What am I looking at here?
Hi! In case this is your first post you’ve seen here, you need to know I am a trans masculine post-op transgender person. I was raised a girl, and now my body has a penis and balls. I didn’t have all my original parts changed, because I like some of them, or it was more trouble than it was worth to me. I am nonbinary, so I don’t feel totally male or totally female. I like that my body can express that too.
With brightness turned up, my urethra is marked around in YELLOW and my vaginal opening is marked around in BLUE.
What if this looks weird or gross to me?
You have a few options. Close this window, don’t have this surgery, and don’t become my lover. Any of those work, because I, my lover, and others do admire this set up and want to learn about it. Aka GTFO, *points to door* – you came here of your own free will and nobody asked if you liked it.
What is urethral lengthening (UL)?
That’s when they build a urethra inside the new penis and connect it to your old urethra. It’s also called urethral hookup. This is a higher complication part of the surgery, prone to strictures and fistula. Yet do not despair!
On Phalloplasty and UL complications
There are a lot of commonly-repeated myths that “phalloplasty is not there yet, scientifically, because of complications”. Phalloplasty without complications of any kind is rare, because unlike other forms of plastic surgery, a penis has to perform many functions (1) aesthetically, (2) in terms of sensation, (3) in terms of sexuality, (4) and in terms of urination. Phalloplasty is sometimes called the most complex task in urology-plastic surgery because of the many roles the penis must perform. Although complications are frequent, it is very rare to have a complication that destroys the four surgery aims completely. Interestingly, the rate of complication does not correlate to the satisfaction of the patients. You can have complications and still be very happy with your outcome. You can have complications which heal with time, complications which need surgical correction and then resolve, and very *very* rarely, complications can lead someone to start the entire surgery over again. But for people who need this surgery, complication rates are a thing to consider– but it should not keep you from getting a penis if you need one. If you NEED to stand to pee, then by all means have urethral lengthening. I did not need to stand to pee. (Although I have had some fun times STPing now and then. Oh the stories I could tell… Later. Get your mind out of the gutter, it was harmless defacement.)
Where does the pee come out with no urethral lengthening?
Where it always did.
Like about half of the population, my urethra exits perineally, between my legs, where it always has. I had phalloplasty and scrotoplasty a year-and-a-half ago, and I opted not to move the urethra to simplify things. You are looking at healed radial forearm free flap phalloplasty, completed. There is no such thing as “full” phalloplasty, because bottom surgery is done when you know it is done. (Can people stop using the term “full phalloplasty” to refer to one with all the cis-typical parts? We can be full and complete with no surgery at all.) Aka my penis is a recreational organ, *thumbs up*.
What options do I see here?
Just so you know, this passage is gonna use body part words. My full bottom surgery did not include urethral lengthening, burial of the natal glans, or vaginectomy.
It did include scrotoplasty, glansplasty, nerve hookup and testicular+erectile implant. I hope you see a whole lotta awesome! Hello, modern medicine.
Can I have vaginectomy and leave the original urethra?
Yes, you can leave the original urethra. There would just be a slight part or opening in the perineum there. Mysterious to many people, the vulval urethra– natal pee hole– is not the vagina, not located in the vagina, and does not need a vagina there to be there. The pee hole is natally on the pink mucosal flesh of the taint, between the natal glans and the canal opening. Haha, all pu****s are also taints when you think about it.
I pulled up my ball sack from where it usually hangs over and conceals the urethral opening. My vagina is low enough toward my butt that it doesn’t show when standing or laying legs together. I outlined the urethral hole in YELLOW and the opening of my vagina in BLUE. I thought pink would be a little too… on the nose.
How do you pee if your balls are over that space?
When I sit to pee, i lift my balls up slightly to keep them out of the way. My stream is more direct when I pull up a bit. It’s not quite as direct of a pull as you see here, but this is how it works for me. All of the original parts are right where they ever were. In other words, ball sacks move? They’re stretchy as fuck and mine aren’t delicate. I jerk them babies all over the place.
Can I get vaginectomy in the future?
At any time, you can elect it. For now there is not a reliable way to elect UL in the future, however. You have to know that at Stage 1 of phalloplasty so they can lay the groundwork. This is weirdly reminding me of the sprinkler system plan I bungled.
Do you have issues with stuff getting too close to your urethra in clothes, etc?
Well, these pictures are everything pulled up and legs splayed. When my legs are together, the urethra is still pretty bundled up in that tissue coming together. When it isn’t I have minora which do some protection. I seem to be a bit more susceptible to yeast or UTIs than before scrotoplasty? Not sure which played into it most, because I was on antibiotics a long time, the majora are gone, and boy underwear doesn’t have a strip of cotton at the crotch to keep that area quite as dry as before. Getting further out from surgery, that seems to have resolved to a great degree. I can’t remember having any issues with it this year. I seem to do better with cotton underwear of any kind than those masculine “sport” synthetic fabrics that are stylish in some crowds. If you’re a nudist, you’re gonna want a nudist towel all the time, because you can leave a moisture print (eek!). Unless we are in a sexy fluid sharing occasion, haha, let’s keep that one to oneself…
Can you stand to pee out of that urethral opening?
Only if I have an external device to get it out in front of me. If I have one, I can STP with a shewee (theywee/hewee, lol) with the extender tube. It is discreet and functional, for those unhygienic truck stop situations, hiking, and when only urinals are available at a big event. Otherwise the pee goes sort of straight down or diagonally forward toward the ground, definitely not enough to clear the fly.
Day to day, I feel good about it. I pay more attention to whether I’m hydrated enough. It works for me, and I wish I had gotten more information about what it would be like, before surgery. I hope these pics help someone else make their decision, knowing more of what to expect.