Perineal Urethra Pride Flag
The yellow might be a little too literal, but I couldn't think of anything else. As with the other flags I've designed, the gray half represents one's natural genital set, while the yellow represents the urinary track, with the circle on the bottom for the perineal orifice.
Perineal, if one hadn't guessed, refers to the perineum, and in typical human physiology, the bladder doesn't empty back there, but there are several reasons why someone might be different.
In a lot of cases one might be born that way, such as y-type urethral duplication, in which a person has a urethra in the normal position, and a second one in the back; in female or close-to-female persons, this may result in the second urethra being fused to the vaginal wall, so pee comes out the vagina. Other cases may result from severe hypospadias or for reasons that have yet to be determined.
Just as many incidences are caused by treatment for medical conditions. In the event of gender incongruent men born female or close-to-female, who suffer from gender dysphoria and wish to have male genitalia but not urethroplasty, the position of their urethra behind the new scrotum can be preserved with a procedure similar to a urethrostomy.
In the case of fe/male/close-to-either -to-nullo with gender dysphoria (who may be men, agender, or anything in between), the result of having their genitals removed results in either needing a urethrostomy or the female/close-to-female urethral opening morphing into a noticeable hole about where the vagina used to be-the perineal zone.
For gender incongruent women born male/close-to-male with gender dysphoria who want female-looking genitals but don't want to go through a vaginoplasty, a urethrostomy is a very simple solution.
The most common medical condition that requires creation of a perineal urethra is strictures in the male/close-to-male urinary tract: as one gets older, the more likely this will be the result of prostatic hyperplasia, in which the prostate gland constricts around the urethra at the base of the bladder, creating a potentially fatal blockage.
In rare cases of hypospadias without any history of complications, they'll suddenly start having catastrophic strictures later in adulthood with creating a perineal urethra the only way to preserve life.
How many people have perineal urethras no one knows because medical associations and disease analysts haven't been keeping track-but I imagine it's quite a lot.
In many cultures, standing to urinate is essential to masculinity, and the loss of that ability can cause men to have a lot of emotional distress, even gender dysphoria. For trans men and transmascs who get too many fistulas in their urethral lengthenings and have to reverse the surgery, I imagine that's also really tough to come to terms with...
...or, sitting to urinate not being a component of their gender dysphoria may lead their therapists or their peers to doubt their transness, their manliness, with the concomitant social pressure to conform.
For duplicated urethras, the second one can be seen as an unsightly deformity, or there may be a slight incontinence problem, which is also socially unacceptable, so it's dissected away at the earliest opportunity.
With hypospadias, Real Men Stand To Pee (tm) is the whole point of those urethroplasties, which usually cause more problems than they solve, such as spraying, but the child may feel under so much pressure to conform that they won't even dare think to sit.
As I frequently bemoaned in my article, "So your date's sexless: what to expect when there's nothing down there," because perineal urethras are positioned where a vagina typically is, and because they are a noticeable orifice, they are often confused for vaginas-and better sex ed is needed, simply put, so that people understand that these things exist and how to tell the difference.
Having a perineal urethra myself, I do stand to urinate (it's actually easier), so I can dispel some misconceptions: it's mostly a matter of technology.
The "pack 'n' pee" things made for trans men cannot work with my anatomy: because the female urethra is right on top of the vagina, the funnel part of the thing has to go into the vagina, otherwise the urine backs out and sprays everywhere-and I don't have a vagina.
At home, I can just stand over the bowl, but in public or outdoors that isn't feasible, and the thing that I found that actually works are urinary prosthetics made for female persons who do a lot of camping, specifically the pStyle device, extremely simply designed, and doesn't get in the way of my microphallus-which was another problem that kept coming up when looking for a device: despite about half my groin being on the female-ish end of things, stuff made for the female end, men and women alike, doesn't fit me (hashtag third sex problems).
Technically, a person with a scrotum can use a pStyle, but you would need to pull your sac upward to get the thing in place.
So this pride flag is for us saints and scalawags who pee out the back, that we should not be stigmatized for being born this way, or coming to be this way via a medical condition, nor should we be made fun of for using prostheses.
We are joy, and we will be liberating a urinal next to you.
