6 things I wish I’d known before I had sexual reassignment surgery

BaileyHaving genital dysphoria gives you a pretty distorted world-view. It’s hard to stay objective about your body, your sex-life, your identity, when you feel like you have this aberration between your legs. That’s why I opted to have it surgically removed and turned into a vagina – a procedure I had carried out earlier this year.

From getting in the shower or putting on underwear, to the awkward conversations with new partners, that dysphoria made it hard to really conceptualize what surgery would actually be like. So to my 26-year-old self, here’s what you need to know.

It’s actually not all that special.

The fact that sexual reassignment surgery (SRS) is even an option for trans people is nothing short of a goddamn miracle. It’s easy to get swept up in the idea of surgery being this glorious re-birth – this summation of your transition and the end of the struggle – but as much as it is life-changing and mind-blowing and dysphoria-killing, you are having SRS to feel normal.

Most surgeons who perform SRS do between 3 and 5 a week, 48 weeks a year. This creates a conveyer belt effect; where a new person is shuffled along from hotel to hospital to clinic and back again daily. It all starts with the hospital, and….

There is nothing sexy about hospitals.

For some reason you’re convinced the hospitals in Thailand are going to be 5-star resorts with coconut mojitos and cabana boys with palm fronds gently fanning you as you recovered pool-side. In reality the SRS ward is all harsh, stripped down concrete halls on the 9th floor of a building that would make even the most ardent brutalism fan quiver. Not that it really matters, because 95% of your time there will be spent lying in a tiny carriage bed.

Five days straight you lie on that bed, a tonne of bandages wrapped around your groin, a catheter and a blood drain poking out, doped up on as much morphine as you can get before the nurses take it away from you and unable to poop no matter how many mocha frappes your mum smuggles up from the cafe downstairs. Feeling special yet? No? Good, because…

This is going to hurt. A lot.

And it’s not going to stop hurting for a long, long time. Even once you’re allowed out of that bed you will be very keen to get horizontal as often as possible. Popping pain killers only gets you so far, and chronic pain saps your energy and your patience and leaves you buried in a constant malaise. You tell yourself it’s going to get better, but it really doesn’t – the pain just morphs and expands into new areas. A sore back from lying down all day, weak muscles from never exercising, raw and cracked heels from them always rubbing on the bed, and as the actual surgery site heals you go from a general ache to the more specific burn of tissue damage, the chunky irritation of swollen areas, and the sharp pangs as nerves reconnect. Which is why…

You are going to crash.

You invested a lot in SRS – feelings, money, time, anxiety, fear, hope – and once you’re finally on the other side of it all of that is going to come flooding back on you like a tsunami. Add in the pain of recovery and it’s not a matter of “if” you’ll break down under that load, it’s a matter of when.

Being post-op is mostly pain and isolation and endless worry over depth, and the only people who can really empathise are the other patients going through their recovery with you. Having that support group around you is damn important, and it is often the only way to see yourself through these depressive episodes. Everyone heals in their own way, but the support of your new friends will help normalise the process and make a world of difference to your mental health. Especially when you consider that…

Complications are super common.

Like, there-is-a-100%-chance-you-will-have-complications common. Granulation (where skin grows over a small cut before it can properly heal) and necrotic tissue (dead or dying skin that sloughs off as new healthy skin grows underneath it) are two of the most common issues, but everything from popped stitches, blocked urethras, excessive bleeding, bruising, micro tears and even swelling so bad your labia literally detaches from the base of your vulva can and do happen.

Remember – it’s a conveyor belt. The clinic staff have seen literally everything that could go wrong with surgery and all you’re going to hear is “it’s ok, don’t stop dilating”. Because of this, it is super important to advocate for yourself and not just accept that whatever is going wrong will sort itself out. This applies to anything from issues with your neo-vagina, to any medications you are taking (some pain killers can really mess with you if you’re on SSRI’s, or conversely going off SSRI’s to take pain killers can actually be worse for you), or how hormones are affecting you.

Putting yourself through all this is incredibly challenging – and it continues to be a challenge well after you leave Thailand. That’s ok, because the most important thing to know is…

It is so totally worth it.

Seriously. You have a vagina! It’s still sore and swollen but it’s brilliant and sexy and amazing. You can wear whatever you want and not have to worry about tucking anymore. And oh my god just wait until you get to feel how good oral sex is now.

It hasn’t solved all your problems; you still have body issues and you still struggle with accepting yourself. But it has freed you from the incessant need to prove yourself as female, to constantly reinforce your femininity or feel ashamed for enjoying masculinity. You finally get to define yourself, and that’s worth suffering for.

Bailey Lions


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Photography: Alice Chapman
MUA: Loren Sadik

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