Susanna's Account of her SRS with Dr. Suporn.
Chonburi, Thailand.

Surgery Date:- 23rd May 2003

This is my full SRS Account (Page 1 to 5 incl.)
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Disclaimer: This is a personal account and as such it reflects my own feelings and experiences. Dr. Suporn and his staff have had no input to this account of my genital Sex Reassignment Surgery. There is no sexually explicit photography on this wesite. If this is what you wish to obtain please go elsewhere. This account is provided for information and educational purposes only and all rights are reserved for all matierals.

I am in the process of splitting this page into 4 or 5 smaller sections so that they can be downloaded much quicker. While I am doing this please be patient! Sorry Folks! *Smile!*

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You can jump directly to the following sections in this account :-

Poem : Overload - 28th May 2003

Poem: The Piano Room - 2nd June 2003

Why I Chose Dr. Suporn In Thailand

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Departure to Thailand 20th May 2003

Consultation with Dr. Suporn at the Clinic

Admission to Aikchol Hospital, Chonburi

Photo's while in Aikchol Hospital

Return to the Mercure Hotel, Chonburi

Follow up visit at the Dr. Suporn Clinic

The Royal Twin Palace Hotel in Pattaya

Photo's of Nong Nooch Tropical Gardens

Photo's of Buddhist Temple Visits

Photo's from around Pattaya

Bangkok and the Flight Home

Life After SRS...

Susanna on Christmas Day 2003

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My SRS notes after surgery with Dr Suporn, Thailand

Back to Susanna's Little KnooK on the Net

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One thing I have wanted to do is capture some of the emotional side of going through SRS… There are several good accounts of the physical events of what happens. But few with much emotional reference other then they had some very weepy days!

I hope here to document some of my emotions and feelings during the first few months after SRS… I will start with the period immediately before departure, the process of induction into hospital, the actual SRS and the weeks that follow.

This is initially summed up in a poem I wrote 5 days post-op entitled:-

Overload - 28th May 2003

For days now – Overload!

“Hello”,“Goodbye”, shaving, enema(10),“again”, Overload.
Time watching, tick, tick, tick, knock, knock, just the cleaner, temperature,
blood pressure, tick, tick, tick, nearly time, Overload.

Gurney, theatre, kisses goodbye, looks, nurses, cold, fear, “its ok – all are scared”
tick, tick, tick, saline drip, bandages (legs and head), waiting, fear! Doctor here, Overload.

Pain. Loads of it! Smile, “it’s ok”, smile, Overload.

Slow breathing, holding hands, tissues and tears, Overload.

Tick, tick, tick, pain, pain, pain, close my eyes and wait,
menu’s, nurses, coming – going, cleaners, caterers, nurses with pills,
empty catheter, saline drip, drip, drip, Overload.

Time to stand, woo, dizzy! Pain! Steady!
Slow breathing… shower time, Space Walk, heart rate, sitting, touching, water, soap, pain, Overload.
Insert saline drip, no vain, no vain, no vain, pain, shock, Overload.

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The Piano Room - 2nd June 2003

What do you believe in?
What makes tomorrow?

If tomorrow didn’t answer your dreams, and you knew the truth of your life...

Would you still believe any way?

Numb with pain...

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Why I Chose Dr. Suporn In Thailand

Firstly, I should say why I chose Dr. Suporn in Thailand to be the surgeon for my genital Sex Reassignment Surgery. After having a number of consultations with UK surgeons who specialise in SRS, it was clear that their techniques where not as advanced as Dr. Suporn’s.

Dr. Suporn takes great pride that the vulva formed is as close to a natal woman as possible. I had seen the result achieved from a number of my post-operative friends who had gone to him and was impressed with the standard of surgery they had received, compared to that achieved by UK surgeons.

Dr. Suporn uses a 3-dimensional layering technique, which is far superior to anything that the UK surgeons are currently doing. This is more invasive than conventional 2D (surface only) formation of the labia and clitoris but is definitely worth it for the improvement in the aesthetic appearance achieved! The results are indistinguishable from a natal woman’s vulva in appearance and function. He is also able to preserve and relocate all or nearly all of the nerves. Hence post-operative sensitivity is extremely good and the prognosis for being orgasmic is very high indeed. I believe his failure rate is significantly below 1% in this regard! I have heard of only one woman, who has had necrosis of the clitoris. This is far better than that achieved by other surgeons who typically have a 5 to 10% failure rate (where the nerves die following surgery).

Dr. Suporn is also the only surgeon who has perfected a technique that enables the splitting of the skin used to line the vagina. This removes the hair follicle bearing layer and hence prevents hair being transplanted inside the vagina. Normally without this technique scrotal and genital electrolysis is required to ensure that the skin is hair free prior to surgery. This is obviously very painful and most unpleasant to undergo! Electrolysis also hardens and thickens the skin, which makes it less pliable and less suitable for lining the vagina.

