I didn’t always know I wanted bottom surgery in fact if you told just came out April 2018 Kian that in four years they would have a penis I probably wouldn’t be ready to hear that. I think my reaction would be a combination of disbelief and repression of my identity out of fear of the unknown. Quite honestly I wasn’t completely sure I wanted bottom surgery until almost one year before I had it. (I got the call receiving my surgery date exactly one year after I decided I was going to have phalloplasty.) From the moment I jumped head first into the world of bottom surgery and phalloplasty, I quickly learned all my natural tendencies of impatience, anxiety, and perfectionism would not serve me in this journey. My phalloplasty story isn’t just a story of me finally feeling complete in my body but almost more so a story of me having to reinvent myself into a person who is strong enough and capable of undergoing such intense physical and mental changes. To get where I am I had to completely let go of my need for control. Now here I am writing about how I survived one of the hardest journies I’ve been on. I hope as you read this my words would speak to you and you find community in whatever journey you are on. Thank you.
Step one: The Surrender
Step one is the surrender and the surrender can happen at any place and any time. When I say the surrender what I mean is the moment you put down your fears, uncertainties, and in my case pros and cons lists and you just say “I dont know when and I don’t know how but I am going to go on this journey and have this surgery.” This is the beginning and it’s a big deal. My surrender happened on Valentine’s Day 2021. This wasn’t the first time I heavily considered bottom surgery. I had been thinking about it on and off since I had top surgery in January of 2020. I had this meditative practice where I’d go on walks and just think through issues on my mind. Having phalloplasty was very often the subject of my walks. I remember in October of 2020 thinking “It’s not that I want phalloplasty but in the end, I will ultimately need it” but it wasn’t until I had the biggest dysphoria-induced sex meltdown on Valentine’s Day that I took the official plunge and surrendered to the unknown.
Step two: Acceptance
Step two is a painful one that came with a lot of resistance to me. Unlike step one where the surrender often happens in a single moment step two is a process. I think the acceptance stage would be easier if you only had to accept one thing but when it comes to phalloplasty there are a lot of hard truths you have to just be okay with. You have to accept it’s going to take a long time. Even if you get lucky and go to a surgeon with a short waitlist like I did it’s still gonna take longer than you want and longer than you feel it should. You have to accept that you’re going to have to sacrifice a lot for this. Everybody’s sacrifices look different depending on your situation but for me, I think the biggest sacrifice was the time and money I had to commit to electrolysis. I missed out on a lot of fun activities because I had committed myself to driving an hour both ways for two-hour appointments twice a week for nine months. I think the biggest thing you have to accept is the reality of the surgery itself. We don’t like to talk about this in the community because we don’t want to scare people away but this surgery has a 50% complication rate and it ranges from very minor to very severe. Before you go any further into your journey you must be okay with this reality. Things could go bad and no penis is perfect. If you can wholeheartedly accept these truths without resistance to the unknown everything will be much easier for you.
Step three: Excitement
Once you’ve decided you’re going to have phalloplasty and you’ve accepted the reality of this journey it’s time to get excited! The biggest advice I would suggest for anyone on this journey is to buy a notebook and keep track of every joy and sorrow you encounter. Take pictures of you at your consultations. Make a bucket list of the things you’re excited to try post-op. Celebrate and get ice cream every small victory of the way. Don’t let any small win go unnoticed create a habit of lifting up all the good and wonderful things that happen on this journey. Things will be hard and some days it’s gonna feel impossible but let your excitement for the future outweigh the pain of the process. On the days when it feels like you’ll never get there practice imagining what it’s going to be like and how you’re going to feel when do make it.
Step four: Bargaining
At some point in your journey, you’re gonna hit a point where you’ve done your consultations, you’ve been doing electrolysis for months, and you’re just honestly ready for the next steps. At this point, I call it bargaining with the universe. For me, bargaining with the universe consisted of making a very very detailed phalloplasty manifestation letter. Unfortunately, I had to learn you cannot will something to go your way. It happens as it happens and as hard as you try you can’t control divine timing. At this stage of the journey, I do recommend doing something that makes you feel like you’re moving forward. Creating my phalloplasty manifestation letter was a way for me to feel involved in the waiting process without emailing my surgery scheduler every week asking for an update. All I did was create a document on my computer and wrote what I want to happen, how this will make me feel, and my plan to get where I want to go. I read this document daily and reminded myself I am one day closer to my dreams.
