VAGINA, MANUAL

How I learned to orgasm after sex reassignment surgery

Elena Scotti/FUSION

My vagina came with an instruction manual.

At least that’s what I called the papers my surgeon gave me before I was discharged from the hospital. Those documents told me how to care for the scars next to my labia so that they would fade over time. They told me when to see a gynecologist and how often to get a pap smear. They even specified how long I would have to wait to use a hot tub again—12 weeks, if you’re wondering.

But one thing they didn’t teach me was how to have an orgasm. I had to figure that out on my own.

After my sex reassignment surgery two-and-a-half years ago, my doctor ensured I could locate the essentials: clitoris, urethra, and vagina. Beyond that, though, her main advice for sexual gratification was to “be inventive and open-minded,” as if I were about to finger paint or go on a study abroad trip. I wanted details. You don’t give a novice baker a pantry full of ingredients and tell them to be creative; you say precisely how much flour and butter to use.

But there’s no one recipe for orgasm. And learning how to climax after your genitals have been reconfigured is a lot more complicated than baking a cake.

🌷🌷🌷

People who are transphobic spread three major myths about transgender women who have had sex reassignment surgery. The first is that our bodies have been “mutilated.” The second is that we regret what we did. The third is that we can’t come.

All of them are false. Scientific research proves it and so does my personal experience.

For a long time, I didn’t want to tell my own story. But it’s difficult to debunk those transphobic fictions without veering into personal and potentially uncomfortable territory. As Vogue columnist Karley Sciortino recently observed, there is a “lack of conversation around sex for women who have had sex reassignment surgery,” partly because those of us in the transgender community usually have to “steer the focus away from ‘the surgery’” when interviewers get fixated on our genitals.

“Is it time for a nuanced discussion about sex and pleasure for trans women?” Sciortino asked.

That conversation is already happening away from prying eyes. But even though transgender people are not obligated to clear up public misconceptions about their private parts, I volunteer as tribute. Those three myths have been around too long.

Before I can continue my story I have to bust the first one: Sex reassignment surgery is not “mutilation.” The American Medical Association wouldn’t support it if it were.

Instead of “mutilation,” picture the surgery I underwent as time travel for my genitals. My surgeon, sex reassignment pioneer Dr. Marci Bowers, puts it this way: “As everyone has female genitalia early in gestation, the goal of the procedure is to reverse the current anatomy to its earlier configuration.”

Contrary to popular belief, there is not some vast unbridgeable gulf between the sexes. As a committee of the National Academy of Medicine explained in a 2001 volume, we all “begin development from the same starting point,” regardless of chromosomes. In fact, until our eighth week in the womb, our external genitalia “have the capacity to differentiate in either direction.” The clitoris and the penis come from the same tissue, as do the labia and the scrotum. The vaginal orifice that everyone has in the womb can become a full-on vagina or it can close.

What that means is there’s plenty of genital tissue and space between our legs for everyone to have a vagina if they want one. And thanks to my gender dysphoria—a persistent feeling of distress at the mismatch between my gender and some parts of my body—I didn’t just want one. I needed one.

I will spare you the nitty-gritty of how Dr. Bowers met that need but the short version is that she constructed my clitoris out of the most sensitive tissue I had, using the remaining skin to form my labia and vagina. Once you understand the science, the process makes sense.

It was not grotesque for my body to be rearranged in a way that could have developed on its own. It was not butchery for my clitoris to be made out of something that was going to be a clitoris in the first place. It was a logical way to fix a long-ago mistake.

🐱🐱🐱

My first attempts at orgasming after surgery were like the black-and-white scenes in an infomercial—comically clumsy and ultimately unsuccessful attempts to get the job done.

I would start touching myself but then I’d have to pee. I would fumble around for a few minutes before being interrupted by thoughts of work or memories of mortifying things that happened to me in high school and I would lose the thread entirely. Sex felt great but it was even harder to concentrate on an end goal with another person in the room.

“I have to have the focus of an Olympic hopeful on a balance beam,” Amy Schumer once joked about her own attempts to hit the Big O. “And I get distracted.”

