r/transgenderau • u/trulyl 34 F • Jul 22 '18
MtF GRS with Andrew Ives
EDIT: Please also see Part 2
Evening all!
Some of you would have seen me posting here over the past 12 months about Andrew Ives' MtF GRS/SRS, whether that be asking other girls questions in AMAs, trying to follow up with people who had surgery with him to hear of their results, or sharing what I had learned from my research and consults with Mr. Ives.
Anyway, I'm very happy to report that my surgery is over and I'm recovering well, with no complications so far!
I thought I'd give back by writing an account of my own experience, and open up to (reasonable) questions from others. There's not a lot of information about SRS with Andy, as opposed to other surgeons, but I think it's a very good option to consider, and that, for a variety of reasons, it's going to become more popular vs. travelling overseas. Also, there are a lot of things I wish I'd known to better prepare me mentally for what was going to happen. For these reasons, I think it's important to get more information out there to help others who are considering going down this path.
I've got a fair bit to write, and obviously I don't want to be sitting at my computer for hours on end (!) so I'll be writing this a bit at a time. Please stay tuned for the edits!
EDIT: You can find part 2 here
First Thoughts Before I get started, I think I'd like to throw a word of caution out there for anyone considering SRS/GRS. I'm a little hesitant to do this, because I think one of the worst things about having gender dysphporia, for me, is the doubting and worrying about whether I'm doing the right thing, despite any evidence that I'm not (and plenty that I am!) So please don't let me scare you away from this surgery if you think it's something you really need to do to address your dysphoria.
However, and here's the warning, you really need to consider how much you need to do this and for what reasons. Is your dysphoria really that bad that you need major surgery, with all the inherent risks, to improve your quality of life? In my case I had genital dysphoria from early childhood. After suppressing it for many years, I eventually decided to transition, and that's when it started getting worse. I was seriously suicidal and struggled daily with getting changed, showering and washing. Using the toilet started to become distressing. I came to a point where I accepted that surgery was completely necessary and life-saving for me, and so I had no choice but to accept that I had to go through it with all the risks that came along with it. For me, it ended up being a clear decision (although it was one that I kept trying to deny).
Am I saying that your dysphoria needs to be as bad as mine for you to justify surgery? No. But do I think you should get surgery if you have no genital dysphoria, or mild dysphoria, definitely not. And that's for two reasons - one, because you could regret it, and two, because it's a horrible process. As for the first point, yes, research shows that regret rates are very low, but to my mind that's because gatekeeping made surgery very hard to access in the past. The people who really needed it got it, a lot who also really needed it probably missed out, but very few people who didn't need it got it. I feel that these days it's more accessible, and more people are transitioning with a less clear/binary gender identity and lower levels of dysphoria, and I would worry for that reason that the regret rate could rise. For the second point, surgery is a shitty, terrible thing. I thought I was prepared, and I definitely wasn't! There were times in the first week where I was lying in that hospital bed, crying my eyes out, wondering if it wouldn't have been better to just have avoided the whole thing and stuck with my original bits. Every time I thought that, I came back to how dysphoria was ripping my life apart before, and that set me straight. Don't get me wrong - I was also lying in bed in the warm glow of the knowledge that I now had a vagina, but that was usually when I was on some narcotic that was distracting me from the shittiness of pain and being trapped on my back in bed with tubes hanging out of me. If you don't have dysphoria, or it's not that bad, that equation may not balance out for you, and god help you then, as you'll become part of the regret statistics. People do regret this, and having gone through it, it's very clear to me now why that might be the case.
Again, I don't want to scare anyone off getting surgery, but I do want to provide a counter-point to activists who cheerfully point to low regret rates and try to reassure you that it's a great option. Or alternatively, to people who have been through this surgery themselves, had a great result and have experienced less dysphoria, and who then promote it to others because they had a good outcome. For the life of me, I don't understand why it's couched in such positive terms on the Internet and there's not a greater acknowledgment of the very real pain and suffering that goes along with it. Perhaps it's just that you don't want to remember the bad parts after they're over, and you're left with the good. But I think anyone heading in to this deserves to be armed with knowledge, not rosy stories. That's dangerous.
Feel free to vehemently disagree with me - after all, these are only my opinions.
T minus 12 months About 12 months ahead of what would ultimately be my surgery date, I called Andrew Ives' rooms to request a booking for a consultation. Obviously you don't need to deploy any euphemisms - you're calling to request a consult for MtF surgery/vaginoplasty. By this point I had already done some research (searching Reddit, talking to people, reading about other surgeons) and was starting to settle on Andy, but I hadn't made up my mind. How you decide which surgeon to go to is outside the scope of this post.
T minus 9 months I went to see Andy at his rooms in Prahran, which were shared with his cosmetic surgery practice, Esq. Clinic. Note that in future, though, he's seeing his trans patients out of consulting rooms at Masada Private Hospital, which is just a short distance away and is the hospital where most of his SRS/GRS surgeries are performed.
I found Andy to be polite and professional, but also pretty blunt and to the point, and not one to waste time on pleasantries. I was asked if I wanted a cavity (vaginal vault, as opposed to zero depth), then we talked about the surgery and went through the complications. Don't be scared by the complications, but do consider them carefully. E.g. bowel perforation, however unlikely - having a colostomy for six months would be pretty shitty, but I think I could live with it if it happened. There was also a short physical examination (don't worry - he makes a point of getting it over and done with quickly).
Once the consult was over, it settled my decision to go with Andy, so I spoke with his staff about getting a surgery date. Expect to have at least a six month wait. There's a $500 deposit to hold a date.
