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Back to the Cutting Table: Journaling Through Genital Reassignment Surgery

As I write this paragraph, I have been back home since yesterday evening. I am sitting by my computer, perhaps a little less comfortable than usual. Still, you probably wouldn’t think that just a week ago I went under the knife for what came to be the most radical surgery I have had so far. The first time I had surgery, it was for facial feminization surgery. A week after deliberately having my skull broken, I was back to giving conferences. This time, I am much more constrained in energy and movements.

During the week following my surgery, I took detailed notes of my impressions and thoughts relating to surgery and the recovery process. The notes ended yesterday night, which is when I headed back to my parents’ place from the recovery centre. I will be here for the next few months, recuperating. Note-taking was a therapeutic exercise, as writing often is for me, of course. However, my primary intent in taking them was to lay out the humanity and messiness of the process. Prior to surgery, I gained insight into the ups and downs of surgery by seeing friends go through the experience. Few written sources were available and those that existed put their vaginoplasty on a pedestal. As someone who romanticises the messiness of everyday life more so than the divine, I hope to provide an alternative narrative. Never have I felt more human.

On the first day, there was surgery

The medication they gave me prior to surgery made me quite relaxed and prompted me to write many a silly Facebook post.

When you think about it, chop chop—as vaginoplasties are to be called from now on—is like a mini version of me transitioning. I transitioned and now it’s my penis’ turn to transition! I grew boobs so it’ll grow… lips? I can imagine a comic based on that, like Lady Penis goes into the doctor for a nip n’ tuck.

Although epidurals are uncomfortable, being awake during surgery is really not all bad since you’re relaxed and dozing in and out of consciousness. I had to ask to be sedated to sleep after the wonderful surgeon Bélanger asked the chatty anaesthesiologist and me to keep a bit more quiet. I’m sure others were also thinking “Oh my God, shut up.” It’s not scary at all, though, since sedatives leave you feeling relaxed, comfortable, and fully confident that everything is and will be fine.

People who speak of chop chop as though it’s the most life-changing event, as though your life will never be the same, as though you’ll be a new person annoy me. Yes, it’s chill, I know. That’s why I jumped through the dehumanizing hoops and accepted the pain. But we remain the same people. It does us a disservice to place too high an expectation on surgery. Perhaps I think this way because I see gendered bodily modifications as a form of creative transfiguration whereby I make my body mine rather than as a fundamental shift to my existence as an embodied mind.

The morning of, I had a “no-mo-penis” happy dance in front of the mirror at home. A dozen minutes before surgery, the last time I peed with a penis, I bade farewell to my floppy stick: “Goodbye friend, see you on the other side.”

My first thought when I woke up was that the sedation leaves me feeling rather well and mentally present compared to general anesthesia which I underwent for facial feminisation surgery a year ago.

The pain is rather intense—seven out of 10—but once painkillers kicked in it stabilised around three or four. The worst part was having to stand up—just once for today. Nonetheless, it is quite manageable. The best advice I was given is not to hesitate to ask for painkillers well before the pain gets too intense. Ironically, opiate injections—which are used for the first day before switching to pill form—hurt and leave a burning sensation behind for a few minutes. Perhaps the goal is to discourage asking for injections too often? Or it’s because many people are prone to vomiting which, despite eating without any problem, I did. Some purple liquid came out, dyed by the cranberry juice I had ingested earlier. Came suddenly and was gone just as quickly.

Being my usual self as soon as I got a bit warm I bared my right breast and told everyone it was to emulate classical paintings. In reality, I couldn’t bare the other because of the IV. The staff seems to appreciate my bad jokes.

My parents and partner Rowan visited. Them progenitors brought me flowers, which I’m so fucking gay for.

My Roboo brought me a little pink plushie dragon. I love them so much. I named it Liv. They use they and she pronouns, of a gender best described as “I’m a goddess I want nothing to do with your puny notions of gender.” In other words, just like me. They watch over me, protecting me with their dragon magic.

Since I’m awake and not hurting I like the company, but painkillers are making me drowsy. I need to rest.

Despite the pain, happiness is what has brought me the closest to tears today. I fell asleep thinking of that.

