Franches

Franches is a former patient of GrS Montréal et of Dr. Pierre Brassard. She is a strong proponent of self empowerment through knowledge and experimentation. Franches is also the author and publisher of HolaSoyYo.com (‘Hello, it’s me’ in Spanish), a blog where she shares her experiences and thoughts on changing gender expression.

www.HolaSoyYo.com

Not long ago, a close friend of mine asked me how to have a natural relationship with a neo-vagina? She was considering genital reconstruction surgery, but she felt uncertain about it. Hence her question to me. She had heard from a few friends that it took them up to 2 years to be ok with their post-op anatomy. That lag from her friends in becoming comfortable with their results made her doubtful.

After thinking hard about her question, I had an answer. I am sure that I have a healthy – good relationship with my neo-vulva (I had a vaginoplasty without cavity) because of my preparation for surgery.

When I say “preparation for surgery” I don’t mean packing my suitcase with everything I needed for the trip. I mean everything that lead me to consider the surgery and live with myself afterwards. Looking back, I can break up this preparation into 3 major phases. They are mostly sequential, but not necessarily. A consistent element through these major phases was making sure I’d answer each and every question I had about the process.

When I was offered to write this article, my first full draft was 7,000+ words long! As you can imagine, that would be too long for a single post. I decided to rewrite this more condensed version. Then I broke up my original long draft into 3 separate posts and linked to them from here. If you want to know more, at the end of each section in this article you’ll find a link to the longer, more detailed version on my blog.

First Phase: Unheeding From My Old Ways of Thinking

Where I Was Coming From

Let’s start from the beginning, a time before I even started considering surgery seriously. All my life I believed that changing my gender expression was not in the cards for me. Despite this I always wondered what it would be like to grow up and live in a girl’s body. Cut to 2015 when I started HRT along with changing my gender presentation. At that time, I simply wasn’t interested in genital surgery. I still kept that view after going full time, after having facial feminization surgery (FFS) and after my breast augmentation. It was sometime in 2017, while I was making arrangements for my mammaplasty, that I started thinking about a vulvoplasty or maybe a vaginoplasty. Yet every time I thought about surgery, there was something in my head stopping me from seriously considering it. It felt like I had a lot of questions but wasn’t even sure if I wanted to know what those questions were.

Wondering What Would Life be After Surgery

I could not clearly visualize how my life would change after surgery. This was one of the first mental blocks preventing me from considering surgery. Yeah, there were some changes that I was keen on, like not having to tuck anymore, but there were others I wasn’t sure.

An early question I had to answer was if I’d be able to pee sitting down for the rest of my life. Gee, even just writing this makes me see how basic the question was, but I didn’t see it like that then. Though I’d been peeing sitting for several years, I didn’t do it always. I’d pee standing if I felt a situation was too unsanitary.

To get the answer I was looking for I forced myself to pee sitting or squatting for about a year. I did it every time, no exception. Of course, it was possible, just the way 50% of the population has done it all their lives, but I had to experience it. I also wondered how my (scarce) sex life may change. For this one I was already satisfied without getting an accurate answer before surgery. Speaking with Dr. Brassard beforehand, he explained the procedure and how the glans would very likely still be erogenous. At the end I was happy with not knowing for sure but understanding my chances.

Rethinking my Relationship With my Genitalia

Here I get really personal, but I feel it’s important to open up. Though I don’t expect everyone to see my point of view, probably someone might relate a little. At the very least opening up helps explain a major hurtle I had before considering surgery. I clearly see now that this was my hardest mental block but then I wasn’t even aware of this. As mentioned above, most of my life I never thought I’d change my gender expression. Part of it was that I was happy with my body and the genitalia I was born with. It never caused me dysphoria or unease. If anything, I was ok with it and had lots of fun with it. Maybe that’s why it took me so long to start considering getting a vulvoplasty.

Digging Deep

Every time I thought about surgery, I felt there was something that wasn’t adding up. So I dug deep to find out what didn’t add up. After a lot of soul searching, I found I was allowing my penis to define me. This was a breakthrough because I could finally see what my main mental barrier was. If anything, this speaks a lot about how the patriarchal environment I grew up in affected me.

There was a tug of war in my mind. I wanted to consider surgery but how would I even think of getting rid of what defined me. Again, digging even deeper I questioned why I thought the genitalia I was borne with defined me. As soon as the question was asked the answer appeared: it clearly didn’t.

