Today marks the day I had vaginoplasty last year, a date which will henceforth forever be known as my Vaginaversary.
Earlier this month I made a list of 10 Brutally Honest Tips for those seeking SRS based on the hardest aspects of having and recovering from surgery. I did this because SRS is probably the most difficult thing I’ve had to go through and I wanted to help other women avoid my pitfalls as much as could be controlled.
But today I want to give a more generalized review of my surgery with Dr. Chettawut and my results because I know there are lots of other trans women out there who need to do research on who is the best fit for them. So without further ado, let’s start talking about my snatch.
Hotel and Neighborhood:
Dr. Chettawut works with two hotels for your stay. I chose the Bangkok Rama Hotel because it was slightly cheaper, but I was actually really pleased with it. Some complain that the bungalows and the neighborhood are “rough”, but I don’t think it’s worse than anywhere I’ve personally lived. You can add a daily breakfast to your stay for next to nothing, which I recommend. It’s a buffet with an even mix of Thai and Western Breakfast options, so you get to be a little adventurous if your stomach can handle it. Housekeeping also provides you with two giant bottles of water (don’t use the tap water except to wash) and two little bottles of Coke and Sprite everyday.
The hotel grounds housing the bungalows are lovely, and mostly populated with permanent residents so you can get a nice feel for your neighbors. (Yes, all the locals know why you’re there. Just accept it and move on with your life.) There were lots of cats to pet and love, which was nice because I missed my own. I recommend going on a walk around the grounds a couple times a day if you can. The local plants are gorgeous and well kept and walking helps to speed up recovery (however it is also exhausting).
The bungalows are essentially studio apartments. One of the things I noticed with my neighbor’s room was that each one is a little different in terms of furniture and arrangement, but all the essentials are there. There’s a kitchenette area with dishes, a fridge, a sink, and some very basic cookwear (hot plate, rice cooker, etc.). The main room has a Queen bed and a seating area with a TV (only a handful of English channels though) and, most importantly, a bathroom with a shower you don’t have to lift your legs to get into with a wand-style shower head. THIS HELPS SO MUCH WHEN RECOVERING! I honestly think the showers alone are reason enough to pick Bangkok Rama over the other option.
Do yourself a favor and make sure your kitchen is well-stocked and situated so you can make easily-prepared, mild-but-high-protein foods. I practically ate nothing but scrambled eggs, toast, and peanut butter sandwiches because whenever I tried to get adventurous my painkiller soaked digestive tract wasn’t having it. A little bit of exciting food now and then is okay, but take it easy.
Don’t worry about how bland and boring that food sounds because you’re getting ready to not eat anything and shit your brains out for three days before surgery. Have fun with that. Go ahead and just leave your laptop in the bathroom because you’ll be spending a lot of time in there. Incidentally, you’re supposed to mix your medicine with a drink in order to make it taste slightly less awful. I found Sprite was the only thing even remotely tolerable and even that put me off drinking the un-desecrated sodas for a while. Peppermint tea is good to have on hand for after to get that awful taste out of your mouth (from the medicine or vomiting or both). Then you’ll be on a liquid diet for almost a week after surgery so you will be ravenous by the time you’re back at your hotel.
I will warn my fellow coffee drinkers that anything other than crystallized coffee was really hard for me to find, however there are some delicious Kopiko Candies made in Thailand from real coffee. I recommend the Cappuccino ones. These were an acceptable substitute so long as I had tea, which is everywhere.
As I said, the neighborhood might look a little “rough” to some, but I felt at home. There’s lots of street vendors (Once in a while I would buy some duck to have with my eggs, which I highly recommend!) as well as two 7-Eleven stores and a big Tesco across the road. Tesco has everything you’ll probably ever need because they’re essentially the British Wal-Mart but be warned, you will have to take stairs to get to it and that’s pretty difficult after surgery. I mostly relied on the convenience stores except maybe once a week for that reason.
There are also a couple shopping malls that are within reasonable walking distance if you’ve got the energy. I only tried that once and got too tired though, so take a taxi or something if you feel adventurous so you have energy to explore and not just walk.
