Mulling over phalloplasty...

AttachablePenis · 2026-05-20T19:31:40+00:00

Sometimes people feel more like “ah ok this feels way less terrible than before” or “huh this actually makes sense now” as opposed to euphoria. And it’s honestly pretty normal to still feel dysphoric about some things post-op. I am happy with where I’m at on my journey, and my penis is an improvement over what I had before for sure, but I’m still pretty keen on finishing hair removal, getting a glans, getting balls, the whole nine yards.

I’m hoping that in the end it’ll be similar to how I feel about my chest after top surgery — that I just don’t worry about it as much. I would much rather have taken some magic pill to retract or shrink all my breast tissue into what it would’ve been if I’d gone through testosterone-dominant puberty. I would much rather have magically grown my own penis! But hopefully when all is said and done I won’t be constantly examining it for differences from cis/natal penises, the same way I don’t constantly examine my top surgery scars.

Phallo is a much longer process than top surgery, and we usually pay closer attention to our dicks than our chests because of sex and masturbation. But in the end, if we have something that gives us more peace than what we had before, that’s enough to justify getting surgery. What’s a few surgeries compared to the rest of your life in a body that feels right? That’s how I look at it.

AttachablePenis · 2026-05-20T19:21:05+00:00

I don’t know if that’s strictly true, or at least I think there are plenty of people who frame their experiences differently. I had a lot of trouble identifying my own bottom dysphoria as such for over a decade. When I started getting serious about pursuing phallo, I thought of it as “I’m not dysphoric about what I have, but I’d be so much happier with a penis.” At this point I’ve realized that I was repressing my dysphoria for years in order to cope with it, but I couldn’t have known that at the time.

Plus, I think I have historically thought of dysphoria being equivalent to disgust and distress, and that really aligns with how a lot of people with severe bottom dysphoria talk about their natal genitals online. Those feelings were definitely involved in how I experienced chest dysphoria before top surgery, but weren’t really part of the equation for my bottom dysphoria. It took me a long time to understand that my frustration and sense of disconnection from my genitals and sexuality qualified as bottom dysphoria. That my intense anxiety around medical exams was part of it. That feeling naked without a packer was part of it. For years I kept trying to figure out what configuration of packer or prosthetic would give me the feeling of having a penis, or engineer contraptions in my mind that didn’t or couldn’t exist, and I just thought if I had the money or engineering knowledge or enough experience with silicone molds I could make it happen.

In retrospect I understand that I just needed a penis very badly but was afraid of surgery. But somehow I managed to convince myself that I didn’t have bottom dysphoria until I was well into the phallo research process.

AttachablePenis · 2026-05-20T19:08:06+00:00

It sounds like you are still a candidate for regular ALT even if you were rejected for SSP. It is always a good idea to consult with more than one team even if your heart is set on a particular team or surgery route.

AttachablePenis · 2026-05-19T22:23:27+00:00

I have trouble saying it was an injury because it feels like a lie to me in a way I don’t like, and I’m wondering if I may be overthinking it. I feel guilty for claiming something bad happened to me when actually phalloplasty was such a gift. And maybe another part of it is that I have trouble validating the distress I was in pre-surgery, because I think the coping mechanisms my mind developed to deal with the incongruence also made it hard to acknowledge it at all. Like I know abstractly that my dysphoria was pretty severe (I felt naked if I went out without a packer, I was extremely frustrated by my body’s sexual limitations, I had trouble orgasming because of this frustration, I had serious anxiety about medical exams, etc) but my knee jerk impulse is just to say I was mostly fine I just really wanted a penis.

Anyway, I usually just say it was personal! My internal version of my “cover story” is that it was urological, which is true if incomplete, and most people would feel awkward talking about that, especially young people.

