Who to go to for SRS?

I’m going to need to get SRS for many reasons. So how do I choose a doc? There are hundreds of them, no way to really objectively compare them since you can’t really do it twice, and most people seem to think theirs is the best. Not to mention the cost and do I try to get insurance to cover it, or pay out of pocket? What method do I want to go with, the Thai method or the penile-inversion method? On and on and on.

So let’s start with the basics. What are the two methods used globally, and what are their pros and cons? So first up is the older method which is the penile inversion method. The gist of it is they slice the shaft open, remove things from inside, then use the “casing” so to speak as the inside of the new vaginal canal. Then skin from elsewhere, like the scrotal sack get shaped into the clitoris. This method is widely used, has a lot of knowledge around it, and people who have gotten it are happy with the results from what I’ve read/seen as a general rule.

    Benefits

  • Older technique, more global experience doing it
  • Faster recovery time
  • More docs doing the procedure means insurance likely can get used for it
  • Less travel time and time in the hospital
  • Not as cumbersome dilation requirements
    Drawbacks

  • Results depend on “package” size
  • The sensitive bits are on the inside
  • Requires genital electrolysis before hand
  • No natural lubrication
  • Slight differences from ciswomen’s anatomy

 

 

 

 

 

 

 

The other method is known as the “Thai method” and was introduced in the early 2000’s and is really only used by docs in Thailand. Instead of taking the penis and turning it “inside out” and using less sensitive skin for the clitoris, they instead take the penis and make that into the clitoris. They take the scrotal sack and score it in a cross hatch (i.e. criss cross) pattern, then that gets turned into the vaginal canal. This skin is already elastic in nature so it can stretch easier, plus the sensitive bits are on the outside like a ciswoman’s are.

    Benefits

  • Most people end up with 6+ inches of depth
  • The sensitive bits are on the outside
  • No electrolysis (they scrape follicles off during surgery)
  • Preserves Cowper gland that provides some lubrication
  • Essentially the same as a ciswoman’s anatomy (or hard to see differences anyways)
    Drawbacks

  • Newer technique, no as many surgeons do it
  • Longer recovery time (plan for a month near the doc)
  • Unlikely to get insurance to pay as it’s not in the US
  • A day of travel each way from where I’m at (US East coast)
  • Much more intensive dilation schedule and requirements

 

 

 

 

 

 

 

 

So, for me what it boils down to is a decision to be made between where I want the sensitive bits (outside/inside), cost to me (entirely on me/insurance), and travel as well as how long I want to stay at that location (1 month/2 weeks). Personally, what matters to me is being able to orgasm after (both methods give that) and be as close to “normal” as I could hope to be in my circumstances. I was torn between the two for a bit.

What ultimately made my decision were two things. First off, the results aesthetically speaking. I looked at many of the surgeons out there doing penile inversion and most of them looked “off”. The reason for this was in part due to the method used. It looks like they sliced a slit, then added some skin in there, and made the clit. It didn’t look quite “right” to me (or either of my gf’s). Secondly was the location of things and lubrication. I want to be able to have some self-lube so I don’t always have to carry it with me, but I also want the sensitive bits like a ciswoman’s would be. This told me I was going to do the Thai method. There are two main surgeons who are used: Suporn and Chettawut.

For completion sake, the main doctors used for penile inversion are: BowersBrassard, Meltzer, Spiegel, and McGinn. There are a ton of others but those are the ones I commonly hear of. Also I have not spent the time researching the non-Thai docs as much as Suporn/Chettawut. And even there you should do your own research on what’s right for you.

About that time eh?

So here I sit, a year and a half after starting my transition working on taking the next step. SRS… “The big one.” How do I know this is right? How do I know I won’t regret it? How do I know everything will be fine, wait… no… scratch that… amazing? Quite frankly, I don’t. But there hasn’t been a point on this journey I’ve looked back longingly. Nor a point where I’ve regretted going down this path. I know it won’t fix my stresses about money, my house, job, or anything else. But I firmly believe it will help me, which is kind of the point of this whole thing. All the bad days, weeks, and months. All the fears and concerns. All of it was done out of the belief that it would help me. It was a correct belief for the record.

So, what’s the purpose of this blog? Well, it was started primarily to be able to share my experiences with SRS, as well as transitioning in general. But I’m sure I’ll post musings from other realms and whatever is really going on. Do I think I’m that interesting? Not really. But I do think that it could be another resource (even if it helps only one other person… it’s worth it) for trans individuals. And who knows, perhaps it’ll evolve to minimize that aspect to transition (pun intended) to another type of blog.