I don’t disagree that getting out of OK is a top priority, I just think it’s going to take a while to make a move like that happen. You can get on HRT much more quickly and it will likely provide immediate benefit.

It also makes sense to come up with several plans to leave the state, some of which are quick / emergency style plans (just get out even if it means temporary homelessness in a trans refuge state) while others are more ideal (move into housing with your stuff, with your family, etc.) but slower.

I certainly drew up several plans and also wrote up an escalation of what exactly would trigger the emergency plan.

For me, that was legislation being passed or change in law enforcement such that simply being trans was directly criminalized - i.e. trans people being picked off the streets or being targeted door to door and put in prisons and forcefully detransitioned in prison (like they are doing in Florida). That was my “red alarm” level, I get in a car and flee the state even if it means being homeless and not having any of my possessions, etc.

Luckily my state did not manage to pass any such legislation in that year I was trying to move (though I will note, Texas did attempt to pass a bill that would have criminalized all trans people, and luckily it did not pass), and I managed to get out under ideal circumstances.

There are relatively affordable trans refuge states like Minnesota (which is is in the upper half for affordability) - while it would be better, you don’t have to move to a big city to be much safer and have access to healthcare.

Here are some other considerations:

https://www.erininthemorning.com/p/top-5-states-to-be-transgender-in

Another benefit to moving to a blue state is you are more likely to earn higher wages and enjoy better benefits, as unions are more common in those states and the laws are more equitable. Depending on where you move, there might also be more programs to help assist with a disability (even financially). For example, Minnesota has various services for disabled adults, and a food and financial assistance program for families with low income. I don’t know what it’s like in Oklahoma, but where I was in the South there were not a lot of supportive services or programs like that in the state I came from.

The bigger struggle will be with affording the costs of moving / relocating - it’s expensive to move, if you need a truck to bring furniture across state, it might be cheaper to try to sell most of what you own and move with as little as possible. Otherwise, it can be thousands of dollars to rent a truck and move it across the country.

There are potentially funds you could apply for to relocate:

https://www.hrc.org/resources/emergency-funds-for-relocating-families

Finding a job in another state is another major hurdle / challenge.

But that’s why right now it’s just a matter of sketching out a plan and moving towards it, this is a big project, don’t have to have everything figured out at the start. It took me almost a year from when I started planning to when I was able to actually get out.

eh, I’m not going to lie, that sounds awful and I wouldn’t wish that life on anyone. I spent a decade like that - cross-dressing in private and not socially or medically transitioning. I almost didn’t survive it, and unfortunately that’s not uncommon.

I have a trans girl friend IRL who was in her 40s when her egg cracked; she lost her marriage as a result of her transition, but is much happier now and in retrospect is glad she transitioned even though she lost her marriage.

Obviously I don’t want to give the advice that trans people should always just disregard their family in favor of transition, because that doesn’t seem right to me - but most of the time because the social situation views transition as immoral, as a matter of personal choice or lifestyle, and so on it’s not viewed as a medical concern and isn’t taken seriously, so people get stuck and they capitulate to their spouses and they don’t transition. From a social perspective, this creates a situation where people are living in a repressed state, often with serious mental health issues, and this obviously increases risks of suicide, self harm, and drug abuse. So from a clinical and social perspective, there clearly needs to be some balance here, and trans people generally need to transition to avoid those harms, but that has to be done in a way that isn’t unethical in the context of the family.

Sometimes this means the marriage has to end, though this is more common when the partner is straight. Luckily my partner was pansexual, and that’s probably not that much of a coincidence if I’m being honest with myself. I’ve never been with a straight person, and that is some luck (or maybe it’s a kind of selection).

Either way, I really feel for anyone in the position of choosing between transition and their family - and to be fully honest, I would have never transitioned if that were my situation. In the end, I only transitioned for my spouse, it was a bit of a reversal - my mental health issues were causing so much distress to my partner that I realized I have a duty to take care of myself so that I’m not a burden and not creating so much distress for those that care about me. In the end, I didn’t transition for myself, but out of a sense of obligation or duty to be a better person to those in my life.

