META: These series of posts are collated reposts from a dedicated twitter account: https://twitter.com/kybele_deployed that document, specifically, my experiences from the point of preparing for SRS, then experiences in hospital for said procedure, then the recovery process thereafter, followed by some discoveries in new embodiment and the followup surgery. As such it spans for now the mid-2020 to mid-2021 time frame, overlapping largely with COVID-19 lockdown. The original posts are still up as tweet chains. Their relative order has been preserved, but not their exact time positions. The first operation took place November 10 2020, the second June 21 2021. For purposes of being possible to upload sensibly, the collated accounts have been subdivided thus preserving, again, relative time order but not relative time position, and the time stamp of these blog posts therefore does not correspond to the actual times of the tweets.

So! Catheter is out. Was not particularly painful to have it out (felt more or less like passing urine during UTI which, you know, just makes sense). Now in principle I am supposed to wait and see if I can void. Had a lot of coffee earlier so it may become a salient point soon, I suppose. At that point, I am supposed to call for the doctor who will instruct me. In before that I suppose I have some time to try to sort out sensation. So currently, there is no catheter, there is no urethral compress packing, but only vaginal compresses. I feel… sore, throughout most of that, and a bit swollen. Which is a good cue for an ibuprofen. But makes sense, and now it makes a little more sense to actually process some of those perceptions. I have some soreness on what I guess is the lower half of the vaginal opening, and I guess also on the urethral opening and the vestibule in between. But all of this makes sense after the recent inspection. So I suppose I will just now try to relax a while now, until I feel the need to void, and then call them and then we take it from there. If I cannot, then presumably it will be the suprapubic catheter instead. For now, let me simply centre and be present here for a while.

OK, so this will again be graphic (not literally) but I guess you would not still be reading this if it bothered you. I was able to void some urine. It felt weird as everything still is swollen (comparing, perhaps, to the painful sensation of urinating while partially erect, before, which should be similar). And messy – first hitting my groin and my leg and so on. And probably not getting everything out, though also no need to. And not super easy yet to clean the surface (and probably did so insufficiently) as I don’t want to push paper into that swollen area too aggressively. Should be sterile though, and later I might shower or douche it? That might be a good habit actually, to wash outside with water after each time. But more of that for later. For now just proof of principle and hopefully such that I won’t need another catheter. Not out of the urinary woods yet, but one step taken, and if I continue similarly, should make me safe in that regard. I foresee sleep becoming less easy now, in that I may fall back into my old “need to go up every 2h to urinate” habit. And I should definitely ensure I don’t drink less now. So not out of the wood yet, this part can still go wrong, but if I improve my approach with how to clean after, and I retain the ability for sufficient voiding, then one scary obstacle off list. I feel more in control therefore. There are major questions continuing – how to keep clean, what to clean how, and there still is the vaginal packing material, which still drips blood lymph. I assume this will continue for quite some though that is what pads are for, of course. I will soon be shown how to dilate (in an unpredictably “soon” sense) and they tell me it might hurt because I am still quite swollen. Well, if so I will deal with that. Perhaps more interestingly, now without catheter tube and urethral compresses and bandages connecting those up along the tube and through the hood area, I now basically just have a wad of compresses stuffed in my panties, besides the packing inside. Those I feel I can replace myself. So finally my crotch is feeling a little less like the motherboard of a computer I put together from parts, and more like ME. Swollen, swollen me. But still me. And I asked for a mirror, and I was given one, and I pulled down panties and compress wads standing up and looked for the first time at myself, 15 days post-op. Unfamiliar sight, but far less disconcerting than I expected from being raw from the first operation! The stitches on the labia majora is the main sign of damage, and they also are much larger near the top than expected, with bunched-up skin and some visible threads. This is by design – the surgeon leaves available skin there to have material to work with in the second operation once swelling has died down six months from now. So that part stands out, and this is fine. But otherwise, just seeing my lips in semi-closed position, different skin (prepucial in origin) for inner lips, vestibule beyond, on a brief glance I did not see radical poor fit to the spectrum of paleovulvae I have seen over time, which is more than I had expected. I also don’t see the stuffing compresses, unlike before it does not protrude, though I do visibly drip from my vagina, this wound healing fluid. Still unsure what the final verdict will be with the inner deep graft. But this feels like I have an outside I can begin to slowly and carefully become familiar with, move around as, and keep clean. I can keep on learning, and I am filled with some sense of peace and serenity right now. Also, of urine, which I will attempt once more to rid myself of.

Urinating a second time worked as well, got rid of more this time, still SUPER MESSY and runs across the skin to everywhere, and still complex to find out where to wipe/gently press paper to dry the stuff off. But this is good, it implies perhaps I can feel confident I am retaining and maintaining this ability (#ToiletTrainingAt40) which is so essential to being able to live a normal independent life. And each time lets me be a little less afraid of handling my body, a little more confident, less worried I will cause or worsen harm. What’s more interesting is how that so central experience of urination differs between having versus not having a penis. The letting go part is the same (which makes sense because presumably that is the part close to the bladder which is unchanged) but before, there was always clear sensory feedback on when, in fact, fluid was actually streaming out (which makes sense given the urethra then went straight through that which is now my clitoris, activating all those nerves). The spongiform tissue surrounding the current urethral opening is far less hypersensitive I think. Such that now, when trying to urinate, I became aware of being successful through indirect sensory cues only – sound of liquid hitting porcelain, or the feel of it moving over previously dry skin. This is an entirely novel experience and it delights me in that it is one of few such which is only possible to have along the experiental track I have followed. And once I learn how to dilate and repack (if indeed I should), then maybe finally I can shower?

I’m euphoric right now, I realize. I have not looked at myself again yet (was too busy managing body functions or healing or communications) but the memory of seeing my vulva in the mirror keeps returning to me and the reality of all this is slowly, slowly sinking in that it really was successful, that my body has been adjusted as I needed it to, that I will get to know myself as my body and then, later, have others know me and see me as well. Feeling so incredibly happy in this moment.

Those who knew me before: am I reacting and responding and adapting to all this in a way consistent with your prior expectations from me? Curious! I do feel there is some externally legitimate purpose to this oversharing – things I was not already aware of might be new to others undergoing this, and I want to put that information out there to inform such persons. Especially in regards to what it all feels like. Kindly paleovagina holders (“sempai!”), when you sit down to pee (as the vernacular has it), do you keep your thighs pressed together or slightly apart? I keep them apart so far a little and I wonder if that contributes to how messy the stream gets. Not sure if it would go straight down otherwise or be blocked, and a little too swollen yet to investigate without a prior hypothesis. Also, how often do you change pads when you wear them? Already when stained, or not until it starts failing to absorb more? Or based on the time elapsed? Sleep worked fine. I woke once needing to empty bladder, but not so much (though, dense urine when not drinking a lot seems to sting and hurt a bit), then again as I woke properly. It really just runs down the skin though, on my bum and between my labia, slowly without so much force. My guess is that the area it passes through really is still swollen enough that it limits volume throughput/time and therefore stream is too weak to form a beam rather than trickle out; simple matter of hydrodynamics. If so, it will resolve as I heal but it does mean that my vestibule keeps getting urine washed. Wiping is less of an issue than I feared – since I have access, I can dab paper against to soak up (no desire to scratch this skin by shear motion), then do the same with a wet wipe to clear of residue. No idea if this is “right” but makes me feel clean enough and removes stinging sensation when that occurred. It also does not take prohibitively long (a little extra time needed also for gloves, as I don’t want to wet the plaster on my hand where the IV port was) in part because the whole time sink before with cleaning out all the residual drops from inside a longer urethra and from underneath prepuce no longer is there. That might not be something most cis men do, I guess. Any leftover fluid on that skin, pre-op, would cool and then remind me of the shape of the anatomy, which would leave me dysphoric and very uncomfortable, so I spent perhaps unusually much time and paper ensuring it was all emptied out and dried off. This shorter urethra does not appear to buffer much. I have heard trans guys have the opposite change under some of the phalloplasties they can have, which makes sense, and I tip my hat to them. Also, I note that my vestibule (here referring to area between urethra and vagina, which presumably have an even more exact name) is mostly urethral skin, and I do note that for me so far, it is quite swollen. Whether this is inflammation or remaining erectile tissue, I am not wholly sure of. It looks like the paleo equivalent but feels harder to the touch. This is also the area where I suspect I must keep the highest hygiene right now to prevent strain or tearing or irritation, which is also where the wet wipes come in. But more importantly, most likely, to give it time. Swelling is due presumably to the substantive removal of erectile tissue essentially all the penile “grow capacity”, so there must be plenty of internal injury there in what is spongiform and capillary-dense tissue, and that won’t heal in a month. Beyond occasional stings along labial suture edges, remaining pain also is such dull, swollen, bruise-like pain in that area and all surrounding the urethra. It is also one of the known quirks of the Combined Method – the “urethral bulbus” can be swollen and protruding and often this is adjusted in the second stage of the surgery, or so I have heard. We will see how my healing and thereby specific revision needs continue in this regard. Mobility is up substantially, it feels less scary and painful to get into or out of bed now, and that is supremely liberating. Nurses are beginning to ask how long I will stay, and I think I am not long for it now – the doctors need to inspect a little more, hopefully, and give me full and proper aftercare instructions, including for dilating, and I suspect thereafter I might actually be ready to switch to home recovery. It’s been 17 days since the surgery, so within the scope of what I expected. They tell me dilation may be painful, and from this swelling, my suspicion is this may be true, but perhaps not then from the vagina itself but merely that stretching the opening and vestibule might hurt when that is swollen. I am a little scared anticipating that, but more excited and resolved still. I am very glad I have this time period free from my regular work duties, as all this, trivial though it might be in one sense, still takes up a lot of headspace. That said, I feel, I think, all in all, very very good. All these obstacles are ones I was ready for, and all progress delights me. I am blessed to be alive and to live true to myself in this beautiful and crazy world.

Feeling primal physical stuff of some kind. Just came from cleaning session. The plan was to fully clean out my vagina, remove the expected necrotic parts of the deep graft (apparently, smell indicates there should be _something_ like that) and then I’d be ready to start dilation. For this, they use both halves of the speculum. Apparently, getting deep enough inside is hard, and despite a long while pushing and searching and water throughput, they could not really see any necrotic regions. So either those were now washed out or they are somehow even deeper, or it is scattered out somehow among healthy tissue. Young doctor will phone old doctor to ask. I take this as generally a good sign, there is a boundedness to how damaged the graft is, and not all of the graft is dead, some of it probably lives. The experience was vaguely painful though more on level of weird and uncomfortable than proper pain. Being pushed wide open like this and dug inside with the speculum moving and shifting around, and also the state now when I am packed full with double normal compresses, that… feels, in a weird way. I am not even 100% sure there isn’t a sexual component to how my nerves process being filled up like this, though I can’t place it well. I feel sort of drugged from it, almost. Can’t fully decide how I feel. And additionally was able to place how some parts I really thought must be on the outside, now are on the inside? I have sensory input from what used to be penile skin but it is inside my vaginal opening. This puzzle is so intriguing and I look forward to eventually solving it. That said, it all took a lot of energy out of me again. There are things I feel I ought to work on, but honestly I am not sure I can do much more of anything tonight, despite having done nothing more active than trying to stay relaxed while doctors try to get deep enough into my vagina to see what lies at the bottom. Going to try to rest a while now. Feeling excited for the future.

