#DrewsViews: Planning for Bottom Surgery

Matthew's Place
Matthew’s Place
Published in
4 min readJan 12, 2021

by Andrew Adams

I have been looking into getting bottom surgery for over a year now, and I have made a lot of progress. I am getting radial forearm phalloplasty, with urethral lengthening, and scrotoplasty eventually. I am also getting a hysterectomy at the same time, or maybe sooner, depending on a few things. I thought I would share the steps that I took so that anyone who is interested in bottom surgery and might not know where to start.

I found a care team that I feel comfortable with

I chose the University of Florida transgender care team. This is because they have a whole transgender care team, meaning that I trust them to know how to be respectful to trans people, and I know that they have some experience with trans people. I also chose them because they are fairly close to me — a 2 hour drive on a good day — so it isn’t too inconvenient to me. I started the process by calling their women’s center, since I was looking into the hysterectomy first, and I was able to schedule an appointment with a doctor who has a lot of experience in trans men having hysterectomies.

I had consultations with surgeons

So far, I have had 3 consultations with my Gynecologist, plus one telehealth visit, and one with my plastic surgeon. I will need to have at least one more with each surgeon, plus at least one with a surgical urologist. At my first appointment, my doctor informed me that they might be able to do the hysterectomy and phalloplasty in one surgery!

I had imaging and testing done

I had to have a pap smear, exam of the surgical area, and a pelvic ultrasound. I shouldn’t need to have anything else, except regular examinations closer to the surgery. While these exams were not fun, they had to be done, and now I am closer to being ready for the surgery because of it.

I made a plan to get in better shape

My plastic surgeon gave my arm a pinch in my first consultation with her, and she determined that I need to lose a little bit of weight. While I really don’t like having to watch my weight, she said that the layer of fat on my arm is a little too thick to create the new organ in surgery. The words she said were “coke can dick” and that definitely isn’t my goal. Therefore, I am working on slimming down a little bit, so that the layer of fat on my arm will work better for the surgery.

I am working on my mental health

This surgery is going to be difficult. I need to be okay mentally so that I can deal with the difficulties of this surgery. When I got my top surgery, I didn’t realize how tiring it would be to not be able to move, and to rely on everyone else for just about anything. Phalloplasty will be even more intense, and I will need to rely on others for a long time. I want to be mentally healthy so that I can deal with how exhausting this is going to be.

I won’t be getting this surgery until at least summer 2021, but I need to start getting ready now. I will keep doing updates and blog posts about the process from time to time as I prepare, plan, and eventually recover.

About the Author:

Andrew Adams is a transgender college sophomore at the University of Central Florida who is committed to LGBTQ advocacy at the local and national levels. Nationally, Andrew serves as a youth ambassador and advocacy volunteer for The Trevor Project, a youth social media ambassador for the Matthew Shepard Foundation, and a Volunteer and Intern Coordinator for Point of Pride. On the legislative side, Andrew lobbies for the Equality Act by visiting with his Congressional representatives and their staff.

Additionally, Andrew has spent years fighting to change his school district’s bathroom policy to be trans-inclusive, and the fight is still ongoing. Andrew is an International Baccalaureate student and a volunteer at the Mayo Clinic, and he hopes to go to medical school and become an adolescent psychiatrist specializing in transgender health. For fun, he practices Brazilian Jiu-Jitsu, creates sculpture art and plays the piano.

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