13 FTM Surgery Tips You Need To Know
by Mark Van Streefkerk
I’ve had three surgeries in the last four years. It started with a non-transition related surgery: removing a benign tumor from behind my left eye, then top surgery the next year, followed by a year off, and then I had my hysterectomy a few weeks ago. Though I’m open to considering bottom surgery (phalloplasty or metoidioplasty) in the future, it feels good to be at a stopping point right now. Three surgeries in four years feels like a lot to me but there are plenty of folks who have had many more transition-related surgeries than I have. Just as there are many trans folks who don’t want surgery at all. Everyone’s gender expression looks different, and even among people who have had the same procedure from the same doctor, results can vary widely. If you’re considering gender-affirming surgery, here’s what I’ve learned from my own experiences that may help you.
1. Be Wary of YouTube
Everyone is different and everyone’s results are different. If you’re like me, you’ll probably look up everything you can on YouTube and the internet about the surgery you’re preparing for. While it’s a great source for general tips, knowing what to expect and providing comfort when you’re nervous about surgery, I think the algorithm can skew searches. You might only find exceptionally good results or scary surgeries with complications.
Kinda like Yelp reviews, you’ll hear less from people who have had an “average” experience and more from folks who have had really good surgeries (“It was a breeze! I was back at the gym in 2 days!”--which is never, ever true, by the way) or folks who had complications. It’s good to watch those, but keep in mind your experience will likely fall between the two extremes.
2. Try To Let Go of What You Can’t Control
Nervous about surgery? Your only job is getting to the hospital on time, then the highly-qualified, trained professionals take over. What you can control is setting yourself up for a successful recovery as best you can.
3. Stock Your Fridge Beforehand
At the very least, prepare for two weeks of not leaving your house much, if at all. I’d recommend a big grocery haul a couple of days before surgery. If you’re on a budget, go to Trader Joe’s or discount grocery stores. I put in $150 at Grocery Outlet and got a lot more than I thought I would.
4. Prepare Food In Advance
When you shop, aim for snacks and easy-to-make foods like instant oatmeal, microwavable dinners, and canned soups. You’ll want some easy-to-digest foods too because your post-op system will be slowed from anesthesia. Grab some apple sauce, saltines, and instant mashed potatoes, all of which are easy on your stomach. Take some time the evening before surgery to pre-slice some fruits and veggies. Prepare your first few post-op meals in advance or at least plan them out.
5. Set Up Your Recovery Area
Before surgery practice how you’ll get in and out of bed / the couch. One of my biggest challenges post op was just that, getting in and out of bed without using my arms (for top surgery) and without using my core (post-hysterectomy). Make up your post-op bed before you head out for surgery, get your pillows (and neck pillows and bed loungers) and bedside station just right, with everything you need within reach. I needed my girlfriend’s help every time I got in and out of bed for the first few days post-hysterectomy. She eventually found a really handy bed rail at a thrift store. It’s a large handle made for the side of a bed. The base anchors between the boxspring and mattress. It was a huge help for me getting in and out of bed on my own.
6. Consider These Helpful SuppliesIf you’re heading in for top surgery, get a back scratcher and some reusable drinking straws. Get a pack of cleansing wipes since you won’t be able to shower for a few days post-op. A cushioned lap desk makes eating easier when you’re lying or reclining.
7. Dealing With NauseaMaybe you’ve had anesthesia before or maybe not, but if you haven’t, I’d highly recommend asking for a scopolamine patch before surgery. It’s a little round patch they stick behind your ear that releases anti-nausea medication. It’s good for about three days. Coming out of my first surgery I was so nauseous from the anesthesia I puked a bunch of times, what little I had in my stomach. That was miserable. I’ve asked for the patch ever since and never had that problem again.
8. Reduce or Quit Smoking
If you smoke, pot included, every surgeon will tell you to quit before surgery. Smoking anything cuts off oxygen to your body, making its healing job a lot harder. The longer you quit smoking before surgery the better. It helps if you quit even the day before.
9. Befriend Your Post-Op BodUnfortunately, we don’t get to spring off the cutting board and immediately resume life in our new form. Bodies have to heal and regrow around parts that were cut into. My post-op bod was swollen, stinky, bloated, constipated, sore and so many more decidedly UNsexy things for a while, and yours probably will be too. If you’ve had top surgery, you’ll probably be wearing a binder, have drains or big incisions. Anesthesia and medication, as well as the gas they may use during surgery, might leave you bloated. Your post-op state could trigger body or disordered eating issues. You might gain weight and that’s perfectly fine. Consider the fact that you literally have the rest of your life to work out or exercise if that’s your thing.
10. Start Moving (Slowly) When Your Body Is Ready
Start stretching your lower half and walking when you can, even if that’s just walking around your house for a few minutes a couple of times a day. Movement helps decrease your risk of blood clots after surgery and helps with the next point.
11. Dealing With ConstipationConstipation wasn’t that bad for my first two surgeries but it was awful for my last one. I’ll spare you the particulars, but here’s a few things that helped me: drinking LOTS of water, walking, stool softeners and laxatives. Also, prune juice is king.
12. Facing Post-Op Blues
It’s entirely possible you could get caught up in the feels. Feeling down post-op is such a common experience. Pain and discomfort aside, you’re basically being sidelined from your life for a few weeks, away from work or friend groups, not having sex for a while, and you have to rely on others for help. After my latest surgery I felt hopeful and excited for the first few days, but as recovery dragged on, I got frustrated and depressed thinking I should be farther along by now.
The days dragged on and on and I had all that time to sit with my feelings, bummed that I felt exhausted walking to the end of the block and back, couldn’t lift more than 15 pounds and couldn’t roll on my side and cuddle my girlfriend. When I met with my surgeon for a post-op appointment however, she told me I was right on course.
My advice is to give all those feelings the space they need without feeling bad about them or trying to shove them away. Talk about them, post about it or write them down. Journaling is my go-to. When I journal I also note what things have improved, however little they may seem, and that makes each day a little more exciting as I observe small improvements. I reached out to people on Instagram who were open to messaging about similar post-op experiences. You’d be surprised at the number of folks who might have the same surgery date as you.
13. Get Used To Asking For Help
Asking for and receiving help can be a big deal if you’re used to a busy, independent life. For at least the first two days after surgery, expect to need some kind of round-the-clock care whether that’s from a partner, parent, friends or roommates. I’ve had to ask housemates to help me get dressed or help make me food.
Fresh haircuts have always made me feel good, but post-op top surgery I couldn’t raise my arms high enough to comb my hair. It was a humbling experience when I had to ask my friend to comb my hair. My partner, community and friends have all been lifelines in my recoveries. I’m grateful to the friends who came over, brought food and watched TV with me.
Even though your body might feel gross, bloated and painful for days, I promise it’s not the final destination. You’re just traveling through.
Comment your post-op tips below!
Other articles by Mark Van Streefkerk:
Unpacking Money and My Masculinity
Staring At Other Guys' Dicks and Puberty As a Grown Man