The down side of these advances is that the recovery time is at least twice as long as that required by other surgeons. The pain is also likely to be significantly greater as more nerves are preserved! The period required for post-operative dilating is also considerably extended and duration of daily dilating is at least four to six times that required by most other SRS methods (4 hours per day for the first 6 months which can then be slowly reduced to once a week or less)! No gain without pain, discomfort and a lot of hard work! For me the benefits that Dr. Suporn offered where more than worth it. There being only one chance to get it right!

Dr Suporn and Staff 19th June 2003

Aey, Amanda, Susanna, Dr. Suporn, Aoi and Wannee
at the Clinic 19th June 2003

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Departure to Thailand
20th May 2003

The period leading up to our departure was less than smooth… I had withdrawn completely from my hormones two weeks before my surgery was due and this put me in a state that I can only describe as PMT. I am sure Amanda had to hold her tongue on more than one occasion during those preparative weeks! I started hormone withdrawal 6 weeks before my surgery – so I became progressively crankier, emotional and irritable as the weeks passed and the time to depart approached. My concentration had all but gone, so work was also rather trying!

Susanna and Amanda
at Heathrow Airport

Finally Tuesday 20th May came though. After last minute frantic packing I was relieved when the taxi finally arrived at 3:30PM to take us to Heathrow airport. Our flight was at 9:30PM. It all felt dreamlike! Especially to Amanda! As I had made all the arrangements it felt somewhat more real to me, I had also parted with a large sum of money to pay for my forthcoming surgery! A dear friend, Helen, met us at the airport and saw us off which was lovely. Having the emotional support of my friends around me really helped me a lot!

The flight to Thailand was mostly pleasant and uneventful. We flew with EVA Air Deluxe Class and would really recommend them! We where met at Bangkok airport by Wannee (one of Dr. Suporn’s staff who look after his clients) who took us to the Mercure Hotel in Chonburi. Chonburi is about 90 minutes drive around the coast to the south-east from Bangkok. After checking in to our hotel and given an hours rest we where taken to the Dr. Suporn Clinic (7:30PM local time). It is only two minutes walk from the Mercure Hotel which makes it very easy for ongoing after care should this be needed.

Susanna and Helen at Heathrow Airport

Consultation with Dr. Suporn at the Clinic

The consultation with Dr. Suporn was concise and brief. He gave me a physical examination of my genitals and then explained the procedure with me given his assessment of what was possible. Dr. Suporn is a progressive surgeon and he explained that he had a new technique, which would give me greater sensitivity of the labia as well as a sensate clitoris and vagina. I was also to have a tracheal shave to remove my Adam’s apple. This is only a minor procedure though and one I thought would be worth getting out of the way while having my SRS. It was only a marginal extra cost on top of the SRS and would only add a small increase to the time that I would be under general anaesthesia. The SRS would take approximately 7 hours to complete.

My first impressions of the clinic were that it was a warm and friendly place. While we where waiting to have our consultation with Dr. Suporn to discuss my surgery, we made friends with several of the post-op women who were resting at the clinic. The staff where very friendly and welcoming and I felt immediately at home. We where even given a nice meal which was extremely cheap!

Aey at the Dr. Suporn Clinic

I was probably not taking it all in I suspect but I got the gist of what he was telling me. We had had a very long day and my head was not exactly the clearest it has ever been! Gaining the 6 hours time difference meant that it was about 2PM the next day in the UK! Not the most conducive time to be making critical decisions that would affect the rest of my life, after a 12-hour flight! I was dog-tired! Dr. Suporn’s English is thankfully very reasonable so ‘attentive listening’ skills are not too critical! Giggles!

It was raining on the way back to the hotel so we stopped at a street restaurant and had something to eat and drink. I needed this time to mull over what I had been told and to get my head around just being in Thailand! In hindsight eating at such a place just before major surgery was probably not a good idea… Upset tummies are a regular occurrence when eating at such street side venues!

One minor event that amused me was that I needed to go to the toilets. After finding the street restaurant toilets, I discovered that they were less than ideal… It was a case of squat over a whole in the floor or use the urinal. Both facilities were in a communal bathroom. I haven’t stood for a long time now but rather ironically, I chose the latter out of expediency. I knew it would be the last time I ever stood to go!

The evening was spent mostly relaxing and we had an early night, as we were so tired from the travelling. I was very thankful for the extra nights rest before my surgery!

Admission to Aikchol Hospital, Chonburi
22nd May 2003

The following morning after breakfast we were taken to Aikchol hospital in Chonburi. It is a typical, reasonably modern, privately run hospital. What did surprise me was the speed of admission! I was expecting to be spending much of the day hanging around waiting to have all my pre-operative tests done. This was far from the case! After showing my passport at the admissions desk, I was whisked from one test to the next, blood, X-ray, ECG etc. The blood tests where for HIV and other transmittable diseases. I needed to be clear on all of these tests or Dr. Suporn would not be proceeding with the surgery. Within half an hour of our arrival at the hospital we where on our way up to the 8th floor. This is where the VIP suites are located for private patients. We were shown into a large room (802). The en-suite bathroom was immediately to the left (for Amanda’s benefit mostly, as I would be in bed for most of our stay). On entering the main space, there was a couch to the left and two hospital beds taking up most of the room, a table at the far end by the balcony. The suite had a television and some storage space. A safe was also provided for valuables. This hospital room was to be home for the next week.

