I originally wrote this up and posted it on Reddit in Nov 2017 but I think it's worth sharing it on my blog too. I have made some small edits to the original post for posting here. The above video was shot in Dec 2018, one year after my SRS when I was visiting Thailand on a vacation. I have also written a post on going under the knife as a transgender person that you may find useful. Finally, if you are not transgender, and not into details about a complex and challenging surgery, please don't read this post :)
I had my SRS (sex reassignment surgery) with Dr. Chettawut (Dr. Chet as he is often called) in Oct 2017 and I would like to share my experience with all of you. I have learned a lot from the experience others share here and I wanna do my bit. A lot has been written about SRS in general and also in particular on SRS with Dr Chet so I will skip the common stuff. I am going to talk about things that I found useful/interesting and that weren’t mentioned elsewhere.
Why SRS and why specifically with Dr. Chettawut?
I didn’t hate my genitals but I was sorta indifferent to them all my life. HRT and other aspects of transition had improved my life enough that I wanted to try out SRS and see if helped me live a happier life. I also didn’t like the depression that came with cipro (AA) even though I finally reduced my dose to only 12.5mg a day. I also read about the burst of feminization that happened to many girls after their SRS and wanted to try my hand in that lottery!
When picking the surgeon, I honestly didn’t research as much as I could have. Thai surgeons are mentioned quite often here and I knew about Dr. Suporn and Dr. Chettawut. I picked Dr. Chet because his wait list was much shorter (I booked the date in feb) and also because I didn’t like the idea of living any longer with erectile tissue (it was the most challenging thing about having a penis). I didn’t consider US surgeons because at the time I believed that they would be prohibitively expensive. In the end, I think I could have paid for them but I don’t regret my choice one bit. I don’t know if penile inversion or the thai technique is superior to the other but I am happy with my results and experience.
Letter of Recommendations
Dr Chet requires two letter of recommendations, one from a therapist/social worker and another one from a licensed psychiatrist. I found out much later that you can get these letters in Thailand but honestly I would not have wanted to have something so important delegated to the last minute. I don’t live in South America so it was a quite challenging for me to find these letters locally. Finally, I got my letters after skype calls from Shawn McGill and from Dr Lori Becker. Both were extremely friendly and knowledgeable. In the process of talking about my trans journey, they both offered very useful suggestions. I highly recommend them not only for getting referral letters but for any counselling pre or post op as well.
Planning the Surgery/Logistics
Planning the surgery was quite smooth. Dr. Chet’s team (Som) is quite responsive and there were only a few occasions where I had to send a reminder to get an answer. To be honest, I also didn’t have any out of the ordinary questions since I don’t have a complex medical background. As for the logistics, I didn’t book my flights up until a month or two before the surgery since I kept thinking that I am going to postpone the surgery (fear!). Finally, I booked business class tickets for myself and my mom and even though they were expensive, they were totally worth it (especially on the way back from the surgery - sitting would have been very challenging). We stayed at the vertical suites and found the quality of the apartment and service quite agreeable. Their everyday cleaning service is especially useful as you recover and use up a lot of paper/towels etc. The breakfast buffet gets old pretty fast and you are better off with something more nutritious anyway.
Making the most of your stay in BKK
I know a lot has been written about the stay in BKK. The shopping in tesco and the night markets. I wanna add a few things that I didn’t read about anywhere but that helped me a lot.
I ordered a lot of food using the Food Panda app. The service is excellent and you can get a ton of food delivered in 30 mins or less. I hooked it up with my credit card and I would have food handed over to me everyday w/o worrying out cash etc. If you use the app, my favorite restaurants were Donburi Sushi, The Witch Restaurant (Curries and European) and Ripasso (Italian).
Tesco is a massive place to shop but if you are looking for better quality food, checkout the Tops market in the basement of Seacon Square. There are plenty of other locations for this store as well. You get much higher quality stuff there. Paradise mall has “Villa Market” that apparently has a big organic section (though I found out about it only after my surgery so couldn’t try it out).
For buying meds/supplements I found the Safe and Save pharmacy pretty good. I also bought a foam top for the bed that really helped me be comfortable after the surgery. I left it behind with another girl in Vertical Suite and may be it will find it’s way to you one day :)
The Consultation/Pre Surgery Prep
The consultation with Dr. Chet was brief since once again I didn’t have many questions. I did need the extra skin graft (who doesn’t!) and also discussed a second tracheal shave with me (which I opted for). I found him to be friendly but to the point. In all of my interaction with me I didn’t find him rude as some posts here have suggested. If you are worried about it, you most likely don’t need to. He and his staff speak English though you may have to slow down to get your point across and sometimes it may be challenging to communicate with them. It was never a deal breaker though.
The liquid diet wasn’t too bad. I had a lot of soup and sugar! I have never had and plan to never have so many gummy bears again :)
The bowel cleansing wasn’t pleasant but you live through it. The clock ticks the day away and you get to the surgery day.
The Surgery and Stay at the Clinic
Dr. Chet’s clinic is small and can feel underwhelming at first. However it’s quite modern in terms of comfort and facilities. The operating room is quite big and the attached recovery room small but comfortable. The private rooms that you are moved to after the first night are small but cozy. There is fast wifi and apple TV in every room. There are no windows but honestly I didn’t miss them (though before the surgery I was very worried about the lack of them). The bed is comfortable and you can control it using a remote which helps when you want to eat and drink. You get two sponge baths a day, 3 soft meals and tons of medications during your stay there. Overall I was pretty comfortable there.
