Fears, Doubts, & (Relationship) Insecurities About Lower Surgery

Be forewarned, this post is very much about process and very little about logistics. It’s long and in depth about a lot of the thoughts I’ve been having lately.

This isn’t easy… Preparing for and having genital surgery, yes… But also, possibly even equally, sharing these things so publicly even if mostly anonymously. These are REALLY BIG DECISIONS that we are contemplating and mulling over in our minds as to which are the rights paths for us personally. In so many ways, it’s really impossible to KNOW what our final outcomes will be and how we will adapt to the changes that our bodies go through. We do our research, endlessly, sometimes even obsessively collect data, read medical journals, and reach out to other men who have bravely gone before us. But in the end, we have to make our own decisions, then courageously and with a bit of faith, just leap and see with what grace we land.

The past 2 weeks or so I’ve been having A LOT of anxiety about my decision to have phalloplasty. To be honest, my first impulse was to hide that uncertainty. I think a big part of that knee-jerk reaction comes from not wanting to seem indecisive, or unsure that I need this surgery… I ask myself further though: “Why is that?” What is wrong with having doubts about likely the biggest decision I will make in my life about my body and my health (mental and physical) and all the overreaching impacts on sexual relationships and general contentedness with one’s life?!?! How could one NOT have fears, doubts, and insecurities?

As I’m writing this now I’m acutely aware that likely another component to all of this has to do with the experience so many of us have with coming out to others about this intrinsic and deeply rooted understanding of ourselves… I know I’ve had experiences of people doubting, questioning, and prodding at the validity of these needs that I’ve expressed in regards to hormones, top surgery, and lower surgery – every step of the way there have been at least some people in my life doubting me. These people have been: family, “friends”, lovers, doctors, and mental health workers. Through this process, I am aware that I have developed a defense mechanism that automatically wants to only present with 100% confidence and assuredness. Because I know even when I present as such I still encounter these naysayers, but confidence makes it a bit easier to calm them.

So often when I come out (I’ll speak for myself) in situations where I’ve disclosed information about needing to make changes to my body, the hope is that I might receive some emotional support but I think too often that’s not really what the coming out ends up being about. It’s more so about comforting and reassuring the person I’m disclosing to that everything is going to be okay and that they don’t need to worry about me. It’s all about soothing their fears… Long story short, I think this is a big part of why I felt embarrassed about sharing my doubts and fears about moving forward with phalloplasty. There is the anxiety about not being seen as valid or genuine. And I think that really sums up a lot of the trans* experience. Too often we are told that we are not genuine/genuinely who we say we are. We are not real… But you know what IS real?.. Emotions, doubt, fears, anxiety, insecurity, vulnerability, and the need to be treated with compassion and empathy.

I had a pretty loaded conversation with an on-again/off-again lover (you guessed it) 2 weeks ago. I know that this conversation is what triggered a lot of my anxiety about phalloplasty (and really any kind of lower surgery). I had been telling a friend prior to this that I couldn’t really comprehend what it would be like to be in a committed relationship while going through this process. I know my emotions about all of this are kind of off the charts in terms of intensity. So I can only imagine trying to navigate dynamics with a loved one (although I’m sure it has its perks) must be difficult in its own right… I had intentionally not disclosed my plans for lower surgery to this person until a couple of weeks ago. Long story, but I knew it wasn’t going to result in anything positive. While she didn’t tell me explicitly that she didn’t want me to have surgery, it was said in as many words… She did however ask:  “Is there any chance of you not having the surgery?” as well as lots of sweeping judgements and suggestions that I’m doing this based on how I feel about how other people witness my body and not at all about just needing this for myself. While this conversation pointed to bigger issues – like, I don’t know,  the 100th red flag that we’re a terrible match (apparently the first 10 weren’t enough) it also boiled those lingering insecurities that I have about needing lower surgery, right to the surface, bubbling and bobbing their ugly heads, forcing me to face them again and again.

FLASHBACK: I remember being 19 (pre-t, pre-op, had only recently come out as trans* to a select few) and being involved with a woman who I was utterly infatuated with. When we would have sex it ALWAYS involved me wearing a strap on. Not just because that was what I wanted, but because that was her primary preference in terms of what sex looked like for her. I finally worked up the courage to say to her: “What would you think if I told you that I liked to pack a soft penis in my underwear?” Her: “It would make me feel uncomfortable.”… I remember processing this reaction from her afterwards and thinking that it seemed MORE strange to ME that she was completely turned on and into me wearing a hard cock during our most intimate interactions/sex and interacting with her with it, but that as soon as that action stopped she believed that there was no continued connection for ME with that part/organ. Even though I knew it was unhealthy and the wrong choice, I remember packing my packer away deep in a locked chest and not ever wearing it when I was around her. Obviously, that wasn’t the best decision for me, and I knew it at the time. But I had the biggest hard on for her and unfortunately I was willing to disconnect from an integral part of myself if it meant that I could connect with such an intimate part of her.

