Content warning: I’m going to be talking about sex and genital surgery. Be forewarned.

Now that I have done some work in therapy to work through my fears about surgery, I am starting to explore my options in earnest.

For years I thought that I wouldn’t want to get surgery unless I found an option where they could add a vagina while keeping my penis intact. This was partly based on how I envisioned myself and those I was attracted to in my dreams as a teen. Before I knew that trans people existed, most of my imaginations centered around people who had both sets in tandem, sometimes with retractable phalluses and always with breasts. A year ago I tried to do some research to see if that was possible. At that time they had just successfully done the first neo-vagina made from peritoneum, the internal connective tissue in your abdomen. But everywhere I looked people either weren’t talking about that option or claimed that it was impossible to construct a vagina without damaging the penis.

So I had pretty much given up on that idea and gotten on board with a standard penile inversion vaginoplasty. But this time when I started doing research on surgeons I came across the website of Dr. Heidi Wittenberg who mentions that for gender nonconforming people she offers a penile preservation vaginoplasty. I can’t find many details online about the technique but apparently it involves using skin from another area such as doing a tummy tuck or a strip from the thigh. The scrotum is still used to build the labia and the phallus is left intact. And I hear from other trans people that she isn’t the only one. There are several surgeons who trained under Brownstein and Crane who can do this.

The odd thing is, now that I’ve finally found the thing that I always thought I wanted, I’m not sure that’s actually what I want. The more I think about it the happier I am with the idea of having a well constructed neo-vagina. I’ve seen the work that surgeons can do firsthand and it is incredible how hard it is to tell that it isn’t natal.

Luckily I don’t need to decide just yet. Next year is my jaw surgery (hopefully with some chin correction while I’m at it) and I know I can’t afford both in the same year so this will have to wait until at least late 2019 or probably 2020. My current plan is to go to both Gender Odyssey in Seattle and Philly Trans Wellness to learn more about the current techniques and hopefully catch Dr. Wittenberg’s presentation. I can get a consultation there and schedule something if I want. I do like the idea of having a surgery done with someone who recognizes transitions outside the binary and can talk me through the options. Not to mention that she specializes in Gynecologic urology exclusively for trans people and is considered an expert in neurology and minimally invasive surgery. Currently her waitlists appear to only be 3 months which is much better than most of the surgeons out there.

What I have noticed is that making up my mind that I do want surgery and giving myself permission to explore that in earnest has improved my sex life quite a bit. My libido has picked up and I find myself more ready to utilize my penis now that I know it is short term. It almost feels like I want to make good use of it while I have it as a way of wishing it goodbye. I have also noticed a difference in sensation as my brain rewires itself for estrogen. The head of the penis is more sensitive almost to the point that it already feels like I imagine a large clitoris must feel. And stimulation on the shaft somehow evokes the sensation of being penetrated. Not sure how to describe that and how much is me envisioning it in different ways but it does feel more and more like what I have right now is an inverted vagina, not the same penis I used to have.

That may be TMI but you can’t say I didn’t warn you.