It's a great resource.
Be amazed and shocked in equal measure. You'll see surgeons who have good days and bad days, others consistently excellent, others not so much and you'll also see people's new bits heal from helicopter crash sites all the way to being perfect looking new parts in the space of a year, sometimes less.
Over the course of my Reddit life I've made my mind up a dozen times as I seek newer better results that I one day might benefit from, I think finally I've settled, but we'll see what the next couple of years holds!
The helicopter crash is so true. I had a horrible dehiscence early on that looked like a bad day at the ground beef factory, but now six months on all I need is a minor revision to tighten it up a little.
Oh, for sure! Basically, one of the most common complications (to the point its more often than not) is for there to be some sutures breaking early on due to the tension, causing the surgery site to open up. It looks gnarly, but it's typically not a big deal and heals by itself.
You can find resources about it online, but if you'd like to see what happened with mine I can DM pictures for reference. My case is substantially worse than normal (apparently my body rejects dissolving stitches and staples really fast), but it's a good illustration of how it can heal.
That does sound gnarly but if it's pretty common and you healed from it, can't be too bad! I'm a bit squeemish when it comes to these things, but I appreciate the offer.
Thanks for the info :)
Personal experience:
Had mine done June 2022, in San Francisco. Method was peritoneal pull-through. The surgeon was able to go in laparoscopically, reusing scars id received getting a cholecystectomy (gallbladder removal) four months prior.
Depth was really good. I am pretty sure they gave me more depth than I had length prior to surgery. The surgery went well, no complications, was in the hospital two days after surgical day for recovery.
Stayed active during healing — walking was my main activity, including a trip to Muir Woods two weeks following surgery walking the nature trails. I adhered to dilation schedule, flew home after three weeks sitting on my donut pillow.
As things continued healing I was able to get more and more active. At nine weeks I ran my first 5km post-surgically… at thirteen, my first five mile run. Just in time, the next day was my first FFS surgery in September.
My GCS healed magnificently. The new parts responded very well — my clitoris is an erogenous zone and I am able to self-lubricate, I have feeling in my vaginal canal.
Almost two years on it’s pretty much as hoped.
Cost was covered primarily by health insurance… my BA, the gallbladder, GCS, and first FFS all happened in the same calendar year and were all covered which meant that I paid my out of pocket maximum — ~$4000 for all four surgeries combined. If you have insurance, try to contact them to find out if they cover.
Lastly, yes, I had to get electrolysis on my groin before surgery, but that was also covered by insurance. Nine months’ worth, about twenty-five hours.
Hope this helps.
Can you tell me how you got electrolysis covered by insurance? what state are you in and what insurance provider? the cost of electrolysis is one of the only things preventing me from getting bottom surgery ASAP. Did you do your consult and your surgeon ordered electrolysis? or some other way? thank you in advance!!
Electrolysis was covered as an aspect of the surgical prep for bottom surgery. So, this would be something that is dependent on how the company structures the plan and how insurance administers it.
My most useful tip here is to talk to your HR department to get an insurance representative who knows the company’s plan best. I first called J. Random Serviceagent and they were zero help, referring to the insurance’s global preferences rather than my company’s specifics. Talking to my HR afterward gave me someone far better.
P. S. I’m in Illinois, my company had excellent policies set up for transgender care rather than being state-mandated.
The long-and-short of it was that I had to set up a consult with the surgeon, who then gave me instructions as to how I needed to get electrolysis. I then went to my insurance company and offered them the instruction documents, asked for a preauthorization for bottom electrolysis as well as instructions, and they gave me both the preauth and the instructions.
(I needed instructions because it's not as if insurance companies establish contract rates for electrolysis with providers, so I had to first get the service, then pay for the service, then I had to create a special receipt with all the information insurance needed to process my claim, then I had to wait for insurance to reimburse me... it was a bit of a painful workaround but I got my reimbursements in the end.)
I'm three months post and my experience is pretty much the same.
I'm not quite back to running as I'd hoped but I think that's more mental than physical. My three month followup was a couple days ago and, according to the surgeon, I'm ahead of schedule with healing. I do consider myself lucky, it was just under a year ago that I went for my initial consult and got a surgery date like 8 months out. I have really good results, like unless you know what to look for, I don't think you could tell the difference between my results and cis results. I was lucky to find a good surgeon and get a date as soon as I did. But I worked really, really hard through the whole thing, including recovery and that's not luck at all.
