These updates seem to be spaced out by six months - unintentional, I assure you. A lot has changed in my personal life over the last six months, but this page isn’t about that, so I’ll stick to the relevant updates.
In the end, I went to a local sexual health clinic. After explaining my situation the nurse didn’t seem surprised at all, and apparently this is a known issue in the NHS system (at least in our local area). They are currently developing a fix in the system which she said should hopefully be rolled out by the next time I need a smear test - so that’s good! (Results also came back with no issues, so it should be a few years before I need another one)
In short I’ve had no update, but it’s only been a year. The waitlist for masculinizing bottom surgery is a notorious pain in the ass at the minute.
As a plus, the previously linked article, "What’s happening with NHS phalloplasty and metoidioplasty?" by TransActual UK claims that metoidioplasty has been performed at Chelsea and Westminster Hospital as of January 2023, which is great news and indicates that at least things are in the works to try to alleviate the waiting list problems.
The last update with specific numbers (October 2022) approximates that New Victoria Hospital was performing ~23 procedures a month, in March 2022 the wait list for phallo & meta was 967. NHS England were aiming for 39 procedures a month.
Using a low-ball estimate of 25 procedures per month, that gives us a 38.68 month waiting list for someone referred around that time. Using the NHS goal of 39 procedures per month, that gives us a 24.79 month waiting list.
For quick reference, that gives us around a waitlist time of [3 years, 2 months, 3 weeks] at longest, and around a waitlist time of [2 years, 1 month, 3 weeks] at shortest.
This is assuming that the amount per month doesn't decrease.
I’m going to assume my maths is off so taking this as an extremely rough window, but as the specific numbers we’re using regarding procedures per month come from before my referral was sent through, I'm going to estimate that if everything goes well, the procedure will probably be between 2025 and mid 2026. Which, on one hand, feels like ages away, but we’re nearing the end of 2023…
I’m also not entirely sure if this is the wait list for the first appointment (discussion with the surgeon) or the rough wait list times from referral to procedure.
Whilst the wait-time is long, being on the referral list has given me more time to be conscious of what I really want, and to explore options. I wrote a list of my priorities before writing this, and they roughly match the ones from last year, so hey - consistency!
It’s time to talk about some mature (NSFW) developments in my life. I've put them under an expandable section so if you don’t wish to know, you do not have to.
So, I’m not young. I’m not old, either. I’ve been sexually active for over 15 years. And I thought I knew what an orgasm was; you do sexual stuff until it stops feeling good, or you start to feel tired, or it starts to hurt. I could never get the hang of masturbating - externally or internally. I’d do it every now and again (maybe a handful of times per year). I tried with my hands, I tried with toys, etc. and it felt… nice, but not amazing.
So earlier this year I discovered what I was experiencing wasn’t an orgasm. I don’t know what changed - maybe it was the position, maybe it was just luck, maybe after being on T for almost a decade my t-dick managed to grow the right kind of nerve-endings; but I was trying to masturbate and out of nowhere had an actual orgasm. At first I was worried because I felt oddly light headed and my vision felt bright, until I figured out what was going on.
So… yeah. It hasn’t changed my life overall or anything, but definitely changed my daily life. Previously my feelings on my sexual functions were “it’s fun with my partner, but I get nothing really from masturbation” - but now I do it every couple of days. There was a period of a few months after I discovered this ability where I was masturbating multiple times a day, every day. I think my body was just “lost in the sauce” of having discovered I can do this, but now it’s calmed down, and aside from the occasional “random week of intense horny-ness”, I think I have a pretty average urge to masturbate.
Without going into explicit details, after learning I can (clitorially) orgasm, I begun to explore other avenues and I can now also have penetrative vaginal orgasms if I’m also having t-dick/clitoral stimulation at the same time
The main thing this has changed in relation to my wants for bottom surgery, is that I definitely want to keep as much sensitivity as possible, especially around the areas I know are particularly erogenous - and the fact that I get stimulation from penetration vaginally means I’m leaning toward keeping that.
So with all that in mind, I’m leaning towards something… mixed, I suppose. Visually and functionally I want to have a penis (no size preference), but I’m paranoid about complications, and wanting to keep potential sexual function. There is a community for this over on Reddit, known as Salmacian, for people who wish to have a mixed set of genitalia, and I’m glad to know I’m not the only trans masculine person who feels this way. I’ve known about the community since late 2021, but mentally been weighing up if it applies to me and how I feel about my body.
I’m unsure if I’ve mentioned it here before, but it seems relevant to mention that whilst I was assigned female at birth, I later found out that I am intersex. It was flagged up as a possibility during my teenage years, but my GP didn’t see it necessary to investigate further and thought it might be damaging to me (???) to know. It wasn’t until I actually went to the GIC that it was… confirmed, I suppose is the right word? However, aside from more involved hormone monitoring early on and delaying my ability to be prescribed testosterone at first, being intersex hasn’t affected my transition. I am not sure if this will affect my ability to access bottom surgery, from what I’ve read it shouldn’t do, but you never know.
