Thread by @vyrthandi

Bottom surgery consultation questions!

I didn't know which questions to ask during my consult in 2019. I think few people do. Now I know exactly what I would have asked. (I also know I should’ve taken a friend so I didn't feel so overwhelmed.) #LadyeVossSRS

Here's my list now:

· "Which method(s) do you use?"
· "What tissue do you use? Will you require grafts?"
· "Will I have both outer labia and inner labia?"
· "Is there an option for a two-step process for my surgery which might provide a more 'cis-passing' appearance, or not?"

· "Can you provide a diagram to show what tissue is used for each section of the vagina and vulva?"
· “How long is the expected wait until my surgical date?”
· "If the wait is expected to be long, do you advise against a pre-surgical orchiectomy to maintain scrotal tissue area?"

· "How important is it for me to routinely masturbate prior to surgery to maintain active and healthy tissue?"
· "Will excess fat be removed around my labia and on my pubic mound?"
· "Will my clitoris be hooded, or just flanked with inner labia?"

· "Do you preserve a portion of erectile tissue under the clitoris?”
· "What is my expected vaginal depth, and what determines it?"
· "What is my expected vaginal diameter, and what determines it?"
· "Will my vagina be self-lubricating?"

· "Will my vagina be constructed using a particular dilator? If so, which?"
· "Will I be provided dilators as part of my surgery? If so, which color, materials and manufacturer?"
· "Will anyone guide me through dilation the first time, or first several times?”

· "What is my expected dilation schedule?”
· "At what points will frequency of dilation change?”
· "Which time-based benchmarks do you generally expect on each dilator? ", i.e.: "How many days on blue polyurethane until green, then how many days on green until orange?"

· "Will I have in-person follow-up appointments? If so, how frequently?”
· "How long after surgery until I need to start seeing a gynecologist?”
· If local, “Do you recommend any gynecologists?”
· "How long will I need to be out of work?”

· "Do you think it’s necessary to cease HRT prior to surgery? If so, how long until I may resume taking HRT?"
· "How often will I need to douche?"
· "What will I be douching with? Are there recommended products I should consider purchasing in advance, or will they be provided?"

· "If granulation tissue occurs, how often will it need to be treated, and by whom?"
· "Will the hospital staff—including nurses, social workers, physical therapists, janitors, etc.—encountered during my stay reliably use my pronouns and respect my gender identity?"

· "Will the hospital floor/wing specifically be for those receiving gender-affirming care, or will it be mixed in with other patients?"
· "Will my hospital room be single occupancy? If not, will I be with another patient receiving gender-affirming care?”

· "If I have dietary restrictions, will the hospital go above and beyond to accommodate my particular needs and provide a healthy variety?"
· "Would YOU eat the hospital food?"
· "Do you recommend a post-surgical nutrition plan?”

· "Do you require hair removal? If so, what method, and can you provide a diagram of the area which needs cleared? Also, how soon should I begin?"
· If local, "Where would you suggest getting hair removal?"
· "How long will my surgery be?"
· “How long will I be hospitalized?”

“How long after release from the hospital will I need to remain local?”
· “How long after release from the hospital will I need a caregiver?”
· If you do not have a potential caregiver, “Are there caregiving networks or services you recommend?”

Feel free to reply with your own suggested questions. I'll add them into the thread if I think they're important additions.

Thanks to the trans gal who slid into my DMs and asked me the question that prompted this thread. 💖

Feel free to share, favorite, bookmark and retweet.

You might not like all the questions, or how they're worded. Sorry. But others might want to know the answers, even if they make us uncomfortable. I'm more interested in people getting the help they need than in maintaining the hegemony of acceptable trans Twitter discourse.

Also, if you don't know what is meant by one or more of these questions, consider this an opportunity to try to educate yourself now, so that when you do have the opportunity to speak with your prospective surgeon, you will be able to understand the answer they provide you.

BMI requirement questions were neglected, but none of you caught me! I caught myself!

Expect a BMI conversation if you or your surgeon are concerned. For better or worse, many surgeons will have BMI requirements for vaginoplasty, but perhaps not for zero-depth vulvoplasty.

Regarding pre-bottom surgery orchiectomies:

https://twitter.com/LenKusov/status/1514434430840066048?s=20&t=ljj0S7DJ0IynJ9DPmAOgZg

Fissures:

(My addendum: expect to take a daily stool softener such as Colace/Docusate. I also recommend eating oatmeal daily for regular bowel movements for 6-9 months. Treat oatmeal and stool softeners as HRT if you need to emphasize their importance.)

https://twitter.com/BonzoixofMN/status/1514448941928046598?s=20&t=ljj0S7DJ0IynJ9DPmAOgZg