Reaching new levels of detailed oversharing of “private” information here, but it serves the purpose of concretizing (might still end up merging this twitter and my blof posts together at some point into a coherent text, perhaps), and right now I got a lot of information that I will have to remember, as I enter the stage of aftercare where I must do it myself. So writing down those details makes it easier for me to remember them, anchor them in my memory, and doing so witnessed like this is easier for my (possibly neurodivergent) brain. Today the old surgeon flew here, and will fly back tonight, primarily I think to make final calls on my healing. Waiting for the appointment I sat down a little, which hurts a lot in the labial stitches if I set the angle wrong, but which is otherwise OK. Then into the operating theatre again. Again with the large speculum; sometimes at edge of pain proper, sometimes not, but all something I can endure by putting willpower above sensation (and was it not this, somehow, that tiny 20 year old Sofia practiced that time when she had her eyebrow pierced in late year 2000? Going through whatever it is to achieve whatever is truly wanted?). The vestibule urethra is still very swollen, and there is a small open wound there somehow also, but from what I understood this is not a cause for alarm; it can heal on its own. If not, I have a gynecologist appointment in December where surely I would get feedback as needed. And the swelling should go down, and with it, the low throughput of urine, all on its own, over time. More relevant instead is the vagina. So there is a part of the deep graft which does not attach, and which should not be allowed to fester. But cutting it out would harm the healty sections, so we must allow it to be shed by its own, which means, primarily, cleaning and waiting. I am to start dilation and douching routine, and over time, this will mean the nonviable skin will be cleansed out, and then we will see whether another graft section is needed to complete that part or not. This is sufficient safety for me. Additionally, the urethral canal segment has something wrong with it (unclear if he meant swelling or skin condition) but here the surgeon is confident it should likely also just heal on its own. Taken together, these two sources may presumably have explained my discharge. So a few areas of damage we expect to self-heal, one area of damage we expect to self-cleanse, and followup later accordingly. He seemed satisfied with the outcome otherwise, all in all. Then I was given a demonstration of what to do, across the language barrier. I should cleanse and dilate two or three times per day. Safest to make that three, I think, if uncertain. I can finally shower again! I can do so (and presumably go to the restroom normally, etc.) without removing the placeholder, which I should have in my vagina at all times except when dilating, until (presumably) the dilation scheme relaxes down from 3/day by time of the second operation. These steps require some supplies and tools, and take some time, and I expect this will structure my life a bit now during the next months. I also don’t have all answers, but will request clarification throughout as needed. Surgeon noted; the skin of my new parts is not as fragile as I fear, it can be stretched and handled, and I don’t need to be so afraid. As he noted I have my body back now. For the cleaning, I should wipe the outer areas (and the edge between legs and torso) with antibacterial (alcohol) solution, whereas between the folds and inside, I should only use water. For the first few days now, sterile hospital water. To clean inside, meanwhile, I should use a douche, and do this prior to dilation but not after. Sticking the douche in as far as I can, filling myself up with water using it, then pull the water (bloodied, some) back out. The douche I have might not be the right kind, not long enough hose. I am something like 12-15 cm deep I think? And getting the hose all the way onto the back, so it hits the back wall, hurts. Presumably after doing this, I should always clean the douche fully and desinfection spray the parts. After douching, dilation. I assume for now I work with the small dilator (Kirk) but would increase thereafter. As I assumed, it should be covered with a fresh condom, so I am looking at a consumption of a hundred condoms per month, about the same rate of consumption as pads. Talk about catching up with a life not lead. One covers the dilator with a fresh condom, wearing gloves, then cover the tip of it with a large amount of a white cream, then a yellow cream. I must get prescriptions for both of these. They are, I think both antibacterials. Push the dilator in at one angle, then once past some point inside (which I remember from my cis lovers, actually), tilt it a little and push it all the way in. Rotate it a bit in the beginning to spread the cream around. As the old doctor did this first, I was happy to note it does not really hurt at all for me, though there was bloody discharge on it as he pulled it out. By his assessment, for me the issue is not musculature (my PC muscles largely accept they surround a vagina now) but rather it is about pushing down the sutures and keeping them compacted for some time regularly, as well as distributing the creams. The deep part may well come to hurt some, or the opening. We will see how that goes. And increasing to Bones or Spock size dilators might also hurt more. He did not underscore a need to do it for long, maybe just a few minutes, but the gynecologist he collaborates with suggests maybe 15-20 minutes at a time at least is good, so probably that is what I will do. After dilation, I need to put a placeholder in. This is not a reusable device; instead one builds a placeholder from compresses and condoms: fold compress around a long, straight object; put a condom over it, cover the condom also with the two creams, use the long object as an applicator to place the whole thing deep inside, then pull the applicator out. Keep this in between dilations. So actually, I am looking at 200 condoms in a month. Surely this will exceed my full consumption throughout near two decades of sexual activity. I should purchase in bulk. With the placeholder in (as I have one in, right now), I should be able to live relatively normally. Then stroke the white salve over all the bare urethral parts in the vestibule, and around the vaginal opening. And of course I still drip with stuff, so I need pads on top of that. I presume that within a few months, more and more of these steps will reduce, up until the second surgery, though I am not sure which ones will stay. I think eventually I probably shift to regular lubricant perhaps? But this depends also on the state of the deep graft dead part sloughing right, and that will have to be inspected by the gynaecologist later. So for now, I simply prepare this way, which means stocking up on a couple months’ worth of menstrual pads, compresses, condoms, gloves antibacterial solution and those two creams, which I must ask what they are and get prescriptions for. I also need to get a douche of the right kind, and since I will start doing this tonight here in the hospital already, I must request some of these things from them already now, as well as sterile water. This indeed should be my project this evening, practicing the full cleanse and dilation regime from start to end at least once, and then be ready to do it again in the morning, and then tomorrow during mid-day to ensure I can stably keep up and run and maintain this as a habit for my healing. So next step, I will request the supplies I need from the nurses (again across a language barrier). This will mean work, but it is liberating work, it is establishing a structure conducive for healing and independence and eventually, its own obsolescence. I much look forward to it (as well as to the exploratory aspect of mapping sensations as I dilate and clean). It seems it shall indeed be a major time sink for the near future and I must take this into account when making my plans (more delegation, less availability) and also ensure that I have as much of supplies as I need also in my home. I feel empowered to do these things now. The great work begins. Much love! ♡

Going to try showering/douching/dilating now myself for first time! Exciting/scary!

OK, that was surreal and weird and complicated and I am not sure I did it right and I need to ask about that and need to make sure I am not doing damage by using the wrong technique but despite the challenge I absolutely got through it at least. I think my tendency to ritual might have helped, and also seeing the surgeons lay out all tools within reach before starting to work on me several times now. I did that, but did not remember several things I really should have kept close, but will in the future, so there’s that at least. First took out the old placeholder. It is really hard not to get it wet when urinating and I really need to ask about that to see if I do it right, mailed the surgeon but will ask the local ones too again to show me again somehow. Then finally I showered for first time and first time warm in months. I drip light red liquid slowly thereafter, so put myself up on bedpad with the mirror they gave me on stand and looked at myself again. Could now more clearly see where there are parts still healing, somehow ragged edges, and it is certainly more than a little bit scary, but whatever. I may have some sort of adrenaline high now maybe. The parts that look scary are the major labial seams and the whole vestibule made from urethra which indeed is very red and swollen, the bulbus. This will change but that will absolutely take time, and I hope it does not get hurt in the meantime. Hence why I want to learn to be the gentlest I can. Putting in the tube for the water shower was complex, but it does not hurt much to put it into me or slowly push it in further. (6/23)

However, I have no idea if it goes straight or somehow bunches up, nor when I reach the bottom, and I was not able to push out then pull in the water, and that too I must ask if it makes a difference. Also needed to go back and forth between bedpad and bathroom for this part. Well, I washed – somehow – out a few rounds of water, regular tap water sadly but the local doctor said it would be fine. Then it was time for the actual dilation. Apply condom to dilator with gloved hands, apply collagenase and antibiotic to that and then push inside. Should probably start with a finger first next time, because unlike in the gyn chair it was relatively difficult. I know, of course, the feeling from pushing similar objects into others and myself, how to gently apply slow pressure and so on, but it then took a lot of time, I am not sure I got the medication everywhere it should, that I used the right amount, or that I went either deep enough or not too deep. Some bleeding when I finally pulled out. Watched the full moon and listened to music as I neither had set an alarm nor had other media close enough – will remember that for next time and also to keep spare gloves, condoms, compresses etc. nearby. And would need a mark on the dilator to check depth. I really need to do this again when they can see and verify I have it right. But will get there. Slowly pulled out – looked almost precisely like when there’s been condomed penetration during a lover’s period – and then tried to wipe up a little of the bloody mess before assembling the placeholder. This part ended up hardest as the object (the tube) was so flimsy, so getting it in did not work well. I mailed the surgeon on this also. Probably a true solid object is needed. I could use my fingers to push it in, but of course I don’t know that it goes deep enough and I am now worried if somehow there will be issues during the night because of it. But since several surgeons do not even use a placeholder, perhaps it isn’t so crucial, and waiting until tomorrow with it imperfectly placed won’t do me so much damage. Looking forward to speaking with them though. Main worry/challenge now: how to ensure I don’t pee all over the placeholder if that is a problem, and to ensure I have enough around of the medications (will need a prescription as this uses up ridiculous amounts) and all the other gear. But I suppose, one thing at a time, one set of challenges to try to perfect at a time. And hoping (and again, asked in an email) that I put the right medication on the external parts and not the wrong one. And that I did not contaminate anything with my relative pragmatism of wetlab courses so long ago. It feels a little anxious and major and challenging but of course, it will all be all right eventually, and will get easier eventually, and the whole experience was also complex and powerful as I have muscle memory of inserting dilator-like sex toys into others with near exact the same movements and kinetics and seeing and feeling that go into myself was now quite remarkable. Not erotic or sexual, not yet at this stage, but complex. It dawns on me that perhaps the 1000 hours of dilation before me this year might be quite introspective ones, with utility for getting to know bodily sensations and mapping. I just need to make absolutely sure I do it right so that I don’t risk causing any harm or infection. So I will bug them and ask. The night nurse who came in when I was trying pathetically with the placeholder did not know what to do and I think perhaps the bloody mess and the uncertainty scared her a little, but the surgeons should have no excuse so them I will absolutely ask. This was crucial, important, tiring. I won’t go over those answers to the Nature reviewers tonight either, I think, this was probably all the executive capacity I have and honestly some calming/anxiolytic would be nice right about now, but at the same time this is also brilliant and perfect and progress. Also, it is 80 minutes before I turn 40 and I just dilated for the first time, so I think I got my birthday wish of having a vagina before 40. I will just savour that for now and worry tomorrow. Love to all! ♡

Morning dilation went a little better, but honestly I don’t know yet what I am doing. I don’t think I get the douche far enough in. I also am worried the creams are used up at such a high rate (am I using too much?), and am uncertain furthermore if I get the dilator to the right depth – do I go too deep and hurt myself? Or not deep enough so I lose depth? Really need to mark this somehow. Hacked up a new applicator for the placeholder but this one does not slide nicely out, so also does not really work – still concerned the placeholder therefore does not go deep enough, and over bleeding while dilating. That said, little I can do but try and to ask as soon as I again see a doctor here. It took about 2h both of these times, but should end up substantially quicker later. Some very interesting parts – putting a finger inside, either to find the path or guide the placeholder, feels just how it has felt to similarly place a finger into a paleovagina (same sense of curvature above etc.) and also does not hurt. If I can just make sure I heal properly, I think this must be considered overall a successful outcome of surgery. Outside also looks largely paleo with main tells the vestibule swelling and the labial seams. Interesting. Also draining, with so much responsibility now for the healing but I will handle that. And I did in fact begin dilating to Star Trek: The Original Series, as planned, with the Kirk dilator now. Saw pilot and halfway through first episode and oh god this is dated, but makes sense, and I am fine not paying it full attention this way.

