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Couple of vaginoplasty questions

Discussion in 'Gender Identity and Expression' started by AliceSlick, Dec 5, 2020.

  1. AliceSlick

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    I recently got my orchiectomy scheduled but only just realized that it does not include vaginoplasty, and that I will have to fly out to the other side of the country to get that done. That, in and of itself, is not the end of the world (although it does suck, as it means I'll have to at least wait til the COVID crisis is over before I can safely fly out there.) It does, however, raise two specific questions

    1: As I've always heard orchiectomy and vaginoplasty described as a package deal, is it really true that there is no one (or no practice) that does both? As I said, I'm perfectly willing to get them done separately, it just seems to conflict with the information I thought I had. I might just be misremembering though.

    2: I remember hearing in support groups that the wait lists for vaginoplasty usually last for 1-2 years. This is the part that's causing me to feel rather hopeless and powerless at the moment. I know it may sound selfish and defeatist (and, to be honest, it kinda is) but I just can't face the prospect of another year + of powerless waiting. I've already been through so many different phases of waiting: the time it took to recognize I wanted to transition, then to get to a point viz a viz family situation where it was safe to begin the process, then going through HRT to prepare for surgery, and now waiting for COVID and a surgical wiaitng list. And, of course, the fact that as of a few days ago, I beleived the end was a few weeks or months away (when the orchiectomy was scheduled) and now suddenly I'm looking at a possible multi-year wait. Forgive me the melodrama, but it's enough to make me want to dive to the bottom of a Whiskey River for the foreseeable future.

    Can anyone here who's been through this process offer me some hope? Any good news would be useful at the moment. I just need something hold on to, after being blindsided like that.

    P. S. the two practices I'm looking at for vaginoplasty at the moment are Mt. Sinai in New York and Align Surgical in SF, both because they're supposed to be the best, and because I have family in both areas I could stay with. Not sure if that's relevant, and I would be happy to consider other options if I have reason to, just FYI.
     
  2. QuietPeace

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    An orchiectomy is just the removal of the testes, it is also done as a cancer treatment (not the first action though). If you have not had an orchiectomy then when they do the vaginoplasty they automatically do one (the scrotum is used to create the labia thus leaving you with no place to keep the testes so they have to take them out).

    One to two year waiting list for vaginoplasty is also what I have heard from everyone who has had one and from online discussions. Rather than seeing yourself as powerless and not being able to finish the process it would be better for you to look from the other side. You are already living as your true self, you have been on hormones for a while now, you are a woman and are fully presenting as such in real life. The orchi will nudge the physical development and allow you to stop taking any androgen suppressing medications, it will also allow you to correct your birth certificate. All of these developments are good news and you should celebrate them.

    To put your wait in a bit of perspective, I started living as my true self in 1986, I was forced back into the closet twice and only started living permanently as a woman in 2006 (legal changes in 2007). I was only able to finally get an orchi in 2014 and I have never had the financial privilege to be able to afford vaginoplasty, compared to that a two year wait should be a walk in the park. I also know a number of others who had decades long waits.
     
    #2 QuietPeace, Dec 5, 2020
    Last edited: Dec 5, 2020
  3. AliceSlick

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    QUOTE="QuietPeace, post: 6719993, member: 103947"]An orchiectomy is just the removal of the testes, it is also done as a cancer treatment (not the first action though). If you have not had an orchiectomy then when they do the vaginoplasty they automatically do one (the scrotum is used to create the labia thus leaving you with no place to keep the testes so they have to take them out).


    One to two year waiting list for vaginoplasty is also what I have heard from everyone who has had one and from online discussions. Rather than seeing yourself as powerless and not being able to finish the process it would be better for you to look from the other side. You are already living as your true self, you have been on hormones for a while now, you are a woman and are fully presenting as such in real life. The orchi will nudge the physical development and allow you to stop taking any androgen suppressing medications, it will also allow you to correct your birth certificate. All of these developments are good news and you should celebrate them.

    To put your wait in a bit of perspective, I started living as my true self in 1986, I was forced back into the closet twice and only started living permanently as a woman in 2006 (legal changes in 2007). I was only able to finally get an orchi in 2014 and I have never had the financial privilege to be able to afford vaginoplasty, compared to that a two year wait should be a walk in the park. I also know a number of others who had decades long waits.[/QUOTE]

    I know I am incredibly privileged to even be at this point, but to explain my perspective a bit: the entire point of transitioning for me, from day one, has been about acquiring a vagina. All of the other steps (to a greater or lesser extent) were either things that I was indifferent about, or that, all things being equal, it's nice to have, but I didn't really want much for their own sake. I don't even really feel super comfortable defining myself as a woman, although I think I like it slightly better than nonbinary, and I do prefer female pronouns over neutral pronouns, and a female name. I identify as a woman when I'm talking to other people because it's simpler and helps them understand which pronouns to use and such, but in my own head I prefer to think of myself as a "person with a vagina" (to borrow a term from Archer) or as a lesbian (because to me, lesbian just means "person with vagina who is attracted to other people with vaginas.) And just in case you think I sound a lot like a sex addict, let me make clear that it's not about actually HAVING sex, it's about having the biological capacity to have sex in the way I would want, to relate to sexuality in the way I would want. The depth of this was just driven home to me in a new way recently when I realized that the prospect of continued quarantine (which would obviously prevent me from getting laid) after I had a functional vagina didn't really bother me at all. At that time I would be my true self, and if I had to be a celibate version of my true self for a while, that was fine. Again I don't mean to deny my privilege, but I hope that this at least explains why , for me, presenting as female in any way or ways, without a vagina, feels just as much like being stuck in the closet as presenting as male does (or close enough as makes no difference when contemplating a year long period).
     
