By Leo Aquino
Congratulations on your decision to undergo bottom surgery! As the gender-expansive community gains more visibility, there’s more access to penile inversion vaginoplasty, aka transfeminine gender affirmation surgery.
Whether you’re preparing for this life-changing vaginoplasty surgery or early in your recovery period, you’ve probably got at least one question in the back of your mind: What is sex going to feel like?
After hours of research about MTF surgery, finding a great surgeon, and arranging complicated logistics for your aftercare, you deserve nothing but the best.
Here are the best tips and tricks to reconnecting with sexual pleasure after recovering from MTF bottom surgery:
What is transfeminine bottom surgery?
First, let’s review the basics: Gender-affirming surgeries are used to treat gender dysphoria, the feeling of distress and depression that arises when your body does not match your gender identity.
Penile inversion vaginoplasty is a gender-affirming surgery for transgender women, non-binary folx, and gender-non conforming people. It’s a very complicated medical procedure that takes 2-5 hours and requires an intense recovery period. Here are the nuts and bolts, as paraphrased from Healthline:
- The testicles are removed, and a new vaginal cavity is created in the space between the urethra and rectum.
- The skin from the penis is used to create vaginal walls. In some cases, there may not be enough skin to line the vaginal wall and a surgeon may perform a skin graft from the hip or stomach, which may be less sensitive than penile skin and can result in less sexual pleasure down the line.
- A triangular piece from the glans (the head) of the penis is removed to become the clitoris.
- The urethra is removed, shortened, and repositioned in the same way as a biologically formed vagina.
- Labia can be constructed with the scrotal skin.
- The remaining parts of the penis are removed and discarded.
Where can I find more resources about bottom surgery?
To find more resources about MTF bottom surgery, visit these websites:
- Folx Health Library includes resources for gender-affirming surgeries and hormone replacement therapy.
- Transbucket is a place where trans people share pre- and post-op photos. Content warning for fresh surgery pics.
- The Los Angeles LGBTQ+ Discord Server is a great place to chat with other gender-diverse people. There are multiple threads for gender-affirming surgeries.
How soon can I start having sex after the surgery?
In a blog post detailing sex tips after vaginoplasty, transgender surgery specialist Dr. Ashley DeLeon suggests waiting 12 weeks before exploring your vaginal canal. In fact, 12 weeks is still early and it may be best to get the green-light from your surgeon during post-op appointments to make sure that your new vaginal canal can handle intercourse.
Dr. DeLeon also suggests waiting 12 weeks before having oral sex. Since MTF bottom surgery involves so many complicated steps, your vulva will likely be vulnerable to bacterial infections which your partner's mouth can easily introduce.
Sex and Masturbation After MTF Bottom Surgery
Learning how to have sex again isn’t easy
In an interview with Vogue, transwoman Nomi Ruiz opened up about reconnecting with sexual pleasure after her bottom surgery. She shared her concerns about not being able to achieve orgasm. In her own words, “...there was always that fear and that risk. But I eventually got to the point where I was like, ‘I don’t care. I’d rather not enjoy sex than live this way.’”
Thankfully, you don’t have to choose. All it takes is a little bit of patience and, if you’re engaging in partnered sex, a partner who is dedicated to finding the best ways to give you pleasure. Ruiz also shared, “You need someone to help you enjoy your body, not someone who just wants to fuck you.” The right partner makes a world of a difference
Dilation
After the surgery, you’ll need to stay at the hospital for 7-10 days. Before you leave, someone on your clinical team will teach you how to dilate. Dilating is the process of inserting medical-grade silicone phalluses of varying sizes into the vagina to maintain the vaginal canal that was created during surgery.
Similar to prematurely removing jewelry from an unhealed body piercing, the vaginal canal can close or become smaller if you don’t follow through with dilation for the first few weeks after your surgery. According to Johns Hopkins Center for Transgender Health, you’ll need to dilate twice a day for at least 15 minutes. You’ll be provided with a set of dilators in varying sizes, and you’ll dilate starting with the smallest one, working your way up to subsequent sizes when you feel ready.
Dilation shouldn’t be painful. If it is, you likely have to switch to a more comfortable position or adjust the dilator to a position that works best for you. Always use lubricant for a more comfortable experience.
