Not the same issue but this talk of vagina upkeep reminded me of some stuff I read about “vaginal atrophy” recently. I have seen mentions of vaginal atrophy in transmen a dozen times, but I assumed (as most transmen probably do as well) that it just meant the muscles getting a bit weaker. In reality, estrogen is needed to rebuild vaginal cells properly, so the vagina essentially stops rebuilding itself and thins out. The reduced turnover in the epithelial cells also changes the vaginal pH, which makes it easier for different, 'bad' types of bacteria to grow, so you can end up with chronic infections.
Most of the information online talks about it in relationship to postmenopausal women: almost half of postmenopausal women get atrophy bad enough to cause symptoms, apparently. I would imagine (and I have no choice but to imagine, since no one is collecting data!) that the effects on younger FtMs would actually be worse though. For one, most women going through menopause are in their 40s or 50s, and by that age most people are
generally good at paying attention to negative signals their bodies are sending them, and then getting treatment or taking action in some way. Also, menopausal women are usually
told what to expect and know to look out for it, and can generally be trusted to remember to treat the condition with estrogen cream or whatever else is needed.
On the other hand, a 20-year-old FtM who dissociates whenever she thinks about having a vagina is probably going to ignore symptoms until the atrophy is irreversible.
It gets worse! The estrogen receptors in the vagina that cause these issues are apparently found in the same concentration in parts of the urethra, so your pee-tube can atrophy as well, which causes painful urination and recurrent UTIs. So even if you don't get a flesh-tube installed you might end up with a kidney infection just from hormones alone.
On the plus side, though, you also get an uptick in age-related diseases and an increased risk of Alzheimers:
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Can't wait until we have a generation of female dementia patients with male pattern baldness, their sagging testicular implants slowly working their way out through their thinning crotch skin, screaming in pain whenever they have to pee and attacking their caretakers because they are terrified and can't remember where their breasts went.