Transsexualism, My SRS And Some Thoughts…

Last Revised – March 2009

I, my partner, Charlotte, and almost all of my close friends are all transsexuals. For the uninitiated, that means we were born one sex / gender and ‘transitioned’ or ‘changed over’ to the other. Now, I’m actually a little uncomfortable writing about this for two reasons. The first is that the precise definitions of the terms transsexual, sex and gender is a political minefield, and they change to suit the political purposes and prejudices of every group which uses them. I’m not going to get caught up in all that nonsense, it just doesn’t bother me, so throughout this page, and on my blog as a whole, I tend to use the terms in the same ways in which most ordinary people use them, unless clarification is necessary to make a particular point.

The second reason why I don’t like talking or writing about this kind of thing is because I don’t actually like being a transsexual. Never have, never will. For all the progress made in gaining equality of rights and social acceptance over the past decades, life can still suck big time for transsexuals. We’re one of the few groups left it seems acceptable to deride, discriminate and hate. I would never have chosen to be what I am.

That said, I am what I am, and there is sod all I can do about it. And, at the end of the day, my life is pretty sweet. In terms of acceptance I go about my life 90% of the time in peace and quiet, people either don’t know about me or don’t care, just as it should be. I’m in a secure and happy relationship with someone I love dearly, a true kindred spirit, and I have a successful career and a happy work life. So I can’t really complain can I?

Many people believe that being a transsexual is a choice. They’re not quite right about that, the evidence for a physiological cause in brain structure, however that is caused, is pretty conclusive now, but we do all have a choice about whether or not to change over and I’m sure for every out transsexual there are tens, possibly even hundreds of people who have chosen not to do anything about it, and I wish those people nothing but success and happiness.

For me, however, I don’t think not doing anything was ever a serious option. Go back to my late teens and early twenties and my life was a train wreck. Unemployed and unemployable, wracked with depression and a history of half-arsed suicide attempts. It was only when I started to accept myself as a transsexual and came to the conclusion that I had to do something about it that my life started to change for the better. Every year since I’ve been able to look back and see how far I’ve come, how much happier I am, and I’m by no means finished yet!

However, my journey as a transsexual, my transition from one side of the gender divide to the other is over. For me, like most transsexuals, it culminated with sex reassignment surgery, the last medical procedure I hope I will ever undergo. I had my operation with Dr. Chettawut Tulayaphanich in March 2006 in Bangkok, Thailand, one of the world’s leading centres in this type of surgery. What follows is my account of that experience. My intended audience is other transsexuals, looking for information and advice just like I was not so long ago, so the rest of you may find it all a little boring, or even gross in places, so you lot can all just look at the pretty pictures I took of Bangkok.

Some Background

All mammalian embryos (yes, even you) start off as female, and if it’s in your genes to be male you get a burst of testosterone at one particular point during the pregnancy which tells your body to develop the male characteristics. Of course, things can and do go wrong. If you don’t get the right amount of testosterone, or even if you just get it at slightly the wrong time your body doesn’t always develop properly. One problem that can happen is your body will develop as male, but your brain stays female.

That is the currently prevailing theory for what causes transsexualism, and it’s what happened to me.

I always knew something was wrong with me, but it wasn’t until I was 15 that I had the knowledge and the maturity to recognise and name the problem. Almost ten years later I finished the course of treatment that would change my body into a woman’s, or at least as close as I can ever get, by having sex, or gender reassignment surgery (SRS, or GRS).

Preparations

I have a very blasé attitude these days, telling everyone who will listen that SRS was the easiest thing in the world, but getting there was undoubtedly one of the hardest and most frightening things I’ve ever had to do.

Leaving my friends behind at Manchester Airport was the first shock, I felt so scared and lonely, I wish I had had the money to have paid for someone to come with me. Either that or rich friends.

The second big scare came on my first night in Thailand. My plane was late arriving and I was frightened of being left on my own, but Tair, Dr. Chettawut’s wife, was still there waiting for me like an angel. The drive to the hotel was amazing, the sights, the lights, the temperature. This was late at night, 10 or 11pm, but it felt like Britain during a mid-summers day. That first night in the hotel I became very overwhelmed, and I couldn’t image how I was going to get through everything alone. I had visions of me staying cooped up in my hotel room, only leaving to go to the hospital.

A good night’s sleep and things seemed brighter, then I met Denise and Mike, two people who were to become as close to me as family, and everything seemed a whole lot less frightening.