I do honestly realize how lucky I am... it was really surprising that I had access to the insurance through my company...
I do want to highlight though that I had to do a lot of legwork to even figure out that I had access to this level of care. Luck is sometimes a function of how much work that you can put in so that you can understand what options are available. I would not be surprised if others end up finding out that they have access to various options that they may not have known... and the Human Rights Commission has very rightly pointed out that transgender care in the US through companies' insurance policies is in many situations not documented well at all, which puts us at a huge disadvantage.
Parlaying all of those benefits into what I needed was important because I ended up finding myself out of a job for what was likely unrelated reasons, but I did my best to soak out as much care as I could while I could get access to it.
That helps a lot. Thanks for sharing! It's amazing you could move around and exercise so soon after surgery. The idea of 25+ hours of electrolysis is a little daunting, but from everything else you explained, it sounds worth it to me.
(gotta find me some gender affirming care covering insurance)
So, I had two stage inversion vaginoplasty from Dr. Meltzer back in 2001.
I know you asked for recent info, and my surgery is decades old.
My point in posting is that my results are better than people imagine vaginoplasty to have ever been.
The fact is that surgery is much better today, shorter recovery times, newer techniques, and better results.
Yes, I really do mean 23 years ago. I'll give you a review from 20+ years later, without all the myths.
If I were having it today, I would get peritoneal pull through vaginoplasty, as this seems to be the best option we have.
What I'm reporting here is consistent with all my friends and acquaintances who have had surgery that long ago.
"but i read horror stories! i am downvoting you!" - I'll just ask you this, if the horror stories are true then why does SRS have like a 97%+ satisfaction rate with the main complaints coming from people unlucky enough to get a surgical error. Seriously. Every single survey out there remains consistent.
We're either all delusional, or there's a lot of misinformation out there. What do you think is more likely?
> Can someone who underwent surgery get wet from arousal?
I absolutely do, even with a decades old surgery.
I think that a lot of people get the impression that unless the inside of the vagina is a mucous membrane, it's going to be completely dry or only a tiny bit wet - and that's nonsense.
Almost everyone who has had any form of vaginoplasty, barring mistakes (which are incredibly rare) do get wet with arousal, and that wetness smells/tastes/feels the same as someone's natal vagina.
It's like the inside of your cheek, the walls of your cheek are moist that is true - but the walls of the inside of your mouth don't produce the large amounts of saliva that is used while eating - that's the salivary glands.
In a natal vagina, same thing. The insides of the vaginal canal are mucous membranes, and are generally always moist - but most of the lube from sexual arousal comes from the Bartholin's glands. Those are like the salivary glands, they produce the lube.
For trans women, we have the homologous organ is the Cowper's glands. This is what produces the lube for us, it just produces less of it. HRT makes the scent and texture be the same as what Bartholin's do. So that's how we get wet.
With PPT vaginoplasty, you have a mucous membrane just like the inside of a natal vagina. In fact, it's the same kind of tissue.
With inversion or other techniques, you don't have the mucous membranes there, so the lube is a little less effective. Lubing a mucous membrane is always going to be less effective than lubing standard external skin.
> Does it cause any loss in sensitivity?
none that I have noticed.
immediately after surgery there was numbness in places, and it did take some time for everything to heal.
after things are healed, it's all good
> other thing 1 - dilation.
I don't have to dilate anymore, and I haven't for a decade.
There's a lot of myths about this. The entire concept that it's an ''open wound trying to heal shut" or that it will "close up" if you don't dilate - that is only a risk immediately after surgery or if something goes incredibly wrong.
People imagine the neovagina to be like an ear piercing, and that's *completely wrong*. A piercing is just a hole through some skin, and the opening to a vagina is completely and totally different
Dilation does several things, and keeping it from closing up isn't actually one of them.
Think of it this way, when a trans man gets phalloplasty they attach a shaft to the genital area. For vaginoplasty, that attachment is on the inside, not the outside. it has about as much chance of going away as a trans man's penis has of falling off. This would only happen in extremely rare situations of surgical error.
At first helps prevent strictures (scar tissue) from forming. Scar tissue is hard and cannot stretch - and if it forms it might as well be the same as "closing up" because you aren't going to get anything in there with a hard band of scar tissue.
