loadingluke

[loadingluke]

Hi Luke, I have had an initial consultation with Dr Goosen however there was just not enough time to run through all my questions. I am hoping you may be able to shed some light on the following based on your experience? 1.How does urination occurs after stage 1? 2. Why RFF over ALT? 3. Did you put on weight or lose weight as a result of the process? 4. Do you know when the forearm can be tattooed post surgery? 5. Is there a lot urine leakage and can this be easily managed? Thanks mate!

Hey- no problem.

1) Following stage 1, your original urethra is unaltered. The new urethra will be made in stage 1, and until hookup in stage 2 will end by a small hole on the left side of the natal genitalia.

2) in general? Hard to say. Really depends on the person and what they are prioritising. For me, I only really seriously considered RFF as my top priority going into surgery was the aesthetic look of my penis- in my case, I didn’t think that ALT would give me what I’d want. To be a good candidate for ALT, you need to have fairly low body fat on your legs, and although I’m lean enough, I knew that I’d still end up too girthy for my liking if I opted ALT. Furthermore, Dr Goossen does not perform any debulking procedures, and so only really likes to do ALT if you’re a very good candidate. I also was prioritising sensation, and as they typically take more nerves in RFF it felt like the better option (though take that with a grain of salt as I know many people who have no issues with sensation following ALT). It’s a very personal choice though and ALT in general is a great option if you’re a good candidate, I just wasn’t the best candidate and the cons would have outweighed the pros in my case so it was a fairly easy decision for me, if a decision at all.

3) I lost weight after surgery- in general I completely lose my appetite after surgery, and combined with the exhaustion and how taxing the healing process is I expected to lose a little. I lost about 5 kilos from pre stage 1 to the end of stage 3, with minimal changes to my activity. I do know some people who did gain weight though, due to their decreased activity, so I guess it depends.

4) Dr Goossen recommends that you wait 2 years post stage 1 before tattooing it, but I know someone who got his done earlier with no issues. I’m still considering doing this myself, but as I’ve never had a tattoo I’m still working out the specifics as I’d hate to mess it up due to my inexperience!

5) this really depends on the person. I know some people who have issues with dripping, either just because or due to a urethral stricture or pocket/balloon in the urethra. I’ve personally not had any issues with this though- once I was all healed up and the swelling was down dripping wasn’t a problem. I do have to ‘milk’ the urethra, usually just squeezing along the shaft to make sure that nothing is left. As long as I do that and give it a couple shakes, I’m fine. Might still get one or two drips every now and then, but I hear that’s still fairly common with cis men anyway 🤷‍♂️

[loadingluke]

6 months post stage 3

Hello! Sorry for my absence. Since I’m fully recovered from all my surgeries, I’ve not really had much to say, and I have been keeping very busy with my honours year, on top of being in lockdown of course. I thought I’d make a quick update on how everything is going though since at this point it has been several months. As of August, I am 1 and a half years post stage 1, 1 year post stage 2 and 6 months post stage 3.

Nothing has really changed since my most recent update, and everything is ticking along fine. I’ve not had any complications, or any issues of note in the last few months since I last updated. I’m very happy with how everything has gone, and honestly, I don’t really think about it all that much on a day to day. Life feels pretty normal these days, which is a nice feeling after so many years of discomfort and disconnect. 

I’m able to do everything I hoped I would be able to after surgery, and I don’t have any complaints. Everything feels so normal and natural now that I sometimes forget that my body ever was different. Since surgery, and most especially since stage 3, I feel a lot more connected to my body in general, but especially in intimate situations. Without going into too much personal detail, I’m very happy with how everything works in that context, and I’m not regretting my decision to go with the inflatable device, and I’ve not had any issues with just having one cylinder. I think that’s all the detail anyone really needs to hear about lol, but yes, it all works and it's all great. 

I am meant to be having my sign off appointment with Dr Goossen in November, but I’m gonna say that’s not happening with the whole COVID sitch. I’m fine with that though as I don’t really have any issues or anything, so I guess I’ll just pop back up when things are more normal again. After restrictions ease, I am also planning on continuing with my electrolysis, and organising medical tattooing, but I’m not gonna rush it given the state of things. When I start to get back into looking at that I’ll give an update on how all that process is going and the steps and costs involved.

I think from now on I’ll really only post here if something of note happens or if I have any information that I think would be beneficial. If anyone has anything in particular that they would like me to talk about please let me know and I’ll do my best to reply 

[loadingluke]

12 weeks post op stage 3

Hello everyone! Today I am 12 weeks post op stage 3. At this point, I am well and truly recovered from surgery, and I’m settling back into life as normal (or well...as normal as life in a pandemic is!)

I am still cycling the device daily per Goossen’s instructions, and I will continue to do so for the next 3 or so months. I was told that by 6 months post op I won’t need to keep cycling. It’s really not too bothersome though, it takes about a minute all up so doing it before I go to bed really isn’t a drama. I’ve not had any issues with inflating or deflating the device, I can feel the button really easily and so it’s been really effortless. The device still feels very firm. Due to the current pandemic I’m living with my entire family and I have very limited privacy so I’ve not really had much of an opportunity to test it out unfortunately, but I’m very much looking forward to it and I have confidence that the device will have no issues!

My testicular implant has definitely loosened up and is starting to sit much lower which I am very happy about. I’m still pulling on it and hoping it’ll sit more naturally at a lower spot, but I’m feeling more confident after seeing how much my constant tugging has changed it already and I feel hopeful that it will keep dropping. My feelings about the position of the implant have changed a little too, I’m feeling a lot less bothered by the position than I was more immediately post op. At the moment, I’m just gonna see what Goossen says at my Skype appointment before I make any decisions or plans about how I want to tackle it...I’m happy to give it time and seeing how it’ll go and maybe leaving it until I need my device changed in a few years, but if Goossen offers up an easy fix that will make it a little tidier I may consider that too. I also have a weird little dimple on the right side of my scrotum from how my scrotal revision healed that I’d like to get removed as it looks a little weird. It would be a super easy fix, but not something I’d do by itself so that’ll stick around until whenever I get a revision. Either way, any potential revision I would be having would be very minor and would be a pretty easy recovery, so I’d have to see if I can be bothered or fit it in at some point, and if not, I’m not too stressed about it and I’ll get it all sorted if/when I need my implant changed. I originally was thinking I’d do something end of the year about it (mainly because I’ve already paid my insurance excess for this year so it would end up being cheaper than if I were to wait until next year) but given how everything has gone and how it is all looking now I don’t know if I’ll really have the time. I feel a lot more relaxed about it though, and it really doesn’t feel as urgent, so I’ll see what Goossen says in May.

Other than that, now that I’ve had all my stages I want to focus on hair removal. I was about to start back with electrolysis and then COVID-19 hit so I’ve not had a chance to get back to it. When this all settles I intend to go back and continuing with that. I don’t have very much hair left so I don’t think I’d need to have many more sessions, but we shall see. I’ve not had any sessions for over 8 months, so I’m not looking forward to going back to it with much more sensation, but what can you do. Since I’m not able to get anything done for the time being I’m just managing the extra hairs with veet. I’d probably be fine to do this indefinitely and not bothering with electrolysis, but I think if I were to just smash out the electrolysis I’d end up happier as I wouldn’t need to deal with regrowth. Again this is super not urgent so I’ll get around to it eventually lol.

