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.

OMG!!!!

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.