#transman phalloplasty education blog

[answersfromzestual]

Hi! I was wondering if it is possible to have abdominal phalloplasty and have a urethra hook up?(I think that’s the right term for it)

I’ve seen different things about it so I wasn’t sure if it was just one type that works/doesn’t or if it’s specific surgeons that do/don’t

It is possible to have I believe the new coined term now is "Urethroplasty", which it used to be and still can be called "Urethra Lengthening" Procedure. So you're right. I've seen articles use both terms.

So actually there are two different kinds of terms. (according to my research)

Let's get into it now.

The first procedure to lengthen your urethra (Urethroplasty) is called radial artery urethroplasty, this is where they use a piece tissue from a more sensitive body parts such as your forearm or leg to create the Urethra (they make the skin into a small tube). They do not take near as much skin from a graft site to make the urethra, however I have not seen images of these scars. This process however gives you the ability to feel sensation from the base to the tip, instead of only towards the bottom of the shaft and base. They do say that using the tissue on your forearm in general will produce the most tactile function, and having more sensations.

The other procedure is the same as the graft sites (general term I use) typical phalloplasty. They use extra tissue from the area to create the urethra. This does not help with adding sensation, you would still only have tactile feeling around the base and bottom of your shaft.

It is hard to get exact specifications about the typical urethraplasty and abdominal phalloplasty. I've also found contradictory articles. So I feel this may be very much a surgeon's preference of what they are willing to perform.

I am not sure which surgeons include abdominal phalloplasty in their procedures. This may be something you may have to narrow down some choices and contact the clinics and see what procedures the doctor performs and if they can't help you do they know another professional who would. Clinics are awesome resources to get what you need to know. Sometimes you need a professional to clear up what is on the internet as well. As far as my experience with contacting clinics it has actually always been pleasant. Don't be afraid, and don't feel pressured. I have never been pressured for making a consult or anything with clinics.

Here is an article I have previously used in my abdominal phalloplasty research. This does feature Doctor Daniel Freet.

Here is a list of surgeons who perform phalloplasty

I found one list here

Here is another list this features surgeons all over the USA

I hope I helped a little more.

If you need me, I'm just an ask away

Stay Golden ✌🏽💙❤️

Zestual

[answersfromzestual]

So is the whole "phallo is EXTREMELY dangerous and riskier than heart surgery" shit untrue too..I really hope it is...

Oh yeah, it’s absolutely a crock of shit.

Listen, any time you go under general anesthesia is risky, and the longer you’re under, the more risks there are. So a surgery that takes 6-8 hours, no matter what it is, is going to be potentially dangerous.

But it’s important to know that a risk being present doesn’t make it LIKELY. You take at least as much risk driving to the grocery store as you would having phalloplasty—and if lightning strikes and something life-threatening DOES happen to you on the road, you’re not going to have an entire team of highly-trained, well-equipped medical personnel literally standing over you seeing to your wellbeing when it happens.

The single most important thing that gets considered when deciding if a patient needs surgery is whether the potential risks are outweighed by the benefits. I think the fact a 2020 study found that 59% of trans men were under the impression that bottom surgery is “too risky” but 97% of those who’ve had radial arm flap phalloplasty report full satisfaction with the results says a lot, don’t you? (Source)

[transistus]

An Introduction: From Coming Out to Phalloplasty in Less Than Five Years

[Trigger Warning: Mentions depression, self harm, suicide, and death]

Hello, Tumblr!

I’d like to start this blog by writing a brief introduction about myself and my transition.

Let’s start with the basics: My name is Alastair and I’m a twenty-seven-year-old transman from the UK. I have an MA in Psychology (with a particular interest in mental health, sexuality, and gender) and am also a writer. 

On to my transition. I started suffering from gender dysphoria during my teens resulting in severe depression, self harm, and suicide attempts, though at the time I had no idea that there was even a word for what I was suffering from. I tried desperately to be a girl, to fit into the appropriate box, to keep my parents happy, etc, but it eventually became obvious that I couldn’t be something I wasn’t and I soon discovered the word ‘transgender’. 

I first came out as trans when I was twenty-one in late 2016 to my friends, my devoted long-time boyfriend (now current fiancé) and my then tentatively supportive though mostly bewildered parents. Since then, I have been on HRT since 2017, had top surgery, and recently had the first stage of RFF Phalloplasty. 

Things progressed rapidly from coming out to where I am now thanks to me being fortunate enough to have every stage of my transition done privately which is something I am eternally grateful for. I fully appreciate the fact that my circumstances are unusual among the transgender community, but I hope to share my experiences so I can potentially help and educate others. 

Now, as I said, I came out as transgender in 2016, and after a lot of debating, I finally settled on the name ‘Alastair’. My doctor attempted to put me on the NHS pathway to transition with no success, so I decided to seek out private treatment to access hormones as soon as possible which is how I came to meet Dr Stuart Lorimer. I made an appointment with him and was seen privately three months later, two months after my appointment I began taking Testogel on September 22 2017 (though I later changed to Nebido). 