I’m also starting to look into tattooing, both medical tattooing to add realism to my penis as well as a cover up on my donor arm. I haven’t really made much progress on either, but again I am not really in a rush and it’s not really something I can attend to now anyway given the state of things. I know of a few places in Melbourne that have done medical tattooing for people post top surgery for nipples, so I’m gonna start there and I’ll see if any of them have any leads. I’m not planning on getting anything too crazy, just a little bit of colour on my glans to help differentiate it a little more as my glansplasty scar has healed white and so it isn’t as pronounced as I’d like. I may consider getting some vein details on the shaft but I’m still not too sure. Once I’m allowed to, I’ll contact some artists and have chat and see what they recommend. I’d say this will probably be more of a 2021 project though as I’d like to be done with electrolysis first and I don’t know when I’ll be able to get back to that.

I’m constantly going back and forth about my arm tattoo. If no one else had an opinion, I would be doing it 100%, and I think I personally will prefer a cover up...but my entire family and most of my friends are pretty anti tattoo so I can’t lie and say that it isn’t playing on my mind. At the end of the day I know it is my decision, and I personally think tattoos are great, and I do think it will end up being something that I’ll pursue, but since I’ve not really had much experience in that world I’m worried I will mess it up with my inexperience, and I’m concerned that my donor skin is fragile/I won’t know if an artist is experienced with scar tissue/grafts. I’m sure that more research and actually actively looking for and talking to artists will help me feel more prepared for it. I’m also pretty stuck on what exactly I want to do, and my mind changes pretty much daily. There are just so many choices! Colour or no colour? Full sleeve, half sleeve or just partial cover up? Realistic or more abstract or traditional? What do I even want? No idea tbh. Trying not to think about it because honestly, it’s all so overwhelming lol. Either way I’m just gonna sit on it and when the time is right and I know what I want I’ll work on it then. Goossen advises to not tattoo your arm until 2 years post op anyway, and I am definitely not in a rush.

I have a skype appointment with Dr Goossen scheduled for mid May, and then an in person appointment for sometime in July (which at the moment isn’t confirmed due to the circumstances). If anything happens in them I’ll be sure to let you all know.I hope you’re all keeping well and safe. It’s a bit of a weird time for everyone so I hope you’re doing okay! Until next time :)

[loadingluke]

6 weeks post stage 3

Hey all, today I am 6 weeks post op stage 3.

Since my last update, I started to struggle with deflating the device. I started to notice that it felt like the device had twisted even more, and that the button was even further in my leg crease and borderline inaccessible. This all came to a head about a week ago, where I was stuck inflated for about an hour and was unable to completely deflate my device as normal and as I had previously. I emailed Dr Goossen and we decided to stop with the cycling as I was seeing him in a few days. I was really stressed that the deflate button was broken or something, and my anxiety proceeded to spiral to that point that just accepted that I will probably need to have another surgery to reposition the pump as the way it was was not really working, or worse, that I’d need my entire device replaced.

On Tuesday I had my 6 week post op checkup back in Brisbane, so I few up for the day. I went in with René and explained the situation, and I pumped up the device as normal. René then went to have a look and tried to deflate the device, and was also struggling. She said she had felt some scar tissue around the button (which is normal as scar tissue forms a capsule around the device as part of the natural healing) but this may be contributing to the issues I was having with deflation. After about 15 minutes of both of us trying our hardest to deflate the device we decided to just leave it until Dr Goossen could have a look.

When Goossen came in to have a look I explained our issues and braced myself as he is often not the most gentle (and I was a little raw from our 15 minutes of attempted deflation). He started to have a feel around the pump and then, like magic, deflated it with zero issues in 2 seconds. René and I both just stared at him amazed and dumbfounded as we have no idea how he managed it so easily when we had been on struggle street not even 5 minutes prior. I inflated the device again and he showed me exactly where to push and where the button was.

TURNS OUT. THIS ENTIRE TIME. I THOUGHT THE PUMP HAD TWISTED 90º TO THE LEFT, AND THAT THE BUTTON WAS IN MY LEG CREASE. WHEN ACTUALLY. THE DEVICE ROTATED TO THE RIGHT. AND THE BUTTON WAS ON THE FRONT, LITERALLY RIGHT THERE, EASY AS TO ACCESS. SO, this entire time, I had been pushing and prodding and squeezing my poor poor left nut in the complete wrong spot, and for no reason at all (see the attached video of the pump bulb to help explain this visually!).

I am assuming that during the earlier stages of healing when I was still a little swollen the button was being pressed even when I was putting pressure on the wrong side because it was able to press against the swelling, but as that has gone down the lack of resistance meant that the pressure on the wrong side wasn’t enough to deflate the device, which is why one day what was working fine suddenly wasn’t sufficient. Either way, once this was all clarified, I had no issue. I deflated and inflated about 4 times to make sure, and then sheepishly thanked Goossen for tolerating my ineptitude. Since then, the pump has been working completely perfectly, and the button is actually super easy to press. So there we go. I stressed out for no reason and all is well😂

Once that was all fixed up, Goossen and I had a little chat about what happens from here. I was given the blessing to go ahead to have sex once I hit 8 weeks, and he told me that he was very happy with how I’ve healed and that I have a beautiful penis (to which I replied with ‘thank you…literally thank you’ 😂). I’ve also been cleared to go back to the gym as of 6 weeks (gently at first of course!) and have been given instructions to continue cycling the device daily until I’m about 6 months post op. We’ve arranged to have a Skype check up in about 10 weeks, and then I’ll pop back up to Brisbane for hopefully my final sign off in the end of July, also around 6 months post op. Hearing that was honestly a tad overwhelming, it’s really hard to believe that I’m all done and that I don’t have to keep coming back, and honestly a little bit of sadness that I’ll not have much of a reason to see Goossen again once I’m all settled- he’s honestly an amazing surgeon and I think I’ll honestly miss him haha.

I did mention that I was concerned about my testicular implant and that aesthetically it’s still sitting a little too high for my liking right now. We’ve decided to not worry about it yet as 1) there is still a lot of swelling and 2) there is still a chance I’ll be able to yank it down over time. He said we can discuss it in July if it’s still something I’m unhappy about, but he was a little hesitant to surgically intervene unless I really insist- as this would require replacing the implant and could pose an infection risk/ could compromise the erectile device and probably wouldn’t be worth the risk. I decided to just keep tugging and then in July if it’s still an issue we can discuss it again then. He seemed optimistic that with some determination and patience that I should be able to shift it, so I’ll keep working on that.

I’m honestly still a little bewildered and shocked that this is all nearly over, after years of waiting to be at this point. Some days I catch myself thinking about and dreading having stage one, only to remember that I’ve already done it and I don’t ever have to do it again. I feel so blessed and happy I made it here, and I’m excited to move forward with my life without having my body holding me back. I’d just like to say thanks to everyone in here for being respectful and supporting me over the last 2 or so years during this process. All the kind words and support have meant a lot and I’ve appreciated it loads.

