so, I should start by saying vaginoplasty significantly reduced my genital dysphoria, and in general has helped me feel more like a woman - it’s overall quite clear it was the right choice for me (and same with transition overall).

… but I’ve struggled a lot with continued bottom dysphoria and anxiety that I made a mistake or the surgery was problematic or wrong in some way

for example, my labia continue to look and feel like scrotal tissue, and I feel insecure about this - they can sag and look wrinkly at times, which makes them look scrotal to me.

I also seem to have no labia minora as far as I can tell, or perhaps it’s too early post-op to tell, the clitoral hood is just a tighter part of the same labia majora - so maybe as swelling goes down there will be more of a sense of inner folds vs outer folds?

Anyway, lots of insecurity and concerns that my genitals are still male. Any time I’m aroused and my clit becomes engorged, it feels so much like an erection that I become dysphoric and I struggle to stay in the moment and maintain arousal.

Last night I had a dream that a stitch popped or something changed in my recovery overnight, and I woke up with my labia sagging even more and bunching into an empty scrotal sack, and my clit when engorged would become erect and push out several inches into an erect penis. It was very distressing in my dream, I was panicking and trying to find a private place to capture photos to send my surgeon. (In some ways this nightmare was clarifying or affirming - knowing my unconscious is not secretly coveting having male genitals again makes me feel more confident I made the right choice.)

I guess I never expected to have so much bottom dysphoria post-op, or to struggle so much to see my vagina as female. Sometimes I even wonder if this is what it’s like to be a trans man, to “feel male” internally and to have female genitals (though obviously this isn’t how trans men feel, trans men generally want to feel male in body and mind, something I don’t experience - and my “feeling male” is more like insecurity and imposter syndrome than whatever trans men experience).

It still hasn’t been six months since my surgery, and I’m so early in my transition in general - I just trust it will get better over time … but right now anyway, I am struggling more than I expected with challenges I perhaps naively expected or hoped the surgery would just immediately solve.

I have noticed that the dysphoria I would feel when I lay on my back and twist my lower body in a way that allows me to feel the length of my clit embedded in me, and it would feel like my penis was sewn onto me, has gone away - with the healing I think inflammation has gone down and I no longer notice that sensation of length in me, and when I do twist or pull in a way that seems to engage my clit, it feels more “normal” and doesn’t create dysphoria. So already the dysphoria I had earlier in my recovery is subsiding, which is good!

I think this was mostly a vent post / brain dump, but I did want to ask about others’ experiences - I wanted to invite general sharing of what surgeries were like for others (esp. what wasn’t expected or isn’t commonly discussed).

If anyone has advice for me, I’m completely open. Thanks for reading 😊

  • Marcela (she/her)@lemmy.blahaj.zoneEnglish
    2·
    2 days ago

    Let me highlight some bits of your message:

    I clearly have attitudes that being trans is monstrous

    Exposure therapy has been helpful, and my overall distress from trans people is much less now than it was at the start.

    But surgeries do not resolve trauma and setbacks formed through years of closetedness, dysphoria, and denial.

    I am beginning to feel like this is one of the biggest sources of my continued distress - it’s not just that I am trans, it’s that I lived so long as a man and what that did to me (physically yes, but mentally is what I mean).

    But I have get across other people who like you have gone through surgeries to find something to be desired at the other end.

    I do think this is the right take-away, the fact that neovaginas are lined with skin that will never be like or function like a natal vagina is a technicality - the bottom line is that vaginoplasty has excellent outcomes and are totally worth it. (Even if it’s not quite as good as you mentioned.)

    Let me start by that last part. I meant that a bit differently. I meant that I have met people who have undergone SRS and then they want to be done with gender dysphoria and the trans label. A person might develop dysphoria later in life about a facial feature for instance, but fails to realize it is dysphoria, because she is “done” with surgeries, and done with “being trans”. This is related to the misconception that HRT and SRS eventually “make you cis”. Because supposedly they define transness as the presence of dysphoria, thus relieving dysphoria makes you not-trans anymore. That is why I prefer (and WHO) to base the definition on gender incongruence, or simply “being trans”. It might also be based on an individualist and assimilationist approach to transitioning. And it is rooted in internalized transphobia, in your case with a prominent disgust/aversion element.

    This might also make you want to be singled out and not be lumped together with the category of trans people. You framed your exposure to us as exposure therapy. This might come off as a bit dehumanizing. It is the solidarity and community with other trans people that is a substinence and steadfastiness parameter, the opposite of individualist assimilationism. It is very important for marginalized groups to come together. Come to think of it, I was active in support groups both online and IRL, and that also helped me get through transition. Actually this is a reason I sought out to be a member of this community, solidarity among trans women must be a given. Just being together with other people like you is something of itself. I always feel relief and sisterhood in the company of trans women, not that I hadn’t been disappointed or betrayed. I have.

    I tend to think that psychology is just not a matured discipline and operates on poor theories, and at the very least most psychologists leave the field ill equipped to deal with the kinds of issues I had.

    This is the closest to the possible reasons I intuitively thought that would be a barrier for you to be helped by therapy. I think you are in error about this on multiple levels, the first is that I don’t see a direct link from academic psychology to therapy practice. But some of it is related, and there are studies that show that therapy is effective. The school of thought of therapy is not significant, it seems that the critical factor is the relationship with a therapist and the process itself. So it is a process. These attitudes, together with rationalization, might have been barriers for you to be helped.

    Of course it goes without question that the therapist must be knowledgable in gender dysphoria. I also see that you feel like your problems are to specific and particular to be handled by just any therapist, or the field of psychology itself. I don’t have an answer for you right there, but I have seen it before. I don’t know what it means, but I know that it has hindered people from starting therapy or make them postpone it till their problems become overwhelming. Of course you said you have tried therapy consistently, but you might have been looking down at psychology as a discipline and at the same time not trusting it to understand your specific situation. Rationalization and possible neurodivergence also may be part of it. Your eclecticism (eg PhD psychologists) might not be helpful, I don’t know the Southern US situation well, but a PhD could be too sterile academic work. You need someone with relevant field knowledge, clinical experience, and a good fit to you personally. All these are more important factors than PhDs.

    To continue a thought from before, this is a way you’re setting yourself up to not be helped by therapy. You already bring up yourself several issues that you need to process within a relationship and within a community. So you are smart enough to see that your nightmare and following post here was literally the tip of the iceberg, and there is a bullet list of topics already, internalized misandry, internalized aversion to transness, being unprepared for your new normal, and then the self-esteem issues and being made redundant, which is stressful in itself. Also, this is already too personal and you should not be so open about it on the internet. It belongs to therapy, or other trusted setting. There is also this community’s matrix which has encrypted channels and an emotional support room. Best of luck!