Do phalloplasties actually work?

[SilverTapz]

After wondering about this for a while, I ended up searching phalloplasty online and ended up on a Reddit page where people post their progress. I had never seen one before an was curious, I guess. It was actually quite shocking. People with what looks like no muscle left on their forearms, someone with a necrotic 'scrotum', someone where the stitches were wide open and the tip has turned black and left a gaping hole etc etc. People seem to be commenting saying that they look great, they've made the right decision etc, but honestly they look absolutely butchered. It's scary. And I guess my question is, do they actually function? Some of these people are so young and it's scary what they've done to their bodies. I can't help but think a lot of them will regret the decision. Is it mainly cosmetic? Can they orgasm? Honestly just very shocked by what I've seen!

Yes, pre public toilets for women ( ha, ha , those were the days) women had to pee ‘standing up’ , or at least squatting a bit. The older public female loos in many parts of France and in the Middle East have loos designed for this, they consist of a ceramic tray with a drain and two raised areas for the feet. Grim but presumably usable.

‘Lower class’ women pre public loos used to pee in pairs, so one could shield the other.

Ah yes, another "very not pro phalloplasty" poster who seems very determined to shut down honest discussion.

You know your intentions are obvious, right?

I think you equate gender critical with anti-trans or transphobic which is not the case we are just pro women’s single sex rights.

I would have no issue with your theoretical man asking questions. It’s often a good idea to consider a wide wide range of places to get information from as you learn nothing in an echo chamber.

The problem is when you take that knowledge and try and impose your viewpoints on others. I do believe that some women regret abortions and they can (rarely) cause future fertility issues, still very pro choice but people need proper counselling and to make an informed choice.

I think phalloplasty surgery sounds brutal, multiple surgeries over years for often questionable results. I’m not saying no one should have it done . I’m saying that given the permanent effects, chance of negative outcomes and sterility thst there should be a lot of psychological counselling and the decision making should be informed.

I’d also question use of NHS resources on gender reassignment. I think they’d better spent on mental health care and counselling to help people accept their bodies.

I suspect such a forum might be rather a dangerous place to look for honest answers.

@SilverTapz a study on sexual function / sensitivity after surgery https://pmc.ncbi.nlm.nih.gov/articles/PMC8498953/ …points to note from the authors “Transmasculine persons should be informed that there is a chance that postoperative sexual functionality of the neophallus will be suboptimal and that sensitivity will likely be reduced, with a long and slow recovery toward an end result that remains unclear” “Sensory outcomes are complex and this study only measured the most superficial components of sensory experience. Based on qualitative findings, we conclude that outcomes often do not match expectations, which causes dissatisfaction in a proportion of participants. Hence, it is necessary to inform transmasculine persons extensively on what to expect after phalloplasty and discuss the considerable probability of having to face shortcomings with regard to the esthetic and/or functional outcomes as well as a reduced sensibility and long recovery time”. @peachgreen you do realise that there is a difference between personal experiences and research studies?

I wouldn't want my child to do this either. I'd be massively concerned about the risks and future maintenance and would tell them so.

The difference is I wouldn't be called a bigot and told suicide is the only alternative.

I spent my teens and 20s wishing for bigger breasts. Then I had children and now they are a pain in the arse and I'd like to be flat chested again.

I wonder if people are dismissive of the risks because they are primarily young.

Conversely this site worries more because most of us are mothers and have experienced incontinence so it's not an abstract thing that might happen. We know how debilitating it can be.

We've also had to get used to bodies we no longer recognise as our own after childbirth. It's not easy but surgery is also rarely the answer.

Whatever peachgreen was trying to do, they've managed to keep the thread in "Trending" for a while 😆

Another odd thing you see on the phalloplasty reddit is how they seem obsessed with peeing standing up, and with hanging around locker rooms naked. They don't seem to be aware that many men do neither, and even more perhaps would never do the latter.

Omg im shocked that this is even a thing. Terrible 😣

Thank you for this link and the wider site. As a feminist I find the stories of trans people who want to share the insights it gives them into how men and women exist in the world so valuable and interesting.

I find the rhetoric of 'only someone with X can have knowledge about X' very odd - I've lived somewhere with a gas boiler most of my life but I know naff all about boilers.

