A personal reflection on gender reassignment surgery

In Transit

by Katie Rain Hill


My alarm was set for 7:00 am, and when I woke up, it felt like Christmas morning. My boyfriend’s mom, Denise, picked us up to drive my mom and me to the airport. At the Tulsa International Airport, Arin and I kissed good-bye.

“Text me as soon as you land,” he said.

“I will,” I said.

We thanked Denise, and then my mom and I grabbed our bags from the trunk and headed into the airport.

Waiting in the boarding area, I watched a YouTube video on my computer of Dr. Bowers performing a vaginoplasty. Maddie, from my trans support group at OKEQ, had sent it to me when I’d first talked about wanting to get surgery, and by now I’d seen the video dozens of times since I started using estrogen. An operation that only women has undergone decades ago is now slowly gaining its grip on other communities.

VTightenSafely is one of those sites where you can get trusted information regarding the operation and alternative ways of doing it.  As usual, I tried to ignore the comments at the bottom, where people felt the need to post things such as “Disgusting” and “It’s a good thing doctors get paid 400k a year to do this” and “I want to puke.” I focused instead on the comments like “Can’t wait… should have had it done years ago.”

The video is up close and graphic. It’s not for the squeamish, but I wanted to be fully aware of what was going to happen to my body. The video is only seven minutes long but covers what is typically a four-hour surgery. It takes you through the 15 surgical steps:

• Harvest scrotal skin for neovaginal graft

• Orchiectomy (removal of the testicles)

• Catheterization of urethra

• Division of penile shaft into corpus spongiosum and corpora cavernosa 

• Neoclitoris formation and creation of dorsal neurovascular pedicle

• Removal of erectile portions of corpora cavernosa

• Ligature placement of neoclitoris and dorsal neurovascular pedicle

• Creation of neovaginal cavity

• Creation of distal neovagina from scrotal skin

• Clearing of hair follicles from graft and attachment of vaginal graft to inverted penile skin

• Placement of graft-lined stint into final
neovaginal location

• Creation of neourethra

• Creation of labia minora/clitoral hooding

• Drain placement

• Closure of labia majora

It’s crazy impressive, is what it is. I haven’t had too much personal experience with vaginas, but I showed post-op photos from Dr. Bowers’ website to my lesbian friends, and they all agreed: “Looks like a real vagina to me!”

“We will now begin boarding flight 542 to San Carlos,” the announcer called out.

I was so tired from staying up late with Arin that I fell straight to sleep on the plane. Honestly, I can fall asleep anywhere, anytime. I adore sleeping.

I woke up just as we landed. My mom and I rented a car and drove to our hotel in San Mateo, where we would be staying for 12 days. Dr. Bowers’ office requires that you have a few days pre-op and a week post-op to rest and recover. At the hotel we lounged around watching TV while I waited for my pre-surgery meeting with Dr. Bowers. She was going to need to examine my genitals and make sure there wouldn’t be any issues with the surgery.

At the hospital the nurse instructed me to take off all my clothes, put on a gown, and lie on the examining table with my feet in the stirrups. Because of my shame and alienation from my body, this was pretty much my nightmare scenario. The only people who had ever seen me naked were my mom, Hawthorne, and Arin. But I figured, Dr. Bowers is going to have to see my penis eventually—spend four hours with it, in fact—so let’s just do this. I was lying there when the door creaked open and in walked Dr. Bowers, pushing her thin wire-frame glasses up on her nose.

“Oh! Hi…” she said, as if she were surprised to see me there.

“Uh, hi,” I said. There is nothing more awkward than greeting someone while your legs are in stirrups.

Dr. Bowers walked over and poked and prodded me a little. In just two days it won’t be there anymore, I told myself.

Dr. Bowers looked up and adjusted her glasses again. “Okay… Well… everything seems good… I guess I’ll see you Wednesday,” she said in a placid tone.

I liked her, and knew she was an amazing surgeon, but my God was she awkward.

“Um, okay. Thanks,” I said.

And then, before I knew it, she had walked out the door.

That’s it? I thought. I guess I’d assumed we’d chat a little more. At first I hadn’t wanted her to come into the room, but now I kind of wish she’d stayed.

The day before my surgery I was allowed to consume only clear liquids, and after midnight, nothing. I also had to drink a bottle of this bowel prep stuff to clear my system out, and that kept me in the bathroom, as sick as hell, for hours.

“You’re sure you’re okay?” my mom shouted from hotel room bed.

“I’m fine. I’m just dying,” I shouted back, hunched over the toilet.

I woke up the next morning, giddy and nervous. I knew this was a very invasive surgery, and that a lot could potentially go wrong. I could bleed to death. I could react badly to the anesthesia and not wake up. My nerves could be damaged and I could lose all sensation in my new vagina. Honestly, though, I wasn’t that worried. I’d thoroughly researched Dr. Bowers. She’d performed this surgery hundreds of times, and I felt confident. When we’d first scheduled the surgery and I’d spoken with her on the phone, she’d told me that because I was young, I had a very high chance of retaining all sexual feeling. No part of me second-guessed my decision to have surgery, even for a moment. I wanted this more than anything else, and it was finally, finally happening.

