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A Step by Step Guide to Losing Your D**k

I recently wrote a series of messages to my aunt talking about all the steps I need to do to get bottom surgery, a penile inversion vaginoplasty at Mt. Sinai, in the next year or two. Its a long list. And everytime I added something she had a sort of “wow thats rough” reaction, but to me its just the to do list. So I decided to write them all out.

Start transition DONE

Most insurance companies and surgeons require you to have socially transitioned and have done HRT for at least 1 year at the time of operation

For social transition, this was March of 2024

For HRT it will be January of 2025

Get a referral to a surgeon (I am here)

In my case, Mt. Sinai in Manhattan

My Doctor referred me, but Mt. Sinai takes self referrals

Start laser hair removal

Book a consultation (I am here)

Go to laser frequently enough to satisfy surgeon

Convince Mom and Dad to help out DONE

Get 2 letters

Social Worker (1)

PCP's Office

Social Worker (2)

Mt. Sinai

Get a gender affirmation loan through the local credit union

Work two weeks so I can take in pay stubs

Get a letter from anybody (probably my HRT prescriber

Meet with representative and either open a line of credit or take out a loan

Consultation with Mt. Sinai’s team

Wait 3-6 months (I’m here)

Bring letters

My insurance only requires 2, less than Mt. Sinai thinks insurance will need, and Mt. Sinai provides 1 of them. Meaning the other is through IHS Behavioral

Schedule Social Work pre surgical consult appt

Schedule Mental Health and Medical Clearance with Registrar

Go to NYC for 1-2 nights, maybe for each, hopefully just once

Maybe also for Social Work thing

Consult with Surgeon

Wait until I’ve worked about 12 months to get short term disability

Probably summer (ASAP) and when Mom has time off

Do logistics

Book an airbnb, hotel, etc for recovery

Starting a few days after OR date and lasting a little over a month

Within a 90 minute drive of Mt. Sinai

Rural enough that Mom is comfortable to help and can go home if someone else shows up

Probably New Jersey, maybe Hudson Valley

Has at least 1, preferably 2, separate bedrooms

Has 2 beds

Has ADA accessible entry

Has a kitchen

Has a full bath, preferably and a half

Has internet and preferably a TV

Lodging for Mom + Dad/care team while I’m in OR

Probably 5-7 days

Preferably with a 1-2 day buffer period before OR date (included in the 7 day estimate) so I can enjoy the city

Either within a short walk from Mt. Sinai or on the same subway line as Mt. Sinai

RW, 1, or ACE

Someone to help me get from recovery location to Mt. Sinai while not in NYC

Develop and get list of items needed for recovery

Dilator

Pads

Gowns/loose clothing

Comfort food

Coordinate missing 8-9 weeks of work

Take care with who knows what before I leave

Inform HR, department manager, and work friends whats up

Get cleared for surgery and get an OR date

Probably a 6-12 month date from clearance

Get pre clearance testing through PCP or a lab in hometown

Go to NYC for that if need be

Week Before Surgery

No alcohol, no aspirin, NSAIDs, herbal supplements, or fish oil

Consult for other non aspirin blood thinners (which I am not on)

No alcohol for 3 weeks after as well

Tylenol/Acetaminophen is okay

Go downstate

See friends from NYC?

Bring Mom/Dad?

Do something fun in Manhattan

Get a COVID test

Take an anti-bacterial bath

Day before surgery

Breakfast before 9am

Last meal

Drink Golytely bowel solution around noon

Chemically induced diarrhea

Clear fluids only after golytely

(includes coffee, tea, water, broth, some juices)

Nothing goes in the stomach after midnight

Some medication okay with a sip of water

HRT???

Get surgery (a penile inversion vaginoplasty)

1 to 1+½ days

I’ve heard of as long as three

3-5 day hospital stay

Mom and Dad probably stay in Manhattan then

Go to recovery location

Drive with seat reclined

Stay for 4 weeks, pretty much bedridden

Go to follow ups

Dilate

Go home

Continue recovery for another 2-4 weeks at home

Follow up with PCP

Return to life

autistic trans woman here, so I learned the etiquette like a rulebook. (also I'm in the UK, so it might be a bit different for you if you aren't)

you go to whatever thing you need (noone knows what you do on a cubicle, so don't feel like to need to wait till you need a shit before you go). try to leave an empty apace between you and any other person (but this is more of a thing with urinals)

you look at the floor or the walls. you'd usually try to avoid looking at other people too much (so just pretend you're the only person in there I guess). if you feel like it, it's standard to check yourself out in the mirror

and of course you should wash your hands. some people don't, but that's just gross

hope this could help!

Will someone help a trans guy out with bathroom etiquette, in the men's bathroom specifically, as someone who has no cis male friends?

Where do I go? Where do I look? Do I wash my hands (I'm not not washing them, gross)?

the names of certain mob-involved trans women have been changed

Link to original