I was woken up around 10 p.m. for medication. The pain was at a manageable four—spiking only when I raise my torso—but my butthole itches. I feel like I need to pee but the catheter and bag are taking care of that. A numb sensation has begun to spread in my taint, almost like I need to poop. When I fall asleep, my mouth starts twitching as though I’m trying to suckle on something while my mouth is closed. Perhaps it’s my body’s way of saying I miss penises… but just in my mouth? My heels hurt from always being in the same position so I asked the staff for help and they brought me some padding to elevate my feet.

No, seriously, my butthole itches. I need a scratching stick. It was a great idea to bring earplugs, an eye-mask, and plushies.

Phantom penis, stop thinking you need to pee. You don’t. You have a catheter in. You don’t even exist anymore. Sheesh. Bodies aren’t the brightest bulbs in the bunch eh?

I’m sort of hungry now, as I write more inane posts on Facebook and Twitter at three in the morning. A penis-turned-vagina ought clearly be named a “pecunt,” pronounced like “pecan” with a “t,” with a forced, fake British accent.

On the second day, there was toplessness

I was woken up by the care team a little before 6 a.m. to have my bandages changed. Only one of them wasn’t immaculate and even then there was barely a tinge of yellow on an otherwise pristine bandage. Very little blood, with the drain having seen a drop over 5 mL for the whole night. We’ll see how things go, but I seem to be healing exceptionally well thus far.

I took to thinking about how fascinating it is to be on the patient side after having read countless studies on genital reassignment surgery and having worked on policy arguments as a jurist and bioethicist.

It feels a bit surreal that it’s done. When I woke up it took a second to remember and then another to believe it. It feels good. A heavy weight is off my shoulders after weeks of freaking out, amplified by my anxiety disorder. I didn’t expect to be so unambiguously happy. I really expected I’d have some mixed feelings. But nope. Then again, I’m known to have a certain fondness for pain…

Both doctors Bélanger and Brassard came to check in on me, asking me how I was and confirming that the surgery had gone flawlessly and without complication. Some bruises hurt if I touch my lower abdomen, though it doesn’t hurt much.

I can’t take stronger meds before breakfast without risking nausea so I’m trying to wait but it’s getting hard. A bit over half an hour to go and the pain is steadily increasing.

Breakfast was good—a iögo, some oatmeal, and some cranberry juice. We get to pick from a decent selection!

I did have to wait even longer to get my painkillers but it’s not so bad. I’m really not as funny now that I’m off of painkillers. Let’s hope those new ones kick in soon. 

Want to know what my favourite hospital song is? "No Scrubs."

I did a walk around the nurses’ post and it really pulled on one of my stitches and made me feel like I had a weight inside of my vagina that was pulling down. I compared it to a steel ball. Others said cobalt. I don’t think it really matters which metal the metaphorical ball is composed of. Afterward, we re-did my bandages and the nurse confided that in her seven years working at the surgical centre, she never saw this little bleeding.

There’s a bit of blood in the urine making my urine bag look like it’s filled with tasty, tasty old fashioned apple juice. Miam!

The food was surprisingly good for lunch. You can tell it’s not your average hospital food. My roommate and her family are really nice and funny. Very nerdy and very punny, just how I like them.

Pain is back and oxycodone isn’t working long enough so I’m going back on Dilaudid. Sitting up for lunch is what brought back the pain. Still manageable at around six out of ten. I have to wait another 20 minutes for the Dilaudid since I took oxycodone too recently. In the meantime, I’m cuddling Liv and Cuddles, my plushies.

You’ll be glad to learn that the dilaudid took effect. I’m well enough to take topless pics and trade nudes with a lovely cutie over Facebook. I’ve been topless all day due to my moral qualm with clothes. Nurses probably find me weird especially as I’ve proclaimed out loud that I dislike clothes and made them pass my IV through the arm hole to go fully topless, even though they have to pass it back in and out for walks.

Walking a second time in a day was quite a bit of hurties but I managed to walk twice around the nursing station. I powered through like a big girl.

I’m a bit sad because I don’t have a penis any more, putting me in the normal competitive market instead of being a hot, rare commodity to sugar daddies.

I can’t believe I just got my dick chopped off! This is so amazing, beautiful, and surreal. It is sublime in the full romantic sense of the term: it transcends our mere mortal affairs and makes them feel meaningless as though we are looking down from a high cliff at the murderous spikes straddled by water below. Yet at the same time it feels too messy to be sublime, too... human. Yet isn’t messiness sublime? Doesn’t humanity transcend itself?