In March 2018, after six months on HRT, I had another appointment with Dr Lorimer where I asked for a referral for top surgery with Mr Miles Berry. He agreed to refer me and I had my double incision mastectomy on the 30th of May that year. 

After top surgery, I set my sights on having RFF Phalloplasty one day, however, with my father’s attitude towards my transition (he tolerated it at best), I came to accept that there would be no way I would be able to have the surgeries done privately due to the cost of it all. Up until this point, I had paid out of my own pocket for my HRT and top surgery as although my parents were well off, my father was a miser about almost everything, especially when it came to anything gender-related. I knew I would have to wait until later in life to have phalloplasty through the NHS, provided I ever heard back from the clinic. 

Or so I thought at the time. 

In Janary 2019 my father was killed in an accident a mere month after coming to accept me as his son. My world was turned upside down, my depression worsened, and I suffered terribly from PTSD. However, sometimes, as my mother is fond of saying, ‘an ill wind can blow you a bit of good’, after all, once you’ve hit rock bottom the only way to go is up. My mother, who was living abroad after separating from my father, returned to England and insisted that I use some of my inheritance to have RFF Phalloplasty privately for the sake of my mental health (as at the time my lower dysphoria was atrocious and a cause of enormous distress), so I agreed to make an appointment with the surgeon.

Soon enough I found myself sitting down with Mr Christopher from The London Clinic discussing the surgery and I was eventually booked in for surgery on the 18th of February this year.

It was a seven and a half-hour long surgery and everything went well and I’ve thankfully not had any complications. Now, almost four months to the day later, I have healed ‘perfectly’ and can safely say for the first time in twelve years that I‘m no longer depressed.

So that’s the story so far, albeit the short version!

I hope that my future posts will be insightful to others and please know that I will always be happy to answer any questions you have regarding being transgender and transitioning!       

[answersfromzestual]

"Hi, I think some of your bottom surgery info might not be completely accurate. You've said that a hysterectomy (in an ftm context) also includes a removal of the ovaries, but the doctors I've talked to so far have all said that that step is optional (I asked about this because I want to have a hysterectomy, but keep my ovaries). "

- follower

Hysterectomy is removal of the uterus, oophorectomy is removal of the ovaries. If I posted that they were both the same, I apologize they are not.

I may have misworded something. Can you give me a post link? Please? I'll correct it. But you are correct, a hysterectomy is just the uterus.

(I did not want to post the actual ask, so asker can you please send me another ask with a link to the article(s) that are incorrect? Thank you. I'm sorry if I caused you any stress.

[answersfromzestual]

Improved Blog Directory - Find what you need

BLOG RULES: PLEASE READ

Educational Article on the Phalloplasty Surgical Procedure -self written

Beginning testosterone, testosterone hormone therapy - Article on HRT

How to choose clothing/shoe sizes during transition - clothing on smaller feet and frames

Formal Wear - how to dress formally during transition.

Need to speak to someone? Do you need help with your legal name change? Please click here. Translifeline.org

USA Safe States for Trans-People (Constantly Updated by the website Owner)

What to Update After Legal Name Change

Hormone Replacement Therapy (HRT) Testosterone - storage, travel, and injection advice

Facial Hair Information- Tips and Tricks on How to Shave (HRT)

Frequently Asked Questions about Phalloplasty - My [personal] Experiences

How can one ejaculate after phalloplasty procedure? -ask answered.

Common Phalloplasty Misconceptions- Article

Male Mannerisms- help to know male gestures, wording, and attitude- (ask)

Testosterone Experiences That Caught Me Off Guard - (Ask)

Safe Binding and Packing - Articles Purchase Sites Also

Staying Stealth During Surgeries, Explaing Scarring - advice (ask)

Top Surgery (both ftm & mtf), procedures, and approximate costs.

Can I have top surgery and be overweight?

Keyhole Top Surgery Procdure- Outline and what qualifies you as a potential candidate

Finding a Top Surgeron in North America

So You Just Had Surgery (Top)- Advice on the best way to heal after surgery/ minimize scarring.

Is more time on the operating table really better? Operating time and infection information.

Metoidioplasty FAQ

My arm and upper thigh after about a decade after phalloplasty.

My Personal Surgeon and Their Clinic

Interview with Dr. Chen about Bottom Surgery

Penile/ Phalloplasty Erectile Devices

Expectations- Personal Advice on Setting Expectations

Urethra lengthening Procedure Information- Self written article.

Importance of Uriologist

Phalloplasty Website - Includes Parents Guide

Urethra Lengthening Procedure

General Surgical Risks

Plus Sized Surgery Risks

List of Phalloplasty Surgerons in the USA

Vaginal-Perservering Phalloplasty Procedure

Graft SiteCare for Forearm -Free Flap Phalloplasty

What Happens if Erectile Device Breaks?

