Model Oliver Wight documented their bottom surgery with Vice in 2017, wanting to share the structural barriers that transgender people face when it comes to getting medical care. New York’s Callen Lorde Center notes that “People of transgender and gender non-binary (TGNB) experience often face widespread discrimination and misunderstanding from health care providers. As a consequence, many people of transgender experience do not have safe access to primary and preventive healthcare.” The long wait lists for trans patients are well documented. For the International Day of Trans Visibility 2021, Oliver has written about their follow up surgery and the many hurdles it entailed, after discovering that their initial procedure had not gone quite as planned. Photographer Soraya Zaman was there to document the journey.
In 2017 I had bottom surgery. If you’ve stopped reading to look at photos of me to figure out if I started or ended with a penis, good. I documented the experience with Vice, so if you want the story feel free to check it out. In summation, surgery was hard to get, but freeing overall. A large part of what made the process so difficult was having to work through the structural barriers that I, as a trans person, have to face on a regular basis. That severe of a procedure is always going to be difficult, but I had hoped it would be easier than it was.
I don’t have regrets about my original piece, so much as I’ve since learned the importance of admitting to things 2017 Oliver wouldn’t. My own disappointment was difficult to understand. I didn’t want to admit there were things I didn’t know or like. I felt like admitting that seeing my vagina for the first time was difficult was wrong somehow. Making out what it might look like fully healed was difficult through the swelling and stitches. I was worried I had spent over two years of my life on a mistake. I have never fully felt that way, then or now. The gaps in my understanding are a reflection of my doctor’s failure to temper expectations. The messier parts of transition are usually kept out of the public eye. Bottom surgery is on this weird pedestal where people think it’s a button you press. I had researched to the best of my ability but there was no way I alone could prepare myself for that moment. My surgical team was happy to say, “Do you have any questions?” Not being sure even how to ask for reassurance, I would always say no.
“Dilating is a necessary part of the recovery process where you shove a hard plastic dildo in your vagina and watch anime for 30 minutes several times a day. ”
I’m a survivor of child sexual assault. At the time of my first surgery, I didn’t know because I couldn’t remember. I was confused and terrified when the internal tension around my genitals didn’t fully dissolve post-surgery. The memories of the experiences returned to me in September 2019. Dilating is a necessary part of the recovery process where you shove a hard plastic dildo in your vagina and watch anime for 30 minutes several times a day. My introduction to it was my surgeon sliding a dilator in me and saying, “See? Nice deep vagina”. This is the medical equivalent to patting the hood of your car and saying “this baby can fit so many dicks inside of it”. My trauma made dilating an increasingly painful and disorienting practice, so I stopped doing it. My vagina lost depth and diameter. When I healed enough that dilating became easier, it felt useless without surgical assistance.
Last summer, I spent over a month trying to get in contact with my surgeon’s office. I wanted to schedule a check-up in order to get a better understanding of what a revision would look like. Once a week, I got the same phone call where someone would very cheerily ask me, “What surgery were you interested in getting?” and I would recount the same details and they would assure me someone would reach out. Finally, after crying on the phone to a physician’s assistant, she said she would personally reach out to the surgeon’s office that day. I was given an appointment in late January 2021. Apparently he wouldn’t be in the city until then.
In October, my body presented a new genitalia-related problem requiring surgical intervention. One day, my vagina started off sore. By the afternoon, it was swollen and painful. I sent a photo to my surgeon. He said it was erectile tissue and removing it should alleviate the problem. I love Lovecraftian themes. The idea of something old and unknowable pressing outward against someone’s skin is very much My Vibe. The practical application within my body made me a little more empathetic towards Kane in Alien or Tetsuo in Akira.
“Very cool,” I thought, “thank you for letting me know”. I would have appreciated him being at all proactive in resolving the situation, but I understand he’s a very important surgeon man and I, lowly transexual I am, should be thankful he responded to me so quickly. Asking if there was any recourse, he looped in his assistant and I was given an appointment in two weeks time. I guess he was in the city. It feels really bad to be lied to by the people you’re trusting such an intimate part of your healthcare to.
