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My final form: Completing my trans surgery journey

Tomorrow is, hopefully, the final stage of my transition surgery. 

This will be my fourth or fifth such procedure; I’ve lost count.

(Content note: medical detail.)

The first stage of my bottom surgery, several years ago, was followed closely by an unrelated emergency that put me in hospital for almost a year, setting the process back.

I have an excellent surgeon. He does damn good work and is just a great guy; he used to come and visit me on the stomach ward when I was sick that year.

I think I’m feeling pretty good about tomorrow.

I have to fast from midnight, and in the morning, a friend will drive me to the hospital.

I’m lucky to have been able to access the surgeries that I’ve wanted to. Most trans people, even if they want surgery, lack either a doctor who can do it or the money to pay.

My physical transition has been all but complete for some time now.

Hormones finished their work within a year or so of when I started transition in my early thirties; the only thing that will probably continue changing is my hairline as middle age encroaches.

My metoidioplasty and scrotoplasty have been completed, and tomorrow morning I’ll finally get the testicle implants I’ve been waiting for to finish the whole process.

I take one last set of ‘before’ photos.

I’ve had enough of feeling like a work in progress, apologising to sexual partners for my half-finished parts. I’m looking forward to being in my final form.

Painkillers and ice packs

The last thing I remember discussing with the surgeon before my lights go out is possible outcomes.

He’ll aim to get two testicle implants into me, but it’s possible only one will fit, or maybe even none. 

I tell him I’m happy to proceed conservatively. After my metoidioplasty, I had a painful tissue rupture that left me with an extra hole for some time before it could be repaired, and I’d rather avoid anything like a repeat.

I come to in the recovery room, drowsy and in pain but not too badly. 

A nurse brings me some painkillers, water, ice packs. I’m still waking up properly when I’m wheeled up to the ward where I’ll spend the night.

My vitals are checked, and one of the nurses has a peek at the surgical area. It’s my first look at it too.

It looks, so far, better than I could have imagined. 

One implant, big enough for the appearance of two balls. Nice, normal-looking scrotum, at a glance.

I get up to pee. It looks like mostly blood, and it hurts like a bitch. 

I make noise, drip blood all over the bathroom floor, apologise for myself. I have half a mind to avoid fluids to put off peeing again for as long as I can.

I clean myself up and swap my bloodied surgical gown for a t-shirt and hospital-issue disposable elastic shorts.

Back in bed, I get as comfortable as I can and set myself up to watch some movies to pass the time.

I’m discharged from the hospital after staying overnight. 

My junk area is a little sore as expected, and it’s still intensely painful to pee, but I’m no longer passing much blood. My throat is a bit sore after being intubated during the surgery.

I get some painkillers and antibiotics to take home.

I notice that my procedure is described on the discharge paperwork as ‘gender affirmation’, a term that irritates me almost as much as ‘gender reassignment’. 

The latter annoys me because it sounds like surgery you get after your name is drawn in some kind of dystopian demographic lottery.

I can’t quite put my finger on why I also hate ‘gender affirmation’. Maybe just because my balls and my gender are different matters to me.

The last procedure I had was also referred to as gender something, even though it was solely to correct a defect and nothing to do with transition as such.

When I was in the hospital with my stomach issue, I once heard someone on rounds describe me as ‘a gender reassignment’, which is a weird way to pronounce trans.

Before I leave the hospital, I take some photos of my new balls for posterity and text them to my partner.

Pretty delighted

Three days after surgery, I feel pretty good for the most part. I’m unsteady on my feet at the best of times, so my cane has made an appearance to support my waddle while I’m a bit swollen and sore.

Pissing is still excruciating, and I don’t know why.

I’m still passing a little blood, and the burning pain during and after urination radiates to my ass and down my legs, making me howl each time.

Other than the pain, nothing seems to suggest any infection or other problem. I’ll call the surgeon’s office in the morning to book my follow-up appointment and see what he thinks.

Aesthetically, I’m still pretty delighted with how everything looks, swelling and bruising notwithstanding.

Almost two weeks have passed. The pain has settled, and I’ve made the connection between that and keeping my hand off it like I was told to.

When I finally take off the bandage, I see that the surgeon has used a pair of tiny unobtrusive incisions at the base of my dick. The healed scars should be just about invisible.

My scrotum is still swollen like a baseball, but the bruising is gone, and I can get around without my cane again.

The surgeon is happy with it so far, as am I. 

How I want it

I’m forced to drop into emergency over Christmas when a minuscule hole in one of my new scars widens and bleeds a little.

The doc gives me some dressings and antibiotics in case infection develops over the new year period, which it does. 

By the time I visit the surgeon at the hospital in mid-January with freshly shaved balls for a checkup, everything is healed up and comfortable.

My anatomy is finally more or less how I want it and how I’ve long imagined it. 

Nobody who sees me naked will ever mistake me for cis, but I’m happy enough.

A buddy and I have taken my new parts for a couple of spins and confirmed it all works.

I can’t remember anymore when my journey with the surgeon started – perhaps four or five years ago now.

“Are we… done with all this now?” I ask at the end of my consult.

“Yeah,” the surgeon smiles.

“See you around, hopefully not here.”

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