Got some vague answers across the language barrier from one of the doctors. He claims I will feel when the dilator is deep enough. I am doubtful, but he does suggest I should be 12-14 cm deep, so at least I can try using that as a guidance. He also says not to worry over urine contamination of the placeholder, so I suppose I will go with that (and sort of make sense – if the urethral opening can heal despite that contamination, so most likely can my vagina) and not to worry over blood while dilating. He sort of confirmed which cream to use inside and out, and mostly implied i could use another larger applicator for the placeholder, I think he was going to talk to the nurses about that. That said, frustrating and time-pressured communication, where I could not get my questions or answers across fully. His main message was for dilation to use a U-shaped motion for entry, which does make sense and I will try my best to do that. I also guess that since they don’t warn me about a lot of things I worry over, maybe those things are not actually major risks. That is, perhaps it is hard for example for me to damage myself or give myself an infection by way of the dilation or douching scheme. And probably I am not losing depth or width very quickly either given this is not a split-thickness graft scenario. I can just do my best. As I wrote this, the other doctor (somewhat easier to talk to) brought me larger tubes on recommendation from the first doctor, which should hopefully mean it will be easier to both douche and apply the placeholder, so will then try again this afternoon and that should hopefully make things a little easier. Life is strange and so am I. But I like better than before the look of my face in the mirror now. Somehow. And all in all, I feel good.

Third dilation session still took near 2h but was a little easier. Sturdier tube for the washing really helps both with the placeholder and the douche. Also I need to be more careful when holding in a lot of urine as I now lack the sensations from what used to be the distal urethra, so there is only one checkpoint that matters any longer. I hope I shall not come to have trouble controlling that, but I think when swelling is down, it will be far less of an issue. Slowly learning how to go with the placeholder in place, by shielding it with tissue held in gloved hands. The main challenge this time around was getting the dilator all the way in. I marked both dilator and tube at the 12/14 cm mark, but it must have taken near 10-15min to reach 12 cm with the dilator, and it yielded some bleeding around the opening as a result, though I am quite sure this all heals when it can and as it has to. I feel somewhat more confident. Also, it required patience and lying down and shifting position and pressure to get the last few centimeters in. Which makes sense, I guess. Of course, in some future where I might be sexual with someone, it will be up to them to get me to relax enough that I can receive. However, here I must see to it myself, and I still do remain tense, I sense tense musculature around the dilator. In other news, I will probably get to go home Monday, so needing to start to set things in motion to ensure I have all the supplies. This whole journey, as predicted, forces me to be more structured than usual. That is, however, a price worth paying.

“Stop if it hurts” is a really difficult direction to follow for me now, I realize, as there is a discomfort-to-pain continuum where I’d only consider things fairly close to the pain pole to be “relevant pain”. But I suppose I can be careful, and try to work off of depth markers. (As in, to count as pain, it has to be severe enough I have to make an active effort to endure it, the kind of thing where painkillers or local anaesthesia would be warranted. Not sure how sane this stance is.) A somewhat dire component to my pervasive sense of peace now: I now know that no matter if transphobia increases in the world to gatekeep us further, I will never risk detransitioning from any care being denied to me. This is my ground state now and I need not fear its reversal. But worth noting? This stuff is heavy in the sense of, creates a sense of tiredness following it and living within it. This all does make use of most of my energies, which I know to be substantial. I am not left with a lot of executive capacity. It is possible energy drinks or other stimulants could be used to push further, but they are unavailable in the hospital for good reason and I think I should keep such consumption low for a while in any case. Let myself be relatively improductive for a while in all regards.

Doctor with better English checked in with me and I could ask most of my questions. I feel safer accordingly in carrying out the routine. Feeling borderline sore, but should still dilate once more today, but probably try to keep it safe. Wanting to get this clear in my mind so I know I can do it right. I should not push too far or too hard. Apparently canal goes like 20-24cm deep, but due to various issues, cannot dilate that far. However, that does give some space for a followup revision to deepen, and I have at least enough depth that I can do something with it. That makes me motivated to now just focus on healing wholly and fully, and the way to go is to let it take time and keep at the routine. Once that is in place, I think my executive capacity will rise again. Also wearing tights for first time since surgery, and it feels good to finally wear clothes again, and it also feels good to be able to wear tight clothing without tucking and I think that feeling will unfold and unfold as time goes by.

Fourth dilation session. Cleaning went fine, dilation itself fine (watching Star Trek TOS S01E03 – “Enterprise vs Psychic Elliot Rodgers”) but putting the placeholder in was harder, possibly I closed up after the dilation. Sensations are beginning to remap and it is a complex, hard-to-describe, not-neutral experience to feel the dilator as deep within me as I can handle it. Beyond the wound care and muscle training, this training does have value for anchoring my embodiment. Moreover, looking at myself again, I honestly suspect that once I heal enough for scars to fade, and dog ears are revised, unless a lover is actively looking for it, someone seeing and touching my genitals won’t necessarily conclude I am trans if I have not told them. This made me happy to suspect. I want it known but because I told them, and in case of e.g. hooking up with people at parties (when those exist again), I might want to have the choice not to bother disclosing. Complex. But feeling good. There are things it would be good if I did, including commenting on a number of manuscripts, but right now, this whole set of things is really all I have executive capacity for. Will see how that proceeds. It will be good to come home soon. Love to all! ♡

This is just to confirm that, de facto, I am in fact dilating to Star Trek: The Original Series. I should finish that and move on to TNG some time during the first recovery, I think. How deep I get, how easily, and how/whether I bleed seems to vary from occasion to occasion. Star Trek TOS: S01E01-E04 (D6): Out of four episodes so far, all four has “entity with psychic power somehow among the crew/disguised as crew is/becomes a megalomaniac without conscience, abuses the crew, and is cunningly with”. Unexpected theme. Got to probably 14 cm depth.

So… putting the tube in for douching is scary because I worry its edge will hurt if it hits surfaces at wrong angles. And now I begin to get why approach vectors really matter in this sense, but from a first rather than second person perspective – it’s wild to know from the inside what I previously did from the outside. And it’s challenging and requires finagling to get the dilator in, with almost pain-seeming pressure sensations before I am there. But when it is finally in, I… like this sensation? There is something akin to the experience of electrolysis pain; when I am not dilating I find myself casually fantasizing over the sensation again? And I might somehow… like it? It is not sexual (I am too early in healing by far) but also not entirely and wholly not so? And makes me wonder, how will my preferences and desires evolve as my body is coming to be, once I am healed and have learned to map myself better? Possibly somewhat different from before. I look forward to slowly learning that, and to exercise agency as I do.

Waiting now for my ride home. Will send the clinic some chocolate later to thank for careful and compassionate care.

META: These series of posts are collated reposts from a dedicated twitter account: https://twitter.com/kybele_deployed that document, specifically, my experiences from the point of preparing for SRS, then experiences in hospital for said procedure, then the recovery process thereafter, followed by some discoveries in new embodiment and the followup surgery. As such it spans for now the mid-2020 to mid-2021 time frame, overlapping largely with COVID-19 lockdown. The original posts are still up as tweet chains. Their relative order has been preserved, but not their exact time positions. The first operation took place November 10 2020, the second June 21 2021. For purposes of being possible to upload sensibly, the collated accounts have been subdivided thus preserving, again, relative time order but not relative time position, and the time stamp of these blog posts therefore does not correspond to the actual times of the tweets.

Recovery poses unexpected challenges in terms of weakness and low mobility but all seems to go normal so far. First time in forever I let myself be helpless and I think I have needed it. https://t.co/JXg1MVBJSW

Written yesternight, posted now. I am still very tired but not sure sleep is what I want yet. Unlike yesterday this feels OK. I know memories will fade fast so want to write these down before they do. Unlike before my genitals now have a word for them that does not feel like self harm to use about myself. Still not a polite, unloaded word though. Where relevant now will use the closest medical term.

Complicated in that I don’t yet know what is what in the sensory qualia. Unsure esp what labia, vestibule vs deep vagina feels like. This matters currently re: pain. Still in no pain but that hinges on staying in exact this position. Even changing upper body creates some sensation I think contrary to immediate-scale healing. Angle shift provokes (vaginal?) swelling. Clearing throat or gut peristalsis, tugging of deep parts (neocervical anchor?). Avoiding use of local tensing muscles for now. Later probably crucial for blood flow in autograft. Staying still is a mental challenge. Easier while remaining anaesthesia makes me pleasantly slow. Feels like when waking 12-14h and then sleeping aa long earlier this fall. Reboots. Dulls but only temporarily. Nice. After gown prep I waited 3h unquietly. Severe caffeine withdrawal headache, on full fast including water. Started listening to more Galactic North. Surprised when they finally came. Took tongue piercing out and went with. Nude under gown. Rolled into basement. Anaesthesiologists were lovely, soothing, calming. Only used vein port canulla. Still has it. That was scariest part for me because painful needle. I mostly used German, shifted to English when I did not know a phrase or word. It was OK. Lay in station with canulla in, calm but headached. Old man snores like he was choking. Finally rolled in. During this waiting time silently prayed: praise to Inanna, petition for her Rite of Head-Overturning (that is, transition), and gifting to her all the upcoming shed blood and the pain and fear and discomfort, as sacrifice. Main anaesthesiologist and resident got me in specific position into, essentally, operating gyn chair. Then added drug to canulla. This was only other pain, and weird one – felt like freezing my hand far below subzero, radiating.

Then suddenly started feeling like fuzzy, drunk, blurred. And next I woke feeling like when I repaid a sleep debt in past. Happy, still tired, unable to focus but wholly safe at last. Spoke with anaesthiologist. They rolled me back to the room, gave me some whater and I try since to let my loved ones know but without pushing myself at all. Typing slow. Love you all! ♡ More later to come.

Noting with some satisfaction I had two shamans (eclectic Siberian and Celtic) and one witch (Gaian/Wiccan) sending me healing thoughts during procedure, beyond my other loved ones. Plus my own Sumerian prayers. I remain a STEM materialist but I now let myself add meaning through spiritual overlays, recognizing humans as creating meaning. I could never let myself do that pretransition, my wishes did not feel important enough then.

Healing challenges today: – vaginal packing material causes v painful intestinal gas buildup, learned eventually an approach to handle it from my roommate who had the first operation in May – got onto meds: minor painkillers, escitalopram, antibiotics, antithrombolytics – learned that if I try to sit up or stand up yet, I will faint. They do not use bedpans so must learn in next few days. But already easier. Probably due to blood loss – concern from nurses and ward residents of little catheter throughput. Mostly probably means I must drink much more as my body is a virtual sponge. Might be why my weight fluctuate so widely generally – light but stinging/hot pain in various parts of vulva. I see this as a good sign, implying thus far all is intact. May need ice pack and painkillers tonight though – pain/discomfort from just laying flat is real. Learning how much I can move but weights of sand limit that, need to ask for help – learning to use the phone to ask for help whenever needed, ask again if needed, and wait if needed – broke fast, eventually making healthier choices than default for what to request. Staying as vegan as I can, feeling good over this – little energy for anything complex but all is OK.

Met with surgeon who inspected. Overall good but some parts need extra attention for cleaning and also he advises against the antithrombolytics. Instead I should constantly move my feat while lying down, which I do worry might tear a bit. Will see. And do as he says.

Still a way to go. Could not really sleep, and felt helpless and tired as the day began, wondering how to kill time. I still feel too tired to be much use, but I don’t have to be. I will just accept mindless impressions. Tonight I may sleep better. But at least now I can stand without lightheadedness, and may be able to handle bathroom stuff, when intestines work again, on my own. Less helpless to come. My vulva still hurts, and still seeps blood and lymph from all the stitches (but nowhere near the red tide…) of the first night, and there is a minor hematoma, but doctors say it looks good. Reducing swelling and pain with an ice pack now. And had an experience which made me feel a lot better. One of the doctors cut away the hospital panties to change them, then left me lying for a while as he picked up another pair somewhere. I haven’t looked at myself yet, and I am sure so far I am a bloody, swollen mess. But where before there would be a pervasive sense of wrongness from being seen and visible like that, here it just felt like any utilitarian, medical nudity. The specifics of my body in that situation simply was not an issue any longer. I was just a person undergoing treatment, comfortable in her own skin. There is still a long way to go, but the most major step was already taken.

