Surgeons have to create a wound into the pelvic area to insert a blind fistula. It has to be managed to prevent it shrinking or closing up.
That thread you linked to in outrage over the title is about a surgery that did not heal, so it was in fact an open wound. It was described by the person who had the surgery;
*I tried to have sex with a man 8 months after my bottom surgery and I felt disgusted with myself for having him penetrate a pool of bacteria. Blood came out of the cavity during penetration and I could see he was uncomfortable with the looks of the vulva and with the feeling of the vagina on his penis.
He knew I was trans, I told him, but he had never dated a trans woman before.
I was diagnosed with bacterial vaginosis around 1 year post op. The vaginal cavity was full of unhealthy bacteria, despite me douching with isobetadine regularly.
At this point it became very clear to me that what I have between my legs is nothing more than a surgically created wound.
I honestly don’t understand how this surgery is even legal. It butchers a healthy body and comes with life threatening side effects.*
Surgery is actually pretty barbaric, making the words sound prettier doesn't alter reality.