Step five: Self Reinvention
Okay, step five is the most important step you can do to ensure you have the best phalloplasty experience. If you take anything away from this paper please keep step five in your back pocket. I didn’t start the process of reinvention until I figured out bargaining with the universe was just not working. I came to a point where I could either spend every day leading up to surgery just sitting around thinking about it or I could do the work to be the most fully prepared and best version of myself for this surgery. Not only did working through my issues give me the best phalloplasty experience possible but it also gave me a goal every day leading up to surgery. Even when I was just sitting counting down the days I was doing something productive and positive to meet my goals. The first step to solving your limiting beliefs is identifying them. I made another computer document and wrote down every fear, negative thought, negative pattern, and just things I knew would hold me back during my recovery. I would say the biggest thing everyone should be at peace with before going into phalloplasty is letting go of the need for control and learning to have patience with yourself and your body. What you need to work through may be different than what I needed to work through but how I worked through it was journaling about it until I had nothing left to say, following therapy worksheets such as challenging anxious thoughts/circle of control/decatastrophizing, having people you can be completely honest with and share what you’re feeling, finding what coping skills work best for you, and lastly turning inward and meditating seeing yourself as who you want to be. What worked for me will not work for everyone but spend time with your issues and learn about them, be curious about them, and be nonjudgmental towards yourself. After spending enough time with my fears and monsters (and adapting a large number of new coping skills) suddenly things seemed less scary.
Step six: The Letter
Out of everything I did to prepare for surgery I would say the letter was one of the most important aspects of my recovery. All I did was write a letter to myself to read during recovery if things started to feel tough and I couldn’t keep a positive mindset. I thankfully only had to read my letter twice but on those days when I just wanted to cry and I felt hopeless the words of excitement from pre-op Kian kept me going. What you put in your letter is up to you because you know yourself and know what you need to hear but here are the parts of my letter. My letter starts out congratulating myself and taking a moment to acknowledge how far I’ve come and how hard I’ve worked to be here. In the next two paragraphs, I go on to talk about why I needed this surgery and how much I’ve struggled up until this point. I wanted to add in my story of struggle in case when things got hard and if complications felt hopeless I would be reminded of what I was fighting for. I then went on to write every reason I wanted to have this surgery and things I was looking forward to after recovery. Next, I added a small paragraph talking about religion and trusting God because bible verses are something comforting to me. The next segment was my favorite which was a large paragraph of community advice I had been given by people who had already been through this surgery. In the last fully written paragraph I called my hype section where I just wrote about how strong and resilient I am and how I knew I could do this and at the very end, I included my post-op buck list that I could look at and feel excited about. Reading my letter on the particularly rough days inspired me and gave me a moment to connect and reground with the version of myself who so desperately longed to be at the place where I currently was.
Step seven: The Support System
Something I learned in my recovery is you will only be as strong as your support system is. The people you let in physically and emotionally during your recovery have the opportunity of making or breaking you. I don’t like saying that because I think putting your health in the hands of others is dangerous but when it came to my phalloplasty recovery I was only as strong as my weakest supporting member. Choose your support system wisely and before even going into surgery establish expectations, rules, roles, and boundaries. Not everyone is equipped with the same skills to support you so you must figure out who is comfortable and good with what. I recommend selecting a main figure of support and then choosing other people who can rotate in whether physically or mentally to be there for you. Before going into surgery I spoke with my close friends and family to discuss how they could best support me and I set the ground rule for people coming to visit me that my recovery space was a no negativity zone. Try to anticipate what you think you’ll need from your people and establish a game plan that everyone understands way before surgery day.
Step eight: Endless Gratitude
Lastly is step eight and it’s the most life-changing step you can follow. Through everything, you need to have gratitude, and a lot of it. Gratitude changes your perspective on seemingly negative situations. I know for me when complications came up I had to put my gratitude glasses on and go yes I am having this complication and it sucks but I’m grateful I even get to be in a position where I’m having this complication. Have gratitude for everything and it will change your mindset completely. A practice I started doing during my recovery was anytime I was feeling down I closed my eyes and listed every little thing I was grateful for and then suddenly those dark sad feelings were replaced with happiness and light. I know it might seem silly but trust me give it a try.
Thank you, everyone, for reading my phalloplasty survival guide I hope you were able to get something positive out of it and I hope you now feel more prepared to begin whatever journey you are embarking on.
