The Corrective Model of Trans Healthcare

The Corrective Model of Trans Healthcare

In order to think about the logical limits of the informed consent model (IC) we need to imagine if it was practically feasible to do same-day bottom surgery on trans folks and someone woke up one day wanting gender confirmation surgery (GCS) after spending the entire morning making themselves informed on the risks and benefits. Furthermore, assume they are of sound mind and not having a…

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Message for all trans* people:
  • If your friend gets mad at you and attempts to hurt your feelings by making fun of your gender - THEY ARE NOT YOUR FRIEND, DO NOT TRUST THEM.
  • If your significant other gets mad at you and attempts to hurt your feelings by making fun of your gender - DO NOT GO BACK TO THEM. DUMP THEM RIGHT THEN AND THERE AND NEVER LOOK BACK.  They are not who you’re supposed to be with.
  • If anyone ever says your birth name on purpose to upset you - DO NOT TOLERATE THEIR CRAP. THEY ARE NOT GOOD HUMAN BEINGS.
  • There is no such thing as “not being trans* enough.”
  • You do not need to pack/bind or tuck/stuff in order to pass.
  • You can wear make up or go without makeup all you want.
  • You can wear as much jewelry as you want.
  • You don’t have to start hormones or have surgery.
  • You are allowed to want to be called  by your chosen name and correct pronouns. 


YOU ARE PERFECT AND YOUR GENDER AND FEELINGS ARE COMPLETELY VALID.  

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And then came surgery…..I had a glansplasty because it did not hold the first time (phalloplasty performed on June 24, 2015). The below picture is where skin was taken in order to build the graft. And below that is my mummy phallus coming out of surgery, all happy, and bandaged up! 

Shown below: At 3 days post op, I attempted to change the dressings and xeroform. The xeroform was so stuck to the ridge or the new glands, then we called the doc and he told us we could leave it on until day 5 post op! So pretty soon, I will have pre and post glansplasty photos! 

The guide to proper trans terminology!

binding: The process of flattening one’s breast tissue in order to create a male-appearing chest. The type of materials and methods used for binding will vary depending on the size of an individual’s chest and the overall build of his body. Some trans men don’t bind at all due to personal preference, comfort issues, or because they may have small chests. Some use different methods of layering clothing to help hide their chests. Some bind only on certain occasions; some bind all the time. 

bottom surgery: see “genital reconstruction surgery”

chest surgery, chest reconstruction surgery:Sometimes also referred to as “top surgery.” Chest surgery is the most common surgical procedure sought by trans men. The goal of chest surgery is to create a contoured, male-looking chest. There are two basic procedures that are usually performed to accomplish this goal: 1. Double incision/Bilateral mastectomy, or 2. Keyhole/Peri-areolar incision (see individual entries for more detail).

There are a few other surgical variations used for chest reconstruction, including the “inverted T” incision, the “pie wedge” method, and other combinations of incisions that a surgeon may see as the best approach for the patient. 

cypionate: Short for testosterone cypionate. (Chemical Formula C27H40O3) Testosterone cypionate is one of the main injectable forms of testosterone prescribed to trans men in the United States. It is a slow-acting ester with a release time between 10 to 14 days. The name-brand of T-cypionate available in the United States is called “Depo-Testosterone,” which is suspended in cottonseed oil. Testosterone cypionate is typically injected intramuscularly anywhere between once every week to once every three weeks. 

double incision: Also called “bilateral mastectomy.” A type of chest surgery procedure that is effective for individuals with a medium to large amount of breast tissue. In this method, large incisions are made horizontally across each breast, usually below the nipple. The skin is then peeled back so that the mammary glands and fatty tissue can be removed with a scalpel. The muscles of the chest are not touched. Certain areas of harder-to-reach fatty tissue may also be removed via liposuction (such as areas near the armpits). Once the extraneous tissue has been removed, the excess chest skin is trimmed and the incisions closed, leaving two seams/scars just below the line of the pectoral muscles. Nipples are usually resized and grafted into place. 