  4. AliceSlick

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    Another, simpler way of putting it, would be to say that for me, I can't be my true self without a vaginoplasty because the only significant differences between my current physical self and my true self are the possession of a penis and the lack of a vagina. While I don't like, for example, having facial hair, it feels more like a cosmetic dislike, equivalent to a woman who doesn't like having hair on her legs. While I'll appreciate the convenience of not having to shave anymore after my orchiectomy, if that for some reason was impossible, I wouldn't feel that having to shave my face before a date (for example) seriously conflicted with my sense of self, or at least I don't think so.
     
  5. QuietPeace

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    Who told you that your facial hair would stop growing after an orchiectomy? Lower testosterone levels from the testes being gone may slow down but facial hair will not stop. The only way to get rid of facial hair is Laser or Electrolysis (and if you get laser you still have to have electrolysis for the final part) (as an aside you seem to be diving into this major surgery without much knowledge of what it really involves, maybe you should read up more about it first)
    https://www.mtfsurgery.net/orchiectomy.htm
    (emphasis added by me)

    We are so far apart in our self views that I am afraid that I cannot help you with this, hopefully someone else can chime in with something helpful for you.
     
    #5 QuietPeace, Dec 6, 2020
    Last edited: Dec 6, 2020
  6. AliceSlick

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    What you are saying about facial hair is what my research had lead me to believe prior to my appointment with the orchiectomy surgeon a few days ago, at which point I was given the impression, apparently mistaken, that it would actually stop facial hair production. This seemed odd to me at the time, but I trusted her more than my prior research. Again, I was probably just misinterpreting what she said. As for laser, I was actually doing it, until COVID put a stop to that. The main reason I chose it, though, is that, for reasons completely unrelated to transition, it is physically painful for me to shave my face, and the temporary pain of a laser treatment is preferable to the daily pain of shaving.

    As for jumping in without much knowledge, yes and no. On the one hand, my entire transition process has been (from a certain point of view) the process of determining exactly which hoops I have to jump through in order to acquire breasts and a vagina. On the other hand, I have done plenty of research on orchiectomy and vaginoplasty.. The only big surprise for me has been the frequency with which one is performed without the other. I was already aware that this as possible. I simply believed that only the (presumably) relatively small percentage of trans women who also happen to be asexual would choose this option, and, therefore, that the "default" assumption would be to combine them. This is why I was surprised that my surgeon was so surprised to discover that I wanted both.
     
  7. QuietPeace

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    1 ) One can have sex and not have vaginoplasty, the vast majority of AMAB persons do so, even those who live as women (I do).

    2 ) Most who choose to only have an orchi do so either because the cannot afford vaginoplasty which for many is simply out of reach. A few do so because due to medical reasons they are unable to have as invasive a surgery as vaginoplasty (it is a much longer surgery).

    3 ) An AMAB person cannot have vaginoplasty without an orchi. The only persons who have vaginoplasty without an orchi are AFAB or intersex persons who are having labial adjustments. Usually if you are going to have vaginoplasty as an AMAB person they recommend not having an orchi because it can cause later problems with the vaginoplasty (shrinkage of tissue after the orchi as well as some minor scarring).

    addendum: I want to make sure that you do understand that after vaginoplasty you will not have a vagina, you will have a neovagina. A vagina is a tunnel of muscle while a neovagina is a pocket of skin which is created surgically from the penile skin and sometimes from an additional section of intestine.
     
  8. Daddio

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    I've been doing some looking into vaginoplasty and have not come across anything that mentions the cost.
    How much would one expect to pay and are there any insurances that cover this procedure?
     
  9. QuietPeace

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    It really depends on where you are and where you choose to have it done. It ranges from around $20,000 and goes up from there. There are hospital costs and other care which are usually not included in the price. You also need to have been on HRT for a year usually and you need papers from two psychiatric professionals. There is often also preparation cost (genital hair removal). There is also aftercare, dilation, rechecks etc. This does not include having to have rework done, at times the first surgery does not have a perfect outcome (ranging from needing appearance adjustment to even needing to repair fistulas) and that means paying for the whole thing again.

    One cheaper alternative is Labiaplasty, this gives the outer appearance but no neovagina.

    Most insurances in the USA do not cover it but you need to check with your specific insurance to be sure. If you have a solid high paying job with great insurance they do often cover it. For most regular jobs with normal insurance no. I never had insurance which would cover it and I was a software engineer.
     
  10. Daddio

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    What is the best part of having this procedure done?
    Having a vagina?
    Or not having a penis and testicles?
     
  11. Phoenix92

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    The best part of the procedure is that it helps to alleviate dysphoria, so it’s both the having of a vagina and the lack of male anatomy.
     
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  12. QuietPeace

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    I have not had vaginoplasty so I cannot really answer that. I have had an orchiectomy, it was great for two reasons. One I no longer had to take medications to flush androgens from my body and two it finally stopped the pain (being on estrogen for years damages testes).

    Considering if I did have vaginoplasty the good parts of converting the penis and scrotum into a neovagina (NOT a vagina) and labia at least in my mind are.
    Not having to worry about clothes shifting and getting outed by a bulge.
    Not having someone try to murder me because when they try to rape me they find something that they do not like (this actually happened to me).
    Being comfortable with what I see in the mirror (at this point there are no full length mirrors in my home).

    Weighed against the difficulties
    A neovagina requires maintenance and upkeep, having to dilate for the rest of my life or it sealing up.
    The pain of everything in preparation (genital hair removal), very painful recovery and painful dilation for at least a year.
    The possibility that it might take more than one operation to get it right (from what I hear this is as much as one in four).
    The extreme cost (the only way I could have had this done in the past would have been to do a LOT of sex work, which I am unwilling to do - I have always been on the lower end of the income ladder).
     
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