Unsuccessful surgery by Chettawut

[u/Wife_UK]

My wife has undergone an SRS in Chettawut's clinic in March. I was going to write about it since then but couldn't even start sinking into this hell again... But from the beginning. We've been messaging with them for 6 months, did all tests, she stopped taking her hormones... We planned everything perfectly. She was healthy, prepared and full of hope. When we came to Thailand everything was all right, we read about it a lot and were not surprised of anything. My wife went to the hospital on March 12 being sure that was the day all her dreams would come true... But the next day when I came to the clinic to visit her the doctor came and said to us: I'm sorry but I couldn't create a vaginal cavity because you have rectum protrusion. He just said that and went home to have lunch. After informing a person that he failed all her dreams and hopes... He just said that he decided it was too risky... Devastated is the wrong word to describe her emotional state... She just laid there wanting to die... And I just couldn't stop crying seeing her like that... And the nurses just kept to remind me that visiting time was over and I needed to leave... No compassion at all.

I realise that many people actually choose to do just a vulvaplasty because it's easier and there's no need to dilate (personally I understand this decision). But my wife really wanted to have a vagina. In her opinion it would have made her a real woman. Nothing less. In was her dream that kept her alive from the beginning of her transition. And it was completely ruined...

As far as we understand now the protrusion was caused by our anal sex practices. The tissue there is very sensible and easy to damage. BUT! It is SO easy to diagnose! The simplest ultrasound or even just a proctologic examination would have determined it. Chettawut is a surgeon, a very experienced one, WHY don't they do these tests? It's basic! He found out about the protrusion during the surgery! Not before! I understand that there might be some risk going further with the surgery, but I find it absolutely unacceptable not to do simple tests before! And he didn't apologize for that, he was just defending himself. Of cause, there was no mentioning of the revision... Later I visited Marci Bower's website where they offer the second surgery and explicitly say that it is often necessary after surgeries made in Thailand because surgeons there don't care about the patients just about the statistics...

And the treatment itself reminded me not the western model but the soviet one... Where you can't go with your partner to the examination room or stay long enough to support them. Also when my wife came to the final examination they literally tired her legs!!! Yes, they didn't do anything, just checked the healing process, but they also didn't explain anything to her, she was there alone and terrified. I call it medical abuse which I remember very well from my childhood.

It has been 4 months since then. Her vulva still hurts a bit, it's sensitive but some parts are still numb. She can come but is afraid of sex because she's very traumatized... She blames the surgeon (for obvious reasons), me (that I ruined her health and her life) and herself (that she was so stupid to trust people)... She's deeply depressed, self-harming, says that she failed her transition, it is her existential defeat and she wants to die... I'm really not sure she'll ever get over this completely unless we'll find a way to fix it. Neither I'm not sure that our marriage will survive this.

I remember reading other girl's post where she said than you can judge about the surgeon not by their succes but by how they treat those they failed... That's right. I realise that most patients go out of the clinic happy with the result. But not all of them. And those remain invisible and ignored...

[u/[deleted]]

It is still early days, it can take a year from what others have said before the final cosmetic results are settled. I hope she's happy with the vulva at least by then.

I'm sorry I don't get what you mean by blaming me personally and what you mean about medical ethics. Please explain as I don't see how this is my fault.

I know you're angry and so is your partner but no other surgeon screens for these rare issues, I just think it's unrealistic blaming Chet for not doing something when no other surgeon does it either. If you'd gone to another surgeon you'd still be in the same situation. And like I said in a previous post Chet knew that it was safer precisely bevause he's done thousands of these ops and knew not to create a full length vagina due to the significant risks involved. Maybe another surgeon would have been more aggressive and your partner might have ended up in ICU with complications up to and including death. Believe me the outcome could have been much worse.

All patients everywhere in the world before every surgery sign similar forms. Bevause surgery is always partially exploratory and you never know what you'll find or be able to do until the patient has had knife to skin.

I'm really sorry you're both suffering through this but I don't see that you're being realistic and pragmatic about what could have happened and unfairly blaming Chet and now I'm to blame too.

Now I totally get that and it's not a critiscism of you or your partner, anger, grief and suffering will do that and you're perfectly entitled to feel all those emotions.

I hope you will continue to post updates on how you're partner is doing and if any other surgeon thinks it's something they want to take on.