With all that being said, at the moment, I am looking at:
I am not interested in getting:
There’s a few questions I’m currently investigating/researching before I solidify what I want:
Finally, I want to document information on the current state of DHT (Dihydrotestosterone) (as a medicine, it is also known as Androstanolone, Stanolone, or Andractim), at least in the UK. For those reading this and are unaware, DHT in it’s cream or gel form is a specific type of testosterone which can enhance bottom growth in AFAB individuals. It does not, according to both studies and anecdotal online evidence, increase penile growth in AMAB individuals. It is a prescription-only medicine, but is very rare for it to be prescribed as it’s not produced anywhere in the UK… or in most countries. It is a rare medicine.
I am not a doctor, pharmacist, or lawyer, this is not legal advice. This is the law as I understand it as an unqualified citizen.
It is a Schedule 4 (Part II) controlled drug under The Misuse of Drugs Regulation 2001, listed under the name Stanolone. In simple English, if you are prescribed it, you are allowed to have it. However, if you sell it, it is explicitly illegal. What about if you import it, but don't have a prescription? That's a grey area, but one I would definitely lean on the side of illegal.
There has been some talk of compound pharmacies, however as of yet no one has managed to find one which will create DHT, regardless of prescription (UK GICs and GPs are often unwilling to prescribe medicine that isn’t readily available).
As with almost anything, you can find less than legal avenues of people selling this online. However… The vast majority of them are fakes. You’ll be paying for cream which at best does nothing, at worst… you have no idea what’s in it. Even the most “trustworthy” seller of dubiously legal DHT creams has a very mixed review rate, with some saying the DHT cream worked, and others saying it seemed to do nothing at all.
I’ll be writing a full article at some point about DHT and it’s legality, but for now, anyone reading this, it probably ain’t worth it.
I'm not scheduled to have an appointment (at least, I've had no letters), but developments in my life have given me pause and energy to write an update.
At the moment, I'm currently brushing up against my GP (in the US, I think this would be the "Primary Care Physician"?) on account of wanting... a smear test. Smear tests (or cervical screening tests) are very important as they screen for HPV, which can lead to cervical cancer. Whilst I did have a cearvical cancer vaccine as a teenager, it is still recommend just to be safe - and man, cancer is no joke. I'll take the awkward and uncomfortable test if it means a clean bill of health (or early detection, which saves lives!)
At least I would, were my GP not saying that they need "authorization" from the GIC or NHS Dorset to provide me with a smear test. They said I would need a letter of authorization, and that "even cis women need them [from NHS Dorset]" - except, unfortunately, that isn't the case, because my partner is a cis women; same age bracket, same GP - she never got a letter, just booked one when she remembered and there was no pushback.
Originally, I had phoned up when booking my last T shot, and on the end asked "hey, I'm over 25, I know my gender marker is down as M but I'm transgender man so have a cearvix [etc]. May I book a smear test?" I'm not sure if something got lost over the phone, but the receptionst insisted I needed an "authorization letter" and that "without one, [they] were simply unable to book anything at all relating to a smear test for a trans guy".
Now, I've been in the trans community for over a decade, and I've been part of a lot of support groups and heard a lot of weird siutations, but I ain't never heard of this - granted, not many trans men and trans mascs are comfortable discussing or even getting a smear test, understandably so, but I've heard all sorts of weird arbitrary rules relating to accessing healthcare and this wasn't one of them.
Thankfully, I got a lot of good advice on Reddit about the situation. Mostly that yeah, it's not normal and definitely not standard procedure. So I'm going to be going back to the GP, and if they won't do it, I'll find a local sexual health clinic and ask them.
A half hour ago, I had my appointment with the GIC. The last appointment I had was a year and a half ago, and at this appointment we discussed the future of my transition, primarily about bottom surgery. I am now in the process of being refered, and will thus keep this website as a diary of-sorts to track and document the stages of my journey.
Resources for transgender people, especially trans men, are scattered and far-between across the internet. There is no central resource of information which can provide a difinitive overview at present - and whilst this likely will not become truely difinitive, I would like to keep an account with as thorough information as I can to help future people who may be seeking bottom surgery, in particular, a form of metoidiplasty.
At this point, I am currently considering exactly what I want. Bottom surgery will likely (hopefully) be the biggest surgery of my life, and even though I feel dysphoria regarding my below-the-belt region, I am not as gun-ho about it as I was with top surgery, which I knew going in I 100% wanted and would not regret even if I were to have complications (which, thankfully, I didn't). Bottom surgery is definitely something I want, but I feel much more pragmatic about, weighing up the pros and the cons. I spent a long time contemplating whether phalloplasty was right for me, but ultimately decided that I'm comfortable with having a micro-penis, and the extra length and girth of phalloplasty would be nice, but not nessisary for me to live my life in a comfortable way.
I am going into this with the current certainties