My SRS with Dr Sanguan
by Petra White
Here is my account of my sexual reassignment surgery. For me the experience was very much like being pregnant, the closest I'll ever get to feeling that. Difficulty getting up and down, the waddling walk, constipation, headaches, cramps from wind. For several months after the surgery I was embarrassed by how often I passed wind in public and had to explain that it was the after effects of surgery. I also came to know what it means to have "fanny farts". a strange
sensation at first.
Initially the feeling in my new genitals was very much like a very tight tuck, like I could just put my fingers down there and release it. That gradually disappeared as the swelling went down and the vulva took on a normal look. People have talked about having phantom erections and feeling a phantom penis after the operation, but I never experienced that. I did, however, a couple of times, have the feeling of an itch on the outside while meanwhile the body part (scrotal skin) was now buried deep inside me. This I believe is because it takes the brain some time to re-map the nerves in the surgical area.
One question in considering surgery is whether to take a support person with you. This is a personal preference. Some say it is
essential. While I was in hospital there were five of us having SRS and only one had a support person (the guy who is now my boyfriend). I found that it was not necessary for me. We supported each other on the ward to the extent we were capable. There were phones in our rooms so we could phone each other. There was also the TV and video for entertainment. And in between I read my book. However, there is a language barrier and it is sometimes difficult to communicate.
Another question is whether you need to take a ring cushion with you. This also is a personal preference. I didn't. I tried one and found it didn't help. Instead I found it easier to sit with a pillow under one buttock or to place my leg under one buttock (something I often did pre-op anyway).
11 July 05
The day before the operation I drove into Oneroa to do some banking. As I drove I felt I felt a sense of completion in myself, as though the operation had already happened and I was a complete woman at last. Psychologically I knew I was ready. My boss Flynn rang later that day and said, "It's strange to think of you as a woman with a penis about to have it removed. I just see you as a woman." I rang my cousin Marian later and told her about this and she agreed with Flynn.
12 July 05
The day I left for Thailand, Flynn drove me to the ferry and my ex boyfriend John drove me to the airport. With all the talk from
various people warning me to have my bags shrink-wrapped so they wouldn't be tampered with, when I got to Bangkok that night there was no customs officers there at all checking for drugs or items to declare. I just sailed through.
13 July 05
I walked the streets of Bangkok looking for a bank to get some money. The first thing I was aware of was the putrid smell of pollution. There is a continuous stream of cars, buses, motor bikes, and people everywhere. It rained intensely much of the day and the streets were in places ankle deep in water. They seem to have no idea of stormwater control ? it just discharges into the streets and you have to dodge water gushing out of downpipes from above. Nor do they know about safety and electricity, judging by the electric wiring, draped crazily everywhere, unsheathed, exposed to the weather. I was told that Thailand has three climates ? hot, very hot and hottest. Everywhere there are food stalls lining the streets and alleyways and any convenient place that people might walk past. What they were serving I didn't dare ask lest I be conned into buying something. Anyone who is selling anything is very pushy and it's very difficult to get away without buying something.
14 July 05
I flew down to Phuket and was picked up at the airport by Surat, Sanguan's driver, and admitted to hospital that afternoon. I was
weighed, given a chest x-ray, ECG, blood test and had my BP taken. Sanguan came to my hospital room and I showed him pictures of me and my family and other documents I had with me, including the final one page report from my counsellor, which he took a copy of. Then Poom came and I filled out the consent forms.
Did I say hospital room? It was in a hospital but it was more like a hotel room. I had my own shower and toilet, small fridge, TV and video, a couch, coffee table and chair for visitors. There was a balcony with a sink unit one end where one could wash one's hair that overlooked a large pond with a fountain. At night the fountain lit up. In the distance lay the bush clad hills of Phuket Island. Every morning cleaning staff came to clean the room, wearing their spotlessly clean white gumboots.
That evening I met an American, Malcolm, who at that time presented as Deborah. He was acting as support person for an American girl, Holly, who had already had the operation. The nurses shaved me and gave me a small amount of foul-tasting liquid to drink to clear out my bowels. I was running to the toilet every half hour and during the night had to get up to wash myself and call the nurses to change my bedding and my pink two piece hospital garb.
