Vaginoplasty or labiaplasty?

If you are having GRS, should you have vaginoplasty or labiaplasty? Vaginoplasty creates an orifice, perhaps seven inches long, inside you. Labiaplasty creates an orifice about an inch long, which has the urethra, but not a vagina opening onto it. An alternative name is “vaginoplasty without vaginal cavity”, used by GRS Montréal, which uses the term “labiaplasty” to mean a later alteration to the labia.

The vagina needs to be lined, with the skin of the penis or scrotum. You do not want hair growing inside, so that means either laser or electrolysis hair removal before, or a lengthy procedure removing each follicle as carried out by my own surgeon, which lengthened the time the operation took. GRS Montréal says the surgery without the vaginal cavity takes 1½ hours, with admission on the day of the operation, two days in the hospital after, and returning to sports after six to eight weeks.

Surgery with the cavity in 2004 took seven hours, but in Montréal it is two. That surprised me, and shows I should check the current conditions before pontificating. Anyway. What about dilation? It seems far less onerous than it was 14 years ago. After my op in 2004, I was told to dilate for two hours in the morning and two hours in the evening, on top of time spent preparing and cleaning up afterwards. I did this early before work, and noticed that even though I was lying on my back, it was not restful. I could not sleep with the stent in. After six months, I had been told that I could reduce it to one two-hour session a day, but that immediately resulted in a narrowing of the opening, which I found so distressing that I gave up. A surgeon in England told me “There are no rules”: you find what you need to do to maintain width and depth, or you stop. Those are your choices. If dilating is not keeping the orifice open, dilate more.

Montréal recommends four times a day in the first month, but never more than half an hour in total, and after the first year once a week. This is considerably less. If you are having penetrative sex to the full depth- what a friend jokingly called “organic dilation”- you do not need your stents at all.

You need to keep your orifice clean. To the tune of “Keep young and beautiful”:

Whereever you have been
You must keep your new vagina clean
Hibiscrub and betadine, every morning and night
To help you feel serene
Or only just to feel fit to be seen
Hibiscrub and betadine, every morning and night.

Montréal, however, only recommends salt in the douche, but gives a graphic account of what happens if you don’t do it properly: abundant, smelly and bloody vaginal discharge, deterioration and enlargement of the wound surface, risk of infection.


While it is less onerous than it was in my day, dilation and cleansing is still a significant drain on your time. I don’t know what research they do to check whether the dilation times and frequencies recommended succeed. How many people give up? How many still have the full depth and width, five years later?


Yet, unless you want to be penetrated, why would you have this operation? The comments on my previous post give some clue. Joanna referred to it as “full transition”- so expressing yourself female is in some way not enough, the operation completes transition. If you have a partner, could they accept your body without such an alteration? Can you? Can anyone commit to living in the world as their real self, without altering their body?

The person variously known as “trans heretic”, “sock puppet” and “the sceptic” writes she was “surgically corrected”, because of a need deep within me to correct a fundamental physical wrongness with my body. However badly the cultural concept of trans including surgery fits others, it fits her perfectly. It was right for her. Apparently, it still is. “Transgenderism” is my physical reality, wrote someone on facebook. That was what I believed, then. It is not what I believe now. I see no way of being certain if anyone else would cease to believe it, but if it’s tied up with the idea of yourself as fitting into society alternatives would include becoming able to bear not fitting in, or finding your own tribe to fit. I don’t think we are accepted as trans women, not really. No-one who would not accept you as a feminine man will accept you as a trans woman.

If you want male partners, it makes sense to have the orifice. If you don’t, it is less clear to me. Then the orifice is part of your self-image as a woman. You would have a uterus transplant if you could, but given that you can’t at the moment you go as far as you can. So it’s about being genuine, being a real trans woman, rather than about what the alteration will accomplish. It is about ideas and not reality. It is all in your head.

I fear that the concept of a woman with testicles makes no sense to us. We say we are women, and some say not trans women but “women with a trans history”- trans is crossing over, and that is in the past. I fear that the operation is seen to complete transition, rather than to achieve what it achieves.

I have been mutilated. I wish I hadn’t. If it was a mistake for me, is it for anyone else? Hormones and surgery reduce libido and sexual responsiveness. That was a relief at the time, and now is aching regret. How can you accept yourself as you are?

