Bottom Surgery

This month March, I underwent sigmoid colon vaginoplasty at CANS Hospital. This post details my experience—from admission and preparation to the surgery itself and the post-operative recovery.

I was admitted in the early evening. The initial procedures included signing consent forms, providing insurance details, and undergoing tests (blood work, ECG, ultrasound, and chest X-ray). An IV cannula was placed in my hand to facilitate the process.

I was given a pre-operative drink called Pegleg—a powdered supplement mixed into a 2-litre bottle of water with a flavour sachet (I chose orange). After drinking about 60% of the mixture, I began experiencing loose motions that continued for hours, eventually subsiding to clear, watery stools until morning. The discomfort kept me awake all night, and although I wasn’t allowed water in the morning, this restriction helped me finally get some rest before the surgery.

I was moved to the operation theatre where Dr. Arjun Nagraj, the urologist at CANS Hospital, explained the procedure and the associated risks in detail. After reaffirming my consent, the anesthesiologist had a brief chat with me before I was put under anaesthesia.

The procedure performed was a sigmoid colon vaginoplasty. This technique involves using a segment of the sigmoid colon to construct a neovagina, providing a natural lining and lubrication. This method is chosen for its ability to create aesthetically pleasing and functional results, which was a crucial factor for me.

Upon waking up, I found myself in the ICU, overwhelmed by pain and unable to move. I experienced bouts of disorientation, frequently drifting in and out of consciousness due to the intense pain.

For the first 5 to 6 days, I was not allowed any water, except for extremely limited sips of distilled water (only two drops at a time). The pain persisted, and I continued to struggle with thirst and discomfort during this critical period. I spent 24 hours in the ICU before being moved to my room—a challenging transition given my inability to move and disorientation.

I had both a drain bag attached to my stomach and a urine catheter. Despite feeling the urge to urinate, I often couldn’t due to my condition, although there was significant urine output. I remained hospitalized for a total of 15 days.

As I write this, I’m now at home—about 4 to 5 days post-discharge, making it roughly 19 to 20 days since the surgery. I’m able to eat and drink normally, but I still face challenges with mobility, such as difficulty sitting, rising from a chair or bed, and even turning in bed. My gait currently resembles that of a penguin. Pain remains a constant, albeit reduced, companion, and the necessary dilation process is quite painful due to increased sensitivity. However, it is critical to prevent the wound from contracting.

I’m satisfied with the surgery overall, though I’m still awaiting the full aesthetic results. The sigmoid colon vaginoplasty has provided a significant step forward in my journey, and while recovery is ongoing, each day brings progress.

Breast Augmentation Surgery

It’s been a long time since my last post, so here’s an update on the breast augmentation surgery I had last year.

I underwent the procedure right after the RG Kar Doctor strike had ended. My surgery took place at CANS Hospital in Bangalore, where two skilled plastic surgeons, Dr. Roshan and Dr. Karthik, performed the operation. They waited for me to decide on the size I was comfortable with; I ultimately chose 500cc, which turned out to be the perfect fit for my body type—even though arriving at that decision was a challenge.

This was a complete cash procedure, costing me 1.4 Lakhs. I stayed in the hospital for about 7 to 10 days. After the surgery, I experienced immense pain, but the satisfaction of affirming my gender was overwhelmingly ecstatic—an emotion that’s hard to put into words.

I started to regain my strength after about five days. I initially struggled with dizziness and tended to stay in bed, but eventually, I adjusted by sitting up more, and the dizziness subsided. Once discharged, I returned home and immediately resumed college.

I began using a comprehension bra, which was recommended to provide a natural look and keep my breasts in place. Although it did the job, it made me sweat excessively and was a bit uncomfortable. Despite these minor issues, I was able to return to my normal routine within a month.

In the first few months, I experienced reduced sensation in my breasts—something I had anticipated due to the skin stretching from the silicone implants. Thankfully, I have gradually regained about 70% of the sensation, and my nipples have maintained full sensitivity, which is a relief. I had hoped for some growth in my nipples, but while they haven’t, the area surrounding them has developed significantly.

Currently, my size is 46D, but due to my body type, I find that I need to wear a 48C bra. I’m not too fond of the bra, so I’ve been opting for shapewear instead, which provides a similar effect and offers an aesthetically pleasing shape.

Completing 1 Year of HRT and life event updates

It’s been a while since I last shared an update about my transition, so I thought it was high time I filled you all in on what’s been happening in my life!