The afternoon was spent with me teaching Amanda some new card games. It helped take my mind off the immanent surgery. We also visited a friend (Michelle) a few doors up who had had her surgery two days earlier. She was not in the best frame of mind herself I suspect, which didn’t do my confidence level any good at all. She was asking me if I really wanted to go through with my surgery and that it was perfectly possible to back-out and that there was an element of being carried along with the tide… This all struck me as a strange perspective given that she had just had her own SRS! The thought of cancelling my SRS was quite abhorrent to me despite knowing that it was going to be a very harrowing few months ahead of me! The waiting was the worst part. Time passed slowly and my anxiety level was not so slowly mounting.

View over Chonburi Bay from Aikchol Hospital

The evening’s entertainment in the hospital was to have my genitals shaved, which tickled a lot, and then to undergo an enema. What I didn’t know beforehand is that I would require ten enemas to clear my bowels! Thailand is fairly backward in terms of general hospital techniques and so the enema consisted of a soap and water solution applied by a tube. All rather unpleasant! After the 5th I was decidedly nauseous… after the 10th I can only describe my condition as grim… I had bad tummy pains from the ongoing physical assault to my body functions… None of this did my emotional equilibrium, which was already decidedly wobbly, much good either! Amazingly though, I did manage to sleep that Thursday night despite the hospital bed and the pending surgery in the morning. Mostly from emotional exhaustion I suspect…

Rebirth Day...
23rd May 2003

Friday, 23rd May 2003 finally dawned. Today my life was going to change forever. The Gender Dysphoria I had been struggling to deal with all my life was to be finally dealt with. I was woken up at 6AM by a nurse and got up and showered. I dressed in the provided gown. It was then a case of waiting until 7:50AM when I was collected and taken down to theatre. My surgery was scheduled to begin a 8AM. Those two hours seemed like forever! When the knock at the door finally came and several nurses walked in, I felt like I was being taken to the electric chair. Suppressed panic and fear was setting in fast!

I climbed onto the theatre trolley and Amanda followed us all out. She held my hand as much as possible to give me as much reassurance as she could. On arriving at the 1st floor I was wheeled out and taken to the exterior door to the anteroom, which lead into the operating theatre. Amanda was told that she could go no further with me. She gave me a kiss and a hug and we said our farewells. We where both very emotional by this time! I was feeling very helpless and that from here on I was just taking whatever came next.

The theatre was rather old by modern western standards... It had very ferocious air conditioning though! I was already shaking and the cold air only worsened my state further! I only had a very thin sheet over me for warmth. I was wheeled to the right hand side of the theatre beside a table of medical equipment. To my right were the double doors and to the left of the doors was a clock. It was 8AM when I arrived.

Dr. Suporn was late arriving at the theatre. His normal practice is to do his rounds before the days surgery so I presume that one of the other patients had some issue. Presumably with ‘unpacking’ I surmised! While waiting for his arrival the nurses milling around prepared me for surgery. Thai music played on a radio in the corner. A saline drip was inserted into my left hand and my legs and head bandaged. It was then a long wait for Dr. Suporn’s arrival. I was cold and very scared and shaking badly! One of the nurses said to me, in pigeon English, “It’s OK, all are scared…” I didn’t know whether to be comforted or not by this comment!

Dr. Suporn arrived after 45 minutes and quickly got scrubbed up ready for surgery. He came over and said hello and asked how I was. I suspect my answer was probably rather vague and less than gracious… I was very scared and my genitals were feeling decidedly ‘tight’. After one last, “Are you ready?” to which I nodded, I was injected via the drip in my hand. One, quick, hot flush of heat all over my body and I was unconscious. Fortunately, they had spared me the part when my legs were put in the stirrups for the surgery. They must have known how frightened I was so spared me this distress!

When I came to after some 7 hours of surgery, the post-surgical pain was more painful than I can even begin to express... Fortunately I can’t remember what that level of pain even felt like now. I guess my mind has blanked that out. Morphine hardly touched the pain for the first 3 days. I must have come around in the recovery room but don’t remember that. I do remember being taken up to my room and the trolley I was on being wheeled in. I was extremely pleased to see Amanda! Amanda had been sunbathing on the balcony I think. She was very pleased to see me too! Amanda helped to transfer me from the theatre trolley to the bed and sort out my drip. I was only vaguely with it I think, as my recollection is very vague.

