TMI… lots of talk regarding questions about clits, vulvas, and vaginas that are created via genital reassignment surgery

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Someone asked if I had a clitoris created as part of GRS. And the answer is YES!

They reconstructed one out of the head of the penis The head is left intact on the “stalk” of nerves in order to preserve sensation, and this particular surgeon uses the stalk to approximate the “legs” of the clit that occur in cisgender women.

That said, my clit probably won’t as quite as sensitive as the factory-installed version, simply because clits have twice as many nerves, as the head of the penis, so I don’t think there’s anything any surgeon can do to change that.

However, this particular surgeon also adds a second sensate area just below the surface of the clit (by reusing erectile tissue). That’s in part “defensive surgery” on his part because sometimes there’s tissue necrosis  — which worse case means your clit dies and falls off.

I in these cases, I think he may be able to recreate something that looks clit-like, but doesn’t have the same sensitivity because he has to use different tissue to do it. Hence the extra sensate area as a back up.

Tissue necrosis can occur in other parts of the vulva, so he intentionally leaves “extra” tissue, which does mean that one can end up with larger-sized labia. Some patients opt to take advantage of the free revision offered (available post-op) to do a bit of labia reduction. There’s other issues that can occur, such as asymmetrical labia, or gaps where the labia is slightly detached at various points.

One minor difference with the factory-installed vulva is that this particular surgeon doesn’t join the labia behind the vaginal opening (the posterior labial commissure, for you medical nerds). That’s because it would tear during the dilation process that one needs to do during the initial year post-op. Joining it is something that can be done as a revision — but the trade-off is that it tightens things, so that penetrative sex can be difficult.

One difference with the after-market anatomy is that it’s not as stretchy around the vaginal opening as the factory-installed version, due to differences in the tissue being used. Also, unlike a cisgender vagina, mine won’t “text” when aroused to enlarge itself — which is why dilation is so critical, since whatever depth you have, is what you have. My particular surgeon generally guarantees 5 inches of depth, but 6-7 inches are pretty common, and some patients even get as much as 8 inches. But you have to be extremely diligent with your dilation schedule, otherwise you’ll end up losing depth as your body tries to close up the “wound.” And once lost, there’s not easy way to regain it. (There is a surgery where part of the colon is reused to add depth, but my surgeon wants to avoid it unless absolutely necessary, because it’s complicated, with a difficult recovery, and the results can be less than desired.)

But overall the genital reassignment surgery truly is a marvel — especially with this surgeon the appearance from the outside are very hard to distinguish from the factory-installed version. (I’ve seen a number of photos of results.)

It may be bragging, but one former patient claims that her GYN didn’t realize she’d had SRS until the GYN did an internal exam.

Admittedly, if you know what to look for there are some telltale scars (there’s some long ones on the outer labia where the tissue is joined to create the “hump” of the labia, as well as on the inner labia as well). But this particular surgeon’s stitching technique is so fine that the scars actually become extremely difficult to see once they fade. (As a Thai surgeon, he’s said that Asian skin is more prone to scarring than for Westerns, hence his stitching technique is more fine than a typical Western surgeon. Don’t know the truth of the matter there, but that what he says.) Plus if you’re rocking a full bush, that’ll generally cover the scars as well.