For me, life itself became the chief distraction. I got lost in the daily rhythms of my demanding journalism job, only making time to visit my nether regions every few weeks, then every few months. The more time passed, the more certain I became that I would never come again, even though Dr. Bowers says that “orgasm should be an expectation of each and every patient.”’ To be fair, she also warns her patients that it could take “up to one year” to learn the ropes. And what devilishly complicated ropes they are!

Orgasming before surgery—and especially before I started taking estrogen, which changes how your genitals function—was not a challenge. To put it bluntly, if you can polish a candlestick, you’re all set. Having to navigate a vagina was like being plucked out of preschool and placed in a quantum physics course overnight. Add in an unhealthy dose of anxious thoughts, and finishing seemed next to impossible.

I was out of my depth. I got discouraged. And I gave up.

🌮🌮🌮

I could have easily blamed my surgery for my inability to orgasm. But statistically speaking, chances were my vagina was not the problem—it was my head that was getting in the way.

One 2005 study of 55 Dutch transgender people who had undergone sex reassignment surgery between 1986 and 2001 found that all of the transgender men and 85% of the transgender women were able to orgasm through some form of sexual activity. Another larger study found that 82.4% of transgender women could climax after surgery. Surgical techniques are only improving and other studies have reported higher rates of orgasm.

Given my situation, too, I should have been able to come: Like the transgender women in the Dutch study, I had “excellent sensitivity.” But stimulation alone was not enough.

That’s when I discovered a reassuring word: anorgasmia, or the inability to orgasm. At my most pessimistic, that term made me feel less alone. The percentage of cisgender women who experience some form of anorgasmia is not that much lower than the percentage of transgender women who have reported being anorgasmic after surgery across several studies.

Back in the 1950s, famed sex researcher Alfred Kinsey reported that 10% of women said they had never orgasmed, a stat Ball State sociologist Justin Lehmiller notes on his Sex and Psychology blog. More recent data paint a similar if slightly less discouraging picture. One 1997 British study found that just 7% of a small sample of women was “completely anorgasmic,” but 20% had “situational anorgasmia,” meaning that they could only orgasm under specific circumstances.

Frankly, it’s a miracle those numbers aren’t higher given how many obstacles women face on the way to the big finish. As sex researchers Ellen Laan and Alessandra Rellini observed in a 2011 journal article on anorgasmia, “a number of psychosocial factors” can “interfere with women’s capacity for orgasm”—including sexual inexperience, childhood trauma, inadequate stimulation, and “fear of losing control.”

But the good news, as Laan and Rellini note, is that many forms of anorgasmia can be treated with therapy, “directed masturbation,” and good old-fashioned vibrator use. For most women, not being able to come is a problem that can be overcome—even if you’re pretty new at the whole “having a vagina” thing.

🌷🌷🌷

I was stunned when it happened. It had been two years since the surgery.

At home alone one day during my lunch hour, an old fantasy crossed my mind and practically tugged me into the bedroom. Out came the vibrator along with some erotica. I had no goal in mind. I didn’t expect to reach climax. I was simply following a stray impulse wherever it led, like a dog chasing a car or a Seeker following the Snitch in a game of Quidditch.

Not thinking about orgasming actually made it easier to get close. The same principle behind watched pots never boiling apparently applies to my vulva, too. Or as sex coach Xanet Pailet once told Cosmo, the “best way to have an orgasm is not to care about having an orgasm.”

In the end, that tactic worked for me. First, there was a tingling sensation in my head. Then, a familiar funny feeling behind my knees. My chest flushed. This. Is. Happening, I thought.

A long time ago—before my surgery—I was cast in a production of theVagina Monologues that included a trans-inclusive addition Eve Ensler wrote in 2004. “My vagina is so much friendlier,” I had said on stage, vagina-less at the time, but in character as a transgender woman who had already undergone surgery. “It brings me joy,” the monologue continued. “The orgasms come in waves.”

It felt hypothetical—aspirational even—to say those words back then. But on that afternoon two years after my surgery, I finally realized what Eve Ensler meant by “waves.”