That’s all I’ve got to say for now, so far so good. I might be a little quiet now that I’m healed up and done with all my surgeries (at least for the time being) but as usual I’m happy to answer questions, and I will of course update if anything of note happens. Until next time 👍

[loadingluke]

1 month post stage 3

Hey all! I’m one month post stage 3. I’m not in much pain or anything and haven’t really felt there has been much of a need to update. All my incisions are closed and healed now, and so I’m allowed to shower as normal. I went back to work a few days ago as well. I had my 2.5 week post op check up on the 11th with Goossen, and it went well. I was a lot less swollen and we managed quite well. Upon inspection, René and Goossen noticed that my pump seems to have twisted about 90º to the side- this is a little annoying, but not the end of the world and I’ll touch on this later. We started to attempt to cycle the device, René started by showing me how to do it and then let me try myself. I managed alright at the start, but I did need to go slow and only give small squeezes. It would take about 20 squeezes to mostly pump it up, and then I would have to deflate it on my own. As I mentioned, the pump twisted and so the deflate button is a little harder to actually use as the button I need to push is basically in my leg crease…so to press it I kinda need to shove my finger between my scrotum and my leg crease whilst trying to lift the pump up to actually access it. It was a little painful to start, though over time it has gotten easier. There is still a chance that the pump will twist around again, but the way it is now is honestly fine and I wouldn’t really care if it ended up staying this way, as long as I can continue to access it without a problem. I’ve worked out what works to access the button and I can deflate it with minimal effort, so no harm done. We cycled the device about 4 or 5 times, and then after that Goossen gave me the go ahead to head home 🥳. I was sent home with instructions to try to inflate and deflate the device 1-2 times a day. Every day using the pump gets easier and more natural to use, and as the swelling is continuing to go down. I’ve not had any issues cycling the device myself (excluding one panic-inducing moment when I couldn’t work the deflate button for a couple minutes 😬) and now that I am further along I am noticing I can press the pump harder and so it only takes 5-10 squeezes to fully inflate the device. Because I am not having any trouble cycling the device myself, I don’t need to come back for a few more weeks, and so I have my next appointment on the 3rd (a little sooner than we were going to go for, but the only time to work around both of our schedules). After this appointment (if all goes well) I will be given the blessing to try it out once I hit 8 weeks, which I am very excited for. I found the easiest way to use the pump is to pump it using my left hand and use my right hand to push against the testicular implant to provide some stability, and I press the bulb up and against the implant. Then I just squeeze the bulb until I feel that there isn’t any fluid in the bulb and that the squeezes don’t seem to inflate the device further. It’s kind of hard to explain, but it feels different and is easy to tell once it’s inflated all the way. Then I leave it inflated for a couple minutes, deflate it and then repeat. It usually takes less than a minute to completely inflate it and about the same to deflate it, so it’s pretty easy and quick to do. In my last few posts I mentioned a few things that now I’m further down on the line I can further comment on. I previously mentioned that the pump makes a whooshing sound, which hasn’t happened since that first time, and I’m honestly thinking I was just focusing on the feeling that I just felt like it made a noise. It doesn’t actually make a noise, or at least if it did it’s pretty quiet. I think when you’re inflating it yourself and you can feel the movement of the fluid you can kinda feel the whoosh, but there is no sound so don’t worry about that. I also mentioned that I was told to leave the device semi inflated until I could start cycling, and upon starting to cycle I was told to do a half squeeze after I’ve fully deflated to help prevent the tubes from kinking. At my last appointment, I was told that I should keep doing this indefinitely- both to stop the cylinder kinking, and also to make the implant easier to deflate as having some fluid in the cylinder helps to reduce the amount of force needed to start inflating the pump again apparently. Even with one pump,  the cylinder is still very flaccid so I don't mind continuing to do this.
Since the swelling in my penis has gone down I have noticed that I can feel the cylinder more on one side and that it is firmer on that side. It is noticeable, but only if you’re really thinking and focussing on it. It is still very firm though and I’m not concerned, just thought I’d comment on it as I think I jumped the gun a little when I said the firmness wasn’t noticeably uneven when I was still swollen. I’m still struggling with my testicular implant, which is still sitting really high. I’ve just been trying to pull it down and it is moving a bit, but I’m worried that it won’t drop low enough to be aesthetically pleasing to me. Right now, this is the only issue I have with the appearance of my genitals, so hopefully it will eventually fall into a place I’m happy with. If not, I will get Goossen to surgically move it later this year. I’m trying to remain hopeful, but it’s hard when it doesn’t move very much and when things are still swollen and not fully settled. Fingers crossed though. So far so good. I probably won’t update again until after I see Goossen or if anything of note happens. Until then!

[loadingluke]

Howdy everyone, thought I’d update as yesterday was the much anticipated ~deflate day~!

My appointment was at 11 and I decided to go in on the bus...or at least attempted to before realising I caught the one going the opposite way and had to get off and take an Uber of shame. rip. I will never understand Brisbane transport- I miss my trams!

I had some panadol and an endone in prep for the deflating as I have heard it isn’t the most pleasant experience. René was wonderful as usual, and she managed to get the dressings off with minimal discomfort fortunately. She said they’re looking good and that the one on the left is fully sealed, while the right one has a little bit that isn’t quite there yet. She said everything is looking pretty good though.

Goossen came in and had a fiddle, mainly feeling to see where the pump was sitting. He managed to deflate me pretty easily actually, but he wanted to try to reinflate me to see how it was all working and sitting. The inflating hurt a lot more than the deflating, and it felt really weird. I could feel the fluid moving in and out of the cylinder and it made a bit of a whooshing sound. It was a little sore, but it wasn’t as bad as I expected.

After having a look Goossen decided that due to my swelling (particularly in the mid seam of my scrotum), he doesn’t want me to start to cycle the pump just yet. He was concerned that doing so would 1) still be too painful with my current swelling and 2) it will still be too hard for me to actually deflate myself so I might get stuck. He doesn’t want me to compromise on the wound healing either, and thinks it’s best to leave it all for another week.

He fully deflated me again, and then squeezed the pump once in order to partially inflate me to avoid the cylinder kinking, and asked me to come back in 1 week. I was a little bummed out hearing this as I was planning on going home on Thursday and I didn’t really want to keep having to fly up and back. I decided that it would be best to change my flight so I can fly out after my next appointment rather than tomorrow, to save me having to book another $300+ day return trip with less than a weeks notice. I’m a little sad as I did want to go home and I was looking forward to it, but such is life. These surgeries remind you you need to be flexible and open to changes from your original plan, and I can’t be too mad since I’ve had a pretty decent run this entire time, and I’m very lucky I have supportive family friends who are happy to deal with this ugly mug for an extra 5 days 😅

Being mostly deflated has made a huge difference. I was getting pretty sick of having to constantly hide my crotch and being paranoid of creeping people out, and was basically doing everything one handed as I was using the other to hold my decency bag. Even in just 24 hours I feel a new sense of freedom being able to just exist without constantly trying to hide it all.

I’m off painkillers completely now and I’m feeling pretty good. Goossen gave me another script for antibiotics as I think I was only given half of what I was meant to at discharge and he wanted me on them again just in case. The plan now is to just hang around Brisbane for another week, and now that I’m more mobile (and less indecent) I’m definitely free to catch up if anyone is around and would like to. Shoot me a message!

Here’s hoping the swelling goes down a lot more by next week 👍

[loadingluke]

Today I’m one year post stage 1 phalloplasty. I was going to make a long post breaking down everything I’ve gone through in the last year, all about my recovery and the physical stuff, but I think I’ll leave that for later when I’m more recovered from stage 3 and I’m better prepared. But I did want to take a moment to talk a little about the mental impact that this year and this surgery has had on me.

This year has been one of the most challenging and rewarding years of my life. A lot of sacrifice, pain, and years of preperation has resulted in what is and will continue to be a peace and comfort I didn’t know was possible. This surgery has been the best decision I’ve ever made. I have been given the ability to actually function, and I am now able to actually work towards becoming the person I know I can be. I know I’m now able to actually work towards my goals without the fog that was daily debilitating dysphoria and hopelessness that got in the way. Even though it took a lot of work and heartache, money and time on hold to get here I’d do it again in a heartbeat.

