Before August 30, 2016, getting stitches at age seven was the most time Emmie Smith had ever spent in a hospital.
That morning, she swapped her plaid shirt and jean shorts for a gown, tucked her hair into a cap, and prepared for surgery to conform her anatomy to the gender she already identified with: woman. In the operating room with her was National Geographic photographer Lynn Johnson. She and Emmie hoped they could demystify the procedure by documenting it, close-up and unflinching. “It was stressful and scary at times, but it almost created a mission other than just recovery,” Emmie says. “We were making something together.”
It had been a year and a half since Emmie had first come out as a transgender woman on Facebook. Telling her family and friends had been an enormous relief. “I’m not sure I could have taken another few years of being closeted,” she says.
Still, it was a challenging time for her family. Her mother, Reverend Kate Malin, is a prominent figure in their Massachusetts town, and her identical twin sons Caleb and Walker were familiar fixtures at her Episcopal church. A month after Walker came out as Emmie, Malin stepped out from behind her pulpit and walked into the aisle. Halfway through her sermon she decided it was time to address the change in her family.
“As most of you know, Bruce and I have three children,” she began. “Caleb and Walker, who are 17, and 13-year-old Owen. Walker’s new name is Emerson, and she prefers Emmie or Em. She’s wearing feminine clothing and makeup and will likely continue to move in the direction of a more feminized body.”
Kate nervously revealed her struggle to the attentive New England crowd. “I feel broken much of the time,” she confessed. “I’ve wanted to run away, and I’ve prayed for this child that I would gladly die for, guilty for how much I miss the person I thought was Walker and everything I thought might be.”
After the sermon, the congregation engulfed her in a hug. Then they moved to offer words of support to the sandy-haired 17-year-old sitting in the pews. In the first of many awkward mistakes the family would later laugh about, it was Caleb—Emmie’s identical twin.
After that sermon, a “new normal” set in. On a Saturday night soon after, they had their first “out” outing. Kate took Emmie—whose hair was still short and chest was flat—to buy a prom dress at David’s Bridal. She feared someone would point or laugh, but the crowds of brides and bridesmaids in the dressing room offered only compliments.
Though she hadn’t initially considered surgery, after a couple of months Emmie had grown frustrated by the tucking and taping required to fit into women’s clothes. That fall, her senior year of high school, she decided to do it.
But waking up after the operation, Emmie felt none of the immediate relief she’d expected. In the recovery room her earbuds played a soothing loop of Bon Iver and Simon and Garfunkel, but it didn’t drown out her disappointment and fear. In retrospect, she thought, hadn’t life before been OK?
It wasn’t until months later, when she was home and could walk and sit again, that Emmie knew she’d made the right choice. “If you’re not living freely that’s time wasted, and I felt my time was wasted pretending to be a boy,” she says. “It was the best decision in my life.”
Now, halfway through a gap year, she’s applying to college theater programs. It’s strange, she says, knowing that her future classmates may watch Johnson’s film and learn the most intimate details of her life. She’s hopeful that her participation will evolve the public’s understanding of gender reassignment surgery. “It’s not science fiction or mythology,” Emmie says. “It’s what happens to women just trying to be at peace with themselves and their bodies.”
A transgender woman who underwent a vaginoplasty to have her penis turned into a vagina has described in graphic detail what the process was really like.
Jessica, who identifies as a queer woman, had already started hormone replacement therapy and gone all the way to South Korea to have vocal chord surgery to transform her baritone voice when she decided to have a breast augmentation surgery and a vaginoplasty in one operation.
After her vaginoplasty, which she had near her home in East Bay Area, California, she warned 'there are going to be parts of you that are going to melt off' in an interview with Truth Speak Project.
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Melting: A transgender woman has described what it is like to undergo gender reassignment surgery; a video reenactment by the European Association of Urology shows what genitals might look like after the procedure
Jessica, whose partner was also born male and had already had the surgery, said there were elements of her recovery that she was not warned about by doctors, adding that it was 'really scary'.
She said: 'There are going to be parts of you that are going to melt off...It is really scary. But it’s also perfectly normal and most people recover from that completely as if nothing has happened.
'Basically the furniture down there gets rearranged during the surgery. One of the many things I learned along this journey is that male genitalia and female genitalia aren’t that different. They’re arranged differently, but the individual parts are really similar.
'So vaginoplasty consists of a re-positioning and folding of all these tissues using the existing tissues.
'When that’s done, some of the tissues might not get as much blood flow as they did before, so they get starved of nutrients and oxygen.
'That’s when the surface tissue tends to die off — which is as gross as it sounds. It is really really awful.'
Warning: Jessica, who was born male, said: 'There are going to be parts of you that melt off' after surgery (medical diagram shown)
Although Jessica said she was expecting her vagina to 'look like Frankenp***y' after surgery, it was much worse that she could have imagined.
At one point she claims she thought she was 'dying'.
'It’s red, there’s stitches and it’s swollen, you can see the stitch lines. You expect that,' she said.