My surgery lasted around 8 hours since I think I bled more than normal. Also my second tracheal shave was a little more complex because of the scar tissue from the first one. I remember coming out of anaesthesia around 11pm and Dr. Chet asking me if I was doing fine. He left after that and nurse Sri slept with me in the recovery room. Sri is an amazing individual and deserves a special mention. Her role is as important in the process as Dr. Chet’s. She is very compassionate and her presence made the entire experience a lot less anxious than it would have been otherwise.
The dreaded walk down from the recovery room to my bedroom wasn’t too bad. Sri gives you a gentle hand and they get a wheelchair once you are past the steps. Once you are on the bed, you don’t get out of it for the next 3 nights. I didn’t really have any pain thanks to the Epidural Block and tramadol. I was surprisingly chill (I think morphine) for having had such a big surgery. I never tucked (ever) but I can see what people mean by the immediate post op feeling being like a giant tuck! You feel all packed up and obviously can’t see anything. You just have to believe that they did the job. For the first few nights you still have your legs massaged using the compression device but it didn’t stop me from sleeping most of the time. Before you leave the clinic the spinal tap, drainage tubes and the compression device are removed. Some girls even had their pressure dressing removed on the day of the discharge but I didn’t have mine until day 7 post op.
I had lots of vivid dreams the first few nights. Most of them were about wanting to have surgery. They felt so real that I would wake up from them and it would take me a few moments to realize that I am in BKK and the surgery has already happened! I was on my back most of the time even though I was allowed to turn to my side with a pillow between my legs. I was just afraid of hurting myself (paranoia, nothing more). You can pick from a few choices for your meals and I opted for a soup and soy milk for almost all the meals. There is choice of chicken, miso and mushroom soup for food and then soy milk and a few others for drinks. I didn’t mind the repetition and was grateful for the lack of bowel movement.
You can have visitors everyday and my mom visited me every few for a little bit. I was happy to see her but obviously didn’t have much to talk about and so the visits were short. Dr Chet also visited me everyday and provided feedback on the recovery and on the last day gave me the meds and certificates. Once again, I found the interactions with him quite pleasant (and short).
The first couple of weeks back in the hotel
The drive back to the hotel was uncomfortable and I opted to walk from the reception to my room. I wish I hadn’t! I was really dizzy and couldn’t wait to get to my bed. For the next 3 nights, I was in bed almost all the time. The pressure dressing was removed on day 7 post op and I was able to shower later that day. This was also the first time I looked at my vagina and I was quite happy despite the skin down there looking quite lifeless. The nurses also measured the initial depth and showed me the first dilation the next day. Early on, I did see some tissue/dry blood on the dilators and was told that this is normal. Over the weeks, I have seen lesser and lesser of it.
I had my first bowel movement on day 7 after the packing was removed. I had been drinking plenty of water and eating fibers on day 6/7 but I had a very hard time passing stool and had to take a glycerine suppository. To be honest, this was one of the most traumatic experiences of the whole process for me! I was later given some herbal stool softeners by the nurses and that helped. I wish I had them sooner though.
I had my catheter removed on day 14. The first pee wasn’t hard but definitely messy and it stayed messy for a few more weeks. It still gets messy often. What I mean is that I will end up spraying a little over myself and will have to use the shower or a wet wipe to clean up. Back in Thailand when I was in the apartment, I would always use the hand shower in the shower to cleanup. I was so worried about getting a UTI that I didn’t wanna take a chance. Thankfully I have been UTI free so far.
By week two the dilations were up to 40 mins x 3 sessions. It actually takes longer than that to setup, reach depth, switch dilators and then cleanup. I would say if 30 mins extra per session so about 3 - 3.5 hours per day. It’s a lot of time and my life definitely revolves around dilating. I sometimes miss a dilation here or there and it’s fine. However after the long flight back home the dilations have been a little more uncomfortable. I didn’t lose any depth but definitely the ease of dilating. I think it’s temporary and will gain it back.
In general, the dilations haven’t been painful. They are just tiring and sometimes leave me feeling uncomfortable. They do get a little painful when I need to move up to the next size. That’s the only time I use the doccaine jelly now (topical anesthetic). Other times I can dilate without it. The most uncomfortable part is getting the dilator in. I am still getting a hang of it. Everything is so close to each other down there that it’s easy to push it into the urethra or the mucosal lining. I always need to use the handheld mirror (and usually a flash light!) to align it properly and measure the depth.
Dr Chet recommends that you dilate 50 min x 3 times a day for two years post-op but that just seems unrealistic and unnecessary. I am planning to dilate 3 times for the first three months and then drop it to 2x/day for the next 3 and then to 1/day for the next 6 or so. I would like to know if any other Chett girl has experience with tweaking their dilation frequency.
Overall, I would say that my SRS experience and results were better than I expected. During my stay in BKK, a lot of other girls felt similarly. SRS is full of potential complications and I feel fortunate to not have had any serious one so far. I read somewhere that SRS is more of constant low pain and I think I agree with it. You are almost always aware of the surgery with some kind of pain or sensation down there but usually it’s not crippling. The first few weeks are definitely challenging but you can sleep through them for most part. My coping up strategy with pain or discomfort was to lay down, try to sleep and let it pass. It usually worked well.
Now that I am back home, I want to resume my regular life but have to remind myself that I just had major surgery. It’s easy to overdo it and then find myself in pain or discomfort. Overall I am very happy that I had the surgery but I do feel overwhelmed now and then by the amount of time spent dilating. I am confident that I will feel much better as the frequency drops to 2x and eventually to 1x per day.
As I mentioned earlier, this was my experience in up until Nov 2017. I am quite happy with my recovery now that I am 1.5 years post-op and while I do have some more thoughts on the whole experience, I'll reserve them for a future post.