Accepting the decision

I'm working on a list of things I want to bring up/ask my surgeon about getting metoidioplasty, relating to both the first and second stages. I don't think I have any questions about the hysto. But otherwise things I should have brought up at the consultation but for some reason or another didn't. So I thought it could be good to contact the surgery department at Linköping's hospital about my questions/thoughts before I'll actually have the surgery. Cause not knowing this stresses me out. It's mostly just practical stuff that I'm curious about that keeps nagging at me, like what size of testicular implants I will/would/should be getting, ask about mons resection, and what method of the vaginectomy would/will be performed.

As far as I know about that latter one, there are at least 3 different methods that are used on different patients and all of them come with different amounts and types of risks. They also do provide with slightly different visual results as well. Even though the visual aspect most likely won't be much of a bother for me as that scar will likely end up under my balls and therefore not show at all. Others, who get the newer "v-y method" of scrotoplasty instead will have that scar showing then (like in the perineum, between balls and ass) as their balls end up higher up and more hanging. I'll be having an older method of scrotoplasty which will leave them being further back and "tighter" like closer to my body. The "v-y" method is not being performed in Sweden, only the older one, so I didn't have any choice in the matter compared to trans guys in other countries, but I also don't really care much about that detail. I only mention it now cause it's relevant to that my vaginectomy scar most likely will end up being completely hidden, or at least partially hidden.

But the risks invloved with each type of vaginectomy method and just not knowing what will happen stresses me out. Maybe also because of how emotional I am about having that particular procedure, which I will rant more about further in this entry, I need to try to calm my mind about it in any and every way I possibly can.

1.) From what I know, there's one method called "coplectomy" which is a half closure. As far as I understand it they remove most of the internal tissue but leave a bit at the opening which makes it (somehow?) safer than option nr. 2 but not as safe as option nr. 3 which I'll get to later on. This method leaves you with a little bit of a dip there (up to a couple of cm deep) and it's the kinda medium safe/risky one of these methods. Risk of internal bleeding is somewhat high-ish and other issues can happen too but not so high risk.
- I'd be okay with getting this method, as the dip most likely wouldn't show on me due to the placement of my balls and the risks are not unreasonably high.

2.) Then it's something I'm not sure what the technical term for is, but commonly just referred to as "vaginectomy" which is a total closure but not a good one. They practically remove all vaginal tissue in there and it's unsafe to do so, and *should* only be done on patients with severe vaginal cancer that can't otherwise be treated, in my humble opinion. It doesn't leave a dip in the area but has a fairly high risk of re-opening again. But more importantly it has high risks of issues such as internal bleedings, puncture/rupture of both the urine bladder and the rectum and what more in that general area. It's the most risky of these methods.
- I'd like to avoid getting this particular method done if possible, but I guess I'd survive it if given no other option. However then it would be damn good to know so I could be extra cautious to heal well!

3.) And then it's one called "colpocleisis" which is also a total closure but a good one. They don't remove the internal tissue but cauterize it and then stitch it up from the top to the opening. It's been highly recommended for trans guys who want a vaginectomy, and is most commonly practiced on elder women who have vaginal issues and don't have that type of sex anymore. There's some/low risk of getting bladder/rectum punctured and fairly low risk of internal bleedings as well. It doesn't leave a dip at where the opening used to be, but usually a vertical scar and the surface gets flat, with little to no risk of it re-opening again during healing time, as far as know at least.
- It's the least risky and safest method, so this is the method I'd most prefer to have done, if I'll have the option then.

So, it's not just "sewing it up" or simple/easy like that. When there are at least 3 different ways a surgeon can go about it that all affect both safety/risks and looks in different ways. I'm getting myself into nerdy levels of SRS by now... but at the same time it just stresses me out to not know what's gonna happen to my body down there in that aspect, like I just need to know regardless of which and what more. The more I know, the more calm and at ease I will be about it.

I'm still thinking I should go ahead with having that procedure done, cause it's really just on a few odd days where I feel uncertain and nostalgic about that, when dysphoria isn't as bad as it most often is. And knowing that dysphoria has only gotten increasingly worse and worse over the years, it's just not gonna get better. And holding onto that junk for the sake of nostalgia while it still causing dysphoria is just not a solution in any capacity. But sure, I'll think extra hard about it between the first and second stage, as by then I'll know if that hole is even still usable after it having been a bit used and abused by the urethral lengthening/hookup procedure and possibly also by the hysto, which I do not want to opt out of regardlessly.

