Can Transgenders Have Orgasims

Can Transgenders Have Orgasims

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1 Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium. selvaggigennaro@yahoo.it

Gennaro Selvaggi et al.

Ann Plast Surg .

2007 Apr .

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1 Department of Plastic Surgery, Ghent University Hospital, Gent, Belgium. selvaggigennaro@yahoo.it

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Background:

Tactile and erogenous sensitivity in reconstructed genitals is one of the goals in sex reassignment surgery. Since November 1993 until April 2003, a total of 105 phalloplasties with the radial forearm free flap and 127 vaginoclitoridoplasties with the inverted penoscrotal skin flap and the dorsal glans pedicled flap have been performed at Ghent University Hospital. The specific surgical tricks used to preserve genital and tactile sensitivity are presented. In phalloplasty, the dorsal hood of the clitoris is incorporated into the neoscrotum; the clitoris is transposed, buried, and fixed directly below the reconstructed phallic shaft; and the medial and lateral antebrachial nerves are coapted to the inguinal nerve and to one of the 2 dorsal nerves of the clitoris. In vaginoplasty, the clitoris is reconstructed from a part of the glans penis inclusive of a part of the corona, the inner side of the prepuce is used to reconstruct the labia minora, and the penile shaft is inverted to line the vaginal cavity.

Material and methods:

A long-term sensitivity evaluation (performed by the Semmes-Weinstein monofilament and the Vibration tests) of 27 reconstructed phalli and 30 clitorises has been performed.

Results:

The average pressure and vibratory thresholds values for the phallus tip were, respectively, 11.1 g/mm and 3 microm. These values have been compared with the ones of the forearm (donor site). The average pressure and vibratory thresholds values for the clitoris were, respectively, 11.1 g/mm and 0.5 microm. These values have been compared with the ones of the normal male glans, taken from the literature. We also asked the examined patients if they experienced orgasm after surgery, during any sexual practice (ie, we considered only patients who attempted to have orgasm): all female-to-male and 85% of the male-to-female patients reported orgasm.

Conclusion:

With our techniques, the reconstructed genitalia obtain tactile and erogenous sensitivity. To obtain a good tactile sensitivity in the reconstructed phallus, we believe that the coaptation of the cutaneous nerves of the flap with the ilioinguinalis nerve and with one of the 2 nerves of the clitoris is essential in obtaining this result. To obtain orgasm after phalloplasty, we believe that preservation of the clitoris beneath the reconstructed phallus and some preservation of the clitoris hood are essential. To obtain orgasm after a vaginoplasty, the reconstruction of the clitoris from the neurovascular pedicled glans flap is essential.

