s if you have any more questions or concerns please feel free to contact me (or if my wording is confusing). I do not mind answering questions one bit.
"Female to male transition" - the full term and proper medical terminology will help you find reliable sources. Using quotes around a phrase like this will help zero in on the exact words or phrases you have input.
We want to use terms that would be used in the medical field (the real, biological names for your reproductive organs clitoris, vagina, urethra, penis, phalloplasty (not just "phallo"), breast augmentation. Using professional terms will bring up more professional and reliable sources.
"Urethraplasty" or "urethra lengthening procedure" - this will help you find more reliable studies on the subject of urethra lengthening operations for example.
Finding out the actual medical term for a procedure will increase the accuracy of results.
Rewording your phrases- if you know the name for something and you cannot seem to find anything about it that relates to you. Try rewording the search terms, reorganize the words.
If you do not know the name of something, you only know the "slang" term, input that term similar to: "what does *input phrase* mean?" - I often have to do this when I get asked and do not know what slang terms are defined as. Sometimes even add the words "Urban dictionary" and the term will come up with a definition that will include a more specific wording to use in your search.
I know it sucks to have to use terms that are mainly referred to the female body/ reproductive organs. But using this biological terminology, you will get more accurate and reliable information and find useful sources for other reasons as well.
If you are really stumped,nothing is coming up. Try finding an important word(s) and quoting them individually, separated using commas. Ex. "Chest masculinization", "gender affirmation", "surgeons", "Ohio". This would help you find a top surgeon in Ohio for example.
