Disclaimers
I am one singular post-phalloplasty transmasculine person, and I cannot speak for the opinions of others. I am in community with a lot of post-bottom surgery people, which informs my statements about bodies that are not mine, but I cannot speak for them.
I use anatomical language (e.g. clitoris, vagina, vulva) for clarity, especially given I’m talking about genitals both pre and post reconstruction. This may not be the language you personally use, especially in a sexual context.
This is not intended as a guide for people pursuing bottom surgery. Please seek out other resources, particularly ones that can speak to the experiences of particular surgeons. This guide is only intended to aid people in writing fiction.
Contents
- Intro
- Who am I and why do I care?
- Why does post-phallo representation matter?
- What is Phalloplasty?
- The Basics
- Pre-Surgery Hair Removal
- Graft Site Options
- Optional Procedures
- Erectile Implants
- Phalloplasty Size
- Putting It All Together: What A Post-Phallo Body Could Look Like
- Sex Post-Phalloplasty
- Arousal, Sensation, and Orgasm
- Topping Post-Phalloplasty
- Bottoming Post-Phalloplasty
- Non-Penetrative Sex Post-Phalloplasty
- BDSM/Kink Post-Phalloplasty
- Social Experiences Post-Phalloplasty
- Navigating Stigma
- Navigating Sex & Relationships
- Visible Scarring
- Body Modification
- Underwear
Intro
Who am I and why do I care?
I’m kaiju and I’m a post-phalloplasty transmasculine person. I’ve been in fandom since around 2010 (which is also the year I came out as trans), writing fic most of that time across a range of fandoms and psueds/usernames.
I love the new growth of transmasc representation in fandom, but have noticed the vast bulk of this is about non-bottom surgery characters. I appreciate that this is often due to transmasc people who are non/pre-bottom surgery writing about bodies similar to theirs (and I think that's cool and rad!), but do also think there’s a few other factors at play,
including ignorance about what post-bottom surgery bodies are like and how they work, as well as general heavy stigma around post-op bodies.
Because of this (and inspired by
How To Write Trans Men: A Guide by budgie_smuggled), I thought it might be useful for me to write about my own experiences as a post-phalloplasty person in order to make writers more familiar with what it’s like.
I will give the caveat I am writing based on my own experiences. I am one post-op person with one particular series of surgical experiences, and while I can give overall information on other surgical pathways, I cannot speak to what the experience is like. I particularly cannot speak to the experiences of post-metoidioplasty transmasculine people. (FYI if you are post-meta and want to write a guide like this, please let me know so I can link it!)
Why does post-phallo representation matter?
This is a question I get quite a lot when I bring up post-phalloplasty representation —
why don’t post-op trans men and transmasculine people just read about cis men?
To be clear, plenty of post-op people do this, and I don't fault any post-op trans man or transmasculine person who wants to navigate art and fiction this way. But
I personally don’t think this is adequate as a response to the issue of post-op representation. I also think it’s exceptionally dismissive, and honestly would even go so far as to say it’s transphobic to imply that post-op trans people don’t deserve representation as much as non/pre-op trans people.
Additionally,
post-phalloplasty penises do differ in terms of function compared to standard issue penises (note I do not say ‘cis penises’ or ‘natal penises’ here, as some cis men also have phalloplasty!).
Plenty of erotic material that features cis men with penises involves things post-phalloplasty penises simply cannot do, such as produce sperm/carry a pregnancy risk for their partners and get unassisted erections. I don't feel represented by these depictions, because they're not true to me or my body - it's imo basically the equivalent of asking transmascs who bottom for PiV why they don’t just read cishet erotica.
I also think post-op transmasculine representation is particularly important because there is a huge stigma attached to post-op genitals. Even within the trans community, the language that is often deemed acceptable to use about our bodies draws on and contributes to transphobic rhetoric. I think a lot of this comes from ignorance allowing for misinformation to spread, and the more we as a community properly and accurately represent post-op bodies, the more we can fight this stigma.