First off, I’m thrilled to share that I’ve been accepted into the prestigious National Law School of India University in Bangalore for the BA LLB (Hons) 5-year course. It’s a dream come true, and I’m so excited about this new chapter in my life.

In terms of my transition, I’ve just completed my first year of Hormone Replacement Therapy (HRT), and I’m now in my 14th month. It’s been an incredible journey of growth and self-discovery, and I’m so grateful for the progress I’ve made.

As I’ve navigated this journey, one quote that has resonated with me is 

BODY

"If they see breasts and long hair coming, they call it woman.

If beard and whiskers they call it man.

But look, the self that hovers in between

Is neither man nor woman ..."

- Nivedita Menon, Seeing Like a Feminist 2012 

These words remind me that my identity is not confined by societal labels but is a reflection of my own truth.

With a year of HRT behind me, I’ve started planning for my surgery, which has been both exciting and a bit overwhelming. As I explored my options, I encountered some challenges, such as time constraints and bureaucratic hurdles, but I’m determined to make it work.

I’ve decided to go ahead with my top surgery—Breast Augmentation—and I was faced with the decision of choosing between Fat Grafting and Silicone Implants. After weighing the pros and cons, I’ve opted for silicone implants. But then came the tricky part: deciding on the right size. To help me figure it out, I consulted with a few plastic surgeons here in Bangalore. When I still wasn’t sure, I turned to YouTube and found the Rice Bag test, which gave me a general idea of the size I might want. Trying on implant sizers afterward really solidified my decision.

Once I made up my mind, I began the cashless pre-approval process with a non-network hospital. Unfortunately, the process is taking longer than expected, and as I write this, it’s still not complete, even though the day I planned to be admitted has arrived.

So, here I am, at the university, taking a break during class to update my blog and share my journey with you all. I can’t wait to give you my next update once I’ve fully recovered and had my follow-up appointments with the doctors.

Until then, wish me luck, and I’ll talk to you soon!

Process of getting TG ID and Certificate in India

 Process of getting a TG ID & Certificate under Section 6

 

Step 1: Get a Non-Judicial Stamp Paper aka an Affidavit (Note Stamp duty for the Non-Judicial Stamp paper is different in each state).

 

Step 2: Use the format provided either for gender and name change or only gender change (Note you can only declare yourself transgender if applying under section 6).

 

Step 3: Get the affidavit Notarized by Public Notary they are usually an advocate, Minimum cost of Notary is Rs. 50 per page.

 

Step 4: Apply for TG ID and Certificate online on the following link 

https://transgender.dosje.gov.in/Applicant/Registration/Index (Note you will have to keep a picture of yourself ready, a picture of your signature, affidavit both sides picture and any government issued ID card usually Aadhar card or Voter’s ID) .

 

Step 5: If any urgency to receive TG ID and Certificate early first write a letter to the District Magistrate mentioning your urgency and take a xerox of the same document. Original letter is for the DM and the xerox copy is for you as office copy.

 

Step 6: Meet the District Magistrate first submit the letter to dm and ask for an acknowledgement receipt which they can do by putting the stamp or signature with date on your letter and then meet with whoever the DM directs you to meet for getting the TG ID.

 

Step 7: If you have received your ID congratulations now you can start changing your other documents but remember all documents will show that you are transgender.

 

NOTE GETTING A TG ID & CERTIFICATE UNDER SECTION

6 IS NOT MANDATORY IF YOU HAVE A GD/GID CERTIFICATE FROM A PSYCHIATRIST OR PSYCHOLOGIST YOU CAN APPLY FOR TG ID AND CERTIFICATE UNDER SECTION 7 ITSELF

 

Affidavit Format

Understanding Gender Dysphoria: A Personal Journey

I was recently asked how one can determine if they have gender dysphoria. It's important to note that there is no standardized testing or evaluation for gender dysphoria at this time. The process often involves reflecting on your past experiences and feelings. Unless you specifically mention gender dysphoria, a doctor is unlikely to suggest it out of the blue. Currently, the primary criterion for diagnosis is your own narrative and self-awareness.

If you find yourself uncertain or questioning your gender identity, there are several steps you can take to explore this further:

1. Consult a Clinical Psychologist: A mental health professional can provide a safe space for you to discuss your feelings and experiences, helping you to understand your gender identity better.

