There’s no dignified way to get through these surgeries. None.

Prudes need not apply. There are so many doctors and nurses poking and prodding down there that any delusions for an intimate aspect to your genitals will be shattered. Well, maybe prudes should apply. After all, we get to be born again virgins!

Some of you may find what follows to be rather ghastly humour. I couldn’t agree more. I enjoyed the gas mask before general anesthesia and I thought what gas I could pass until my bowels forgave the cleanse and antibiotics to be nothing short of a miracle. I’d mention laughing gas but they leave that one out.

I’d like to offer one idea of what could greatly improve the process: if we could will a fetish or two. Along with the ability to switch for those who are tops. Kink has much in common with lower surgery when it comes to pain, humiliation and perversity. How did I reach this conclusion?

It all starts with a harmless idea: you want lower surgery. Unless you have access to a hundred thousand dollars, in which case I’m looking for a sugar parent, you apply for insurance coverage. You receive your first of many forms to come. For your surgeon, there’s the outlining that you understand all the possible complications. Another has you swearing up and down that you do not nor will you smoke. The following form asks you to accept that should there be any glitch communication between your insurance, the hospital and/or your surgeon, you are financially responsible for the whole affair. There’s the other one where you forfeit the surgeon’s responsibility if you don’t comply with every aspect of after care. To say nothing of the exhaustive background health check. You’ll also need to keep hard copies of every flight, hotel, prescription, and so on for tax season. You may think the scariest part is the scalpel but even if it never gives you a paper cut, it’s the paperwork that will haunt you for years to come.

Before things can be added, you must clear out the insides. You begin a liquid only diet the day before surgery and do a cleanse. You’ve heard that Vaseline can be helpful to insert things in certain places but did you know it can also help when too many things are going the other way? You’ll never look at Vaseline the same again. Buy extra soft toilet paper, cherish your asshole.

A walk through of a typical post-surgery day:

You wake up; you take a painkiller. You drink water. You empty your catheter bag. You convince yourself this is as cool as standing to pee. After all, you are standing and peeing. It’s the little things in life. Well not so little anymore.

You remove your wound dressing. You hook your catheter bag to the inner rail in the shower. You hold your JP drain in your non-dominant hand. You creatively shower praying (even if you’re an atheist) that you won’t move more than 2 inches in any direction. Your evil mind plays out all the different ways any one of three tubes could come ripping out of your body. You finish two of eight daily wound dressing change. You consider buying stocks in 3M and Polysporin.

You take medication. You drink more water. You select your next least favourite pair of underwear. You wish you’d kept more old undies over the years. You eat, and take more medication to counter the side effects of the first medication. And another painkiller. You check and adjust your catheter tube for air bubbles. You feel some faint relief in your belly. You briefly rest.

You do a wound dressing change. You empty your catheter bag. You drink more water. As per post-operative care instruction, you take a walk. You. feel. accomplished. You do another wound dressing change. You curse the latest stained pair of underwear. Every time you walk. Seriously. You take more pills. You apologise to your gut for the medications’ side effect. You’ll never take it for granted again.

You drink more water. You play with the catheter tube again to pass more air bubbles. This is the highlight of your day. You take more medication. You receive e-mails from colleagues, friends and family asking how you’re enjoying your “vacation”. Your catheter bag breaks open. There goes your internet. They’re spared the full extent of your eye roll. You call the surgeon’s office after hour line and request another catheter bag. You engineer your latest temporary fix to get the content of your bladder through the night. You do another wound dressing change. You pass out.

This routine, and its variations, done over several months should count as several credits towards a nursing degree. To say nothing of the practice you get at stitch and bolster removal, learning how to inject into ports and managing referrals between medical professionals. Scraps credits, you should get a whole diploma.

It’s time to get rid of your catheters! You’re given a beaker and off to the toilet you go to find out how much your bladder muscles have atrophied. If you’re like me, the nurse applauds when you report back a miniscule post-void quantity. If your parent(s) could only see you now, rocking that toilet training. You’re cleared to go, you proceed to confidently strut out. Suddenly, you feel the teaspoon worth of pee that didn’t quite make it out while you were over the toilet bowl become a pee stain. Stay classy.