It dawns on me I have had the ability to give (certain several kinds of) fucks surgically removed and I think this is something wonderful, both needed and elegant.

@eirenliel I want to only give the kind of fucks I am happier for giving. ♡

I do wonder what my gut microbiome will be like (“might f**k around and find out”). Mechanical cleansing, 4 days 3rd-gen cephalosporin IV. Restarting with mostly fruits, vegetables, grains, soy, but in a hospital setting. I hope in the end will be eubiotic. Confounded by, in meantime, mechanical castration, blood loss and healing from the penectomy trauma, all of which should have some impact on inflammatory state and thereby gut microbiota too. Plus hormones, I went off blockers near a month ago, and off estradiol on Sunday but started again today, after realizing it might have contributed to the downer mood. Though main factor probably is still the relative lack of control in small everyday things, I do feel a lot better this evening. Largely this is because today I am strong enough to walk around with the catheter bag within the room, and resolve the painful and frustrating intestinal resting state. Having eaten normally for a few days, peristalsis does its job despite how the passage is narrower where the end of the vaginal canal is adjacent to the intestine, so apparently everyone has painful bloating during this stage of this particular vaginoplasty technique. Being now no longer lightheaded from standing, I could initiate normal stool with softeners and then fearfully do my best to pass it without contaminating the surgery site, the compresses or the packing material. Remembering the times I heard girls admonished always to wipe from front to back (because notably, those were the messages that stuck with me, funny how that works?) and learning very down-to-earth practical tasks again. Now relatively easier and I am less afraid – this was one of the things I dreaded most. I still will ask during the MD checkup tomorrow if all is well, if I didn’t harm any of my new self by not dealing with it right but already feeling there are more and more parts of this existence I can control better and better, where I have agency. I had expected to go very vulnerable, but so far I sort of feel mostly more confident? We shall see how it all goes. Pain is increasing more also, and I am on no serious pain medication. Might or might not need to. Worried over the hematoma, over healing issues somehow, over thrombosis impeding any capillary healing, over infection once IV with antibiotics stops tonight, over the nightmare scenario of graft not taking inside. But all of that for later. For now, I just feel good. I look forward to relearning my body while fully present in and as it. Much love! ♡

Milestone: Anxiously worrying if that rich/bloody discharge from your nethers is a sign something is wrong. (It was not, I think. There’s just still a while left until I no longer shed blood lymph.)

Also, not taking blockers every morning means I need a new routine to make sure I take my anxiolytic every morning. Probably forgot it yesterday.

And some progress already since last night in that sitting up now feels easier.

Note to self: do not neglect stool softeners.

Surgeon came by in an eccentric flurry, accompanied by his local acolyte. She literally offered “I’ll be your hands” when the gloves he wants were not available, and so the two unfolded my labia and looked around. From what I could tell, he thinks they heal well. He asked her to remove a single, specific stitch (after randomly walking off looking for a scalpel) around the clitoris so they could see healing there, which apparently was fine, and I noticed the tactile sensation. Nothing sexual with it, but I know now that part is there and that it is sensate; somehow not sure which parts of the old glans sensations readings from it corresponds to. Will see how that develops. For now, at least feeling comforted we likely are going in the right direction.

Loving the pragmatism of nurses. One helped me now in several ways; removing need for super itchy bed covers (“Hrmph. Synthetmaterial.”) by me wearing a pad instead, fixing catheter flow, and removing the back-of-hand vein IV port, as from here I take oral antibiotics. Port was much less severe to remove than I thought, not a large stretching of vein by a rigid object needing stitching, but a flexible small plastic tube. Every piece of anchoring thus gone frees me a little bit more in the moment. Embodiment and the path there is wild.

Moved to another room. No pain doing it but I have been… so physically tired for an hour since? WEIRD. Was not using my crotch for it after all. So, physical exertion being more major during recovery is a thing? Moved to a new room. Felt like no effort during, but exhausted after. Altar setup now on side table. https://t.co/QjU7K86VG4

So there is this special pain which comes from tensing the body with a catheter in place and the weird part is, I feel I have experienced that somehow before vividly even though I know I haven’t? Oh yeah. I remember it from suppositories, that is what this feels like. Huh.

Likely good sign of healing but still weird feeling as parts of my old anatomy randomly comes online in the sensory map, but 1) as parts rather than the whole segments they were and 2) without me having as yet _any idea where they are currently located_ either in absolute or relative terms. Plus, of course, it is largely a stinging pain or prickling kind of sensory data so far. Integrating this into a new homunculus whole will be a remarkable journey, but once I am better healed. For now, contributes to the pain, largely. That said, I offered this pain wholeheartedly as sacrifice to Inanna and I will bear whatever it turns out to be, to offer her glory. I am wholly happy with my choice. And might ask for painkillers soon, so I can sleep. Both of these are true at once.

Had followup with surgeon today. This time walked on my own down to surgical suites in basement, got mask and shoe and hair protections and a cardigan over my surgical gown. Led into another theatre and seated in gyn chair setup once more. I could smell how unwashed I am and felt self-conscious, lots of smell of dried wound liquid especially, musky. But surgeon and resident ignored this happily. Maybe I will try to see if I can get to shower tomorrow somehow. Would need help of resident in repacking compresses afterwards. I will ask if I can shower before he does it. It would feel so so good. Anyway. Surgeon kept smiling, comforting me in his whimsical way, like soothing a scared animal which I was I guess. He told me he’d describe all he did and I realized with some fear this would mean painful steps perhaps without anaesthesia. It was all right but left me in all quite drained, in a meaningful way. He cut the external stitches, which I had not realized were there but which I now realize were connected to some of my stinging/restricted sense of motion pain. Weird if I am already healed enough for that, but apparently. Not so painful except one in the clitoris, which felt like being cut directly. I cried out and he asked “Which means?” and I responded that it was a sign that nerves were intact. It took a while longer. Maybe it was several stitches. The pain was intense, and I groaned, staring up at the surgical lights stating within praises to Inanna and dedicating, as I have promised, this pain to her as sacrifice. It helped me to do this, made it easier. Surreal. He needed to clean that a little extra, and I think there is special packing surrounding the clitoris inside the inner labia. Apparently I must take care to ensure the catheter extends up symmetrically between the inner labia so it does not strain them. Will have to look out for this. One issue: urethra is unusually swollen and bleeding, and this must be fixed somehow. I think it was now cleaned out and hopefully will be in better shape next time we meet, in two days. He was not sure why though I am concerned maybe the catheter is hurting it when I move? The bulbus region (unique to this method: urethral segment used in the vaginal vestibule to bridge) being perhaps also unusually swollen. This is one thing the second surgery often corrects. Another would be the surplus skin folds now in the outer labia (this I see already without mirror) which allows for those revisions more readily. Then removing from the vagina itself the tightly packed compresses that filled it. This did not hurt as I feared, but I also was not yet (and won’t yet be for a while) ready to really map those sensations. Angle and direction is… unlike what I’ve known. Somehow I think I expected a rectum-like vector but of course not, this is some sort of perineum surface inverse normal vector. I worried before that I would be at risk of breaking if penetrated other than carefully (and let’s face it, I will want at some point penetration where such care needs not be taken!) so it was interesting to see the speculum parts and feel them being used to hold the sides apart quite painlessly. Apparently the canal does heal well, but the inner deep graft (which is made from scrotal skin) might not yet have. This worries me of course a lot, but less so than for the outer parts. Surgeon seemed optimistic, and filled me up, as he explained, more tightly with rolled up compresses containing some medical solutions. This higher pressure, he explained, should probably help. I will, of course, worry. But I assume that even if it does not work, he can rescue the outer part. I would have some depth at least, even if the recovery and stay here might need to take longer. I will leave this worry as I have done all I can in choosing the practitioner and procedure, it will go as well as it can. I will learn in two days whether it helped. Then he cleaned up more and more, and took me back up to the part of the clinic which looks more like a hotel. Tomorrow the resident who attended will change the bandages externally, then on Wednesday the surgeon looks again inside. At least that long with the catheter. However, I feel already with the stitches out that I can be a little more relaxed in laying down or moving around. Returning, I was tired. More emotionally than physically, unlike yesterday. And should spend tonight doing very low-effort, low-engagement relaxing tasks, I think. But all in all, gradually it is becoming more and more how my body is unfolding, and I feel joy and faith in slowly initiating that unfolding. The major parts are all behind me now. Sending you all love! ♡

Finally slept almost a full night. Probably the stitches being off, I think. Still tired but this may be sign of healing. Also helping: instead of hot cover, covering legs with the lunghi I got for that tantra workshop so long ago now, which helped me so much in working out I wanted this. It has served me well since as shawl and dress and pillow and picnic blanket, so I am glad to see it come to use now come full circle to help me rest. I should probably look into more of them, very nice quality and material.

I think exactly a week ago I must have been mid-surgery. There has been so much healing and progress since, I am honestly surprised to be this relatively pain free and functional already. Tomorrow, hoping to learn if deep skin graft (back of vagina) has begun to heal properly. And hopefully in a few more days, will be rid of catheter. Having the speculum inside me today was interesting; a little painful though largely from the opening (and I feel they kept having to use serious muscle force to dilate me?). Did not have much sensation from the canal wall itself, more from the surrounding structure, though I suppose this is something which will continue to evolve. This was again in the context of cleaning out and changing packing materials. That which seeps out is still reddish but maybe clearer now, as though I am shifting into more lymph, less blood from the sutures inside, however those are made. Was seated on a chair for first time post-op while waiting for the inspection and it was remarkable in how it was at once not very painful, and at the same time very draining. I wonder if my internal support musculature is atrophying already from a week of lying down? Or if there is competition for resources given internal healing happening. Beginning to understand therefore how people have described the recovery period as limiting activity – not from pain or steric hindrance, but from systemic quick exhaustion somehow? And is it possible this has overlap with ME/CFS mechanisms actually? Needs exploring! Later! And eventually I shall need to start practising simple activities like sitting and walking, probably still while here in hospital. Not out of the woods yet, and overall very tired, but still feeling better and better both physically and mentally? Wondering a little if I have some phenotype where damage and healing produces some internal painkiller equivalent, as otherwise so far that has been so relatively minor a factor. Maybe the injuries to parts which do not have nociceptors still trigger this? Not that I have an idea what I am talking about. Hmmmm.

Ugh. There are voluminous wound-liquid wet tissue wads hanging out of my uncomfortable hospital panties making a mess but I cannot really change them myself yet as I don’t know what packing material should go where, so it will have to wait for tomorrow somehow. Oh well. And my entire backside is a mass of dry itchy skin I am trying not to scratch to pieces, from lying down all the time, sweating and not having been able to shower. I so look forward to some stage when I can wear saner things like tights/tops/panties with just regular pads. Hopefully once catheter and packing stent is out.

