April 24, 2011
I am in therapy now and have been since February, will start hormones in May 2011, and I will begin my real life experience of living as a woman full time when I leave the military next spring. I am 53 years old, excellent health, 162 lbs, due to daily aerobic workouts, non-smoker, very healthy diet.
Specific_Questions: Dr Reed, I am beginning to do my research as to where to go for my eventual SRS. So far everything I know I have learned from online forums and the recommendations of other trans women, and it’s time for me to begin asking my own questions. 2 questions for now – I am interested in any SRS procedure which will yield not only a sensate clitoris but to be self lubricating as well. What is your method for achieving a lubricious vulva, and what is the likelihood of success in achieving this for the average patient? What are the limiting factors? Second question – there is much talk among trans women (and also among surgeons) as to whether a 2 stage vaginoplasty/labioplasty done during the same surgical visit is desirable, appropriate or even necessary. What is your view on this? Thank you, Madoline
Good afternoon Madoline,
Based on work with about 500 vaginioplasty procedures, I believe a sensate clitoris is virtually a given.
Please bear in mind most gynecologists use water soluble lubricant such as KY-jelly to examine a natal female. Only during arousal is there sufficient lubrication based upon Bartholin’s and possibly Skene’s glans which natal men do not have.
We can evert the urethral mucosa which creates a moist appearance but may or may not be adequate for penetration, given the possibility of pre-orgasmic emission from your partner.
Same for colonic vaginioplasty as I do not know of any urologist who when examining the rectum with a gloved finger does not use lubricant.
We are proponents of the 2 stage procedure. Seeing patients done elsewhere with ostensibly one stage vaginioplasty who need a touch up is a common occurrence in our practice.
The week commencing May 2nd, I believe we have 2 patients on the schedule who are seeking revision. Like they say when your plane has landed, be careful accessing the overhead racks as luggage tends to shift in flight. Same for vaginioplasty.
Have a restful Easter Sunday,
Harold M. Reed, M.D.