Some updates

There’s a lot going on in my life right now so here’s a little update.

This week I’m headed down to San Francisco to do consults with 2 possible surgeons for vaginoplasty (bottom surgery). I’m seeing Dr. Heidi Wittenberg and Dr. Thomas Satterwhite, the two surgeons I know of who specialize in nonbinary surgical procedures. Ironically, now that the procedure I always thought I wanted, penile preservation vaginoplasty, is possible, I’ve realized that I most likely want a standard penile inversion technique. Especially now that I’ve been on estrogen, my desire to use my penis has disappeared and my dysphoria around it has increased. I’ve also realized that I enjoy using a harness a lot more than my own parts and having a vagina with full depth for penetration is more important. I still want to talk with these surgeons specifically because they are specialists in a variety of techniques and can talk to me about my options in a way that isn’t focused on a binary transition path or assumption. I’ll post an update about what I learned when I get back.

I’m doing the research now on how to change my name and gender marker on my identity documents. It’s a way more complicated process than it should be with a lot of dependencies and some required letters from physicians. I thought that changing my middle name would be sufficient but I’ve realized now that in a lot of medical settings I still have to use my old name and it’s getting old fast. Now I just need to settle on a new middle name…

I’ve started trying out she/her pronouns again to see how I feel about them. Last time I tried it just felt like a painful reminder of how far I was from that ideal but I’m starting to find now that I’m pretty obviously a transfeminine person, a lot of people are defaulting to that and I think it might be easier to get people to use my pronouns if I switched, especially my parents.

I also just finished my 4th laser hair removal session for my face and I feel so much better now! I no longer constantly have stubble and I only need to shave what little I have every other day which makes my skin a lot happier too. I think I will probably only do one or two more sessions before I switch back to electrolysis to get the really stubborn hairs under my nose and under my lip.

I continue to hate my braces with a burning passion and can’t stand how my smile looks in photos right now. But with any luck, my next surgery will be in December and then I can get the braces off in June next year. I’m planning my next surgery for July next summer hopefully so this time next year I should be nearing the end of my intense phase of transition.

My libido is still abysmally low so I’m going to talk to my doctor at the end of the month about adding progesterone to see if that makes a difference. For some people it helps and others it makes it worse. The added bonus is that it might give me a boost on breast growth.

Well that ended up being longer than I thought but that’s what’s going on right now.

Inheriting a fixer-upper

I just scheduled my jaw surgery to do the first part of correcting my bite for mid-May. It’s something I’ve been dreading for the last 10 years since my dentist identified the root problem. And I’ve been surprised at how many emotions around surgery are coming up for me now that it is an undeniable reality, not just about this procedure but about my plans for bottom surgery.

My original plan was to get my jaw surgery out of the way this year and then go in for vaginoplasty next year. And in the interim I was going to meet with the surgeons I was interested in when they were in town for Gender Odyssey. But now I feel like that plan has come crashing down around my ears (like most plans have in my life).

I found out a few weeks ago that my jaw surgery is so intensive that they need to split it into two separate procedures with a year of expanding my top palate in between. So now I have another surgery on my face to dread but at least I have jaw feminization included to look forward to. Unfortunately that means I have to rethink my whole plan around bottom surgery.

To complicate things further, I found out that Gender Odyssey isn’t in Seattle this year and they aren’t doing a conference for trans adults this year anyway. So now there’s no opportunity to meet with them that doesn’t involve investing in travel. I feel like I need to decide whether to try to attend Philly Trans Wellness where I might meet some potential providers (although not my top choice – Heidi Wittenberg), or whether to travel to San Francisco to meet with them directly.

And trying to figure this all out while I’m also undergoing intensive laser hair reduction on my face (I put electrolysis on hold for now because it was too slow) just feels like so much. I feel totally overwhelmed by how far I still have to go before I’m done with all these medical procedures and honestly I’m feeling pretty despondent and hopeless about it all.

I just want to fast forward to a point in time where I feel like my body is my own. But instead I feel like I inherited a fixer-upper house that needs major repairs to be livable and every time I fix one thing, another breaks. I know that all these surgeries and procedures aren’t going to fix everything but I still have to rest my hopes on life getting easier once I’m past it all. Because without that hope I don’t know how to keep going.

This is one of those points where I really wish I had been born with a brain and body that matched and I didn’t have to go through all this work just to be myself. And sometimes it feels like I should just throw in the towel on life and give up. Don’t worry, I don’t actually have plans to do so but I can’t say I haven’t thought about it.

Anyway, I don’t know where all this is going right now other than hopefully forward even if it takes a painstakingly long time to get there. I know I wouldn’t be able to keep wading into the fray if it wasn’t for my partners and friends so I am very thankful to all of them for keeping me going. I know things have to get worse before they get better but I really hope I turn that corner soon.

Exploring surgery further

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.