2. Connect with Trans Individuals: Talking to someone who has gone through a similar journey can offer valuable insights and support. They can share their personal experiences and offer practical advice.

3. Experience Real-Life Situations: Within your comfort zone, try living as your identified gender. This could be through clothing, social interactions, or other gender expressions. This real-life experience can be very illuminating.

4. Read and Research: There is a wealth of literature about transgender experiences. Books, articles, and online resources can provide a broader understanding and help you see different perspectives on gender identity.

Ultimately, the decision about your gender identity is deeply personal and should be based on your self-discovery and research. It's a journey that requires introspection, courage, and sometimes, professional guidance. Remember, you are the one who best understands your own experiences and feelings. Trust yourself and give yourself the time and space to explore your identity fully.

I hope this helps!

All India Institute of Medical Sciences, New Delhi *FREE TREATMENT AND SURGERY FOR TRANS*

Greetings once again,

As promised in the previous post, here is the latest update from my recent visits to two prominent hospitals in Delhi, RML and AIIMS, prompted by information gleaned from various sources including YouTube, forums, and a telegram group.

My experience at RML Hospital was disappointing, starting from interactions with the ground staff to senior faculty. The lack of transparency and proper communication led me to not recommend it until improvements are made in these aspects.

Conversely, my visit to AIIMS proved informative, as I gained valuable insights from the attending doctor.

For those seeking appointments at AIIMS, it's imperative to physically visit the AIIMS New RAK OPD (Rajkumari Amrit Kaur OPD Block) in Delhi. Due to the high volume of patients, securing an appointment may require advanced planning, particularly if applying online through the government portal, where appointments open at midnight at 12 AM.

At present, only one endocrinologist specializes in treating transgender patients at AIIMS. He allocates time for five new patients every Monday, prioritizing privacy and confidentiality I cannot mention his name here. Additionally, a team of psychiatrists evaluates patients, who are then referred back to the endocrinologist with a gender dysphoria (GD) certificate to commence Hormone Replacement Therapy (HRT). After one year of HRT, patients are referred back to the psychiatrist before being considered for surgery.

For new patients or those on HRT for over a year, the process unfolds as follows:

1. Consultation with the Endocrinologist: Necessary tests are conducted to determine eligibility for HRT or surgery.

2. Evaluation by Psychiatrist: Following the endocrinologist's referral, patients undergo assessment, leading to the issuance of a GD certificate if deemed suitable. This certificate facilitates the initiation of HRT by the endocrinologist or referral to the surgery department.

3-A. Commencement of HRT: Patients receive treatment from the endocrinologist and, after a year, are referred back to the psychiatrist for further assessment and certification for surgery.

3-B. Surgery: Patients recommended for surgery are directed to the AIIMS Casualty/Emergency block, where experienced surgeons perform a range of transgender-related surgeries.

It's essential to note that AIIMS does not charge consultation fees apart from the initial payment for the OPD slip appointment. Medications and consultations are provided free of charge. However, implants used during surgery and certain expensive medications/injections for HRT may incur charges which would be subsidized. Private room accommodations and other amenities may also entail additional charges.

In summary, to ensure a smooth process:

- Schedule an appointment with the Endocrinologist for a consultation on Monday.

- Be prepared to undergo evaluations by the endocrinologist and psychiatrist which will not incur any cost.

- Bring medical records and documentation if transferring from another doctor to AIIMS.

- Collaborate with the psychiatry and surgery departments as needed.

I hope this update proves helpful. Until next time!

Bangalore to Delhi and Back to Bangalore

Hey you !

It's been a while since I last posted. Recently, in May 2024, I visited New Delhi, our nation's capital. I had the chance to meet a lot of bureaucrats who are working on improving the lives of transgender individuals. I also have some medical updates to share, but I'll save those for the next post. This one is all about my meetings with the officials.

First, I stopped by the Ministry of Social Justice and Empowerment. I spoke with a senior bureaucrat there, who gave me some hope. They mentioned a few small changes, notifications, and guidelines for district officials who handle the transgender identity cards and certificates. I asked about the binary gender marker ID card, and they explained that the 2019 Act requires surgery for a binary gender marker. But in 2020, they updated the rules so that now you just need a medical certificate for gender dysphoria to apply for a binary gender certificate.

They're also planning to create a proper format for the transgender ID cards so they can be printed and laminated like regular ID cards.