After my driver picked me up from the airport and dropped off my bags at the hotel, I was taken to see Dr. Chettawut for my pre-consultation. This is when you’ll hand over all those hard-won documents and money and other shit he needs from you before surgery. You’ll get your Swiff, the awful shit-my-brains-out-before-surgery medicine, a packet of information about pre-surgery preparation and post-surgery care, and Dr. Chettawut will examine you and answer whatever questions you have. You can also get a rent a phone the nurses will refill with minutes for you so you can make calls to the clinic as well as back home without roaming.
You’re only going to see Dr. Chettawut a handful of times the entire month, so I recommend writing down all your questions before you even leave home. By the time I got to his office I was so tired and overwhelmed I didn’t make efficient use of his time and hardly asked him anything. Also, wear a skirt or dress because you’re gonna have to strip so he can look at what he’s working with down there. He always makes sure there’s a nurse in the room with you when he’s there, which I appreciate, but it’s still awkward and awful. He’ll have her take some pictures so he can plan out your surgery the next couple days, so don’t be weirded out by that. After that your driver will take you home and you’ll prepare yourself for the mass evacuation of your bowels.
Or if you still need to have a chest X-Ray and some bloodwork done, like when I landed, he’ll take you to a local hospital to have that work done for a little extra money which you already pay for at the clinic as well as extra for a skin graft if you need it. (Honestly, if you’re not insured, this is way cheaper than trying to do it at home before you leave. If you are insured though, it’s one less thing to stress about so do what you will.)
How do you know if you’ll need a skin graft? Well, look at what you’re giving him to work with. Is it a lot or a little? I think you can make some guesses after that, but it’s ultimately up to him to decide. He says it doesn’t matter if you’re circumcised or not, but I’m sure that’s got to factor in somewhere.
I was a hot mess of nerves the day before surgery, so I didn’t sleep the night before. I recommend watching something comforting while waiting for your driver to pick you up. Personally, I watched a lot of Disney movies and listened to Harry Potter. Be sure to follow his pre-surgery instructions to the letter, including when to cease all fluids before surgery.
Technically, you can check out of your hotel and check back in after surgery. They’ll even hold your bags for you so your hospital room isn’t crowded but, honestly, it’s not worth it. Being able to make sure your kitchen and room is laid out how you want it before surgery is totally worth the extra $50 or $100 or whatever the cost might be. All I took with me to the clinic was a laptop bag with other odds and ends for entertainment. That was more than enough.
From what I’ve heard, Dr. Chettawut likes to schedule his surgeries during midday so he has plenty of time to rest and prepare. Unfortunately this means it will be late by the time you wake up after, so just let people back home know. Your nurses will take you to a room where you can strip and put on the hospital cap and gown, then lead you to the prep room. It’s actually pretty neat, the room connects to the operating room so they can wheel your bed back and forth very easily. Here the nurses will shave all of your “nethers”, walk you through what to expect when you wake up, and do their best to keep you calm as you lie in bed and wait for everything else to get ready for you. Then they’ll walk you back to the OR, you’ll climb onto the bed and talk to the anesthesiologist and Dr. Chettawut one last time. You’ll feel a prick on your wrist and…
Then before you know it, you’ll wake up confused and disoriented and stoned with a lot of weird sensations and pressure around your groin. If I had to try to describe it, I would say it’s a combination of urgently needing to pee and having a giant sit on your crotch. There will be compression things wrapped around your legs that inflate and deflate all hours to make sure you don’t get blood clots. You’ll have a lot of wires all over your body, monitors on your fingers, and an oxygen tube coming from your nose, as well as a catheter bag coming from between your legs. They’ll ask you your name and some other basic questions to make sure the anesthetic has worn off, then lift you from the O.R. table to your hospital bed for the night and wheel you back to the prep room.
If I remember correctly, my surgery took somewhere between 6 and 8 hours. So I woke up from surgery around 10 or 11pm before promptly falling back to sleep. A nurse will spend the whole night in the room with you to make sure that everything is okay as you come off from the anesthetic and to keep an eye on all those screens and monitors and shit you’re too high to understand right now. I personally had an epidural as well as morphine while I was at the clinic. It doesn’t actually make you high, or even really kill the pain all that much, but it does make you cold and foggy and sleepy so I guess that’s good enough.