'What you don’t expect is this yellow-y, clumpy, almost mucus-y, looks-like-someone-sneezed-on-your-p***y kind of residue.
'So you might have a chunk of your inner labia just die off, just fall off, and it’ll just grow right back. It’s hard to believe because when you lose a limb or a toe it doesn’t grow back. But it turns out that your p***y does. It’s strange.
'And it’s gross and it’s funky and it’s awful and you think, "Oh my god, What is happening? My p***y is melting. I’m dying." But it turns out that it is perfectly normal.'
She said doctors should better prepare patients for what will happen following the surgery.
'It’s something doctors should tell patients beforehand. Because you’re already dealing with so many changes, working with so many geographic changes on your body.
Healing: She said she had anticipated her vagina looking 'like Frankenp***y' after surgery, pictured in diagram, but said it was much worse than she expected (medical diagram shown)
'Your clitoris, which used to be the head of your penis, is positioned in a completely different way,' she said.
In the early days after the operation, Jessica said there were occasions when she thought she still had male genitalia.
She said: 'There were times early on when I felt like I could feel my penis. I figured out what was going on though.
'Basically, my clit was telling me that it was still the head of my penis, that the most sensitive part of it was still there. It took a lot of adjusting and it was pretty weird at first.'
She said she has shown her new sexual organs to cisgender females who have told her the surgeon 'did a great job'.
Jessica said she has a G-spot and that she has had orgasms - but they are 'very different' to what she experienced before surgery.
She said: 'I do have a G-spot. In fact, I still have a prostate, even though it’s much smaller than it was because of hormone replacement therapy. But it’s still there and it can still be stimulated. It’s still very enjoyable...
'Orgasms are very different. Oh my goodness. They were different even before my surgery after I started hormone replacement therapy. That’s when I started having more full-body orgasms.
Icon: Transgender actress Laverne Cox, 31, left, has previously said she was pleased she could undergo gender reassignment in private; transgender model Andreja Pejic, right, also underwent the procedure in 2014
'The sensation wasn’t just concentrated immediately around my genitals anymore. It was more like waves of pleasure throughout my body.
'So that started happening with just hormones. But then, of course, the surgery changes everything.'
She added: 'I didn’t think that I would get such good results from my surgery but there they are.
'I definitely experience internal stimulation orgasms and they are different from the orgasms I get from clitoral stimulation.
'They’re deeper and they’re more intense — always gush from internal orgasms.'
She said the development of surgery has made experiences for people undergoing the procedure 'a lot better' in the last decade.
She added: 'Some things are different for trans feminine people who had their surgery ten years ago.
'Doctors have gotten to a point now where they can make a vagina that allows you to come and really gush from internal vaginal stimulation just like a cis-gendered woman does, if that’s something that you’re capable of doing.'
Jessica paid for her breast augmentation herself but the vaginoplasty was covered by her insurance as required by California law after a doctor said it was medically needed.
Despite having done so herself, Jessica warned against having both surgeries in one operation.
'I woke up in the recovery room in a world of pain, unable to move,' she said. 'I really underestimated how much the recovery from breast augmentation takes out of you.'
She said she opted for a full vaginal canal because she wanted to experience penetrative sex and to 'relate to cis-gendered women'.
Content: Jessica said she is pleased with the surgery, pictured above, and said since then she has found she has a G-spot and has had orgasms
Progress: Jessica said vaginoplasty surgery, pictured in diagram, has developed considerably over last decade
She added: 'I had to wear a pad every day and I get it. The struggle is real...I have this newfound respect and empathy for my fellow sisters. I get it now...
'I just had my first p-in-v sex as a vagina-haver and it was different from what I expected. It was more intense than I expected.
'I had gotten used to the process of dilating my vagina, which I do with a medical phallus one to two times a day, to keep the new vagina from closing up.
'I’ve been doing that for 9.5 months since my surgery. So having something in my vagina is a normal sensation for me because I experience it every day.
'There are going to be parts of you that are going to melt off... It is really scary. But it’s also perfectly normal
Jessica, transgender woman
'But having a person inside my vagina was a relatively new experience for me. I’ve had fingers but I’ve never had a penis.
'It was a little overwhelming, but it was pleasant and fun and I would totally do it again. The person I had sex with was a preoperative trans woman.'
Transgender model Andreja Pejic underwent gender-reassignment surgery, also known as gender-reconfirmation surgery, in 2014.
Talking about the decision last year the Bosnian model told Vogue: 'Society doesn't tell you that you can be trans. I thought about being gay, but it didn't fit…
'I thought, well, maybe this is just something you like to imagine sometimes'.
Orange Is The New Black star Laverne Cox said she does not like the focus on gender reassignment surgery - saying she is 'grateful' she could have gender reassignment surgery in 'private' unlike Caitlyn Jenner.
The transgender actress told Entertainment Weekly last year: 'I’m so grateful that I had the luxury of transitioning in private because when you transition in the public eye, the transition becomes the story.
'I’m always disturbed when I see conversations about trans people that focus on surgery. But I believe Caitlyn will transcend this moment.'
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