On a more selfish note, I don’t think it’s unreasonable for post-op transmasculine people to want to see bodies like ours treated as desirable! Speaking for myself, before I had bottom surgery I had never seen a depiction of post-phalloplasty bodies in erotic art or writing that wasn’t made by me (based on post-phallo sexual partners I’d had).
Something I really struggled with post-surgery was actually accepting I could be found sexy by somebody else, and that I wasn’t seen as either ‘not as good as/a stand-in for a cis man’ or ‘having ruined the unique selling point I had’ (despite hating PiV pre-op). I want other post-op men and transmasculine people to get to see themselves as sexy, and I want people who are questioning if they want bottom surgery to not have to graple with the desirability politics that I did and that made it hard for me admit I wanted bottom surgery!
What Is Phalloplasty?
The Basics
Tl;dr: what is phalloplasty?
- Phalloplasty is a kind of genital reconstructive surgery that involves creating a phallus (or penis) from a graft of skin taken from a surgical subject. It was originally created for cisgender men who had experienced loss or severe traumatic damage to their penises, but was later adapted for transmasculine people who wanted to create a penis.
- ‘Phalloplasty’ technically only refers to the surgery that creates the phallus, and not to any of the other procedures that may be involved in a particular surgical pathway. This includes urethral lengthening (often called UL, which allows for somebody to urinate through their new penis), vaginectomy (which is removal of the vagina), glansplasty (which makes the head of the new penis resemble a standard issue glans more), scrotoplasty (creation of a scrotum), clitoral burial (which 'buries' the original clitoris in the base of the new phallus), or nerve hookup (which helps with sensation in the new penis).
- Because of this, the term 'vaginal preserving phalloplasty' (which I've seen used a lot more recently) doesn't actually make sense. The correct term would be 'phalloplasty without vaginectomy'
- Phalloplasty is usually a multi-stage procedure. I was told by my surgeon to expect 3 stages, but this can vary depending on what procedures somebody wants in their surgical pathway. Some surgeons will carry out a hysterectomy (and potentially a bilateral salpingo-oophorectomy (BSO), which removes the fallopian tubes and the ovaries) during phalloplasty, while others require it is carried out prior to phalloplasty.
- Phalloplasty is not a surgery that only binary, stealth, gender-conforming, straight men who top cis women have! I know non-binary people who’ve had bottom surgery (including one who identifies as a non-binary woman, which I think rules), openly trans people who’ve had bottom surgery, people who are not always/often read as the gender they identify as who have had bottom surgery, GNC people who’ve had bottom surgery, gay and bi and asexual people who’ve had bottom surgery, bottoms who’ve had bottom surgery, and people who’ve had bottom surgery who only sleep with other trans people. I know people who are multiple of these things. There is not one singular type of person who has bottom surgery - we are as diverse as any other group of trans people.
Pre-Surgery Hair Removal
As well as being multi-stage, phalloplasty often requires pre-surgical preparation. For people who are having their urethra lengthened so they can urinate from their new penis, this involves hair removal, either using laser hair removal, electrolysis, or a combination of the two.
People who are not having UL may choose to have hair removal anyway for aesthetic reasons.
However, in the case of people who are having UL, this is treated as medically necessary. Hair regrowth inside the urethra can result in discomfort and infections, and can potentially affect urine flow.
The length of time and number of sessions needed for hair removal can vary, and the graft site will need to be checked by a surgeon. The process of this does vary, but with my surgeon it was checking the graft site was >70% hair free after 12 weeks since hair removal treatment.
Graft Site Options
The place where a skin graft is taken from can vary, depending on individual anatomy and preference, as well as what techniques are offered by particular surgeons.
The most common graft site is from the forearm. This is called radial artery phalloplasty (RFF).
This is the graft site I personally chose, as my surgeon only offered UL with this graft site, although other surgeons may/do offer UL with other graft sites. The main concern people tend to have with this graft site is that it’s very visible and can’t be exposed to the sun, although I haven’t really found I care about the visible scarring (more about this in the ‘The Post-Op Experience’ section).