I feel like my urethra is pulsating at the tip of my penis. It’s a peculiar sensation. I didn’t know I could fart on the painkillers but I farted twice in the last half hour, huh. My genitals are somewhat hurting and it’s quite unpleasant. Manageable though.

I just heard someone go “that’s what she said” in a valley girl accent through the door. Hah. I also keep farting.

I did three turns around the nurse post and it’s rapidly hurting less and less. The IV came out after dinner, which was rather tasty—chicken wrap with couscous. I’m regaining flexibility and am able to partly flex my legs in bed which is a nice change from being a plank. God knows I’m bad at being that straight.

On the third day, there was disbelief

I slept through the night, so I don’t have much to report. Can you believe I have a vulva and vagina? I still find it hard to believe, especially since I haven’t seen it. The most I saw was the bandage that’s stitched to my skin. It’s small enough to confirm that I no longer have a penis—because clearly, I can’t trust the doctors who said so. Just imagine if they had colluded to lie about having done surgery on me... It really would’ve been the biggest dick move.

I wonder if once I’m healed I’ll start having sex with cis men without telling them I’m trans. On one hand, it’s hard for me to hide I’m trans given that it’s all I talk about. On the other hand, it’s definitely easier that way for a quick fuck.

It took a bit longer than usual to get painkillers because the earlier nurse forgot I had asked for some. Drs Bélanger and Brassard came to say hi again. In a few hours, I’ll be heading to L’Asclépiade, where I’ll stay a week to recover. I’ll be more mobile there and slowly regain function. I can’t wait: my legs and back are killing me from being bedridden. I try to rest slightly more on my side to ease the discomfort but the position hurts and is only comfortable for so long.

I’m thinking about surgery and what it means. I feel like a statistic. I feel like I’m less trans. Maybe even a normie. But then I remember that article I saw published last week, Wonderfully Monstrous Bodies. This surgery makes me the messy human that I am and being human is all there is. Remember how you felt the first time you heard The Mountain Goats’ All Hail West Texas? That’s how human I feel.

Oh my god I have a vulva that’s so wholesome I want to cry. I can’t wait to see it!

Walking to the healing centre next door was intense and I’m proud of myself for walking up the stairs. I have my own room now which is lovely. It’s huge!

Yikes. After a bit of time in my room, a stinging sensation took over my crotch. I think the feeling of my urethra hurting is actually my clitoris hurting from being cut and shaped.

Just before leaving the hospital my roommate said she wanted to shave. I knowingly didn’t bring my razor. They’ll have to deal with my “fuck the cis” beard. When I moved to L’Asclepiade, the nurse called me “madame” so I corrected them. I don’t want to erase my non-binariness. Not today. Not here. Not where we have such a hard time being accepted, in this trans medical world. I don’t want to pretend I’m a woman. I’m not. I’m a gorgeous cyborg witch with flowers in her hair. I’m a glimpse at the essence of the sublime. Gender shall not constrain me... for I am Shehulk! Which explains why I couldn’t put on my socks without the nurse’s help. I’m clearly too ripped.

Holy moly removing the drain hurt. It wasn’t long but the first centimetre they take out is extremely painful. My right leg had a cramp which of course made me wonder if there’s something that went wrong with removing the drain. Maybe I’m bleeding internally… Or maybe it’s a leg cramp due to, you know, barely moving in the last few days.

I’m wearing a pad which is oddly validating though I’d probably find it more validating if the painkillers would kick in. I still have The Mountain Goats stuck in my head.

I went to pee all on my own, using the valve in the catheter, and it felt good. Since the catheter bag came out, I feel like a robot when I pee. “Evacuating waste material. Beep boop,” as the pee comes out of the tube as soon as I release the latch. Hot damn I just went and I already feel like peeing again.

I’m mostly back to normal psychological functioning give or take painkiller dizziness. I can’t wait to see my vulva. Chop chopped, away went the penis!

Lunch was good—big juicy wiener in my mouth—but sitting is ouch.

I wonder how my brain will remap my junk. Will the tip of my clit feel like the tip of my penis and the brain will just update the position or will it create a whole new location-feel for my clit? I bet my vagina looks like a really gross gaping hole right now.