I want to thank all the health care professionals who have made this possible for me, all my doctors and nurses and OTs especially Dr Goossen and Dr Ingram.

I want to thank everyone else who is brave enough to share their experiences online and this community we are building- knowing this isn’t something I have to go through alone has been very comforting and I’m glad to call you my friends.

I want to thank my family and friends, especially my mum who stayed with me during stage 1 and 2, the and my friends who have opened their home to me for months while I recover.

And of course, my wonderful partner, who has been my bloody rock for the last 4 years, but especially this year. I don’t know how I would have coped without her at my side throughout this entire process and I love her dearly.

This surgery isn’t something that happens overnight, and it’s not something that one can just get over and done with on your own. I guess it takes a village to make a penis (I thought this was clever but I think it sounds kinda weird but the point still stands so I’m keeping it in!).

If this is something you are planning or actively pursuing, know you aren’t alone and there are tons of people in the same boat here with you, and many people around who will help you get there. It might feel forever away and trust me I know how much it sucks but the wait is worth it. I really hope that whoever you are you are able to experience peace in your body, surgical intervention required or not, and I wish you the best of luck on all your endeavours.

Happy 1 year post op to me and here is to the rest of my life with this body I’ll be forever grateful for ❤️

[loadingluke]

1 week post op stage 3 today!

I'm managing really well. I haven't had any stronger pain meds for about 3 days, and I'm taking panadol and ibuprofen regularly to keep everything at bay. I reckon if I didn't want to take anything I probably could function okay at this point without taking anything, but I'm happy to stay on top of it so I'm more comfortable. My pain is worst first thing in the morning, but once I get up and shift positions it tends to ease up. Every morning this is getting better though, so I don't foresee needing to take anything for much longer. I finished my last antibiotic today, and still have no symptoms of any infection or issues which is great.

Swelling is still pretty intense but is also going down pretty quick, especially in my penis. For context, once I got out of the hospital I measured my girth and was 4cm girthier than pre op because of the swelling, and at 5 days since then I'm back down to 2.5cm girthier than pre surgery. I don't know how much of this is permanent or due to the device being inflated, but I definitely think it is still looking pretty swollen. Whether or not I end up with more girth now remains to be seen, but I wouldn't be surprised if I am once fully healed. I haven't had any change in length. (On a slightly related note, I've not gained or lost any length of girth permanently since stage 1, though this can happen due to tethering, tightness in scars, skin elasticity differences, and even gravity. I've been the same dimensions (once post op swelling went down of course) after every op and during recovery, just in case anyone was wondering!)

My scrotum is still very swollen, but especially over the last few days I've noticed it starting to go down more. My implants are still fairly high, but I think they still sit quite well. Hopefully when more swelling goes down they'll have a little more room to move, and will be able to fall a little lower with some gentle persuasion. I am now able to actually feel the deflate button and part of the bulb of the pump, but touching them too much does hurt...not keen for Tuesday 😅.

I've also noticed that the scars in this area in general are swollen and raised, including part of the top of my vaginectomy scar, the seam joining my scrotum, the scar on the underside of my penis and the scar around my penis where it is attached are all raised. When I first noticed this it really stressed me out, but Goossen assured me that it is only temporary and will go back down in time when I'm less swollen all over.

My incisions on either side of my groin, and they're pretty hidden due to the swelling/implants/natural crease of my leg. I've currently got waterproof dressings on them that will stay until my appointment on Tuesday. They're holding up quite well, but I've got some replacements in case they do start to come off. I've been given the go ahead to start showering on the weekend (as long as I'm careful that the incisions stay dry).

Still rocking my decency bag and trying my best to keep everything pointing the right way. also still not wearing underwear, just my ugly surgery pants. Such is life. I'm looking forward to getting deflated on Tuesday so I can start to dress a little less daggy 😅

Hope everyone is well!

[loadingluke]

Stage 3 4 days post op update

Hi all, today I’m 4 days post op stage 3. I thought I’d do a little update as I’m out of hospital now.

I was discharged on Saturday afternoon. That morning I had my catheter removed (finally, bloody hate those things and I was starting to feel some bladder irritation). I had to do a void trial, so I had to pee into a bottle and then have my bladder scanned 3 times. If I wasn’t able to pee or I was retaining a lot of urine I may have had to be catheterised again, so I am very glad that that didn’t happen 😅. I had my canula removed as well, and was switched to oral antibiotics instead of IV. I was able to get up and wander around, albeit very slowly and carefully. Dr Goossen came in and removed all my dressings, including the large amount of padding on my penis, so I could actually have a look at it all, and it looks amazing! The prosthesis is VERY rigid, a lot more rigid than I expected, and the testicular implant and pump bulb have filled out my scrotum very nicely- only issue is that I am currently very swollen so it’s hard to really imagine what it’ll look like once it settles- but for now I am very happy.

I ended up getting the coloplast titan touch 3 piece prosthetic with one cylinder. Goossen said that he had to use an 18cm cylinder, which is a little longer than what he normally implants. This prosthesis is VERY rigid, and I have no concerns about the future with it and whether or not it’ll be hard enough. Even with one cylinder the rigidity I’ve gotten is very impressive. I can feel the harder end of the cylinder when I touch the tip of my penis, which also will provide some control down the line. I was initially concerned that the cylinder was too close to the end of my penis and that I was at risk of erosion, but apparently this is normal and as long as I can move the skin around the tip I should be okay. I’ve not noticed any pressure points or weird colour change due to it, so I’m not too concerned.

Goossen also managed to squeeze in a medium sized testicular implant in my right side. I was ecstatic hearing this, as I thought I’d only be able to fit in the smallest implant possible as he was uncertain if I could get an implant at all due to the size of my scrotum. So yay! Upon inspection he noted that both the pump and implant are sitting a touch higher than he wanted them to, but that is mainly due to all the swelling and hopefully I’ll be able to coax them down a little once the swelling dissipates. If they don’t budge, I can either leave them if they don’t bother me, or I can have another surgery to move them down again. I’m just gonna wait and see how it goes, I’m definitely not in any rush to have any more surgery unless I really have to.

I have two incisions on either side of my groin, one for the pump and one for the implant. I’m changing my dressings every couple of days, and they’ve actually been staying pretty clean and aren’t weeping much. I’m dressing them with steri strips and a large cutifilm dressing. Because of the location and the swelling, it’s a touch difficult to actually apply them, but we did our best.

Pain wise, I’m managing pretty well. As long as I take my ibuprofen and paracetamol regularly, I can usually tolerate it. I’m taking targin in the morning when I first wake up (when the pain is at its highest once everything wears off during the night) but I don’t need anything stronger during the day. I’m also taking oral antibiotics twice a day, which is a lot easier to remember compared to the 2 part regimen I was on after stage 2.

My only concerns at the moment are that I’m keeping my penis straight enough, as I don’t want to influence how it’ll heal, and infection. I’ve had no sign of infection at all, but it’s definitely scary as the consequence of the implant being infected is so huge. Im just monitoring myself, but I definitely am anxious about it, even though I have no real need to be.