Antero-lateral thigh phalloplasty (ALT) uses a graft from the thigh. These penises tend on average to be thicker than RFF penises, and some people actually have their penis size reduced ('debulked') after the first stage construction.
Other less common sites include pubic phalloplasty (which uses a flap from the lower body and crotch area), or back skin that’s called the musculocutaneous latissimus dorsi skin flap (MLD).
Regardless of the graft site chosen, the area does scar. Over time and if treated correctly (as little sun exposure as possible in the first couple of years etc), they can fade to being quite faint.
Optional Procedures
Other procedures involved in phalloplasty can be combined in a number of different ways, although particular surgeons will be more or less happy for particular combinations. In my case, my surgeon was happy to carry out UL without vaginectomy, although many surgeons will not.
- Glansplasty is also called coronaplasty and creates the glans or ‘head’ of the penis. At the time of writing, all post-glansplasty penises look circumcised. Some people who particularly want the look of an uncircumcised penis may forgo glansplasty and opt for medical tattooing.
- Urethroplasty involves creating a long neo-urethra inside the penis, and then at a later stage hooking it up to the existing urethra. It is optional, and some people opt not to have it. For some people who produced a lot of fluid pre-op, this fluid can dribble out of the penis post-op, although this isn’t guaranteed.
- Vaginectomy involves the removal of the vaginal lining and fusion of the vaginal walls. It requires a hysterectomy, and can also be carried out as a stand alone procedure without phalloplasty.
- My surgeon also offered an alternative to it where there was no longer enough vaginal depth for penetrative sex, but enough that vaginal fluids were still produced and able to be used for grinding/frottage/etc.
- People who don't have a vaginectomy and do have either UL or scrotoplasty will likely need to dilate during recovery to maintain depth.
- Scrotoplasty involves the creation of a scrotum from the labia majora, with prosthetic testicles added for shape. One testicle may also be part of a pump system for an erectile implant (more on this later). If somebody doesn't have vaginectomy, the vaginal opening may either be placed behind the balls (where the perinium/taint is) or between them.
- Clitoral Burial involves placing the original clitoris within the new phallus. It is entirely optional, but does mean that even if sensation isn’t gained in the new phallus, a post-op person can stimulate their buried anatomy through the new penis.
- Nerve Hookup involves connecting nerves from the graft site and connecting them to nerves in the new penis, allowing for sensation in the newly constructed penis.
- Hysterectomy & BSO. Hysterectomy is required for vaginectomy and some surgeons will require them even for non-vaginectomy procedures. However, it is possible to not have them and have vaginectomy (although there are some considerations when it comes to implants if somebody wants to become pregnant).
- Medical tattooing normally takes place a few years after surgery is complete. It involves using pigment to shade and add detail to a post-phalloplasty penis, such as veins.
Erectile Implants
Post-phalloplasty penises cannot get erect on their own, as they do not have erectile tissue in the way that a standard issue penis does. This also means they are the same side flaccid as they are when erect.
Some people choose not to have an erectile device implant. This could be for a number of reasons — for some people, being able to penetrate with their penis just isn’t a priority, while others may be happy using an external device. Just like the implants used for phalloplasty are also used to treat erectile dysfunction in cis men, trans men and transmasculine people may be happy to use external devices intended for cis men with erectile dysfunction. This can include penis sleeves or sheaths (including
fun fantasy dildo style ones), or more medical devices like
the Elator. Because an implant is not inserted in the first stage, a lot of people who do want an inserted erectile device may also use them to have sex between stages.
There’s generally two kinds of erectile implants: malleable or inflatable.
Malleable implants are a silicone coated metal cylinder that’s implanted into the penis. It can then be bent into the preferred angle for penetrative sex. These are mechanically very simple so tend to last a long time, although some surgeons won’t use them as the first implant due to risk of tissue erosion when a penis is new. They can also look a bit like a semi-erect penis when bent into a flaccid shape, which some people dislike.
In the case of my surgeon, I mentioned malleable implants were my preferred option. Due to the risk of tissue wear, he advised inserting an inflatable initially, and then replacing it with a malleable implant when my current implant needs replacement down the line.
