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[linger-straits]

Bottom Surgery Journal 240420

It has gone a bit more than a month since my catheter was removed and was put back on dilating my urethra. I’m unsure what to think of the progress, it doesn’t feel consistent and I’m periodically still in pain while peeing. I got catheters with wider girth, but I don’t notice any difference; still just unpredictable how the next day will look like.

On a different note though, there’s one quality improvement to my life. I’ve always struggled with hygiene due to both my DSD condition and my bottom dysphoria. I thought I was doing okay, or at least kind of bare minimum, until I got intimate with my girlfriend and she made a comment on my poor hygiene below. She absolutely had no malicious intent, she knows it’s a struggle for me, but she also knows I need feedback on this topic. I felt pretty embarrassed, of course, but I wanted to do better. But it was so hard for me and I kept struggling despite truly trying my best.

My bottom surgery isn’t complete. And it looks like nothing human in this stage. But I’ve noticed I’ve become better at washing up. I can actually see what needs to be done, -something I couldn’t before. It’s still a bit of a struggle in the sense that I don’t get a good view while standing in the shower, but being seated helps. Complications and aesthetics aside, if getting a better hygiene is the only upside I get from this surgery, I think it’s an improvement, even if it’s not what I expected.

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I got a question from a friend regarding taking a graft from my mouth to create the urethral lengthening that I thought could be nice to share. I definitely only complain about my crotch, and nothing about how my mouth is healing. The truth is that they didn’t take a graft from my mouth, instead everything is made from what my crotch already had. I’m not fully aware of the technicalities because I’ve only ever heard about the mouth graft up until I was laying on the surgical bed, but I was told the tissue of the inner labia is what was used. That’s actually kinda wild to me because my inner labia were underdeveloped (to the point my previous surgeon told me it’s impossible for me to get a UL together with a metoidioplasty, too little tissue to work with), but my current surgeon is a wizard.

But yeah, dodged that bullet. Honestly it was what scared me the most regarding bottom surgery, sounds incredibly painful.

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Bottom Surgery Journal 240329

So I have a speculation of what might be causing my urethra to close up despite dilation. Illustrated a cross section of the metoidioplasty, where the left picture is kinda what I imagine the inside to look like (and what is expected to be ideal). The added length to the urethra is wider, but the natal one is more narrow, which is how I know I dilate deep enough; it’s supposed to block me from entering the natal urethra. But I speculate I might have a sort of flap in the tissue that goes about as deep as the added length. Maybe the dilator is caught in this flap, which prevents me from widening the very last part of the new urethra, but because I reach just as deep as if I would otherwise, it gives the false impression that I’ve dilated correctly. Do this too many times in a row and one day I will suddenly be clogged "out of nowhere". Maybe the flap is tiny like I illustrated. maybe the flap is longer than this, and maybe I even have a flap that goes all around the circumference. I really have no other idea what else could be causing this to be such a miserable progress

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One funny thing regarding bottom surgery is that if you get testicular implants, you get this funny little ID card for them. They can be productive members of society now.

Jokes aside, I don’t know when this is needed. I was told it’s for “when travelling” and instinctively I thought they meant in cases of flights and body scans. But it’s silicone. And when I did fly, they didn’t detect it (they did detect the half a litre of fluid strapped to my leg though. I had to show it was my pee bag because my urethra was shut at the time, and that was a little comical. Maybe that’s how I can sneak through apple juice in the future, lol). Maybe it’s meant to be medical info in case I actually need to go to a hospital abroad. Who knows

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In other news, I’m considering to replace injections with gel. I think injections are super convenient, especially since the EU standard is to have one injection every 12 weeks. However, there are some things that is making me consider gel instead.

One, I get a depressive dip the last two or three weeks before an injection. This was partly fixed by taking the injections every 11th week instead, but not fully.

Second, I want to actually be on a lower dose. I can’t be on a lower dose on injections without making the depressive dip prolonged. My reasoning for wanting a lower dose is that my skin is awful. It’s so oily, and testosterone straight up spawns more sebum glands. Because my skin was nice before HRT (which makes sense, I never had a natal puberty), maybe a lower dose will help out. Aside from that, my appetite is way out of control, and I struggle to have a normal relationship with food. And lastly, while I’ve always been heat sensitive, the extra weight and hormones give me hot flashes. I sweat so much from nothing. It can be peak Swedish winter but I still sweat when I get out. It’s annoying and embarrassing, and because I have congenial anosmia (inability to smell), sweating makes me very neurotic about my hygiene where I either wash in excess or completely forget about it.

Maybe a lower dose will help with all of this, or even just one aspect. I have no plans in stopping HRT fully, because that would lead to other health complications as my body can’t produce hormones on its own. But it’ll be interesting to see if I experience any changes at all, and I’ll probably make an update on any findings.

