Permanence and Clown Noses

As I am steadily marching towards the next major milestone of my transition I can’t help but sit here wondering what drives me to pursue this procedure? Why do I want this? What are my expectations of going through with this?

As those of you closest to me already know, I have decided to have a surgical procedure called Vaginoplasty. You may know this surgery as Gender Reassignment Surgery (GRS) or Sex Reassignment Surgery (SRS).

With this decision, I have set the wheels in motion to ensure I meet all of the requirements outlined in the WPATH Standards of Care (link). I have also scheduled my first surgical consult for a few months from now.

So, why do I want to do this?

Honestly, it’s complicated… I wish I had a two or three-word answer to this, but I really don’t.

It’s not even that I hate my genitalia. I have a perfectly average penis. There is nothing particularly weird or off-putting about it. I don’t expect anyone to understand this, it’s just that it’s wrong. It doesn’t belong.

When I, for instance, am in the shower and look down, it looks out of place. This odd attachment that simply shouldn’t be there.

It’s kind of like a big red fluffy clown nose. There is nothing particularly wrong about it, and it might even be fun to play with now and again, but you know it looks silly on you, makes you uncomfortable, and you don’t really want anyone to see you with it.

That might seem like an odd analogy, and I agree, but this is also an odd thing to write about, so… yeah.

There are other reasons, and thoughts I could share, some big, some small, but it only gets more awkward from here, so I’ll spare you the details.

Just know that at this point it is awkward and sometimes painful to live with external genitalia. After more than a year of hormone therapy, it doesn’t function the way you might think it ought to and impacts any chance of intimacy negatively. It makes me uncomfortable, gives me anxiety, and sometimes pain when I least expect it. Furthermore, it is a symbol of something I never was, nor wanted to be.

Having this surgery feels like a final, permanent step, in cementing my identity as a woman firmly in this world.

Also… leggings.

What am I expecting to gain from this?

This question is much simpler to answer for me.

When I had my trachea shave this past summer, I felt immediate relief. The anxiety surrounding that area of my body was gone, and as a result, I felt more comfortable in my skin, and more confident stepping out into the world. It gave me a genuine improvement in my quality of life.

If I can have this procedure and feel the same way I did after the trachea shave, it will already have been worth it. Though I have been told by more than one person that the impact on my life and psyche may be much more profound than that, I am trying to be realistic about my expectations.

What this isn’t?

I want to be very clear in that I am not under any delusion that this procedure will resolve all of the world’s problems. It’s not all rainbows and unicorns.

Life will go on, I will be faced with many of the same issues and circumstances as I was prior to surgery. I will have the same job, live in the same city, in the same house. I will work with the same co-workers and have the same friends, family, and acquaintances. Life at its core won’t be drastically different.

However, as mentioned above, I hope that by feeling more comfortable in my own skin, I will be better equipped to deal with life. More willing to take chances, and to venture out on new adventures. More able to just live my life.

So, what are the downsides?

Like I said, having this surgery isn’t all rainbows and unicorns. There are certainly some things I don’t look forward to. The thought of dilation for one is rather intimidating.

While some women describe it as “not that bad”, others talk of pain and discomfort, especially if a regular schedule isn’t adhered to.

With this new anatomy, there is also a greater chance of urinary tract infections and other bacterial infections such as bacterial vaginosis. These things are just part of having a vagina and something all women deal with to some extent. Given proper care (i.e. hygiene), these sorts of things should be infrequent, however.

Then, of course, there is always the chance of complications, as with any surgery. The most common ones are bleeding, infection, skin or clitoral necrosis, rupture of the sutures, urinary retention, vaginal prolapse, and fistulas.

Assuming an established, reputable surgeon performs the procedure, these complications seem to be rare, but can still occur. All I can do is ensure I am being very diligent in doing my homework and picking a surgeon I can trust in order to minimize the chances of such things happening. Truthfully, I am oddly not super concerned about this though.

Final Thoughts

Let me close this out by saying that this isn’t some spontaneous decision I made. It’s something I have been thinking about off and on ever since I first heard these procedures existed many years ago, and even so, it’s not a decision I came to easily.

It’s been a lifelong journey to get to this point and I feel like this is the right decision for me.

Also… did I mention leggings?