enanthate: Short for testosterone enanthate. (Chemical Formula C26H40O3) Testosterone enanthate is one of the main forms of testosterone prescribed to trans men in the United States. It is a slow-acting ester with a release time between 10 to 14 days. The name-brand of T-enanthate available in the United States is called “Delatestryl,” which is suspended in sesame oil. Testosterone enanthate is typically injected intramuscularly anywhere between once every week to once every three weeks.

ester: A name for a chemical compound that is formed from reaction between a carboxylic acid and an alcohol. Much of the testosterone that is prescribed for the purposes of hormone therapy is in the form of esters. The most commonly prescribed testosterone esters in the United States for FTM hormone therapy are testosterone cypionate and testosterone enanthate. 

F2M: see “FTM”

female-to-male transsexual: Often referred to as FTM, F2M, or a trans man. A person who was born in a female body but whose gender identity is male. Also can refer to those assigned female at birth, in the case of intersex people, whose gender identity is male. Usually, female-to-male transsexuals will seek hormonal and/or surgical treatment in order to live successfully as a men in society.

FTM: Short for Female-To-Male. Usually said aloud as “F to M.” The term originally was intended to refer specifically to female-to-male transsexuals (and the female-to-male transition process), though in recent years it has come to be used by others who are born in female bodies and who move toward masculine or male presentation without hormones or surgery. See also “female-to-male transsexual” and “transition.”

gender confirmation surgery (GCS): Considered by some to be an affirming and positive term for the various surgical procedures included under the broad category of “sex reassignment surgery (SRS).” See also “sex reassignment surgery (SRS),” “chest surgery,” “genital reconstruction surgery (GRS),” “hysterectomy,” and “oophorectomy.”

gender dysphoria: Also body dysphoria. A term coined by psychologists and medical doctors that refers to the state of discomfort felt by transsexuals and some transgender people caused by the incongruity between one’s physical sex and one’s gender identity.

gender identity: A person’s internal self-awareness of being either male or female, masculine or feminine, or something in-between.

Gender Identity Disorder (GID): A condition identified by psychologists and medical doctors wherein a person who has been identified as/assigned a specific gender at birth identifies as belonging to another gender.

genderqueer: A person whose gender identity is neither male nor female, is between or beyond genders, or is some combination of genders.

genital reconstruction surgery (GRS): Sometimes also referred to as “genital reassignment surgery,” “bottom surgery,” or “lower surgery.” For trans men, this is the process of constructing a phallus/penis from an individual’s own donor tissue (this is usually referred to as “phalloplasty”), or the process of “freeing up” the enlarged clitoris from its connective tissue (the clitoris is typically elongated and changed somewhat in appearance as a result of testosterone therapy) so that it is presented on the body in a more phallic/penis-like manner (this is usually referred to as “metoidioplasty”). Scrotal implants may or may not be added during these procedures. 

GID: see “Gender Identity Disorder”

GRS: see “genital reconstruction surgery”

hermaphrodite: considered by many to be an outdated and pejorative term; see “intersex”

hysterectomy: Sometimes shortened to “hysto.” The surgical removal of the uterus. This surgery is often pursued by trans men as part of the transition process, as well as for health reasons. A hysterectomy is required by some states in order to legally change one’s gender status from female to male. 

hysto: see “hysterectomy”

intersex: The condition of being born with genitalia or reproductive anatomy that is difficult to label as male or female, and/or developing secondary sexual characteristics of indeterminate sex or which combine features of both sexes. The term “hermaphrodite” had been used in the past to refer to intersex persons, but that term is now considered by many to be negative and inaccurate. 