At that point my relationship with my penis switched from an element that defined me to something that didn’t add much value. I saw that after living full time it kind of got on the way more than anything. From that point on I could seriously consider having genital reconstruction surgery. If that mind shift hadn’t happened, most certainly I would have had a hard time developing a healthy relationship with my post-op physiognomy. You can read more details on some other mental barriers I had and how I dare to consider surgery on HolaSoyYo.com

Second Phase: Serenity Through Knowledge (Pre-op)

Once my primordial questions were answered it was time I’d get into the details. I wanted to get to know as much as I could about the surgical procedure. By doing so I could understand better what to expect aesthetically and during recovery. Then and only then I felt I’d be able to make a decision to either go ahead or not. At the end, all this knowledge helped me evolve a natural relationship with my results after surgery. Post-op it helped me get an intimate understanding what was done and how that influences my daily life.

Considering Surgeons

When it came to looking at surgeons and/or surgical centres, luck was on my side. My medical insurance covered surgery at GRS Montreal.

However, cost or insurance coverage was not the only or the main factor. The aesthetics of their results, my ability to have low friction communication, and their experience were the other important points I considered. The idea was to have all those elements ensured to feel at ease with the surgery, and more importantly with myself long term.

The patient coordinator at GRS Montreal helped me arrange a consultation with Dr. Brassard. A number of weeks prior to my surgery I spoke with him over the phone. At that time, he answered my long list of questions. This also gave me a small insight into the surgeon’s personality and philosophy. On top of this, knowing that they perform hundreds of genital surgeries a year, both male and female, added to my confidence in them.

Thoroughly Understanding the Procedure

As I’ve mentioned a few times, I did not decide on having surgery until I understood the procedure, risks, and recovery protocols. I spent countless hours reading and learning about the different feminizing genital surgery options. Personally, I rather get medical facts opposite to personal accounts from other patients. The main reason is that anecdotal information is always coloured by the speaker. On the other hand, medical documentation is often based on years of impartial clinical observations, for the most part.

I based my understanding of the procedure mostly from the package that GrS Montreal sends its patients. Also, by reading about the procedures on the websites of multiple surgeons/surgical centres helped me grasp the concepts. The information package from GRS Montréal contained invaluable details about pre-op preparations, the procedure itself, and aftercare protocols.

I strongly advise anyone considering genital surgery to read the official documentation. Parts A,B, and postoperative care (Part C) of GRS Montréal’s patient information package are linked off their website. Look for the links at the end of their respective webpages, which are also quite insightful:

• Vaginoplasty
• Vaginoplasty without vaginal cavity (vulvoplasty)

I too relied heavily on my discussions with the psychologists during each of my two surgical assessments. Before deciding on having surgery, I went through the assessment process to get medical information, not to get approved. I believe this gave me some clarity because during the assessments I was not rushing ‘to get accepted’. Rather my interest was to learn as much as I could and then make an informed decision.

Recognizing and Accepting the Risks

If understanding the procedure and recovery was important, recognizing the possible risks was paramount for my peace of mind. My first opportunity to ask someone qualified about the risks was during the surgical assessment process. The next big chance to enquire about risks and complications was during my phone consultation with Dr. Brassard.

Reading through the GrS Montreal information package and multiple surgeons’ websites I got a fairly clear perspective on the risks and aftercare. I also met with a registered nurse at my local gender clinic before surgery. Chatting with her, plus my conversations with the surgeon and psychologists, and the reading materials I studied, all helped me see and accept the risks.

As a PSA (Public Service Announcement) I want you to be aware of the most common risks and complications in vaginoplasties (with or without cavity). It’s a good idea to familiarize with some of these if you or someone you know is considering surgery:

• Infection/Abscesses.
• Hypergranulation
• UTIs (urinary track infections).
• Recto-vaginal Fistula (does not apply to vulvoplasties).
• Prolapse of the neovagina (does not apply to vulvoplasties).
• Hair growth inside the neovagina (or inside the dimple vestibule in a vulvoplasty).
• Loss of sensation and inability to orgasm.

Download the TRS Surgical summary sheets from Rainbow Health Ontario and look for the Vaginoplasty sheet for concise clinical information.

You can find more details of how I gathered knowledge and made the decision to have surgery on my blog. Many of those details relate to the pre and post-op planning documentation GrS Montréal provided as well as other sources of factual information.

Last Phase: Confidence in Recovery (Post-op)

In my opinion recovery is the Holy Grail. Surgery is just a point in time, a quick methodical controlled trauma. Then recovery starts. All my prior mind shifting regarding my genitals, the learning, questioning, and understanding was to prepare for recovery and life beyond. The first few weeks and months post-op are crucial. From past surgeries I learnt that the more support one can get during early recovery, the easier, or rather less complicated it would be.