Image of My Phalloplasty (wearing underwear) Educational Purposes Only

Phalloplasty Procedure Outline by GRS Montreal - (Link to Webpage)

First Ever Phalloplasty Procedure - Surgeon

Michael Dillon- Trans Pioneer (First phalloplasty patient)

How to Find Proper Sources of Information in a World of False Information/ Online Safety

Why certain terms can be hurtful. Please respect my/others views.

Tattooing over your forearm skin graft -ask

Testosterone and Hair Loss Information

If there are any other posts/ other topics I should add to this directory, please send me an ask. I will never post your username without your expressed consent in the ask.

[answersfromzestual]

Leaving this here because sometimes we need to hear nice things.

trans people i’m happy you’re alive!!!!!!!!!!!!!!! i’m so glad you’re here!!!!!!!!!!!!!!!!! keep doing your best!!!!!!!!!!!!!! i love you!!!!!!!!!!!!!!!!!!!

[answersfromzestual]

Please Reblog this Post Trans Community and Allies.

I am Zestual (some know me as Shadow), and I run a blog for female to male transition and have for almost four years now.

A little about me I am a retired social worker and addictions counsellor. I have completed all surgeries (last one was just over a decade ago). I've had chest surgery, I've had phalloplasy. I actually enjoy sleuthing the internet for proper information to inform the community that phalloplasty is not bad, and not nearly as risky as many say. As long as you take care of yourself pre and post op you will have a phallis that you've dreamed of.

This includes hormone treatments, top surgeries, metoidioplasty, phalloplasty, and much much more.

If you are looking for a resource that only uses reputable sources and is a source of unbiased information on transition.

Here is the blog directory:

https://www.tumblr.com/answersfromzestual/748974533324800000/improved-blog-directory-find-what-you-need?source=share

Feel free to ask question, send in concerns or questions. I welcome all blog related questions, comments, and concerns.

-Zestual

[answersfromzestual]

***Educational Purposes Only***

Normal questions for phallo (my personal experience, and facts)

"Do you feel anything?" - yes, I feel everything from touch, stroking, temperature, pain, pressure, pleasure, gusts of cold air. They do disconnect and reconnect nerves, so it does take time (years) depending on how you heal to have complete sensation. But you always have sensation there even beforr you are fully healed. I found the Urethral Lengthening Procedure and the Implants (erectile device and prothetic testicle). It took probably 3 years after all of the procedures for me to have what is called "complete tactile function".

"How do you get erect?" - it's a pump, after they create the scrotum (they use the labia for this), you get your pump installed into your main hand side (ex. My pump is on the right testie), and the other testie is just an implant. I squeeze my pump (or my partner), and then saline water is pumped from the testicle into two tubes (one on each side on my penis). Creating a natural looking erection besides having to pump. It only takes about six pumps for me. Doesn't take much effort. I have a three part inflatable device.

"How do you "deflate"/ go down after an erection" -on the testie that is the pump, there is a small button above it, it is actually kind of a small box with a button on it. I hold the button for about 15 seconds and just let my erection naturally go down.

"How many surgeries does it take?" - well, I guess four in total. You have your hysterectomy (which included for me a complete oophorectomy as well, recent advancements in this procedure have made it so an oophorectomy is now optional), then your phalloplasty the building and attaching of the phallis and vaginectomy only at this part. The next surgery was to connect my urethral, called urethra lengthening. The last surgery was to install the penile pump and testicular implant.

"What are the chances it will fall off?" - less than 1% in the hands of a skilled surgeon. (My surgeon told me this information as the source) - note post operative care is the most important part of healing properly.

"Where did they take the skin?" - they took the skin for my phallis from my forearm and used a thin layer of the skin on my upper thigh to cover the tissue left exposed on my arm.

"Do you have any issues today?" - No issues, I've been finished for quite a bit now. I enjoy sex, it feels good. It looks good. I've never been clocked even naked in a locker room. I do dribble sometimes if I hurry while urinating, and I have to use a special technique to ensure 100% emptiness, but I can pee just fine. I found the installation of the pump helps me urinate easier than without.

"Can you ejaculate?" - Yup! I can, at least. I also have pre-ejaculate. I ejaculate almost everytime I orgasm. (With this said, the ability to ejaculate, amount of, and frequency of are all variable factors that can depend on person to person)

"Is the orgasm different?" -yes! It feels better to me. It could be comfort, but ejaculating does feel good when you orgasm. Ejaculating can vary from person to person. This ejacuate is not like cis men's, it is a clear fluid from the Skenes Glands.