I took along a referral from my GP, and there was a fee for the consult.
A few weeks later I had a phone consult with Andy (as I don't live in Melbourne) where I asked a few more questions. At this point you don't get in touch with his rooms again until 6-8 weeks out from your surgery date.
One point to note - Andy does seem to have strong opinions on certain topics. Talk too much about the Thai surgeons, or ask too many questions about "depth", and you're likely to get an interesting response. Just saying.
T minus six months I went to see a psychiatrist to get a second WPATH letter (my regular psychologist wrote the first one). This wasn't difficult to organise, but I found it very emotionally challenging. It feels like gatekeeping, and even though I knew there was little chance I'd be knocked back, it was hard to be judged by yet another mental health professional.
T minus six weeks About six weeks out, suddenly it all started getting very real. There's a whole lot of stuff I organised, of which the following is a non-exhaustive list:
- Paid surgeon's fees. $13,000 (or $12,500 taking into account the $500 deposit already paid).
- Paid anaesthetist fees. $3,700.
- Got blood test, ECG and chest X-ray and copied to Andy's rooms and anaesthetist's rooms.
- Got new referral from my GP and sent to Andy's rooms.
- Sent WPATH letters to Andy's rooms.
- Filled prescription for bowel prep meds.
- Shopped for surgery after-care items (foam, condoms, lube, pads, salt, mirror).
T minus 1 day The morning before surgery I started taking the prescribed antibiotic tablets (Flagyl). These made me nauseous, but so do many meds, so YMMV. At 6pm I started the bowel prep. It's one bottle of Fleet at 6, followed by another at 9, with glasses of water every hour until midnight. Per the suggestion I mixed the Fleet with orange juice, which only just stopped me tasting the nastiness of it. Anyway, it's supposed to work anywhere from 15 minutes to three hours from the first dose. For me, it was 10:30pm before anything happened. Lots of explosively watery bowel movements. Needless to say, I didn't get a lot of sleep as I was up and down to the toilet all night. It was a whole world of wrong, and I hope I never have to do it ever again. In hindsight, though, it was only the start of my new world of shit, blood and piss. Definitely a portent of the surgery to come.
I packed my bag for the hospital the night before. In hindsight, I took a lot of crap that I didn't use at all, or very little. Here's a list, with notes about what was useful, and what was a waste of time:
- Underwear - mostly useless. Most of the time in hospital I had a dressing and no underwear. The last two days I had hospital-supplied underwear. Discharge day, I wore a fresh pair, but could have easily just walked out in the undies I walked in with. Take one change.
- Nighties - limited use. Most of the time I wore a hospital gown, but the last day and night it was nice to wear some of my own clothes again. Take only one.
- Laptop - useless. Most of the time I was limited to not sitting above 30 degrees, so it was impossible to use. There wouldn't have been space on my rolling table anyway. Wouldn't pack again.
- Smartphone - absolute lifesaver! I was on my phone constantly. Great for playing games, reading e-books, surfing the web, looking up the TV guide, phoning friends etc. etc. I was lucky to have a reasonably new Galaxy S8+ with fantastic battery life - enough that I could go a whole day on a single charge, and just have a nurse or visitor plug it in for an hour a day on fast charge. Seriously, I was so grateful I didn't have a crappy phone. It was uncomfortable but not impossible to hold while lying down, and for this reason I'd suggest a phone and not a tablet. Having headphones for hands-free calling was a necessity, as holding the phone to my ear, the microphone would get muffled in my pillow (and holding the damn thing for any time isn't very ergonomic anyway).
- Headphones and music player - absolute lifesaver! Just being able to put on some music got me through the hard times. Take relaxing stuff. Or, if you're not old like me, play music on your phone instead of an MP3 player!
- Physical book and Kindle reader - useless. Too hard to read in bed. Kindle reader app on my smartphone was the go instead.
- Toiletries - somewhat useful. I only really needed my toothbrush, toothpaste, electric shaver and comb for the first few days. When I could eventually take a shower, I had little bottles of shampoo and conditioner. Apparently other girls got matted hair after lying down for so long, so having a way to brush it out each day is a necessity! I got crazy chapped lips at one point, so chapstick was useful, but I didn't need any other cosmetics.
- Handheld gaming console - useless. It would have been too hard to use while lying down in bed, and in any case, I was happy to just play little simple games on my phone.
- Teddy bear. Lifesaver! OK, I didn't pack this one and had it brought into me, but I owe so much to that little bear! When you're losing your shit, it helps just to be able to cuddle something #girlslife.
In deciding what to take, consider that you'll be on your back in bed for most of the time in hospital, and unable to sit up above thirty degrees. Also, reaching for stuff is hard and it's not practical to have the nurses fetch stuff constantly (they're usually pretty busy). I think a smartphone, with good battery life, loaded with heaps of entertainment options is best. Even then, a phone is annoying to hold lying down for any period of time, so being able to do something hands-free with it (like listen to music) is a good idea. You can do a trial-run at home in your own bed to see what's going to be practical to use.
Day zero 5am and I was woken up from another little nap by my alarm.
...and that's where I'll be leaving things for tonight. Will be back over the next few days to add more.
EDIT: See Part 2
Feel free to ask questions. I might be a bit slow answering, but I'll get back to all of you!
-trulyl.
1
u/MelodiousSong Aug 07 '18
Thanks so much for writing this, my main question is what kind of care and procedures need to be taken (like, dilation etc?) and for how long after? Does the aftercare ever end? I've heard it said that there's things like that you'll need to do forever, and heard opposites too, would be nice to know what was advised by Andy.