Your new clitoris
Before the requisite 12-week recovery period, you can actually begin exploring sexual pleasure by using your clean hands or your thoroughly-cleaned favorite vibrator to stimulate the clitoris gently and achieve orgasm. Again, CLEAN is the key word here, as we’re trying to avoid bacterial infections.
Still, everybody’s body is different. In theory, the clitoris is made from the most sensitive part of the penis, but sometime it takes a while to align mentally and get used to your new anatomy. If things don't feel "right" off the bat, try to give yourself time. This isn't just a physical journey, it's a mental one too.
Trans YouTube influencer Jesyka S. shared her personal experience on her channel a few months after her surgery. She shared that her first time having vaginal sex was with her boyfriend, whom she felt completely safe with. “The first time I did it, it was not the best, I have to be honest,” she shares. “That’s where I can see that dilating is extremely important.”
After 5-6 months, Jesyka was able to achieve a vaginal orgasm where she felt “wet, sweaty and hot.” However, she had trouble having a clitoral orgasms during partnered and solo sex. “6-7 months post-op, I was getting a little frustrated because I couldn’t seem to have [a clitoral orgasm.] … I was trying, I was watching porn, I was doing everything to excite myself.”
Finally, after a few more months, Jesyka was able to achieve a clitoral orgasm. “I felt a sudden heat. My forehead was sweating, my palms were soaked, my palms were soaked. And I finally hit the orgasm, which I have to say was amazing.” She advises her followers that it just takes time to get used to your new body. Don’t give up! Persistence is key.
Lube
Unlike a biologically formed self-lubricating vagina, the neovagina is lined with penile skin and doesn’t produce its own lubrication. Be sure to use water-based lube that’s easy to clean after intercourse. Because your new vagina is lined with skin, not a self-cleaning mucous layer like a biologically-formed vagina, it will be virtually impossible to clean out silicone-based lubricants, which could result in bacterial infections.
Some people still continue having anal sex after MTF bottom surgery. In that case, check out our guide to lubricants to see which one might work best for you. It’s recommended that you wait at least 12 weeks after getting bottom surgery to try anal sex because its proximity to the new vagina could rupture the parts that your surgeon constructed.
Resources for partners and allies
How can I become intimate with my partner while they’re recovering from bottom surgery?
You have the unique pleasure of supporting your partner through a life-changing, gender-affirming surgery, but you’re horny as f*ck. We totally get it. Your partner’s comfort definitely comes first. Ask for their consent and what they may be comfortable with.
Are they comfortable watching you masturbate? Are they comfortable lending you a hand? No, literally, are they down to give you a hand job? Or would they prefer to perform oral sex?
If they’re uncomfortable doing those things, you may have to rely on solo play while they heal and find non-sexual ways to create intimacy.
Is it okay to ask my trans friends about their bottom surgery?
Generally, no. It’s invasive and inappropriate to ask a trans person about their genitals. The only question you should ask is, “How can I support you?”
Of course, most people have different friendship dynamics and preferences. If your trans friend feels safe enough to disclose details with you and you have additional questions, it may be best to ask, “Can I ask a follow-up question? Is that okay?” before asking for more details.
How can I support gender-expansive people who are undergoing bottom surgery?
Here are a few ways you can support your friends who are getting ready to undergo bottom surgery:
- Donate to their GoFundMe page. This is crucial as only 12 states’ Medicaid plans cover the cost of the surgery completely. Plus, most people don’t have the luxury of taking paid time off to focus on their recovery. If you’re unable to make a monetary donation, help spread the word about their surgery fund.
- Educate yourself on the issues that gender-expansive people face. In 2021, over 100 anti-trans bills were proposed, preventing transgender youth from joining school sports teams and accessing gender-affirming healthcare. Show up at the polls to vote against these discriminatory laws and use your voice to show love and allyship to the transgender, non-binary and gender non-conforming communities.
- Support trans women, like the ones mentioned in this post. Follow Nomi Ruiz on Instagram and Jesyka S. on YouTube and support their work.
Knowledge is Pleasure with the Lioness Vibrator!
Lioness is the first and only vibrator that helps you improve your orgasms.
The world’s most advanced vibrator. Precision sensors let you literally see your arousal and orgasm. Experiment, understand yourself, and have better orgasms—after all, as the saying goes, “never measured, never improved.”
Click here to learn more about the Lioness.