"Did you have any major issues?" - not really, I did have to see a wound clinic for my implant surgery. I had wounds that needed care. I got a bladder infection with the catheter during the healing stage of urethral lengthening and had it removed after just over two weeks (it was supposed to be in for six weeks), as a reference though one of my urine bags broke and I had a plastic baggie to try to repair it until I could get a replacement (i had to wait hours), I also have a compromised immune system. For my arm, I wore my compression sleeve 100% of the time, and my arm healed extremely well and flat. You just need to listen to the rules and be sure not to break them.

"Do you have to do anything (e.g weekly)?" - sorta, I have to make sure I pump fully once a week.

"Any issues urinating?" - nope, takes some getting used to, though (standing). I find that I dribble, but it's only when I'm rushing when I shake. I still sit most of the time, it's even very common in cis men as an FYI. (I asked a large group of cismen)

"Does it look real?" -Yes, my wife said she never would have known I was trans until I told her. All penises look different. Even getting an erection looks natural.

"Did you have any corrective surgeries?" -No, I got pretty great results the first time. I do plan on going to closer, regular plastic surgeon to put in a larger implant as my left testicle (non-pumping side).

Have any of your own questions? Send me an ask, I'll be happy to answer!

Stay Golden Everyone ✌️💙💜

[answersfromzestual]

what does a tdick like... actually look like? or how they behave post-testoterone and pre-surgery? I haven't really been able to find like anything educational about how they work- what the look like, how they differ from other genitalia during sex and/or arousal, any of that stuff. I'd really appreciate it if you could explain it?

Bottom Growth or T-Dick Info:

For educational purposes only

I will be calling a "T-dick" a "T-phallus" in this answer.

I highly suggest all read through my second source, it is very informative about growth, sensations, and also has some good general knowledge as well.

Clitoral hypertrophy: the clitoris growing in length and width while taking testosterone.

So a t-phallus very much looks like the head of a penis, the shape, the contours, it just doesn't have a hole for urination like a penis or a shaft especially when you are aroused. A t-phallus gets erect when you are aroused just like a penis. It is considered the pleasure organ.

During arousal (turned on), it actually swells up and fills with blood, becoming erect and more stiff (hard)

While your t-phallus gets bigger on testosterone many people describe their changes in their orgasms and pleasurable feeling. For example you may like a different kind of touch now because that feels more pleasurable. "Some people describe feeling a more erection-like sensation when aroused." - source 2

Typical bottom growth on testosterone therapy is typically 1 to 4 cm, sometimes even more, this growth varies. One small study¹ about bottom surgery reported the average length of bottom growth measured from 2.5 cm to 4 cm in the study participants who eventually underwent surgery. Another study² found that at the one year mark, the average growth was 4.6 cm.

During sexual intercourse with someone with female genitalia: will require you to use a dental dam as protection (dental dam information), this is just basically a sheet of latex or another kind of plastic (like male condoms), to prevent direct contact. You don't not just need to use one during oral sex but if you are rubbing your genitals together it may be a good idea. If you are sharing toys make sure to clean them thoroughly between using it on the opposite person. (Making sure sex toys are clean is always a good idea).

If you are having sexual intercourse with cis males/ male genitalia: you should be requiring that person to wear a condom, even if they are trans themselves, any bodily fluid contact can spread a STI. Or you can use female condoms.

Here are some articles on sexual health.

Sexual health article 1

Sexual health article 2

Below are example images of a t-phallus and growth:

Source²

Source²

- a more realistic view.

You can see that there is a tip that gets slightly thinner with the connective tissues. So you have a head of a penis to put it very generally and your 'shaft' is almost buried in the connective tissue/ hood (which I used to call my 'foreskin', it made me feel more comfortable.

Sources, Images, and Studies

Source 1

Source 2

Medical Study¹ -PDF

Medical Study²

Fun facts: We all are actually considered to have female genitalia in the womb until about the second trimester of pregnancy, then your body gets a flood of either estrogen (X) or testosterone (Y), which is what tells your body to form the genitals. This is actually interesting because it shows that the clitoris is actually a tiny penis in a way, since it actually does become a penis as a fetus develops. - I learned this in my child development class.

[answersfromzestual]

All bank stuff (loans, debit cards, morgages, rent, debt, etc.)

Email name tag

Car registration

Organizations you participate in

Your resume

Make sure your references are all aware of your name change

Any contract you are in (ex. You finaced outside of a bank such as a furniture place), if this applies

If you have children, their school contact information and make them also aware

Google/apple/Samsung information

Any warranties you have issued (let's say you have a 10 year on your laptop for ex)

things to update after a legal name change!

Social security card

Driver’s license

Passport

Birth certificate

Employer HR

Bank account

Credit card company

Car insurance

Health insurance

Utilities

Cell phone account

Voter registration

Your school

Professional organizations (for nursing, bar, teaching, etc.)

Doctor’s office & other health specialists

TV & internet

Paypal

*Please add to this list if you can think of anything else!!!

[answersfromzestual]

Phalloplasty Procedure Full Outline Offical (Radical Free Flap Procedure)

What is phalloplasty/ phallo?