I missed the appointment. Woops! I would now be seen in February. It didn’t matter that I was in pain all the time. Desperate for help, I called NYU Langone’s office of transgender surgery. I was told to go to the emergency room. Immediately. You’ll notice a disconnect between the immediacy of my situation and the sense of urgency expressed by my surgeon.
I was in the emergency room for over five hours. In the end, they shot me full of Toradol and told me to expect a call from my surgeon within the week. There were “a lot of sick people who actually need the bed tonight,” after all. Something that had become apparent was that the doctors I spoke to didn’t seem to believe I was in pain. I’ve worked restaurant shifts on a sprained ankle. I have a high tolerance for pain. It takes a lot to brace against pain for so long. It isn’t something that can just be turned off and on. I don’t know what they wanted from me.
“Something that had become apparent was that the doctors I spoke to didn’t seem to believe I was in pain.”
A urologist confirmed everything I already knew and told me he would be perfectly capable of performing the procedure I needed. He even thought he could help me recover some depth, but wanted me to wait to hear from his colleague so no toes were stepped on. Curious to me, was how both of these healthcare professionals seemed more interested in my vagina’s look and functionality then resolving the immediate issue of my pain. Don’t get me wrong, I wanted to have those conversations at some point anyway. My mentioning how my condition was making my life increasingly difficult to live seemed to mean, to them, what the potential reality of getting absolutely railed from behind was to me. I received an appointment three months away in February 2021. I resolved myself to more fighting with the hospital.
I was scared to advocate for myself too aggressively. I’ve seen people get pretty upset when I ask for anything more than scraps. I was worried if I pushed my surgeon’s office too hard I would be less likely to receive sufficient care. As a trans person there’s this thing people do where they act like they’re doing you a favor for doing the bare minimum. It ultimately just leads to more work for us.
I got the surgery. I had to start a GoFundMe because even though my insurance covered the procedure, that is just where the cost begins for surgery. I wasn’t able to work because of the pain. The options I did approve with my agent came with the caveat of “unless surgery comes up”. If you went back and read my original article, you might notice my family of origin is missing from this narrative. Their absence certainly made parts of this more difficult. I do think overall it made things easier more than it hurt. If that makes you sad, I’m sorry. It makes me sad too.
This current moment is the best I have ever felt about my vagina. Dilating, while at times a logistical hassle, is no longer accompanied by the guilt or painful confusion it once was. Sometimes, it feels good enough that I’m inclined to rub one off after. I think it actually helps loosen me up a bit which makes dilating easier. My orgasms feel like how I hoped they would after my first surgery.
It’s hard to shake the feeling that I’m not out of the woods. What happens if the tissue grows back again? Nothing about the way I was treated came out of left field. Any surprise I had towards the behavior of the cis medical professionals I was interacting with was born out of a sense of hope I often debate whether or not to maintain. I’ve held suicidal ideation in the past, as many trans people have or still do. There are two ideas I need to hold simultaneously to hold off despondency. First, that the world will continue to hold violent stances toward me and my body. To forget this is to leave myself unprotected and unprepared to care for the wounds I will receive. The second, is that I and my circumstances will continue to get better regardless. This truth is worthy of celebration.
There is still much of my experience I’m processing. I don’t know if I will feel I’ve said enough in six months time. I’m scared to admit there are still things I don’t know. In our culture, it’s shameful to have a vagina. Plenty of people have said it before me. Initially, I wanted to pretend I was immune to it. I don’t think that helped me. I guess this piece is a sign I’ve been working on it. There are still barriers within my body I am not aware of. I’m a survivor, and I think it’s more constructive to accept that and move on. It is a sign of trust in myself to do so. That sense of trust has certainly grown after fighting for myself like I have the last few months.
I worry it might sound like I have a lid on all of this. I think my story is better if that’s the angle I’m writing from. I want to assure you that since the time of writing, I will have spiralled in some way where I could have taken my own advice here but didn’t. I don’t want anyone thinking I’m perfect. Perfection is flat and flavorless and I would rather taste something rotten than taste nothing at all.