Many intersex infants and children are subjected to genital surgeries and hormone treatments in order to conform their bodies to the standard of either “male” or “female.” There is a growing movement to prevent such surgeries in children to allow freedom of choice for intersex people regarding their bodies.

keyhole:A type of chest surgery procedure that is effective for individuals with small amounts of breast tissue. In the keyhole method, a small incision is made along the border of the areola (usually along the bottom), and the breast tissue is removed via a liposuction needle through the incision. The nipple is left attached to the body via a pedicle (a stalk of tissue) in an attempt to maintain sensation. Once the breast tissue has been removed, the incision is closed. The nipple is usually not resized or repositioned. 

low ho or lo-ho: A term that refers to taking relatively low doses of testosterone.

lower surgery: see “genital reconstruction surgery”

meta: see “metoidioplasty”

metaoidioplasty: alternate spelling for “metoidioplasty”

metoidioplasty: Sometimes spelled “metaoidioplasty;” sometimes shortened to “meta.” The surgical process of “freeing up” the enlarged clitoris from its connective tissue (the clitoris is typically elongated and changed somewhat in appearance as a result of testosterone therapy) so that it is presented on the body in a more phallic or penis-like manner. Scrotal implants may or may not be added. 

oophorectomy: The surgical removal of one or both ovaries. This surgery is often pursued by trans men, usually in combination with a hysterectomy, as part of the transition process, as well as for health reasons. A hysterectomy is required by some states in order to legally change one’s gender status from female to male. 

packer: see “packing”

packing: The process of creating a male-looking and/or male-feeling bulge in one’s crotch. This can be accomplished through a home-made or store-bought pants stuffer, or through a realistic-looking prosthetic device. A packing device may be referred to as a “packer” or “packy,” or as an “STP packer” if it can also be used to pee through while standing up (STP= Stand To Pee). Some guys simply refer to their packer or prosthetic as a cock and balls, a dick, etc.

Some trans men do not pack at all– some find it too hot and/or sticky, others find it uncomfortable and/or inconvenient, and still others find it personally unnecessary. Some trans men pack simply for the sake of creating a realistic-looking bulge in their pants. Others may pack only on certain occasions (while swimming, while in the locker room, or wearing tight-fitting pants). Still others may feel incomplete and/or conspicuous without wearing a packer or prosthetic device. Some have realistic prosthetics that are affixed to the skin for wear throughout the day and night. For some trans men, the term “packing” itself is not even an accurate descriptor for the wearing of a prosthetic device– a prosthetic may be considered more an extension of the body rather than merely a pants-stuffer. 

passing: In an FTM context, being seen or read as male by others (e.g., “On the street, Alex was passing as a man”). Many trans people object to the term “passing,” as it implies that one is being mistaken for something they are not, or engaging in deception.

patch, the, or T patch: Refers to testosterone as applied via a patch adhered daily to the skin. There are currently two brand-name testosterone patches available in the United States: “Androderm” and “Testoderm.” The testosterone in these patches is suspended in an alcohol-based gel. In order to deliver the testosterone efficiently into the body, chemical enhancers are added to the patch to increase permeability of the skin. 

peri-areolar:Sometimes shortened to “peri.” A type of chest surgery procedure that is effective for individuals with small to medium amounts of breast tissue. In the peri-areolar method, an incision is made along the entire circumference of the areola. The nipple is usually left attached to the body via a pedicle in an attempt to maintain sensation. Breast tissue is then “scooped out” by scalpel, or with a combination of scalpel and liposuction. The areola may be trimmed somewhat to reduce its size. Excess skin on the chest may also be trimmed away along the circumference of the incision. The skin is then pulled taut toward the center of the opening and the nipple is reattached to cover the opening– much like pulling a drawstring bag closed. Thus, this procedure is also sometimes referred to as the drawstring or “purse string” technique. The nipple/areola may be repositioned slightly, depending on original chest size and the available skin. 

phalloplasty:Sometimes shortened to “phallo.” A type of genital reconstruction surgery in which a phallus/penis is constructed from an individual’s own donor tissue (usually taken from the forearm, leg, side of the torso, and/or abdomen) that has been shaped and grafted into place. Phalloplasty operations are usually done in stages requiring multiple surgeries. Scrotal implants may or may not be added.