By going through my mental shift that allowed me to consider surgery, and learning as much as I could, I was able to increase my confidence in my decision. Following a consistent theme, all these later contributed to my natural relationship with my neo-vulva. All even before I left home to Montréal. However, my recovery’s contribution to the satisfaction with my results built up as it happened. Meaning that for the most part my confidence grew during recovery, and not prior.

Not Bothering with Things Outside my Control

Are you happy with your results? How much it hurts? What is sex like? How does it look? How does it feel? These are examples of some of the questions people get post-op. At first, I had similar questions though I realized that the answers didn’t matter. They were really not important because there was no way to know. Someone may tell you their perspective, but creating a personal expectation based on someone else’s subjective narrative, in my opinion, is not a good idea. A very simple example: If you ask me if I’m happy with my results, the answer is yes. Though that answer should be meaningless to you unless you knew what my expectations were.

When it came to things outside of my control, I did not spend much time thinking about them before I had to face them. Another example: I knew I would be uncomfortable and most likely in pain the first few days. How much? The only way to know was to go through recovery and see how much it’d hurt at the time. The way I prepared was by expecting the most painful experience ever, though chances were that it wouldn’t reach that point. Instead of mulling over it before surgery, I’d deal with pain once I felt it.

My Past Surgical Experience as Reference

While I was preparing for this surgery I looked back at my past surgical experiences and noted the similarities. Though there are massive differences between the kinds of surgeries, there’s a lot that is shared. In all my surgeries I developed similar relationships with the surgeons and nursing staff. The way I healed was fairly similar between surgeries. How I dealt with pain and my reaction to anesthesia were comparable. Based on all these common elements I could picture in my mind how I’d do for my vulvoplasty.

Asclépiade

GrS Montreal includes a few nights at the recovery home, Asclépiade, before discharging their patients to return home. That stay at Asclépiade made the first few days after surgery much easier than all other options. To give you an idea of the impact that Asclépiade had imagine being in a home with other trans patients that went through genital reconstruction. Then add being under the care of nurses that specifically work with these patients, and all your basic necessities (boarding, medication management, wound and patient care) are overseen by the staff. And then compare that package to recovering at home, at a hospital, or a hotel room.

As I went through the experience at Asclépiade it was easy to predict that if I were to have any complication, that it would be minimal. And that peace of mind also boosted my confidence in my relationship with my surgical results.

Recovery at Home

I made every effort to make my flight home as comfortable as possible. In general flying after surgery can be tough, specially on long flights and furthermore when the surgical site could make sitting uncomfortable or painful. Also, I had made arrangements at my local gender clinic to see a nurse a few days after my return. The nurse would be monitoring my recovery and aftercare once I returned home. So, even before leaving for Montréal I already felt a certain sense of ease knowing someone could take care of me locally. BTW, this is the same nurse that gave me some insider pointers weeks before flying for surgery.

You can find more details on how I prepared for recovery on HolaSoyYo.com and even how I dealt with an issue I encountered after I got home.

Conclusion

As I said at the beginning of this article. I was able to develop a natural relationship with my neo-vulva by answering every single question, even if the answer was “I don’t have a definite answer yet”. This included changing my relationship and understanding of my original born organs before I could contemplate surgery. If I hadn’t done that most likely I would have left doubts in my head that would have undermined my appreciation of my new physiognomy.

Once I was able to seriously consider surgery, knowledge about the procedure, and specifically its risks, possible complications, and recovery were the most important aspects of being happy with my results. If you or someone you know is considering surgery, any surgery, but more importantly a vaginoplasty, please make sure you or they know the commitment it takes.

Once I was able to seriously consider surgery, knowledge about the procedure, and specifically its risks, possible complications, and recovery were the most important aspects of being happy with my results.

If you or someone you know is considering surgery, any surgery, but more importantly a vaginoplasty, please make sure you or they know the commitment it takes. The first few months of recovery from a vaginoplasty can be intense. Any and all support that one can get during that time, should help develop a natural relationship with the neo-vagina.

L’article My complex mental process to prepare for surgery est apparu en premier sur TransAvenue.

At the beginning of the 20th century, psychoanalysis was recommended for patients suffering from gender dysphoria. It was believed that the mind must be changed to match the body. Today, we see things differently, mostly because of Dr. Harry Benjamin who made his career in the United States. He created the term Benjamin’s Syndrome to designate “transsexualism” which he is the first to define as “neither a perversion, nor a homosexuality” in 1949. He was one of the first to believe that the body must be altered to fit its perceived identity, and to recommend surgery or hormone therapy to his trans patients. Initially considered as an eccentric by the medical community, his views were eventually adopted.