And also there will be scarring around the opening from where the labia minora will have used to have been (am I Englishing that sentence right? "will have used to have been" sounds weird as fuck, but talking about the present as though it was the past in the future is hard to English, okay? I don't even know how I would say it in Swedish) and that kind of scarring might make it difficult to access that hole and use it then. So, I'll have to give it more thought then, like if I would consider trying to dilate it with "toys" or whatever they're called (dilators, but they look like smooth dildos) by the time everything's healed, as well as use some kind of topical estrogen stuff for the atrophy that is likely the cause of the physical pain in there, and then just hope it could work without me psychologically dying of dysphoria. Which it most likely just freaking won't. More likely me fidgeting with it much more with topical estrogen and dilators would increase my dysphoria massively.

Cause at this point, all I ever do with that hole is like putting a dildo, dick or fingers in it on a whim at most 2-3 times a year which leaves me feeling emotionally traumatised and physically in pain afterwards. So go figure, if I'd start poking around in there like every day, I'd probably be in constant panic brought on by dysphoria. I'd be close to suicidal, and probably begging for instant death until just giving up on that hole and wishing I had gotten it closed up instead of leaving it open. I'd likely regret not having done it then. Even though there's an extremely small chance it might get better physically and that might decrease the dysphoria panic enough to roughly how it is now, and I might be able to enjoy getting my pussy pounded in sexual situations but still be as dysphoric as I am now about it all the other times. And that's about the best I think could ever become of that. And 99% of the time, or at least 80% of the time (if I'd be really fucking a lot), I'd not be having sex, but instead (not) dealing with this crippling dysphoria. It doesn't feel worth it, it feels like a whole lot of work and a whole lot of pain, for a whole lot of barely anything at all. Like spending several years and lots of hard work to build a beautiful, strong house but all you end up with is an ugly tent.

But then if I'd rather just go ahead with getting it sewn up instead, I might likely be very sad and upset about not having that option anymore despite how useless it is, and I'd likely beat myself up over that decision, regret it, wish I hadn't done it and hate myself over it. But that I'd also feel relieved that it's gone at the same time, but struggle to appreciate it. I think I'd struggle hard to come to terms with it, that I'd forget why I made that decision in the first place and call myself a complete fucking idiot. I'd probably cry a lot over it too, and try my best to hide my emotional reaction from doctors, therapists and family members. Although I might talk about it with a therapist to just have some way of calming the fuck down about it and stop flailing.

Cause if it's done then it's done and having a temper tantrum about it wouldn't solve anything. But I'd know that then, but would also need to release that angst first before I could calm down and be more logical and reasonable about it. Then I'd likely have a lot of work with my issues around that, and exactly how it would impact my sex life I'm not sure, but I think I'd feel like something's missing and I might struggle to orgasm cause of that likely emotional block of no longer having what I've always used in my fantasies to reach orgasm. And then likely having to throw myself right into sex work while still having a temper tantrum about my discarded vag... sounds delightful. But eventually, I think the end result would be a much calmer, happier me with little to no dysphoria. Just that it will likely take a while and a hot struggle to get to that point. But if I'd opt out, I don't think I could ever reach a point of being either happy, calm or free of dysphoria. So I'm saying, either which way, I will most likely go through an intense emotional struggle, with either dysphoria or regret. But regret I might "get over" in terms of finding ways to let go and move on eventually, but dysphoria won't disappear or be relieved for as long as I still have that hole.

The questions are not "will I regret it or feel relieved if I have it removed? Will I die of dysphoria or find a way if I keep it?" but rather it's just this one question: "what would be the worst: stuck with crippling dysphoria forever, or stuck with regret forever?" which is exactly why I completely fucking hate this shit. Cause it could be so bad that if I do it, that I'll always regret it, which I'd need to somehow mentally visualise and prepare myself for. Cause at this point I just see one misery or another no matter which decision I go with. And I know I can't keep living with this dysphoria cause I'm constantly at the freaking verge of breaking down. Knowing I'll soon have that surgery is the only thing that keeps me from breaking down completely. The hole is what I'm literally the most dysphoric about down there and altogether. Much more so than the labia or the uterus or the ovaries, the lack of balls or having a small dick-like clit. Arguably equally as much as my wide hips though, depending on the day and what I'm doing. Together with my hips, that leaking hole is what the absolute most makes me want to rip my skin off and set it on fire. And of course my vag is also the part I'm the most ambivalent about.

That stresses me out, makes me severely frustrated and has me bouncing between and smashing into two opposite walls. Like a pendulum slamming back and forth with nowhere else to go. So, in two opposing ways I feel very strongly about my vag. I hate it, I hate it so much. I hate it both for the pleasure and for the pain. I feel like I'm stuck with an impossible choice. That I will suffer no matter what I choose. But I know that if I'll go with having it removed, at least there is a chance it will make me feel better at some point later on if I can work through my issues with that nostalgia. Cause maybe, hopefully, nostalgia is not quite as incurable a condition as dysphoria. But it would be taking a chance... an irreversible chance, at that... Oh my god, I'm scared.