Phalloplasty - "includes several surgical procedures that aim to construct male genitalia that looks as natural as possible. The surgery is divided into several steps that may vary from patient to patient. Generally, they are the three following steps" (Source1) . We aren't going to count if the prerequisite of hysterectomy. Since my surgical procedure, they have removed the requisite of an oophorectomy, that procedure is now optional thanks to the always advancing technology.

The first step:

a surgery that consists of creating a penis from a skin flap from a specific area of your body (most common areas are forearm and lower back) of the body that you would chat about with the surgeon(s) and that specific skin will be grafted to the genital area.

The second step:

Here, surgeons construct the urethra that will llow urination. This is known as Urethra Lengthening (often referred to UL) (Urethra Lengthening Procedure Post)

The third step:

At this stage, you will receive testicular and erectile implants that will allow for penetrative sex. Note: this is not the only type of phalloplasty sugerical options.

The first surgical step consists of:

the creation of a penis or phallus from a skin flap and fatty tissue of the donorn site involving the removal of blood vessels (to create a blood supply) and nerves (this is where nerves are disconnected and reconnected, which can take some time to gain full tactile function or feeling. This skin will be grafted to the genital area where a penis would naturally sit on your body. The next part of the procedure is:

"the burial of the clitoris at the base of the phallus;

the creation of the penile urethra within the phallus;

the lengthening of the biological urethra;

the creation of the glans;

the creation of the scrotum;

the closing of the vaginal cavity; and

the removal of a layer of skin from the thigh to compensate for tissue loss

on the donor arm." - (Source1) Some of these things are not the same for every surgeon, be sure to ask about if your clitoris could be not buried for example, or different pumping systems, varying styles in surgerical procedures from clinic to clinic, even surgeon to surgeon.

The second step consists of the construction of the urethra:

This procedure connects the penile urethra so the part of the urethra inside the phallus itself to your biological urethra that was elongated in the first step of the phalloplasty surgical procedure. The connection of the urethra is made by creating a tube from the skin of the scrotum between the openings of both parts of the urethra.

Note that the anatomical makeup of the phallus is composed of only skin, fatty tissue, blood vessels, and nerves.

It does not contain any muscles or a sphincter (a muscle that opens and closes like your butt does aka "the breakwall"), which means that after the second step, you may have to empty your urine either temporarily or permanently manually from the portion of the phallus by applying pressure to the phallus. (UL Article)

A minimum of a six month waiting period is necessary between this and the next stage planning.

Permanent hair removal from the area that will be used to construct the urethra is also required to avoid complications (unless during the consult the doctor states otherwise). Note that it is impossible to determine in advance which area will be depilated since it must be evaluated after Step one. It is at this time that you will receive information about hair removal,

The third step:

Involves insertion of implants (erectile device and testicular implants).

This procedure will allow you to be able to get an erection in your penis (phallus) and now you have the ability of penetrative sex. Erectile Devcies Post

You will have to wait a minimum of three to six months after the second step (healing and surgeon(s) pending) and have no urinary problems before planning the third step. If complications do come up, they will have to be completely treated and healed before the implant surgery can be performed.

"Depending on the surgeon's assessment, the second and third steps may be reversed." (Source1)

Everyone has to decide whether to undergo one, two, or all three steps. Meaning you can stop after any phase/step of the three)

This choice is super personal and must be made according to what you need, your expectations of the outcome, and the impact it has on your daily life.

There are a few factors that may influence your decisions, such as wanting to urinate while standing, the desire to have penetrative sex, having more masculine genitalia, etc.

The estimated time to complete all three stages of phalloplasty can vary from two to three years, including the waiting I'm between surgeries.

These results may vary according to the age, weight, quality, and elasticity of the skin at the donor site, the scarring process, lifestyle habits and the overall health of the patients, healing, how well you take care of yourself, etc. The radial forearm free-flap technique is shown to produce the best results from bottom masculinizing surgery options.

Mandatory Prerequisites for Phalloplasty:

Hysterectomy with removal of the cervix done minimum six months before the phalloplasty procedure. *There are two options for this: removing the uterus only (called "total hysterectomy"), or option two removing the uterus, fallopian tubes, and the ovaries, also called "total hysterectomy with salpingo-oophorectomy"*

Permanent hair removal (second step when recommended to start). The recommended options are laser hair removal or electrolysis, which may be more beneficial for results. from the area of the phallus donor site to prevent complications with hair growth (fistuals), which can cause issues such as infection and even surgerical intervention to fix the issue area(s). Surgeons typically like to see the graft site not have any hair growth for a minimum of three months.

Talk to your primary physician and/or gynecologist to help you make an informed decision about your choice on the type of hysterectomy you get.

And talk to your surgeon and your primary doctor about which option of hair removal is better suited if one is not insisted on you using it.

A vaginectomy can be removed since only 2 cm will be used for the phallus.