One other thing to note is that I definitely can’t leave the house looking like this. The device is very obvious, and I am very conscious of it. I’ve just been wandering around carrying a strategically placed empty tote bag specifically to cover myself up, and that has worked like a treat. It’s way too hot to wear extra blankets anyway 😂 I’m just currently rocking my surgery pants, which are gym shorts a good 3 sizes too big, and a long T-shirt. I’m not planning on leaving the house anytime soon though, but even hanging out at home with my family friends feels awkward. my partner Maddy arrived on Saturday, and has done an excellent job at fetching me things so I don’t need to move, and checking to see if the coast is clear if I forget my decency bag. Honestly, this must be true love 😂🥰

I’ve got an appointment with Goossen on Tuesday morning, and I’ll probably make another update after that. All things considered this recovery has been worlds smoother than stage 1 and 2, and I’ve felt pretty comfortable.

Let me know if you have any questions as usual and I hope you have a good day!

[loadingluke]

Stage 3- day of surgery

Hey all! This morning I had stage 3 (pump and testicular implant placement) and I thought I’d make a little post to keep everyone updated.

I was admitted nice and early at 6:30am, and was first on the list which was nice. I got into my gown and went through all my information, and then the nurse gave me a padded cushion thing to stick to my sacrum to help prevent tissue breakdown since the surgery was ‘so long’ (longer than 2 hours apparently) which I laughed at seeing as this one is by far the shortest stage and I had nothing at all like that for the other ones that, if we’re saying 2 hours is very long, must be veeeeeeeeeeerry long. I think because I’ve done so much research on phallo I forget just how bloody long the surgeries are and how abnormal that is! She told me that it’s a case by case thing and some nurses like to put it on just in case, and others don’t find it necessary in ‘young, fit people’ such as myself which is why I mightn’t have seen one before. Another thing to note is that I had a little scab from when I lost some skin at work moving boxes on Saturday. They said it was fine and then put a bandaid on it (Even though it was fully closed over, and Goossen needed to take it off to check on it? But whatever). It isn’t infected though so there’s no issue there, though I assume if it was it may have caused trouble given to how sensitive this stage is to infection. If the devices get infected they all need to be completely removed, and I don’t think anyone wants that!

It all moved pretty quick once I was in my bay, and I was in the anaesthetic room by 8. Apparently surgery lasted about 3.5 hours, and went well. I have two incisions, one for the pump and one for the testicular implant, but I’m currently not too sure where they actually are. Goossen put the pump in the left, and implant in the right.

As for pain, I’ve mainly got it when I move in my lower left abdomen where the reservoir is located, as well as in my scrotum. I’ve been given some endone and I don’t have a PCA this time. I was on oxygen for a little as I had a low respiration rate in recovery, but that didn’t last long as I don’t need it without the PCA. I have some IV fluids in, but from what I heard I only have them overnight. I also have a catheter, which should be removed tomorrow. Thankfully, I only have one cannula and it’s in my hand, so I don’t set off the machine gods every time I go to move my arm. I was on half hourly obs until about 4, and from then I’ve been on hourly. Everything is coming back normal so that’s great.

Goossen came in at about 5 to have a little look and to see how it was going. He said he was happy with where the implant and pump were sitting, and said that I was partially inflated. He also said he may leave it like this, or may go to fully inflate me sometime tomorrow depending on how it’s looking, and concerningly, apologised for that in advance 😬. He was a little unhappy with how my penis was sitting as it was sort of leaning to the right side because of the weight of the blankets, and if it stayed that way it could mean that when I inflate the device my penis will have a bit of a lean, so he went to fix it and OUCH. He made a bit of a supportive ring around it and told the nurses to get a cradle so that the blankets won’t press directly on it. He also took this time to have a feel of where the implant and pump was sitting and that was similarly sore, though he said he was happy so I guess that makes it all worth it.

I also received a nice little pack with the instructions for the device (featuring what looks to be a very happy older couple) and a little pump keyring so I can practice using the device. Not gonna lie, would be tempted to put it on my keys if I didn’t think I’d be asked about it every time I use them 😂

I’m just having some dinner now and trying to rest up. So far so good. I’ll keep everyone updated 👍

[loadingluke]

Update

Hey everyone! Hope you’ve all been having a great holiday period!

I just thought I would do a pretty quick update post on how I’ve been going since my revision in October, as I’ve not really said much since. Honestly there hasn’t been much to say so I’ve not really felt compelled to post, but as s3 is coming up fairly soon (as well as 1 year since stage one, wtf? This year has FLOWN) I thought I’d do a quick little post. I’ll do some more in depth posts when I hit 1 year, as well as some more specific S3 stuff when it comes up.

As you can probably guess, no news is good news and I’ve been trucking along great. On the 1st I will be 11 months post stage 1 and 5 months post stage 2, and I’m about 2.5 months post my scrotal revision. Everything has healed really well and I’m happy where I am at. My arm is still fading but is fully healed (and has been for about 8 months I’d say). I haven’t had any urethral issues which I’m very happy about as that was my biggest fear going into stage 2. I still am worried about developing a problem but so far (touch wood) I’m still in the clear and have no reason to be concerned. My scrotum has healed up great from the revision and I’m very happy we decided to fix it up before s3. My scrotum is a lot more aesthetically pleasing to me and I’m really happy with how it looks, and I think with the bulk of the pump and implant it’ll look really natural. I’ve been tugging on it every night to give it the best chance of fitting both my testicular implant and the pump and I’m remaining optimistic I’ll be able to have both fitted. If not, no harm done, I’ll just get the pump and have an implant put in sometime later next year.

Honestly I’m just really looking forward to be done. I am really excited to be able to focus on other aspects of my life (like my honours program and med school application next year!). It’s been a wild year and I’ve had to sacrifice and put off a lot for surgery, but I’m so glad I did what I did so that I can move forward into this new year without my dysphoria holding me back. Emotionally I feel great- this surgery has been the one of the best decisions I’ve ever made and I don’t regret it in the slightest. It took a lot to get here, but for me it has been well worth it!

Stage 3 is on the 23rd of January, a little over 3 weeks away 😱. I’m flying up on the 21st for a pre op appointment and I’ll be in Brissy for about 2 weeks. This one is a much shorter recovery so hopefully all goes well and I can get home pretty quick. I have a flight booked for the 6th, so hopefully I’ll be back home then.

You probably won’t hear from me too much until then, so happy new year and as usual feel free to leave any questions you have and I’ll answer what I can!

[loadingluke]

No shave November for the last 5 years. First photo: 1 year on T, last photo 5 years on t. It takes time ☺️

[loadingluke]

1 week post scrotal revision

I’m 1 week post my minor scrotal revision, and so far things have gone well. I’ve been off pain meds for about 4 days, and I finish up my antibiotics tomorrow. So far it’s looking really good, I’m much happier with how it all looks and I think it was definitely a good move to do before S3. I’m back up to Brissy (again 🙄) on Tuesday for my final time and hopefully after that I can leave it until Jan. Flights are definitely denting my wallet, so I’d like to limit the amount I have to come up if I can.

Surgery was pretty uneventful. I was last on the list, and my check in was at 10:30am, and I was fasting from 7am. I have absolutely no idea why I was asked to fast and come in so early as I wasn’t taken in until 6:30pm. I was absolutely starving by the end of it, but keen to rock and roll. After the surgery I was feeling pretty good, I was only under for about an hour and a half so it was a lot nicer than the other times I’ve been under. I didn’t have a catheter either which was a nice change of pace. I was discharged the next day at about 5pm after my dressings had been changed, and headed back home on Saturday morning.

Dressings wise I’ve been using some of the cutifilm adhesive dressings directly on the incision, and then some combine pads in my underwear to catch any extra blood. I stopped using the combine pads on Tuesday as I wasn’t bleeding anymore and honestly they give me insane dysphoria 😩. The last few days I’ve been enjoying recovering home as I can just not wear clothes and really let the incisions air which I think has really helped them along healing wise. I’ve stopped dressing them now as there isn’t a need to in my opinion, though I do use a bit of gauze when I go out of the house just in case.

