Since I got past my swim suit panic (Did I ever tell you she settled on a pink swim shirt over a sports bra and bright blue/purple girls swim shorts?) and researched hormones within an inch of my life, I've moved on to Gender Reassignment Surgery (GRS) or Sex Reassignment Surgery (SRS).* C is only just 15 -- oh yeah, it was her birthday last week and it was so fun giving our daughter her first birthday -- so we have a long time to wait for surgery should she continue to want it. But I need to be as informed as possible.
Turns out it might not be as long a wait as I thought. Most doctors who perform these procedures require their patients to be 18, although I have found one that has made exceptions and performed surgery on a couple of 16 year olds. I don't know yet whether there is only one and if that would even be the right path, but that's what I've found so far. I have been blown away by how many people perform SRS around the world. Another case of not having any idea what's out there until you start looking for it!
I don't plan to provide links for any of the surgeons and clinics I've found since I really, really don't want to influence anyone's decisions, but lordy is there a lot of information to wade through! I don't pretend for a second to be an expert so please do not take what I'm saying as anything more than a friend talking about what she's found. Please consult experts if you need real information!
I'm finding that there are three main ways to perform a male-to-female SRS: the colon graft technique, where part of the colon tissue is used to create the internal walls of the vagina while scrotal and penile tissue is used for the labia majora and minora; penile inversion technique in which the penis is essentially inverted and creates the vaginal walls while the scrotal tissue creates the labia; and the non-penile inversion technique in which the penile tissue is used for the labia and clitoral hood, the glans creates the clitoris and scrotal tissue grafts are used for the vaginal walls. Most of the doctors I've researched use a combination of the second two techniques and each of these doctors has subtle and not-so-subtle differences in their methods.
I've read so many pros and cons for all of these techniques that I'm starting to go cross-eyed! Like any parent, I want what is best for my child. I research primary care physicians, I read labels on my kids' food products, I read up on immunizations and how much screen time they should have. Why would I not research reassignment surgery? Seriously, though, I have spent hours going down the rabbit hole of procedures, results, etc. I have looked at more pictures of vaginas than a teenager with a stack of Hustlers. I cannot believe what these surgeons can do - it's incredible! How can we possibly choose which doctor is right? How can we know which procedure is right? I have read forum after forum after forum. I have joined Facebook groups and talked to anyone who is willing to tell me their own personal story - some have even sent me their own pictures.
When I first began to research I naively thought there was only one technique. Or more accurately, I just didn't think there were loads. I never considered that good results should include a hair-free vaginal wall. One doctor's website says you positively mustn't get electrolysis before SRS while the next says do it for two years before. I never thought about the fact that a neo-vagina may not create it's own lubrication, though some techniques aim to preserve secretive parts of the male anatomy in order to help a bit, which is why some people choose to use colon grafts which have mucous glands capable of natural lubrication. It didn't occur to me that you might want to live near your surgeon so you can have "revision surgery" to fix things as your healing progresses. It never crossed my mind that follow-up to SRS would include dilation of the vagina, meaning the insertion of a phallic object designed to help the vagina reach and maintain maximum depth and that, according to some doctors, this dilation could be required for life.
Like so much of my life since I learned I am the parent of a trans daughter, this whole thing is surreal. It is so surreal to be "shopping" for a vagina for my daughter. We will have to have conversations about what she most wants from her SRS. We'll have to discuss (or will we?) whether she wants to have sex pre-op and how that might affect her sex life post-op. We will have to consider price, travel time, techniques, when she wants to have the surgery. Does she take a year abroad and visit Asia, popping in to Thailand for a little SRS? Does she head to Oregon and disappear in to the woods of the Pacific Northwest for vaginoplasty? Will she be up front with her people? Will she just say it like it is: "Hey guys, off to get a vagina! See you in a few months."
My husband and I have only just glossed over this topic. He needs much more time to take in the whole son-becomes-a-daughter thing before crossing this bridge. But I know when the time comes he will supportive. He probably won't want to talk details or know too much about the actual process, but he will be 100% behind his daughter as he has since day one. As of now, we're looking at about three years before C can have any procedures so my husband has time to get used to the idea. For now, he's still coming to grips with the fact that she's developing boobs. I know an awful lot of dads of teen and pre-teen cis girls who have their heads in the sand when it comes to boobs so I think he's doing pretty damn well.
For now, I'll continue to pour over images I never in a million years expected to be viewing, much less studying. And I'll hope whatever new job I find down the road will help us cover the expenses of what is going to be an insanely costly procedure.
*I have since learned that some folks like to use the term Gender Confirmation Surgery, which, honestly, makes way more sense to me.