When it comes to scholarships, there's still nothing decided yet. The same goes for the Garima Greh scheme. As for the Composite Medical Health Scheme, they need to talk with the Ministry of Family Health and Welfare, the Director General of Health Services, and the National Health Authority before they can implement any health policies.

Next, I visited another ministry that deals with medical affairs. They told me that medical issues are mostly handled by state governments, so the central government can't do much directly. But they are working on new policies and a health package for transgender individuals under the Ayushmann Bharat scheme. It's hard to say when this will happen, but it might be after the next elections. Meanwhile, we can keep hoping and maybe write letters to push for quicker action or some interim relief.

Unfortunately, not everything went smoothly on my trip. I had two really bad experiences. Once, near my hotel in Delhi, I was catcalled, and another time, when I was in an auto, the same thing happened. Then, when I got back to Bangalore and was waiting for an auto to take me home, an old guy kept touching his groin area and trying to call me over. I felt disgusted, angry, and concerned about such behavior. It made me reflect on the challenges people from outside Bangalore might face when they visit here.

But aside from those three incidents, everything else was good

Thanks for reading, and I'll be back soon with more updates!

Obstacles

Tonight, I find myself drowning in a sea of emotions as I confront the seemingly insurmountable obstacles on my path towards transition surgeries. It's a journey fraught with darkness, where every step forward feels like a battle against the tide of despair.

The obstacles that loom before me cast long shadows over my soul, weighing me down with their oppressive presence. There are the personal challenges, the relentless whispers of doubt and insecurity that echo in the recesses of my mind. Coping with dysphoria and the relentless onslaught of anxiety threatens to consume me, leaving me gasping for air in a sea of self-loathing constantly feeling incomplete.

And then there are the social challenges, the harsh realities of a world that refuses to see me for who I truly am. It's a world where the words of others cut like knives, slicing through the fragile veneer of my self-worth. Their unintentional comments and unintentional benifit of the doubt opportunity slights serve as painful reminders of the hurdles that stand between me and the life I long to live.

Relationships are a minefield, fraught with the constant fear of rejection and abandonment. The thought of opening up to others, only to be met with disdain or indifference, fills me with a bone-deep ache that refuses to be ignored. It's a lonely existence, surrounded by people yet feeling utterly alone in my struggle.

But amidst the darkness, there are fleeting moments of respite. A kind word from a friend, a gentle touch that speaks volumes more than words ever could. In those moments, I find a flicker of hope amidst the despair, a glimmer of light in the suffocating darkness.

So as I navigate through the treacherous waters of my surgical journey, I cling to that flicker of hope with all the strength I can muster. It may be small, barely visible against the overwhelming tide of despair, but it's enough to keep me going for another day trying to complete myself to feel myself.

STOPPING HRT

In the midst of my journey, life threw several curveballs my way, prompting me to hit pause on my Hormone Replacement Therapy (HRT) last August. It was a tough call, triggered by the passing of my grandmother, followed by a bout of tonsillitis that landed me in the hospital for a week. Throw in the chaos of college entrance exams, and my HRT plans took a backseat. It felt like a series of relentless challenges, but I knew I had to navigate them one step at a time.

Finally, after wrapping up my exams in December, I recommitted to my HRT journey. Those intervening months brought their own set of hurdles, including a not-so-great experience that tested my resilience. But I held my ground, and in January, I marked a significant milestone – my sixth dose of testosterone blocker which is the duration of three months. But the estrogen dosage, however, will remain consistent during this period, a strategic move as I gear up for the next phase of my journey.

In the midst of all this, there's a bright spot on the horizon. I've been accepted into a fantastic prestigious Law College, and the best part is, I don't have to move away from home. That's a huge relief, though I'm fully aware that the college experience will bring its own set of adventures and challenges. But hey, I'm up for it. There's just a few hurdle's left to clear before I can dive into this new chapter, and I'm hopeful it won't be long before I can put it behind me.

Looking forward, before the end of March 2024 holds another significant event for me – Top Surgery. It's a decision I've considered carefully, a pivotal step in aligning my physical self with my true identity. The anticipation is a mix of nerves and excitement, but deep down, I know it's the right path for me.

As I gear up for college and the transformative journey ahead, I want to acknowledge every twist and turn that has shaped my story. Each setback, each decision to forge ahead – it's all part of the tapestry of my life. Sharing this journey is not just a personal reflection but also a way to connect with others on similar paths. Here's to the coming months, filled with victories, support, and the continued pursuit of authenticity.