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Trans Summer School: Vaginoplasty (also “bottom surgery”)

In vaginoplasty, which may require multiple surgeries, depending on your case, your existing genital tissue is creatively recycled into a vagina⁠, set of labia⁠, and a clitoris⁠. After vaginoplasty, you will be able to have vaginal intercourse⁠, you should be able to have orgasms, and your body will produce some lubrication. (Your surgeon may recommend the use of additional lubrication to protect your vagina from microtearing and other issues.)

You will need to stay in the hospital for several days following surgery, and you will be pretty uncomfortable—there’s a lot of packing and bandaging down there. Once your vagina has its grand opening, you’ll be directed in the use of dilators (also called stents), which look and work rather a lot like dildos—you’ll be gently inserting them, with plenty of lube, during the recovery process while your vagina heals. Your doctor may have additional directions for vaginal care during healing and over the course of your life.

Risks can include infection⁠, scarring, and tissue necrosis (death). If you don’t keep up with dilation and aftercare, your vaginal canal may narrow, which can lead to pain or discomfort during insertive sex⁠, whether with a penis⁠, toy, or hand. 

This section is part of a larger piece, Trans Summer School: The Wide World of Surgical Transition

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    • Gabriel Leão

    The Care We Dream Of: Liberatory and Transformative Approaches to LGBTQ+ Health, edited by Zena Sharman, was created in collaboration with fifteen contributors from across North America, and “merges practical ideas with liberatory imaginings about what queer and trans health care could be, grounded in historical examples, present-day experiments, and dreams of the future. At its heart, The Care We Dream Of is a spell of transformation, one that’s both a loving invitation and an urgent demand to leave no one behind as we dream a more liberated future into being.” In conversation with Garbiel Leão, Sharman talks about all this and more.