My farts have turned into cramps, though I doubt I’ll poop right away given the medication I’ve been on… nevermind I did manage to poop. It felt so weird, too! My butthole is sore. The other patients will resent me for pooping so early.

On the fourth day, there was my sister

One of the new people at the recovery centre is really cute and I have a mini crush. I saw her on Tinder and super-liked her but she didn’t like me back. Oh well.

I’m eating nerds, which my partner brought me yesterday night. Cuddling was fun. I like cuddling.

Today was boring.

I’m sad I can’t shower until tomorrow—I counted the date wrong. The cast-slash-bandages are getting quite hard and it’s pulling on the stitching on my pubis. I can’t get a second dilaudid for another hour because they only let you complete your dose for one hour after you take the initial one if you only ask for one... So next time I’ll know to ask for two even if I don’t need them.

My sister visited and asked me about my vagina so that was a thing that happened. She drew butterflies on a sheet of paper. Later, my parents visited and my mother and I told off my father for not knowing the difference between vulva and vagina—is that what sisterhood and validation feels like?

The more the cast hardens the more I feel as though my penis is still there, barely just being grazed by the cast’s inside. Of course, I know it’s not, but it’s still a rather freaky feeling.

On the fifth day, there was a fanny (ice) pack

Didn’t sleep very well last night. The stitches are really starting to pull, causing a distracting pain. At least we’re taking a lot of it the sewn bandages off today. My vulva will probably look gross. It’ll be awesome.

“Good morning ladies,” at breakfast. Nah. Don’t. But they always call me Florence instead of Miss last name when giving my medication, which I appreciate. The message was received and registered the first time we had a conversation about me disliking “madam.”

It felt so weird having the bandages removed especially when they cut the stitches and it releases the skin but it’s really more fear than hurt. Now I have to ice my fanny for a quarter hour before I shower and finally see my monstrous vulva.

It was quite cool seeing the skin detach from the bandages and return to its natural position. I have, however, been called out for calling things like that cool and fun... Apparently, I have an unusually morbid fascination with messy bodies.

I just took a picture and sadly my coochie doesn’t look as gruesome as I’d hoped. My vulva is swollen—almost swole—but definitely not as disgusting as my morbid fascination hoped. The little hanging end of a condom poking through is hilarious, as though I had sex and forgot to take it out.

Finally showering was liberating. It weirdly didn’t hurt to touch down there. Now I get to really be myself: naked. Doctor’s orders!

I no longer have a penis, though I do have a peepee—the catheter. It’s like a robot penis! I had a small moment of sadness looking in the mirror after peeing. That little dick was cute as hell. RIP. This whole surgery thing is a lot of work, all because my penis wanted to hang out inside instead.

I can’t wait to have sex with a cishet guy and ask him: “Oh, babe, how does it feel fucking a penis with your penis?”

I napped and woke up to my heels hurting so I’m grumpy. Plus bathing was not as nice as showering. It hurt a bit from stretching the genitals and all.

I’m glad my parents didn’t visit long. After all their visits we don’t have much left to tell each other.

The stent is hurting me, pushing to get out and making the skin distended, ready to rupture. I can’t wait to have it out today but in the meantime, it is making it hard to sleep.

On the sixth day, there were no pogo sticks

Oh dear lord removing the stent felt so weird. It didn’t hurt but it was the most awkward feeling of pulling in my crotch, followed by an amazing sensation of freedom! That pogo was so big, holy moly. Can’t wait to get rammed by a dick—plastic or skin—of that size.

My happiness from the removal of the stent was tainted by this online trans group overtly defending islamophobia and threatening members with a ban for calling it out. Fuck that hypocritical noise. You can’t ask for equality for trans people while tolerating discrimination and hostility towards muslims. That’s not how it works. All humans deserve respect as a baseline and Muslim people have done nothing to deserve your hostility.

As for my vagina, it looks like a gaping hole so I don’t have much to report. Having the stent out gives me mixed feelings. Yay, I don’t hurt any more. Boo, now I have to dilate four times a day and wash my coochie every single time afterwards, eating up half my day. Dilating feels a lot like taking it up the ass, minus the fear of pooping everywhere. I don’t dislike it.