Here’s Grace Petrie (pronounce Pee-trie, whose pronouns are she and her). If you are not weeping by the time she bites her lip, I don’t understand you. She is trans-affirming, gender non-conforming, and female.

32 thoughts on “Vaginoplasty or labiaplasty?

    • Mmm. Why was I? Well, I saw her in her “Year 11 Hell”, being “pampered”, treated in a way she is supposed to enjoy, forced to appear not herself, which is indeed hellish. Then she is offered a way out- “You will find clothes that fit”, and “Love and be loved”. I am imagining my own hells, and my own movements into freedom.

      How did you react to the start of “The King’s Speech”, if you saw it? Man has task which he cannot possibly complete but which is seen as simple, so that he is an idiot- including by him. Again, I was weeping, and surely everybody with a heart would too. Those who would not were simply unable to see parallels between themselves and this situation, which was stupid, or incapable of sympathy. Obviously.

      Thank you for reminding me that the sign of emotion- weeping- is not a sign of it for everyone; and that a majority response is not therefore the natural response.

      Liked by 1 person

      • I don’t recall the start of The King’s Speech, so it couldn’t have moved me very much. Except I do recall thinking his experience was familiar in some ways. It’s not that I’m not capable of empathy. My own experience of adversity didn’t bring me despair or even sadness, and if I place myself in someone else’s shoes then the emotions I experience are those I would feel under those circumstances. Does that make sense?

        When I look back at how I was treated by those outside my family because I was totally incapable of understanding social expectations but was expected to conform none the less, I empathise with her Year 11 Hell. But to be honest, I’m not sure what emotional pain is. Perhaps if I did, I would be more vocal and outspoken over matters of social justice I consider important. That’s one reason why I stated that the world would be a better place with people like her.

        I’m not sure if you’ve read my post “If I was you, I would kill myself”. Perhaps that explains the way I respond emotionally.


        • Your post explains a lot. I don’t think I had read it, it was before I found your blog. This acceptance of things as they are, including things others might “Why Me?” about, might produce equanimity others might envy. The thought that you should be able to function optimally every day, and a deep resentment of symptoms stopping you, might produce frustration leading that counsellor to kill herself.

          And, such an attitude might make The King’s Speech far less affecting. It’s about how he will appear to others, and even to himself, as useless or idiotic, that is so affecting. If everyone involved thought to themselves, “Oh, there’s stuttering. The speech will take longer, but that’s alright” everyone would be happier, and George might have worked to stop stuttering because success would waste a lot less of everyone’s time, but there would not be the emotional charge. If that’s a typical autistic response, then it could be the NTs who are disabled.

          Some people cannot even place themselves in another’s shoes. That is an effort of imagination. Yet it might be useful for you to try and imagine that “Why Me?” resentment. It is my most paralysing feeling. If someone cannot act to improve their situation because it should not be so, that helps explain why people do not act in their own interests. It would make others appear less unpredictable, though perhaps no less weird.

          Liked by 1 person

  1. So l cannot comment on the Petrie piece because l am in an area with almost nonexistent web access.
    However, l can agree with your premise that what is essentially a false construct or narrative is responsible for so many unwise or unsuccessful attempted transitions.
    “…I fear that the concept of a woman with testicles makes no sense to us….trans is crossing over, and that is in the past. I fear that the operation is seen to complete transition, rather than to achieve what it achieves.”
    Indeed, it is this false narrative that grs is necessary to be “fully trans” or “really trans” or trannier than thou”, that contributes to this false concept of a hierarchy with all it’s attendant negative effects.
    I am angered and saddened that these activists, (those who speak without real world knowledge or experience), who are more concerned with their agendas rather than the welfare of others, have facilitated so much unnecessary pain and suffering.


    • It shows her “Year eleven hell”, having her hair styled and her makeup done. Now in her twenties, she sings,

      and if you need me you can find me ironing my shirt
      cos I’m in
      Black Tie tonight
      get a postcard to my year eleven self
      in a year eleven hell
      saying everything’s gonna be all right
      no you won’t grow out of it
      you will find clothes that fit
      and the images that fucked yer
      were a patriarchal structure
      and you never will surrender
      to a narrow view of gender
      and I swear there’ll come a day
      when you won’t worry what they say
      on the labels on the doors
      you will figure out what’s- Yours.