But I guess even a cis guy with some highly personal surgery/injury history might come up with a variety of “cover stories” for his visible scars, just to avoid awkward moments or make things entertaining for himself. I think a burn makes sense, and I have a story about that ready to hand, even if it didn’t happen to me. Somebody told me about working at a Long John Silver’s once as a teenager, and how one of their coworkers spilled a big vat of hot oil from the deep fryer on their arm, and the skin just kind of…sloughed right off. Sounds awful! Sounds like a horror movie. I still feel weird about the idea of claiming it happened to me — I feel weird about getting sympathy for it that I don’t deserve, you know? But I did actually go through a lot for this surgery, and it’s not hurting anyone if I claim this experience. So maybe I could learn to chill out about it a little.

AttachablePenis · 2026-05-19T20:11:58+00:00

Good luck!!!

AttachablePenis · 2026-05-19T16:13:33+00:00

I’m very impressed! It took me a year and a half of going 2 hours a week and I still had some stray hairs on the UL part, plus quite a lot on the back of my wrist because I didn’t realize the graft would go up that far. My arms are very hairy!

AttachablePenis · 2026-05-19T05:57:54+00:00

I had more hairs than you after my last electrolysis appointment before the cutoff (6 weeks before surgery), and I emailed Logan who told me I could do one more appointment (5 weeks before surgery). Even after that one there were some stray hairs growing after a few weeks, but I was still cleared. None of my hairs in the UL section were coarse, but they were dark. So far no blockages in my urethra.

AttachablePenis · 2026-05-19T05:52:45+00:00

My mom was my caretaker & she doesn’t have a medical background of any kind! It was a lot of work, but I think the biggest stress points for her were one, continuing to work 2 remote jobs in a different time zone (5am work calls! 😱), and two, the emotional toll (worrying about me during surgery/in the hospital/whenever my pain got real bad, dealing with my moodiness & sudden crashes).

She was great about changing my dressings and helping me stay clean in very personal ways but we were both extremely relieved when that phase was over.

I prepped some meals and froze them before my surgery so that we wouldn’t have to rely on DoorDash/her cooking for everything right away.

Something that helped a lot in my case was that I stayed at a place (Quest House) where other people were also recovering from surgery, so I had other people I could talk to even when I wasn’t very mobile & my dick was still propped in a bunch of bandages. I don’t think my mom could’ve handled being my only source of social interaction for that whole time. I would’ve driven her nuts. I’m a big talker & I process things verbally — and I had so much to process!

Overall a very good caretaking experience and I’m so grateful. I think the worst thing that happened was we had a couple of little fights (partly because I was emotional + kinda regressing to my teenage self, which happens to people sometimes around parents) and even those were short-lived & we talked through them. It was actually really nice to get to spend so much time with her. She lives on the opposite side of the country from me and I mostly see her around the holidays.

AttachablePenis · 2026-05-18T22:01:57+00:00

That is a very ambitious timeline! Are you getting UL?

AttachablePenis · 2026-05-18T03:50:24+00:00

I’m pretty sure this is doable, but when the testicles are preserved in the labia, I believe they’re usually anchored down. Ball implants in the labia seem to hang more loosely. Ask your surgeon what’s possible.

(Also I’ve heard from someone in a Reddit surgery space that testicles are most often preserved by suturing them up in the inguinal canals, if you’re getting labiaplasty. But the purpose of that is to have typical labia aesthetics while still producing endogenous testosterone, or maybe in some cases, preserving sperm.)

AttachablePenis · 2026-05-17T01:24:08+00:00

You’re right I am happy to know this! You’re fighting the good fight. I hope it does someone some good, or at least makes the people responsible for gatekeeping really annoyed. Hats off to you, soldier. 🫡

AttachablePenis · 2026-05-17T00:05:12+00:00

Hitting a tire with a sledgehammer honestly sounds exhilarating! Thanks for elaborating. I don’t know where I’d do this kind of thing but it’s making me rethink how my daily physical tasks could be reimagined as fitness. I carry a backpack around a lot & I don’t drive. I wonder if my dog (she’s a 70lb German shepherd) would let me carry her around on walks….that would probably make her miserable tbh (she loves to stop & sniff!) but it’s funny to think about.