Your inflatable erectile device is left partially inflated the first month. Combine this with post-op swelling and that isn’t a banana in your pants, you are happy to meet every body. You laugh at yourself, thinking your current girth might be on par with Ron Jeremy’s. You google the porn star’s dimensions to find out you are presently bigger than him. Penile implant is a day surgery, so that wider than a pop can erect dick is what you’re trying to conceal on your way home. Mercifully at least you’re not as long as Ron. It doesn’t matter that it’s warm outside, nor that the hospital is in a posh part of town, you’re rocking jogging pants and a trench coat. Staying classy.

For better and worse, the catheter isn’t in long for your penile implant. What could go wrong with having it out fast? No one’s concerned about your bladder muscles. Before we get to that, you grip the patient bed with all your might as you’re implant is deflated for the 1st time. Whoosh: you let out a small stream of pee that manages to cover an unfortunately impressive surface area that includes your nearby clothes. You didn’t foresee this and don’t have a spare pair of pants. The nurse re-inflates you and hurries you out in your pee stained clothes. This gives new meaning to walk of shame.

Eventually, the banal need to pee returns. Your erection makes it impossible to use a toilet bowl, unless you intend to clean the entire washroom floor. Since you don’t have a urinal at home, you get into the shower. If you must make due with a bathtub, you contemplate softly sobbing. Your tried, tested and true way of milking out the last teaspoon of pee since completing urethraplasty is presently useless. You carefully try to lean over in some fashion to get some of the last bit of urine out. You are determined to wait this out. You stand leaning there for a while. You have nothing else to do with your time but wait this sucker out. Minutes go by. You rinse yourself from the belly button down. If you don’t have a handheld shower head, you consider softly sobbing some more. You pat yourself dry. You use a tissue to get any residual moisture. You put underwear on and leave the toilet. You might make it to the end of the hallway when on cue, there goes the last of the pee. You summon a way to retain composure. You remove your underwear, dry yourself again. Apply Sudocrem on your nappy rash. Reassure yourself that despite your current inability to use a toilet bowl or control your erection along with having nappy rash, you really are an adult. Repeat this a few times a day for a month.

As you prepare to return home, you look back fondly at those times you debated whether or not to pack silicone before going through full body scans at airports. A pat down is not an option.

You can’t do anything physically demanding for a while; even sitting may prove to be a sport but that doesn’t mean you must forgo having a hobby. Between the painkillers, anti-inflammatories, and antibiotics it is a matter of time before you geek out when you get a pill bottle in a new shape, colour or size. You compare the safety measures built into the caps depending on pharmacies, the size, colour and font of safety labels based on country and really, when you think about it, there are lots of fascinating things about prescription bottles. Start a prescription bottle collection!

Post pictures of your results in online phalloplasty groups. It’s the easiest way to have straight guys e-mailing to compliment your dick! Whenever possible meet up with other guys who’ve had phallo in real life. As you look through the crowd you’ll realize both of you are wearing pants and you’ve never seen each other’s face!

I’ve earned a reputation as one of the most entertaining patient in an OR. Here are 3 examples of neat things to do during surgery:

– Compare real life blood and guts with special effects in TV shows

– Debate musical tastes as though your surgeon and you are sipping tea

– Show nurses how to add the OR as a location to Facebook updates

Laughter is the best medicine and I continue my search to find it through this emotional as well as physiological roller coaster. And while I’ve been battling depression no one should doubt that I’d do it all over again. I wish the best of luck to anyone considering these surgeries.

Written in 2012 intended to be performed as a spoken piece but sharing by request. Edited and updated in 2016. I hope the tones and sarcasm come through in text format.

If you’re struggling with post-op depression following lower surgeries, check out this list of suggestions for what may help. Know you are not alone and there are resources out there to help.

PS This isn’t intended to capture a non-existing universal experience.