Photo's while in Aikchol Hospital

Susanna 3 days post-op 26th May 2003
Susanna sleeping while in Aikchol hospital

Susanna recovering after her operation
3 days post-op 26th May 2003

Susanna sleeping while in Aikchol Hospital

Susanna 4 days post-op 27th May 2003 Susanna standing for the 1st time 28th June 2003

Susanna recovering after her operation
4 days post-op
27th May 2003

Susanna getting out of bed
for the first time 5 days post-op
28th May 2003

Wannee stayed with me the whole of the first night and slept by my side on the couch. She was paying close attention to me as the smallest movement I made in order to get comfortable would rouse her and she would be up seeing if I was OK. Amanda also was paying a lot of care and attention to me too during the night. It was extremely comforting to have such care to hand! Wannee paid me regular visits in hospital during the following days. She was very concerned about the level of pain I was experiencing.

I had very little ability to concentrate so reading etc was not really an option to distract me either. Amanda was wonderful at looking after me though. I really don’t know how I would have got through those first few days without her there!

Unfortunately my mobile failed on me after only a few days so I could no longer keep in touch with Helen, Jenny and my other friends back in the UK by texting. Amanda went shopping with Aey and came back with a brand new Nokia 3650 mobile – one for each of us! It was a lovely present and I was very delighted! It made a very big difference to me and was worth its weight in gold!

Dr. Suporn had to make a special visit to see me on the Sunday evening. He removed the outer dressing to relieve the pressure causing much of the pain. I also had blistering of the skin from the tape used to secure the dressing. With the outer dressing removed the pain was significantly reduced. It was a hell of a relief! The morphine was then able to control the pain much better. But I was far from OK as I was still often in very severe pain. The time passed in a blur of pain mostly. I remember little of those first few days thankfully.

Wannee visiting me at Aikchol hospital

Once Wannee had left after the first night, I was left to the care of the hospital nursing staff. They were as a rule very pleasant and very helpful. However I did have cause for concern on a number of occasions. Many of the nurses appeared to work double shifts and Amanda reported seeing them dosing at the nurses station just outside our room. I mention this because on a number of occasions they where less than attentive to what they where doing while changing my saline drip or adding antibiotics to it. Air was left in the saline drip line to which I was attached on several occasions! On one occasion I had to frantically indicate to the nurse that air was still in the line. It came within a half an inch of being injected into me! An embolism I really didn’t want to add to my woes!

One further event really distressed me while in hospital. After 5 days I was to get out of bed and have a much needed shower. Amanda had been giving me bed baths twice a day, which was really appreciated but that is not the same as a proper shower! I had heard that the nurses where not especially gentle when giving a bed bath so I was very thankful that Amanda was able to do this for me! She is a Registered General Nurse so this was normal care for her. The liberation from being confined to bed was wonderful!

Walking the short distance to the bathroom to shower just felt bizarre! Literally like I was space walking - Miss Wayne style, with my catheter bag in hand! Being free of my male genitals was absolutely wonderful though!!! It felt immediately normal and right to me and exactly as I had imagined it would. It was such a relief to be liberated from my life long discomfort and to be as I felt I should be! No words can do it justice!

My shower went well (but felt very strange touching myself for the first time!). It was a little rushed though as the nursing staff who where helping didn’t know how long I would manage before passing out… Obviously this is a potential problem with patients who are still very weak after surgery. The shower was lovely. However, my dressing over my saline drip became wet and then loose. I asked to have the dressing replaced. This was a mistake because the needle came out of the back of my hand. Gentleness is not a gift that Thai nurses have… Replacing it rapidly became a nightmare!

Several nurses had many attempts at inserting the needle needed for the saline drip into a vain. They called the head nurse, again no joy. The Anaesthetist was called and she could not get the needle in either. A neonatal nurse from the baby care unit was called, as she was more experienced at finding very difficult veins. She also failed to get a needle to stay in. By this time I was in a very bad state, both emotionally and mentally, and went into shock. Amanda was wonderful and comforted me by holding me during all of this. After the worst of the shock had passed she made me a cup of tea with lots of sugar in it. I felt much better after that and slowly recovered from this added ordeal.

Amanda looking after me
in Aikchol Hospital

The whole experience was extremely unpleasant and I now have a fairly bad fear of needles. As I required several more antibiotic doses, which where being added to my saline drip, the head nurse tried again to put a drip in my hand the following morning. She was surprisingly confident as she put the dose of antibiotic into the saline drip before turning to me to insert the needle. Thankfully she was successful!!! You can imagine my apprehension during this! A repeat of the night before, I really didn’t want to endure. The alternative was a number of injections into my bottom, which Amanda warned me, would be very painful. She had strongly advised me that having the saline drip line reinserted was the best option! I refused to have any further injections after the last dose of antibiotics had been given though. That was it as far as I was concerned. The needles where going to be staying well away from me from now on! My anxiety about needles has now lessened but I suspect not gone, even months after these events.