Body Mass Index (BMI)

Before phalloplasty can be performed, it is important to know that you must have a healthy weight or have a BMI under 30, and you can not have excessive fat accumulation in your abdominal area.

"Being overweight and abdominal fat can compromise the connection of blood vessels during the procedure and lead to significant surgical complications.

If your BMI is 31 or higher you be most likely required to lose weight before the surgeon will perform the procedure.

Patients with a high BMI also have a decreased potential for healing and decreased satisfaction with surgical results." - (Source1)

Source List:

Source1 -GRS Montreal,Quebec, Canada - downloadable PDF -used as the direct quotes and most of the information

John Hopkins Hospital - used for an information source. -https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/phalloplasty-for-gender-affirmation

Cleveland Clinic -an information source (I barely used this)- https://my.clevelandclinic.org/health/treatments/21585-phalloplasty

Article- Self written on Urethra Lengthening Procedure

Article- Self Written - Erectile Devices Available

[answersfromzestual]

For those of you on hormones replacement treatment (HRT) Testosterone;

a shaving kit makes a great and natural way to store and travel (where legal) with your testosterone. Going to a friend's house? Bam, it's natural to have a shaving kit. Or I found emptying out the hard case of a set of old hair clippers. If you carry needles and you are stowing your needles, I recommend using a hard case of some sort. I've had the airline break my syringes/ needles before, and when you have to ask a pharmacy that doesn't know, they may be hesitant to give you any needles without knowing the medication you are on.

Do research on where you are going if leaving the country, make sure you have what you need (if you can) to be able to have legal possession in that country and any other country where you may stop or another potential area to explore.

Keep yourself safe, it's always good to keep a note from the doctor and your prescription history.

If you, for some reason do no longer have your testosterone, missing a dose or two will not cause any issues (I was told this by my family doctor).

Also, it's a good idea to perhaps take your vial and put it safely in a carry-on. They will not let you take your syringes (if they have needles attached, they will not let these on your carry-on).

It's good to have a hard case for long distance travels, otherwise a shaving bag works well. Find a more padded one if you can, and that closes securely.

I like to keep all my things together (Needles, testosterone, alcohol/alcohol wipes, and cotton balls/pads.) So that if you ever need to leave in a hurry you have to only go to one place and grab one thing.

I try to buy syringes with needles by the box. They cost me about $0.25 each and I get 100 in a box, all for $25.

It is also important to get a proper sharps disposal. You can usually ask the pharmacy and they will give you one. (In Canada I believe they are free).

About injection,

Unless instructed how to properly by a health care professional, I would not use your thigh for intermuscular injection. A great place, and the least painful I have found is in your gluteal muscles. It is important to rotate injection sites/sides. Give the muscles a break, especially if you need a dose weekly like I do.

Try to get air out before injection

Make sure you pull back the plunger to make sure you do not inject into a vein. If you pull the plunger and you see blood, do not inject. Find another location.

Do not use a needle more than once if possible (during a single injection, you can use attempt a few times), try to get it right the first poke, and it will hurt less.

The more a needle is used, the more it actually starts to spur at the tip, which means it's going to be harder to poke yourself, and it can be more painful

Do not share needles

Dispose of your needles properly by using a sharps container. Return it to the pharmacy when finished and they should give you a free exchange for a new one.

Do not throw needles out in the trash even with the cap on it can still be dangerous. I've personally seen (had) a needle peirce through the cap, have gotten stabbed.

Try to minimize air bubbles in the needle. But if you are scared of air bubbles. My cousin is a nurse practitioner, and she told me that it takes a lot more air than that empty syringe can hold to cause an embolism. But it is still important to minimize bubbles just to be easier on your body and help better absorption. So, a couple of tiny little bubbles are okay.

Make sure you are using a sterile area to place your things.

Make sure your hands are clean and sanitized.

Afterwards, press and slightly massage the injection site for at least 1 minute to help the testosterone absorb and to stop the bleeding.

The rule of thumb if you ever forget where to inject into your butox, upper and outer area of your gluteal muscle (so upper and outer buttcheeck).

Before you poke yourself, I find it helpful to press with your finger/alcohol pad and find a nice area, I usually do it as I apply the alcohol to sterilize the area. I find it helps me get it right the first time.

Any other questions? Let me know!

Do not inject yourself unless you have been properly taught how.

Do not fool around with your dose, more is NOT better

It may take a few years to fall into the safe/average hormone levels areas or what arrangement you have discussed with your prescribing physician.

Be careful! I am not a physican, always listen to the professional and be safe!

Stay Golden

✌️ 💙 💜

[answersfromzestual]

Can I have top surgery and be overweight? The Truth.

I am here to clear things about being overweight and top surgery (aka double mastectomy).

Can I have chest surgery if I am overweight? Blanket answer, yes you can.

HOWEVER, let's talk about some things first.