Denise and I were heading to Dr. Chettawut’s clinic for our pre-operative assessment where we met Dr. Chettawut and all his wonderful staff for the first time. The appointment was fairly uneventful, I discussed some of the concerns I had, and Dr. Chettawut performed his assessment and took some pictures for his records.

I had a couple of days grace before I was due to go into hospital so was lucky to be able to see some of the sights and do some shopping with some of the other girls who were recovering at the Bann-Siri hotel. I highly recommend the Bann-Siri to anyone having surgery with Dr. Chettawut as most of his patients opt to stay there, forming a small and friendly community with the ‘veterans’ looking after the new arrivals and the recently post-op.

I had been give laxatives to take on the day before admission and instructed not to eat any heavy foods. On the day I went in the laxatives were stepped up to some more powerful varieties and I was subjected to the various pokings and proddings you would expect before having major surgery. I was also given an enema which has to be one of the most unpleasant things I’ve ever experienced!

Surgery

I can’t remember now what time I was taken into theatre, or when I came out, but I am reliably informed by Mike that I was gone for around ten hours. Mike was there looking after Denise who had had her operation the day before me.

All of the hospital staff treated me wonderfully, much better than I had been treated by the NHS staff who were taking care of me after the operations I had on my jaw, but I would like to single out one particular person for my special gratitude. I don’t know who you are, and I’m not sure that I ever saw you again, but I will always remember you as the man who stood there holding my hand as I was given the drugs to put me under, when I was trembling with fear. Thank you.

The next thing I remember will go down as possibly the weirdest experience of my life – I woke up during the op! Let me explain – Dr. Chettawut does not use a full general anaesthetic, preferring instead to use an epidural with heavy sedation. In addition to SRS I was also having a rhinoplasty and a trachea shave (think of it as an Adam’s Apple-ectomy) as part of the same operation, with the trachea shave being done first as it was the least complicated procedure. During this stage I was under a much lighter level of sedation and I can remember regaining some level of consciousness. I could feel sensations of pulling and prodding around my neck, hear voices and I remember the lights – they were amazing! Presumably I had tape over my eyes or something, so I doubt I actually opened them, but what I remember seeing was pink, fuzzy light all around me, like being in the womb. I remember the feeling of warmth and peace. It was quite lovely. I should stress that at no point did I feel any pain, it was a very cool experience.

Then I woke up properly, and that wasn’t so much fun. Sex reassignment surgery is a very major operation and no matter what precautions are taken something will go wrong fairly often. I once read that around one in four people having SRS will suffer a major complication, and regrettably, I can include myself in that statistic.

The pain in my leg would have terrified me had I not known what it was, but I’d had a DVT about 18 months before hand from the very high dose oestrogen I was taking at the time. Communicating the problem was the biggest difficulty, with me drugged up and not being able to speak properly, but it only took two or three attempts at saying ‘DVT’ before someone understood me and repeated it back. Then I knew I would be okay, that Dr. Chettawut and his team would take care of me. Because of the previous DVT I has suffered I had paid extra, at Dr. Chettawut’s recommendation, for a pre-operative check and extra cover during my surgery from a cardiologist, Dr. Semchai. I am very glad I followed Dr. Chettawut’s advice on this matter, and highly recommend that anyone else in my position does likewise. I believe it only added $500 to the price I paid, and it was certainly well worth the money.

Recovery

I can’t remember how long I was in hospital after the operation, I think it was four or five days. It didn’t really matter as they all blended into one another. What I remember from this time is the pain in my leg, some discomfort in my lower back from the cannula, taking lots and lots of pills and trying to drink chicken soup through a straw two or three times a day.

And Mike. I remember Mike very clearly. A man I barely knew at the time, who was so kind as to pop in and see me once or twice every day and bring me Sprite. Thank you Mike! You’re a beautiful person and Denise is a very lucky girl to have you.

I recovered very quickly and couldn’t be held back when it came to discharge time. Dr. Chettawut’s own nursing team (not the hospital’s) came to see me the day I was due out to remove the packing in my new vagina and the catheter. As soon as I could pee naturally I would be able to get dressed and be taken back to the hotel. That wasn’t a problem – I felt like I needed to pee all the time with the catheter in, and as soon as it was out I was stumbling out of bed to get to the toilet.

