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My Affirming Surgery experience (and some tips)

It's been a bit more than a month since my Galentine's Day miracle, and I have settled in to the routines of after care, so I've learned a few things along the way.

The experience leading up to the actual surgery was stellar. We agreed not to name them in social media settings, so I'll leave you to extrapolate based on my nationality, but they are outstanding in taking the stress of the trip off your mind. Everything in the city is arranged, from hotel, to rides, to food (they gave me an Uber Eats voucher!) and more. I think getting rid of that stress is huge, all I had to do was get there and take a PCR test.

Now, waiting for the results of the PCR test was nerve wracking, but when it came back as a negative for covid, I just about jumped through the ceiling of my mom and sister's hotel room! On that note, if you can bring support, do that. Your weight lift limit is piddly and you will need assistance getting home. I was so incredibly happy that my mom and sister were there, it was a true full circle moment for us. 

The day of surgery was a bit of hurry up and wait. I got there at the alloted time, but then waited for a couple of hours before being called back to finish the forms and take pre-operative meds. They also take the time to explain everything that is going to happen and answer any questions you might have. Eventually they bring you to the operating room and ask you things like name, date of birth, your surgeon, what surgery you're having and then they go work.

The operating room is explicitly designed for this job and everyone works like they've done this a hundred times, because they have. On the table they gave me an epidural and as they started to apply sedation, the last thing I remember is my feet being placed in what almost looked like ski boots. Then I woke up and I was whole.

A funny anecdote on this. When I leaned forward for the epidural, my gown flopped away from my chest and my breasts were a bit exposed. One of the nurses pulled it back, commenting about protecting my modesty as my very naked bottom half was being positioned for surgery! One thing that I quickly got over there was modesty, you spend a lot of time with your bottom half exposed as nurses check on you and teach you what you need to know. So, worrying about someone seeing my boobs was not a priority for me!

For the first couple of evenings after surgery they kept me at the surgical hospital and they make sure you're up and walking very quickly. I was standing on the first night, then started walking about on the second day. I found day 2 to be the worst for pain, Tylenol 2 x 500mg was not enough, but that was the only day. On the morning of the 15th, I moved over to the convalesence house where they start to get you to do a lot more for yourself.

On day 5 they removed most of the dressing and I got my first look. Now, you absolutely must go into this understanding that what you see on day 5 is not the final result! It's a surgical site and it looks like it: swollen, red, with stiches and blood. Despite that, though, I could glimpse what will be and that made me so happy.

On day 6, they removed the stent and let me tell you OMG THAT THING IS HUGE! My reaction was, wait, that was inside of me?! No wonder sitting in my bed got immeasurably more comfortable! They may also remove the catheter at this time, but I think that's quite rare. This is also the day you start dilations and, yes, it is intimidating and messy. There will be a lot of blood, especially the first few days and weeks, but that abates and by the end of my first week back, there was no blood.

On day 7, the catheter came out and then they start using ultrasound to check my bladder volume. Basically, they want to make sure that you won't end up in emergency when you get home because you can't pee. It was a little touch and go early for me, but by the end of the day I was going freely and, let me tell you, that was a relief. The irony of having had to stand to pee with the catheter was not lost on me!

The next day, on my way home! 

Some tips:

  • You can make your own saline solution. They give instructions for boiled water, which is 2 tsp for 1 litre of boiled water, but you can also make it from distilled water and that is way easier!
  • Get some additional supplies:
    • Large incontinance pads (23x36) - I use one a day, so figure you're likely going to need about 2-3 months worth. You can get re-usable washable ones too, very recommended.
    • Medium incontinance pads (17x 24) - I use them on a tray with my dilators and then use previous one under me for the dilation session before throwing it out.
    • Get a tray, with side walls, to hold the dilators. It doesn't need to be huge, somwhere around 12x18 is plenty big. It amuses me to no end that my sister had exactly the same tray as the clinic used for this.
    • Dental bibs - I use them to place my dilators after use, they're disposable and pretty cheap.
    • Get a huge supply of baby wipes - I often wipe before and a few times after dilation, so use about 4-5 each time, but you also really need to consider that your butt and your new vulva are very close to each other. You need to stay very clean. So, do the math, you need a lot!
    • Rechargeable LED travel makeup mirrors are great for dilation as they light up the area and give you a really good look.
    • You may want to get post-partum undies as well, depends on how many you come home with. Get them larger than you think you need so that they don't apply too much pressure when you put a thick pad in there.
    • Get stuff to make you comfy while dilating. I'm still contemplating one of those hospital tables as I'll be doing this for a while. They're about $130 on Amazon and, heck, I can use it for D&D later!
  • It's a lot in the first month. Now I know that the different clinics have different routines for dilation in the first year, but for me, it was about 8 hours of my day with little "in between" time for the first month. It's discouraging in some ways, but keep your eye on the rewards of doing it well. Remember, dilation is about teaching your muscles and keeping depth.
  • Listen to your body. You will be weak at first, you need to build strength and you need energy to heal. I've been eating a lot more and I can't say it's been adding a lot of weight. So make sure you are getting the calories and the protein to fuel the healing process.
  • Some moments of "what the heck did I just do?!" are perfectly normal, it's common in any surgery and the dilation schedule exacerbated it. I found that as my hormones got back into shape, the feelings really started to desist and that was helpful. Being off HRT for more than a month was not good for my mental state and I recommend pushing back on stopping it if they request it of you. The new WPATH SOC says it is unnecessary and, to me, I think it's hard on mental health.
After all of that, today I finally put on a regular pair of panties and the euphoria was near overwhelming as, finally, I looked right to my eyes. The road to recovery from this is a year of work, but today proved to me why this journey matters.


  1. There is a lot of palaver, but it is all worth it in the end. I think we all have an "Oh my God! WHAT HAVE I DONE?!" moment but it soon passes. Now it's a few years ago I simply can't remember what it was like before.


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