Inflatable implants come in 2-piece and 3-piece options. Both use a reservoir that holds saline and a hydraulic pump to inflate cylinders implanted within the penis shaft. For 3-piece options, the reservoir is in the abdomen, which means it can be larger and provide better rigidity for larger dicks. In either case, the pump is concealed in the scrotum. If somebody is not having scrotoplasty, it can also be placed in one of the labia majora.
Gently squeezing the pump inflates the cylinder and causes the penis to become erect. To make a penis flaccid again, a 2-piece requires the penis to be gently bent downwards for a few seconds. A 3-piece implant has a release valve in the scrotum for deflation.
Erectile devices are one of the things I’ve seen a wide range of emotional responses to in the post/mid-bottom surgery circles I run in. Some people are really upset or dysphoric about not being able to have unassisted erections,
some people are ok with it if they think about it in terms of erectile dysfunction, and some people are neutral on it.
I personally actually prefer having manual control over my erections, but that view is not universal.
Pregnancy is something really important to think about when it comes to implants!
Pregnancy can put an unsafe amount of pressure on an implant, causing tissue erosion and other complications. I've only heard of a few people who pursued phalloplasty while intending to get pregnant at some point, and while it was possible it also meant forgoing an implant until they were done with having children and fully healed post-birth.
Phalloplasty Size
The question everybody asks when it comes to transmasculine bottom surgery is ‘do you get to pick how big it is?’. And the answer is...
sort of yes, but also sort of no.
You can tell a rough size goal to your surgeon. Some graft sites allow for more customisation than others (I’ve heard ALT allows for longer penises than RFF, but to my knowledge there’s no literature on this), but it is very anatomy dependant. Most surgeons will aim for an average length. There aren’t really guarantees though, and a penis size can change during the healing process, either gaining or losing a bit of length.
Something to consider is that the longer a phallus, the more potential complications and risk there is for tissue loss or necrosis. In addition, as post-phallo penises don’t have different sizes flaccid and erect, you have to deal with that same length in daily life.
A six inch penis sounds great, until you have to find underwear that fits (which is also a general problem with post-phallo penises FYI — I’ve had to specifically seek out brands specifically for very hung men).
Putting It All Together: What A Post-Phallo Body Could Look Like
So we’ve talked about all the different options there are when it comes to phalloplasty. But you write about characters, not about medical procedures!
Here’s some examples of how different post-phallo bodies might look:
Person A has had a RFF phalloplasty with vaginectomy, hysterectomy and BSO, UL, glansplasty, scrotoplasty, clitoral burial, nerve hookup, and a 3-piece implant. They also had medical tattooing a few years after their final stage. They do not produce any fluid through their penis and use their implant for erections.
Person B had ALT. They decided not to have an implant, UL, or clitoral burial, but did choose to have scrotoplasty and a vaginectomy. Their testicles are silicone implants, and their clitoris and urethra sit between their scrotum and shaft. They use an external sleeve if they want to be able to penetrate somebody, and can also stimulate their clitoris by itself.
Person C had RFF with UL. They produced a lot of fluid pre-surgery and the way their skene’s glands were connected to their new urethra means they now produce a ‘pre-cum’ like fluid. They had a vaginectomy but did not have a scrotoplasty or clitoral burial. For now, they have an inflatable implant and the pump sits in their labia majora. Later, they intend to replace it with a bendable rod.
Person D had MLD. They intended to carry a child, so have not had UL, hysterectomy and BSO, scrotoplasty, vaginectomy, clitoral burial, or an implant inserted. They have had glansplasty, and intend to continue with further surgeries (hysto + BSO, vaginectomy, scrotoplasty) once they have finished having children.
Sex Post Phalloplasty
Arousal, Sensation, and Orgasm
Experience of arousal can really vary, depending on what options somebody has chosen.
For people who’ve not had vaginectomy or only had partial vaginectomy, there’s still fluid produced in response to arousal.
