#vy-plasty

[tontherocks]

My surgerymates and I are tired and enraged. Multiple surgeries take their toll.

I'm part of a WhatsApp group with the three guys I shared a room with as I had meta surgery and some two other guys that the others met at their first time at the hospital. 

We check in with each other from time to time: How's life going, what's up next, who's going to have surgery soon. Yesterday, one of those convos sparked up. We shared our next scheduled dates, we talked about about balls, since O got his recently and chatted about our preferences regarding EDs, the unreliability of the models available. M told us he met a guy who accumulated no less than 19 hospital stays (!) for his ED alone. Dark humored, we turned about other unreliabilities within surgeries:

"You remember that one time where Dr L squeezed out this hematoma on O's scrotum right there in his bed?" O said he'll never forget that for sure. And that's what it got started. Just as the clocked dark blood exploded in Os bed, all this anger, frustration, angst, desperation sprayed around. 

The bitterness that there are still just pumps designed for cis guys available, that the current EDs fail regularily and there is no silver lining to recieving better medical care in time. Insecurity to be stuck between two less than optimal options and to need it anyway. Frustration of one hospital stay after another, surgical burnout and The Fear To Never Be Done After All. Piled about, delayed longing for a life of just a guy among guys. The anger, that we didn't succeed to fulfill this so very basic human need. The desire to Just Be Done With It Already. Our dwindling resources to hold on, keep going and get shit done nonetheless. Tired, sore and fucked up.

Then we went on to compensate with sarcasm: the crowded hospital, where you never know whether you get to stay at the hospital itself or get a bed at a non-specialized facility (non-educated medical staff being a real thing). The burnout after three surgeries on your urethra and no end in sight. The transphobia medical professionals displayed (stories about an endocrinologist, a psychologist and a nurse). Transphobia within college, work and society in general, where we're told that autism and trans don't occur together, that trans is a trend, that we do all that for attention, that we just have to think positive and it's all gonna be resolved by itself.

All the minor disturbances within surgeries: the crowded hospital, thats doesn't allow the patient to stay the night before surgery any more, so you have to afford at least one night at a hotel (or more, if you have your pre-medical consultation on Friday and surgery on Monday, like M did). You have to get tested for HIV for every surgery you undergo in the phallo process (All the orgy you're going to have between stage 1 and 2, with your frickin sexy healing penis!). Dating cis women. Being prohibited to donor blood. All the shit.

And we were quite a bit raging against the dying of the night, so to speak. Because we don't deserve to be treated like shit. We deserve our healing, our dignity, our own time. We deserve our fuckin penis. We deserve medical care and we aint no leaving without what we need.

[tontherocks]

Exploring surgery options: another consult for scrotoplasty

On June 21, I had a consult with another surgeon. She performs metoidioplasty and scrotoplasty with and without implants.

I went there to explore whether I still do want to go with phalloplasty and if not, how I could possibly move along with my then-next steps vy-scrotoplasty and implants on one hand. On the other, I want to get familiar with surgical options beyond getting phallo, since she does scrotoplasty for post-phallo folks as well. Besides that, she just started to practice at the beginning of this year and since I was in the area anyway I wanted to get to know her.

I had my appointment late in the morning at 11.15am. Compared to the previous hospitals where I recieved trans-related health care, this one looked much less clean and well-organized. My consult took place at the station, next to the patients rooms. My boyfriend was with me and we sat with two other people I recognized as fellow trans/nb guys in a small room. They avoided eye contact, so we didn’t spoke to each other.

I waited for like half an hour or so, then we were called into the doctor’s office. She was in her late 30s or early 40s and introduced herself in a friendly manner. I told her why I was there and what had happened so far, lower surgery-wise. After setting this framework, I went with her alone into a room with a gyn chair. I changed and sat down.

While I held a big mirror and watched, she examined my current genital situation. Getting a mirror to actually see what my junk looks like from below and what can be changed, and in which ways was a real game changer for me. 10/10 would recommend. It influenced profoundly how save, informed and respected I felt throughout the examination.

Possible improvements of my meta penis

She complimented me for a beautiful and well-crafted penis. The doctor spoke respectfully about my junk, touched me gently and showed carefully what she would change in a possible furthcoming surgery with her:

- re-working my current tent-ish-, triangularily shaped shaft into a more round form. She says that there is some excess tissue that can safely be removed without doing harm to my urethra.

- loosening the small ribbon within the upper part of my my scrotal skin, so that my penis appears more prominently between my nuts.

- she could loosen the part of my dick that holds my glans and erectile tissue down (this procedure is sometimes referred to as “simple meta”). However she doesn’t expect this to change much of my appeareance since she felt that there is not much of a so-called small ribbon anyway.

- the excess skin I have where my front opening used to be will be removed to gain a smooth surface.

Next steps

The next surgical step would contain aforementioned aesthetical improvements, vy-scrotoplasty and scrotal implants. There is no waiting time in between surgies needed since she can perform it in one stage. Since I have a lot of natal tissue to work with to form my new scrotum, I can choose how much volume I want my nuts to be filled with. I forgot which sizes they offer (the different implants will be ordered a few weeks in advance of surgery), but I’d go with the biggest one available anyway.

She advised me against having a mons resection (at least in the next furthcoming surgery) since she said that there could be nerve damage done and that she doesn’t expect this to change the appearance of my junk (e.g. helping with exposing my penis) that much. She also mentioned infections and damage done to the lymphs as possile risks.

Q&A

Then we went back into her office. There, I had the opportunity to ask the questions I had prepared.

Q: Is it possible to gain additional length?

A: Since a re-positioning of my scrotal tissue will be done, the current length will appear more prominent and accessible. Maybe a gentle dilation will be possible, but there are just a few millimeters to gain.

Q: How was her technique different from the other surgeons in the area (e.g. the one who performed my initial metoidioplasty)?

A: All in all, she works closely with and was in part trained by Dr. Miro Djordjevic from Belgrade, Serbia. Basically he forms the urethra in a different way than my surgeon did (albeit they both don’t use a buccoal muccosa graft), including at least one labia minora graft.

Q: How many people do they operate right now?

A: Since she just started to practice at the beginning of the year, they don’t have as much experience as other teams. Currently they perform like one lower surgery per week. They think about offering phallo some day, but the capacities in the hospital don’t allow to do so right now.

Later, we talked a bit about community and changes within gender affirmative care system. She mentioned that there are people were approaching her to request nullification surgery and other options of non-binary and non-traditional gender affirmative surgery now. Their team is working out on how to help with their surgical needs. It was extremely reassuring for me to see her valueing the different wants and needs of her patients and she seemed to really care about them.

Overall, I felt very secure, seen and understood in this situation. In case I’d decide against phalloplasty somehow, I’d go with her for scrotoplasty and implants. Even if I do get phallo, she can be my surgeon for those surgeries as well, and I contemplate to go with her for that.