Does someone with a pacemaker automatically achieve knowledge about pacemakers? They could tell you about their experience of having one but that's it.

I'd rather hear from someone who
is qualified in the area, or someone who has read widely on it. When it comes to any controversial topic or where money is changing hands there will be bias. A surgeon who is paid to do phalloplasty is not unbiased.

It must be interesting to see the tactics for the first time, particularly the disingenuity and the dismissal of the idea that we have genuine, well founded concerns. No wonder MN has peaked so many.

I'd like to see the charities and advocacy groups who have pushed the, "if you don't hurt yourself then other people will hurt you" message onto vulnerable young people in the dock for child abuse. The media is complicit too.

How the hell does a sane, mature adult think this is the best way to support already distressed teenagers. It makes me so angry.

Two things from a trans man.

1. I do think MN is a great place to ask such questions, because here you can find both educated women and TRAs. The educated women will point to the studies, the articles, the statistics, and so on. The TRAs will give pro-trans views. The result is extensive information mixed with lived experience, which is ideal I would say.

Would it be better to go on trans men forums? No, I don't think so, quite simply because there, the harsh realities of the studies and statistics would not be welcome by some participants, so they would either not be mentioned, or they would risk deeply upsetting some members who would not react well and the conversation would quickly become unpleasant for everyone involved.

2. One thing that cannot be emphasised enough is that there's extremely little actual safeguarding possible regarding sex reassignment surgeries. What I mean is, trans men are extremely good at sharing tips and advice on how to get what they want. "Go see Dr X", "Say this and never admit to that," are commonplace advice among trans men. So even if doctors wanted to ensure that the person in front of them is properly aware of the risks and truly consenting to them, they couldn't be sure, because the person would say all the right things, without necessarily having thought through any of them.

I was once friend with a trans man who couldn't consider transitioning socially - but still had top surgery and then had his documents changed. He ended up being officially Mr X, with his breasts gone, but still presenting as Mrs Y, even while refusing to understand why his family was making lesbophobic comments towards him and his girlfriend. It was a complete mess, and it took him years and years to set things straight in his head. Now imagine if it hadn't been about a marker on official documents, but about a massive surgery...

I wonder if people are dismissive of the risks because they are primarily young.

Taking risks is part and parcel of young adulthood - it is programmed into brain development, probably as part of the evolutionary need to break away from the original family unit.

@MyOliveHelper just seen the discussion about teeth and cosmetic dentistry - if you read the personal accounts of Scott Nugent and Buck Angel you will actually see, ironically, that as a result of enforced early menopause and subsequent osteoarthritis, they lost many of their teeth (Scott mentioned in one interview that most of them cracked and had to be removed) so that cosmetic dentistry was something that became necessitated by trans affirming surgery.

It's ironic that a poster is suggesting a board of women with endless experience and knowledge of women's bodies may not be a good place to discuss the mutilation of female bodies in pursuit of allaying a mental health issue.

Also worth pointing out that trans lobby groups have been all over schools, children's homes, online - see Hannah Barnes book Time to Think for details of the inappropriate influence Gendered Intelligence and Mermaids had on GIDS, influencing "child healthcare" for their own political ends. Despite their lack of knowledge of child psychology, development, parenting and education.

We're in this mess because people, especially women, have been routinely bullied and intimidated into keeping quiet.

No more #nodebate. We must talk and expose what's being done to children and young people in the name of queer theory / trans ideology.

'One thing that cannot be emphasised enough is that there's extremely little actual safeguarding possible regarding sex reassignment surgeries. What I mean is, trans men are extremely good at sharing tips and advice on how to get what they want.'

It's the same with everything, to get what you want you do need to research and know what to say. Is this available on the nhs and do you agree it shouldn't be?

I'm interested in the term sex reassignment surgery as sex can't be reassigned. They should rename it body modification/alteration surgery.