For people who produced a lot of fluid pre-op and have had UL and hookup, this can sometimes result in clear fluid coming through the penis. It isn’t with the same force as a standard issue penis, but can be noticeable.
Some people only produce fluid post-orgasm, while some produce it with general arousal.
For people who’ve not had clitoral burial, there are still the visual signs of arousal from pre-op. And for people who’ve had clitoral burial, these signs of arousal may not be visible but they can be felt. For a few people, burial may also involve visible twitching from the outside, but this isn’t guaranteed or even common.
Sensation wise, it does feel like getting an erection, and even if it doesn’t feel ‘hard’ per say, it does feel more sensitive.
Depending on sensation and nerve hookup, this feeling of an erection can also extend through part or the whole of the penis.
A lot of people I know have described it as feeling like it goes ‘up’ the shaft, starting with the buried clitoris.
Some people say that the base of their penis is most sensitive (particularly if this is where the clitoris is buried), while a handful of others have said their head is the most sensitive. There may be patches of the phallus that regain sensation at different rates post-surgery, and
in some situations patches of the phallus may not regain any sensation or may only have tactile non-erotic sensation.
Whether sensation feels tactile or erotic can also vary depending on how turned on somebody is.
Light touch when I’m not horny doesn’t feel erotic, whereas if the same kind of touch takes place when I’m turned on it does.
Unlike standard issue penises, arousal doesn’t lead to erections. This is something some people dislike, others tolerate, and a few prefer. Making a post-phallo penis erect can be quite quick and incorporated into general ‘playing with the balls’ (or labia if somebody is non-scrotoplasty).
The process does involve some manual dexterity, but I’ve not personally found it has an impact on how spontaneous sex can be.
The vast majority of people can orgasm post-phalloplasty. Even if somebody doesn’t have erotic sensation in their new phallus, if they have a buried clitoris this can be stimulated through the new penis (and if it’s not buried, you can still stimulate it the same way as pre-surgery).
The person I know who does not orgasm post-phallo was also unable to orgasm pre-op (and I know a few people who had their first orgasm post-op). It’s not a complete guarantee that somebody won’t be able to orgasm post-op, but
it is exceptionally rare.
I can’t speak for everyone, but my orgasms feel pretty similar to the way they did pre-op physically. Testosterone HRT made my orgasms feel a lot more concentrated in my genitals rather than ‘full bodied’ (and my transfem partners have had the opposite experience going on estrogen), and this continued post-op. It feels more like my clitoris is ‘extended’ rather than a new sensation.
The main difference is psychological — everything feels more ‘right’ than it did pre-bottom surgery.
Topping Post-Phalloplasty
You can top for both anal and vaginal sex post-phalloplasty — I want to specifically say this because I have seen some disinformation that it’s not possible to top for anal because it very much is!
However, for people who haven’t had erectile implants, there can be a bit more prep involved in anal sex than vaginal sex. As well the earlier mentioned sleeves and external devices, making the penis more rigid can be needed to make anal possible.
The main way I see people talk about this is using coban to wrap the penis before putting it in a condom. Having the receptive partner stretch out and prep a bit more can also make it a lot easier to insert.
There’s also some considerations when it comes to positioning, for both vaginal and anal sex.
While for the most part positions that would be possible with a standard issue penis are possible, there’s some risk associated with ‘receptive partner on top’ positions, such as cowgirl/reverse cowgirl. These put more weight on the pelvis so can be uncomfortable. With reverse cowgirl in particular, in much the same way it has a risk of bending a standard issue penis uncomfortably,
there are risks in terms of implant damage. Different people’s risk profiles are different, but
I personally stay away from reverse cowgirl for this reason.
Another thing mention is that occasionally I’ve heard receptive partners of post-phalloplasty people say that they can feel the end of an implant, and it’s pointy/pokey/uncomfortable. This is something that’s fixable with a condom and lube though.
On the subject of lube, because post-phallo dicks don’t tend to produce lubrication in the same way as pre-op anatomy (if at all) lube becomes super important for even jerking off, let alone penetrative sex.