I’m back to showering again as of today, which is great. Hopefully on Tuesday I’ll be cleared to go back to regular activities, or at least a bit more of a timeline as to when I can expect to. I’d say I already feel back to 100% though, so as long as I don’t go around doing the splits I don’t think I’ll have too much of an issue.

I’ll touch base a little more after my appointment on Tuesday. If people are around or want a visit/coffee let me know and I’ll try to arrange :)

[loadingluke]

Stage 2 post op/stage3 pre op

This morning I woke up nice and early to catch the red eye flight to Brisbane for my stage 2 post op/stage 3 pre op! My appointment was at 11am. It was pretty quick, we went over risks and potential complications and went over my healing and how I was feeling about it all. Pretty minor and quick, nothing really to report.

I went over to the bench so he could have a look at how it was all going, and this is how the conversation went:

Goossen: ‘Hmm....there’s a little bit of scar tissue that has retracted which is causing a bit of a divot which I think would be best to repair before stage 3, you’re all healed now, so realistically we can do it whenever you want’

Me: ‘oh okay that sounds fine, I can come up whenever really if it’s something pretty minor!’

Goossen: ‘Great, how does Thursday sound’

Me:’.....as in in 3 days time?!?’

Apparently yes. Flights are booked, and I’m back up to Brisbane Thursday morning for a minor scrotal revision in the afternoon, and I’m going back home Saturday afternoon 😂 as he described it, he’s just going to remove some of the scar tissue that retracted a bit, which should hopefully help my scrotum look a little more aesthetically pleasing. I should be under for about an hour all up, and the recovery should be relatively easy.

We had a bit of a chat about what my options are from here provided all heals well after Thursday, namely whether or not I would be getting tissue expanders, a testicular implant and pump, or just a pump.

If I were to get tissue expanders, I would get them placed in January instead of stage 3, and would need them in for 6 months at which point they would be changed for the erectile device and testicular implant. However this isn’t really an option for me as I wouldn’t be able to have stage 3 until November 2020- I’m doing honours program next year that I can’t really take time off for surgery from and that doesn’t finish until end of the year. Additionally, leaving the expanders in for longer than 6 months isn’t ideal as it can pose an infection risk, and I’d need to find someone with experience with them to fill them every couple of weeks, or else I’ll need to come to Brisbane to do so, which is totally unrealistic.

We both decided no on the expanders for now, Goossen doesn’t think I will need them anyway as well as the reasons mentioned above, so right now we are still aiming for late January for stage 3. At this point, Goossen will either place just the pump by itself and then later in the year I’ll come up for another procedure where I’ll have a testicular implant fitted, or he will do both at the same time if he doesn’t think there will be a risk. So, pending all heals well this week, I’ll still be able to have stage 3 when I was hoping, yay! I don’t really mind waiting later in the year for a testicular implant if he thinks it is for the best, as the surgery for that by itself should be pretty minor. I just would prefer to have the erectile device fitted as the recovery for that one is a little longer and more inconvenient to arrange. Hopefully I can have both done in January, but if not, it’s no big deal. It’s all a process.

I definitely can’t say I expected to leave this appointment with a surgery date for less than 72 hours away, but I’m glad he was able to squeeze me in as early as he could and that it shouldn’t compromise my date for stage 3. I guess all I need to do now is wait 🤷‍♂️

[loadingluke]

I have been umming and ahhing about making this post for a few weeks. I’m not really one to discuss being trans all that much, and in general I’ve been living as myself for such a long time that I’ve started to forget the specifics. I often forget dates to milestones that I used to hold so dear, not really thinking about them until weeks later.

This year however, I felt differently. Yesterday, October 7th 2019, marks my 5 years on testosterone, the hormone that quite literally saved my life. For some reason, 5 years has been a milestone I’ve always had in the back of my mind. The idea of being on hormones for that long honestly felt impossible.

5 years ago, at freshly 18, I caught a bus alone to a random clinic in a city I didn’t know. I sat in a waiting room for an hour, had the first of many blood tests, and left starting a new chapter of my life. I hadn’t told my parents, and only had a handful of friends who knew me for me and who loved and supported me anyway. I knew from this moment forward, my life would never be the same. I was fucking terrified, but so so ecstatic. I knew I was finally going to have a chance at feeling at peace in myself, that I was able to actually live my life the way I want to and on my own terms.

Without trying to make this post too depressing, when I first realised I was trans, nearly 9 years ago now, I didn’t know if I’d even make it to being on testosterone, let alone living to be 5 years on. My life was a state of constant fear, hopelessness and depression. I didn’t think there was any way I’d ever stop feeling the way I did. I still look back and wonder how I made it through school, and it was the darkest and scariest time in my life. The only thing I had to hold on to at 14 years old was turning 18, moving far away from everyone who ever knew me and starting again. I didn’t think I’d ever be loved and accepted for who I am, I didn’t think any of my family or friends would support me, but I knew that I’d need to do this to have a life worth living. Before I transitioned, I couldn’t connect with anyone. I couldn’t express myself, and honestly, I hated myself. I hated how I looked, I hated how people perceived me, and I hated how stuck and frustrated I was. Back then being trans wasn’t as talked about as it is now, and I honestly thought I was the only one who felt the way I did. I thought I was crazy and that no one would ever listen to me. I thought that I would never love myself.

Of course, testosterone didn't magically fix all of that, but making the decision to start my medical transition was the first time I ever stood up and put myself first. I decided to be brave, that I didn’t care if it was selfish, what anyone else thought or if I was going to make life harder for everyone else. I decided that maybe I was actually worth something and my life did matter, and I knew that this was the only shot I had at happiness.

That one act of self love has given me a life so full of love and joy. Over the last 5 years, I’ve experienced things I could only dream of. I've got great friends and support, a loving family, an amazing partner, and honestly, I wouldn't change anything. As much as it's been a hard road to get here, it has made me resilient, patient, persistent and unapologetic of who I am. I know my worth, and I have a life that I love and that is worth living for, and for that I am so grateful, and this all is only possible because of that day 5 years ago.

This is getting long, and I don't think I'll ever have the words to describe how transitioning changed my life, and how proud I am of myself for making a decision for myself and myself only. Thank you to everyone who has supported me along the way, it’s meant more than you could know.

Here’s to the next 5, and the 5 after that, and the rest of my life. I know it's cheesy, but it really does get better, so so much better. <3

[loadingluke]

8 months post op stage 1, 2 months post op stage 2

Hey all! Yesterday I was 2 months post stage 2 and 8 months post stage one (it’s rather convenient that they fall on the same day 😁) so I thought I’d do a super quick update.

As I mentioned previously, I think I’m fully recovered from stage 2. I’ve been working a lot recently (seems like everyone is getting the flu now 🙃) and my job is fairly physical, walking around and lifting/moving heavy boxes, and I’ve been just fine. Yesterday I got back into the gym which was nice. I started off pretty slow and I’ve definitely lost some strength since surgery, but that’s expected as I’ve not worked out for over 2 months. I’m really looking forward to not having surgery recovery getting in the way of my progress as it’s pretty annoying hitting milestones in my fitness only to have to try to hit them again because I’m forced out of the gym for months at a time!