      She is in black tie, with short hair, not a prom dress. She has a female partner. She expresses gender and apparently is happy that she is a butch woman, not a trans man, and she supports trans rights.

      Some activists are strongly against surgery. That’s why we say “trans” not “transsexual” now. Some cis people who would police us are in favour. The last time I was challenged in women’s space, the woman asked if I had had the operation. So at least she would feel more right to object to me if I had not.

      This is just audio, so you may find it easier to stream. It concerns simplifying narratives, stopping us seeing a full picture.

      At the top of the hierarchy, I see people who are comfortable in their own skin.

      Liked by 1 person

  2. I am very comfortable in my own skin. I have absolutely no concern about gender roles or “presentation”.
    I rarely ever wear a dress, heels or make up, although l can, and when l do, l wear them well.
    My point is any woman can wear anything she wants with the caveat that others, the general public, might find out wardrobe choices inappropriate.
    In other words, l don’t wear the same clothes to church that l do to work or around the house.
    It’s what we adults refer to as be “presentable”.
    Would l go out to dinner with my husband, or some other formal affair, wearing a tuxedo? No. Why not? Because besides being inappropriate and showing disrespect to my husband, it is simply inappropriate.
    If l had some uncontrollable need to wear a tuxedo or “present” male, l would certainly would not do that around my old man.
    So maybe l am missing something. If this woman, or any woman, (or man), wants to present as the gender not associated with their sex, what’s the problem?


  3. “Some activists are strongly against surgery. That’s why we say “trans” not “transsexual” now. Some cis people who would police us are in favour. The last time I was challenged in women’s space, the woman asked if I had had the operation. So at least she would feel more right to object to me if I had not.”

    So there is alot to unpack here. I will try to take it piece by piece.
    “Some activists are strongly against surgery. That’s why we say “trans” not “transsexual” now. ”
    So l don’t see the connection. I understand the term “transsexual” to mean something significantly different trans or transgender. To be honest l have never been clear on the ever changing definition of the various terms.
    I do know that l needed, and greatly benefited greatly, from my srs. It allowed me to live a long and happy life.
    ” Some cis people who would police us are in favour. The last time I was challenged in women’s space, the woman asked if I had had the operation. So at least she would feel more right to object to me if I had not.”
    So it sounds like to me that from your experience, srs or grs seems to give you greater legitimacy.
    Please forgive me if l am misreading or misunderstanding.


    • Congratulations on being comfortable in your own skin. I am happy for you.

      Few people wear high heels for housework. Whether one wears them to work depends on the office culture, though glamming up then taking no shit was the way my engineer friend maintained authority on site. I don’t understand your position on Grace Petrie wearing a dinner suit. You would not yourself- fine, that is your choice. But many adults find it “presentable”- let’s not debate who is being “adult” here, I doubt it adds anything. Believe you are being adult if you like, but your comment that it is “simply inappropriate” seems pointlessly judgmental. She looks good in it to me. I am pleased that she presents as she likes, and identifies as she likes. I find it stretches boundaries in a healthy way.

      I don’t think you managed to unpack the issues around grs. If being transsexual is significantly different from being transgender, the significant difference is desiring surgery, and nothing else. It is not in the rights one should have, nor in the social acceptance as a woman.

      I did not tell that woman that I had had surgery, so it did not get me acceptance in her individual case. I was in that women’s space because the law allows it and the festival programme specified that I was welcome there. GRS appears to give greater legitimacy in some eyes, but not generally, nor in the view of international human rights law.

      I don’t want to put words in your mouth, but it seems you, as a transsexual woman (feel free to specify the term you would like to use) feel significantly different from transgender M-F people who do not want GRS. It is not quite clear from what you say here whether you think that should mean significantly different rights, social status or acceptance. To me, it should not: different rights creates social pressure for transgender people to have GRS, and pushes them (us) outside the bounds of ordinary society’s judgment of what is “appropriate”.


  4. Clare, I thank you for bringing this decision to the forefront for me. I’m a lesbian so on that basis I may not need the vaginoplasty. And yet, I don’t really know what I’m going to need, even with only female partners. I’ve thus decided to go ahead with vaginoplasty. This decision feels right to me.