Real Life Test (RLT):A period of time in which a transsexual person is required to live full time in the role of the sex they identify with (i.e., a transsexual person born female would be living full time as a male) before the medical community will begin steps in a medical gender reassignment process such as hormone therapy or surgeries. The RLT is required under some Standards of Care for the treatment of transsexuals; however, mental health and medical professionals may sometimes use discretion when determining if a RLT is necessary for a given individual. See also “World Professional Association for Transgender Health Standards of Care (WPATH SOC)” and “Standards of Care.”

sex change operation:see “sex reassignment surgery”

sex reassignment surgery (SRS): Commonly termed a “sex change operation.” This term is somewhat of a misnomer, because it implies there is one surgical procedure for successful transition into presenting or living as male. For trans men, there are several surgical procedures available, including chest reconstruction surgery, hysterectomy/oophorectomy, and different types of genital reconstruction surgery (GRS). Many trans men undergo chest surgery, but not GRS. Many have chest surgery and a hysterectomy, but not GRS. Some have all three procedures (which may total more than three surgeries, as GRS can often involve several surgical procedures). Still others may not be able to afford any surgery at all, or choose not to have surgery for various reasons, yet live very successfully as men in society through ongoing testosterone treatment.

The requirements for “changing sex” under the law (i.e., changing one’s legally recognized sex) vary from state to state, and often depend on the amount and type of surgery or hormone therapy one has had. A few states will not allow for a change in legal sex no matter how much surgery of treatment one has had. Thus, the idea that there is one clear-cut surgical solution for “changing sex” is a bit misleading. See also “gender confirmation surgery (GCS),” “chest surgery,” “genital reconstruction surgery (GRS),” “hysterectomy,” and “oophorectomy.”

SOC: see “Standards of Care”

SRS: see “sex reassignment surgery”

Standards of Care (SOC): When someone uses the term “Standards of Care,” they are often (but not always) referring to the WPATH SOC (formerly known as the Harry Benjamin Standards of Care, or HBSOC)– a set of standards and guidelines used by professionals for the medical and mental health treatment of transsexuals. Certain health clinics and gender clinics have devised their own Standards of Care for transsexual and transgender people, which may differ from the WPATH SOC. See also “World Professional Association for Transgender Health (WPATH)” and “World Professional Association for Transgender Health Standards of Care (WPATH SOC).”

STP device:Short for “Stand to Pee” device. A device designed to aid the user in standing to pee at a urinal or toilet. There are a few different types of STP devices, both homemade and store-bought.

stealth: After a trans man has transitioned, he may choose not to reveal his transsexual status to those around him (for example, to coworkers, friends, neighbors, etc.); this is referred to as “going stealth” or “being stealth.”

Sustanon: The brand name for two formulas of injectable testosterone that contain a blend of esters. “Sustanon 100” contains three testosterone esters: testosterone propionate (C22H32O3), testosterone phenylpropionate (C28H36O3), and testosterone isocaproate (C25H3803). “Sustanon 250” contains four testosterone esters: testosterone propionate (C22H32O3), testosterone phenylpropionate (C28H36O3), testosterone isocaproate (C25H3803), and testosterone decanoate (C29H4603). Both formulas feature both fast-acting and slow-acting esters, and can be injected anywhere from once every week to once every four weeks. Sustanon is prescribed outside of the United States. See also “esters.”

top surgery: see “chest surgery”

T: see “testosterone”

testosterone: Sometimes shortened to “T.” An androgenic hormone responsible for producing masculine secondary sex characteristics such as facial hair growth, deepening of the voice, increased body hair growth, and increased muscle development. Testosterone therapy is administered to trans men to induce and maintain the presence of masculine secondary sex characteristics.

