Knowledge does not seem to help you.

I want to embroider this and hang it in my house 😆 What a pithy observation!

Two things I learned early in transition and helped me come alive on the other side. These two things (and faith). The axioms are: 1) Being trans sucks. 2) But being trans is not wrong.

hm, I guess I don’t think being trans is wrong the way that hurting someone is wrong, i.e. it’s not immoral, but I clearly have attitudes that being trans is monstrous - akin to the way we might see someone with a birth defect, burn scars, disfigured or amputated limbs, etc. - there is a body horror to being trans that betrays the social attitudes I was indoctrinated with growing up (assuming there is not some deeper biological impulse to avoid the disfigured and diseased).

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).

My entire way of thinking about myself and even about both genders has been informed by coping mindsets - I was raised partially by a deeply hateful misandrist, and my dysphoria flourished and intersected with that misandry nicely. I came to hate myself for being a man and to hate all men, etc. I also thought in salvational terms: that all men should want to become women as they are obviously superior, and that my own desires to have been born a woman makes sense because I simply recognize the superiority of women.

This led to weird places, like learning to identify my feminine thinking and behavior as masculine, and struggling in the end to even acknowledge masculinity exists in other people (since I struggled to identify it as masculinity).

Anyway, this is just a small window into how upside down and confused my whole socialization and systems of belief were formed growing up, and I completely agree that the years of staying closeted and deeply dysphoric and in denial have really fucked up my mind.

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.)

As a congenial stranger, a fellow trans person, I see you deprive yourself of options and also deprive yourself of happiness.

I should be clear that my clarification about the differences between a natal and neovagina don’t particularly rob me of any happiness - sure, it’s a little unsettling, but it’s just something to adapt to for me, it doesn’t feel like a complete invalidation of my womanhood.

I am sensitive about the anatomy not looking “right” and the absence of labia minora, for some reason that does strike me more as missing out on some normative sense of having a female body - but realistically I know most people will not notice the discrepancy or think I’m not a woman because of these differences. I know they are just something that bother me.

I wonder then what options you think I am depriving myself of … I agree with you that I deprive myself of happiness, but I also wonder if you could expand more on this, I assume you just mean that by obsessing on small details I undermine my own happiness? (Just want to make sure I understand your observations!)

You will definately benefit from therapy, although finding the right person can be challenging. Mine was an LGBT specialist, but had also a background in cognitive therapy and dealing with trauma. I had other therapists before, and had lots of groundwork done before even tackling transition issues. (Don’'t get me wrong I would never achieve a basic level of psychological functioning without transitioning.)

The last two therapists I saw were specialized in LGBT+ issues (which, living in the South in the U.S., that just meant they were themselves LGBT+ or allies, and were willing to see LGBT+ patients; as far as I know neither of them had any actual formal education on LGBT+ issues). I tend to be choosy about my therapists, e.g. I only choose therapists who have PhDs in psychology. I’ve seen therapists whose education and specialty were in trauma (that’s the biggest complaint / area I have sought therapy for, though none of it helped me for over the decade of therapy I went to).

The penultimate psychologist I saw did tell me that I was her most challenging patient, and she told me I was good at rationalizing - we focused more on trying to stay in an emotional space and explore emotions & feelings rather than thoughts, and that seemed insightful … now when I journal I try to center my thinking around my feelings - what am I feeling, what are the current emotional tones, etc.

You had many therapists and none helped. With all respect and solidarity to your troubles, this might mean that you are not allowing yourself to be helped.

I mean, I saw a psychologist for years with the explicit therapy goals of not wanting to be a man and wanting to undo my male socialization, and not once was it suggested that I might have gender dysphoria. Before therapy I sketch out the major issues I’m having and I come up with goals and plans to address those therapy goals. Therapy is expensive, and I was paying for therapy even when I was a dishwasher and couldn’t afford it (my therapist had to offer me a reduced rate, and had no access to health insurance, so everything was out of pocket - therapy was a major chunk of my monthly budget). So I wouldn’t say that I wouldn’t allow myself to be helped; I don’t mean to be antagonistic, but you should probably be aware that this can feel a bit like victim blaming, the idea that if it doesn’t work for someone, then it must be their fault - it’s a possibility (and not an unreasonable one to point out), but it’s also possible I was failed.

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. For example, I don’t know that a psychologist would ever learn about gender dysphoria in school, and certainly none recognized it in me (and to be fair, I didn’t acknowledge or recognize it in myself either - though I didn’t have a PhD, I shouldn’t have to be the expert).

Many therapists will also be intimidated by your intelligence and attention to detail. This is a tricky bit, with many of us, growing up accustomed to being the smartest person in the room.