Some concerns. Hoping and praying they will resolve perfectly, working on least-bad strategies if they cannot. And what fear may then still remain, I dedicate, just as the pain, to Inanna as sacrifice. For the cleaning session this morning I was woken at 7 and asked to come down to the surgical suite, freshly awoken. Surgeon heads back to his other city so wanted our appointment done before his main operation; moreover, theatre was also not available so this time I had inspection in the actual airlock to the surgical suite. Very surreal. Catheter still in place, no news on the urethral swelling, but updating on the vaginal healing. To give context to less obsessive readers, the combined method is called as such because it follows a “penile inversion” skin flap + urethra for the outer parts of the canal (same as classic Western methods) and then lengthen that with a scrotal skin graft (same as the advanced Thai methods); this is what makes it “combined”. In my case, from what I could gain from rather hurried conversation, the deep graft so far has not attached properly, meaning while it is sutured together with the outer part of the canal, it is neither binding to nor receiving vasculature yet from the body cavity. This was the concern two days ago, and the hope then being that to repack it, but back it tighter to the back wall with compresses, might speed that process. This has not worked as well as hoped, though it is still possible it might; another two days will now follow of such packing. If it does not work, what I learned during quick conversation is, it will have to be adjusted during the second stage operation in six months, making that more complex and also presumably expanding period of intensive dilation from six to twelve months, assuming it is successful then. I also am not sure what happens with the graft itself if it does not take; if it can be preserved inside and reused, or if it needs removal and the much shorter vagina needs closing in some other way then. Nor whether there is any risk of the unattached graft going necrotic under those circumstances. Nor what options then would exist for alternate graft sources: having external skin wounds as a result? Ultimately, this would seem to make for two possible outcomes: one where I am lucky and this present deep graft still takes, and one where I am looking at longer followups during next year, possibly more full anaesthesia, possibly painful skin graft sourcings and recovery therefrom, and a worst-case scenario where the vagina simply ends up quite shallow – unclear how shallow, but possibly such that penetrative sex may be difficult or more limited. It’s not possible to say yet either way on any of this, and all I can do in one sense is, try to deal with it. This too makes for multi-pronged efforts. I would need to mourn the extra time lost, try to find ways of making that time useful, and to make the most of any outcome there is. The latter is most accessible – this would still not be as bad as, say, losing the clitoris to necrosis as some do, but I honestly do feel that I want as much of this as I can, so depth also matters. However every woman has her limitations of her body, parts and aspects she is uncomfortable or have trouble with. I have had both cis and trans lovers who mourn and navigate how issues ranging from vestibulitis to damage to anatomical limitations prevent them from either vaginal or anal penetration to the extent their desires called for. I can draw on their experiences and kinship if I end up having to live with a similar limitation. I would just find the sex I can have comfortably and follow that up. The fact that I no longer am alienated by having my old anatomy there, or feel awkward having another touch or see it, already empowers me now. Likely I retain sensation, so the chance of me having clitoral orgasms at some point seems good. And if lovers want to do with me things I physically cannot offer them, I suppose I can get good at other things instead to keep them interested, if need be. I will manage, either way. I feel finally I am the one steering the ship of how I live within my body, no matter how the graft takes and what depth I achieve in the end. And if anyone can work out a solution to deepen me if needed in followup, it would be this surgeon. I’m still emotional, of course, and during the day now I anticipate that this all will be in the back of my mind causing rumination and trouble but that is just how having a mind and a heart is. I would not have undertaken this if I were not prepared for a range of outcomes, this is part of what my process on deciding on having this surgery was about. I considered a far wider range than this already. Then there is the question on whether I can now make a difference to the immediate outcome. Surgeon is unsure what the issue with the deep graft is. Probably not the skin itself, but as noted, I have had substantial issues with bloating and intestinal gas and blockage during the healing. My fear all throughout that, and remaining now, is that perhaps that has physically made it difficult for the graft to find adherence to the cavity, as it has been pushed out too often too quickly. So perhaps what I can try to do is to quiet my digestion as far as is possible. I can try to eat slightly less, and being even more diligent keeping fibre high. I will start now the use of probiotics which I brought along rather for their vaginal colonization potential, taking them orally in the hope they may shift gut functional state away from gas producers. Nurses are unwilling to provide more than two stool softeners per day but do provide “buttermilch”, which is not vegan but can serve a similar purpose, allowing me perhaps to ensure smoother, less gassy digestion. This is lay speculation, but at least a little closer to my actual expertise, and as complement when the treating physicians also are at a loss, can hardly hurt. And beyond that point, further still, is the point of the even less formally evidenced namely the spiritual. As stated, I don’t really conceive of that as anything outside of ourselves or of ways of systematizing the world, but that no longer holds me back from choosing to relate to myself and the world through such a lens when helpful. And it is here literally about something within myself – healing processes and calm centered between what some would consider sacral and root chakra. And I have framed this entire procedure within the scope of that ceremony which trans priesthoods of Inanna may have underwent so long ago, asking for her grace as they did, and offering to her all my pain and confusion and fear and response to ordeals along the path as sacrifice. Here I proceed – I continue to pray and sacrifice that this Goddess within whom I see so much of my ideals for my own womanhood transcendentally embodied may grant me relief and lead me through this to the best possible outcomes. So I act, on several fronts, and through acting, have a way to cope with the uncertainty. There are a few other things, also. Still of course no certainty yet catheter removal will be a success, if swelling has continued. If it has, it will then be a matter of further waiting. Frustrating and anxiety inducing but again naught else to do. Where I can act however is on the level of how my skin suffers. I must get them to show me how, somehow, I can shower. My whole body itches now and it is hard not to scratch. Lying in bed, sweating, for over a week, makes this near unavoidable. I need to shower, then moisturize. For both of these I need the instructions and collaboration of the nurses and doctors, so they can help me do so without harming packing materials or cathether. Perhaps there is a way I can separately wash my hair finally, or separate parts on their own, and then if they get me some moisturizer, I can use that. If not, I will try to ask my Berlin girlfriend to bring me some. Restoring moisture to the dry, dry skin should help at least make everything else more comfortable. And I sense within me, with some mourning, that I am moving to want to look into some efforts that can bring me later glory, though still not available to the world. I could do some work that I would not have done otherwise, but also would not have done now if fully relaxed and at peace with the healing flow. This in a sense serves to prepare for the potential reality of next year having a longer recovery period for the second procedure (as well as, perhaps, from procedures to deal with the sizable lipoma now seen on my side), freeing me up to not worry so much over productivity loss in that. As I wrote this, nurse came by and noted just how much my skin now was scratched from the itch. She offered much-needed sympathy, helped me apply a topical solution, gave me an antihistamine tablet, changed all bed materials away from synthetic materials to cotton and says the doctor will get back to me re: maybe changing my antibiotic, in case it is that which is triggering an allergic reaction. Thus all who saw now seem to agree it is allergy either to something in the protective sheets, antibiotic, or both, meaning we can address that part at least. A little concerned the antihistamine tablet may be counterproductive to wound healing and therefore also to the graft acceptance process but in such open-ended circumstances, must be pragmatic and consider how little certainty I have either way. So, all in all – one part of healing (urethra) still ongoing and uncertain; another part (deep graft) also ongoing but may end up a significant complication or limitation, which I am dealing pragmatically, emotionally and spiritually with, and finally for the mess of skin reaction, at least now I have allies to deal with it. Feeling affected, impacted but resolved, in action, in movement, in hope. No matter what happens I will be far better

off than where I started. Sending you all love! ♡

Update: Going off all meds for now due to the allergy – no more systemic antibiotics, no more painkillers. Luckily I don’t really need them at this stage. Pestered the junior doctors to clarify; if then there is an infection, they will use topical antibiotics for the suture sites or canal, so that is solvable if so. Re: the back end graft; indeed if it does not take now, they need to close that part (shortening the canal) and later use another skin graft (so probably would end up with another scar somewhere) to lengthen in repair or revision surgery, once everything is healed. It is conceivable this would cost me more out of pocket and need to involve more approval bureaucracy, which is concerning, but I would deal with that then. Resolving now that if I do get a disfiguring scar from needing external grafting, I will look into ways of framing that with a tattoo somehow. They suggest, we won’t know until later – another two days to wait first, then another two – if this new approach changes things. But at least this means they are not convinced it will NOT take, they see it still as a possibility. So I will try to help them by sleeping, avoiding itches, avoiding bloating etc. as above. And while the packing is in, no way to remove the catheter, and no way to shower. So there will be at least until next week with that. Which is not great. But no matter. I am the witch who faces the storm head-on, whether I weep or laugh or stare disapprovingly as I do.

Now staying off all meds for a while (well, off of pain meds and antibiotics) to verify none of them was driving the allergic reaction. Mostly OK but feeling how swelling and pain increases as a result. Hoping somehow that can be healing and aiming to sleep through it anyway.

So, some sort of allergy either to bedding, antibiotics or both, most likely. Got topical and pill form antihistamines, then back to the IV port in the hand (ugh) for IV hydrocortisone. While skin itches all over showing flame patterns. Frustrating. Though really my main worry is if this can further complicate any of the vaginal healing. It’s out of my hands though. Tired, itching less, coping. Well, even if this contributes to either a longer surgical journey or a less ideal inner outcome in the end, I will make the most of everything. Probably another week or so before catheter is out and I get to shower, I expect. Ugh.

With blood-mixed fluid slowly dripping out of me as I lie down with insufficient packing materials provided, I find myself googling whether people get similarly uncomfortable and undignified experiences while menstruating wearing pads and I suppose the scope of this diverse squicky reality does help me a little in coping with it, at least, in not being afraid or thinking that this amount of liquid going wrong places isn’t necessarily dangerous or a warning sign. Shedding a uterine lining of course is in no way the same as trying to attach grafts or skin/mucosal flaps sewn together but at least the experiences may share some overlap in being cumbersome and uncomfortable.

The adventure continues! Was wheeled down for followup not of the vaginal compresses, but the urethral compresses. Lots of messing around with pushing in fluids and… urethral speculums? Which felt remarkably painful. Especially when one slipped. But one reason may be apparently a 10-14mm bleeding tear in the urethra. They spent a lot of time trying to fix this, with several phone calls to the old surgeon and sending him pictures. Pressing down hard for five minutes a few times. Using some sort of electrified tweezers that make sparks and burnt flesh smell, making me nostalgic for laser. However, nothing to do but put in stitches. Without anaesthesia (they debated it but had no good options). I did the Golden Dawn Fourfold Breath and rode the pain. It hurt less than the way the torn opening hurt when stretched by the speculum at least. Apparently bleeding finally stopped (but now I do need blood thinners for the night) which they had not expected (but from how I understood it, old surgeon did). I hope this will solve the issues with the urethral healing at least. We will see. I was complimented on my pain tolerance and on not getting panicked, so I guess I’ll just endure whatever needed to get through this? Also they noted my clitoris as unusually sensitive at this stage and I really hope it stays that way. Thanked them, elevated back up and probably will need to largely rest tonight as all this still took a lot out of me. I hope I will not harm these stitches with how I move during the evening and night. That worries me in a way the pain does not. I wonder if perhaps my preparations really did work? In the sense of, for years even pre-transition treating every painful experience as practice for this, Gom Jabbar-style (“What’s in the box?” “Pain.”). And then slowly starting to associate prolonged pain with pleasant fuzziness afterwards. Have I succeeded in training a certain kind of pain response, I wonder?

More followups; urethral healing seems well; but most likely the deep graft won’t make it. Sad but not end of the road. Meaning about half the depth needs replacement by later skin graft. I have lots of questions but so far could not get them answered across the language barrier. But from what I can tell, they do not plan to excise the dead graft part, but just to let it shed? Which raises the question: will half the vagina before revision lack a lining? If so, what will the walls be made of? And what does this mean for dilation? I am sure I shall learn. And will navigate it optimally. And realizing that being Twitter-open with even things like this is part of how I handle it – parts of the surgery being dissatisfactory or requiring followup is easier to bear if it does not feel like something shameful that I have to hide. Life in public is safer than life in private for me, somehow.

My parents and sisters and families sent me roses! https://t.co/bz1LwKJyMH

Spots on the arm with the IV which grew dark and flushed when we added the prednisone to treat the antibiotics allergy, are beginning to fade from dark red to mid brown now. I wonder if their chief presence there implies most response was there, and if there is such a think as antibiotics deposits from antibiotics IV and if those are unevenly distributed across the body from where the IV port is located?