Here’s the root of it all folks.  I’ve been rambling on and on and not really gotten down to the nuts and bolts of what I figured I’d be sharing in this post, and STILL I digress, but here it is, at least for me… A huge part of what makes these decisions so scary for me, and is hard to admit, is the nagging fear: will I be lovable/desirable after it’s all said and done?… The thing is, cognitively, I know that the answer is a resounding yes. We are infinitely greater than the sum of our parts. But I think in my heart, in my gut, that fear is still alive and well. Whispering in my ear from time to time: “Who will ever love you? Who could possibly be attracted to you?” I think that the most frustrating, offensive, and infuriating thing was hearing this woman tell me that she doubted my intentions and questioned if I was “doing this for others”. Because the truth is, if I based my transition decisions on the opinions and desires of those around me, well, I’d be a dead “girl” right now. Pre-coming out, I was on a warpath to a violent self-inflicted death with a couple “failed” attempts under my belt. The ONLY thing that derailed all of that was aligning with my true self, internally (mind), externally (verbally with others), and eventually physically (through medical transition). All I have to go on at this point, is an almost 11 year track record of making all the right decisions for myself, even in the face of people telling me not to. Looking back, I don’t regret any one of my decisions – I’m exactly where and who I need to be.

Conflict and uncertainty about my exact surgical path is not a new experience. For years I wavered between meta and phallo. Only somewhat recently (about 9 months ago) did I being to settle into trusting my need for an “average” adult male-sized penis and the day-to-day bouncing between meta and phallo tipped to a solid comfort in moving forward with phallo. But since THAT decision, there has been quite a bit of uncertainty surrounding other decisions: donor site, vaginectomy, whether or not to leave the little guy exposed, and choosing penis size. Some of this uncertainty stems purely from a lack of readily available facts about the procedures themselves and common experiences with each of them, including the risk factors. Whereas other uncertainty revolves around just not being 100% certain of one procedure over another, or if a specific procedure is even needed for me personally based on my self-assessment of dysphoria with said parts. We can all agree there is a lot to consider here – more angles than most people realize or even have the capability of wrapping their head around. I think I’m saying this because I need to hear these things for my own validation of the difficulty through this process, but also because I KNOW I can’t be the only one having this experience.

I believe that these uncertainties and anxieties that are showing up are actually signs of a healthy outlook and realistic view of this process. There are risks, as there have been every step of the way along this transition, and to ignore them would be the truly unrealistic, unhealthy approach. And when I’m honest with myself, as shitty as it is… it’s been all the difficult conversations that I’ve had with the naysayers over the years that’s really made me so strong. To have the courage to do what people believe is impossible and beg you not to do, and come out on the other side happier and healthier than ever. I know that if I can get through this process of lower surgery, I can do absolutely anything. I know that this is the biggest obstacle of my life. Another reason why I think so many things are coming up for me is that up until last year, I honestly never believed that I would be able to access this surgery. I fantasized about it from afar and didn’t have to actually fully process all of the feelings about it that I would have had I known 10 years ago that this was something attainable for me in the future. I truly, truly believed I could never be whole in this particular way. As a result, the reality of it all never actually needed to be dealt with. So I just lived with a dream of what it would be like to embody a penis, not the whole process that actually goes into getting from point A to point P(enis), although I was somewhat aware of it in my peripheral.

Here’s what I’ve been so unnecessarily worried about sharing: I have been spending quite a bit of time doing what I was doing a couple years ago when I was attempting to pursue meta with hookup. Pulling my little guy out and away from my body, imagining it closed on the underside and released from my body, and pulling my (what I call my) empty sac (labial tissue) down and behind my penis. Asking myself: could I be happy with this? Wishing and thinking that maybe, just maybe I could be happy with a micro-penis that has fun and fully mobile foreskin, super-amazing ready-present sensation, and pretty sweet erectile capabilities!!! I keep thinking about how nice it would be to not have any scaring outside of my genital region, a much quicker (likely, though not a guaranteed) healing process, and convenience of not having to worry about grafts and erectile implants… Of course though there are just as many cons (for my personal needs) that relate to going with a more conservative route of having meta such as: inability to truly penetrate (with a stroking effect, rather than a grind/rub), a size that I may likely not be able to feel comfortable/safe being nude in public situations with, a very small flaccid penile state, the possibility of not clearing my fly enough to pee successfully at a urinal without peeing down the front of my clothes…

I have come to accept that I need to continue to push forward to my surgery date and just know that during this time leading up to my actual day of surgery, hesitations, uncertainties, fears, and shifting is bound to occur. I am choosing to embrace these shifts because I know that ultimately I will make the decision(s) that feel truest and best for me at this time – even if what I need to is have meta as a stage one in order to know that phallo is/is not right for me. In the meantime, I am continuing with the hair removal on my forearm, because just as my feelings have shifted to meta these days, it would be silly to think that they won’t again shift back to phallo at some point if not multiple times before January rolls around… It is my intention to hold myself in loving kindness and compassion through this time and to respect and honor the mix of emotions and thoughts that are swirling inside of me, as each and every one of them is valid and worthy of my attention and evaluation and is nothing to be ashamed, or embarrassed by.

“There are no mistakes. The events we bring upon ourselves, no matter how unpleasant, are necessary in order to learn what we need to learn; whatever steps we take, they’re necessary to reach the places we’ve chosen to go.” ~Richard Bach~

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