EDIT: looks like OP’s wife is supportive, which is a huge relief and great news all around

for a lot of us HRT is a terrifying step and we build it up as you say as invasive and risky - this is mostly due to social pressure not to transition. In reality, the risks are extremely low to non-existent, and the potential benefits are literally life saving. A lot of lives would be saved if HRT were the first step. It very often clears up depression, anxiety, and suicidal ideation without any other treatment, and for many it feels like the first time they were starting to be alive.

Clinically I think it’s unethical to play into false narratives that HRT is risky, irreversible, or severe - instead I think it should be part of the first steps someone takes when they come to realize they have dysphoria, since the risks are so low and the clinical benefits are so well demonstrated.

Not that I don’t acknowledge the psychological reality that it will continue to be perceived as risky and something people should wait to do and thus will be a scary and intimidating step, but then I feel that is all the more reason for those of us who know better to try to help compensate the social pressures against HRT by encouraging and reassuring early transitioners that HRT is low risk and life-saving.

One of the reasons I list it as the first step is because the depression that is so common in untreated trans people makes everything harder to deal with, egg cracking and looking at how to socially transition is stressful enough without depression, so by treating the debilitating anxiety and depression those challenges will be easier to take on. Simply put, addressing depression first helps address everything else.

Before estrogen, I could barely manage to go to the grocery store once a week. After estrogen I was able to clean and declutter my house, run errands multiple times a week, and generally became mentally normal for the first time in my life. So many of us experience this, and from a clinical perspective it seems more than worth it to encourage that treatment be started as soon as possible for others with similar symptoms. In the worst case scenario, if after a few weeks no mood changes happen and it’s not helping, they can stop HRT if they don’t feel like continuing at that moment.

It could be a lot worse - a lot of folks don’t realize until their 40s or later, 34 isn’t too bad! And Oklahoma isn’t as bad as where I lived for roughly the first two years of my transition, in the South.

My story sounds pretty similar to yours - I also rationalized in similar ways (my intense feminism, thinking women are just better and easier to get along with, thinking of myself as non-binary so I didn’t have to think about transition seriously, etc.).

In my experience it’s scariest at the beginning, it only gets easier from here.

The main generic advice at this point would be:

1. start HRT first

I know this sounds like a much later step, but it’s actually one of the first things I would do: it is a useful diagnostic step, changes are very slow and it can take a while to even get an appt. to start, and it’s extremely low risk and potentially extremely helpful for mental health - you can even stop HRT anytime within the first 3 months without any permanent changes, and after that the only permanent change you risk is having breast bud growth that sticks around.

2. educate yourself

Read any trans related educational material you feel might be useful, but here’s a starting list:

• Gender Dysphoria Bible
• Whipping Girl by Julia Serano (and Sexed Up as well)
• Yes, You Are Trans Enough by Mia Violet
• “What Does the Scholarly Research Say about the Effect of Gender Transition on Transgender Well-Being?”
• An Introduction to Hormone Therapy for Transfeminine People

You might also find helpful this longer list of resources.

I’ve also put together some tips on how to help with dysphoria you might find useful.

3. get a trans-affirming therapist who has worked with trans patients

It is helpful to work with a therapist, especially early in transition. You might also need them to write letters for you down the road for insurance to cover certain things.

4. if your partner is straight and/or worried about your transition, consider a couples therapist

Unfortunately a lot of marriages go through major changes (or in the worst case, don’t survive), so it can be helpful to work with a therapist to help navigate transition in the context of your relationship.

5. start sketching out plans to leave Oklahoma

Honestly you should do this even if you weren’t trans, all kinds of important metrics like quality of healthcare, health outcomes, risks of being in a car accident or victim of a crime, etc. are overall better in blue states where the government is functioning better.

Being trans is just another reason among many to leave for a better place.

That said, moving is hard. I recently had to flee from the South and I lost my home, left behind all of my friends and family, and I ended up losing my career of over 10 years. I’m still thankful I did it, but I understand it can be hard. You don’t have to have it figured out now, but at this point it’s a good idea to have a plan to escape and to work towards it.