As soon as we peek under my blanket statement, most doctors will not want to touch you if you are too far outside their BMI index. Sounds like a preference, right? I mean, true, but they are a business and, like any other business, can refuse service for any reason. Especially when your life is in their hands.

The BMI index is followed to a degree by most plastic surgerons. This index is not to body shame you in this case. It is strictly for medical reasons. There are many medical reasons to refuse the surgery.

As you lay flat on your back, your own weight presses on your lungs and heart. This can actually cause damage your heart and lungs and also restrict your breathing even further.

Anesthesia issues are a lot deeper than most people realize. It is not just a harmless gas to keep you asleep. Anesthesia is poisonous to us, and it does more harm to your body the longer you are under its direct effect. Also, the more you weigh, the more they have to use. The best anesthesiologists in the world probably would have a hard time with this, especially depending on how long you can potentially be under. The more you weigh means more tissue they need to work with and extra time can mean complications not only while under the drug but can cause many complications after the procedure is done, and even when you wake up. Issues include headaches/migranes, intense nausea, vertigo like symptoms, having a hard time passing urine, lack of gross and fine motor functions, brain functions, paralysis, coma, and death.

Blood flow issues for people who are overweight are a real risk. The skin has stretched over time , and more skin, along with viable tissue, is thinner, with less of a blood supply being delivered to the skin and tissues itself.

Being overweight also means your skin is stretched and no longer has the same elasticity as if you were not overweight. This thin skin is easy to pull apart/tear.

Time in the operating room, more is not better. The longer you are being operated on, the more complications can occur during the procedure and during the healing process. (This is also a general risk)

Upping complications means more likely needing revisions. Plastic surgerons take this into consideration for your health. Insurance probably won't shell out for the same operation twice because of the views on transitioning lead to a lot of "this is just cosmetic."

Diabetes exponentially increases risk of infection and potential necrosis and gangrene (death of tissue).

You are a living canvas for the plastic surgeron(s), your results reflect highly on them. They want the best results for you, but they also have a reputation to upkeep.

If the surgeon gives a condition they consider reasonable and the patient does not produce results near their actual target BMI, which tends to be more liberal than the numbers that are thrown around, the surgeon can question the patients ability to be able to take care of themselves and adhere to the strict rules given for post operative care. A surgeon can also think "does this person want it bad enough if they can't do this request?". They may not say that out loud, but they may think it.

The heavier you are, the harder it is on your body to heal because the extra work your body needs to do to do daily tasks, let alone extra tasks yet also rest.

You do not realize how much and how often you use your chest muscles. Getting out of bed without being able to lift yourself up is really a thing. Using those muscles in some cases can cause rips and tears of stitches, tissues, and muscles.

Surgeons will give you realistic, cis-like results with your chest, this may mean you will not have a flat chest, they may perform more of a reduction than a double mastectomy. Surgeons will make your chest look proportional to your body, hence another surgery if you do lose weight.

Do they want you to have bad results? This is a physical correction to make a positive mental impact if you have bad results post-op. This may not really fulfill the function of procedures purpose to help you like your body.

Doctors want to know you want this surgery, so if they give you a time frame and you don't meet their goals, that's fair. You may have seen your day to day but the surgeron didn't and doesn't care. To them, you didn't meet their goals/ requirements. No surgeon wants to lose their job, role, or status.

Surgeons only want what's best for your health. It's not a shaming conspiracy, it's literally just biology.

Waiting sucks, we know. But what sucks more is that having bad results, you will have forever and potentially risking your life.

Source List:

Anesthesia 1

Anesthesia 2

Anesthesia 3

Anesthesia and Obesity

Surgery 1

Surgery 2

Post Op Risk

Minimal use of being overweight during a procedure personal experience.

P.s: I tried to use respectful and professional terms and wording. If anything is offensive, please let me know in my ask box, and I will fix it.

Stay Safe

Stay Golden Everyone ✌️ 💙 💜

[answersfromzestual]

Another person out there! Answered a different way as well. And a similar but different procedure. It gives you options and I like how he mentioned his previous bladder conditions to help clarify more and show that maybe if you have the same issues they should consider the risks as he has.

I'm sure he wouldn't mind a follow?

The options are great, and I would say, actually, numerous.

I like to see other trans men post op posting and letting others know it's not scary, but definitely has some risks depending on your health.

Thanks @twinfools for your post!

I would love if you wanted to submit more about your journey choosing not to lengthen your urethra and why you chose phalloplasty? And anything else you feel like sharing would also be great!

Stay Golden Everyone ✌️ 💙 💜

I’m 3 years post phalloplasty and I realized I’ve never really made a post about how things are going. Phalloplasty is a hard surgery to talk about because, bottom line, it’s not part of common conversation to talk about yo dick. That being said I think it’s really important for me to talk about this procedure to help break stigma and misinformation— both inside and outside of trans and non-binary communities.