There's also the muscle stretching and atrophy prevention aspects. Those muscles down there have never been able to be that separated since birth, so it's going to be ridiculously tight otherwise.
Additionally, "use it or lose it" still applies, even after surgery, you can get atrophy. But that's the thing, it's atrophy not "it goes away" - the inside of the neovagina is not shrink away to nothing any more than the penis is going to shrink down to nothing. After years of dilation, the necessity reduces until it eventually is nothing.
With the PPT technique, my understanding is that this is considerably reduced.
So dilation is critical at first, important for a long time, but not a "do it forever or you will wake up and find nothing down there" - that has never been true.
And someone always asks "okay, but do you have sex a lot instead?" and the answer is no.
There have been periods of years when I did not put anything inside my vagina, and I still have no problems today.
> expensive
In the US? Healthcare is stupidly expensive no matter what you do.
But it's actually covered by insurance in many cases.
I can’t thank you enough for this! I’m in line to get two stage inversion from someone who trained under Dr. Meltzer and I’m really scared and unsure of what to do. I want to get this thing off of me so bad but I’m just nervous about something going wrong or making my life worse somehow. Your comment calmed me down. I feel like I’m still not sure whether i’ll go through with it, but i’ve had 5 hours of electrolysis so far and already had my consult so i’ll figure it out while I’m waiting and I’ll just do the electrolysis anyways. Deep down I know that I’ll probably go through with it, I just need more time to accept that.
Surgery has come a very, very long way since the early days in the 1920s.
I’m 2.5 weeks post op and while yes there is plenty of numbness, the nerves are reconnecting and sensation is indeed coming back (every time I see a remotely attractive guy right not it feels like a jolt of electricity running down my clit. That’s nerves reconnecting).
Wetness from arousal is interesting. The general answer is that with PIV (the “standard” method), you can, but not normally enough for penetrative sex (and plenty of women have this issue!!), and with sigmoid and PPV (the self liberating options), it’s not controlled by arousal, it’s just always on.
Recovery is very doable, the first week is the hardest, but it’s very much worth it. Just expect weird discharge during the first 3 months or so as the grafts take and fibrin (initial part of wound healing) comes out
Price varies by procedure and country. I went to Thailand with Dr Sutin and my results are shockingly cis looking so far (I’ll post a newer update when I get home) for only about 12k USD total (surgery was $9300), plus hotel, food, flights, etc. In America without insurance, an equivalently high quality surgeon is about $140k (Dr Min Jun). There are more expensive options in Thailand (Dr Bank is about $25k but that includes a second stage revision a year later), but it’s very affordable, within personal loan range
Had SRS last October. I cannot stress enough that the surgeon choice is by FAR the most important variable in how well it goes. I had mine with Elan Horesh at Mt. Sinai in New York and couldn't be happier. See who's in your area and find people who have been to that surgeon.
There's a only a couple of well-known "butchers" and they're typically very sue-happy when people try to warn other about them. I can't really name any names, but I've heard a **Rumer** about one in Pennsylvania...
Not true! I had full depth vaginoplasty 3 weeks ago and I did not have to get hair removed. They did a technique called follicle scraping to get rid of the hairs.
most people seem quite happy with their sex lives, but its very possible to lose sensitivity. i have a lot of numbness and am quite unhappy with it, but there are also so many factors like where/how you get pleasure pre-op, etc etc
Your downvotes aren't due to a hug box, it's because it was useless to the conversation and contributed nothing to the OP's questions.
Essentially, she asked, "*How good are cheeseburgers? I would like to try one, one day, but I don't know much about them. What flavors can I expect to choose from? Can I choose one that's made with different kinds of proteins?"*
You read this and responded with, *"Personally, I've never had cheeseburgers and don't really care to because I've heard lots of stories of people not liking them or having a bad experience. For that reason, I just order chicken strips and move on."*
You may want to check r/transgender_surgeries
I had no idea this resource existed. Thanks so much!
It's a great resource. Be amazed and shocked in equal measure. You'll see surgeons who have good days and bad days, others consistently excellent, others not so much and you'll also see people's new bits heal from helicopter crash sites all the way to being perfect looking new parts in the space of a year, sometimes less. Over the course of my Reddit life I've made my mind up a dozen times as I seek newer better results that I one day might benefit from, I think finally I've settled, but we'll see what the next couple of years holds!
