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What It's Like to Get Gender-Affirmation Surgery

The process is painful, scary, expensive, and time-consuming. And he'd do it all over again if he had to.

In Chris Edwards's new book, Balls: It Takes Some to Get Some, out today, he offers an ultra-candid account of the five years of operations he underwent in order to get complete bottom surgery. With a light touch and a heavy dose of gory detail, Edwards walks you through the experience from soup to, ah, nuts.—Kate Lowenstein

From 2002 to 2007, I had surgery 22 times.

If you break it down, that's roughly one procedure every three months. Some required multiple-night stays in the hospital and a few weeks' recovery in Nashville. Others I was able to knock out over a long weekend. Those "weekend wonders" were performed in Doc's office with me wide-awake, acting as his assistant. Once I was numb from the Novocain and the continual sight of my own blood, I had no problem handing him instruments, applying pressure with gauze, or holding my would-be shaft at a certain angle while he stitched, cut, or cauterized. These newfound medical skills were saving thousands of dollars in hospital bills.


In the end, my five-year quest for male genitalia would cost more than $100,000, not including travel. I was beyond fortunate my parents had the means to pay for my surgery. Lord knows I sure didn't. Nor do most people in my situation today. Again, this is why I'm one of only a small group of transgender men in this country who have chosen to "go all the way" when it comes to bottom surgery. As I've mentioned, the"deluxe model" doesn't come cheaply or easily. It's an expensive, painful, and time-consuming proposition with the potential for myriad complications and no guarantees when it comes to aesthetics or sensation. It's pretty freaking scary, and oftentimes I felt like I was in what would have been Dante's tenth circle of hell. But I'd do it all over again if I had to. That feeling of finally being complete—of being who you really are—trumps everything.

That said, many people who are transgender choose not to undergo surgery, even if they can afford it. There could be a number of reasons: pain, risk, fear, uncertain results, lack of support, or just being happy with their body the way it is and not feeling the need. Which brings me to an important point: You should never ask someone who is transgender if they have had or plan to have surgery. First, it's none of your business. Second, it's offensive because by asking that question you are implying that the person is not the gender they feel they are unless they alter their genitals. The fact is gender identity is not defined by what's inside your pants; it's defined by what's inside your brain. It's also something nobody questions or even thinks about unless it doesn't match the body they were born with. This is why people who are not transgender have so much trouble understanding what it's like to be in our shoes, and often why they are compelled to ask so many questions.


While many members of the transgender community consider the surgery topic off limits, I was very open about it. I didn't care if people knew I was having surgery. It was actually less stressful for me knowing I didn't have to hide it, especially at work. What was I going to do? Make up 22 different stories about why I would be out of the office for weeks at a time? It was a relief being able to be honest. I'd simply say, "I'm having surgery," and people would just say,"Ohhhhh," and kind of nod. When I'd come back from medical leave, everyone would ask me how it went—more out of genuine concern than anything else—and wait for me to offer up whatever information I was willing to share.

Of course my close friends and family were privy to all the gory details—partly because I'm an over-sharer and partly because they were curious and wanted to know. I tried to explain the basic procedure in terms they'd understand, which was challenging because I was having difficulty understanding it myself. Doc took me through it at least three times, but I still couldn't process all the technical details—kind of like when I'm lost and someone is giving me directions that start to get complicated. I'll nod along, but if it takes more than three steps to get me back on track, I just stop listening.

So the simplest way I could describe the first stage of my phalloplasty surgery was that the doctor would use abdominal tissue and a skin graft from my hip to create a vertical tube resembling a suitcase handle. One end would be attached below the belly button and the other at the pubic bone. After three months, I'd go back for the second stage of the procedure, in which the top part of the "handle" below the belly button would be detached so that it hung down, and voila! The shaft.


This sparked major discussion among my female friends who, upon finding out I'd have some control over the dimensions of my penis, felt compelled to weigh in. Aside from one assertion that "it's not the size of the wave but the motion of the ocean,"most of the female input I received was that size did matter but length was not as important as girth.

"You definitely don't want the nickname 'needle dick,'" I was told.

"Go for the beer can!"

These comments led to an in-depth discussion with my doctor about penis size. I had read somewhere that the average penis was 3 to 3.5 inches long when flaccid and 5 to 5.5 inches when erect. Since my penis would remain the same length in both situations, I needed to take a one-size-fits-all approach. Doc said he would make the shaft six inches long to start and that he could make it up to two inches longer or shorter at a later stage. He said he couldn't make any promises on the girth as it would depend on my abdominal tissue and skin graft but assured me I would definitely not be called "needle dick." He added that most guys come in wanting huge penises and then end up coming back in to have them made smaller because it's too much to carry around all day—especially for patients who are vertically challenged (i.e. short) like me. Since my penis would be spending most of its time inside my pants, I was leaning more toward being average size than porn star size. Little did I know, Doc had other plans . . .



Everything was dark. I could hear voices but couldn't make out words. The one with the Greek accent that was extremely chipper I knew belonged to my doctor. That's right, I'm in the hospital. I tried to open my eyes but again, the sandbags were back. That must be the anesthesia kicking in. Then I heard laughter and two voices I recognized as my parents.

"What's so funny?" Imumbled, straining to open my eyes.

"Heeeey, Chris," Doc said cheerfully. "You're awake."

"Hi, Shtine," I heard Mom say and then felt a light kiss on my forehead.

"Are they taking me in now?" I asked, catching a blurry glimpse of the three of them standing over me like Mount Rushmore before my eyes drooped closed again.

"You're all done," Dadsaid warmly. I felt his hand pat my leg.

"You were in there six hours," Mom added.

"I gave you eight inches!" Doc announced.

I recall muttering something about not needing a kickstand, which got everyone laughing, and then felt a draft below my waist from what I presumed were blankets being lifted off of me.

"Jesus Christ!" I heard my dad say. "That thing is bigger than mine!"

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Photo: Maureen Sargent