I guess I should say something about toilet training! The catheter was removed just before the vaginal packing was removed. I found urinating no problem – not as far as doing it was concerned anyway… I needed to go while I was still dilating for the first time so I did not have long to wait to ensure that that was OK! The stent must have applied additional pressure on my bladder, which I was not used to. What did surprise me was that it took me about a week to recognise when I needed to go! The sensory feedback is quite different and I had to re-learn when I needed to go to the toilet. This was particularly the case if I woke up in the middle of the night. The sensation is not entirely the same, especially as the nerves are very raw in that area after so much surgery! After a week or so though it wasn’t a problem and I could tell when I needed to go without having to go to the toilet for a ‘tester’.

The next big event was the ‘unpacking’ and starting to dilate. This was one week post-op and after my first dilation I was to be shipped out of hospital and back to the Mercure hotel within an hour! The experience was intense! First the removal of the packing in my vagina… Dr. Suporn came at about 7:30am to do this. A bed pan was placed under me and the packing pulled out. It was only moderately unpleasant fortunately. It was amazing though how much packing had been put inside me! Some parts of the packing had stuck to the vaginal wall and stung when it was pulled out. After an initial inspection to check that I had healed sufficiently to enable dilation, he showed me how to dilate. The next two hours were then spent dilating with a stent inserted in my vagina. I had an initial depth of approximately 8 inches. It was uncomfortable but not too painful. The bleeding was surprisingly little considering. I then had to shower and get dressed etc as we were to leave the hospital by about 11AM! Obviously doing anything at more than a snails pace was decidedly not possible because I was so weak! I felt very rushed and this only added to my distress of handling so much, so soon.

Return to the Mercure Hotel, Chonburi
30th May 2003

Because of the level of pain I had been experiencing (far more than usual for this operation even for Dr. Suporn’s patients), I had not been able to sit even remotely comfortably. A doughnut ring cushion had been provided for this purpose. My cushion was to be a constant companion for the next few months wherever I went! So the whole experience of getting into a wheelchair to be taken down to the car and then being driven across town was very taxing! I only just made it to the hotel room and I passed out on the bed while people where desperately fanning me! Not that untypical an experience I subsequently found out. A little more time to recover (both emotionally as well as physically) and to prepare for the transfer would have helped a lot. I felt that I really needed another day in hospital before being transferred back to the hotel. The Thai way of doing things can be a little ruff at times. I hope this is one aspect of the way the clinic handles their clients that they will try to do something about. It is just too grueling, both physically and emotionally.

All of this I found very distressing and I felt triggered the very deep depression that I went into immediately after leaving hospital, on the 30th May. The reactive depression lasted only for two to three days fortunately but I didn’t know that at the time. I was less than a compliant patient during this period! Wannee had brought over a syringe of something that would have helped but I just refused to have any injections at all! Due to my extreme weakness (I could hardly stand!), I was feeling exceedingly vulnerable and my trust in those caring for me was in tatters following the difficulties with re-inserting the saline drip while in hopsital. Obviously this had nothing to do with Dr. Suporn's staff - it just made it harder for them to care for me...

During this time I was feeling very alienated from those around me because I didn’t feel they were listening to my needs and because I had developed a health dose of paranoia, this was not helping matters much either. I was asked if I would take some Diazepam to help me sleep, expecting a minimal dose. I was given Valium. I didn't realise at the time that this is one and the same thing! Unfortunately, because of my state of mine, this further infuriated me as I felt my dignity was not being respected. Looking back on that now, I can only blush with shame at how emotionally unstable I had become... However, the Valium did put me to sleep. I had only been sleeping for two hours each night for the past week, so the sleep was much needed indeed!!! Being so vulnerable at this time didn’t help matters I am sure. I could only stand for a few minutes at a time because I was so weak and in severe pain. Amanda was very concerned indeed about my physical and mental state and didn’t know what to do to help either! It was a very distressing time for all of us.

Dilating initially took some getting used to. This was because having a vagina was not part of my psyche to start with. It took a few weeks for me to really relate to it as part of my body. Having sensations deep within my body during dilation was a very new experience. Full dilation would take about 20 minutes for me to achieve. I have since managed to maintain a depth of approximately 8½ inches. I found that when dilating, maximal depth hurts the same as allowing about a ½ inch withdrawal, to reduce the pain. This seems to be because about 5-15 minutes later, after easing off the pressure, the vagina collapses accordingly... Hence relieving the pressure (and hence pain) is only temporary and only reduces the depth that you will finally be able to achieve… I don’t know if this is an unusual observation. I should certainly take it up with Dr. Suporn at some point.

I was advised though, to endure the discomfort of dilating, as the depth achieved and maintained over the first three weeks would likely be kept thereafter. I should also spend some time describing the pain I was experiencing. This took three main forms. Firstly, I felt like a horse had kicked me up my backside!!! This was very painful and unpleasant for the first few weeks but slowly diminished with time.