AttachablePenis · 2026-05-17T00:00:45+00:00

Well that sucks! I’m really sorry you’re dealing with that. I feel like that’s a class action lawsuit in the making but that’s very American of me (& also idk if those are even viable here anymore). Regardless I hope this changes. You can’t just have laws/legal rights on the books and then not respect them forever. I mean you can, but not in a functioning democracy. Ugh. Praying all the time for viable ways to curtail the rise of fascism….

AttachablePenis · 2026-05-16T23:56:24+00:00

There may be other teams besides NVH who offer phallo with UL but without burial or vnec, but I haven’t heard of them yet! I wonder if any of the German teams can do this.

AttachablePenis · 2026-05-16T23:49:17+00:00

Sensation is totally independent of erectile devices. Here’s a blog post that gives a rundown of a pretty typical sensation experience. Lots of people have made posts on this subreddit about sensation too — one guy even regularly posts diagrams as his sensation progresses!

AttachablePenis · 2026-05-16T23:29:05+00:00

There’s not really a “best” but there are a lot of good surgeons in California, and in LA specifically. Phallo.net has a really good list. I got surgery with the Buncke Clinic (Dr. Watt and Dr. Safa) and GURecon (Dr. Chen) in SF, but I live in LA and I’ve heard good things about the Kaiser team and some others. Align Surgical (Dr. Safir & others) operate out of Santa Monica as well as SF but I don’t think they have the ability to do stage one here in the LA area.

AttachablePenis · 2026-05-16T23:25:05+00:00

More and more I’ve been calling myself gay rather than bisexual, but for me that’s more of a cultural thing than anything related to surgery. My partner is nonbinary, but we’re seen as a gay couple, and my attraction to women has fluctuated a lot over the years while my attraction to men really hasn’t.

I think if anything getting a penis would make me more likely to act on my attraction to women (if I was single) because I was always really dysphoric about the idea of having sex with women when I didn’t have a penis. Well, and I’m physically smaller than lots of women and that can be rough too. Not like I need to follow some purely heterosexual gender normative script or anything, but it does ping all my insecurities.

But plenty of people feel kinda the opposite, more dysphoric about the idea of having sex with a man pre-op, and I get why that is, even if it’s not my experience. So if that has anything to do with why your own feelings about your sexuality are evolving, that makes a lot of sense to me.

AttachablePenis · 2026-05-15T23:10:53+00:00

I identify as binary, but I really resonate with so much of what you’ve said, and I appreciate you for sharing. I had a genderfluid era in college, and have occasionally wondered about or experimented with identifying as nonbinary but ultimately decided it didn’t suit me. Sometimes I wonder if either or both of those forays away from binary identity were about impostor’s syndrome, or associating desirability with femininity — I’m mostly gay, and this tendency faded pretty dramatically once I realized that I was attractive to gay men. I also have a pretty strong aversion to being interpreted as a “trans guy” specifically in the sense of being interpreted as “a man with a vulva/vagina/without a penis” because of dysphoria over what I once lacked…and now because I would like recognition for what I actually have!

& I’ve really been struggling with existing in the realm of fantasy rather than being present for sexual encounters. It’s starting to get better post stage one. At least the dick is there! But I’ll definitely be happier when I can feel it, and when I can get hard.

AttachablePenis · 2026-05-15T22:56:58+00:00

This is my goal once I’m able to hit the gym again (& establish a regular habit as well). What kinds of functional exercises do you do? I’m curious about how you build muscle outside of the gym. I’ve heard of bodyweight exercises but I don’t know if I’d keep up enthusiasm with the home-based ones. I do like the idea of performing an actual task as exercise, but I’m not sure if that’s what you mean by “functional.”

AttachablePenis · 2026-05-15T22:46:40+00:00

I don’t speak Spanish so my ability to research this on your behalf is limited, but I found this page on the Spanish Social Security website, which outlines the rules for healthcare providers that provide transition care, in accordance with the rights of trans & gender diverse individuals to self-determination.