6. relax and remind yourself you will be OK

egg-cracking is distressing, just remember that this is the hardest part and that it gets better. Pay attention to your emotional needs and take mental breaks from the topic and pace yourself. Find a way to stay within your threshold of tolerance. Seek support and help from supportive friends and family.

7. find a local trans support group and start attending

Admittedly this will have various downsides, but community is important when you are trans. It is how you learn where to find healthcare, which providers are safe, etc. When I lived in the South, I learned who I should see for everything from the trans support group - even where to get haircuts. It can also be helpful to just be around other trans people, to know you aren’t alone in what you are going through.

If your city has a pride parade, usually you can find the trans support group by checking out the organization that organizes the pride parade and other events in town, there is usually at least one big LGBT+ organization in every small to mid-sized city like this, even in places like the South, and usually they host a trans support group.

Feel free to reach out with any questions. I know it’s crazy to say this, but congratulations - this is a huge step for your health and well-being, and I’m so happy for you. I know it’s hard, but life is likely about to get much better soon 💖

Not all cis women have inner labia and imo your result looks pretty good.

while it’s true that not all cis women have inner labia, it’s rather rare and is even considered a condition, labial hypoplasia.

Labial hypoplasia happens often with intersex individuals, usually something goes wrong during puberty to cause it.

Anyway, your message is kind and helpful - there is no reason to be particularly normative about this part of the anatomy, since it is harmless and plays no major functional role …

I guess my fears are of being outed as trans by my genitals, though probably my surgery scars are a bigger threat of that than the lack of inner labia.

During my recovery, I had to reckon with and come to the realization that the sensations I feel are largely just the same sensations cis women feel.

I guess I struggle with feeling this is true - I suspect cis women have different qualia for lots of reasons … but still, the overall gist is probably right, and it’s certainly true that it’s more similar than different.

It took quite a while before the feeling of being constantly tucked went away for me, a common feeling early in recovery because of the way skin is being pulled and things need time to settle.

yes, omg! This was such an adjustment for me, I hated feeling like my penis was still there, just sewn into me - such a weird and awful feeling. It really has gone away as I have healed, I suspect because the inflammation and pain around the phallus has gone away and thus so has the constant sensation generally.

In some ways, we actually have a bit of an advantage imo because you can most likely do a revision to move / reshape things especially in the clitorial area to your liking with a revision. My surgeon was specific that there are limits in what she can do visually in the original surgery and that things like inner labia are more doable in revision, which doesn’t necessarily even have to be in an operating room. I asked for and got significant changes to my clitoral hood and inner labia definition just in her office with local anesthetic, it took like 45 minutes.

Unfortunately I moved far away from where my surgeon is, and I am currently having to fly back for post-op appointments (very expensive) … it’s very unlikely I will have access to revision surgeries, and the current plan is to discharge me 6 months early and not bother with the follow-up appointments I would have otherwise had.

Really interesting that they were able to do out-patient revisions with local anaesthetic in such a short time - thanks for sharing that, I didn’t know that was a possibility.

If I were to prioritize surgery now, it would be FFS or potentially a VFS, as my face and my voice are the two biggest sources of dysphoria for me. Revision to form labia minora would be nice, but I’m too pragmatic to prioritize it, given that it doesn’t create dysphoria for me as much as my face or voice.

Knowledge does not seem to help you.

I want to embroider this and hang it in my house 😆 What a pithy observation!

Two things I learned early in transition and helped me come alive on the other side. These two things (and faith). The axioms are: 1) Being trans sucks. 2) But being trans is not wrong.

hm, I guess I don’t think being trans is wrong the way that hurting someone is wrong, i.e. it’s not immoral, but I clearly have attitudes that being trans is monstrous - akin to the way we might see someone with a birth defect, burn scars, disfigured or amputated limbs, etc. - there is a body horror to being trans that betrays the social attitudes I was indoctrinated with growing up (assuming there is not some deeper biological impulse to avoid the disfigured and diseased).

