So you want to get a pussy
Or how I learned to stop worrying and love the dilator
Part one: The search
I’ve received several messages and questions from people asking for advice on how to get bottom surgery, and what they’ll need to do so. That advice usually begins with explaining how to find surgeons for their procedure. To do so you need to make a decision about how far you’re willing or able to travel, be it within your state or farther across the country. (While this guide is mostly restricted to the United States there are options available more affordably in other countries, particularly Thailand.) Once you are able to decide your travel boundaries you will start to have a better idea of what surgeons are available. Usually I will recommend that prospective patients google search “gender affirming bottom surgeons (selected area) to begin their search. You can also use https://www.transhealthcare.org/, or the transgender surgery reddit wiki at https://old.reddit.com/r/TransSurgeriesWiki/wiki/srs/usa which can be used without a reddit account. After finding a few possible options you should make sure to research them carefully by searching their name along with the search terms, “results”, “Lawsuit”, and, “reviews”. Be careful to double check sources on negative claims and make sure that the articles aren’t being written by known transphobes or anti transgender religious organizations. I also recommend asking around your local friend groups, transgender support spaces, and even your hormone provider for advice or recommendations. Local sources often have more reliable information than the internet. After you’ve decided on one or two options you’ll need to schedule a consult.
Part 2: The interim and preparation
Most clinics will have at least a 3 month wait time for a consult and sometimes up to a year so scheduling as soon as you can is essential to receiving surgery in a timely manner. Make sure to check the websites of your selected surgeons for information on scheduling an appointment. Some will have a form on their website allowing you to schedule directly while others will require you to call. I recommend using both options and calling to confirm that your appointment has in fact been scheduled. Make sure to request to be put on their cancellation list so you can take advantage of earlier appointments if available.
While you wait it’s a good idea to get your surgery recommendation letters in order. Due to (in my opinion unnecessary) concerns about liability and potential patient regret your clinic and insurance provider will require at least one letter written by a medical professional stating that you understand that vaginoplasty is a permanent procedure and confirming that you are in fact transgender. The requirements of the letters and the number of letters required is heavily dependent on insurance, so make sure to check your coverage documents before speaking to your therapist. I would also recommend beginning hair removal as soon as you are able. Hair removal can take up to a year and a half to complete depending on the methods used and the frequency of appointments, because of this it is essential to set appointments with this in mind. Most insurance companies will reimburse your hair removal for bottom surgery, but you should still be prepared to pay up to 200 dollars per session. There is some debate in the trans community about which form of hair removal to select when preparing for surgery. Some will claim that the only permanent option to avoid hair follicles in the vaginal canal is exclusive use of electrolysis. However most surgeons will state that either electrolysis or laser are effective to prevent hair follicles from forming. Whichever option you choose you’ll have a head start on the surgical process and hopefully already be prepared for surgery by the time of your consult.
I've recently begun a surgical advice series on my surgery side blog for any one that might have question about how to start the surgery process. The first two parts were released today and will be updated with more information and more posts later this week. I genuinely hope that this will be useful for girls who may be anxious about the process or not know where to start. I hope you have a wonderful day!