Your first night after surgery, the nurses are going to help you move from the prep room to your permanent room. Yes, that means you’re going to walk. Down stairs, actually. Which is kind of terrifying when every single step feels like you’ve got a bowling ball between your legs and you’re all fucked up, but they’ve got you covered and they’ve done this plenty of times. You actually need to walk a little after surgery to make sure you don’t get any blood clots. After that, your next four or five days will consist of sleeping, waking up for medication, a sponge bath, and your liquid diet meal. This will happen four times a day, but you’ll have a really hard time keeping track of what day or what time it is. Everything during that time is really fuzzy for me, but I remember I was well cared for and as comfortable as could honestly be expected, given the circumstances.
Your last day at the clinic they’ll take off most of your gauze and bandages and you’ll get your first look at your (swollen and angry) vagina. Dr. Chettawut will look everything over, answer any more questions you have, and then walk you through the next stages of your recovery. You’re still going to be packed full of cotton at the moment though. Yeah, that’s uncomfortable. Imagine a giant, six inch long and three inch wide tampon. That’s pretty much what’s going on down there.
After four or five days at the clinic, you’re ready to go back to your hotel. All the tubes and wires except for your catheter bag are removed, they give you your post-surgery kit which includes your Donut Pillow of Shame, as I lovingly called it. As humiliating as it might be, this little buddy will be the only way you can sit down on anything that isn’t ridiculously padded without being in extreme pain, and that includes your ride back to the hotel. Get used to it. You’ll be sitting on this thing for three months at least.
However, good news! You can finally eat real food again! Sort of. I mean, it’s risky but you should indulge because goddamn it’s been forever since you’ve eaten anything more substantial than crackers. You can get practically anything delivered for next to nothing, including most of your favorite major Western fast food, but you might need to call the front desk to ask for help ordering depending on the restaurant. You can also wash and brush your hair, which is likely a hot mess unless you read my last post and made sure it was chopped off or braided. Make sure to ask if you can shower yet, because you might need to wait and just sponge yourself clean still.
For another four or five days, you’ll essentially be doing the same things for yourself the nurses were doing at the clinic. You’ll sleep, wash, take meds and eat every six hours, and empty out your catheter. You’ll get a visit from your nurses every day (except Sunday), who will clean your stitches and check up on you. My personal nurse actually gave me leg messages because I think she could tell I was lonely and “touch starved”. I can’t stress enough how wonderful the nurses are. Mine called me “Bee-yoo-tiful Girl” or “Pretty Little Doll” and were always giving me compliments even though I’m sure I looked like a hot mess.
After a few days in the hotel will come “Unpacking Day”, when they finally take all that stuffing out of you and you’ll get ready for dilation the next day. Picture a magician pulling scarfs from their sleeve, only it’s bloody strips of cotton coming out of your vagina. This is…one of the weirdest sensations I can remember. It’s just freaky feeling. I don’t know any other way to explain it.
Now you have to wear pads every day for the next three or more months (the pregnancy/overnight sized ones work best, because you have to catch blood from your whole vulva not just your vaginal canal), but for the love of everything MAKE SURE YOU CHANGE YOUR PAD BEFORE BED. Yeah, I made that mistake my first night. I thought, “Oh, this pad isn’t that wet it’ll be fine,” and then woke up to a crime scene in my bed. Which I guess you could argue is some kind of vagina rite of passage or something but, really, avoid it if you can. It’s gross and embarrassing. The bleeding will go down a lot after the first week, but then you just kind of…ooze red vaginal fluid for a while.
I recommend getting a reusable pads kit, because wearing disposable pads for three months straight started to give me an awful rash on my labia that went away once I ditched them for Lunapads. Plus, you never know when you need a pantie liner or pad in the future (don’t ask), and this way you’ll always have supplies on hand when you need them. Oh, I’m sure this goes without saying, but don’t wear any panties you’re particularly attached to either.