  5. Claire. The last thing l want to do is forment an argument or cause offense.
    As a heretic and being highly sceptical of the trans narrative or dogma which postulates that “trans women”, (a term wildly variant in its definition), are the same as natally born women, it should be expected that you and l see things differently.
    Getting surgery to gain some sort of legal or “passing” status makes no sense to me.
    For me it was a life saving medical procedure little different from heart surgery.
    It was not by any wild stretch of the imagination a cosmetic or elective surgery.


    • Sock Puppet,

      I am not taking offense, just to add to the discourse. All of these are my own opinions; I can only speak for myself.

      I am unfamiliar with a dogma or narrative that trans women are the same as natally born females. Of course we aren’t, at least in our bodies. Perhaps we are in spirit but we’ll never really know, will we? After all if I see the sky as blue, and if you’re looking at the same sky and also say it’s blue, we have no way of knowing that we truly see the same color.

      That said, it’s becoming increasingly undeniable scientifically that gender identity is something we’re born with. Sure, social mores and so forth are learned, but males tend to want to do/be what males do, and same for females.

      If you have a disagreement or dispute this then, at the risk of being overly direct, you simply don’t know what you’re talking about, since you do not and have not experienced what it is to have gender dysphoria, to live your life desperately trying to be like others of your born sexual characteristics, and the utter relief and peace that is felt as one transitions (however much as needed) to their inborn gender.

      As I’ve written on this blog post I’m planning on getting GCS early next year. But please know that in no way am I doing it because of any legal or sense of passing. Legally, I’m already recognized in my passport and all identity documents as female. If I was wanting to enhance my passing “success” I’d first run to get facial feminization surgery (FFS). I’ve looked into it, talked with surgeons, and do not have any plans or desires for it. It’s just not that important to me. I’m not sure how well or if I pass. I think I do at least sometimes. But it’s not as if I’m going to ask people I pass on the street!

      So, why GCS? For me it’s about just feeling a bit better in my body. I have no distaste for my male genitalia but also no pride or wish for them. As Clare has written so well, maintenance of the neovagina is a big hassle. I don’t look forward to that of course but I’ve decided to take the good with the bad.

      Finally: “trans woman” as a label. I’ve been struggling with this label myself. What do I even call myself to myself, regardless of anyone else? What finally feels right is this: “woman of transgender experience.” As with “people of color” I’m first and foremost a woman and I’ll always have my transgender history as well as be transgender for the remainder of my life.

      My 2c,



      • Hi Emma. Thank you for responding and adding some valuable inputs.
        Firstly, l wholeheartedly agree with the following….”Sure, social mores and so forth are learned, but males tend to want to do/be what males do, and same for females.”
        Why would l not? It makes perfect sense. Why would you think l would not agree?
        Furthermore, l cannot understand why you would think that l would not, or do not understand gender dysphoria or that utter madness that goes along with trying to live a life as someone one is not.
        I underwent what you are currently contemplating almost 50 years ago.


        • Sock Puppet:

          “Why would you think l would not agree?” I suppose I misunderstood you. There was a tone in your writing that made me wonder if you are trans at all. But now I stand corrected! No harm, no foul for me. Hopefully the same is true for you.

          “I underwent what you are currently contemplating almost 50 years ago.” Wow, like in the late-60s? I was about 13 then, still surreptitiously reading articles about Christine Jorgensen! I hope you’re happy and found peace.



          • Actually, early 70’s. I’m still a couple years short of that big five oh.
            And no. No offense taken whatsoever. I am well accustomed to being misunderstood.
            As for finding peace, yes, l have. My life has been exceedingly wonderful. I have no complaints and only wish to leave this earth a better place.


  6. As for wearing a dinner suit to dinner, perhaps you misunderstood. A woman’s dinner suit is visibly different from a mans suit. As l stated, l, you, Petrie are all entitled to wear whatever we chose to wear. I personally would find it highly inappropriate, (whether or not you or others might or might not), to wrar a mans suit to dinner. Whats the point? If you or Petrie are so inclined, more power to you. Different strokes for different folks.


