“You’ve got to suffer to be beautiful.”  The painful preparations for surgery

The joys of laser treatment, plucking, waxing, and electrolysis

Trigger Warning: there are some descriptions of aspects of sex reassignment surgery.

Who remembers the source of that quote, that beauty is suffering.  It wasn’t someone who was learning to walk in high-heeled shoes, or shimmying themselves into painfully tight undergarments.  Suffering need not be just physical, as the loss of time in “getting ready” when doing make-up and hair are real drags on life.

Here’s a link to an article about the history of suffering for beauty.

In order to have sex reassignment surgery (srs), to have one’s penis upcycled into a vagina, there are some preparatory steps.  This is not about the politics of gatekeeping, though there is plenty of that.  No, it is about the physical prep that is required.  And mental.

You might say that changing sex is serious business.  The establishment wants to make sure that we don’t make mistakes.  I thank the nanny state for thinking on my behalf.

Mental health

First, you cannot “easily” get access to hormones, or even begin the process without being “diagnosed” with gender dysphoria.  In practice, that typically means letters from two mental health professionals who have known you therapeutically for a while, and who are usually expected to have expertise in this area.

I have written about the posse who supports me.  They support me in this way too, quite literally.  And while my wife used to rag on me for having two (or more) therapists, it is required.  Nice to be validated in that way.

There are some places, countries, states, that allow for “informed consent” which is essentially being treated like an adult.  Taking steps on one’s own cognizance.

And you can also do what I did which is not really advisable, unless you are really and truly informed, which I was not, and that is to self-medicate.  There are plenty of ways to access bootleg hormones.  Mine was to buy them without a prescription in Mexico.  

You need these two mental health letters in order to ask for surgery from any of the leading clinics around the world, as there is a global standard for transgender health care.  This standard stipulates that you need two letters of support from a mental health professional, but one of which must be a psychiatrist, ie an MD.  In my case, that meant I had to get another therapist.

In addition to these two letters, you need a letter from your endocrinologist, confirming the diagnoses of the mental health professionals, and confirming that you have been on hormones for at least a year, providing details of that medication.

Body Readiness

Amred with the letters and diagnosis, and with a year of hormones, you can then begin the consultation process with a surgeon.  The really good surgeons have long waiting lists, upwards of year, and that is just to be able to talk to them.  Never mind the wait after.

Most surgeons also require you to have insurance in place, from a provider who will support your transition.  I don’t have this yet, though I will try to get it.

But the biggest part of getting ready for surgery is none of the above.  What is it?  Hair removal.

And it is bloody important.  Why?  Because some of the tissue that is used to create the neovagina is groin, scrotal, perineal, and penile tissue, all of which has hair on it.  It is bad news if some of those hair follicles end up inside of you.  Even one.  That means a kind of thoroughness to the job, which can only be achieved over time.  Many sessions.

On the various trans forums I participate in to find advice, it is often said that hair removal is the hardest part of transition.  I have scoffed at the notion.  You can’t tell me that hair removal is worse than having a sex-change operation.  Well, apparently it is.

And yesterday, I began to taste why.

I wrote about how having my face waxed was the most painful thing I had ever experienced.  It was.  Until yesterday.  And besides, what was I doing back at the salon so soon after having my face waxed?  I was ready to do it again.  What?!

Yes, the hair regrowth had been so slow and so much softer than it had been after shaving, that I really liked it.  I was able to pluck my hairs one by one with tweezers in the morning when I got up, and in the evening when I went to bed, and it was painful, but one at a time, it was manageable.  For two weeks I did this, and then it was getting hard to keep up with the growth.  I bought home wax strips, but those just didn’t work—they hurt still, but they didn’t get the hair out super well.  So, I decided I could handle it, mainly because the hair gets weaker with each waxing, so each time would be easier…and plus, I had been plucking.

Plucking is not so joyful either.  Having recently had my eyebrows plucked to a more feminine shape, I know that.  Having plucked my upper lip hairs out one by one, ouch, I know this.  The ones closest to the mouth, to those ever-so-sensitive lips, are the most painful to pull out.

But when I showed up at the salon she took one look and suggested we go straight for electrolysis.  Her nonchalant inspection of my crotch led her to enthuse that what I had done thus far really seemed to be working.

I figured she would just wax my face.  Instead, we set to electrolysis.  It wasn’t that bad.  Okay, she delivers a sharp electric shock to one hair at a time, then goes back and plucks it out with tweezers…but often the shock was insufficient, so she has to shock it again, and again, and then the darn hair will finally come out.  She noted that my facial hairs were rather tenacious.  She kept asking if I could handle it.  Kept asking if she should stop.  I asked her to keep going.  How often do I really want to do this?  Most electrolysis sessions last anywhere from 10 minutes to 30 mintues, and focus on a particular area of the face.  