@SilverTapz this is a fairly comprehensive and balanced summary of transition interventions for men and women ( again we have to be mindful that it’s a highly complicated research field https://link.springer.com/article/10.1007/s13669-024-00390-1….. you did ask about concern about people regretting their surgery later and I thought this statement is apt “In one study, 17% of 69 Trans masculine people who de-transitioned cited medical complications as the main reason [30].”
Also important :
“Pain
Trans men who had undergone phalloplasty were four times more likely to experience pain during sexual intercourse compared to those who underwent metoidioplasty [9]. A recent publication also documented complications of penile and testicular prosthesis following gender-affirming phalloplasty. Three of 45 patients experienced pelvic or pubic pain with prosthesis [29]. Individuals undergoing penile prosthetic implantation may experience acute or chronic post-operative pain. This could be due to prosthesis malpositioning, alterations in proprioceptive nerves particularly with ilioinguinal nerve coaptation, excessive pressure from the prosthesis on the skin of the free flap, or irritation of the pubic bone at the fixation point [30].”
and also this:
“One study including 211 trans men prior to medical or surgical intervention showed a 42.9% rate of difficulty with orgasm that affected their daily life [9]”.
”In a survey study of 170 trans men prior to medical or surgical intervention, 42.9% experienced low sexual desire and 28.6% experienced sexual aversion [9]. Distress surrounding sexual activity or one’s own sexual health, which may or may not include individual anatomy, may impact general sexual satisfaction [17, 18]. Thus, those experiencing high levels of gender dysphoria may have lower levels of sexual satisfaction. Dissatisfaction with one’s body, or body dysmorphia can heavily contribute to sexual dysfunction and plays a large role in gender dysphoria [3]. Specifically, one study of 141 trans men demonstrated a connection between body dysmorphia and difficulty with sexual arousal in 91% of participants [18].”
….it may well be that medical input is seen as important to help trans people with their sexual function but perhaps it’s about researching what other options ( including sexual and psychological therapies) work best to help those individuals rather than proceeding to invasive surgeries that may cause more harm than good.

I've often wondered this, we know osteoporosis can be a problem in menopausal women. These women identifying as men who have had ovaries removed and are testosteroned up with beards will we see wards full of them with broken bones in years to come? I hope not.

Agree, but also, given at least 70% of those referred to the tavistock were autistic, it’s also necessary for these surgeons to understand that autistics are pretty shit a truly appreciating risk. They are emotionally and neurologically less mature than their NT peers and really cannot make risk assessments on the same basis. It is a heinous dereliction of clinical duty that an 18 or 19yo autistic person is ‘trusted’ to make decisions that impact the rest of their lives when they really are not capable of seeing much beyond the ‘now’. It’s only because my DD is now 20 (and after I fiercely gate-keeped who she spoke to and which services she had access to) that she is old enough to appreciate that mastectomies and testosterone would be deeply harmful to her. Mentally and physically.

Just having the opportunity to trial 5 different ADHD meds and even more mood stabilising meds over the period between 14-20, discovering how severe the side-effects can be, has made her very very wary of ever taking hormones. I think she’d still love to magic herself into a male body, ideally one about 5ft 11 by contrast to her 5ft 4 self, but she’s come to understand that drugs and surgeries won’t actually ‘fix’ her. Occasionally she thanks me for ‘getting in her way’ as she now appreciates that even at 20, she is young compared to her peers.

I understand it has already happened with many TMs already using walking sticks and wheelchairs by the time they are 30. I thought it was just the intersection of disabled and trans activists at the demos until it was pointed out that, no, these were long-term T users now damaged as a result of enforced premature menopause. I was horrified.

It's ironic that a poster is suggesting a board of women with endless experience and knowledge of women's bodies may not be a good place to discuss the mutilation of female bodies in pursuit of allaying a mental health issue.

Even more so given that this ideology is driven by men claiming they know what it is to be a woman.

Who’s wagging a finger? I wasn’t even talking to you lot. Just expressing my opinion on the change in Mumsnet.

Thank you so much for saying this, young women like your daughter so often get forgotten in this awful situation. As the mother of a 27 year old autistic son, I am so grateful that he missed this when he was going through puberty, I dread to think what rabbit holes he could have gone down. And you’re absolutely correct in that they are typically young for their chronological age, my son was roughly 18 months to two years behind, which makes a huge difference in the teenage years.

I wish you and your daughter all the very best, you’re clearly a great mum to her, and she will thank you for your ‘fierce gatekeeping’ and keeping her safe.