      • Claire. I am very much aware that l was not born female. I most certainly would not be posting here if l had been.
        However, l do not see myself, nor “identify” as a trans woman, or even a transsexual, even though l am also well aware that l underwent a surgical reconfiguration of my genitals which allows me to live as a simple, happy, fulfilled and un-hyphenated woman.


        • I am glad you have been commenting here. Anyone reading this post and its comments to the end, with or without my other posts on surgery, will then get two views: my own, that the trans woman should have surgery for what it will achieve, and yours, that it was life-saving. I do not want to load anyone with doubt. I felt at the time I wanted the surgery simply for itself, and when the psychiatrist said I should have it is my memory of the most intense happiness.

          Perhaps I misunderstand you, but I feel you are patronising. It could just be that you continue to misspell my name, though it is written over and over again on this page. Your way, seeing yourself as a heretic, a woman without qualification, judging as “inappropriate” the way a gender non-conforming woman dresses- claiming others would judge her, claiming your attitude is “adult”- it all seems as if you protest too much. I hope you are as happy as you protest.

          Transition is never easy. Does your happiness permit you sympathy with others, who experience it differently?

          Whose sock puppet are you, exactly? It’s not Kay, is it? She isn’t very good at English either.


          • I am sorry about misspelling your name. I guess l am sorely lacking in attention to detail. My bad.
            However, l can find no justification for your accusation that l am patronizing or unsympathetic.
            If anything, l have tried mightily to not come off as feeling sorry for your plight. Regret is a harsh mistress, l do feel very badly that things did not work out as you might have hoped.
            Nevertheless, l think there is great value in this discussion as it at least attempts to address the risks and reasoning related to this extremely radical surgery.
            As to the subject of how people choose to dress, l think it is entirely up to them and their business alone. However how others view how you or l or anyone chokes to dress, is in fact entirely up to them and not subject to what you or l might consider “appropriate”.


  7. Now this following comment which you made earlier is interesting to me because on its face, it is something l would not agree with.
    “I don’t think we are accepted as trans women, not really. No-one who would not accept you as a feminine man will accept you as a trans woman.”
    l think trans women are accepted. How could they not be? They exist all around us in the media and on tv. The only caveat that l would add is that it is a limited or prescribed acceptance. In other words, “trans women” are accepted as what they are TRANS-women: ie, something other than “real” women, or natally born genetic women.
    And therein lies the rub. Unless one is able to blend in seamlessly in all ways, voice, appearance, function, demeanor, etc., it is regrettably very difficult to attain full acceptance.


  8. You have a great way of writing about vaginoplasty. I really enjoyed your humor and sarcasm. Lol. I had labiaplasty done and it really improved my life. I’m a very active person and the procedure truly helped that I no longer feel any discomfort down there during those activities like riding a bike, and of course, riding a person. Lol.


  9. Reading this post again is like opening a time capsule. As I wrote a year ago, I was planning on vaginoplasty. Last January I had GCS with a labiaplasty. Why? 1. Because I was (and still am) sure that I didn’t want sex with men. 2. I’m very active, hiking and backpacking, and couldn’t see myself having to dilate while doing such things or more likely, being much less active for at least a year. I’m very happy with my surgery — zero regrets — and of course I still wish I’d just been born with a vagina.

    I had an epiphany several months ago as I fretted about my voice (which has been feminized through training but I remain self-conscious about it) and my face (which I had FFS on this last Spring): no matter how well I pass as a cis woman I will always be trans. There’s nothing I can do about that, it is what it is. It’s time to just own my reality and move on. Easy to say, a bit hard to do, but that’s what I’m working on now.

    As part of my just being myself I’m now taking a weekly adult (only) ballet exercise class. It’s physically quite a workout, challenging for me as I’ve never taken ballet before, and such a joy to do and be a part of.


    • Oh wow! Ballet!

      I have no idea why you got stuck in my spam folder. I am sorry about that. I released your comment when I checked.

      We remain trans. Most people get read at least sometimes. I get read quickly. It is still better than presenting male.

      You sound as if your life is good and you have done the transition well. Congratulations.


  10. My labiaplasty was the best thing for me. I was tired of the pain and discomfort from it all. Dr. Nazarian sat down with me and the consultation really gave me hope for things to get better after the procedure. I am so happy with the results and decreased pain and discomfort. I couldn’t be more thankful.


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