I had ALT phalloplasty, glansplasty, scrotoplasty, no urethral lengthening (UL) with vaginectomy. This means that tissue from my thigh was used to create my penis, my urethra was not extended or moved (so I don’t stand to pee) and my vagina was closed. I feel like this detail is important because this is one of many variations for this procedure and what I opted for/out of were decisions made according to trade-offs between personal benefit and risk.

I opted out of UL because I do not tolerate catheters well and, due to my very active lifestyle, was not willing to risk longer term catheterization or bladder spasms which would impede my quality of life. This risk, for me, outweighed the benefit of standing to pee.

I opted for ALT knowing that I would likely need debulking (which I didn’t end up needing but opted for anyway out of preference). Debulking is a procedure to make the penis less girthy as ALT phalloplasty is more girthy because of the nature of tissue on the thigh. I chose ALT because, first and foremost, I did not want scarring on my forearm. My ALT scar is covered by clothing most of the time which I appreciate. I also chose ALT because I have skinny forearms, which wasn’t ideal for forearm phalloplasty (RFF).

Vaginectomy, for me, was a no brainer. I have never used or connected with that part of my body so I wanted it gone.

Glansplasty is a procedure to make the glans (head) of the penis and was a short procedure done after my initial stage of surgery. I may get it redone but I’m still undecided on that. Scrotoplasty creates a scrotum, I was ambivalent about this procedure but have grown to more appreciate it over time.

I am considering further surgeries: erectile implant (which creates the ability for the penis to “get hard”) and testicular implants (fills to scrotum with testicle implants). But I’m undecided and want a break from surgery while I finish my degree and focus on work. I’m also considering phalloplasty tattooing to help enhance the contour and coloring to make it appear more like a cis penis.

Whew! Lots of info, right? These are big procedures completed over multiple stages and are very unlike chest surgery, hysterectomy and other surgeries I had completed prior. When I was first considering this surgery I didn’t know there was flexibility in terms of tissue donor site and UL. I waited to have this surgery and am so happy I did because the information I gained from research and consulting with professionals and folks with lived experience was so valuable.

Was surgery hard? Yes. This surgery was the hardest thing I’ve ever been through. I’ve never been so uncomfortable for the first 2 weeks after recovering. I had to re-learn how to walk. I couldn’t sleep. Peeing hurt… but would I do it again? Yes. It was worth it for me but I can’t underscore enough that that doesn’t mean I didn’t have moments where I felt regret while recovering because post op depression is a thing and I was in pain while adjusting to a new body part that was also a healing surgical site… LOTS going on there!

3 years on I feel really at home in my body. Just having a penis is such a comfort to me in ways I didn’t anticipate. I’ve had a feeling my entire life that I was missing a body part and this was it. The quiet gender euphoria of just sitting and feeling my body and for once feeling complete in that is something that’s hard to articulate.

I’m thankfully back to full mobility and got back to full mobility about 3 months post op. I was grateful for this since a long term recovery wasn’t what I wanted. There are still weird twitches, pains and feelings, especially around my donor site (thigh) from time to time but nothing that inhibits me. Just interesting when it happens (usually when weather gets colder?).

What is one thing I would want to go back and tell myself before surgery? Well:

Your penis will feel HEAVY. Like it will fall off. It won’t fall off and your body will adjust to the weight in an area you didn’t have it before. Until then it will feel like you need to hold it at all times.

Hopefully this helps someone as an overview of what an experience with this procedure may look like. Again, my goal is to put information out there and have frank conversations— because it’s these same things that greatly benefitted me in my surgery journey.

Finally— my inbox is open for anyone that has questions. I am in a privileged position to feel safe talking about these things and I feel comfortable doing so. Not everyone does, so please don’t assume that this invitation applies to other folks who have accessed surgery unless they say so.

Thank you for reading :)

[answersfromzestual]

This is another header I have been working on,

I thought the quote was great.

"the more I hold myself close, and fully embrace who I am. The more I thrive." -Elliot Page.

[answersfromzestual]

question on phalloplasty: your FAQ post says it is possible, at least for you, to ejaculate post-surgery. I'm curious because I'd only seen people saying that it's not possible till seeing your post. how does it work?

There are two glands located on either side of the urethra (the tube where urine flows from the bladder to outside of your body). These glands are called the Skenes Gland.

When most of the surgeons I have looked up tend to [try to] save these glands, it does not necessarily mean everyone will ejaculate after their procedure. It depends on how active your Skenes Gland is in general.

It is a clear fluid, it is not the same as cis male ejaculate, it does not contain any sperm or semen.

An example of how active your gland is from what I understand how much fluid you excrete during times of intimacy. (Aka "wet").

I found a pretty decent article on the gland itself by the Cleveland Clinic here

I hope this helps answer your question.

If you have any more feel free to ask away!

Stay Golden Anon ✌️ 💙 💜