15 July 05
Malcolm visited me in the morning and was still with me when the nurses came at 9am to collect me for the operation. He was dressed as Deborah again. As the nurses came in I got up off the bed and went to meet them. Malcolm said, "Wow, look how eager she is; she hasn't even waited for you to get to the bed. She's going to race you down to the theatre."
I lay on the operation table watching as they connected me up to their machines and prepared for the surgery. Then around 10am I received the anaesthetic and went to sleep, hardly being aware of any transition. I came round at about 5pm, shaking with cold and feeling groggy and dizzy. My one thought was to lift my head and see the time. I looked around the room and watched as they disconnected everything and prepared to wheel me out. A nurse at my head told me to lie back. They just wheeled me out of the theatre and back to my room, with me attempting to look round and the nurses telling me to
just lie back. The grogginess and dizziness lasted several hours. My sister Julie rang me that evening and we chatted for half an hour or so before the nurses came to take my blood pressure, pulse and temperature again.
16 July 05
Despite regular checks for blood pressure, pulse and temperature through the night, and changes of ice packs, I slept well and woke up without any dizziness, but with a slight headache and slightly elevated temperature. The following days were to be marked by whether I had a headache and whether or not I did a "ka ka" (bowel movement). My temperature went up and down for the next few days also, but I was not conscious of being feverish.
Sanguan visited me and said I had bled a lot during the operation. I told him of a little soreness at the back of my lower legs and
explained that it was rather like the feeling one gets after standing in high heels for 7 hours. He related this to the Thai nurses and they giggled knowingly. I attributed the soreness to my legs resting in the stirrups for hours and hours during the operation. It took several weeks for the soreness to subside (not helped by the fact that I was once again lying in those stirrups for later procedures). I had a little nausea after breakfast but it passed quickly. That evening I got a phone call from my sister Margaret and I chatted with her for a bit and then Mum, who was visiting her. Malcolm visited me that day and left when I got Margaret's phone call.
No ka ka.
17 July 05
During the night I had a dream. I was on a submarine and they were firing torpedoes at two round floating cities. I swam upwards through the water and as I surfaced I began to feel an orgasm. An all over sensation, but particularly in the pelvis and leg areas. I was coming out of the dream at this stage and was aware that I had tubes coming out of me and hoped all this trembling didn't disturb them. I hadn't expected experiencing that so soon. I woke up feeling much better and more myself. I discussed the orgasm with Sanguan when he visited that morning and he said that an experience such as that so soon after the surgery is a rare occurrence, affecting one in one hundred people. He had only had two of his patients report it in the past.
I was allowed to get up and do some short walking that day. Malcolm took me hand in hand for three short walks up to the computer room. Later in the day my cousin Marian rang and then my sister Annette. I met Alison, an Australian girl who had arrived the night before. She came in with Malcolm, who was once again dressed as a woman, and they went shopping together.
Small ka ka after breakfast.
18 July 05
I spent a lot of time in bed but also did some more short walks to the computer room, with Malcolm once again accompanying me. This time he presented as Malcolm, and continued to dress as Malcolm for the rest of the time he visited me. He said, "You think like a woman? and I have been around a lot of TG folk." On our third walk that evening I had a very bad headache and had to be taken back to my room in a wheel chair. They gave me painkillers and a sleeping pill.
Did ka ka in the morning.
19 July 05
I woke in the morning with a headache still but not so bad. I was taken at 9.30am for the packing change, which started at 10.15am after the administration of an epidural. What a strange sensation! Feeling the coldness invading one's lower back and moving down into the legs, then later a feeling like warmth as the lower part of my body became numb. My legs were lifted up into the stirrups, with my legs feeling as though they didn't belong to me. The procedure lasted about an hour and then I was wheeled back to my room and shifted onto the bed as I waited for my legs to come back to me.