I am beginning to be recovered enough that my body is a bit restless, making sleep harder, but still not enough to casually move around (esp. with regards to sensitive bits). Possibly I should start trying to sit up more, but still leaking so much discharge that I fear it would get messy quite quickly. Frustrating but OK. If I understand it right, we now await full urethral healing and end of hematoma, slow sloughing of deep graft, and full healing of shallow graft, before catheter can be dispensed with. Wonder how long it will take? Well, keeping at it, slowly getting better. Allergic itch mostly subsided!

In the interest of reporting trivia, thus far to make time pass during recovery I binge Castlevania, Bojack Horseman and Queen’s Gambit. There is something missing though and as my strength returns I am getting terribly restless.

I need to try to get then to explain to me what to expect if there is a region of vaginal cavity without skin graft even during an intermediate period. I want to know what it means re: risks, challenges, discharge, dilation. I will eventually get those answers, but am impatient for them, as I want to be able to start preparing mentally. I must try to ask again once I have a doctor with good enough English around.

Inspection today was remarkable because the doctor doing it now was actually gentle with me instead of prying up my urethra with the speculum. This was nice. It does make me wonder; of the ones I was so far cleaned by, the men all have been substantially rougher and I cannot help but wonder if it has any connection with whether they know of anatomy like this firsthand or not. That said, this is way too anecdotal, way too little data to say properly. They all seem concerned about the urethra swelling though, even the old doctor. He now suggests: on Monday, we take the current catheter out. If I am able to urinate, then that is great. But if I am not, they will give me a puncture catheter and I may have to take that one home. I am not happy with that, but I will deal with it if I have to. Actually I am quite afraid of that possible scenario so I really don’t want it to happen. Meaning I should focus 100% on urethral healing and gentle handling until then, I suppose. Anyway, I still could not really get clear answers on what to expect with the deep graft. They all say different things, either positive or negative or just (as the old doctor notes) to wait and see. I hold out hope it will heal. Otherwise, at least getting confirmation I will need to dilate, and also to do regular checkups. And the area without graft skin would be some sort of hybrid material involving scar tissue. So no real clarity yet except cannot say yet either way. And very much hope, from my end, that I will be able to urinate without the catheter on Monday, because I really don’t want a suprapubic catheter; the thought of a port going surgically through my abdomen – that I could, in principle, damage by rolling over on the side! – is very scary to me, and it is a scary thought of, what if the regular urethral passage closes somehow? Not that it should though. This will be OK. Sooner or later, one way or the other, it will be OK. I will move through this until the needed outcome is achieved. There is nothing I cannot endure in the pursuit of my goals.

Idly-boredly-hopefully googling “how wipe after urination” and cross-referencing different tutorials. Still stuck in catheter limbo, but would like to have a plan for when not. Apparently children are taught this by parents. Wrote long pretentious tweet chain involving COVID and chrysalis and being a body but Twitter ate it. Might rephrase later, maybe.

It was a little unsure whether I’d get wound cleansing today but the old doctor insisted the young doctor should, and I am glad he did. The concern was mostly, is my urethra strong enough to handle specular inspection yet? Turns out that it was; sensations on the verge of being painful and sign of breaking but staying just here of that. Old blood washed out but no new blood, so maybe I am lucky and now that part is en route to healing. I am beginning to believe that the parts I feel stretchy pain in sometimes really are outer labia and that what hurts (and stains some of the packing) are the seams there. Lower perineum is a little torn but that is not new and hard to avoid under these circumstances. Have not showered for two weeks, and not showered hot for months and months. It seems likely my movements have minimal effects on the urethra except through the catheter sitting inertial within it. This time, feeling urethra stretched with the speculum actually helped me sort of feel where it was, though I have no idea which sensations correspond to its opening yet. No news on the deep graft. I don’t think they changed the vaginal packing this time, and I am not sure why, but judging from the stains on my sheets, that now mostly leaks the salve it it packed with, but little if any blood lymph. I will take this generally as a good sign, whether it signifies full or partial healing. Looking forward to know more, and at least it is new – previous days, that compress was always wet with red liquid and now it doesn’t seem to be. We will see for that part. As for putting bandages back on, the main irritating sensation now is how the catheter tube lies directly against my clitoris. It is not pain sensation (and certainly not pleasure), just the kind of sensory overstimulation and salience I remember from skin that always used to be almost-intolerable to touch directly without anything between (or substantial lubricant). Unless something goes wrong later, it seems I really will retain a lot of sensation there, which eventually I am sure I shall explore and make use of. So next somewhat unclear step is, sometime tomorrow clean again (urethra? vagina? both?), possibly remove the catheter, possibly remove the packing, possibly add another catheter? Nothing really certain either way until it happens. Until then, remaining in chrysalis. Clearly feeling stronger and a little more embodied today though! Love to you all! ♡

I guess the fact that I tweet every detail about my genital surgery recovery on a public account does mean I can’t credibly claim to be a particularly private person, can I? Well, I looked inside myself to see who I’d find there. And this self is the one I found. ♡

Catheter staying in until Wednesday when old doctor is here again. They will then presumably give me a suprapubic catheter thereafter which I can then be weaned off at whatever pace works. Not the most comfortable path forward but at least one which means I am cared for and treated as inpatient as long as possible, which is otherwise, I think, good for healing. Preparing for cleaning again now.

It is quite interesting that so far, that which has hurt, rather than been just uncomfortable, has been: 1) cutting stitches in very sensate places; 2) making stitches; 3) stretching of already-hurting urethra with the speculum. In principle, unless it really involves tearing tissue, I can just navigate it as something other than pain. Still actively working to stay calm on the operating table: fourfold breath and invocation of calm. I can absolutely see how people could end up traumatized by experiences like these, and I think on some level I am trying to protect myself from that by ensuring that I am able to contain emotions and sensations when they happen. Essentially, I am trying to stay unafraid so as to not associate genital sensations with fear. I think I am successful.

To not get too warm/sweaty and trigger allergy again, as I lie in bed these days I cover my legs in the lunghi I got for a tantra course three years ago, and which has served me as multipurpose scarf and pillow and blanket and much more since, one of my favourite pieces of clothing. That workshop was also instrumental in helping me realize I wanted this. Interesting to look back: https://t.co/HRfRPJhDmH

Somewhat chaos of what I am told continues; new catheter should go in probably tomorrow or the day after. Old surgeon prefers starting with that to give urethra time to heal without either catheter or

urine throughflow, and I’m here basically because I trust his judgment, so fine. My worrying mind is concerned that waiting too long to get off the catheter would make it harder, with long-term dependency a worst case scenario, but really, if there are issues, we will just increase efforts until they are resolved. This will all be fine. Still, keeping my emotions a bit in check (and staying in sphere of distractions meanwhile) until resolutions are definite. I observe with some interest this fear in me of complications and imperfect outcomes more generally, not just in and of themselves, but because I fear somehow that others in their heart of hearts would question my choice to do this, or pity me, if I do not solely present a success story. In response to that irrational fear and resulting pressure, I do the opposite – I try to share everything with anyone who tries to listen, thereby removing the hold those fears could have over me and making me free to just be present. It will all be all right, and either way, here I am living my life. https://t.co/x4j4hqIyVL

(Also watch the video because it is amazing and beautiful.)

(Why are my nipples itching?)

Cleaning once more. Speculum hurt less, but apparently some place in urethra is bleeding again. My guess is the catheter roughs it up, so switching to suprapubic tomorrow or Thursday probably is precisely what is needed. Some really painful sensation when the doctor pressed against bleeding, felt like something might end up torn in the connection surfaces between… things, but in practice, I suppose it will all heal up. The body is made to endure continuous damage and heal continuously after all, and especially in these parts. And without the catheter, it really should end up less of a continual insult to the poor tissue. And really, the effort as a whole is remarkable. The vestibule is so tiny yet contain at least three separate systems and interfaces each with different needs. It really is remarkable surgery. But I shall feel calmer and safer once I know all is fixed and done, and I know all parts can finish healing on their own, and all functions are restored properly. I wait patiently until then. I am good at this.

I guess I have some emotions on the urethral healing situation, worrying that there will be longer, more durable complications that take more hassle and pain and scheduling to fix. Or that any of the other parts will be hurt in the course of that healing. But then again I also know this is largely just me being anxious, it will be fine, I just need to wait this all out and let healing and interventions take place as needed so I can get to where I should. I have what I need to do so, I am well-prepared and well capable.

META: These series of posts are collated reposts from a dedicated twitter account: https://twitter.com/kybele_deployed that document, specifically, my experiences from the point of preparing for SRS, then experiences in hospital for said procedure, then the recovery process thereafter, followed by some discoveries in new embodiment and the followup surgery. As such it spans for now the mid-2020 to mid-2021 time frame, overlapping largely with COVID-19 lockdown. The original posts are still up as tweet chains. Their relative order has been preserved, but not their exact time positions. The first operation took place November 10 2020, the second June 21 2021. For purposes of being possible to upload sensibly, the collated accounts have been subdivided thus preserving, again, relative time order but not relative time position, and the time stamp of these blog posts therefore does not correspond to the actual times of the tweets.

Knowing myself, I risk flooding my regular account with way too detailed surgery-related content now that my SRS finally is scheduled, throughout preparation and recovery. Rather than alienate regular followers, I therefore make this alt for that content. Read at own discretion.

Actually preparations are soothing escapes from other stressors. In part because it leads concretely towards something I have longed for. (Maybe I should get a good freezer before Nov 10 so I can keep food stocked more easily during period of low mobility?)

Just as deciding on SRS was almost as slow and complex as deciding to transition in the first place, so is there an analogy between coming out and letting people know I will be away for this. However, at this point no real worry over the process, rather this coming out I enjoy.

Perhaps not least due to my sadism wherein I _know_ people, especially men, will be uncomfortable thinking of what the operation entails, and one side of me delights in causing this discomfort. I am, apparently, a troll.

(Increased priority: do not catch COVID-19 before November 10. Should probably start isolating even more diligently. I wish there were even clearer strategies that I knew of!)

It’s really quite absurd, in a way. Just seeing a needle used for blood draw makes me tense. And in 52 days I’ll have IVs, surgical drains, catheters and probably like several blood tests per day. Not to mention deep surgical incisions through core musculature, removed organs and microsurgical repair surfaces. It’s hard to even imagine. I certainly have no real frame of reference. It feels surreal. But on the other hand… maybe everything is surreal? We just think some things are not because we have a system of habits where they are expected. From those sisters and other siblings who walked this path before, I know it can be done. And once I know that, all the rest is just pain and instinct and fear, and my will ranks beyond each of those. So much of what I did these past years was in order to make it so, to steel my will so that I can have conscious agency, and on some level, having this in mind. I know it will be fine, because I know I am much more than that frightened path, who amuses me now more than anything else. I have learned to take pleasure from pain and excitement from at least some forms of fear. Still, it’s pretty wild. And you know? I bet I’ll _still_ be scared of having blood drawn even after going through vaginoplasty. It would be on brand for me. I… am going to handle this. Beyond the habits and expectations of that small-town child, I am intellect and burning desire for new sensations. Always within me the desire to face the world and be liberated and improved by it, following its dance. That is what I will do again.

Things are getting real. Now have a checklist of documents to bring on day of admission – which is 48 days from now OMG – and a list of blood tests to get before then and I am asked to also order my dilators. I think I will name them Kirk and Spock, in ascending order of size.

