Second post op

I had my second and final post op appointment today and it was a bittersweet moment hopefully seeing my surgical team for the last time. Today’s big hurdle was the “bladder trial” where they pump me full of saline, take out the catheter and see if I can pee the full volume. Luckily this time I passed easily unlike after my first surgery. Everything else looked good other than my persistent yeast infection.

After that I hit the road and two of my partners drove me halfway back home. On Tuesday when I had a short outing in the car I was hurting a lot so I was worried but today was relatively pain free so I feel very thankful. I’m really lucky to have not one but two caretakers here with me. I wish everyone could have that privilege.

Missing home

I miss my pets, my bed, my chosen family, my chair, and my mountain. I just want to be healing at home instead of stuck in an overpriced Airbnb in a strange city just because Seattle doesn’t have trans bottom surgeons.

When we talk about trans health equity, a big part of that is easy access to care instead of driving halfway down the coast (or across the state at best) and spending exorbitant amounts on housing to get the care we need.

Revision post op

Just had my first revision surgery post op where I was really hoping to get the catheter out. Sadly they want me to keep it in a week longer to give the urethra more time to heal. I also have a yeast infection. Otherwise I seem to be healing well though I do have to stay on top of separating the wound at the base of my vagina to make sure it doesn’t heal together like last time. They also gave me tips on how to better manage my pain without opiates.

The team at Mozaic Care are all so wonderful. I hate that I had to have a revision because my original surgery healed weird but I am glad I get to see more of them. Right before surgery when I was waiting for my operating room to be ready I told them about my first orgasm and both surgeons were so excited. One even gave me a hug on the spot.

Angry at the world

Some days I just get so angry at the world for being born trans. Why did I have to inherit a body that was set to hard mode? Why couldn’t I have just been a cis woman with a brain that matched my genitals from birth? I hate that I have to have all these surgeries just to fix something that I didn’t ask to be born with. Being Bisexual feels like something I can be proud of but right now being Trans just feels like I got the short end of the stick.

Sorry for the rant. I’m feeling very emotional today. Earlier I had a good long cry for no discernible reason. And now I’m so angry that if I wasn’t in a city I would go scream at the sky. I guess it’s the after effects of the anesthesia or meds or something.

Update after surgery

The surgery appears to have gone well though it was a little more extensive than originally planned. While they were in there they discovered a hole in my urethra which explains why I was dribbling after I peed. They stitched it up so now I have a catheter and a pee bag tied to my leg for the next week.

The pain hasn’t been as bad as the first surgery but it’s enough that I have to stay on top of pain meds. I haven’t been sleeping well because I keep waking up when they wear off. And it’s painful to sleep on my side right now because that puts pressure on the stitches.

I’m pretty out of it because of the meds so as I’m mostly zoning out and watching bad TV. Hopefully soon I’ll start improving.

Revision surgery day!

Today is my revision surgery on my vulva! The surgeon is going to be modifying my clitoris area to make it easier to access my remaining nerve bundle, removing some scar tissue at the opening of my vulva, and removing excess skin that grew around my urethra that causes me to dribble after I pee. I’m simultaneously glad to get these annoyances dealt with and scared that something is going to go wrong with the surgery or recovery to further damage my ability to orgasm. Fingers crossed everything goes and heals smoothly!

Full orgasm!

I did it! 1 year and 7 weeks after bottom surgery I finally had a full orgasm! I’m not sure what the magic formula was this time but I was trying out a new toy my partner got and a new topical cream that includes Viagra.

It definitely feels very different than my old parts did. It comes on slowly and has a more sustained high point and headiness to it. And I forgot just how wonderful all the happy hormones are that come with it.

I’m excited to have more of them and find out what works. And maybe someday I can get there on my own.

Why is gender affirming care so expensive?

I’ve written quite a bit about the costs that I have incurred along my journey of trying to inhabit a trans body. But even as I look forward to the upcoming revision surgery on my vulva, it is a harsh awakening to realize that I am going to have to spend yet another $6,000+ for housing simply because Seattle has no transgender vaginoplasty surgeons and most insurance refuses to pay for out of state surgery costs.

So how much have I paid out of pocket so far for gender affirming care?

  • $5,000+ for electrolysis and laser hair removal on my face and body (not considered “essential” by insurance)
  • $9,500 in travel costs for consults, surgical recovery housing, and post-op appointments
  • $6,000+ for housing for revision surgery recovery

All told, I can account for over $20,000 in costs that insurance refused to cover.

I am one of the lucky ones. I am privileged enough to have a good job with decent health insurance so my co-pays are minor and I can afford to save up for these procedures. And I have a large network of friends who have generously donated over $5,000 towards those costs.

But can we talk about why these costs exist in the first place? Why is it considered ok for transfeminine people to have to pay for face and body hair removal to deal with dysphoria? In a world that demands that we “pass” as women to use public facilities such as restrooms, that is incredibly classist and discriminatory. And why does insurance not have to pay for the costs of getting an out of town surgery when there are no local surgeons available? My insurance now pays for cancer patients to get out of town specialty care but despite my advocacy for the past several years, continues to deny trans people that same right.

Luckily, starting in 2022, insurers in Washington State are now going to be required to pay for all doctor-prescribed gender affirming treatments and will no longer be allowed to label them as “cosmetic”. This is thanks to the tireless work of many many advocates and organizations who fought for years against insurance denials. And I hear through the trans rumor grapevine that Seattle may FINALLY be getting a surgeon soon who can perform vaginoplasties locally. But while that helps people here in Seattle, that doesn’t change the fact that far too many trans people around the US aren’t given equal healthcare access. We need laws in place federally to mandate coverage of gender-affirming care.

So next time you think of asking someone if they have had “the surgery” or make any kinds of assumptions about what trans people should look like, think about how expensive it is to look like I do. How inaccessible it is to the vast majority of trans people in this country to achieve what Laverne Cox, Caitlyn Jenner, and Elliot Page have done. And if you have resources, I encourage you to donate generously to your local trans fundraisers and places like the Jim Collins Foundation to help more trans people get the care we so desperately need.

Mini Orgasms

Finally a year after my bottom surgery I’m starting to have mini orgasms! I had the first one about a week before my surgery anniversary but I wasn’t sure what it was and I just had three more last night.

They feel like small crests of pleasure but nothing compared to what I was used to before surgery where there is a Big Bang and I’m done. I do come away from sex feeling happy and satisfied though instead of the disappointment and frustration of the last 9 months.

I was hoping for a lot more out of my first orgasm but at this point I’ll take anything I can get. Hopefully my revision surgery will make it a little easier to achieve and they continue to grow in amplitude.

1 year post surgery

I came back to San Francisco today for my 1 year post op for my vaginoplasty. There are a few things that have been annoying me so my surgeon and I decided together to do a minor revision surgery later this year. It should only take 3 weeks in town this time and 6 weeks of healing.

For the trans people reading along, the issues I’m fixing are:

  • The opening to my vagina is a little constricted by a flap of skin at the base that she is going to trim back so I can take bigger partners
  • My urethra has a little diversion that makes it hard to wipe thoroughly and often I leak a little when I stand up
  • My clit fell off during recovery but the underlying nerve bundle is still there under the skin but it moves around and makes it hard to get off. She’ll make a more distinct clitoral area and pin the nerve bundle in place so partners can pinpoint it easier.

Hopefully this goes well and helps me finally achieve orgasm. Fingers crossed!