[linger-straits]

Bottom Surgery Journal 240328

Recovery is so exhausting. I never know when next setback is going to occur, as they happen often and sporadically. I can’t tell if it’s due to something I do wrong or something I don’t do at all, and any adjustment just gives an unpredictable outcome.

I’m currently dilating. 2 times a day is normal, 3 times a day is recommended if I feel tight, and 4 times a day is starting to be a bit excessive, but you do what you must to keep the urethra open so there’s no real limit to how often you should do it. One day, I dilated 8 times, and it still almost completely shut. I had to lie in my bed for over an hour to deal with the agony that comes with a shut urethra, and once I could finally move again, I managed to pry the urethra open after further dilation. It stabilised, the flow was almost back to normal, and the pain was only slight compared to what I dealt with before. I think I used about 15 dilation catheters in the span of two days to deal with this.

Today, I was struck with a very similar pain, the one that occurs when it grows shut. But this time, I could still pee, and it makes me feel helpless. Am I still not dilating enough in that case? Is it in excess? Is it an UTI that have developed and caused some swelling? Did I make a tiny tear in the tissue and that’s what causes the pain?

The level of pain is what makes it so hard to deal with. It’s worse than stumping your toe, it’s closer to injuring your fingers in a closing door hinge. The type of pain that makes you fold over yourself, your brain shuts off, and all you can think of is that you rather just die on the spot that enduring it And it lingers and lingers. Worst thing is that I can’t really get any help for it, for logistic and bureaucratic reasons unless it’s an actual emergency again like being fully unable to pee again. Sigh.

I’m waiting for thicker catheters to arrive, and I’m hoping so badly it’ll help.

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Bottom Surgery Journal 240310

A few days ago, the urologist finally removed the new catheter that was passing through my urethra (which initially replaced the emergency one going through my abdomen) and I am finally peeing normally again. After 5 months of mechanically pissing through a tube or having an external bladder in the shape of a plastic bag next to me (or attached to me), it's so freeing to finally feel normal again. I can't even begin to explain.

Naturally, I was very anxious to have it removed, because I feared that the urethra would grow shut again and I would go through this whole ordeal a third time. It's painful, it's embarrassing, it's time consuming, it's restricting... But right off the bat things looked very bright and promising; at the urologist, I peed normally and with no pain whatsoever (unlike when it was removed the first time after the surgery where it hurt like hell and the stream was so weak that it was almost just dripping). That was such a relief for me and a sign that things would be different this time around. I am back to dilating, something I do 3-4 times a day just to be sure nothing grows shut. It's not fun, but it's not painful. It was very painful the first time around, and I dreaded it each time I was about to do it. Now I just do it without any fuss.

I hope it continues like this. I hope I get to stop dilate soon and I hope my body isn't trying to shut it again once I stop. I want a normal life and a normal relationship with my body, and I'm getting closer to that. I believe I am also on the waiting list for the next step of my bottom surgery journey, which is a hysterectomy and creating a scrotum. The waiting list tend to be a long one, so I probably won't get the next surgery til next year, but I'm patient.

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An update on this; I asked my surgeon about this and how worried I should be. He said that my testicular implants are a bit unfortunately placed atm (I don’t have a scrotum yet, so they are just inserted into the outer labia), but figuring how to bike without sitting on your balls is just a normal guy thing lol

Me: “That bike ride after bottom surgery wasn’t so bad!”

Underwear: //saturated with blood, might as well have been stabbed

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Bottom surgery journal 240209

I’m SO relieved right now; yesterday I had the surgery that opened my urethra, and I have a catheter going through the penis instead of the abdomen. I’ll have it for about a month before it’s removed and I’ll go back to dilating. Hopefully nothing heals shut this second time around, but it seems unlikely.

The day didn’t start well because I almost had to go to the ER the night before, which would have made me miss my surgery. And with the snow, the trains got delayed and I was late to the appointment, but thankfully they took me in anyways. Before the surgery, my surgeon talked to me regarding what I could expect; either I’m lucky and the urethra have only healed shut at the connection between my natal opening and the lengthening (and that he’d just need to puncture it), or if I’m unlucky the whole penis have grown together. If this was the case, I’d have two options; either he open up the whole thing and again tries to make a working urethra, or we remove the added length to the urethra and I pee how I would do pre surgery. Both of these options sounded detrimental to me, as one would mean going through the same surgical trauma as the first time, or going back to something that triggers my dysphoria. And laying on the bed, ready for surgery, I didn’t really have a good answer for him. I didn’t know which I preferred. I said he could make a judgement on what is more suitable once he sees the extent of things.

Then I woke up.

And I was lucky; he only needed to puncture it as the rest of the lengthened urethra have healed nicely. I’m so happy to finally see some light through this whole ordeal, and that healing will be so much easier than before.

[linger-straits]

Bottom surgery journal 240130

Next week, I’ll finally have my healed shut urethra fixed. It’s been a long wait but it’s finally around the corner.

