I visited my urologist this morning to schedule a needed perineal urethrostomy, AND to discuss elective castration. He has no intention of ever performing a bilateral orchiectomy on me. After researching gender dysphoria, reading my therapy letters, and consulting with a reconstructive surgeon who performs gender confirming surgeries, he told me I’ll need to find another provider for that.

Today, he gave me the impression that something from my PhD therapist or MD psychologist killed the deal. He never overtly stated that, but he was much, much cooler to the request than he was just two weeks ago. I never got to read the letters, but I never got anything but support. Maybe the uro is trying to use them as an “out” to cover his own doubts? Idk.

When he came into the exam room, he was all-business and immediately addressed castration before moving on to the urethrostomy. Although I expected some push-back on castration, he pretty much slammed the door shut, locked it, dead bolted it and broke the key. I was stunned then and I still am now. He didn’t even offer to refer me to someone, he just said, “I’m not performing that surgery on you. I strongly advise you in stark terms to not to have it done but if you do, find another provider. Period.”

He went on to talk about the urethrostomy, but I wasn’t having it. I told him the conversation was over—that I’m not interested in a re-route. With all that he has in my medical records—all that background info—that’s how things ended. He wasn’t unprofessional, but I think each one of us set fire to opposite ends of that bridge today.

After work, I came home and drank a couple (or three) glasses of bourbon on the rocks. Bf offered words of support, but he’s pretty much staying clear for now. That’s best.

No thoughts on my next step(s) if any at all.

I’m in an intense session of second guessing myself and what I do or do not want versus what I do or do not need. Maybe the professionals are right. Regardless, I have a lot of thinking to do about what’s important in life and how I see the future—-what I’m doing, and perhaps even who I’m with.

Zach —-

DifferentZach (imported) wrote: Wed Oct 02, 2019 4:41 pm He has no intention of ever performing a bilateral orchiectomy on me. After researching gender dysphoria, reading my therapy letters, and consulting with a reconstructive surgeon who performs gender confirming surgeries, he told me I’ll need to find another provider for that.

Sorry to hear that. The good news is that every day that goes by increases your documented history, builds the weight of evidence on your side, and increases your chance of success with another provider. I have just completed my psychiatric assessment but I am yet to find out whether my urologist is satisfied with it. My long history was very much in my favour, but this is harder to achieve for someone such as yourself less than half my age.

So sorry things went the way they did

Don't second guess yourself if this is what you want. Seek out a second opinion and continue the conversation with you psychologist so there is documentation.

Hang in there!

Zack,

There's an old saying that's helped me more than once: "Don't Just Do Something, Sit There".

Take a day or two and have a decent rant (if only in your head). You have every right to be upset. The question is, however, is it right for you to be upset.

Once you've taken a few days to sit there and do nothing - get the fuck off your ass and start. You went in for a course of Lobster Bisque and were served a turd sandwich. After a few days, it's time to work.

1. Get copies of everything. They will discourage you from asking for copies of your medical records by charging by the page. It's a battle they may very well win. But, if your phone, tell them you'll be in to pick up copies of your records and they try to stall you - stick to your guns. Tell them what time and what you want. Pick a time the doctor is busy. Normally doctors have clinic days and surgery days. Pick a clinic day and stand there demanding your records in a normal tone of voice. Don't shout, don't threaten. Do record.

2. Records are a funny thing in the medical profession. If you go to Dr. "A" for something and then have Dr. "A" send the records to Dr. "B", it's most likely that Dr. "B" will tell you they cannot release the records to you because Dr. "A" created the record and you'll have to get a copy from the original doctor. It's not true. The record belongs to you and they'd be in no trouble if they gave you a copy of the record because you signed the release and the record (letter, test whatever) has always belonged to you. Still, the person behind the desk only wants two things. First, is for the day to go smoothly and the other is for you to buy the bullshit they are selling. Remain firm, polite and keep recording the conversation.

3. Remember the medical field isn't as isolated as it seems from the patient's viewpoint. Doctors talk to each other. If a resident in one doctor's office sneezes, a receptionist across town says, "bless you". So, you must remain polite. It's possible that no urologist will see you if you get too belligerent. You'll call to make an appointment and the next one they'll have is a week from Christmas 2026. So, there is a fine line between being a pain in their ass and getting what you want.

4. If unsure, live to fight another day by backing down. Then go back.

5. There are other cities with other doctors. That might be your best bet. Get your therapist letters, surgical notes, etc and head to the nearest major medical center.

6. Do not hurt yourself and no don't go to a cutter. Yes, there are people on here who've used cutters and it worked out for them. There are people who used cutters who are not here because they have a new name "the dearly departed".

7. If I came off as a bit of a hardass, I'm sorry. I meant to come off as a total hardass. You can't deny your feelings, they are real and I did not mean to dishonor them. Still, you have a great deal of work to do to get your papers in order. Information is power.

Lastly, I'm not surprised the doctor cut off the topic of castration so quickly. I assume there was a large cash payout from the loss of your penis when you were circumcised. Any doctor then being asked to take off your balls would have that in his mind (remember doctors know each other even if they don't want us to know they know each other).

Maybe this post was the pep talk you needed, maybe you will re-read it in a week and appreciate it more and maybe you'll think I'm just not getting it. In any event, know that I'm with you and will offer my ESH (Experience Strength Hope) whenever I can.

have you tried calling dr crane he does nullo surgery and believes that it's your right to have it I've read that in an article he wrote all he requires is 2 letters and payment confirmation.