testosterone gel: A form of testosterone applied directly to the skin on a daily basis. There are currently two brand-name versions of testosterone gel available in the United States: Androgel and Testim. Care must be taken to avoid skin-to-skin contact with a partner on the site of application. Transfer of the testosterone from the site can be prevented by keeping the area covered.

transgender: Broadly speaking, transgender people are individuals whose gender expression and/or gender identity differs from conventional expectations based on the physical sex they were born into. The word transgender is an umbrella term which is often used to describe a wide range of identities and experiences, including: FTM transsexuals, MTF transsexuals, cross-dressers, drag queens, drag kings, genderqueers, and many more. Because transgender is an umbrella term, it is imprecise and does not adequately describe the particulars of specific identities and experiences. (For example, the identity/experience of a post-operative FTM transsexual will probably be very different from that of a female-identified drag king who performs on weekends, but both are often lumped together under the term “transgender.”)

trans: <small> Sometimes short for “transsexual,” sometimes short for “transgender.” See individual listings for those terms.

trans man: Short for “female-to-male transsexual” or “transsexual man;” sometimes also used to refer to those who were identified as/assigned female at birth and identify along a masculine spectrum.

transition: The act(s) of changing from one sex to the other, and/or the act(s) of changing one’s physical body and/or appearance as part of a sex/gender change. For most trans men, transition is not a single discrete event, but a gradual set of changes over a period of time. As such, it is difficult to determine exactly when transition begins and when it ends. Some feel that their transition begins the day they begin hormone treatment. Some feel it begins when they tell their loved ones about their identity. Some feel it begins when they change their name legally to a male name. Some feel they are “in transition” for a few years while hormonal changes settle in. Some feel that their transition has officially ended when and if they are legally recognized as male. Some feel their transition is complete when they have completed genital reconstruction surgery. In short, what constitutes “being in transition” differs among trans men.

transsexual: An individual whose gender identity does not match the sex that was identified with/assigned to them at birth. Many transsexual people will seek hormonal and/or surgical treatment in order to bring their body into alignment with their gender identity. See also “gender identity” and “female-to-male transsexual.”

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A lot of days it seems like our community is forgotten about, left out, and just plain not understood but Transgender visibility is becoming more and more prevalent. November is Transgender Awareness Month and it is a month for our trans brothers, sisters, and nonbinary siblings to feel proud of who they are. 

We have had the privilege to meet and become friends with so many people in the LGBTQ community through FLAVNT and are even luckier to have many of these people representing our brand on a day to day basis. This isn’t even the tip of the iceberg but these amazing people encompass FLAVNT’s mission and live and breathe it when they wear our clothes and spread positivity into the world. 

If you don’t already know about us, we are a small queer-run LGBTQ clothing company that promotes self-love, confidence, and pride within the LGBTQ community and beyond. We have designs for a myriad of gender and sexual identities and have the best reps in the world from all walks of life. We also partner up with nonbinary people to help them raise money for gender-confirming surgeries. We have helped 2 guys achieve their top surgery goal (one of those guys being the amazing Caden in picture #2) by raising $2500 between the two of them. We are now onto our third fundraiser with @tyince (Tyler is pictured in the last picture and he’s the most adorable ever) helping him raise money for his phalloplasty in December.

If you would like to help Tyler reach his bottom surgery fundraising goal, head to flavnt.com and pick up one of these awesome shirts, a hat, or a sticker pack and when prompted say “yes” to 15% of your purchase being donated to his cause. 

Also, check out these guys and gals on their personal pages because they are all individually doing amazing things within and for the community. Through people like them and like you, we can make a difference, we can be seen, and we can grow. 