Exposure therapy has been helpful, and my overall distress from trans people is much less now than it was at the start.

But surgeries do not resolve trauma and setbacks formed through years of closetedness, dysphoria, and denial.

I am beginning to feel like this is one of the biggest sources of my continued distress - it’s not just that I am trans, it’s that I lived so long as a man and what that did to me (physically yes, but mentally is what I mean).

My entire way of thinking about myself and even about both genders has been informed by coping mindsets - I was raised partially by a deeply hateful misandrist, and my dysphoria flourished and intersected with that misandry nicely. I came to hate myself for being a man and to hate all men, etc. I also thought in salvational terms: that all men should want to become women as they are obviously superior, and that my own desires to have been born a woman makes sense because I simply recognize the superiority of women.

This led to weird places, like learning to identify my feminine thinking and behavior as masculine, and struggling in the end to even acknowledge masculinity exists in other people (since I struggled to identify it as masculinity).

Anyway, this is just a small window into how upside down and confused my whole socialization and systems of belief were formed growing up, and I completely agree that the years of staying closeted and deeply dysphoric and in denial have really fucked up my mind.

But I have get across other people who like you have gone through surgeries to find something to be desired at the other end.

I do think this is the right take-away, the fact that neovaginas are lined with skin that will never be like or function like a natal vagina is a technicality - the bottom line is that vaginoplasty has excellent outcomes and are totally worth it. (Even if it’s not quite as good as you mentioned.)

As a congenial stranger, a fellow trans person, I see you deprive yourself of options and also deprive yourself of happiness.

I should be clear that my clarification about the differences between a natal and neovagina don’t particularly rob me of any happiness - sure, it’s a little unsettling, but it’s just something to adapt to for me, it doesn’t feel like a complete invalidation of my womanhood.

I am sensitive about the anatomy not looking “right” and the absence of labia minora, for some reason that does strike me more as missing out on some normative sense of having a female body - but realistically I know most people will not notice the discrepancy or think I’m not a woman because of these differences. I know they are just something that bother me.

I wonder then what options you think I am depriving myself of … I agree with you that I deprive myself of happiness, but I also wonder if you could expand more on this, I assume you just mean that by obsessing on small details I undermine my own happiness? (Just want to make sure I understand your observations!)

You will definately benefit from therapy, although finding the right person can be challenging. Mine was an LGBT specialist, but had also a background in cognitive therapy and dealing with trauma. I had other therapists before, and had lots of groundwork done before even tackling transition issues. (Don’'t get me wrong I would never achieve a basic level of psychological functioning without transitioning.)

The last two therapists I saw were specialized in LGBT+ issues (which, living in the South in the U.S., that just meant they were themselves LGBT+ or allies, and were willing to see LGBT+ patients; as far as I know neither of them had any actual formal education on LGBT+ issues). I tend to be choosy about my therapists, e.g. I only choose therapists who have PhDs in psychology. I’ve seen therapists whose education and specialty were in trauma (that’s the biggest complaint / area I have sought therapy for, though none of it helped me for over the decade of therapy I went to).

The penultimate psychologist I saw did tell me that I was her most challenging patient, and she told me I was good at rationalizing - we focused more on trying to stay in an emotional space and explore emotions & feelings rather than thoughts, and that seemed insightful … now when I journal I try to center my thinking around my feelings - what am I feeling, what are the current emotional tones, etc.

You had many therapists and none helped. With all respect and solidarity to your troubles, this might mean that you are not allowing yourself to be helped.

I mean, I saw a psychologist for years with the explicit therapy goals of not wanting to be a man and wanting to undo my male socialization, and not once was it suggested that I might have gender dysphoria. Before therapy I sketch out the major issues I’m having and I come up with goals and plans to address those therapy goals. Therapy is expensive, and I was paying for therapy even when I was a dishwasher and couldn’t afford it (my therapist had to offer me a reduced rate, and had no access to health insurance, so everything was out of pocket - therapy was a major chunk of my monthly budget). So I wouldn’t say that I wouldn’t allow myself to be helped; I don’t mean to be antagonistic, but you should probably be aware that this can feel a bit like victim blaming, the idea that if it doesn’t work for someone, then it must be their fault - it’s a possibility (and not an unreasonable one to point out), but it’s also possible I was failed.