Malcolm came to visit me again that afternoon and he came with me to the computer room, but my headache was bad again and I had to return to bed. He went shopping for Holly and came back but I was too drained of energy to talk to him. I kept dozing off on him and he left me. I slept and slept after that, hardly being aware when nurses came to check my temperature, BP and pulse.
No ka ka.
20 July 05
While visiting Alison, Sanguan came in to see her. He said to me that there was not enough granulation tissue in my wound yet and he may have to do a second packing change before doing the skin graft. Felt very good all day. Malcolm visited me again. No headache. Did small ka ka in morning.
21 July 05
I had a very bad headache in the morning again, so bad I was whimpering in pain. Thinking the headaches were from dehydration due to the heat and humidity, I drank a lot of water and it went away. Sanguan visited me and said the headaches were due to my losing a lot of blood during the surgery. Luckily the blood loss was not enough for me to need a transfusion. He arranged for me to have a Thai massage later in the afternoon. I was with Malcolm in the computer room when they came to collect me in a wheelchair and take me down in the lift to the physiotherapy department. Wow, what an experience! I lay on my stomach while a Thai girl massaged me all over, then she asked me to turn over while she did the same on my front. I was
feeling very relaxed toward the end of this when a whole pile of hot towels were brought in and my whole body was encased in them. I lay on my back with my eyes closed taking in the warmth and drifting off into a dreamy reverie. When I returned to my room I was glowing and smiling and everyone on the ward wanted to have what I'd just had.
It was a wonderful experience.
But it didn't stop the headaches.
That evening I visited Yuki, a Japanese girl who had her operation that day and had been crying over the fact that Sanguan had only been able to give her a 3" vagina. She had elected not to have an extra skin graft to increase the depth as she didn't want to have a scar that might be visible in a bathing suit. She'd had only 5 minutes to decide. When she started dilating a fortnight later she found she could do 4".
Once again Malcolm visited me and I began to think he might be in love with me. He said, "You're such a woman. I can't see anything male in you at all."
I did a very small ka ka after taking a suppository.
22 July 05
I was taken once again to the operation room and had that weird experience of losing contact with my lower half under the epidural. But instead of the hoped-for skin graft I was given another packing change as there was not enough granulation tissue. Afterwards I had another very bad headache. I drank a lot of water, with Malcolm urging me on, and that cured it.
That evening Malcolm kissed me, a light kiss at first while I was standing, and later as I lay in the bed a much more lingering kiss. Though it was nice to kiss, I felt no sexual feelings at all, just a feeling of confusion, as I knew he was also Deborah. I sensed, though, that it was quite a different affair for him. "I've been wanting to do that ever since I met you," he said. After he left I lay on the bed thinking about him and the kiss and my feelings. It seemed that my feeling that he was in love with me (or thought he was) was now confirmed. I talked to Alison about it and she thought he was attracted to me because I'm trans. My reaction to him was that he was a typical male, yet as I came to know him another softer feminine side began to manifest, which only added to my confused feelings.
23 July 05
I went on several short walks, the computer room, visiting Yuki and Alison, and a longer walk through the hospital grounds hand in hand with Malcolm to the road and back. He didn't try kissing me again. I felt much better today and didn't have a headache. Marian rang.
No ka ka.
24 July 05
Sunday. My second birthday. The day of the skin graft. A two hour procedure between 10am and Noon. As I lay in the stirrups and looked around, feeling ghostly touches round my vulva, I watched as one of the nurses scraped hair follicles off what had once been scrotal skin. I thought, "That's me over there." Then I watched as Sanguan came over to inspect her handiwork and do some minor extra picking at that skin. Then he attached it to me and packed the wound once again.
I was wheeled back to my bed with a huge, peaceful grin on my face. Malcolm was in the corridor and I said to him as we passed, "It's my birthday." Later he took pictures of me in bed with that smile.
Margaret rang and then I dozed through the afternoon. Malcolm came and Julie rang. During dinner I knocked a glass on the floor and it shattered. I asked Malcolm to get the nurses to clean it up but he insisted on cleaning it up himself, then wanted to throw the shards into the waste paper basket. I told him to get something to wrap the glass in rather because otherwise someone might cut themselves. I thought to myself, "Typical male." In the end he took the shards in the dustpan to the nurses station and they disposed of them.