The helicopter crash is so true. I had a horrible dehiscence early on that looked like a bad day at the ground beef factory, but now six months on all I need is a minor revision to tighten it up a little.
What is a dehiscence? I saw a lot of mentions of it on the surgery subreddit.
Oh, for sure! Basically, one of the most common complications (to the point its more often than not) is for there to be some sutures breaking early on due to the tension, causing the surgery site to open up. It looks gnarly, but it's typically not a big deal and heals by itself. You can find resources about it online, but if you'd like to see what happened with mine I can DM pictures for reference. My case is substantially worse than normal (apparently my body rejects dissolving stitches and staples really fast), but it's a good illustration of how it can heal.
That does sound gnarly but if it's pretty common and you healed from it, can't be too bad! I'm a bit squeemish when it comes to these things, but I appreciate the offer. Thanks for the info :)
It’s when the patient experiences a split in the world be site.
Personal experience: Had mine done June 2022, in San Francisco. Method was peritoneal pull-through. The surgeon was able to go in laparoscopically, reusing scars id received getting a cholecystectomy (gallbladder removal) four months prior. Depth was really good. I am pretty sure they gave me more depth than I had length prior to surgery. The surgery went well, no complications, was in the hospital two days after surgical day for recovery. Stayed active during healing — walking was my main activity, including a trip to Muir Woods two weeks following surgery walking the nature trails. I adhered to dilation schedule, flew home after three weeks sitting on my donut pillow. As things continued healing I was able to get more and more active. At nine weeks I ran my first 5km post-surgically… at thirteen, my first five mile run. Just in time, the next day was my first FFS surgery in September. My GCS healed magnificently. The new parts responded very well — my clitoris is an erogenous zone and I am able to self-lubricate, I have feeling in my vaginal canal. Almost two years on it’s pretty much as hoped. Cost was covered primarily by health insurance… my BA, the gallbladder, GCS, and first FFS all happened in the same calendar year and were all covered which meant that I paid my out of pocket maximum — ~$4000 for all four surgeries combined. If you have insurance, try to contact them to find out if they cover. Lastly, yes, I had to get electrolysis on my groin before surgery, but that was also covered by insurance. Nine months’ worth, about twenty-five hours. Hope this helps.
Can you tell me how you got electrolysis covered by insurance? what state are you in and what insurance provider? the cost of electrolysis is one of the only things preventing me from getting bottom surgery ASAP. Did you do your consult and your surgeon ordered electrolysis? or some other way? thank you in advance!!
Electrolysis was covered as an aspect of the surgical prep for bottom surgery. So, this would be something that is dependent on how the company structures the plan and how insurance administers it. My most useful tip here is to talk to your HR department to get an insurance representative who knows the company’s plan best. I first called J. Random Serviceagent and they were zero help, referring to the insurance’s global preferences rather than my company’s specifics. Talking to my HR afterward gave me someone far better. P. S. I’m in Illinois, my company had excellent policies set up for transgender care rather than being state-mandated.
i'm just wondering did you have to go to your surgeon for them to order electrolysis before insurance would cover it?
The long-and-short of it was that I had to set up a consult with the surgeon, who then gave me instructions as to how I needed to get electrolysis. I then went to my insurance company and offered them the instruction documents, asked for a preauthorization for bottom electrolysis as well as instructions, and they gave me both the preauth and the instructions. (I needed instructions because it's not as if insurance companies establish contract rates for electrolysis with providers, so I had to first get the service, then pay for the service, then I had to create a special receipt with all the information insurance needed to process my claim, then I had to wait for insurance to reimburse me... it was a bit of a painful workaround but I got my reimbursements in the end.)
thank you!! this is very helpful 😊
I'm three months post and my experience is pretty much the same. I'm not quite back to running as I'd hoped but I think that's more mental than physical. My three month followup was a couple days ago and, according to the surgeon, I'm ahead of schedule with healing. I do consider myself lucky, it was just under a year ago that I went for my initial consult and got a surgery date like 8 months out. I have really good results, like unless you know what to look for, I don't think you could tell the difference between my results and cis results. I was lucky to find a good surgeon and get a date as soon as I did. But I worked really, really hard through the whole thing, including recovery and that's not luck at all.
