This is my personal account of my Gender Reassignment Surgery which was performed in Brighton by well-known surgeon Mr Michael Royle. It is adapted directly from my handwritten diary which I kept day-by-day during my hospital stay.
The first day begins with an early start, making sure that I have everything I need in my giant suitcase. It seems such a lot for a ten-day hospital stay, what with seemingly endless supplies of clean knickers, nighties and sanitary towels, as well as the usual array of cosmetics and changes of clothing that I like to have with me when I'm away from home. I put on my make-up with care, and select a white embroidered skirt and tie-waisted denim top that matches the pleasant summer weather and shows my figure to best effect. Somehow I feel it's important to look my best on this special day. My last day as a pre-op, a milestone in my life.
I report to the hospital on time, and sit around waiting for a while in the day room. I exchange small-talk with other patients, none of whom has any idea of what I'm there for. When asked, I mumble something about 'something down there'. A nurse shows me to my room, and fills out various forms. I'm sure this must be the thousandth time I've run through my medical history and given the name and address of my next of kin.
After a long spell of nothing to do, I am given the first stage of bowel preparation. They have to clean everything out for safety during the operation. I am given suppositories and then an enema, and scurry repeatedly into the lavatory for a couple of hours.
I feel a strange mix of emotions: on the one hand, excited that something I've known I've wanted for many years is actually going to happen tomorrow morning, and on the other hand, I'm definitely a bit scared! This is my first ever major surgery, so I don't really know what to expect. But I'm already looking forward to phoning all my friends after the op and telling them how happy I am.
Mr. Royle and the anaesthetist come by, ask questions, and pronounce me fit for surgery. I'm due in surgery at about half past eight tomorrow morning. I am offered clear soupy stuff and jelly for dinner. I haven't eaten a thing since breakfast, and I wonder if I can hold out on this meagre diet for five or six days.
Two nurses complete my bowel prep with a rather undignified exercise involving six feet of rubber tubing and a lot of warm soapy water. It's not very pleasant, and my insides are grumbling loudly from this treatment and lack of food, but I tell myself it's going to be worth it. The time is now past midnight; it has been a hectic day and I'm tired. I wonder if I can sleep...
I sleep relatively well, all things considered; I wake up about half past five, and am sent to have my final bath and to shave my entire genital area at about half past six. I wonder if I'm awake enough to shave the area without cutting myself. I take the opportunity to wash and dry my hair, then it's time to put on the TED stockings, which are tight, very sweaty and decidedly not the height of fashion. I lie back and wait for the pre-med.
How do I feel now? Relaxed, surprisingly. I know I'm doing what's right for me, even if it's rather a drastic undertaking. I'm not really too scared, the staff and Mr. Royle all seem very competent and caring. I just want to get it over and done with and start recovering, now. And of course I'm eager with anticipation to 'discover' my new body over the next few weeks.
The pre-med arrives, and I drift off into never-never land...
I awake in mid-afternoon, I think, not really 'with it'. I feel relief, happiness, knowing that I've survived and am now a complete woman. I look down and see the bulky nappy-like bandage around the surgery site.
The recovery nurse, seeing that I'm awake, removes the oxygen mask. The first few minutes of bliss are marred as the pain makes itself known through the anaesthetic fog in my brain. I am given a painkilling injection and feel a bit better. I return to a fogged-out state, from which I emerge briefly in the evening and phone a few close friends, insanely happy despite the pain. I ignore the proffered soup and jelly, and sleep fitfully until the next morning, with another injection during the night.
I seem more awake this morning; a nurse removes the drip that has been in my arm since the start of surgery as I am drinking water greedily now, feeling rather dehydrated from all the drugs. I can see two drain tubes and a catheter tube coming out from under my 'nappy'. The drains look a bit gruesome, draining blood and fluids from my surgery site into little plastic containers.
I still have a slight fever but don't feel too bad as long as I get the four-hourly pain-killing jabs (which leave me feeling pretty stoned, but I'm not complaining!). I'm also on injected Heparin, to prevent blood clots, as well as antibiotic tablets. A nurse comes by and raises me to a semi-sitting position, which hurts at first but at least allows me to catch up with writing my diary!
I still don't know how the op actually turned out, as nothing is visible under the bandages. I'm told that Mr Royle will come to see me tomorrow so I can ask him how it all went.
I get my first localised nervous sensation (as distinct from just general pain and discomfort): a series of mild but sharp sensations corresponding to the organ that I no longer possess. I think, from the description of the op, that those nerves are now in my clitoris. Interesting!
Late at night, I start getting a great deal of wind and abdominal bloating; I think it's the antibiotics. I feel very feverish (it is a hot, muggy night) so the nurses set up a big electric fan by my bed.
Mr Royle comes to see me. He says that all went well, I should have adequate depth, although my labia majora may be a little asymmetric. I should get the drains out today, and may get a chance to have a look at things. Some nervous sensation is reappearing: I can now feel the pack in my vagina. It is such a wonderful thought: My vagina, my labia, my clitoris.
Lying in bed I discover how to clench my vaginal muscles! Quite a wonderful discovery, though with the pack and the swelling, it's a bit uncomfortable at present.