“You ready?” my mom asked, standing by the door. I could tell that she was nervous.

“I’m gonna be fine, Mom,” I said.

“I know you are, baby,” she said.

She drove me over to the hospital while I watched the YouTube surgery video one more time on my phone. Egad, it certainly was graphic. But, yes, I was ready. 

The days following my surgery are foggy. It’s remarkable that I can remember anything at all, I was so doped up on morphine. What I mainly remember, though, is an overwhelming feeling of relief and anticipation. I couldn’t wait to be strong again and move around in my new body. The nurse told me that, at first, walking would be difficult. Not just because of the pain but because your body has to learn to realign itself with the new genital arrangement. I had to stay in my hospital bed for 48 hours and then move to a hospital residence inn for the rest of the week. Every day Arin Skyped me.

“I miss you. How are you?” he’d ask, looking nervous.

“Okay,” I’d manage to whisper. It was comforting to have his sweet, smiling face on my laptop, though I was so out of it on painkillers, I had trouble keeping up a conversation.

On the second day I felt good enough to get out of bed and try walking—but as soon as my feet hit the floor, the rest of me did too. My mom and the nurse had to come pull me up, all my wires and drain tubes in a tangle.

On the third day my mom and I moved to the Residence Inn. As soon as we got there, I hobbled into the bathroom, stripped off all my clothes, and stared at myself in the full-length mirror. When I saw my body, I started crying. They were tears of joy. Sure, my vagina looked like an obscenely swollen red wound packed with gauze and hospital tape. But it was a vagina. I’m finally done with that nonsense, I thought.

I got back to Oklahoma on May 25, and the next day Arin invited me to go out on his boat with his family. I was still in so much pain, but going on a boat meant I got to wear a bikini, right? So, hell yeah.

Arin had given me one of his old swimsuits—a little white bikini. Slipping it on felt amazing. Whenever I used to go swimming or to water parks, I would have to duct tape my genitals up to try to hide them, and even then I still had to wear bikini bottoms with little skirts. It was hugely uncomfortable and impossible to have fun. I’d spend the whole time anxious that someone would notice my bulge. Now, finally, I felt right.

Of course, my vagina had still only just begun to heal. Out on Arin’s boat, I had to carry around a little inflatable doughnut to use every time I sat down. Whenever the motor was going, I’d bounce up and down on my doughnut and feel like my vagina was going to get ripped in half. Well, ripped in half again. It was a lot of fun, though. In the photos I have from that trip, everyone has these huge smiles on their faces—except, my huge smile is also a grimace of pain.


Arin and I did exciting things all summer while I was recovering. We went rock climbing, did archery, took road trips to Missouri and Kansas, played laser tag, went hiking and camping. We did everything we could think of.

One night after a full day of goofing off at the lake, we went back to Arin’s house.

“Dinner’s in half an hour,” Denise called as we ran up the stairs to Arin’s bedroom. I went into the bathroom and changed out of my bikini and into clothes.

“Hey, Arin,” I said, walking into his bedroom and tossing the bikini onto the bed. “Want to try this on?”

“What? No way!” he said.

“I totally get it if you don’t want to,” I said. “I just thought it would be silly. You can draw a mustache on me if you want.”

The more comfortable I was in my own gender, the more I found myself wanting to play around with it. I went over to his mirror and began to apply the mascara mustache myself. Arin stood next to me and examined his facial hair. He’d been on testosterone for a few months now, and his hair was coming in nicely (exactly as I’d predicted). He was feeling a lot more confident in his looks too.

“Eh, why not? Give me that bikini,” he said. He went over to the bed, stripped off his clothes, and put the bikini on. He turned around. “Well, what do you think?”

“You look gorgeous,” I said.

“What? I look as manly as hell,” he said. He flexed his biceps, and we both started laughing.

He took the bikini off and pulled his shorts and tank top back on.

I walked over, and we started kissing, tickling, and wrestling.

“My mom’s gonna call us for dinner any minute!” he said.

“So?” I said, and we toppled onto his bed, laughing and making out. We lay there and looked into each other’s eyes for a moment. A couple of weeks earlier Arin and I had tried having intercourse—as in penis-in-vagina sex—which had been a little weird, since in our case the penis was on a female and the vagina belonged to a boy. It had been a kind of virginity loss for both of us, and while I may not have been totally enjoyable, it had certainly brought us closer.

“I love you,” we said, for the first time, at the same time.

We both immediately started giggling.

“I can’t believe that just happened,” I said.

Published in This Land: Spring 2016. Excerpted from Rethinking Normal: A Memoir in Transition by Katie Rain Hill.