The Masterpost of Resources for female-at-birth Agender People who want Bottom Surgery
So, this is going to be a long post. But it’s necessary. Lots of agender people are able to get top surgery, but I never see anything about bottom surgery. Feel free to signal boost and spread around to help your agender friends. There are no other resources out there like this aside from 1 that I’ve once reblogged where the OP deactivated and all links were broken. This post won’t have any links other than for sources, so that way even if my blog ever becomes deactivated, the information will still be there. As a bigender person I feel such a sense of solidarity with my agender siblings. Peoples misunderstanding and refusal to help you treat your dysphoria absolutely breaks my heart. If I’m allowed to want both parts, you should be allowed to want neither. You are not broken or sick for being agender. You are absolutely valid, and this post is for you. I’ve been planning it for months, and it took a lot of research, but it’s still not going to be perfect, so please feel free to correct any misinformation, and add information on agender bottom surgery in other countries (as this post is very U.S.-centric).
That being said, what DOES agender bottom surgery look like? From how I’ve had it described to me, it involves wanting to look completely flat or “blank” in your bottom area. And how is this done? There are a few different possible surgeries that could be used to complete this look:
-partial clitoridectomy (removel of clitoral hood)
-complete clitoridectomy (removal of clitoral glans + hood)
-clitoroplexy(will make the clitoris smaller)
-clitoral hood reduction (will make the clitoral hood smaller)
-labioplasty(reduction/alteration of the labia)
-vulvectomy/excision (removel of labia)
-infibulation (sowing together of labia)
-complete hysterectomy (removel of uterus/ovaries-necessary for vaginectomy)
-vaginectomy(bye bye vagina)
Clitoridectomy/Clitoroplexy/Clitoral Hood Reduction
A complete clitoridectomy involves the complete removal of the clitoris (an organ that is mostly internal and partially external). It’s illegal in many places due to the fact that it is commonly used as a part of female circumcision. I absolutely don’t support the mutilation of infants body parts for any reason, and fully believe in peoples rights to make their own decisions when they are old enough to. From what I understand, the law banning FGM of 1996 (which was recently declared unconsitutional and appealed by the house of representatives as of November 20, 2018, yikes) only specifies that it bans it for people under 18, however, because of how it is often used, (as a way of mutilating babies rather than a choice for adults) it’s extremely hard to find clinics willing to do it because of the horrible connotations. According to Docdoc.com:
“Under medical use, the clitoris may be cut if it is necrotic (or the tissue is dead) due to poor or failure of blood supply to the organ, the signs of which may begin to show on the outer lips of the vagina. It may also have to be removed if the clitoris or the organs and tissues near it have been damaged due to traumatic injury or if the patient is diagnosed with reproductive cancer, which may require the resection of certain parts to control, reduce, or prevent the spread of the disease.
One of the common reasons for the procedure is clitoris hypertrophy, which means the clitoris has become enlarged due a number of possible reasons including the intake of certain drugs or congenital adrenal hyperplasia (CAH), where the adrenal glands found near the kidneys produce either too much or very little of the sex hormone.”
If you want a clitoridectomy done, and you don’t have what qualifies as the usual medical reasons, a diagnosis of gender dysphoria may be essential when convincing a doctor to perform a clitoridectomy on you. The only place I know of that openly treats nonbinary people is the Mazonni Center located in Philadelphia. From there they may be able to get you in contact with doctors willing to write notes confirming that you are dysphoric and that this is something that is absolutely medically necessary.
Please be informed that the clitoris is a sex organ, and is used for pleasure. Many people report no longer being able to orgasm after the removal of the clitoris [source]. If sexual pleasure is something that’s important to you, and you find that you’re unable to acheive orgasm mentally/vaginally/ect. and don’t want to risk losing the ability to orgasm, it’s okay to reconsider. Due to most of the clitoris being internal, it MAY be possible to only remove the external part so that one can still feel sexual pleasure while still appearing mostly flat down there, however I was unable to find any information on this. If you have an open-minded surgeon, this may be something to talk to them about. Another POSSIBLE option is a process known as infibulation-the sowing together of the labia. Again, I could not find any information on if a clitoridectomy is necessary to get an infibulation, but it is one possible way of achieving “flatness” down there without the possibility of losing the ability to feel sexual pleasure.
Because of the terrible reputations of a clitoridectomy and the horrible way it is used, I was unable to locate a single clinic openly stating that they are willing to do so.
Clitoroplexy and clitoral hood reduction are usually done by plastic surgeons on adult women for aesthetic reasons. They are another possible solution for agender people unable to find a surgeon as they can help to make that area appear flatter, and it *may* be more likely for someone who already does genital surgeries to be willing to do a clitoridectomy.