I'm taken off the injected painkillers, and just on tablets (co-proxamol). I am re-bandaged and the drains are taken out; I stare at my new anatomy in wonder. It's very sore and swollen at present, but I'm sure that it will be fine when the swelling and bruising subside. I can see what Mr. Royle means about asymmetric labia, but I don't think it will be noticeable once the swelling has gone down and the hair has grown back. Tomorrow they should remove the thick 'nappy' bandage and I can switch to panty liners, which will come as a great relief in this hot weather.
Late in the evening, I experience a terrible nausea attack. I'm told it's just a reaction to the drugs I'm on, and given an injection which soon cures it. I awake once or twice during the night with severe 'phantom pain', which later subsides. I'm much more able to move about in bed than I was, as well.
I spend the whole day dozing and reading, feeling fairly reasonable all things considered. My Consultant Psychiatrist calls in to visit. He's glad to see another happy and satisfied patient.
Things are now improving fairly rapidly: it's not too painful, and the amount of bleeding and seepage is easily absorbed by an extra-thick sanitary towel. The thick bandage is gone, much to my relief. A pair of outsize knickers and an extra-super-duper sanitary towel are much more comfortable . Tomorrow, the pack comes out and I have to learn to dilate!
I'm being allowed to gently get back to real food. I have proper tomato soup for lunch, in place of the insipid runny stuff I've been living on, and real, genuine scrambled egg for dinner. I devour it as though it's the finest banquet on Earth. Tomorrow, I should be able to eat a normal diet again.
I feel very tired from the surgery and spend most of the day asleep. I don't even have the energy to read a book.
It is time for the pack to be removed. I dread this moment as so many TS women have described how painful it can be. Two nurses and a doctor who is standing in for Mr Royle arrive to do the deed; I am given nitrous oxide to breathe, and I hyperventilate enthusiastically with it, willing it to do its utmost to block the soon-to-come pain.
There is suddenly excruciating pain, which continues for what seems like an eternity. One of the nurses holds my hand, I bite my tongue and cry. I bleed quite a lot, and lie there exhausted and tearful. The nurses decide that I shouldn't try dilating for a few hours yet.
Later I have some problems with the catheter, it doesn't always drain properly which gives me a lot of discomfort. The nurses fiddle with it periodically and tell me that this does sometimes happen, which is little comfort to me.
I'm allowed out of bed for the first time, and take a bath, which is absolutely blissful after five days in bed. With assistance from a nurse, I do my first dilation, which hurts. The small dilator isn't too bad, it goes in about three inches, but I can't get the big one in at all. By the time I finish, I'm craving my next dose of painkillers.
Because of the trouble with my catheter, Mr Royle decides I should be decatheterised a day early, and I'm now trying to learn the art of peeing with my new anatomy. Messy, inaccurate and slow so far, but it's early days yet. On my first attempt, I faint in the lavatory and have to be carried back to bed. I feel very foolish, but the nurses reassure me that this happens quite often and is nothing to be embarrassed about.
My second dilation goes well: I get the small one in almost four inches and keep it there for four minutes without any pain. The big one won't go right in, but I'm trying to get it in as far as possible and keep it there for about a minute. Apparently I'm doing fairly well for this early in the proceedings.
The 'plumbing' is settling down a bit, I can sometimes get a neat, if mis-directed, stream -- it tends to go straight up, when it isn't trickling pathetically. Still no bowel movement though. Dilation is OK; I'm now doing 5 minutes on the small one; the big one still won't go in, but I'm working on it!
The surgical area is starting to look a bit better: it's not as red and swollen as it was, and the soluble stitches are beginning to break up (as I noticed in the bath this morning). I'm also getting up and about a bit more. I spend a good half-hour studying my new anatomy. The swelling is subsiding and it's now possible to touch most areas lightly without screaming. The urethral exit is very sore and inflamed: hence, presumably, my peeing troubles.
Dilation is no problem, six minutes with the small one, no discomfort, listening to relaxing music on the radio all the while (I find that being relaxed really makes a difference). The big one still won't go right in, but it's getting closer.
Later, my bowels start to become very uncomfortable, and I'm told that that often happens after several days starvation and an anaesthetic. A couple of laxative suppositories quickly resolve the problem.
Dilation is getting easier: the small one virtually drops straight in, about 3.5 inches, maybe even 4, and can easily stay for six minutes. I even get the big one in about three inches today, not terribly comfortable, but possible, and can put up with it for about two minutes. More of the stitching is dissolving, and the soreness and swelling is gradually subsiding.
Peeing is finally getting easier. I feel very relieved, as I was rather worried that I might end up with permanent problems.
I feel a lot better today, and I'm happy that I can pee when I need to. Mr Royle decides that I can be discharged. I phone my best friend and ask her to come and collect me, and to make sure she fills her car with nice soft cushions, as it's a long drive and I'm still very sore.
I get dressed for the first time since the operation. I choose a long red print skirt, red top and white embroidered waistcoat. I put on my make-up with care, wanting to look my best on this special day.
Hand-in-hand with my best friend, I walk out of the hospital into the warm afternoon sunshine, and into my new life.