After dinner I feigned sleep to give him the hint to go but he spent a long time in the toilet and on the balcony while I lay quietly on my back. I was all peopled out and didn't feel like entertaining anyone anymore. And I was tired. Finally he left me and I dozed again and then phoned Alison about 9.30pm for a short chat. I tried to watch a video but kept dozing so I switched it off and slept till 6am when I was awakened by those nurses coming to take my temperature, BP and pulse.
25 July 05
Malcolm was in and out for short visits during the day. He brought me three red roses. Marian rang. I got the cleaning staff to check that Malcolm had cleaned the glass shards up properly. They found the jagged bottom of the glass. "Typical male," I thought once again, "not doing a job properly." Sanguan visited again. I decided that the hospital garb needed something?so I started wearing it as a crop top, tied under my boobs. The nurses and cleaning staff thought this very sexy.
26 July 05
Another visit from Sanguan. Malcolm was in to say goodbye as he and Holly were leaving the following day. Started back on hormones without telling Sanguan.
No ka ka.
27 July 05
Sanguan visited again. Malcolm came to say goodbye, and then later Yuki, who was being discharged and moving into the Metropole Hotel in Phuket. Mum rang and we spoke briefly. Then Julie rang. I told the nurses that I hadn't done ka ka for a few days and they gave me a suppository, which did nothing, so they gave me an enema (squirting liquid up my anus) and this cleared my system very quickly. More and more I was becoming despondent about the fact that my boobs had shrunk while I was off hormones and I wondered if I'd ever get that back again. I thought to myself "Before I was a girl with a penis, now I'm a boy with a vagina." I felt like I'd had a mastectomy. The boobs did come back in time and even grew a little.
28 July 05
In the morning I once again had a bad headache and I took painkillers and lay back on the bed with a cold facecloth over my brow and behind my neck. Later Sanguan came to remove the packing, dressings and catheters and showed me my new body parts and how to dilate. I weed several times that day and was pleased to see it was in a normal stream straight down, with only a little spraying to the sides of my bum. In the afternoon a nurse came to show me the dilation process once again, but I did my evening dilation without supervision. From the start I was able to take all six dilators, which pleased Sanguan.
No ka ka.
29 July 05
Sanguan came and checked my vagina and said that an additional skin graft was not required. Once again that morning I had a splitting headache. Sonja rang.
No ka ka.
30 July 05
Another bad headache in the morning. Breakfast was later and had to go chase it as the others had already eaten. After breakfast I dilated and got another enema. The nurses and cleaning staff commented on how sexy and curvy I was and how nice my hair was. One asked whether I had had work on my lips as they are so full.
31 July 05
Another headache in the morning but not so bad. I used cold wash cloths on the brow and behind the neck while dilating and it went away. For the first time since entering hospital I dressed in my own clothes, a black skirt and purple top. The nurses made sounds of appreciation. Later that day I received several original copies of a letter from Sanguan saying irreversible gender reassignment surgery had been performed on me, I was then discharged from the hospital and Surat drove me to the Metropole. I decided to go to that hotel rather than a cheaper one as Yuki was there and I felt she needed the support of other trans women round her. Also, the idea of walking up and down steps in the cheaper hotel in Phuket didn't appeal.
No ka ka.
1 August 05
Yet another headache in the morning. Went for a walk round the square opposite the hotel and had lunch. Sarot picked me up at 1pm and he took me to a Thai temple and to the duty free shop, where I bought a butterfly print as a souvenir and a fridge magnet for Marian. In the evening I went to Robinsons for dinner with Yuki and Yuka and did some shopping. I was very tired and sore afterwards.
Just a small ka ka in the morning after taking a laxative pill Alison gave me the previous night.
2 August 05
No headache today! I found it easier walking around but my energy was still low. Had to be moved to another room as the power in my room went out.