(Please feel free to add on to this with more areas you were able to find willing to perform these procedures. I will edit the original post to include the information as I’m made aware)
Labioplasty/Excision(vulvectomy)/Infibulation
Like before, excision and infibulation are practices that sadly are done as a form of mutilating infants. Again I don’t support any unnecessary medical procedure before someone is old enough to make that decision for themselves. Regardless of religion or culture, it is unethical to have circumcision done on someone who cannot consent to it.
In the west, excision is used as one form of vulvectomy. It’s primarily done as a way of removing cancer. According to cancer.org, there are 4 main types of vulvectomy (I have omitted the first due to it only removing the top layer of skin on the vulva, thus not being a relevant resource for agender people)
“In a simple vulvectomy, the entire vulva is removed (the inner and outer labia; sometimes the clitoris, too) as well as tissue just under the skin.
A partial or modified radical vulvectomy removes part of the vulva, including the deep tissue.
In a complete radical vulvectomy, the entire vulva and deep tissues, including the clitoris, are removed. A complete radical vulvectomy rarely needed.”
You may notice that oftentimes in a vulvectomy a (partial?- it doesn’t specify how much of the clitoris)clitoridectomy is performed as well. It appears to be reserved for cancer patients, but I was able to find a clinic willing to do it for “aesthetic” reasons.
Unfortunately, almost all of these surgies are considered “cosmetic” so if you needed your insurances to cover them you would, at the very least, need one or several reccomendations from doctors confirming that you are dysphoric and that these are life-saving surgeries for you.
Infibulation is sadly used as a part of FGM in order to make the vaginal opening smaller;the labia sown together partially cover some of the vaginal opening. I am unable to find any clinic openly willing to perform it due to the horrible way its used. If you are with an open-minded surgeon it may be possible to discuss. Again you’d probably need an explicit reccomendation from a doctor due to the connotations of this practice.
Labioplasty is a more common practice, and is usually done by cis women for aesthetic reasons. It means reducing the labia, rather than complete removal, however, a doctor who already does labioplasty *may* be more willing to do a complete removal. It’s such a common practice that I don’t even need to add a list of clinics where it’s available, which is good, since it means this post will be a little shorter.
Hysterectomies
This is a big one, since without a hysterectomy, you cannot have a vaginectomy due to there being nowhere for the blood to escape during your menstrual cycle. It’s also a very hard one to get. There are countless stories from cis women whose doctors refused to perfrom/refer them for a hysterectomy, because they “might change [their] mind and want kids in the future”. For trans men on the other hand, there seems to be less difficulty with these. Possibly due to the health effects of being on testosterone for an extended period of time making your more likely to develope ovarian cancer. In fact, the clinic where I have my phalloplasty consultation lists a hysterectomy as a requirement for having surgery (although, I may attempt to negotiate this, since I am already off testosterone meaning there is less cancer risk).
If you’re between the ages of 40-45, or have been on testosterone/can pass as a trans man, you shouldn’t have much trouble finding a doctor willing to do a hysterectomy. However if you’re young, it may be difficult if you don’t have some sort of pre-existing condition such as endometriosis to “justify” it. I was unable to find any advice from young people with no “justifiable” condition on how they got hysterectomies, nor was I able to find any comprehensive list or links to clinics willing to do them. Whether they’re just that rare, or I’m searching with the wrong keywords, I don’t know. I urge people who have experience or advice in this area to reach out, and I will edit this post accordingly. Definitely reach out to your gender therapist if you have one for a letter of reccomendation, it could go a long way in convincing a surgeon you are sure you want this procedure, and won’t change your mind.
Vaginectomy
This is pretty much exactly what it sounds like. A full vaginectomy (Colpectomy + Colpocleisis) is almost exclusively done on trans men during bottom surgery and the only clinic I could find that even mentions colpocleisis without phalloplasty or metiodioplasty is here and even then it’s specified that its treatment for a prolapse, so I have no idea if an agender person would be able to get surgery there. It’s highly unlikely without a note from a gender clinic.
This is the most information I could gather on possible surgeries for agender people. I am genuinely sorry I couldn’t find any more than this. Hopefully if you’re an agender person this post showed you some options or at the very least gave you some hope. This post is by no means complete and I am 1000% open to suggestions and correcting any misinformation (as long as the corrections are sourced). I encourage you to do your own research and share it so I can edit this post accordingly. Feel free to signal boost and spread this around to give the word to any agender person this may help.