Thank you for the feedback and support. TopManFL, your reply makes complete sense to me.

I don’t think I’d have any trouble getting records of needed. When I mentioned that The uro has my lengthy medical history, I meant that even in light of all the issues I’ve had and that he’s treated, he still gave the big “NO” to castration. On that subject, you have a good counterpoint that I hadn’t thought about—-that my history with medical malpractice may give him an additional reason to deny this request out of caution.

Though I’m disappointed, I understand he has a right to *not* perform surgery he is not comfortable with. I also have to keep in mind that I finally got up the courage to ask him only because I’m facing surgery anyway. I just hoped to get it all done at once. I didn’t follow the more traditional channels. Don’t worry, I have zero interest in seeking out a cutter or any DIY stuff. That’s not my thing.

Yesterday, both of us were cordial, not rude, but we both were very firm. What I will do now is swallow some pride and go ahead and schedule the urethrostomy with him. After that hurdle is crossed and I’ve healed, I’ll pursue castration with a gender specialist. That’s probably the correct order of things anyway. I got everything all jacked up because I didn’t follow the steps in order. I’m still bringing all of this up with my therapist...

Zach

DifferentZach (imported) wrote: Thu Oct 03, 2019 3:16 am Thank you for the feedback and support. TopManFL, your reply makes complete sense to me.

I don’t think I’d have any trouble getting records of needed. When I mentioned that The uro has my lengthy medical history, I meant that even in light of all the issues I’ve had and that he’s treated, he still gave the big “NO” to castration. On that subject, you have a good counterpoint that I hadn’t thought about—-that my history with medical malpractice may give him an additional reason to deny this request out of caution.

Though I’m disappointed, I understand he has a right to *not* perform surgery he is not comfortable with. I also have to keep in mind that I finally got up the courage to ask him only because I’m facing surgery anyway. I just hoped to get it all done at once. I didn’t follow the more traditional channels. Don’t worry, I have zero interest in seeking out a cutter or any DIY stuff. That’s not my thing.

Yesterday, both of us were cordial, not rude, but we both were very firm. What I will do now is swallow some pride and go ahead and schedule the urethrostomy with him. After that hurdle is crossed and I’ve healed, I’ll pursue castration with a gender specialist. That’s probably the correct order of things anyway. I got everything all jacked up because I didn’t follow the steps in order. I’m still bringing all of this up with my therapist...

Zach

Zach,

You Seriously Rock! I mean that. If I were you I'd be so mad right now. Yet, you are taking it in stride far better than I would and I think better than most would.

I was serious about taking a day or so to "don't just do something, sit there". You need a fun day. A last day at the beach as fall sets in, a day at your favorite museum, a picnic on the living room floor with your boyfriend watching both versions of "Mame" (Both Lucille Ball and Roslin Russel are Amazing in that role but, they both do it differently), or maybe a day where you and your boyfriend agree to spend it butt ass naked and have sex as often as possible.

Surgery can bring up emotions like a giant emotional burb. I know with some of the major reconstructions that I had emotions come to the top that I thought I'd dealt with years prior. It's easy to go from extreme anticipation to depression in a flash.

Yet, when I read your posts you seem to have all of that dealt with so nicely.

With my foot crush injury, I remember the day I had lived more than half my life after the accident like it was yesterday. That day meant that from then on I'd always have more experience with a crushed foot than with a "normal" foot.

For you, that mile marker was just a few days after birth and you don't remember any time before your accident. It's beyond not fair and reaches into the realm of abuse and malpractice.

You have every right to be the most pissed off person on earth. Yet, you don't seem to be and that is an amazing thing. Perhaps you have had great therapists, loving parents and family who support you. Nevertheless, the fear of "being found out" must have haunted you all through growing up.

Take a bit of time. Lick your wounds. Then, get back to the business of being very kind to Zach and working to get him what he knows he needs.

Hello Zach,

I can well imagine the quandry you are in. I suggest too, that for now, don't do anything. I'm in a somewhat similar situation, in that the person I am seeing lost his penis do to an accident some years ago. He has become very accepting of his situation, and has no interest in changing anything. We satisfy each very well, orally only. It works. However, I was curious about penis transplants, and googled the question. Several things came up. I found a couple of the links that came up were interesting, although not directly applicable and list them here: https://www.menshealth.com/sex-women/a2 ... ectiveness; https://www.smithsonianmag.com/science- ... 180954639/

They seem to imply that transplants are successful, and becoming more so, for cases such as yours (botched circumcisions, etc.) with the recipient achieving almost complete functionality, including sensation. I would think that that would significantly improve as time goes on. Perhaps you should consider that one of your options...

In any case, I wish you much success and happiness in the future.

Unless it's a matter of insurance coverage, I wouldn't bother with the urethrostomy, unless you're in danger of a stricture closing off your present urethral opening.

Reasoning: Get yourself into the care of a surgeon who is qualified with folks like us. They will do nerve sparing surgery so that you can retain as much sensation (and pleasure) as you possibly can, and have the best result with minimal scarring. One doctor was already mentioned, but I'd check with another doctor in the same location (generally) as Dr. Crane. He's good and knows a lot about men like us, and is the "gold standard" for nullifying intact males, so he'd probably do a fantastic job of giving you what you're looking for.

PM me for details.

--LT

Hello Zach

It's sad to read things didn't go as you'd hoped. You must be terribly frustrated. You and your therapist will work through all the feelings and come up with a new plan of action: reroute with this urologist, castration with another, more sympathetic one.

However it goes, you've clearly got a group of caring and supporting people here!

Brian