I did not grow up as the smartest person in the room, though at some point I did focus on my education as a form of escapism, and that leaves people with an impression of intelligence. I tend to think my intelligence is rather average, but I’m starting to think what people mean by intelligence is more like “education”, and I can understand that I come across as educated. I actually am beginning to suspect I might be on the spectrum, and that might be part of why I give off the “intelligent” vibe to people - what’s probably happening is that I’m just not socially modulating well, after I dove into books to escape reality, my words changed and I didn’t ever learn all the ways to apply them, so my language comes across as pretentious or learned, but really I’m just unaware that I’m violating social norms when using certain words. This has created problems in my life - I had a lot of unfortunate interactions during the blue collar jobs I worked …

Anyway, I don’t know what therapists think of me or my attention to detail. I would have hoped it was helpful, I always tried to be very transparent in the way I was thinking … in the end it was rare that a therapist had insights to offer me, and sometimes I wonder if this is because I had tried to do my homework before I go into the session, and there wasn’t much left for them to offer.

Either way, it still leaves me in the situation that it’s a high cost (time and money) for a low reward. Still, I tend to think going to therapy is a good idea - at the very least it means I’m spending time thinking about and actively engaging with my mental health issues, it forces it as a priority. There is value in that. Also, you never know - with a new therapist maybe they will have information or a perspective that will help you, I cannot say I know they won’t be helpful even if most of my experience in the past makes me think it’s unlikely.

You have your advanced takes on things, your intelligence and diligence and it might be hard to make yourself vulnerable enough to allow and be helped (either by therapy or faith). But you’re setting yourself up. You need to change route, and I worry about you.

I definitely have a hard time being vulnerable in a sense - I do think I tend to be completely open and transparent with people (and my therapists in particular), but this can sometimes be different than being emotionally vulnerable. I don’t know, maybe it’s a new skill I’m learning - to allow myself to feel and to do that in front of others.

Anyway, yeah - thanks for your worry, I guess I’m a little worried too … I didn’t think the hardest part of being trans would be thinking of myself as a woman. I kinda assumed that part would be easy or automatic for trans women … Also, my self esteem is pretty bad, been struggling a lot recently with feeling worthless since I lost my job.

Instead of trying to nullify your transness, consider what being trans has done to your psyche

This is insightful, thank you 🩵

I had bottom surgery a couple of years before covid. FFS was the last real “goal” I had, and I had that done in December 2019, so I had returned home from Argentina and just go through the worst part of my recovery when the first lockdowns started happening

Not all cis women have inner labia and imo your result looks pretty good.

while it’s true that not all cis women have inner labia, it’s rather rare and is even considered a condition, labial hypoplasia.

Labial hypoplasia happens often with intersex individuals, usually something goes wrong during puberty to cause it.

Anyway, your message is kind and helpful - there is no reason to be particularly normative about this part of the anatomy, since it is harmless and plays no major functional role …

I guess my fears are of being outed as trans by my genitals, though probably my surgery scars are a bigger threat of that than the lack of inner labia.

During my recovery, I had to reckon with and come to the realization that the sensations I feel are largely just the same sensations cis women feel.

I guess I struggle with feeling this is true - I suspect cis women have different qualia for lots of reasons … but still, the overall gist is probably right, and it’s certainly true that it’s more similar than different.

It took quite a while before the feeling of being constantly tucked went away for me, a common feeling early in recovery because of the way skin is being pulled and things need time to settle.

yes, omg! This was such an adjustment for me, I hated feeling like my penis was still there, just sewn into me - such a weird and awful feeling. It really has gone away as I have healed, I suspect because the inflammation and pain around the phallus has gone away and thus so has the constant sensation generally.

In some ways, we actually have a bit of an advantage imo because you can most likely do a revision to move / reshape things especially in the clitorial area to your liking with a revision. My surgeon was specific that there are limits in what she can do visually in the original surgery and that things like inner labia are more doable in revision, which doesn’t necessarily even have to be in an operating room. I asked for and got significant changes to my clitoral hood and inner labia definition just in her office with local anesthetic, it took like 45 minutes.

Unfortunately I moved far away from where my surgeon is, and I am currently having to fly back for post-op appointments (very expensive) … it’s very unlikely I will have access to revision surgeries, and the current plan is to discharge me 6 months early and not bother with the follow-up appointments I would have otherwise had.

Really interesting that they were able to do out-patient revisions with local anaesthetic in such a short time - thanks for sharing that, I didn’t know that was a possibility.

If I were to prioritize surgery now, it would be FFS or potentially a VFS, as my face and my voice are the two biggest sources of dysphoria for me. Revision to form labia minora would be nice, but I’m too pragmatic to prioritize it, given that it doesn’t create dysphoria for me as much as my face or voice.