The second form was the very intense stinging/burning pain in my vulva. It was also sometimes more of a stabbing pain. This was primarily centered around my clitoris but I also had a lot of pain from my vagina and labia. It felt as if I had a burning cigarette touching my clitoris! Excruciating is the only word that does it justice! This pain took the longest to settle down and was still quite severe after 2 months! I had to take very large doses of Tramadol Hydrochloride (400mg/day) to control the pain. Initially for the first 5 weeks or so the Tramadol only partially controlled the pain, as it was so intense!!! Tramadol is an opiod analgesic and is usually only given at half of the dose I was taking!

Thirdly, were the electrical shocks that came from my damaged nerves as they regenerated. These where very sharp, painful, raw ‘electrical’ pains just as if I had been plugged into the mains!!! Fortunately they generally only lasted for a few seconds but could last upwards of 20 seconds at a time. These just creased me up in agony and where the most excruciating part of it all. The frequency of these and the severity slowly diminished over a period of about 6 weeks from very frequent and extremely painful to when they were only occurring a few times a day. Even then though they were still eye watering when they occurred!!!

Follow up visit at the Dr. Suporn Clinic
Tuesday 3rd June 2003

Susanna's first gynecological examination 3rd June 2003

Susanna's first gynecological examination

During our stay at the Mercure Hotel I had my first follow up visit to the clinic on Tuesday 3rd June. This was my first gynecological examination! All seemed to be healing well fortunately! By the Friday I was still not strong enough, so the trip to Pattaya was postponed further until Monday 9th June. After a week and a half at the Mercure Hotel my strength had improved and the pain diminished sufficiently for us to finally consider the trip to Pattaya. I was much more able to endure the 70 minute car journey by this time. We even were able to change hotels as the first was rather old and a little depressing, so I must have been feeling much better in my self!

The Royal Twin Palace Hotel in Pattaya
Monday 9th June 2003

Our arrival at The Royal Twin Palace Hotel in Pattaya was when I first started to feel more human and normal life started to have some place in my daily existence. We went to the bar after checking in for a bite to eat and a drink (eating and drinking being a queasy business because of all the antibiotics I was taking…). Despite the pain, discomfort and queasiness I had a wonderful half hour when I just had tears of absolute joy rolling down my cheeks and I sat grinning like a Cheshire cat!

Susanna's Moment of Pure Joy after arriving at Pattaya

Susanna’s Moment of Pure Joy after arriving at Pattaya.
9th June 2003

Sadly my moment of pure joy had to end when everyday realities had to be faced. I had to go and do my afternoon dilation. We went to a lovely Italian restaurant in the evening and I felt very happy despite the pain and discomfort. I was whole at last! My emotions were running very high, I had a long way to go yet but felt a wonderful gift had been given to me. My gratitude towards Dr. Suporn will be life-long I think.

Gradually, each day, I was able to do a little more around my daily dilation routine (2 hours, twice a day). I spent my time either resting by the swimming pool or trips out with Natalie (one of the carers in Pattaya) and her brother Uie.

On Wednesday 11th June Natalie took us to Nong Nooch tropical gardens. This was the first significant outing for me and utterly exhausted me. It was a very enjoyable trip out though and a wonderful first taster of womanhood.

Nong Nooch Tropical Gardens
Wednesday 11th June 2003

Dancing during stage show

Amanda enjoying a fresh cocanut!

Susanna and Amanda with Tiger Cubs

Susanna has a close encounter
when the tiger grabs her skirt...

Amanda and Susanna with Tiger

Susanna with Tiger

On the next trip out we went to two Buddhist temples, which were amazing experiences! Including squatting, Thai style, in the ladies toilets at the second! It struck me as comical that I had to learn to squat so soon after leaving hospital! The swelling was still quite bad and this caused me to spray rather than have an even flow. Hence this was a little more difficult than you might think! This settled down after a month or so and was not an issue after about 6 weeks when the swelling had largely gone.

While visiting the Buddhist temples I was blessed by one of the monks and sprinkled with water (as is there custom). It felt very much like a second baptism into my new gender! I spent a lot of time in prayerful thanksgiving at the temples for the wonderful gift of womanhood I had received!!! I was more than a little tearful. All of this was somewhat to Amanda and Natalie’s endurance and patience I suspect. Natalie is now herself 10 years post-op (Dr. Suporn performed her surgery also and she later went to work for him) so understood the emotional side of what I was going through. The relief following surgery is absolutely wondrous!!! I could not over estimate it if I tried! It really feels like a rebirth…

Buddhist Temple Visits

Buddhist Shrine

Natalie throwing a coin into Buddha

Buddhist Shrine

Buddhist Shrine

Amanda at Buddhist temple
mountain (150 feet high!)