I tend to think that psychology is just not a matured discipline and operates on poor theories, and at the very least most psychologists leave the field ill equipped to deal with the kinds of issues I had. For example, I don’t know that a psychologist would ever learn about gender dysphoria in school, and certainly none recognized it in me (and to be fair, I didn’t acknowledge or recognize it in myself either - though I didn’t have a PhD, I shouldn’t have to be the expert).

Many therapists will also be intimidated by your intelligence and attention to detail. This is a tricky bit, with many of us, growing up accustomed to being the smartest person in the room.

I did not grow up as the smartest person in the room, though at some point I did focus on my education as a form of escapism, and that leaves people with an impression of intelligence. I tend to think my intelligence is rather average, but I’m starting to think what people mean by intelligence is more like “education”, and I can understand that I come across as educated. I actually am beginning to suspect I might be on the spectrum, and that might be part of why I give off the “intelligent” vibe to people - what’s probably happening is that I’m just not socially modulating well, after I dove into books to escape reality, my words changed and I didn’t ever learn all the ways to apply them, so my language comes across as pretentious or learned, but really I’m just unaware that I’m violating social norms when using certain words. This has created problems in my life - I had a lot of unfortunate interactions during the blue collar jobs I worked …

Anyway, I don’t know what therapists think of me or my attention to detail. I would have hoped it was helpful, I always tried to be very transparent in the way I was thinking … in the end it was rare that a therapist had insights to offer me, and sometimes I wonder if this is because I had tried to do my homework before I go into the session, and there wasn’t much left for them to offer.

Either way, it still leaves me in the situation that it’s a high cost (time and money) for a low reward. Still, I tend to think going to therapy is a good idea - at the very least it means I’m spending time thinking about and actively engaging with my mental health issues, it forces it as a priority. There is value in that. Also, you never know - with a new therapist maybe they will have information or a perspective that will help you, I cannot say I know they won’t be helpful even if most of my experience in the past makes me think it’s unlikely.

You have your advanced takes on things, your intelligence and diligence and it might be hard to make yourself vulnerable enough to allow and be helped (either by therapy or faith). But you’re setting yourself up. You need to change route, and I worry about you.

I definitely have a hard time being vulnerable in a sense - I do think I tend to be completely open and transparent with people (and my therapists in particular), but this can sometimes be different than being emotionally vulnerable. I don’t know, maybe it’s a new skill I’m learning - to allow myself to feel and to do that in front of others.

Anyway, yeah - thanks for your worry, I guess I’m a little worried too … I didn’t think the hardest part of being trans would be thinking of myself as a woman. I kinda assumed that part would be easy or automatic for trans women … Also, my self esteem is pretty bad, been struggling a lot recently with feeling worthless since I lost my job.

Instead of trying to nullify your transness, consider what being trans has done to your psyche

This is insightful, thank you 🩵

You’re definitely not overstepping, thank you for your comment!

Regarding trans theory, I was wondering what you would recommend in particular.

Here are some of the resources I’ve read or watched:

Let me know what you would recommend!

Your tissue down there is the exact same tissue that it would be your vagina. The surgeon restored the vagina you would have naturally developed.

I wish this were true, and while the general gist is that the surgery follows the guideline of trying to put anatomy back to how it would have been if it had developed “correctly” - there are several important differences between a natal vagina and a neovagina.

A natal vagina, for example, has a cervix that produces a mucous that flushes the vagina and contains glycogen that feeds lactobacilli, which in conjunction with acidification from the activity of the estrogenized vaginal epithelium, is supposed to create an acidic, low pH environment in which other bacteria cannot grow.