The nurses will teach you how to dilate the next day, which is really fucking painful. Just a heads up. And that’s only using the smallest stint. Think about that. You got three even bigger ones to go. In case you don’t know already, dilation is stretching out your vagina to its full length (and eventually, circumference) so it doesn’t collapse by using stints, which are basically hard medical dildos with little inches marked along one side, for an extended period of time. A lot of people cracked jokes about “having fun” putting things in my vagina but trust, it is not fun. It is one of the most unpleasant experiences I’ve ever had. I’m not going to say you should take an extra pain pill or two when you need it, but I will tell you that the nurses just show up with a giant bottle of them to refill the ones you have without counting or anything, so you may as well. I really wish I had.
At first you have to wait for the nurses to visit you every day before dilating so they can make sure you’re doing it right, but eventually you’re on your own time to do it three times a day for the next three to six months. Also, this might sound weird until you’re doing it, but make sure to turn your stint back and forth rather than in one direction when working it in there. I kinda tore a stitch out of one labia because I only rotated in one direction and now my labia are kinda lopsided. (Then again, pretty much so are everyone’s labia, so who cares? But still, popped stitches aren’t fun.) Make absolutely sure you’re taking all of your antibiotics on time, because you do not want a UTI or yeast infection.
However, if the pain pills ain’t doing it for you and you’d rather get drunk to dilate, you can. BUT you need to go off the pain meds first. DO NOT MIX THE TWO. One or the other. I had a friend who did that and she said it was much easier. I think I’d probably agree because, more than likely, it was the pain meds that fried my digestion and they really didn’t help much. I can’t remember what they were, but they were pretty mild. (Of course, when you get home you can use whatever intoxicant of your choice to deal with the pain. Just don’t go wild, okay? I know it hurts but keep yourself together.)
My last week I had back about 60 to 75% of my energy, which is pretty much where I stayed for several months. This and discovering a neighbor my own age who spoke English made me a tad more adventurous, but I still pretty much spent all day in my hotel. I would not recommend that. Go there with somebody else, try to explore the city if you have the energy, and get a little shopping in too because everything is super cheap. Enjoy this time as much as you can, you’re in a foreign country you might never see again.
Before you leave, you’ll have a final appointment with Dr. Chettawut where you get to go for a ride in the stirrup chair for your first pelvic exam. This is your last chance to ask questions, so speak now or forever hold your peace. He’ll look at the stitches to make sure they’re dissolving at the right rate and everything looks healthy, then give you paperwork to take home and get all your legal documentation corrected. Yes, you now have a certified vagina. I got a real kick out of that, personally.
I already covered my recommendations for having the easiest flight home that you can in my 10 Tips, but I will repeat. Make sure you dilate for twice as long before you leave because you’re gonna go a day or more without it and that makes it all the worst when you do it again. Also, tell the airline your disabled ahead of time and get in the fucking wheelchair at the airport. Ask the driver to help you sort things out if you need to. Don’t be ableist against yourself, because you won’t do yourself any favors.
When you get back home, get whatever drugs of your choice will help with the pain. Eat the food you’ve craved most while you were gone. Be overwhelmed by the sheer number of people who want to talk to you and congratulate you. Hug everyone you’ve been homesick for and prepare to answer lots of questions for other trans women! Also, book another pelvic exam for six months down the line and every year after that. Oh! And you can finally get back on hormones, which is sure to be a relief since you’ve been off them at least six weeks or more by now.
Dr. Chettawut recommends dilating three times a day every day for two years solid, but that is not realistic. He also recommends you douche but my nurses said that wasn’t necessary unless I felt like I “needed it”. So instead, dilate three times a day for at least three months. After that you can do one two-hour long session a day instead for another three months. Then you can switch to dilating every other day, then every two days, and so on. So long as you can maintain your original depth every time you dilate, then you’re doing it often enough. If it’s really difficult to get to full depth, increase how many days you do it. I’m personally on a two-times-a-week regiment right now and that’s working pretty well.
These were some of the most common questions I’ve had about my vagina, so I’ll answer but keep in mind, as always in the trans community, YMMV.
How are the “sensations?”