Much love,

Courtney and Chris

FLAVNT Streetwear

__________________________________________________________________

Who’s in these photos:

1. Chris Rhodes: Co-founder of FLAVNT Streetwear, LGBTQ activist and                                         vlogger 

2. Caden: FLAVNT’s second fundraising partner

3. Rezz: Possibly the most supportive person on the planet when it comes to                   small businesses

4. Sage: Our best buddy and brand rep for FLAVNT, Awarew0lf Apparel, and                   Support Your Brothers

5. Chloe: MTF activist and youtube personality, check out her channel!

6. Spencer: Our good friend, FLAVNT brand rep, and part of FTMTranstastic

7. Ben: Amazing photographer and all-around inspirational guy

8. Drew: FLAVNT brand rep and co-founder of Support Your Brothers

9. Asteria: FLAVNT brand rep and MTF Self-proclaimed social justice amazon                      for equality for all.

10. Tyler: Arguably the single most charismatic and sweetest guy on the planet                  and our current fundraising partner at FLAVNT.

(A) the outline of the radial forearm phalloplasty flap on the arm. The lateral and medial antebrachial cutaneous nerves can be coapted to the ilioinguinal and dorsal penile nerves. The radial artery of the flap can be anastomosed to either the profunda femoris, lateral circumflex femoral, circumflex iliac, or the inferior epigastric artery. The venae comitantes and the cephalic vein of the flap can be anastomosed to branches of the greater saphenous vein. (B) Illustration of the flap following inset, anastomosis, and coaptation. Source: Semin Plast Surg. Aug 2011; 25(3): 196–205.

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The top left is from yesterday when I found out my date for Gender Reassignment Surgery!!! October 24th!! 🎉🎊🎉 I am SOOOO HAPPY and I will finally be complete. Top right is today, my 16 months on estrogen! And the bottom two are just pics where I felt sexyy! 😊😊😊 Happy Thursday Everyonee!!

youtube

Things I had wish I’d known going into RFF Phalloplasty!
Bare with me because this video was filmed, edited, and uploaded all in the hospital. I look forward to making more videos, so let me know what you guys wanna see!

Bottom surgery experiences

(I’ve shared this list in the past, but now it has a few more links, I’ve removed links to websites that don’t exist anymore, and I’ve ordered them by surgeon.)

Original post that I update whenever I find new links: http://transexualidadftm.blogspot.com.es/2013/07/recopilacion-de-blogs-sobre.html


Phalloplasty:

Dr. F. G. Bouman, Netherlands:

Dr. Curtis Crane, United States:

London Team, (Dr. Christopher, Dr. Ralph), United Kingdom:

Dr. Sukit, Thailand:

Dr. Brassard, Canada:

Dr. Salgado, United States:

Dr. Monstrey y Dr. Hoebeke, Belgium:

Dr. Bernard Liedl, Germany:

Dr. Miroslav Djordjevic, Serbia:

Others:

From YouTube:

Dr. Curtis Crane, United States:

Dr. Jurgen Schaff, Germany:

London Team (Dr. Christopher, Dr. Ralph), United Kingdom:

 

Metoidioplasty:

Dr. Miroslav Djordjevic, Serbia:

Dr. Perovic (deceased) / Sava Perovic Team, Serbia:

London Team (Dr. Christopher, Dr. Ralph), United Kingdom:

Dr. Medalie, United States:

Dr. Marci Bowers, United States:

Others:


From YouTube:

Dr. Marci Bowers, United States:

Dr. McGinn, United States:

Dr. Brassard, Canada:

Dr. Miroslav Djordjevic, Serbia:

Dr. Curtis Crane, United States:


For more experiences and results I recommend these links (they require you to sign up, and you need to apply for membership first in the groups):

youcaring.com
Xavier's Surgery Fundraiser
My name is Xavier and I am an 18 year old female-to-male transgender boy from Poland. I have been diagnosed by psychiatrist with substantial experience in transgender patients with gender identity disorder (GID). When I was 4 years old, I realised I am in a body that doesn't fit my gender. My...