Here are some basic facts:
- method was penile inversion
- I opted for full-depth rather than a vulvoplasty
- surgery took 3 hours, though recovery took another hour
- I went under general anaesthesia and had to be intubated and put on a ventilator
- I’m currently admitted in the hospital and bed bound, discharge is scheduled for Friday
- so far pain is between 1 and 3 for me, most of the time it’s between a 0 and 1.
Ask me anything!
As a surgical tech in the process of switching over to nursing:
How was your healthcare team? What did they do that stood out as good / is there anything they could have done better?
I hardly ever get trans patients, but I want to make sure their experience is as good as I can make it.
Thank you for even thinking about these questions! Remember that trans patients are patients, and while some things can be due to medical transition, not everything is. Unless it’s specifically transition-related care, most of us are just there for a stomach bug, or a headache, or the same procedures everyone else is getting. Ask our pronouns, ask our preferred names, make us feel like all of your other patients. This goes such a long way to making it a good experience. When it does come down to gender expression or transition-related things, ask about preferences and goals. Not everyone is binary. Even the binary among us have different options and plans. And sometimes, we can change our minds about things! Don’t stop being an inquisitive person. Learning gives you options and understanding and empathy, and those are the best tools you can have as a caregiver. Thank you for doing what you do!
Thanks!! As a surg tech I don’t get much insight from my patients: they roll into the OR, I introduce myself, anesthesiologist knocks them out, and we get to work. And the times I do get to chat (case delay for whatever reason and the patient is just hanging out with us on the OR bed) I usually try to just keep them distracted with questions about their work or kids or music preference or shit like that. Anything to keep their focus away from the pile of what looks like medieval torture devices I’m assembling, or the alien environment that ORs are for anyone who doesn’t work there. …what I don’t do is grill them about the quality of care they’re receiving lol.
So, conversations like this one are the closest thing I get to direct feedback. So again, thanks!!
Once nursing school is finished up and I switch over to the dark side, there will be a lot more interaction with actual conscious patients, so the feedback I’m getting here is super helpful!
Feel free to send DMs if you want to have a longer chat about this. I’m headed for general anesthesia tomorrow for an unrelated procedure (see, we have normal human things like everyone else!) so I’m sure I’ll be meeting another nice surgical technician like you before I go under. I’ve been through a whirlwind lately, and my post history isn’t even half of it, so I am sure there’s much to discuss. Thanks again for remembering the human part of healthcare!
Right back at you if you have any questions about the OR! Anything specific to the procedure you’re about to have, this late in the game I’d definitely stick with your healthcare team and not a random internet stranger, but anything that’s OR in general, I got you!
Well, the hospital I am going to has a whole trans healthcare wing essentially, though they don’t call it that. It’s a subsection of the plastic surgery group, but my surgeon in particular works with lots of trans patients.
What I’ve noticed is that they make a standard practice of asking for name and pronouns, and then sharing their own. I personally don’t like this, but I get how it would help with non-binary folks or people who use neopronouns - so I tolerate it 😅 Mostly it feels stigmatizing to me, and when I work with people who know I’m trans it’s a different experience than people who don’t know I’m trans and who just see a woman. Since I just wish I were a cis woman, I prefer working with the nurses that don’t know I’m trans and thus don’t try to treat me differently (even as accommodating or being nice) based on my transness. I don’t want to be trans or treated differently for being trans.
The healthcare team was pretty responsive to my questions through the online portal, and in general seem competent.
My surgeon has awful bed-side manner, despite his excellent skills in the operating room - each time I interact with him I come away thinking he could really work on his delivery, lol - for example, when he saw me right before wheeling into the OR for my orchiectomy, he looked at my thighs and said “you need to lose 20 lbs” - it’s true losing weight can improve recovery, esp. for a vaginoplasty, but the way he put it was so direct and rude. (And tbh a bit hurtful, I struggle enough with my body and weight, and it just felt like a confirmation of my negative self image.)
Right before my surgery yesterday, the surgeon said that if the orchiectomy left a scar that makes it too difficult to him to use the scrotum as a graft, he will just do a vulvoplasty / shallow-depth vaginoplasty and then I would have to come back in 6 months to get full-depth (presumably with peritoneal pull through). For context, we specifically asked about whether the orchi he did would interfere with the vaginoplasty, and he said no - so learning it could right before being wheeled into the OR was anxiety producing since I suddenly didn’t know if I would wake up with a full-depth vaginoplasty like we had agreed on.
Other staff had trouble communicating clearly - like they would mumble or speak too quickly for me to understand what they were saying, but these are more like personality issues.
If you want to know how to work with trans patients I would just think the most important thing is to think of them as their gender - if you have a trans woman patient, just think and treat her as a woman and all is well. Ditto for trans man, and for non-binary patients it’s not that different. Knowing and respecting pronouns, and doing what you can to put in your mind that they are the gender they say they are is probably the best advice I could give.
Relatedly, there are lots of intersex people who are trans, so also not making too many assumptions could be good - sometimes anatomy will be different than you thought for a trans person, i.e. a trans woman might be intersex and not even realize they have an intersex condition which might mean they have anatomy they don’t realize they have, etc.
And when you’re working with trans patients I would say it’s important to just treat them like any other patient - when I looked very trans and wasn’t passing, I often would get this overly nice treatment that felt more like pity than respect or support.
Let me know if you have specific questions I didn’t cover!
Huh. We’ll ask during intake, but haven’t offered our own. Do you think that’s a good practice overall, or making it weird? You and a couple other posters have mentioned -and I agree- that trans patients are first and foremost patients who should be able to expect the same care as anyone else, to include not getting special treatment since that can be awkward for the recipient. I have noticed a couple nurses seem like they’re walking on eggshells - like they’ll get WAY apologetic if they fuck up a pronoun. It’s awkward just to see from the sidelines, lol.
Some surgeons are like that. Reeeaaaaally smart in their area of expertise; but dumb as rocks the second they set foot outside of that bubble, to include basic social skills. Med school really needs a course or two on “how to not be an asshole!” …often the side you see as the patient is the ‘nice’ side, too - once you go under, they crank the asshole up to 11 to the staff in the room.
But… we tolerate it. They’re good at providing healthcare, and if that wasn’t keeping them occupied, they’d probably be serial killers or some shit.
Hope your recovery is going well! Unsolicited advice: you’re only about 30% as good as you feel after surgery. It’s the drugs. When you start feeling good enough to return to your normal daily routine, NO YOU DON’T! Sit down, be lazy, and chill for a couple more days. And follow your post-op instructions to the T - the groin is a high infection rate area, so don’t cut any corners with whatever they told you to do for cleaning, dressing changes, etc.
Also, congrats!
Not OP but I went through this in 2017
The good: staff was overall very helpful, seeing my friends was great
The bad: explaining to the chaplain every time he came in that I don’t necessarily care for religion (at least not xtianity)
my hospital is very pushy with the chaplain, but there was a way for me to kinda opt out by disallowing the staff from putting my surgery info on a whiteboard where the chaplain goes to find patients to prey on. This also meant my spouse wouldn’t get updates from that same board, but we agreed it was worth it to avoid the chaplain, lol
sorry you had to deal with that, I think there is a lot of transphobia still and it’s weird to me that chaplains are pushed so hard with gender-affirming surgeries 😬
It’s weird that chaplains are pushed so hard, period. This has been driving me nuts in clinicals - they’ll just drop into a patient’s room completely unsolicited and start asking religious shit. Like… dude, did that patient request a chaplain? No? Then get the fuck out! I can see the value in having a chaplain available to patients who want one, but until that request is made, stay in your damn office!