Content warning: graphic descriptions of vaginoplasty recovery, surgical care, biological processes, emotional distress, and sex.
Eight months??? Has it already been eight months since I had surgery?
For some reason I have it fixed in my brain I had surgery in April 2019, even though it was March. It might be because those first few weeks were so dislocating and painful, I’ve tried to block them out.
Since my last update in May, things have been going better. Much better.
Weeks 8 to about 14 saw a progressive reduction in pain until the only time I felt pain was during dilation, which came from a tender spot in the vaginal canal. I still had and still have some swelling and numbness, mostly in deeper, internal tissues around the vaginal opening. My clitoris still looks raw and can be painful to touch, and I discovered a loose flap of skin under the clitoral hood that will need to be removed at some point.
I’d go to the doctor but I still haven’t sorted out my insurance issues, so I’m way overdue on a followup appointment and I’m hoping to get it sorted out next week. The United States’ health insurance system sucks.
Weeks 14 on saw a very gradual reduction in swelling and numbness. The overall appearance is good, though super-tight clothes give me the mother off all camel toes. At this point I can’t quite tell if that’s a permanent outcome because it’s just how the fat distribution is in my body, or if further reduction in swelling will help smooth things out. My incision lines are fading and I like to believe that at a quick glance they’re hard to see.
Then there’s dilation. Dilation has become even more boring and annoying and I’m anxiously awaiting when I can drop to once a day at my one-year surgical anniversary mark. I’ll admit to skipping a session or even a day here and there when I’m too tired or my kids have made the timing impossible.
I stressed about this at first, but my thinking has shifted to treat it more like the oral estrogen I take: if I miss a day or am late, nothing irreversible is going to happen right away. I also re-framed it in my brain to be physical therapy, and that’s helped me push through when I have some pain or am feeling lazy.
My set of dilators are blue (S), green (M), and orange (L), and after a few attempts of trying to size up to the green one in the early months, I gave up until the blue one wasn’t causing me any pain. Moving up to the green one was painful at first, mostly around the top of the vaginal opening. The whole point is to stretch the tissues and, yeowch, were they stretching!
It took about a month until the green one didn’t hurt anymore. Per the discharge instructions, I started with fourteen minutes with blue, then a minute of green. I added a minute a day to green until I was at five minutes and hung there for a couple of weeks as I worked through the pain. After that, I discovered there wasn’t a change in pain in adding more time, so I jumped to one minute blue and fourteen green.
After another month or so of that, I tried adding orange for a minute. Double yeowch! It was too much, and after trying for a few days, I gave up. Once the green one wasn’t causing me much pain, I tried the orange one again, followed the same sort of ramp-up, and now I’m at one minute blue, one minute green, and thirteen minutes orange. It still hurts a bit with the orange one. I hope the pain goes away at some point.
Let’s talk about sex. Trans woman sex to be precise.
I always had an ambivalent attitude towards my penis. I’ve also always liked sex and had a lot of fun with my penis over the years. Around the time I was trying to come to grips with being trans in my twenties, a mental shift started to happen. I still liked sex, but while having sex I started to imagine myself having a vagina. As the years went on, it reached a point where it was almost impossible to orgasm without those mental gymnastics.
After starting estrogen, I started to experience the typical sexual side effects of decreased libido and attaining or maintaining an erection. My sexual response and desire also changed from a “must and always will orgasm” mode to a “eh, if it happens great but no worries if it doesn’t, and goddamn if it doesn’t take a lot of work to get there so I’m not committing to coming” mode. Intercourse became difficult to impossible due to challenges around getting and maintaining an erection, and when it did happen, I found it physically painful.
One of the few expectations I put to my surgeon pre-surgery was to be orgasmic post-surgery. She assured me it was very likely but that it might take some experimentation and a lot of time to get there. She was not kidding.
For the first few months post-surgery, I was in too much pain to even think about sexytimes. Once the pain receded I still had numbness. But a few months back my brain whispered, “Hey, Heather. Orgasms. Remember those?” and I realized it had been a long time, so I set out to find some.
The few toys I already owned didn’t do a damn thing for me in that department, so I bought a very expensive, very highly reviewed vibrator with clitoral stimulation. And readers, I used it several times with no luck. I tried after dilation, I tried in the morning, the evening, the afternoon, all to no avail. After one session that lasted two and a half hours, (not a typo and thank science for inductive battery charging,) and I got about 70% of the way there before finally giving up, I chucked it in the drawer and started mental work on accepting I might never come again.
Then I met a woman on Tinder this summer who asked me, “What do you like?” and I had no clue how to answer due to continuing numbness and the aforementioned inability to masturbate to orgasm. Despite valiant efforts on her part with her hands, mouth, and a strap-on to discover what I like, there was still no joy in Vaginaville.
I let her try my fancy vibrator and she nearly fell off my bed with ecstasy in under five minutes. So much for me thinking the vibrator was oversold. That woman ended up ghosting me and I went back to my silent and now angry grudge with the vibrator while meditating on being anorgasmic for life.
About a month ago I reduced my dosage of anti-depressants because I realized I hadn’t cried in months and that bothered me, and lo and behold, my libido perked up. And I was able to cry again.
So I took my fancy vibrator out to give it another spin and…still no joy. Worse, it made my clitoris hurt. To add insult on top of injury, the state it left me in reminded me of my male puberty before I had my first orgasm: having tons of tension and knowing an orgasm would relieve it, but being absolutely clueless on how to make it happen and the ways I’d tried didn’t work at all.
And then my brain teleported me back in time to those frustrations and the memory of how I, uh, blew through that barrier. Reader, if you’re under a certain age, do you have any idea how hard it was to research girls’ masturbation techniques in the early 1980s? It was really fucking hard. I don’t recall how or where I found the information, but I eventually did.
The literature was thin and it boiled down to rhythmic rubbing against a surface. Whatever I read, it stuck deep in my brain because I remember with clarity it mentioned horseback and bicycle riding. I didn’t have access to a horse, and I rode my bike every day and I couldn’t recall even getting a boner, let alone an orgasm while I was pedaling. But the third method it mentioned, rubbing the pelvis against a mattress or pillow while face down, worked.
Add, “You might be trans if you masturbate like a girl,” to the, “you might be trans if…” list.
Unsurprisingly, there is little medical literature around female pelvic and clitoral nerves, particularly with how they connect to orgasm. It would be a fascinating study to compare pelvic nerves between trans and cis people.
I hate horses now and I’m not much of a biker anymore, but I still own a mattress and pillows. I’m happy to report that I’ve taken my relationship with them to a new, more intimate level and they make me come about 80% of the time, and this has brought me great mental relief.
There is a wide variance in post-surgical experiences depending on things like the surgeon, surgical technique, general health of the patient, complications, etc. The above are my experiences only, and should not be considered typical or expected for vaginoplasty.