The transgender women in that 2005 Dutch study reported that they had “more intense, smoother, and longer orgasm[s]” after surgery, while transgender men said theirs were “more powerful and shorter” after getting a penis.

I know now what both varieties feel like, and I prefer the first.

Before surgery, orgasming felt sudden, almost disturbingly so, like cliff-diving into the ocean. (“Jerky,” is how the Vagina Monologues puts it.) Now, an orgasm feels like a current that carries me away from the coast until my toes can no longer touch the bottom. Slowly, almost without noticing, I realize that I am floating in a warm sea.

Now, when I want to orgasm, I have a routine that borders on superstition.

I close all the doors and curtains in the house as if I can lock my anxious thoughts in another room. I set the thermostat to 75 degrees, and like Amy Schumer said, “If the temperature changes, I’m like, ‘I lost it. I lost it.’” And I always use the lucky vibrator my partner bought for me as a post-surgery present. (The toymaker, Je Joue, calls it “Mimi,” but we call it a “cookie egg” because it’s the same shape and color as an Easter egg candy.)

Using that method, I have been able to orgasm almost every time.

🐱🐱🐱

The most remarkable thing about my story is how unremarkable it is. Millions of women have trouble orgasming. I’m just one of them.

But as lawmakers in North Carolina and elsewhere attempt to turn bathrooms into borders between cisgender and transgender women, it has never been more vital to build bridges between our experiences. Womanhood is not defined by genitalia nor is orgasm its crowning achievement. But while not all transgender women have vaginas, those of us who do should be able to join feminist discourse around them, if only to say, “Me, too.”

More people should know that many transgender women, like many cisgender women, love their vaginas and think they are beautiful. In his most recent stand-up special, the comedian Patton Oswalt did a routine where he pretended to be an ignorant but good-hearted ally who thought transgender women’s vaginas looked like “a Boris Karloff horror movie.” It’s a common notion that surgically reconstructed genitalia are ugly, but nothing could be further from the truth. Only 3.2% of transgender women in a 2014 study said they were “dissatisfied” with the aesthetic results of their surgery.

(I think my vagina is beautiful, too—so beautiful that Dr. Bowers asked if she could put a picture of it on her results website. I declined. There’s enough of me on the internet already.)

More people should realize that both transgender and cisgender women can find orgasm challenging. Nearly 19% of transgender women in one sample said they can orgasm “rarely easily” after surgery. Compare that to the almost 21% of cisgender women in a 1993 study who said they also “had difficulty at least half of the time,” and it’s clear that women with vaginas face similar barriers to orgasm regardless of the gender they were assigned at birth.

Most importantly, though, people should acknowledge that transgender women—with or without vaginas—are having sex and getting off, just like cisgender women. That completely mundane fact should not be buried beneath mountains of stereotypes. Movies and television shows, as GLAAD notes, tend to depict transgender women as either sexual predators or as taboo sex objects for male characters. Anti-LGBT politicians and pundits paint us as perverts. They all refuse to accept the reality that transgender women can and do have happy sex lives. We do things with our genitals, after all, besides go to the bathroom.

So if you came to this story expecting a sensational tale defined by my difference, I hope you didn’t find it. My experience is not unique. But that’s precisely why I wanted to share it.

🌮🌮🌮

Even if I had been anorgasmic for life, I still would not have regretted my decision to have surgery. Many women like me appear to feel the same way. A 2003 study of 232 transgender women with vaginas found that 97% felt sex reassignment surgery had “improved the quality of their lives.” Better still: “No participants regretted SRS outright, and only 6% were even occasionally regretful.”

Orgasm is not the be-all and end-all of bedroom activities. I had a satisfying sex life without it. And the tragic truth is that the pain of gender dysphoria often cuts far deeper than the pleasure of orgasm can reach. If I had to to give up orgasming to get rid of dysphoria, I would make that choice every time.

As it turns out, I didn’t have to take that deal. I baked my cake and ate it too. What I needed was not an instruction manual but the same things so many other women require: time and healing.

That’s how I got to my happy ending—literally.