Buddhist Shrine

Photo's from around Pattaya

Add, Amuya and Nine
at the
Little Italy Restaurant, Pattaya

Dinning at the
Little Italy Restaurant, Pattaya

New Orleans Restaurant, Pattaya

View to the South of Pattaya

Royal Twin Palace Hotel
swimming pool, Pattaya

Royal Twin Palace Hotel
swimming pool, Pattaya

Amanda at the
Royal Twin Palace Hotel swimming pool, Pattaya

Susanna at the
Royal Twin Palace Hotel
swimming pool, Pattaya


Susanna at the
Royal Twin Palace
Hotel swimming
pool, Pattaya

Unfortunately, my health deteriorated due to these trips out and my level of pain increased significantly. Only one further outing in the evening to see Natalie dancing was possible. Further excursions were curtailed! However, this did mean a very leisurely week or so recovering by the pool side most days and dinning out in the evenings. Pattaya is a fairly pretty, is overly commercialised, centre. With plenty of shops, bars, restaurants and being the centre of the countries sex industry too - night clubs.

The humidity was 'aggressive' and I struggled with this most days when we were out of the hotel, especially in the evenings. Being physically so weak does not help you cope well in such conditions. However, we found a few nice restaurants and enjoyed our time in Pattaya immensley! As I think you can tell from the photo's below...

On the Friday 13th June we had a round trip to Chonburi for my weekly check-up. This was a full vaginal inspection using a speculum. I was rather apprehensive of Dr. Suporn opening my vagina in this way but it proved to be much less painful than I had feared. He informed me that I had no hair in my vagina, which was one worry less. The split skin graft technique that Dr. Suporn uses was intended to ensure that this was the case. This involves removing the hair follicle bearing layer of skin before using it to form the lining for the vagina. This initial skin layer is then replaced as new skin grows over the next few months. The remainder of the week was spent resting as I had been doing too much the previous week and the swelling had worsened and my level of pain increased.

Susanna and Amanda
at the Dr. Suporn Clinic

Susanna and Amanda at the Dr. Suporn Clinic

Our time in Thailand was nearly over. I had my last check-up with Dr. Suporn on the Thursday 19th June at the clinic in Chonburi. He gave me a medical certificate stating I was fit to fly home and also one stating that I had undergone irrevocable male-to-female genital sex reassignment surgery. It struck me as a little strange to see the word ‘irrevocable’ used. It felt as if people had the expectation that I might want it to be revocable. But I guess this is for birth certificate registration reasons. This is how I am to live the rest of my life and I consider myself greatly blessed to have that opportunity! If I had been born even 30 or 40 years earlier I would have been trapped in a body I could no longer stand to live with and would most likely have ended my life as a suicide case. Indeed, that was my intention before I transitioned. Going back to living as a man was never an option. Even if it where possible to undo this surgery… I would never sanction it!!!

Bangkok and the Flight Home

The World Trade Centre,
Bangkok. 20th June 2003

The World Trade Centre, Bangkok

We had arranged to go on to Bangkok and stay there before returning home on Saturday 21st June. This principally was to reduce the travelling time required for the journey home, which I knew was going to be an ordeal. Having the 3-hour journey from Pattaya to Bangkok out of the way would save me a lot of suffering later!

On the Friday we spent a few hours at the world trade centre in Bangkok, which was very impressive and completed our preparations for the return flight home. Saturday was a long, hard day for me. I started dilating at 5:30am to give us time for some breakfast before leaving the hotel. Thankfully I had arranged for wheelchair assess at Bangkok airport! This was a real godsend as it is a big airport and saved me a lot of painful (and slow) walking.

The first 10 hours of the flight home where not too bad. But after that, my level of pain was pretty severe and I was extremely uncomfortable indeed. Every minute of the last few hours was a trial of endurance!

The Flight Home - Some where Over Turkey
21st June 2003

I had a wheelchair to take me off the plane and that helped again enormously! After going through baggage reclaim Helen was there to Arrivals met us. It was wonderful to see Helen again! She brought her car around and I was able to recline the seat for the final leg of the journey home. We had been in daily contact via text messaging during our stay in Thailand and she had been a constant source of help and support during my initial weeks after my surgery. I owe a great debt of gratitude to Amanda and Helen, my other friends that kept in touch with me as well as to Dr. Suporn and all of his staff.

Life After SRS...

It was wonderful to be finally home again. Helen cooked us all a lovely meal and then it was time for more dilating. We finally got to bed about 2AM UK time. Amanda and I had been on the go for nearly two days and were completely exhausted. Amanda had also prepared a lovely surprise for me on our return home. She had arranged for a friend to come and install a shower and re-tile the bathroom. I was just dumbfounded when Helen led me by hand upstairs to see it! Amanda wanted to wait until I discovered it on my own but Helen couldn’t contain herself after an hour or so. Going up or down stairs was still a considerable difficulty for me so I would only do so if really needed. As there was a downstairs toilet I used that. So I suspect Helen was thinking that she would have to intervene if I was to see the bathroom any time soon! It was lovely being home again with my friends!

Susanna, Amanda and Helen
at the Hare and Hounds Pub,
Northbourne. 22nd June 2003

Susanna and Amanda at the Hare and Hounds Pub, Northbourne 22nd June 2003

The following day the three of us went out for a pub lunch, which was lovely. Helen stayed for a few days to help out around the house and give Amanda a break from looking after me. Having her company was great and much appreciated.