Later that day I had my first shower, and it was then that I was able to see my new anatomy for the first time. The feelings I experienced then are very hard to describe… Try to imagine the most important thing that has ever happened to you, the biggest deal you could possibly experience, like getting married or winning the lottery perhaps. The feeling I had was the exact opposite! I looked at my new vagina, as best I could, and it felt like the most natural thing in the world! Like looking at your hand – you wouldn’t be surprised to see four fingers and a thumb would you? You just expect it. That’s how I felt looking down between my legs, and at four days post-op, believe me, it was not pretty! It looked like someone had blow into a rubber glove and stuck it between my legs. I couldn’t for the life of me figure out why I had so many labia, or why each one was swollen up to the size of my thumb?

I was home, back in the Bann Siri, later that evening and the next day I started dilating with the help of Nuut, one of Dr. Chettawut’s nursing staff who would visit us almost every day. That wasn’t very comfortable or nice the first few times, but it was never painful and you quickly get used to it.

And that was pretty much that I’m afraid. Not a lot to tell you about now. Despite the DVT my recovery was very quick. I spent the first week taking it easy, pretty much sticking to the hotel, and by the second week I was feeling almost back to normal and itching to get out and about. The last week before coming home we were all feeling well enough to tackle a long drive across country to visit the Sri Racha Tiger Sanctuary, a wonderful experience, almost on a par with having the operation itself. I love tigers. My Mum would have been so jealous!

A few days before heading home I went back to Dr. Chettawut’s office for my post-operative consultation and check-up. Denise and I both took the opportunity to purchase a set of 4 high quality resin dilators at a very good price, much cheaper than you can buy a set from the traditional suppliers. I’d recommend to anyone having surgery with Dr. Chettawut to buy a set as the complimentary set provided are only made from wax and won’t last long, in fact, I think Denise broke one while still in Thailand. The other benefit is, once you’re healed you can use them just as they are, whereas with the wax ones you always have to use a condom.

Given my unfortunate complications I took the opportunity to ask Dr. Chettawut about the precautions he takes to prevent blood clots during surgery and came away very happy that everything that can be done is done, and I was just very unlucky. Do remember however, that things do go wrong no matter how good your surgeon is and even when all possible precautions have been taken.

Dr. Chettawut gives everyone a letter for the benefit of the airport authorities so that you can get extra assistance with your baggage or with getting around should you need it, but at three and a bit weeks post-op I found myself quite capable of a seven hour flight and then lugging my bags around the massive Dubai International Airport. I’m lucky to have a friend in Dubai, Becky, with whom I was able to have a short stop over and a proper night’s sleep before the second leg of my journey home.

And then I was back, Chrisse and Charlotte waiting for me at Manchester right where I left them. If I didn’t know better, I would be tempted to believe they had hung about waiting for me instead of going home the month before.

Some Final Thoughts

To anyone considering sex reassignment surgery I can highly and unequivocally recommend Dr. Chettawut Tulayaphanich. Not only is the man himself one of the best surgeons in his field, he is one of the most reasonably priced surgeons in Thailand, with basic SRS costing around half as much as you would pay to have the operation privately in the UK (based on 2006 prices, I haven’t kept up to date with this kind of thing). He is a kind and caring person who will go out of his way to make your stay in Thailand as pleasant as possible, and if things do go wrong I know from my own experience that he will stick by you 100% and do everything he can to put things right. Both his own team and the hospital staff are all wonderful, kind people who have helped me to fall in love with Thailand and it’s people. Without question I will be returning for a proper holiday as soon as possible.

One year post-op and I had completely recovered. The cosmetic appearance of my vulva is perfect, a true designer-vagina, I have just under six inches of depth and everything works just the way it should – you know what I mean! I’ve had no infections or serious complications and returned to work full time less than four weeks after my operation. I could not be happier, choosing Dr. Chettawut for my SRS was possibly the best decision I made during my journey.

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For anyone who would like more information I have compiled some links to some of the best resources out there on the web:

The Angels

Chet Plastic Surgery

The Gender Trust

GIRES

Right Side Out

Transsexual Road Map

Transsexual Women’s Resources

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Parents, family members and anyone else who would like to know more about transsexualism and how if affects them may wish to have a look at these resources:

Depend

Transsexualism – What Is It? Help For Families (PDF document)

Mermaids – Helpful Hints and Shared Experiences

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Finally, to anyone reading this feeling confused and lost, know that, for me, taking the decision to undergo gender reassignment was the best decision I ever made. I am complete now, as a person, and my life is complete. By making this bold choice I’ve been able accept myself, and to find love, friendship and happiness – everything I ever wanted from life.