I’ll be honest, it took a long time for the pain to fade away. You can technically have sex three months after surgery and it can be enjoyable but it takes a lot of time and patience and warm-up. At least for me. I still don’t like penetration during sex unless I’ve already had multiple orgasms and am good and relaxed down there, though that might just be me and nothing to do with my vagina.
But my clitoris? Good lord, put your tongue on there the right way and I’ll stay all day! Sorry if that’s TMI, but this is a TMI kind of post. It took probably close to six months or more for sex or masturbation to really feel “good” though. Before then, I just had to get into weird head spaces where pain wasn’t “bad pain” and I could work it.
How does it look?
My vulva looks like a vulva, which is to say it looked weird to me at first but I pretty quickly got over it because I’ve never seen two vulvas that look alike. I had less “material” to work with than my surgeon was happy about, and he had to use some skin grafts to complete everything, so I wish my labia were a bit longer as well as my hood. But honestly, I can’t complain. These are teeny tiny adjustments I would make in a perfect world.
I love my vagina. I love my vulva. She’s goddamn beautiful. The only real noticeable evidence that my vagina was originally inside out are two scars along the outside of my outer labia. Really though, those have faded to the point where I’m probably the only one who even notices them. Someday I’d like to get them covered with tattoos.
What surprised you?
Learning how to pee was more difficult than how to orgasm. I did not see that coming. Everyone is always so stressed out about “sensation” that you don’t think about having to retrain your bladder and urethra to relax, especially when everything is still swollen. Also, that fucker is gonna be like an overhead sprinkler for a while until the swelling goes down. So just go ahead and carry wet wipes with you for a while and be grateful for your pads.
I was surprised to find that I self-lubricate, because you literally have no idea if you will or won’t until you find out. Hell, I accidentally squirted once I came so hard and that surprised me and the girl I was with. So yeah, that’s a thing I was not expecting.
Also, my clitoris is WAY more sensitive than anything I ever had before. I don’t know if that’s because of dysphoria (I almost never touched my genitals if I could help it) or because it’s all the same number of nerves in a much smaller bundle but, GOOD LORD, it’s sensitive. Too sensitive, sometimes, honestly. Which is why I wish my clitoral hood covered a bit more. It sounds like it would be great, and it totally can be, but it can be weird figuring out how to work it in a way that is pleasurable and not just overwhelming. So, uh, have fun and explore.
Related to that, when your nerve endings are reconnecting and waking up or whatever it is they do, it can be way more painful than I would have thought. Like, feels like your VERY SENSITIVE clit is in a vice grip, kind of pain. I affectionately refer to these moments as “pain storms” because I don’t know what else to call it. Make sure whatever drugs you have at home you keep well stocked, is what I’m saying.
Do you recommend your surgeon?
Hell yes. He might not have the best bedside manner but I honestly think most of that is just language barriers and maybe some cultural differences. And besides, his nurses are wonderful. He’s very good at what he does and I am more than satisfied now that my healing is finally coming together. (And it’s honestly still going to be recovering for at least another year.)
The cost was low, the quality was higher than some of the work I’ve seen here in the States, and I got a lot of “bang” for my buck. Can’t recommend him enough.
Do you plan on having any other “work” done now?
Not really. I still want to have hair removal done on my face but thankfully that’s never been an urgent need of mine. I’ll get it done when I have a steady job and means to pay for it. Surgery was such an ordeal I really wouldn’t put myself through it again unless it was absolutely necessary. Which, obviously, was the case for vaginoplasty for me but is not for everyone.
Do you have any regrets?
HELL NO! I have a lot of regrets surrounding surgery (debt, drastic life changes, etc.) but I would NEVER go back. I can’t get over how much calmer I am in my body now that it finally feels whole. I’ll probably never get over it. Sex is so much easier and way less awkward now that I don’t have to keep panties on and hide my junk while having sex. I can shower naked. I can threaten to drop trow and “prove” my gender like an entitled cis woman to get out of potentially dangerous situations. There’s just so many little life changes that have ultimately improved my life. Even if it was possibly the most difficult thing I’ve ever done. It’s so much harder than I thought it would be, but it was all worth it.
If you’re preparing for surgery, I wish you the best of luck. It’s a helluva ride.
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