It can be difficult for some people to feel texture, but there's still sensations of warmth, pressure, and wetness.
Basically, I could not tell you what Tenga Egg is meant to be what, but I do enjoy the feeling of using them.
Bottoming Post-Phalloplasty
Anal play and penetration feels… basically the same for me as it did pre-surgery. Some people I know have said post-vaginectomy anal feels better as they can stimulate the ‘g-spot’ more easily without the vaginal canal between the two. It can also feel psychologically better,
as it feels more like a prostate in terms of placement and how it’s stimulated. This can vary though, and I personally didn’t really notice a difference.
Vaginal bottoming is something that is impacted by phalloplasty though!
The vagina can feel ‘tighter’ as a result of new scar tissue post-hysterectomy and especially post-UL (which is why some surgeons will not offer UL without vaginectomy). Dilation will likely be needed (at least in the early days) if somebody has scrotoplasty and/or UL without vaginectomy. Some people can’t take toys/dicks/hands/etc as large as they used to be able to pre-surgery, while others do return to their pre-op ability.
Non-Penetrative Sex Post-Phalloplasty
I’m not as sensitive to oral sex as I was pre-surgery. This doesn’t mean it’s not enjoyable and I can’t achieve orgasm with it — my partner just needs to concentrate on the more sensitive parts of my penis to bring me to orgasm. I have more sensation right at the base and at the tip, but this can vary. I also have a lot of scrotum sensation, which feels a lot closer to oral pre-surgery.
You do need to be careful with sex toys that potential constrict blood flow. I mentioned penis sleeves earlier in this guide — it’s general accepted to use ones with open ends so you can check your glans’ colour and make sure you’re not restricting blood flow too much. Cock rings (vibrating or otherwise) are something post-phallo people need to be super careful with because of this.
Handjobs, frotting, and grinding can be good for people who have particular combinations of sensitive/non-sensitive patches or who want to specifically indirectly stimulate a buried clitoris. Lube is really important here though, especially for people who no longer produce any/much of their own.
Kink/BDSM Post-Phalloplasty
For the most part, kink or BDSM that doesn’t involve direct genital interaction is pretty much the same for post-phallo people as others. However, there are a few situations where post-phalloplasty people either can’t do or have to make changes to.
A post-phalloplasty penis is more fragile and easy to damage — things like blunt force can cause issues and complications, particularly in the urethral. Penis torture (especially if it’s heavy) is off the table, for the most part. Ball-busting with ball implants or a pump system has a risk of traumatic extrusion.
Sounding is also particularly off the table, as the neo-urethra can be easily damaged or destroyed.
Chastity isn’t a complete no, but does have some considerations. Firstly, if somebody doesn’t have balls fitting a cage style device is not possible, and they’d likely need a belt style device.
Additionally, the risk of blood circulation issues that cock rings carry also applies to chastity cages, so long-term caging would be risky. And finally,
as phalloplasty penises are the same size flaccid and erect… it’s very difficult to find a chastity cage big enough off the shelf. It’ll likely be a custom job.
Bondage needs to be undertaken with care. As well as the ‘no restriction on the penis’ rule, bondage around the graft site can be difficult.
When it comes to rope bondage/shibari especially, being able to feel numbness and tell if it’s from circulation or compression is really important, and difficult to tell apart from graft site numbness. I had RFF, and will not let the arm with my graft site be tied. Instead of using a TK as a base for suspension, I use
this diamond harness.
Finally, watersports isn’t a no, but can be impacted by phalloplasty. The sound/strength/feeling of the steam changes with UL — it’s not quite so much of a hissing sound.
Most surgeons don’t involve the urethra in their nerve hookup, so it’s unlikely somebody post-phalloplasty will be able to feel past their original urethra inside the shaft.
Social Experiences Post-Phalloplasty
If you’re writing a contemporary or contemporary-adjacent setting, I think a huge part of making phalloplasty representation feel grounded is the social side of the experience.