But that is ultimately why I think I will go with it, despite this ambivalence and the quite high chance of feeling regret afterwards. Because the only other option is to do nothing about it. There's nothing else I can do, no halfway or third option. It's only either or. Permanently keep it or permanently close it. And closing it cannot be undone. The decision itself is murdering me. This might seem silly, but I think I really do need to write this little letter:

"Farewell, my vagina. You've given me amazing pleasure that ended, and incredible pain that never ends. You've tormented my mind to no end. You didn't get along well with the testosterone, and I know I need testo more than I ever needed you. You keep begging for mercy, for me to let you live and thrive, but we can't have it both ways. I know you crave dick more than my ass does, but you never like it while my ass almost always likes it. You don't communicate what you actually want, only what you think you want but never do. It's time you snap out of your fantasy. Dysphoria killed you, testo beat your corpse, and what I'll do is simply bury you. And I'll give you the proper funeral that you deserve. You can hate me however much you want, but it won't help and I need to move on. You have to let me move on. Please. How could we ever agree? You know we can't. Please stop crying, your tears are soaking through my pants. Please let me go, as I do not want to, but have to, reluctantly, let go of you. Thank you for the good times we had, they were truly awesome. I'll treasure them always. May you rest in peace."

Writing that made me cry a little, I'll admit. But this is what I mean by mourning my vag. It might seem silly, but I don't think I can just cut such emotional strings without crying a bit. And I should be respectful and caring of both my body and my mind. Not try to brute my way through this. "Precious and fragile things need special handling" I can fittingly quote from a song by Depeche Mode. Now I need a smoke.

I've got another idea for what could be going on with my internal conflict about my vag (to keep or not to keep), or at least a partial reason to consider. And it always comes down to sex, doesn't it? Well, with me it seems to. The idea I got is that maybe I've been struck by convenience and it's messing with what I actually want or not. Cause like 99% of all the guys who have shown sexual interest in me have only been interested in my pussy, not my back door. So maybe a big reason as to why I started being okay with receiving front penetration again was mostly, sadly, for convenience sake and not really cause of wanting it. But also that combined with having had a few weeks of less extreme dysphoria which made it doable. My dysphoria is back up at its usual extreme levels again now though, as I can't even make myself take showers on most days, and the only masturbation I can manage is with my vibrator cause then I don't need to directly touch any part of my pussy with my hands. But of course, what I said before definitely still stands as well.

Because I know, that if I could have it my way, look beyond my tragic reality of going with literally any guy who's interested in me and letting him decide what kind of sex to have as long as it's sex at all, cause apparently I'm that damaged - would be to just move on from my vag as though it was never there to begin with, and enjoy sex as though I had been born male and was just a gay cis guy. To forget about it and start over, without this crippling dysphoria of having mismatching genitals that are a complete fucking eyesore for me. The more male I've begun to look, over the years with testosterone, surgery and just plain old ageing, the more comfortable and happy I've gotten with how I look and how my body feels. The more right and connected to me, it feels. And also the psychological changes from taking testo have a been a sweet blessing that have also further made me more comfortable with myself. Like I really, definitely, absolutely, most certainly know that being and looking male is exactly what I've always needed.

And I know that my pussy is that last thing that keeps chafing against my otherwise new-found maleness that I feel so comfortable and satisfied with. It's that one last puzzle piece that doesn't fit and needs to be carved into a more fitting shape, for me to not feel agitated as though I'm carrying a nasty disease between my legs, as I keep trying to make that piece fit into the rest of the puzzle with all the power and futile efforts I can manage. Like telling myself that "it doesn't need to look or be male to fit... if other trans guys can do it, why can't I?" and there I unknowingly just hit the nail on the head, why it's taken me so long to accept that I do need bottom surgery and that it's the only right decision for me. As I've kept telling myself that I shouldn't need it. That's what's been haunting me all this time, since early on in my transition and I started to get to know other trans people and their thoughts and feelings about their medical journeys: if other trans guys can be fine with their vaginas, then why can't I be fine with mine?

It's made me angry at trans guys who are fine with their parts, as though everytime they say so, it makes me feel like that makes me wrong for having a different idea about my own body. As though me thinking my pussy makes me less male is somehow wrong and something I should be shamed for. I know many if not most non-lower-op trans guys think those who want surgery should have it, but I also keep hearing that they often times also think that them having a pussy doesn't make them any less than 100% male which is a direct contradiction to why most trans guys who want SRS feel a need to have it: because we don't feel 100% male with our pussies. At least, many of us don't. It makes me feel like I'm somehow "wrong" for needing a full transition and can't happily settle for a halfway transition like they can. And they are in the majority. But at the same time I'm also furiously angry at them cause I envy their lack of lower dysphoria, or that they have a lot less of it than I do.