Example of problematic but interesting thought/response/emotion. In continental Europe and internationally, unlike my Scandinavian past, women often perform femininity by greeting each other through mannerisms like cheek kissing. Not during COVID of course. But otherwise. When being invited to these, I feel validated, but also always extremely self-conscious, worried that I overstep boundaries somehow simply by accepting, worrying I will somehow commit a faux pas and be revealed as impostor. I would never initiate these, because one thing from my experience as awkward AMAB person is the fear of being read as predatorial, even where there is no reason whatsoever for that fear. Somehow this fear is also jumbled up with my sense of body and body as seen by others. There is some part within me that feels hope and expectation that ridding my body of a genital configuration that is coded male to many will make it so that I no longer worry about being read or perceived or interpreted as such, by others or myself. And I recognize this whole complex of thoughts and associations and expectations as deeply toxic and problematic and uncalled for, and I can see through it, but I still somehow feel this is one of many small facets by which changing my body might make me feel less uncomfortable, less out of place in my own perception as well as in others’ perception of me. Not rational. But one strand in a large bundle of both rational and irrational needs and yearnings and fears and hopes. Our bodies are flesh and constructs interwoven and there is a myriad paths they can take and this is one of many of those facets, one way in which it shall be interesting and to see how and if the surgery changes how I feel, where and how I feel comfortable. Which is also a regard in which I possess agency, and I shall exercise this agency. All is love!

Insight: This current box of androcur tablets is probably my last, because in 47 days I will no longer need them and I will taper of them in 26 days.

Given two offers to do academic career talks/panels at about a week into planned recovery. I wonder if it is a sign of my deeply flawed judgment that I am considering accepting those invitations anyway, in part because I will want the audience at that time.

Class privilege in transition care: Happening to know a senior cardiologist who can casually arrange your pre-op ECG tests.

OMG 41 days.

“Being ready” might on some level just be realizing that the need to “be ready” is as illusory as “being ready” is. This is going to be surreal and heavy and major. I should prepare that ritual I have been looking to do. And ensure all is in place. Well, that is what I am doing.

I dreamt in several long sweeps tonight how I was in recovery already (but in social context still) and I want back to those dreams rather than wake up. This is new for me.

Also I am panicked about either catching COVID or my surgeon doing so before we get there. But I can do nothing but continue to move.

38 days. This is doing heavy rotation and may the last I choose to hear before going under: https://t.co/Auiqsnnezd

My dilators were delivered now, to my office. Tomorrow I pick them up to see them for the first time. I believe they are very different from the most common designs – they have some yield, for example. Soft bois to keep my garden in shape? Foam-based dilators as per the Combined Method of SRS. I decided already to name the smaller Kirk, the larger Spock, but what about the intermediate? They will boldly go where no man has gone before, but my knowledge of TOS characters is still quite shallow. Sulu? Chekov? https://t.co/0xuiPhtJqE

My nutritionist colleague kindly offered useful advice on how to handle the stages before, during and after my hospital stay. I suppose simplest to say is: vegan high-fiber DASH diet is good, 16/8 or 5/2 is good, do not calory restrict while in hospital, seek antioxidants. Realized while talking to her that not everyone calms down and sleeps well on coffee, or drinks the amounts I do per day without feeling the slightest bit agitated. Given the same applies to other stimulants, this is yet another point in favor of me maybe not being neurotypical. “Bones”. Middle dilator is the doctor, the real McCoy, “Bones”. I believe that both “to Kirk”, “to Spock” and “to Bone” are verbs.

Giving birth to myself. I fear essentialists would deny me the analogy, call it appropriative, but it rings true for me in many ways, including scope and impact and also in several very bodily senses. I am pregnant with myself and I feel some form of fatalist serenity in this. One of my major papers I finished final submission of because the lead authors both gave birth just before we were done. With my own lead author papers now, it seems very likely my collaborators in turn will need to do the final submission as, by that time, I will be in hospital. Knowing I will not be fully ready, that no-one ever is, and that it will have to be as it is, that it is all right that it is. I have until rest of the year still with my therapist before she leaves the praxis. We will schedule a few remote call sessions for the time I am in the hospital and in recovery. In case I am hit harder or weirder than I expect. In particular to look out for post-op depression. My OP date is now within the timeframe by which my meetings are scheduled so I get to tell all my collaborators. Enjoying bc it makes it more real, bc my troll ass enjoys causing mild discomfort, and bc this feels like a teaching opportunity about trans existence in academia. Part of which, honestly, is about more of them knowing concretely that anatomy can and often does change in transition. I want people to know I will have had surgery because I want them to see my body as not so different from that of any other woman’s. How I feel about myself is affected by what I believe others believe about my body. I recognize how this reflects my particular binary modality, perhaps, and must again make clear it is a despicable transmedicalism that states any trans body needs this to be what we say it is. At the same time I need this, and inside me is happiness I almost fear letting myself feel that it finally happens, I fear relying on anything until certain, will worry until I wake up reconfigured. Yet it is now giddy, excited worry… it’s a month away only. Holy shock. This is big and it is time for Feelings to come along, I think. 31 days. Less.

After 32 months, gonadal volume has shrunk to less than a third of what it was pre-HRT, so I hope there has been enough atrophy that three weeks without suppression won’t come with any testosterone spikes. Hopefully, I will just feel as nervous and excited and scared as I do now. So this blister of Androcur pills is likely the last I will ever take; after it is through follows a three-week pre-op washout period. I wonder how that will feel? My hope is, not much, because I hope my endogenous production already may have stopped. Will I Instagram from the hospital 27 days from now? I think it very likely that I will yes. May the Lady have mercy.

I am not sure what it says about me that one major thing I look forward to during recovery is to somehow get to take a break from everything for a while. And that nothing else appears to let me.

Since yesterday, no longer taking androcur (CPA; testosterone blocker) as surgeon recommends going off them for three weeks pre-op. So I might have taken the last of them. Curious on whether that will mean any more changes long term from being off non-bioidentical progestins.

Songs that reference SRS, even extremely indirectly and in weird fashion perhaps only in my head, that used to be somehow very important to me for this reason but without me contacting the dots or even realizing I was trans, just that it was something which made me wistful. Thinking that it was something which… somehow would be meaningful but that wasn’t something which I could be wanting or having. Even the hardships seemed appealing, yet unavailable. Several songs on Forest Families. Zeigeist songs. Others. And now finally I can start moving those images and thoughts and emotions out. Alchemy of lives, of finding ways of becoming ourselves, of moving from dreaming into being. I’ve grown and I am, more than anything, happy with whom I’ve grown into. And I will continue to evolve further onwards.

Not sure which surprises me most: that I could navigate a dermatologist followup in German (understanding ~65%) or being asked about my transition direction by someone who saw ~98% of my bare skin already when I explained I needed the followup done before my imminent SRS. Like, he literally has seen everywhere but front under magnification. Between buttcheeks even, with panties pulled down. And remembered me well, yet still seemed genuinely surprised I was transfeminine. I started HRT at 37. Yet somehow I pass as cis to healthcare providers? My schedule for next two weeks is packed full with items to somehow finish things up or hand things over. It will be intensive, and all of it aiming to be able to move my various projects from a state of requiring immediate attention. Exciting and tiring and… real.

Two weeks.

Scheduled a meeting with my gynaecologist for a week post-release from hospital. Like the parabolic ant, I try to prepare all I can so it can fall into place as well as it can. I hope all will be well.

I think I have 1) ca 30% higher libido and 2) ca 30% higher dysphoric anxiety, these days now. I wonder very much if it is due to being off the testosterone blockers, as both of those things changed in the opposite direction when I started HRT. Curious! Won’t be for long though.

The experience of buying pads, without any idea what size I actually need or what brand is good, so playing it safe in the middle. Not for any uterine lining, but in preparation for substantial bleeding and discharge during healing. I’ve thought many times wistfully of that expectation of coming to bleed a whole life’s worth of periods during a year of recovery. I realize none of this (cis or trans blood) is anything to romanticize, but still there are Emotions surrounding it, by way of symbolic anchoring. Less than two weeks now.

So hard to tell what is nocebo. But while off the T blockers, it really does seem the few strands of facial hair that remains are a little thicker, libido more intrusive, and my anxiety is not great. It latches on to the fear of COVID, that either I will be infected and denied admission, or my surgeon be unable to travel to the city or even catch it himself, or that there will be shutdowns, or that after will become very complicated, all of it. Of course this can just be regular anxiety, but as anecdotal data, it is absolutely at an uncomfortable level right now. However the causality looks, I very much look forward to when this will be over and any elevated T levels will have subsided. I am very anxious over more delays and postponement, so will try to bury myself in work as a distraction.

Really, I am going to believe there will be postponing for whatever reason until I am in the clinic and they put me under. Near unable to believe in a good thing until I am certain it cannot be taken away. I wonder if this masks apprehension I have for what is to come?

Privilege is having a friendly cardiologist effortlessly setting pre-op checks for you. Still waiting for blood tests though so still nervous. And I really do need to deal with this hypertension, else minor valve regurgitation will not stay minor. But so far. And ceasing 60-70h work weeks on stims and salt overdoses should help. But that is for later. For now just noting that dressing down for echocardiogram my breasts looked awesome in the mirror. Frivolous? Sure. But still made me smile a little to see.

Not liking my parts and tucking them out of sight means I only notice now that there is some very dry skin in my groin area. After worrying it might be some form of fungal infection (but probably just dry from tucking), I embark on a project of remoisturization to make the skin material as supple and useful as possible for its soon-to-come origami. Looking at my body for the first time in a long while, using a makeup focus mirror for new angles, it does not look as bad as I feared (dry and flaking) though still will take and follow any recommendations the surgeon makes in response to my email. I can also see how, I suspect, my vulva will look, what stretches of skin will go where, and that is another emotional thought, plus an interesting prediction to try to later assess the accuracy of. Moreover, there is a region of skin noticeably darker since starting estrogen which I suspect is precisely where the vaginal opening will be, and which makes me very curious on what sort of E2-responsive cell differentiation that reflects. It seems like it might be overlaying a void in the musculature, an opening into the body’s inner space. Very much like sensing a sculpture inside a block of stone.

(Oversharing too much yet?)

Just over a week now. Remaining gates to pass: be approved by anaesthesiologist, test COVID PCR negative on Friday, mostly. Still scared to near paralysis that something will block me from this, but I learned over decades that there is no way around fear, only through it. Most preparations are either done or I accept they will not be done. My flat may or may not be cleaned. The hot water may or may not be installed. I will pick up the vaginal douche and my medications, and may or may not get painkillers preemptively prescribed. I expect to resolve the major projects – give my comments on five manuscript drafts with various collaborators I expect to be submitted during my absence, set up funding for my PhD student, and bundle and document some code for my poor coauthors in case they need to rebuild figures. Supervision for students and group meeting schedule is set up, and my postdocs deputized to handle most matters. Setting up email autoreplies for the first time in my life. Scheduled therapy appointments via phone for time in hospital so that if I end up with post-anaesthetic depression, at least someone will notice and we can intervene. Will squeeze in a few more things including meetings for future planned projects also this week. Praying silently to Goddess that I will not get sick, but the way my immune system seems to work, so long as I avoid getting cold, and stay sufficiently high on adrenaline, and sleep enough, I hopefully will avoid that. It is out of my control. Preparing playlist (collaborative! let me know if you want to add songs) to listen to during waiting and waking and recovery, and preparing in my mind the ways in which I hope to make use of this all as a way to work on my issues – largely centred around trust, in a widest possible sense – within scope of what I hope to undergo, and the mythological overlap I create to try to make the most of that, templated on the story of Inanna and the Huluppu-Tree as a woman’s coming of age story and first resolution of conflict with her lack of self-esteem and confidence. I believe within this framework, and linking it to my conclusions from therapy that I could try to consciously learn to stop expecting so little in some ways, learn to be less wary, less afraid, more able to receive and accept all those things the world wants to give me. This I will do. Sorted my moving boxes for first time since coming to Berlin and found a pile of books I have been meaning to read since I got them, and have not made time for. I have not been off work for several years, this will be the first in a long time that I will be unable to stay responsive and I need it and long for it so much. Surgery is no magic bullet for anything, but I hope it can be the opportunity, for how it is placed in my life and in place and time and symbolism and materiality, to let myself finally do the work in my own heart and habit that I need to undertake. I should blog about this, to make my journey of more than three years visible in case it can help others in my situation, but feeling it easier to tweet these days than write on the wordpress site. Perhaps eventually I will collate these tweets as blog entries however. Finally, so much love to all of you who see me and support me and who share this world with me, in all its grotesque glory and hilarious hope.