Navigating Stigma
I won’t lie,
the most difficult thing about getting phalloplasty for me was the stigma. A lot of people (even within the trans community) don’t properly research it and can spread really gross transphobic rhetoric about it. While I’m not saying you need to write in detail about a transmasculine person experiencing stigma about his bottom surgery, that likely is going to be part of the background of their experience.
Because of this stigma, it can take people a really long time to figure out they want bottom surgery, even if they know they’re trans. I’m lucky enough to live somewhere with
socialised healthcare and didn’t need to pay for my bottom surgery, and it still took me the best part of a decade to admit to myself that it was something I wanted. By the time somebody starts pursuing phalloplasty, they are likely
many years into transition. Even if they have worked through internalised transphobia in regards to hormones, top surgery, and the social side of transition, they may grapple with internalised transphobia regarding bottom surgery.
Navigating Sex & Relationships
Quite a few non/pre-bottom surgery transmascs I know have assumed that getting bottom surgery will make sex and relationships easier, but in practice I haven’t found this to be the case. I wouldn’t say it’s necessarily harder, just… different.
I think the first thing to bear in mind is post-phallo trans people are still trans.
Even if our bodies are read as cis (which is not the case for all post-phallo genitals, and is something some people specifically choose not to have), we are still fundamentally trans and do not escape transphobia, including in the dating and hookup scenes. In my experience,
a lot of people still hold transphobic views about post-op trans genitals — the social view that trans people are ‘fake’ or inferior to cis people is still applied to us when we are post-op. In addition,
a lot of people who are interested in trans people can lose that interest once we are post-bottom surgery.
That’s not to say it’s not possible to hookup or date post-bottom surgery
(I manage to be a polyamorous slut after all). However it’s not straightforwardly ‘easier’ than navigating sex and relationships pre-surgery. In addition,
I have found something unexpected I now have to navigate is explaining my body way more — I have functional differences to standard issue dicks so need to explain that if somebody is expecting a standard issue penis, and also do not have the body people expect me to have when I say I’m transmasculine. Either way,
there’s a lot more talking before sex happens than there was pre-surgery.
Dealing With Visible Scarring
I had RFF, so my graft scar is pretty visible day-to-day. In practice, I’ve not found it to cause much of an issue.
The vast, vast majority of people have no idea it’s trans related and most of the time, nobody will comment on it. On the rare occasion somebody does,
it’s along the line of thinking it’s a cool scar, or assuming it’s a burn or due to a motorcycle accident. At most,
people may recognise it as a graft scar as RFF is a common graft site, but even then they don’t assume it’s trans related. It’s also honestly mostly only noticeable because I am very hairy otherwise, but my graft site is hairless. The few times I have been clocked from my scars, it’s been in specifically trans spaces.
Some people I know have had their phalloplasty graft scars tattooed over. My surgeon recommended ideally waiting 3 years post-op for a tattoo, with an absolute minimum of 2 years, but this can vary between surgeons.
Body Modification
This comes up a lot in phalloplasty related forums or groups, so I thought I’d mention it here.
I’ve already mentioned medical tattooing. This involves applying pigment to create shading, including the appearance of veins, varied colour, etc. Some people also use medical tattooing to reduce the appearance of graft scars.
Any tattoos on the graft site prior to grafting will be present on the phallus. You can also get the penis tattooed in general.
Piercings are not generally recommended, and especially not recommended to people who’ve had UL and/or an erectile implant put in place due to risk of damage. I
do know of somebody who has had a series of piercings, but those piercings would be considered to have the same impermanence as surface piercings and a risk of migrating outwards.
Underwear
This is something I didn’t really think about until I was in the process of having surgery, but underwear can be… interesting to navigate post-op.
Too tight underwear can be uncomfortable, too loose underwear may not offer enough support. Larger penises in particular can require supportive underwear, especially because because routinely not supporting the dick can cause thinning near the base as gravity stretches the tissue. I’ve found that briefs with seperate pouches for the shaft work best for me.
Further Questions?
Anything you think I've not covered in this guide? Want a quick opinion on one of your WIPs? Leave a comment, and I'll update this guide with a second chapter answering any further questions people have!
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