It's made me feel as though I'm being outdated and regressive in my own feelings about my own gender and transition choices. Because I don't feel like I'm male enough with that wrongly shaped piece between my legs. I'm fumbling for the rightly shaped one but it's not there. It never was. And what I was cursed with instead was made for females, not for males. I feel as though I cannot be completely male while still being possessed by pussy or anything that appears female. And I cannot possibly make that inherently biologically female part somehow male in my own brain, cause my brain just says "nope" and that's its final word on it. My heart and soul also echo the same firm "nope". But yet I keep flaundering about with a desperate "but what if I just tried harder?" cause getting invasive surgery on your genitals is a fucking scary thought. It's a last resort -kind of thing. Not a first you do -kind of thing. And it scares me, cause I'm out of all other options, tried everything else. Yet I keep scrambling for more options that simply do not exist.

And that's why I need to pull my head out of my arse and yell at myself that "Enough is enough! Stop trying, it's futile!" and I feel the emotional fever rising within me, cause what if there is another option out there that I just haven't found yet? There isn't. Stop. For the love of everything you hold dear, please, please stop scrambling, I keep telling myself. If only I could reason with my emotions, but I simply can't. All I can do is pick if I should go with my logical side or my emotional side and hope I make the right choice. Cause on this topic, they're highly disagreeing with each other, and beat each other bloody over it. It's tiring, and it's not getting anywhere, seemingly.

I made a list, several days ago, on my pros and cons with having a vaginectomy, as I was inspired by another trans guy who had done the same thing and shared it in an ftm bottom surgery group on facebook. Inspired by the concept, I mean, not so much by what he wrote. As I thought, the pros got much more and stronger than the cons on my own list. But I added quite a lot of things to both sides. Here it is:

Pros of having vaginectomy:
1. Not having any female organs/parts anymore, which would make me feel more complete/aligned (bio sex vs. gender)
2. No more of that icky 24/7 lubrication
3. Not being scared/worried of sexual acts happening that I don't want/be less stressed out about it during sex
4. Looking and feeling more male down there
5. No risk ever of ending up pregnant (there's still a very small risk after a hysto, if a released egg is trapped somewhere or whatever)
6. Not being grossed out by my genitals
7. Easier to keep things clean down there
8. Less bad odour
9. Getting to have dry underwear
10. Not having my underwear getting permanently discoloured by that lubrication
11. Might make masturbation easier (as I prefer it dry)
12. Can have UL with potentially fewer/less severe complications
13. No need to rethink how/if to have UL (with vaginal tissue used)
14. Not looking trans, and more likely to be able to pass for cis, also in sexual/naked situations
15. Not feeling so vulnerable in sexual situations, or potential such, like at a gay bar or sauna, etc (although very similar to point nr. 3, there's slight difference in how public/private the situations are)
16. Never ever having to worry about getting vaginal health issues (such as cancer and less severe stuff like internal symptoms of std's and other infections, once it's healed from op)
17. Possibly smaller risk of getting UTI's after healed and post-op, cause of no vaginal bacteria getting into the urethra, I mean

Cons of having vaginectomy:
1. Missing how good it used to feel, and not being able to try again
2. Sex with others might become more complicated (but I'd learn eventually)
3. More difficult to find sex partners (possibly, because most cis guys I've come across and/or heard of who want a trans guy are crazy about pussy, for whatever god damn reason - and most gay cis guys are not into guys with tiny dicks)
4. Might make becoming a sex worker and maintaining such a job more difficult too, for the same reason as the one above
5. Being dependent on only being able to receive penetration anally (no second option)
6. Easier for sex partners to tell if I'm aroused (with the wetness that I hate, it's still a pretty good signal for partners that I'm enjoying things, and as my dick is/will be tiny, a boner doesn't and most likely won't be showing much, compared to how clearly it does on most cis guys. But if my boners will show more clearly after op, then that will be a good enough sign of arousal post-op)

I just now added two more things to the pros than I had originally written, and explained a few things further among both the pros and the cons. That stands with 17 pros and only 6 cons. I know I've made my decision to have it done. But I still have not accepted it. And internally I'm still, probably very obviously, fighting it. I hate to make either decision but a decision has to be made nonetheless. Reality is cruel and doesn't care. I don't think I can take my chances with having surgery as planned but to have the vaginectomy much later on or hanging in the air. I think I need to decide that if I want it then have it with the other procedures as planned, or opt out of it entirely. And reality demands an answer. So, nauseous, dizzy, almost crying, with my stomach in a knot and my heart in my throat I make my decision: have it sewn up. It would be for the best, but it won't be easy.

Quite poetically, and literally, I need closure.