The decision to begin a transition is usually made when an often complicated psychological journey is already well underway. Symptoms of anxiety and depression often mark this difficult journey. This is commonly known as gender dysphoria. Support from loved ones can be of major importance.

The often complicated socio-economic factors only make this suffering worse. For example, the number of homeless trans people is statistically higher than in the general population. Once on the streets, access to information about gender affirmative surgeries and related care that could alleviate their suffering becomes much more complicated. That is not even considering the additional barriers faced by trans people belonging to Aboriginal minorities or refugees, who are alone and do not yet have access to the public health system or speak official languages.

Because morals change slowly, the long journey of accepting oneself and others can be a source of pain that is equally worthy of recognition. However, a recent study from the Yale University School of Public Health in the United States showed that in the years following surgical procedures, transgender individuals are significantly less likely to require mental health follow-up for depression, anxiety or suicide attempts.

More recently, Dr. Pierre Brassard of the GrS Montréal clinic told a journalist from Le Devoir about his first patient: “I saw the extraordinary effect that surgery had on this person and the suffering that had beset her until then. Her reaction convinced me to continue doing this kind of surgery. There is no better patient than a trans patient.”

If a hundred years ago trans individuals were secretly operated on by courageous surgeons who defied the existing laws, today these surgeries are more and more accessible and recognized as therapeutic in the treatment of gender dysphoria. However, it is important to always remember that this choice is very personal and can contribute greatly to improving mental health.

L’article Mental health and gender affirmation surgery est apparu en premier sur TransAvenue.

On May 30th, 2019, Dr. Pierre Brassard was awarded the Phénicia Medal, surrounded by his main collaborators. Plastic surgeon, and medical director of Complexe chirurgical CMC and GrS Montreal, Dr. Brassard is recognized worldwide for his work in the field of FTM and MTF gender affirmation surgeries.

Career

Recently, Dr. Brassard told a journalist from the newspaper Le Devoir, about his first patient:

“I saw the extraordinary effect that the surgery had on this person and the suffering that had beset him until then. […] There is no better patient than a trans patient.”

Dr. Brassard graduated from Laval University in medicine and then in plastic surgery at University of Montreal. He then worked in various hospitals before becoming medical director of the Centre Métropolitain de Chirurgie in 2000. Dr. Brassard has carried out thousands of trans surgeries.

He is also invested in different institutions as an instructor or a lecturer emeritus. In addition to being a brilliant presence in the community, he contributes to the training of doctors who will follow in his footsteps.

The GrS Montréal Clinic

The main contribution of Pierre Brassard is not a small one. His clinic, GrS Montreal, is the only one in Canada that specializes in FTM surgery and MTF surgery. Since its opening in 1980, surgeons have operated on nearly 10,000 patients. The four surgeons currently working there are labouring tirelessly. GrS Montreal welcomes patients from around the world who come for phalloplasty, vaginoplasty, mastectomies, or even facial and body feminization surgeries.

The Phénicia Medal recognizes his dedication and empathy towards the well-being of patients who often carry a long, complicated history with them. His surgical skills and dedication to continuous improvement of his science make him an outstanding practitioner.

L’article Dr. Pierre Brassard, recipient of the CC-LGBT Phénicia Medal est apparu en premier sur TransAvenue.

On average over the last 3 years, 26% are from Quebec, 35% from Ontario, 26% from the western provinces, and 6% from the Maritimes.

The other patients (7%) who benefit from Quebec’s expertise come from Europe, Australia, and the United States.

The high percentage of Canadian patients reflects that in Quebec, as well as in other Canadian provinces, government programs cover almost 100% of the costs for most types of gender affirmation surgery and for the requisite medications.

“Because of superior accessibility, better timelines, and the expertise of GrS Montréal, we welcome many French and American citizens who are wishing to go through trans surgery,” explains Henri Labelle, social worker and psychotherapist.

Recognized and Coveted Expertise

With regard to gender affirmation surgeries, Quebec expertise is well-known and peer recognized. In this respect, GrS Montréal is a preferred location for all those wishing to undergo these types of surgeries.

At CMC, Dr. Pierre Brassard, whose primary training is in microvascular surgery, has developed his skills to the point of mastery over the past 25 years. It follows that the savoir-faire and expertise of Dr. Brassard are in great demand around the globe. In addition, the development of the pre- and post-operative clinics as well as the convalescent care offered at the world-renowned Maison de convalescence Asclépiade, the recovery center unique in the world, make GrS Montréal so very appealing to patients for its quality of care and its overall supportive approach.

