Why I Have No Plans For Bottom Surgery

This post includes frank discussion of sexuality and my body.

It recently occurred to me that, although I have not had genital surgery, in a lot of ways, I no longer feel like someone who has not had genital surgery. I have had surgery once as part of my transition (chest reconstruction) and plan to have surgery once more (hysterectomy, at my doctor’s recommendation). If you had asked me early in my transition, I would have said I wanted to have bottom surgery (probably metoidioplasty) as soon as possible.

What’s changed? Going into this journey, I underestimated two things: how much other transition steps would affect my relationship with my whole body, and how much surgery sucks.

Let’s take the unpleasantness of surgery first. Chest surgery was a great experience–if I had to, I would make that decision again in a heartbeat. It was also a reality check. Pain, recovery time, needing help while healing, taking medications, going under anesthesia, numbness and scarring–all these things real to me now. I have also felt the impact of the financial costs. If genital surgery procedures were comparable to chest surgery in terms of risks and costs–including healing time, dangers of any surgery, possible loss of sensation, dollar cost, etc.–I might consider it. But that’s not the case. Bottom surgery is more dangerous and much more expensive, healing times are much longer, and I would likely need multiple procedures. Considering the price-tag, healing time, and other risks of bottom surgery, it’s just not worth it to me.

It probably would be worth it to me, though, if I still experienced acute dysphoria. That brings me to the other thing I underestimated–how big a difference all the other aspects of my transition have made.

I am now able to move through the world as a man with ease. I am able to feel comfortable during sex. I still have some dysphoria, and it’s not pleasant, but I think it’s now within the range of ordinary body image insecurity that many people experience. I’d say I’ve gone from a 10 to a 2 on a 10-point gender dysphoria scale.

I also underestimated, quite literally, the changes testosterone would cause when it comes to my dick. I had extreme dysphoria around my genitals pre-T. I considered myself stone and always used a strap-on during sex. This has totally reversed–today, using any kind of prosthesis would induce dysphoria, not alleviate it. Though my genital configuration is definitely not average, I am able recognize what I have as male. I have a dick, plain and simple. I still experience dysphoria around that part of my body, but it is manageable.

I also have a partner who perceives my body as male, and I am able to engage sexually in a way that feels right to me–to have intercourse and do all the other fun stuff straight dudes tend to do. I did not know that would happen, and I did not know how much it would mean to me.

Pretty much the only thing I can’t do is pee standing up in a convenient, splash-free fashion. From my observations in public restrooms, it appears that a large proportion of men have this problem.


  1. Reinventing Lucky

    As a cis-gendered guy, trust me most guys can’t stand and pee in a splash free fashion :).

    As for everything else, that is good to hear that others feel the same way. My husband just started transitioning (hopefully on T soon, then another 12 months and top surgery if things work out).

    I know he was thinking the same thing, he isn’t aiming for bottom surgery because his health has always gone out the window when he undergoes anesthesia. Even though that is his plan, I do hope his dysphoria decreases like yours did. It gives me a bit of hope that others men are ok without the surgery, he might be as well.

  2. Josh

    Being in the early stages of getting to know my body and who I am, I’m glad to hear bottom surgery isn’t a top priority. My biggest concern is top surgery and T. I think I can live without bottom surgery…plus I think it would be a lot more “fun” (for lack of a better word) to pump my own dick and basically create it myself with the help of T, if that makes sense :)

  3. rimonim

    Hi, R.L.! Glad the post gave you some hope for your husband’s journey. Some guys do feel a strong need for bottom surgery, but my impression is that most trans men are able to feel comfortable after T and chest surgery. If you or your husband ever need to talk to a trans guy, I am always around. :)

    Hey, Josh! That makes perfect sense. That’s pretty much what I’ve done and it’s worked out well for me. Each transition experience is different–what I found is that after some time on T, I relate to my dick as a dick, and that fact is way more important than the fact that my penis is small, sits at a different angle from most, etc. It is definitely a lot of fun, haha. After all the harrowing experiences of being trans, it is so nice to just enjoy my body.

  4. skye83

    First, I’d like to say that though I am Agender, I still plan on physical transition… the kind of transition most people associate with FTM’s. I already had a hysto, and top surgery is coming up in a month or so.

    Secondly, I’ve wanted a penis since I was 8 in 1985. I spoke with a doctor a few months ago about bottom surgery–a doc who is a trans man and has worked with transgender clients for years. He and I are both in agreement that T is really a bad idea due to my health problems, which pretty much means metoidalplasty is out of the question. I don’t want a 3 cm penis! I don’t want phalloplasty either. I don’t like the idea of taking skin from somewhere else on my body to create a penis. I wish I could get a penis donated from my trans woman friend who wants hers gone asap! It’s just not that simple. I might have to leave that area the way it is.

    • rimonim

      Hi, skye83! I’m glad to hear you are able to take some transition steps you want to take, and I’m sorry you don’t feel there is a bottom surgery option that is right for you. Sometimes, the real experience is different from the idea of the experience. I hope you find happiness with whatever you choose.

  5. Pingback: A Few Thoughts On My Dick & Healing The Mind/Body Split | Today I Am A Man

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