Managed three ka ka during the day.
3 August 05
No headache. Alison arrived at the hotel. Dilating with #5 and #6 a little more uncomfortable but bearable. I think the depth is still 5" but this is difficult to judge as my anatomy looks different down there as the swelling subsides.
Small ka ka in morning.
4 August 05
I did an early dilation (5.30am) and then after breakfast got picked up by Surat for my final checkup.
I was in for a shock.
He took out the stitches while I watched in the mirror. Then he got out a speculum, lubricated it, and inserted it into my vagina to open it up for a look. He told me that the vaginal lining was soft and said that was good. "However," he said, "there is some inflamed tissue at the entrance that is not healing properly. I need to scrape out this skin and perform a minor skin graft." And he showed me where he would take the donor material ? from both sides of the panty line. It would leave scars similar to a hysterectomy scar. Though he had told me about this possibility earlier on, it still came as a shock. Just when I was gaining my strength back! And I was scheduled to go on a tour round the island with Surat that day. And I had hoped to do some shopping. As I trusted Sanguan, I agreed to come back at noon for the operation.
I asked him about the reduction in size in my boobs, as this was quite a concern to me at the time. He said, "Small matter, small matter, considering what you have now." I didn't feel consoled.
I went up to Big C to do some shopping but only ended up buying a pair of earrings. While I was there I met briefly a couple
of "ladyboys" who seemed to be in a relationship together. Then I went back to the hospital and spent some time in the computer room checking my emails. A couple of women there commented on how curvy I was.
At 11.30am I signed the consent form and changed back into the hospital garb, and once again I wore the top tied under my boobs. The operation took 2 hours and was performed under local anaesthetic. That was a strange experience, feeling needles poked into my skin all around the pubic area. Before he started to cut out the skin he needed, he poked me in various places to ensure I couldn't feel anything. Once again I saw my donor skin pinned down and watched as the nurse scraped the hair follicles off. Sanguan told me I would have to limit my walking for 3 days and not dilate for at least a day. As it happened I was leaving Thailand the following day and therefore would not be able to dilate till I got to my Mum's home 2 days later. Sanguan assured me my vagina wouldn't close up in such a short time. I was more worried about how this would affect dilating and whether I would lose any depth or width, and could I dilate without tearing sutures.
I had lunch at an Italian restaurant near the hotel and dinner in the hotel itself, to limit my walking. After dinner I went to see Alison and lay on her bed, feeling so sore, and started to cry. She comforted me as I told her my feelings, about how much of a shock it was coming on the day before my departure and how I was worried how my Mum would cope with this additional news.
That night I had a dream in which people kept saying "sir" to me and my responding by lifting up my skirt or pulling down my pants to show them I'm not a sir.
5 August 05
I spent most of the morning lying down and deciding what to wear and packing. Surat picked me up at 12.30pm but I had to get myself to the foyer instead of him collecting me in my hotel room as he had for Yuka when she left a couple of days previously. He apologised, particularly when he saw me struggling out of the lift. I was thinking, "He's no gentleman," but he made up for it by holding open the car door for me. I sat on one buttock all the way to Bangkok and tried to ignore the soreness between my legs. At Bangkok airport I was in for such a shock. I had such a long way to walk to get to the gate where my plane was leaving. There I was shuffling along, trying not to bend my knees too much and put pressure on my vaginal lips, while loads of people passed me.
6 August 05
I caught a taxi from the airport to Mum's rather than try the train. I wasn't in any state for walking too far and was rather tired after the flight even though I had slept during it. I was also thinking of my first dilation, which I didn't get to till 10am, 29 hours after the last one in Phuket. The dilation was difficult and painful and I noted a small blood discharge afterwards. I tore out a couple of sutures and wrote to Sanguan about it. His reply came several days later and he was not concerned about it, saying that the small discharge was ok. In the meantime I continued dilations, scaling down to number 4 for the next two dilations. I spent much of the day sleeping, feeling the effects of the flight and the beginnings of a cold from the change in climate. I could feel I had a slight fever.