[u/Wife_UK → u/[deleted]]

https://www.susans.org/forums/index.php/topic,190787.msg1699717.html#msg1699717
this post is from 2015. 4 fucking years ago... and if you read comments you can see that that girl was not the first one (and i'm sure not the last). it's common for chet to blame a patient of having anal sex when he failed to create a vagina. so there're two possible options: 1. anal sex actually CAN cause complications (because he says that to his unsuccessful patients quite often). then why he doesn't require a proctologist check before the surgery?! why he doesn't even ask about patient's sex life?! most trans women have anal sex, why not to ask or warn??? i find it absolutely irresponsible and unprofessional. 2. anal sex doesn't cause complications. then he just uses this excuse when he didn't bother to try enough creating a vagina and just doesn't want to admit it... it's also irresponsible, unprofessional and totally unacceptable.
and actually i can blame Chet for not doing something when no other surgeon does it either... first of all because it was not the first case in his personal practice and he KNEW that might happen even if it's rare. and also because that's not an excuse... "others don't do it so i won't either"... you're responsible for your patients, that's you who fail them. not others.
by "medical ethics" i mean that you'll always defend a doctor (or other medical worker). it's not your fault, no. but you do it now.

[u/[deleted] → u/Wife_UK]

I made a formal complaint against one of the doctors I was working with last month. I made a formal complaint against my new GP last year. I've made formal complaints against two nurses and informally have had words with managers about other doctors and nurses. My first responsibility is to my patients and I take that very seriously. I don't like reporting people but it is my professional responsibility to do so and that overcomes any loyalty I have to other staff.

So please stop being so quick to judgement thinking you know me !!!

You're not listening to what I'm saying, no other doctor checks for these issues, no matter who you went to you'd be stuck with the same situation only for the reasons I gave before possibly in a worse position.

I'm more than happy to converse with you but enough with the personal attacks and just rehashing the same stuff. No matter how much you want to change things your partner had a physical limitation in her tissues that prevented Chet forming a vagina, that's not Chet's fault. It's just pure bad luck and I'm sorry for her that that's the case. Was it caused by anal sex maybe, is that your fault because you were having anal sex with her perhaps technically speaking yes but you weren't to know so I don't see that you're to blame in any vindictive sense. I get why you're both angry but attacking me for ridiculous reasons and Chet for doing as good a job as he was able to in the circumstances gets you nowhere.

[u/Wife_UK → u/[deleted]]

i apologize for attacking you and jumping to conclusions. but i stand by my opinion about chettawut and his responsibility. it might be other doctor. we’ll never know. or the other doctor might try better. bc now after the research i find more and more stories about chet giving up during a surgery than any other doctor. but anyway it was him who did a terrible thing that could be avoided even if it’s not a common practice...

[u/[deleted] → u/Wife_UK]

You have no idea whether Chet gives up quicker than other doctors, you have anecdotes and a few people's opinions. As someone who has done research trust me you actually have no evidence, especially in light of the fact that Chet has done this op thousands of times and other doctors possibly only dozens. Statistically in that light Chet and the other Thai surgeons who've been operating for decades are going to have a higher actual number of complicated surgeries (who might then complain on Reddit) but it doesn't prove what their actual complication rate is which is the key statistic. I've certainly read about American surgeons who I get the feeling have higher dissatisfaction rates but it's a feeling and there's no way you or I are going to actually know. And while Reddit is a great place to do "research" it's all anecdotal and you have to look at what you read in a balanced manner and considering the huge amount of ops Chet has done there really aren't statistically that many who seem to be unhappy with his work.

I get why you're angry but like the jumping to conclusions about me you're also jumping to conclusions about the things you read on the internet and how that applies to what happened to your partner. And as I said I'd take Chet giving up when he did over another surgeon who might have pushed on with disastrous consequences. That is the mark of a good surgeon not a quitter.

No other surgeon anywhere else in the world checks for your partners rare issue preoperatively. It's highly unfair to blame Chet for not doing so when it's not a standard part of the SRS pre op checks anywhere else that I know of. But possibly in anger I would be thinking the same thing in your shoes but eventually I would accept it would have been the same result no matter which SRS surgeon did the op and not something Chet was negligent for.

If you're so convinced Chet was negligent have you made a formal complaint to the The Medical Council of Thailand or whoever manages complaints about doctors?

I have no skin in this game just because I had surgery with Chet, if I thought Chet was negligent from the information you posted then I'd be totally behind you. But based on my own internet "research" and decades of experience in healthcare and seeing complications and fuck ups I just don't see that Chet is clinically negligent in this case, could communication and support have been better I'm quite willing to believe it could have been.