The scrotal skin lining in the case of penile-inversion vaginoplasty does not function like vaginal epithelium, and the lack of a cervix to produce mucus is why neovaginal bacterial microflora is usually typical for a vagina with bacterial vaginosis (BV):

https://pmc.ncbi.nlm.nih.gov/articles/PMC2695466/

The resultant BV & inability to “self clean” like a natal vagina is the reason my surgeon and others require patients to douche with vinegar solution every other day (otherwise the BV will increase risk of UTIs and pain).

Still, the overall gist about estrogen being the main lever for biological differentiation between men and women is accurate - especially with very recent publications that confirmed this, e.g. findings that trans women’s proteome matches cis women’s, and that cardiac mass matches gender after only 12 months of HRT which was previously not thought to be impacted by HRT.

I’ve worked with therapists in the past and found it unhelpful - I’m in the double digits on therapists I’ve seen, and the last two were specifically for gender dysphoria. It was necessary to get through the gatekeeping (had to get the letters for surgery, and in case I needed a referral for HRT), but in terms of addressing my dysphoria I found it mostly unhelpful.

One really great moment with a therapist I had, though, was when I was struggling with knowing vaginoplasty was right for me, she asked me how I would feel living the rest of my life with the genitals I had then, and that was quite clarifying - clearly I didn’t want that, in the big picture I realized I would want to be a woman in every way I could be, and I would feel it was a mistake if 20 years later I had done nothing about that.

Anyway - all good advice, thank you … my life post surgery has been hectic (had to leave my home and move to a completely new state, and in the early part of my recovery no less, and afterwards I returned to and then subsequently lost my job of over 10 years). I probably should be seeing a therapist, I just don’t feel I have the time or energy for it given how little it helps me.

Thank you for your perspective and help 💙

well, technically it seems like just outer labia - I’m also overweight, and I don’t know enough to discern whether it played a role in the seeming absence of inner labia …

here are some pictures of results very similar to mine from the same surgeon (warning, NSFW images):

currently my outer labia tuck in where the clit is, and at the clitoris the skin is pulled tighter down. The tighter skin forms the clitoral hood, but the tightened skin doesn’t continue all the way down to form inner labia - at least not currently (maybe after a year of healing the swelling will go down and it will look different?) … also just not sure how common this is, I feel somewhat dumb for not asking more questions or doing more research on this part (apparently I’m not alone).

thank you! 🥰

and did not ask or talk about me being trans at all.

it’s not my business, but does he know you’re trans? If you’re just going on the assumption that “everyone can tell”, just know that sometimes people indeed do not realize (even if you think it’s blindingly obvious), and unless you have explicitly disclosed your trans status, he may not be aware.

(Not to add stress or anything - so glad you had a lovely date, you go girl!)

regardless, isn’t it weird to doubt the reason’s for someone’s erection when the reasons are being celebrated by OP? Like, if someone feels affirmed and happy about something, why suddenly apply skepticism towards it - even when warranted it’s still rude, and in this case it doesn’t actually seem that likely that an erection was due to “emotional excitement” …

That’s the thing about trans women, you can’t gaslight them about what it was like living as a boy or man, they also had involuntary erections and know what that’s like. When cuddling on a date, an erection is probably related to attraction … this doesn’t really need to be litigated (and if there is still a desire to litigate that and raise the nuances of why erections come about, it’s still basic politeness to recognize this isn’t the appropriate moment to do that in).

Trans people feel enough insecurity, tbh.

wouldn’t being appealing to a gay man be invalidating, since it just shows they are attracted to you as a male?

to my mind there is no reason to wait for an orchi, ASAP is best - it allows trans women to go off anti-androgens and the risks and side effects from them, or in the case of monotherapy it allows lowering estrogen dose to more normal levels (also reducing risk). This also saves money and like you said reduces the possibility of forced detransition or accidental detransition due to supply chain problems or political instability.