Obviously though, that’s a super minor complaint and I will absolutely take that given how chuffed I am with everything else. I’ve been incredibly lucky with my surgery and recovery, and I’m so grateful for that. Although it hasn’t been an easy process, it’s been one of the hardest things I’ve had to go through, I’m definitely aware of how fortunate I’ve been given how complex this surgery is. I definitely went into the entire process planning for the worst but hoping the best. For me at least, surgery wasn’t an active choice I made, as I KNEW I would have to have this surgery in order to go forward with my life. No matter what happened or if I had complications, this is something I would have to do. I saw loads of stories when I was researching phalloplasty where things went terribly wrong, and I remember thinking that I’d do it, I’d take that if I could have a chance at eventually having a penis, I was so desperate for it. Of course I never wanted complications, but I definitely went into this whole thing prepared for the worst. This isn’t me trying to scare anyone off or anything, but just be aware the my experience isn’t standard, and to make sure you’re making an informed decision with the risks in mind. In saying that, Goossen is great and a very skilled surgeon, if you were to go with him you’re in excellent hands. I honestly think he’s one of the best in the world for this, and we are very lucky to have him.

Recovery wise, nothing much to report, but here are some little tidbits I’ve noticed and thought worth sharing.

Urinating is still going fine, and now I don’t feel like I’m going to pee on the floor which is nice. I don’t think I can feel it any more than before, but my brain is used to it. Still having no issues with peeing and I’m still drinking loads. I don’t think I’ll ever get over how cool it is, and how happy I am that this is my life now lol.

I’ve been massaging my arm a lot more recently and I’ve switched to a palmers cocoa butter lotion as it’s a lot easier to apply than the oils I was using. Because of this I’ve been massaging my scar a lot more than before as I used to put it off because of how much of a hassle it was being. I’ve noticed a difference in the softness of my graft, so I’m just gonna keep doing it. I’m looking into some more silicone products, but they’re so expensive so it’s hard to make an investment without any experience. I’ve had a good experience with cica care scar sheets though, so I’m hunting around to see if I can get them anywhere cheaper than work. My TSL sleeve is on its last legs- it’s gotten very loose and doesn’t compress my arm as much. I think I’m going to have to retire it soon. It was pretty helpful in the first few months post op and having the silicone imbedded was really convenient, but I won’t be buying another one. It was pretty expensive and I don’t think I can justify spending that again.

I’m happy with how my arm is looking, colour wise it still pretty much matches my normal skin colour. I have a few spots that are still a little hyperpigmented, but it is fading still. I don’t expect this to go back to normal though, so I may look into some other options like laser treatment if I decide against tattooing the graft (which at the moment is looking more likely) my other trouble area is the bottom of my mid seam, which is redder and more raised than the rest of my arm. Depending on how easy it would be I might ask for a little revision to be done on it down the line, once I’ve given it some more time to fade and again if I decide against a tattoo. It can be hard to not want to do all these crazy things to improve the appearance of it, and then I remember that I’m only 8 months post op and I’ve got loads of time for the scar to fade and mature. Still really early days, just got to remind myself. For where it is now though, I’m really happy with it and I don’t regret my choice to use my arm as my donor site.

That is all from me for now. If you have any questions as always feel free to comment or inbox. Have a good week!

[loadingluke]

2-7 weeks post stage 2 update!

Hello! Thought it was about time for an update. Time has gone by incredibly quickly. I’ve been pretty preoccupied with life stuff and honestly stage 2 recovery was pretty uneventful once I was out of the hospital and resting. Strap in though, as this is gonna be a long one.I think the best way I can update you all is by doing a rough update of the past few weeks, and then I will talk specifically about the healing of each section.

GENERAL HEALING FROM 2-6 WEEKS

My last update was from 2 weeks post op, so feel free to go back to that if you want some context. Following that update, I had my first appointment at the continence clinic for my first void trial! I got to the clinic at 7:30am, and this was located at Greenslopes. Goossen came in and had a bit of a look and took my urethral catheter out- he said there wasn’t any resistance which was a good sign. I was then taken to the waiting room area and given some water...and then it was time to wait.

The room itself was quite nice, there were a huge selection of recliners and some TVs, and nurses who were offering food and coffee while I waited. I had my 2L bottle of water and just started chugging. Once I felt the urge to pee I went to the bathroom, and on a table was a selection of bottles all labelled with peoples names. I located my own and then had my first attempt and it went well! I was expecting it to hurt or be uncomfortable, but it didn’t hurt very much at all, possibly because I was so well hydrated. I then went to the consulting room and had an ultrasound on my bladder to see whether or not I completely emptied my bladder. The nurses then measured how much I peed to see if it was all normal. All was looking good so I was sent back into the waiting room for another 2 attempts before I’d be cleared to leave. The other two attempts went off without a hitch and so I was sent off back home, with my SPC being switched to a flip flow instead of a bag. From now on, I will be solely voiding from my penis, but if there is any issue like a stricture or for whatever reason I can’t pee, I have the SPC as a backup option.

The rest of this week was pretty uneventful. The only issue I noticed post urethral catheter removal was that the next few days I had a few issues with bladder spasms, but it passed pretty quick and wasn’t an issue again as long as I took my ditropan. I was oozing less and less, eventually to the point where I only needed 2 pieces of gauze on my scrotum and no more giant pads, and the best part...normal underwear instead of the hospital ones I’d been wearing for 2 weeks 🥰. I just chilled at home, drinking my water and peeing when I needed to- and thankfully there were no issues. I didn’t need to use the SPC at all, and now that it wasn’t being used and I was back to normal underwear it was actually not too bothersome. My family returned to Hong Kong and so I didn’t do too much besides waiting for my next appointment so I could go home. At this point, I was pretty much off pain meds besides random instances of pain or if I overdid it.

On Tuesday I had the SPC removed. This was also at the continence clinic at 7:30am. The nurses started to remove it but found that it wasn’t coming out. They were trying to be very gentle and unfortunately it wasn’t budging. They decided they would wait until Goossen came in to do it. In typical fashion, he removed it in 2 seconds with a few solid tugs. Luckily for me, it was so quick that I didn’t really have time to register what was happening and that it hurt before it was all over, lol. My drainage hole was dressed and I was told to contact him or the hospital if I had any issues. He stressed that I am not to be catheterised by my urethra unless it is done via camera and by someone with experience, and if not to just get an SPC, or, in case of emergencies, a large needle through my spc scar to aspirate urine if I can’t be catheterised. After shuddering at the thought of that I was all set to go and I was cleared to go back to Melbourne the next day.

My flight home was fine. I was a lot more mobile this time around compared to how I was post stage 1, and although I was taking it easy travelling didn’t completely wipe me like it did last time. I had some panadol just to manage my pain during the trip, but I don’t think I really needed it. I was feeling pretty back to normal now at 4 weeks post op, and boy was I glad to be home. I spent a few days relaxing, and then started back into GAMSAT study which took up the majority of my time.