Yeah, just did my second run of dilating and I’m already annoyed.

I just want someone to lock me up in a closet while they make themselves food before coming back to use me. But no, I have to dilate 24/7 for the next three months.

After my fourth dilation, I took a sitting bath and a picture split into two, with each a different filter. There’s something I find really cool and human about those two pictures. One dark, one light, showing two sides of the same situation which, despite the pain, is rife with promise.

On the seventh day, the gold flowed freely

I just had my catheter removed. It was a short, mild burning sensation, really not so bad.

They gave me a plastic thingamabob to pee in so I can record how much I pee each time. My bruises are still what hurts me the most but they’re turning from green to yellow so it’ll be over soon.

I peed about an hour later. It was hard at first—my shy bladder reflex was kicking in somehow—but I eventually peed a lot. Most of it went on my leg and trickled down into the peething, with a tiny bit going in the toilet. I’m surprised at how much liquid that was!

Yikes that first dilation of the day is noooooot pleasant. One thing you don’t think about is how dilating rearranges muscles. Muscles inside are like: “Um what’s this? This doesn’t belong here. It’s in the way.” Gotta get them over that xenophobia. There was almost no blood on the dilators afterwards, which is a notable improvement. Chunks of dead skin and blood came out during the vaginal douche but that’s normal and honestly feels good—makes me feel cleaner, a bit like popping blackheads. CLEANSE THE CORRUPTION!

The little pale red hairs poking through the dark red bruise on my pelvis are quite adorable. I was struck with sorrow just now, seeing myself in the mirror. Not because of any regret or dissatisfaction—fear not. But because I suddenly feel less trans. I know that makes no sense but it makes me sad because being trans is such a huge part of me and I feel less so now. I can’t wait to have my tattoo of Venus from the Birth of Venus with a penis, and my t4t tattoo. That’ll help me feel peak trans again.

It’s nice to resume sitting comfortably without any pain. I showed my sister a picture of my vagina and she said it reminded her of Deadpool. It feels weird saying “my vagina”!

I spoke of phantom penis, but it’s less phantom sensation than confused sensations. I know which part of the penis the sensation corresponds to, but now what does that correspond to on my rearranged and stitched-up body? If it feels like my foreskin, is that my clit? My small lips? Is it itching inside my vagina? The excessive swelling of my vulva makes it feel like I have testicles at times.

I lost a bit of boob from stopping hormones. Roboo peed in the measuring cup thingamabob out of curiosity. I myself pee anywhere from 450 to 700 millilitres per pee, which comes roughly every two hours. They peed 350 millilitres. I also made them cum twice which felt a bit naughty.

Dilating again, I realized that just being slightly propped up makes it much more painful so tonight it went more smoothly than earlier.

I’m currently relaxing in the bath, feeling really comfortable—compared to yesterday’s bath for one. My lover’s gone but they’re still with me, here in spirit. I feel fuzzy inside. Everything is going well. Life is good. I am happy. I haven’t felt this good, this relaxed in nigh a month. So far today I’ve peed 4.275 litres over seven instances, and will probably go for another 0.6 litres before sleep or early during the night.

On the eighth day, there was home

One of the girls here had to get her catheter re-inserted for a week because she wasn’t able to pee due to the swelling.

My vagina has an unpleasant smell when I douche, which makes me feel rather self-conscious. I think I have chafing from the largest dilator. The nurse said it was probably from other causes but I have my doubts for a number of reasons that are hard to put into words.

I’ll get to go back to my parents’ place tonight instead of tomorrow morning. Going back home really irritated my crotch and made it swell so I had to ice it a lot. I punctured the top of my vaginal douche with a drill to make sure it spouts all the way to the end of my vagina to better clean it.

I saw myself in just panties which was lovely, though I want to cry from the dysphoria at my lack of hips. You win some, you lose some. Time for bed. This is where my notes end, for I am home. Although the following weeks involved bleeding and pain, the first week remained the hardest. Being able to stay at my parents’ place has also helped a lot. I hope you enjoyed the ride as much as I’ll enjoy mine in three months!


Florence Ashley

Florence Ashley is a transfeminine jurist, activist, and LL.M. candidate at the McGill University Faculty of Law. Their work focuses on trans healthcare law and bioethics.

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