Indeed, professionals from around the world are contacting GrS Montréal to benefit from its knowledge and many are asking for the privilege of observing its surgeries and viewing its care environment.

No matter where our patients come from, the GrS Montréal team will do everything in its power to facilitate accessibility to its services. Among the coordination services for your stay you could benefit from accommodation in a partner hotel as well as transportation required during your stay in Montreal. All GrS Montréal patients are entitled to the same dedication and quality of care.

L’article Where do the patients of Centre Métropolitain de Chirurgie come from? est apparu en premier sur TransAvenue.

These surgeries are a combination of both cosmetic and maxillofacial surgeries and aim to soften the facial features into a more typically feminine appearance. Read below to find out more about the main types of facial feminization surgeries (FFS).

Forehead Reconstruction

One of the most common FFS surgeries is the reconstruction of the forehead. A look is identified as feminine not because of a difference in the eyes, but because of the shape of the bones that surround them. Female foreheads are often smoother and uniform: women have vertical foreheads, while men’s foreheads descend to create a hump above the eyebrows (the brow bone is pronounced). Female eyebrows are also often high and curved, and men tend to have bare temples. For all these reasons, the reconstruction of the forehead can be a key element of facial feminization.

Several options are available to the patient: depending on the thickness of the skull to remove, the forehead may be ground or remodeled. This surgery can even be done at the same time as another FFS surgery or MTF surgery. In any case, it will be your surgeon who can guide you according to your particular case.

Tracheal Shave (Adam’s Apple Reduction)

The reduction of the Adam’s apple is more or less a 1 hour procedure. It consists of filing the cartilage which constitutes the Adam’s Apple. The surgeon must be suitably experienced to not get too close to the larynx and to not alter the patient’s voice. The small scar is hidden under the chin and will be almost invisible.

Rhinoplasty

Rhinoplasty, better known as plastic surgery of the nose, is done under local or general anesthesia. In the context of an MTF surgery, the surgeon removes excess bone and cartilage from the nose through small incisions inside the nostrils. A thinner nose contributes greatly to facial feminization and is one of the most common FFS surgeries.

Jaw Surgery

Several chin and jaw reduction options can be explored and are done through hidden incisions in the mouth. The V-Line procedure consists in shortening and thinning the jaw, it also allows for making the chin into a rounder shape and moving back a chin that is of a squarer shape. Some surgeons use high tech ultrasonic equipment to cut the bone without creating too much bleeding and to protect the nerves.

In conclusion, FFS surgeries include the face and neck, and focus on bone structure and shape of the nose. Other lighter FFS surgeries are available and can be incorporated to complete facial feminization: face or brow lift, blepharoplasty (eyelids surgery), cheek implants, lip lift, cheek fat resection, otoplasty (ears), or treatment with Botox© or Juvederm©. Many of these surgeries can be combined; talk to your surgeon!

L’article What is facial feminization surgery (FFS)? est apparu en premier sur TransAvenue.

The content of the first video reveals the scope of services available at GrS Montreal and the great importance given to the human component throughout the whole process of a gender affirming surgery.

We also learn that every year, no less than 1000 patients from all over the world choose to trust the Complexe chirurgical CMC and its subsidiary GrS Montreal with their gender affirming surgery. Each year, nearly 700 genital surgeries are performed here.

No wonder that the surgeons at this private hospital are considered the most experienced in the world in the field of gender affirmation surgery and are often cited for reference.

In one of the videos, Dr. Pierre Brassard, Medical Director and Associate Owner of the Complexe chirurgical CMC, mentions the evolution of techniques that continue to improve over the years.

While many of Dr. Brassard’s patients have thanked him for saving their lives, he is keen to qualify these words.

« In reality, we do not save the lives of people who will die of an illness, but we relieve them of a distress so strong that, in the end, the benefit for the patient is immense », says the famous surgeon.

Three Moving Testimonials

In the second video, we can hear the poignant testimonies of Adany, Nicolas, and Laura.

Authentic and moving, these three people from different places and backgrounds tell to what extend their gender affirmation surgery has changed their lives and for what reasons.

For instance, Adany evokes the feeling of being a fraud that has long haunted her.

« I was at a point in my life when going through the process at Complexe chirurgical CMC and the convalescence home Alsclépiade processes would finally allow me to begin to heal. From that moment, I was able to close a chapter and start a new one », she says.

Clearly, these are two revealing videos that help to better understand the universe of gender affirmation surgeries, from both the medical point of view as well as that of the patient.

L’article GrS Montreal is launching two corporate videos at the 2019 CPATH conference est apparu en premier sur TransAvenue.