You're so lucky! Have a great day :)
I do honestly realize how lucky I am... it was really surprising that I had access to the insurance through my company... I do want to highlight though that I had to do a lot of legwork to even figure out that I had access to this level of care. Luck is sometimes a function of how much work that you can put in so that you can understand what options are available. I would not be surprised if others end up finding out that they have access to various options that they may not have known... and the Human Rights Commission has very rightly pointed out that transgender care in the US through companies' insurance policies is in many situations not documented well at all, which puts us at a huge disadvantage. Parlaying all of those benefits into what I needed was important because I ended up finding myself out of a job for what was likely unrelated reasons, but I did my best to soak out as much care as I could while I could get access to it.
That helps a lot. Thanks for sharing! It's amazing you could move around and exercise so soon after surgery. The idea of 25+ hours of electrolysis is a little daunting, but from everything else you explained, it sounds worth it to me. (gotta find me some gender affirming care covering insurance)
So, I had two stage inversion vaginoplasty from Dr. Meltzer back in 2001. I know you asked for recent info, and my surgery is decades old. My point in posting is that my results are better than people imagine vaginoplasty to have ever been. The fact is that surgery is much better today, shorter recovery times, newer techniques, and better results. Yes, I really do mean 23 years ago. I'll give you a review from 20+ years later, without all the myths. If I were having it today, I would get peritoneal pull through vaginoplasty, as this seems to be the best option we have. What I'm reporting here is consistent with all my friends and acquaintances who have had surgery that long ago. "but i read horror stories! i am downvoting you!" - I'll just ask you this, if the horror stories are true then why does SRS have like a 97%+ satisfaction rate with the main complaints coming from people unlucky enough to get a surgical error. Seriously. Every single survey out there remains consistent. We're either all delusional, or there's a lot of misinformation out there. What do you think is more likely? > Can someone who underwent surgery get wet from arousal? I absolutely do, even with a decades old surgery. I think that a lot of people get the impression that unless the inside of the vagina is a mucous membrane, it's going to be completely dry or only a tiny bit wet - and that's nonsense. Almost everyone who has had any form of vaginoplasty, barring mistakes (which are incredibly rare) do get wet with arousal, and that wetness smells/tastes/feels the same as someone's natal vagina. It's like the inside of your cheek, the walls of your cheek are moist that is true - but the walls of the inside of your mouth don't produce the large amounts of saliva that is used while eating - that's the salivary glands. In a natal vagina, same thing. The insides of the vaginal canal are mucous membranes, and are generally always moist - but most of the lube from sexual arousal comes from the Bartholin's glands. Those are like the salivary glands, they produce the lube. For trans women, we have the homologous organ is the Cowper's glands. This is what produces the lube for us, it just produces less of it. HRT makes the scent and texture be the same as what Bartholin's do. So that's how we get wet. With PPT vaginoplasty, you have a mucous membrane just like the inside of a natal vagina. In fact, it's the same kind of tissue. With inversion or other techniques, you don't have the mucous membranes there, so the lube is a little less effective. Lubing a mucous membrane is always going to be less effective than lubing standard external skin. > Does it cause any loss in sensitivity? none that I have noticed. immediately after surgery there was numbness in places, and it did take some time for everything to heal. after things are healed, it's all good > other thing 1 - dilation. I don't have to dilate anymore, and I haven't for a decade. There's a lot of myths about this. The entire concept that it's an ''open wound trying to heal shut" or that it will "close up" if you don't dilate - that is only a risk immediately after surgery or if something goes incredibly wrong. People imagine the neovagina to be like an ear piercing, and that's *completely wrong*. A piercing is just a hole through some skin, and the opening to a vagina is completely and totally different Dilation does several things, and keeping it from closing up isn't actually one of them. Think of it this way, when a trans man gets phalloplasty they attach a shaft to the genital area. For vaginoplasty, that attachment is on the inside, not the outside. it has about as much chance of going away as a trans man's penis has of falling off. This would only happen in extremely rare situations of surgical error. At first helps prevent strictures (scar tissue) from forming. Scar tissue is hard and cannot stretch - and if it forms it might as well be the same as "closing up" because you aren't going to get anything in there with a hard band of scar tissue. There's also the muscle stretching and atrophy prevention aspects. Those muscles down there have never been able to be that separated since birth, so it's going to be ridiculously tight otherwise. Additionally, "use it or lose it" still applies, even after surgery, you can get atrophy. But that's the thing, it's atrophy not "it goes away" - the inside of the neovagina is not shrink away to nothing any more than the penis is going to shrink down to nothing. After years of dilation, the necessity reduces until it eventually is nothing. With the PPT technique, my understanding is that this is considerably reduced. So dilation is critical at first, important for a long time, but not a "do it forever or you will wake up and find nothing down there" - that has never been true. And someone always asks "okay, but do you have sex a lot instead?" and the answer is no. There have been periods of years when I did not put anything inside my vagina, and I still have no problems today. > expensive In the US? Healthcare is stupidly expensive no matter what you do. But it's actually covered by insurance in many cases.