Some thoughts regarding my surgery so far, I’ve realised that it’s easier for me to shower. Hygiene is normally a struggle for me due to my DSD condition, but it’s an additional burden when dealing with gender dysphoria. After surgery, my genitalia doesn’t look male. But because it doesn’t look female either, I’m definitely coping better. It’s a tiny spark of hopefulness, and I got a similar spark when I spent the first intimacy with my girlfriend who told me I look quite different from a girl down there (from clitoris growth). I want it to look male, I has high hopes in it looking male (based on my surgeon’s pictures), but there is a relief in leaving the realm of it looking female, even if it isn’t quite there yet.

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Worst take I’ve seen in a while. Don’t speak for us with DSD. People suffering from DSD are male or female, just like any other human, just like any other mammal. Many DSD conditions are sex specific, meaning you must be male or must be female to have it. Even when it’s not sex specific, you can still tell (some harder than others) which their natal sex is. Show some humanity ffs.

@ridibulous I'm not speaking over anything; It's what science knows of the disorders, it's what science knows of biology, and it's what the intersex have fought for (to be seen as men and women, male and female) for centuries before the trans activism started to hijack what it means to have a DSD condition. Tell me, why do you want transsexualism to be considered intersex? Because in your tags you say you "used to be a transmedicalist", but you still want the trans label (something that is scientifically less studied and less medically understood) to fit in the DSD label (something that is more scientifically studied and medically more understood)? Because either you are trying to demedicalize DSD conditions to be something more "open" and "fluid" and "abstract" so that you can put yourself in another box you think is cool or something, or you are acknowledging transsexualism as something medical and may or may not have an overlap with DSD conditions, and this overlap makes being trans somehow more "real" and "solid". You can't have it both ways.

hey since ASAB terms are sort of becoming the next "biological (fe)male". reminder that ASAB terms simply describe what was observed and assigned by someone else when you were born. It is/was your Legal Sex. not everyone who was AMAB is a "biological male". or vice versa.

use more terms that don't exclude people! say perisex/dyadic! there's even alternative single-word terms that mean "biological (fe)male!": say müllerian! say wolffian!

expand your queer vocabulary to better describe various experiences!!! synonyms exist for a reason!! just start Looking Shit Up I promise it's so much fun! I love learning!!!!!!

[linger-straits]

Me: “That bike ride after bottom surgery wasn’t so bad!”

Underwear: //saturated with blood, might as well have been stabbed

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Finally got an appointment to fix my healed shut urethra, and my options were next week; the same day the studio I’m working at are taking all of us on a conference trip abroad which I’ve been looking forward to for a year, or, in 6 weeks from now. I was really conflicted which to pick, because wearing a catheter through my abdomen is no fun, but on the other hand, this surgery has robbed me of enough enjoyment the last 4 months that I refuse to let it take this single thing from me.

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Nothing like gender affirmation when your girlfriend confesses she thought of you as a dude bro before dating and before knowing you were trans. She still haven’t given me a solid example and just giggle when I try to pry the secret open

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Peach. I don’t have visible scarring either, and frankly it has become a stereotype that we all do have scarring, bigger the better, and we love to flaunt them around. If I had scars and I’d draw myself, I don’t even think I’d draw myself with the scars. I have the same issue with bottom surgery. Yet to see a trans character with bottom surgery, and honestly it’s to the point I’m convinced that people just want an excuse to have d-girls and c-boys (as in fetishising) under the mantle of being including.

not all art depicting trans men needs to show the long scars after top surgery.

Some guys get incisions around their nipples or no visible incisions at all. Such as myself, just tiny faded scars smaller than your pinky finger nail on the sides of my ribs under my armpits. When you have a small enough chest, they just stick some tubes in there and liposuction the tissue out. I never thought I'd be lucky enough to keep my nipples and have a cis presenting torso but here we are.

I know it's a non issue but I would love to see art of a shirtless trans man without big ol scars some time. It's like I don't exist/people don't even know that this is an option when you have a small chest.

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I never went through a natal puberty, and was bound to undergo lifelong hormone therapy regardless if I was trans or not. People used to think I was lucky (from a trans perspective) that I didn’t. That I was practically getting all the perks of hormone blockers without being on hormone blockers. But people don’t know how the lack of natal hormones permanently affect you. People don’t know the drawbacks of having a medical condition that prevent such, including the symptoms that are not hormonal. How I need to deal with disabilities that comes with my condition, how it affects me mentally and how my perception of me and my sexuality got severely skewed.

To some extent, I guess I was lucky. To some other extent, I’m daily dealing with what it entails.

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Recovery from bottom surgery is rough. But I try not to beat myself up because of the negatives. I’m really happy with my top surgery, and reminding myself of this is a very important part of dealing with both the (not final) results of the bottom surgery and the dysphoria it causes.

I’m almost entirely without scars, and this fact helps me living stealth without feeling self conscious or dysphoric.