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A few years ago, as transgender issues leaped to the forefront of the cultural conversation, some famous and otherwise outspoken trans people were quick to steer the focus away from “the surgery.”
Many will remember the moment back in January 2014 when actress Laverne Cox schooled Katie Couric, after Couric ask an invasive question about her body. “The preoccupation with transition and surgery objectifies trans people,” Cox told Couric. “The reality of trans people’s lives is that so often we are targets of violence. We experience discrimination disproportionately to the rest of the community. Our unemployment rate is twice the national average [ . . . ] The homicide rate is highest among trans women. If we focus on transition, we don’t actually get to talk about those things.”
For the most part, people have respected that request. But according to my friend Nomi Ruiz, this has inadvertently created a taboo in the trans community: Nobody talks about sex. Nomi is a transgender singer and host of the podcast Allegedly NYC . “Right now there’s a lot of sensitivity around trans issues,” Nomi told me recently. “At times this makes it easier to communicate, but it also makes people afraid of offending someone, and prevents people from getting deeper into a conversation.” Nomi is concerned, in particular, about the lack of conversation around sex for women who have had sex reassignment surgery (SRS), and the real-life implications the operation can have on their sexual experience. “A lot of girls won’t even talk about it among themselves,” she said. “But I’d like to be someone who can open up this conversation.”
Now, I’m a cis person, and therefore have no personal insight to share on this seemingly off-limits subject. But I do know well that, when dealing with sexuality or any other sensitive topic, it is generally useful to hear the stories of people with experiences similar to your own, because it helps you to better understand your own experience and your own body. It helps you to not feel so fucking alone, basically. And I think Nomi’s concern poses a delicate question: Is it time for a nuanced discussion about sex and pleasure for trans women? Has the cultural conversation around trans culture progressed enough?
Over Chardonnay in Bushwick, Brooklyn, I sat down with Nomi to talk about sex. “I think a lot of people, when they think of trans females, they think ‘a girl with a penis,’” she said. “And if you’re post-op, they think you just had your penis cut off. There’s still this shock factor to having a sex change. People think, ‘Eww, that’s so horrible’ or ‘That’s so crazy .’”
According to Nomi, these misconceptions are common even within her own, progressive social scene. “Sometimes, if I’m dating a guy but I don’t want to sleep with him right away, he’s like, ‘Oh, because it doesn’t work.’ Or people think you can’t orgasm. They don’t realize the reality. But if they knew how beautiful and how natural the vagina really is, and how it’s so in tune with your mind and your body, I think people would start seeing it as sexy rather than as a science experiment. I mean, even I didn’t know the possibilities.”
Nomi said that as she was preparing for SRS, she wished there were more women talking about their experiences of sex after surgery, because she felt sort of in the dark. “There was this myth that you could never have another orgasm, that there’s no sensitivity, and that you could never enjoy sex again,” Nomi said. “So there was always that fear and that risk. But eventually I got to the point where I was like, ‘I don’t care. I’d rather not enjoy sex than live this way.’”
Nomi had SRS five years ago, in her mid-20s. “The conversation with my doctor beforehand was hilarious, because it’s sort of customized,” Nomi said. “She asked me: What are you looking to achieve? Like, are you a lesbian, are you interested in being penetrated? Is it more important to focus on the nerve endings in your clit, or do you want a lot of depth? Or do you want both? I was like, ‘I want it all. Go for gold.’”
Like any major surgery, there is a lengthy recovery period. “I was in bed for a month, and after that, there’s a dilation process,” Nomi said. “They give you four dilators, with a ruler on them. You’re basically fucking yourself: You slowly increase the size, so that you keep the depth and width you’ve achieved.” This process takes six months. “And then you have to dilate once a week for the rest of your life, unless you’re having sex,” Nomi continued. “So now when I’m not having sex, it’s kinda sad, because you’re really reminded of it. You’re like, ‘Oh, God, I have to dilate now because I’m not getting laid. Fuck.’”
(It’s important to note here that Nomi’s experience is not every trans woman’s experience. The process of altering one’s birth sex is complex, happens over a long period of time, and does not always involve surgery. SRS is only one small part of transition, and not all transgender people choose to, or can afford to, undergo surgery. Though it’s sort of strange to think of SRS as a privilege, there are many transgender people who want SRS but do not have access to it. For this and other reasons, sex change and post-op are outdated terms, and are used in this article only in direct quotations.)
At first, Nomi said, she was hesitant to jump into being sexually active: “I didn’t want to give my vagina to every guy, because I was like, ‘Duh, it’s brand-new!’” When she did start having sex, it felt kind of weird for a while. “I was really self-conscious, because I was blaming all of the awkward sex on my neo-vagina,” Nomi said. “I was like, Maybe it’s not working. It’s not like other girls’ vaginas. It’s not right. I’m not getting pleasure.” The first time she got head, it basically felt like nothing, so she called up her BFF, a cis girl, in a panic. “I was like, ‘Girl, is it normal to just feel like you’re rubbing on a carpet when a guy is eating you out?!’ She was like, ‘Oh, girl, yeah, sometimes it’s a fucking nightmare.’”
Nomi was faced with a harsh reality: A lot of guys just aren’t that great with their tongue. “I realized he just wasn’t good at it,” Nomi said. “But then, when I met a guy who was good at it, I was like, ‘Oh, duh, okay, it really depends. It’s not like jerking off a penis.’ When I had better lovers, things changed. It took meeting the right guy, slowly fingering me, seeing how I reacted. You need someone to help you enjoy your body, not someone who just wants to fuck you.”
As she continued to explore her body, sex became better than she ever imagined. “When I was turned on, I would get really wet, and I was shocked, because I’d never heard a [trans] girl say that her vagina got wet,” she said. “I didn’t realize that it would be this beautiful, natural part of me. I was like, ‘Holy shit, this is beyond what I thought my sex life could be.’” She paused for dramatic effect. “But I still love anal sex. The best sex is if we do both. But I learned that you can’t go back and forth, because I got a UTI from that. I was like, ‘Fuck, this is what having a vagina is like?!’ My friend was cracking up, like, ‘Girl, you wanted a pussy.’ I was like, ‘This is too real.’”
Other changes Nomi noticed were more mental than physical. “Before [SRS], sex was almost violent,” she said. “It was like shooting a gun, like I’ve got to get rid of this. But now I really have to be present and be into the person in order for my body to react. Like, my vagina will basically reject a penis if I’m not into the sex. But
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