Preventing cancer is one of the least reasons I can think of to get an orchi, but I don’t know enough about testicular cancer to weigh in on that.

edit: and yes, I had an orchi, and I highly recommend it

edit2: 50 years is when screening starts for men with average risk, but for those with higher risk it can start as early as 40 (but that’s not typical for most men)

you could always just get PSA levels checked

in this case the symptoms and PSA levels tipped off cancer even when paplation would not have found anything…

the risk is pretty high in cis men, I think one in eight men get prostate cancer, and one in four Black men get it - so if you have spent much time with androgens in your body the risks are high enough it’s worth screening, but the loss of androgens in trans women lowers the risk enough that it seems dubious to me every trans woman should be getting prostate exams at age 50 no matter what…

this patient in particular didn’t start HRT until their mid 50s and their father had prostate cancer - so it makes sense they still got it.

yes, WPATH recommendations are currently to have trans women still undergo prostate cancer screening like cis men - at 50 you get the digital rectal exam and PSA levels checked.

If you have a neovagina, they palpate the prostate through the neovagina.

I suspect it would be less painful if you dilated more frequently, could the pain and bleeding be due to going 2 - 3 weeks between dilation instead of dilating once a week?

Even if you are lonely and single now, there is a future in which you may want that possibility, and the dilation might be for that future you, even if it’s just boring and a chore right now.

Either way, I’m sorry to hear about this - as someone who is dilating three times a day when it is painful and when it takes over an hour each time I dilate so I spend 3 - 4 hours a day dilating, I know exactly what you mean about struggling with motivation and exhaustion. (Talk about boredom, TV and movies have lost a lot of their appeal for me.)

But dilating only once a week sounds like a dream to me - I can’t imagine, it would bring my life back.

Have you considered incorporating masturbation & pleasure into your dilation routine? It’s possible to build new associations, even if right now it reminds you of your loneliness, it instead could become a ritual of self love and pleasure. (Maybe incorporate other sensual pleasures around dilation - chocolate, candles, a warm bath - whatever works for you.)

Also, I’ve heard of women using a dildo that is softer and meant for pleasure rather than a hard dilator once they are far enough out from surgery - I suspect you could experience some loss in width that way, but I don’t know how permanent that is (I’ve heard you can regain some width if you go down in size years later, but I don’t really know when stenosis is permanent vs temporary).

What dilator do you start with? I try to start mine with the smallest size (for me that’s the SoulSource purple) so that I can go deeper with it, and then I work my way up to the largest (orange). Maybe that could also help you regain / maintain some of that depth and reduce pain & bleeding?

There is no absolute requirement that you maintain a cavity or depth, it’s your choice and your future - it might be worth talking to a therapist about your priorities and goals, and whether the current suffering is worth keeping open the long term possibility of penetrative sex for you. There might also be middle grounds, like using a smaller dilator to avoid pain, or just masturbating with a dildo to keep some depth and functionality.

When I really struggled to come out to people, sometimes I would try a method like writing a little note on a piece of paper and slipping it to them. I found that easier than initiating the conversation by speaking.

My advice is to just not think about it - don’t anticipate, don’t fret, don’t think - just do it.

that changes, though - there is a tipping point for many where all the collective effort and changes from HRT finally coalesce into passing as cis, and then people (at least strangers) are more comfortable around you.

Some people who knew me pretransition still seem to see me as male, but whether they are comfortable is more about them - one friend felt so much relief at how feminine I was because she was worried about messing up my pronouns, and by passing and being so feminine, I made it easier for her to pronoun me correctly.

Others are obviously experiencing cognitive dissonance in direct proportion to how much I change from my pretransition, male past.

This is why I feel like not spending time with people who knew me before, and why moving to a new city was so helpful. Now I live as a “cis” woman full time, “being trans” is a part of my past in a way. (Obviously I’ll always be trans, but I no longer live as visibly trans - I’m free to live stealth now, which motivates not gender rotting, as well.)

All this to say, keep making effort because eventually it can really improve your situation. Cis people are uncomfortable with people transitioning, but they don’t understand what it’s like for us, or how important it is for our health. So ignore them, and then enjoy the irony when you start to pass when it seems so impossible for that to be true - cis people are also blind and gender-naive in a way.

Are you talking about the time he screwed up his estradiol cream dose (which he uses as a cosmetic) and accidentally over-dosed himself with estrogen and experienced gender dysphoria?