Just so people understand, transitioning isn’t like flipping a switch. It is a long, long process. I have been on hormones for over two years now. I was not happy with my breast development, especially for someone my size, so fortunately, my company has the insurance company covering transgender health. I was able to get breast augmentation covered. I feel much happier now. Could go a little larger, but I am hoping another year on hormones will fix that.

I am still going to my electrologist to have my face cleared. Unfortunately, this is not covered by insurance so I am limited on how often I can go. We have pretty much done all the laser we can. We are pretty much stuck with electrolysis for the rest. This could take years to clear. Unfortunately, that is also what is happening with surgery prep.

Laser can only work on dark hairs with light skin. I have heard there is a new laser that can do the grey too, but no one I know has it. So all the rest of my hair removal will be using electrolysis. Nothing like having a probe stuck in your pores and zapping the roots with electricity. I can use lidocaine cream on my face and that takes some sting off, but the person doing my pre-surgery is allergic and needs EMLA cream. Been going without and let me tell you not a happy camper. Really makes you question that whole life choice talk. Okay, let me take a step back as many don’t know what is involved, so let me share some of what the doctor’s office sent me. Guys, you might want to skip this.

Description of a Typical Neo-vaginoplasty

Patients are admitted to the hospital on the day of the procedure.

The operation generally lasts between five and six hours, plus pre-anesthesia and patient preparation and recovery immediately after the surgery. It is always carried out under general anesthetic. Neo-vaginoplasty usually requires the patient to stay for four (4) nights in the hospital from admission until discharge.

We use a penile inversion technique. This means that the skin of the penis will be used to make the new vagina. Sometimes the scrotal skin is also incorporated if the penile skin isn’t sufficient.

The urethra is shortened and repositioned to just in front of the new vaginal opening. Some of the urethra is used to make a strip of pink tissue between the clitoris and urethra.

The skin on the sides of the scrotum is used to make the labia. The space in the body in which the vagina goes is located between the bladder and the rectum. Once that space has been created, the inverted penis skin is put in there, forming vagina walls. The depth of the vagina depends on the individual patient factors including the amount of penis skin available and the amount of scrotal skin used. Once the vagina is in place, surgical packing is used to keep the skin inverted within the vaginal cavity until it heals.

The next stage of surgery involves constructing the clitoris using the portion of the glans (tip) that has been retained together with its nerves and blood vessels. The clitoris is placed above the urethral meatus (opening) and a hood is made to cover it, using scrotal skin. Typically patients retain sensitivity and the ability to enjoy full sexual satisfaction.

Surgery is concluded after constructing the vaginal labia and clitoral hood. In most cases all this surgery can be performed at once but, it is not unusual to need small revisions. We would not do any revision procedures until at least four (4) months post-surgery.

They point you to look at a video by Drs. Slama and Oates on Youtube.

Of course, before you even get to this point, you have to endure many hours of laser and electrolysis to prepare. Here is their synopsis on genital hair removal. Once again, guys may want to turn away.

Genital Hair Removal

Hair removal is mandatory prior to neo-vaginoplasty surgery. This is done either via electrolysis or laser.

Electrolysis
Electrolysis uses electrical currents to destroy individual hair follicles, which are then removed one by one.

Laser
Laser hair removal uses an intense, pulsating beam of light to remove unwanted hair. A laser beam passes through the skin to an individual hair follicle. The intense heat of the laser damages the hair follicle, which inhibits future growth. Laser works best for dark, coarse hair.  – (Not so good for us old timers with a lot of white and grey.)

For the scrotal sac
Remove all hair from the scrotum!

For the Penile Shaft
Remove all hair from the penile shaft, including a 1 inch area around the base. Skin from the penile shaft and mid-scrotum will be utilized to create the new vagina, therefore all hair on the penile shaft should be removed so the inside of the vagina will be hair-free.

For the perineum
Remove the hair from the bottom of the scrotum to one inch above the anus in order to clear a 2.5 wide strip.

Timeline
Typically you will need multiple treatments over a 5-6 month period (usually 3-6 clearings for laser, 5-8 for electrolysis) to ensure effective and permanent hair removal.

Now, I have had a number of laser treatments and we have moved on to electrolysis to get those stubborn grey and white boogers. I really need to try to get some EMLA before my next appointment. I could handle the laser, but wow!, having that electrical probe inserted into a hair follicle down there and zapped, Yowza!!! I tell you, that could get anyone to talk. I almost admitted to killing Jimmy Hoffa even though I never knew him. LOL.

Scheduling makes it tough as I have to go late afternoon for this treatment, while I can get my face done at night. My next appointment isn’t until mid–April. Like I said, this is a process not an instant light switch. I hope at that time to have her say that I am clear enough to advise the doctor that it is time to get on the schedule. Given what I heard at First Event from their team, it might not be until next year. Though, I did hear a friend got a date with her doctor in June! I am resigned to it being next year. I need that date so I can plan vacation time. I will need at least two weeks out of work, one spent in the hospital and the other at home.  That’s when the fun begins with dilations.

I hope this has brought more understanding on the process involved. I hope to educate and remove any ignorance. I see the idea of someone saying this is a life choice as being totally dismissive on what we go through. It really isn’t a life choice. No one would just choose this life. I hope that you have gotten a better understanding from this series. I plan on continuing as I move forward.

As always, my heart to your heart, one heart, one spirit.

Emma Morgaine Croft