We did my entire face, over three hours.  Shock, pluck, shock, pluck.  She wanted to stop at one point, after doing half my face, showing me in the handheld mirror how irritated and swollen it had become.  I said, “well, the other side isn’t irritated yet,” to her suggestion that she shave the other side for balance.  And so we continued.

She asked, “do you think you will be able to handle this on the scrotum?” It is “lo scroto,” in Italian…somehow sounding better.

“It should be easier,” I said, “after all, there are fewer hairs down there.”

“Dici?” she asked.  This Italian word (she is Italian, we speak Italian together) has a lot in it.  It means “is that what you say?” at once implying incredulity, an ‘if you say so’ kind of ‘we’ll soon see about that’ one, and ‘I’ll take your word for it’.  I was sure.

My face was killing me.  I touched it and it felt bumpy and swollen, as if I had been randomly stung by bees all over.  My complaint that there were still hairs meant back down under the lamp as she plucked and shocked out any others she spotted.

And then we turned to my genitals.  There is an area which is 100% high priority, and that is the base of the penile shaft, the entire scrotum, and all of the area between the legs and extending from the base of the penis to the opening of the anus.  This is where the neo-vagina goes, and it has to be 100% clear.  If it isn’t, they won’t schedule your surgery, let alone do it…and while some doctors may, that should be a sign to run the other way, as it will create a lifelong complication. Nobody wants hair inside the vagina!

Laser hair removal is considered only semi-permanent, so there is nothing like electrolysis for definitive epilation.  Laser hair removal is helped by my doses of oestrogen, as my body hair follicles have gotten sleepier and sleepier to the point where I no longer need to wax…what I have now is a very light golden down that I am inclined to let grow and see how it looks.  Peach fuzz we used to call it.  I rather like it.

My belief that it would not be quite so painful down there was disproven on the first hair follicle.  It hurts.  And to think there are hundreds.  She started and went for 30 minutes.  Who knows how many she got, but decided that it would be easier for me to go back to laser (I’ve already had 3 rounds of laser down there).  She has upgraded her equipment for me to a more powerful laser that is capable of dealing with blonde hair (the lighter the hair, the harder the time that the laser has in working on it).

She asked if I remembered how painful it was the last time, and whether I could take more.  I said I could.  This is not macho.  This is wanting to get it over with and knowing that this is going to be six months or more of hell.  The face is just a bonus.

I said to her, “the face is just a nice to have, down there is a have to have.”

In typical Italian fashion, she said, “the face, are you kidding, of course you have to take care of the face, and then it will be like mine, like a woman, like a baby.”

Her grim sense of humour also applied when I admitted to her that this time it was really painful.

“Hey, we’re making you a woman.  Nobody said it was easy.”

I don’t want to dwell on what happened next, but it was a pain level that I have never, ever experienced, and was beyond torture.  She used her new laser, turned up to a higher power setting, and when she went at it down there, I was doing all I could to not scream, to hold my legs open and to not move.  I slapped myself, I pinched myself, I stopped breathing, I tried breathing, I pushed against the wall, I squeezed the bed, and tried to let go.

She was complimentary of my ‘resistance’.  I thought of how some men choose cock and ball torture as their kink.  That always struck me as a kind of pain that would be too much.  I’ve never really done it (well, not really).  But I am thinking it must be in the ballpark.  Giving birth?  Getting kicked in the nuts?  Other candidates for excruciating pain?

And while the genitals were bad, it was the return to the face that finished me off.  I just wanted to go out into my car and cry, to bawl my eyes out.  When she was working my face over, I could smell the hairs being burned by the laser, and a thousand deep pin pricks.  Hard to imagine this is what light can do.  My face held as still as possible for her, as I wanted it over with, but the rest of my body writhed like a bag of snakes.

The lavender oil that she put on my face after, or wiping off the excess cream that she used to lubricate the passage of the laser was across skin that was so pained and irritated it hurt almost as much, replacing the particular with the general.  A feeling of raw skin, as if someone had taken a cheese grater and just scraped the outer layer off.

After, I got in my car, and to my amazement, I didn’t cry.  My face was bright red.  When I finally got home, I lost all will to stick to my diet, and stuffed my face with peanut butter, my comfort food of choice.  But good girl that I am trying to be, I still managed to go for a run later.

These lasers are serious business.  As I looked at my bumpy and still-somewhat-swollen face the next morning I noted the dead black hairs that are stuck and burned inside of me that I have to get out with a toothbrush, or the skin dots that I now have as if I had had a severe sunburn in places.  No laughing matter.  Topical creams in order, but so too will be my anti-cancer diet until those babies are gone.  No sugar, no alcohol, no excess calories.  Strip it right back.  Raw food diet.  Fermented foods.  No dairy.

You have to suffer to be beautiful.