Met with anaesthesiologist and consented across language barrier. No risk factors or contraindications but realized filling forms: I would have denied them if there were. I am wholly ready to risk my life for this procedure, which surprised me a little. I suppose I am ready now.

First filling of my HRT prescription without the androcur. Having Emotions around no longer needing it (or possible side effects, too) soon. My friend suggests I might be in a dissociative state, given I don’t really feel nervous, but it might also just be that my default state now for a while has been a sense of chronic urgency and swimming in place to stay on top of things. If anything, I feel a dull longing forward and a sense of impending peace and a sense of wanting to dissolve into the process and be cradled for a while.

It’s probably not a great idea to work at this high intensity the week before surgery, but it keeps me at least from worrying something will block my access because my mind is occupied, and if I know later that all my projects and expectations are on track for the rest of the year, then perhaps I will actually succeed in taking time off. First vacation since I don’t know how long. Using 45 unclaimed vacation days from 2019-2020 I would lose otherwise. Time if nothing else to read papers for general curiosity or strategic learning instead of tactical searches for something supporting one point or other. Or just be still and absorb fiction, or be present in my body and see what emotions come to me unbidden. Or something else. Any or all of those things. But so far these last days don’t seem like they will be particularly calm in and of themselves. Though at the same time, I don’t feel stressed. I feel in control, because somehow it will be OK either way, and I recognize my own achievements, or some other mechanism still is operative. I can observe that intensive focus must be followed by some time doing nothing though, before I can be relaxed enough to sleep. Hence why this night of grading a PhD thesis and of commenting on a surprisingly powerful manuscript I found myself involved with now must be followed by something else before I sleep, despite how late it is. Well, these things work. And then we will see what my habits turn into when I don’t have to be so intensely effective. We don’t change our habits easily even when they don’t make us happy. These habits do make me happy, but they are a local minimum in the energy landscape and I hope to find eventually a lower such. I think I will.

Maybe it is nocebo, but after two weeks being off the testosterone blocker pills to reduce thrombosis risk during surgery, I feel stubbly itch in my armpits for first time in forever, and am followed by a whiff of body odor which slightly nauseates me. Very uncomfortable. I am surprised to find that even after 32 months of suppression and visible atrophy, gonadal production still starts up so quickly after suppression ceases. I can’t wait to be rid of this permanently. Less than a week now.

I think that one of the goals I have for personal growth facilitated as side effects of what I plan to undergo, and the opportunity for self-reflection and -adjustment the next months will enable, is to gain the ability to more deliberately decide which fucks to give/not give.

Just one of those things: when you use first name with the really senior clinician because he is not also your treating endocrinologist but simply your collaborator, but feel awkward not doing “Dear Dr X” with his subordinate, who IS your treating endocrinologist. In a conversation about starting up a study on the treatment you are undergoing with them. Mixing almost all roles at the same time (let’s leave aside how it could get even more complicated for now) with resulting confusion on how to address your emails. I assume something similar must have happened somewhere to someone at sometime, but I don’t think it will have occurred often. The surreal experience of being a trans researcher into something relevant to trans health and not leaving well enough alone. #EmbraceYourHubris

I have a slight throatache. I think this is just the kind of microcold I get like all the time, but I am panicky it might be COVID, not because that worries me (though it should) but because then my operation would be delayed. The requirements, with increasing numbers of infection, are to COVID test within 48h (but they say they accept 48h of working days at least) of hospital admission, and warned me now laboratories are getting overwhelmed. So today went physically to testing clinic (because due to bugs could not do it online) to shift my Friday COVID PCR testing appointment to Thursday, which clinic says they will accept. I am calmly frozen fearful over somehow having mild or asymptomatic COVID, but I guess I will know either way. And I feel a weird sense of surreal unrest permeating which I suppose is the beginning of the overall nervosity and emotionality, including the lower layers masked to me, having me dissociate. But it may be just as well, for my way of dealing with this is to work and that means I can address the remaining things, the handover of main long-standing projects mostly, all of which requires a degree of focus and effort that usually comes to me at a cost, and which now forms a welcome distraction and are possible to handle well enough if I bring to bear this numbness in combination with enough (legal) stimulants, for now. Ceasing any alcohol intake at this point. I got all my prescriptions filled, and the only supply I have not yet gotten is the vaginal douche, which required them to resend for it, so that will still happen this week. More of an issue is, no visitors now allowed in the hospital, so my girlfriend cannot accompany me going in (would have liked to hold her hand as they explain the procedure to her, as moral support – will know that she will think of me, at last), and cannot be there when I wake up. However, this is no difference from what, say, someone giving birth in COVID time experiences, not being able to have one’s partner close for important support. I will sense her, and my other partners, there in my heart, and hope for Discord with them after I wake. And with all these emotions and challenges, I long for it like I find myself longing for pain, or for large sea waves – I want it to wash over me, carry me outside my control, and let me change and adapt with it. With all other burdens temporarily set down, I want to see what feeling all this with no way of escaping can do to me, if it can help me become yet more real and present emotionally, as well as facilitate learning to access the embodiment the surgery will give me. Hence the need to be sure everything else that scares me is for a time handled elsewhere, because between the panic zone and the comfort zone, that is where the learning happens. I anticipate coming out of this protective numbness to be faced with something that does not just happen because I keep choosing it, but which has become an independent reality of my situation. I look forward to all of this, including pain, fear and loss of dignity. I look forward to see how I can evolve when exposed to it. And while certainly there is also fear _of_ the surgery masked by greater fear _for_ the surgery, I am secure in the self-insight that right now, and for a long time, I fear being denied this more than almost any other outcome. And so I am smiling calm in the eye of the storm, and I prepare as I can.

Douche arrived. I shall have to ask the nurses for how to use it, and size looks a bit daunting. Interesting times. Waiting for COVID PCR results now. https://t.co/CZozL6P4Ri

COVID antigen test negative but PCR will take a few days to be processed. I am zero chill but this shows only as weird tiredness and body sensations. I suppose this is an example of some form of dissociation. I have rarely felt this way. It feels remarkable.

I am incredibly restless inside, and using full-on my mix of semi-illicit anxiolytic/stimulant combos and workaholism to see to the remaining things (getting things ready for coauthors to finish revising and resubmitting two Nature papers) needing done before I can leave. In my body, less than my conscious mind, is some sort of panicked fear that something will go wrong and deny me this. I feel little on the surface but coming to rest feels intolerable, impossible beyond words and on the level of instinct. And probably other emotions in turn hide behind those. I don’t think I fear what will come, or even what can go wrong much once I am on the operating table (except perhaps I also do and that is somehow part of this too? It would make sense I would be nervous after all) but I am a complete bundle of nerves. Dissociated and distracting myself. It is so rare with emotions like this for me. I am fascinated observing myself, in this stage of pre-op craziness. I am increasingly tired, erratic, feeling my head is full of clouds. At the same time focused anchored. I wonder what will be my new normal? When did I last know “normal” actually? Have I ever? I don’t know. I just know that every fiber of my being right now is an arrow aimed at the moment I have worked for so long, prepared for so long. The moment that I can finally start processes of healing and growth – and mourning, too, I think – that I have denied myself. Nothing is ever a single moment. Nothing is ever over. Everything is a process. But this, if I can make it so, can be a turning point in the road. All of me long for it, and I am held over room-temperature fire on a spit while I wait with bated breath. Great Inanna, Lady of Heaven and Earth, look kindly with grace upon your priestess and grant her your Rite of Head-Overturning. In your infinite love, grace her with your blessing, and she shall bring you glory by making immanence that which you embody in transcendence. May her nervosity and fear and pain and blood and anticipation all be gifted you for sacrifice.

This has stayed on my mind since I read it. https://t.co/eKQEv1nSro

COVID PCR test negative. Slowly, gradually getting obstacles out of the way.

I now started listening to the playlist as my nerves are beginning to sense the realness of it all. Thanks to all who contributed so far! ♡

My validity as a woman does not hinge on my anatomy. That said, I intend to use this much-anticipated change in anatomy to help me lay to rest, gradually more and more, lingering feelings of inadequacy, impostorship, illegitimacy. The two are not directly connected but I wish for the change to remind me saliently that I can and may put those emotions at bay, a symbolic message to myself that I don’t need to hold back, to deny myself space or to think of my inclusion as conditional, by invitation that at any point can be revoked. Others will do and feel and speak as they will. But I can start in myself, my own heart and will and body, and root myself there regardless. I could perhaps do so without taking this step, but I believe one consequence will be to make that work, eventually, easier. There are many other reasons I undergo this, such as wanting to not be uncomfortable with my own sensory input or the input I infer must be in the qualia of those who see and touch me, and those aspects also will follow from internal work I can soon start undertaking more easily, recognizing all internal work happens as part of a whole where also there is an exterior.

I must have listened several hundred times to this song in last three years. Now, en route to the hospital, it feels particularly appropriate. https://t.co/2dmTzH8cgB

(It is of course on the playlist: https://t.co/QS7WclBXwR )

Surreal turning real. The central narrative of my life. I have jumped through so many hoops in the last years in order to get here now. I will still fear it might somehow be taken away until tomorrow morning when they put me under, but today I have hopes of being able to unlock all these emotions more and more. We will see. Emotions were blocked for a long time as the vulnerable parts of me feared opening up to the hope of undergoing this procedure but then being denied, especially now during pandemic.

Arriving at the clinic. Feels like any number of conference venues I’ve had workshops in. https://t.co/xskQNxhLpm

Tonight was first in a long time (years) I woke and could not sleep due to agitation. Used to happen often. Not sure of the emotion. Mostly fear of catching sick and being denied but probably anticipation and spiraling. Made some comfort food and then I could sleep some more.

View from my hospital bed. https://t.co/NtpyBytz3O

I think I am probably going to become more and more nervous and anticipatory as the day and night continues. Well, that is fine.

I am in a liminal state. Operation is sometime the coming afternoon. I am outside my regular and habitual structures in something holding me. I am giving in to the deep fatigue and not forcing focus. It is unfamiliar. Next awaits fear for the body damage itself and the risk of imperfect healing. I accept those risks and that fear but this does not mean they are not still on my mind, now with greater fears no longer masking them. I suppose this is where I, like Inanna in her garden, must learn to trust in that which I do not myself control directly.

Cannot sleep, and here even moreso, cannot comfort food myself to sleep. Despite being too tired for anything complex. Only had this with fever before. Tomorrow hopefully little needed from me though except be present. It will be fine.

Asked to put on gown and wait. Soon now.

Tired, high, good.

More NSFW I guess. I have felt pretty much asexual lately, and I feel it will continue until I have surgery, but there are still times I can be activated and it surprises me what that feeling is like. At this point, finding myself reading a long, rambling story which is basically a superhero/supervillain romance with trans themes, and it gets me… somewhere. The weird part is, I can now be aroused without my genital responding or being much involved? My breathing gets heavier, my tactile sensations shift, everything becomes charged, but it is not centered so clearly genitally?

It is frustrating in a sense, I crave some sort of release, but I have zero wish to involve those parts, no wish to touch like I would have, certainly no wish to orgasm like I used to, short, painful, then an emotional drop and cleanup. I want something else and I don’t know how to get it. I want this whole-body sensation to intensify instead until it overwhelms me? And I don’t know if I can do that myself, I would need some other person to do it to me. And everything stands in the way of that happening.

In some future I will be ready to explore this sensuality or sexuality or whatever it is, won’t have anything that makes me hold back, will finally be desirable that another wants to put in the effort that I also desire in turn. And we will see what I can feel then. For now I will just read supervillain erotica with heavy breath and a sense of being, at least, alive.