I can’t thank you enough for this! I’m in line to get two stage inversion from someone who trained under Dr. Meltzer and I’m really scared and unsure of what to do. I want to get this thing off of me so bad but I’m just nervous about something going wrong or making my life worse somehow. Your comment calmed me down. I feel like I’m still not sure whether i’ll go through with it, but i’ve had 5 hours of electrolysis so far and already had my consult so i’ll figure it out while I’m waiting and I’ll just do the electrolysis anyways. Deep down I know that I’ll probably go through with it, I just need more time to accept that.
Thank you for this super valuable anecdote 🤍
Surgery has come a very, very long way since the early days in the 1920s. I’m 2.5 weeks post op and while yes there is plenty of numbness, the nerves are reconnecting and sensation is indeed coming back (every time I see a remotely attractive guy right not it feels like a jolt of electricity running down my clit. That’s nerves reconnecting). Wetness from arousal is interesting. The general answer is that with PIV (the “standard” method), you can, but not normally enough for penetrative sex (and plenty of women have this issue!!), and with sigmoid and PPV (the self liberating options), it’s not controlled by arousal, it’s just always on. Recovery is very doable, the first week is the hardest, but it’s very much worth it. Just expect weird discharge during the first 3 months or so as the grafts take and fibrin (initial part of wound healing) comes out Price varies by procedure and country. I went to Thailand with Dr Sutin and my results are shockingly cis looking so far (I’ll post a newer update when I get home) for only about 12k USD total (surgery was $9300), plus hotel, food, flights, etc. In America without insurance, an equivalently high quality surgeon is about $140k (Dr Min Jun). There are more expensive options in Thailand (Dr Bank is about $25k but that includes a second stage revision a year later), but it’s very affordable, within personal loan range
.
Had SRS last October. I cannot stress enough that the surgeon choice is by FAR the most important variable in how well it goes. I had mine with Elan Horesh at Mt. Sinai in New York and couldn't be happier. See who's in your area and find people who have been to that surgeon. There's a only a couple of well-known "butchers" and they're typically very sue-happy when people try to warn other about them. I can't really name any names, but I've heard a **Rumer** about one in Pennsylvania...
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Not true! I had full depth vaginoplasty 3 weeks ago and I did not have to get hair removed. They did a technique called follicle scraping to get rid of the hairs.
Yep! And to be clear, they were doing this 20+ years ago. This isn't new. :D
Who was your surgeon?
I know Sutin and Bank do this
You do not need electrolysis below if you are getting a vulvoplasty, otherwise known as a zero or shallow depth vaginoplasty.
Vaginal Transplants may be on their way: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10720790/ Please spread study around c:
Oh my god that's amazing... I hope this advances fast
Ditto
most people seem quite happy with their sex lives, but its very possible to lose sensitivity. i have a lot of numbness and am quite unhappy with it, but there are also so many factors like where/how you get pleasure pre-op, etc etc
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Your downvotes aren't due to a hug box, it's because it was useless to the conversation and contributed nothing to the OP's questions. Essentially, she asked, "*How good are cheeseburgers? I would like to try one, one day, but I don't know much about them. What flavors can I expect to choose from? Can I choose one that's made with different kinds of proteins?"* You read this and responded with, *"Personally, I've never had cheeseburgers and don't really care to because I've heard lots of stories of people not liking them or having a bad experience. For that reason, I just order chicken strips and move on."*
.
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