The GAMSAT was last week, I was 6 weeks post op. For those unfamiliar, it is an exam you need to take to apply for most postgraduate medicine programs and consists of 3 sections that total about 5.5 hours. It’s a mammoth of a day for anyone, let alone someone who had a 6 hour surgery not even 2 months prior. I was feeling pretty back to normal luckily, and I think it went okay…but I’ll find out in November. I applied for accommodations before surgery as I was unsure how I’d be feeling post op, and so I was allowed to bring some pain meds in just in case, as well as a pillow to sit on. Apparently this was a strange request as when I entered the room the lady went “Oh! You’re the pillow man!” lol. I was actually seated in a separate section to the other people sitting the exam due to my accommodations, which was nice as it meant the whole process was smoother and there was less waiting around which I think was good for my body as I was getting a little sore towards the end. I’m just glad it’s all over now!That is about it for my general update, now I’m going to go specifically into how the different wounds/sections travelled and how I managed the healing. I have my next post op in mid October, so I’ll do another update then. I have a date booked for stage 3 for early next year, but at the moment it isn’t confirmed so I’ll find out at my post op if we are all good to go ahead then, so fingers crossed 🤞

GLANS

At this point, I would say my glans is fully healed. I am very happy with the shape and how it looks, it looks better than I could imagine. The scar underneath the corona looks just like a circumcision scar, which has made me feel a lot better about the general look of my penis. So far it hasn’t flattened, but I am going to keep an eye on it. As for the progression of healing, it changed quite a bit. For the first week and a half it was pretty uneventful, and I just had combine dressings on it to keep everything in place. Eventually the glans started to bleed and ooze quite a bit and so I was having to change it more frequently, so I started using gauze on my glans, wrapping it around the incisions and taping it in place. I would change this every day, and use saline-soaked gauze on the wound for about 15 minutes every morning before redressing it to keep it clean as per Goossen’s recommendation. It was pretty sloughy and gross for about 3 weeks, but started settling around the 4 week mark. Eventually I didn’t need gauze anymore and it looked pretty much healed. I occasionally use a little bit of fixomul on the glans, two strips on either side to hold it back so it heals raised, but I stopped doing that as I didn’t really like having to take it off and at this point it doesn’t look necessary. I had a little area that took a little longer to heal, and that formed a bit of a scab. I just left it be and eventually it fell off. This has left s little divot in my glans, but it’s pretty subtle and not really noticeable. I’m super super happy with how it all looks, aesthetically it looks better than I could have dreamed!

SCROTUM AND VAGINECTOMY SITE

I’ll start with my vaginectomy site, which has honestly been the easiest part of recovery. I’ve had no issues at all with the healing of this, it all healed well and all the stitches dissolved no problem. The amount of relief this has given has been huge for me, knowing it’s gone makes me feel so much more at peace. Nothing really to say though as it was pretty uneventful and healed as well as one could hope, with no complications or issues.

My scrotum has taken its time to heal, and this has been the longest process of the whole surgery. Because of the shape of the wound, it’s very hard to actually manage, as you can’t really stick things in place or anything. I had quite a bit of ooze coming from a small hole behind my scrotum, which I just used some gauze on and changed when needed. I also had some ooze coming from the seam line where my scrotum joins in the middle, which I also used gauze for. I would salt bath both wounds for 15-20 minutes a day after my shower and I definitely think that helped. By week 5 most of the ooze was gone, and I felt a lot more comfortable. The hole behind my scrotum is now completely gone, and the seamline looks normal.

The look of my scrotum isn’t pretty, and honestly it looks a little strange without any implants. It’s kinda shrivelled and deflated, but I know implants will improve its look significantly. The right side is quite a bit larger than the left, as the left had some tissue removed in stage 1, but over time this has settled and it looks a lot more even now. I think it’s important to mention this because there is very minimal info regarding the actual scrotoplasty aspect of phallo.

Right after surgery, the scrotum was looking pretty small and Goossen was concerned about me potentially needing tissue expanders to create enough room to accommodate the implant and pump- but since healing I think it has actually descended rather than retracted as we expected. The scrotum looks quite a bit larger now since I last saw him, and I think shouldn’t pose an issue for implants, but I’m not a surgeon so we shall see in October. I’m crossing my fingers that we will be okay to go ahead with stage 3 as planned, as if I need another op before stage 3 it would throw out my timing quite significantly...so we shall see. If it needs to be done it needs to be done, but I’m hoping that it will be fine to proceed without them.

URINATION

The part I was most concerned about of this whole surgery experience was no doubt my urethral lengthening- as this is where most complications typically stem from. I have been super lucky, and haven’t had any issues from the day I could stand to pee. Having the catheter was irritating, but it was so worth it for this result. I am so much more comfortable now and because of this, I’m drinking so much more water! I used to avoid drinking so I wouldn’t have to go to the bathroom because having to think about what I had in my pants stressed me out. Now that that’s not an issue I’m so hydrated. It’s great. I’m still stressing that something is going to go wrong, but there is no reason to. My stream is super strong and nice and straight and hasn’t changed at all. I don’t feel pain or irritation which is good, but the fear is still there and probably will still be there until I’m further down the line.

The sensation of peeing is weird. I can feel it in my natal urethra, and then it going through the bend where the new urethra and my natal urethra join, and then nothing. Because of this, it took a long time for me to not feel like I was just going to pee on the floor as it feels like it is exiting where it used to. I also was quite paranoid I was leaking because of this, even though I had no fistula or any reason to be stressed about it. This took a few weeks to get used to but wasn’t really something I saw discussed pre op. I can feel the urine through my urethra when I hold my penis as it makes it feel stiffer which is super cool.

My number one tip for if you’re having a catheter or just in general for this stage is to drink. Drink as much as you can and then drink more- it helped with the bladder spasms, it helped with the pain and with a catheter especially it’s important to keep things dilute. I had my 2L bottle with me that I took everywhere and I made sure to drink at least that entire thing every day and it made a huge difference, as once I forgot and the bladder pains and stinging was a lot worse. Drinking so much water during my recovery really got me into the habit and I’m really glad about it as it was definitely something I didn’t do as much as I should, and I feel better for it.

I had a bit of issue with post void dripping for a  few weeks, and I combatted this by using a bit of gauze or toilet paper on the end of my penis to catch any remaining drips.  I noticed this improved heaps at 5 weeks post op, as a lot of the swelling went down and it is easier to milk the urethra. I haven't had any issues with dripping since then really, which is good as it was getting kind of frustrating.

MISCELLANEOUS

My incision from where the full thickness graft was taken for my glansplasty is healing well. Pretty uneventful. I put fixomul on it when I can be bothered, but due to its location it doesn’t seem to stretch much anyway and so this may be overkill. My SPC site is closed over, but at this stage is still kinda scabby. I’m just letting it be, it’ll heal in time. Pics of both are attached.

Since stage 2 I’ve noticed an increase in hair growth on my penis, probably due to the increased blood flow to the area. Although it’s a lot better since my electrolysis, this is still super disappointing. Part of me wants to wait until after stage 3 to continue with it as I’m not too keen to put all the time and money into it just to have it all grow back again. For the time being I’m just trimming it and I’ll make more of a decision later.

As I’ve mentioned, I had burial of my original genitals this stage- and since this sexually I feel a lot more comfortable. I am able to tell where it is located at the base of my penis, but honestly I don’t need to find it as just using my penis is enough. I haven’t lost the ability to orgasm, nothing really feels different in terms of the feeling compared to pre burial, just that now I’m not super dysphoric after. That’s all I’ll say about that as it’s pretty personal, but we are all good in that department lol.

Emotionally I feel great, being able to stand to pee has been huge for my dysphoria and I feel awesome about it. I’ve used urinals without issue, and it’s so nice not stressing about an STP failing or there not being any stalls. I also feel a lot more comfortable now that the vaginectomy is done as I still had a lot of dysphoria relating to those parts, so it feels like a weight has been lifted off me. As much as the first few days were awful, recovery for this stage has been a lot less stressful and I’ve been able to bounce back pretty quickly. I’m looking forward to my final stage and for this chapter to be over. As always, let me know if you have any questions, my inbox is always open as well if you want to ask something privately. Hope the past few weeks have been treating you all well!