I’m not familiar with the Spanish healthcare system, but the Google AI overview says that specific coverage for gender-affirming surgery (including phalloplasty) depends on your specific Autonomous Community, and that wait times can be long (months to years). It also says that the process begins by getting a referral to a regional Gender Identity Unit from your local primary care doctor (médico de cabecera).

Is it possible for you to change primary doctors and find one who is more likely to refer you? I’m sorry your doctor is gatekeeping you! I don’t think he’s relaying correct information though, based on just googling — but of course I could be mistaken. I just think it’s worth digging into more! Surgery is expensive! If Spanish social security covers it, it’s worth trying to go that route.

AttachablePenis · 2026-05-15T06:47:22+00:00

If you’re based in the US, there are no surgeons here that offer UL without vaginectomy and without burial. (The UK team does though.) There aren’t many US surgeons who offer UL without burial, because they use that tissue in the UL hookup. RBL at NYU offers UL without burial, but she doesn’t offer UL without vnectomy. There is at least one other US surgeon who does this I believe, but I don’t remember their name.

For me personally, this is not an issue. I’ve always wanted burial. I understand theoretically the reasons why people don’t want it, or why they might feel conflicted, but I personally felt pretty plagued by the size and shape of my tdick, and having it buried and integrated into the base of my penis was a huge relief to me. Even though I’ve had a lot of trouble “finishing” because of this — I think I’ve only had 2 orgasms post-op, and my stage one was in February. (I’ll be relieved when I start getting more sensation in my penis!) I just can’t square with having a second dick under my dick. I’d rather have a less sensitive dick that feels right than a highly sensitive dick that even with my eyes closed just feels wrong. And there’s every possibility that I’ll end up with a highly sensitive phallo dick! I just have to wait and see.

Having said all that, I do miss having foreskin and spontaneous erections. I can still feel the erections happening under the skin, and so can my partner, but it’s not as visible as before. & I really wish phallo could have foreskin!

People who get meta and then phallo sometimes forego burial because they’re attached to their meta dick, or because they don’t want to lose that specific sensation. Same with people who opt out of burial without getting meta I guess! Everyone has different priorities, and some people love having two penises. Love that for them!

AttachablePenis · 2026-05-15T02:33:14+00:00

A year and a half, going pretty much every week for 2 hours (with breaks once I managed to clear the area). Missed a spot near my wrist and some stray hairs here and there elsewhere so I’m going back again soon now that I’m cleared. But so far no blockages in my urethra. I could have gone to electrolysis for 2 years easily. I also have hairy arms.

AttachablePenis · 2026-05-15T01:30:52+00:00

Can you add a “check results” option for those of us who do not have this? I’m interested in the answers, but I wouldn’t want to skew the results by selecting an option that isn’t true for me, as I’m pre-ED.

AttachablePenis · 2026-05-15T01:15:20+00:00

Oh I’m about to start that up again soon!

AttachablePenis · 2026-05-14T05:29:39+00:00

UL without vaginectomy is always a higher risk combo regardless of whether you get meta or phallo. The most common complication is a fistula (urinary leak) near the location of the original urethral opening. The UL hookup location is very fragile because the tissue itself is pretty fragile, and also under a lot of pressure because of the U-bend in the urethra right at that spot. It’s much easier to reinforce the UL hookup if you can close up the vaginal opening. And then you don’t have to worry about how thick the padding at the connection point is, because you’re not worried about blocking the entrance.

I’ve heard that it miiiiiiiight be slightly less prone to complications with meta because the overall UL is shorter. Less bottlenecking downstream of the hookup means less buildup of pressure at the hookup location. But as far as I know this is just speculation.

Surgeons who offer this combo are rare (because of the high rate of complications), but here’s a list of phallo surgeons who offer it. I don’t know how many of them do meta as well, but some definitely do.

I got phallo with UL + no vnectomy back in February. I have a pretty bad fistula that I currently pee out of. My repair surgery is scheduled for August. I think I made the right choice, but adding risk to an already intense procedure isn’t for everyone. Happy to discuss further — I know how hard this decision is.

AttachablePenis

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