Over the following weeks of convalescence at home gave me plenty of rest and I was soon feeling more my self, if still more than a little shaky… The pain slowly diminished as the weeks passed and I got to the point after 7 weeks post-op that I could drive for about 30 minutes reasonably comfortably. Although changing gear was decidedly painful and thankfully I did not have to do an emergency stop!

My increased mobility enabled me to re-start my electrolysis treatment and to resume seeing my counsellor. After 11 weeks I had settled down enough to became orgasmic! Lovely! And after 12 weeks I withdrew from taking Tramadol as I had been having clear signs of addiction, which was very worrying. The pain had reduced enough to be able to manage pretty well without further pain relief. But I was still finding sitting uncomfortable for more than about an hour, even with my doughnut ring cushion. Neuropathic pain had reduced to an occasional intense stabbing pain, which was unpleasant but endurable.

Susanna, Amanda and Helen
at the Hare and Hounds Pub,
Northbourne. 22nd June 2003

Susanna and Amanda at the Hare and Hounds Pub, Northbourne 22nd June 2003

After a little over 3 months post-op (2nd of September) I was able to resume work on a three mornings a week basis for the initial two weeks. I was extremely tired even after being at work for only a few hours. I came home and slept on the settee for most of the afternoon! The second week was better as I needed less sleep. The following two weeks I was able to do 5 mornings and then full time shortly thereafter.

Emotionally I felt quite happy in myself during this recovery phase. However, the realities of dealing with people and their preconceptions soon became very apparent after I was able to resume work and depression set in again. Changing other people’s views is sadly just not possible; especially as gender reassignment invokes an emotional, and some times irrational, subconscious dissonance in people... So I have since resumed therapy (again!) and have begun to deal with more of the relational aspects of dealing with transition. Issues around dating men have become very painful to deal with due to the homophobic preconceptions men have of transwomen and the rejection and negative attitude, which seems almost universal. Forming female friendships has also been difficult! Most women seem to want to distance themselves from being seen to have any association with a transwomen… peer group pressure is always something never to underestimate! For now I will enjoy doing things with my friends and those that do accept me!

Two Stents for Sister Susie!

2 Stents for Sister Susie... Smile!!!


For now I can enjoy being ‘me’ at last… the real ‘me’! Not what society finds comfortable and would like or expects me to be… Perhaps one day, society will grow up and realise that perhaps mother ‘Nature’ is not anywhere near as infallible as she is usually given credit for… one day perhaps people will see past their narrow definitions of sex and gender.

Finally, I hope this account has been worth your time to read. I send you my Love and {{{Hugs}}} and wish you all well.

Finally, a photo taken of me at Christmas 2003! But I will continue to add to this account as time progresses and new things come my way. Next - the acount of my Breast Augmentation which I had with the good Dr. Suporn on the 30th August 2004... along with SRS revision while I was out there, but that is a story for another day *Smile!*

Susanna on Christmas Day 2003

Christmas 2003

May you find your hearts peace and almost as importantly
- someone to share it with!

Finally as a footnote...

I also wrote some notes while out in Thailand that I thought might be helpful to other pre-operative TS’s considering SRS. These are reproduced below. These were just my first thoughts that I jotted down on my mobile and therefore do not necessarily represent what I think now!

My SRS notes after surgery with Dr Suporn, Thailand

1. Hormone changes: Loss of testo post-op causes a massive loss of strength; so much other stuff was going on I didn’t realise this until 2nd week post-op, similar to when I started hormones but this effect was much worse for me this time. Stopping hormones made me feel very emotionally vulnerable as well. I had a constant headache from the day after I stopped taking them all together, after a 1 month withdrawal period as well, as well as emotional changes (pain killers did not have any effect on this as it appeared to be hormonally induced. My headache remained unchanged even when on morphine!). My headache continued until I resumed hormones! So this is a double whammy post-op with loss of testo too... I found it very hard emotionally to handle surgery because of hormone withdrawal. Felt like I was striped of my emotional defences and then had to face SRS...

2. Dizziness and fainting: These occur very rapidly once you start to be exhausted. Lay down ASAP once you start to be exhausted and/or in substantial pain... or expect to fall down! My level of pain accelerated the rate of collapse so factor this in too...

3. Dilation: Use 'loads' of KY jel! More than you think you are going to need. When pushing in the stent, Go Slow! Taking 5 min over entry is really worth it. Pulse the pushing, in a little, release pressure... 2 steps forward then one back... This seems to help with lubrication too. When half way in, slowly completely withdraw the stent and apply a good spurt of KY into the dilated vagina. You should not need additional jel on the stent; it should now slide in really easily. I was initially taught to cover the stent with KY. This does help to ensure lubrication but I found this a time consuming and clumsy way of doing it. By spurting KY directly into the vagina and then taking the stent in and out achieved the same thing much more quickly. Continue pulsing for remainder of your depth that you can reach by gentle hand pulsed pressure. Now place the bottle between your legs and use this for additional leverage on the stent. Roll your hips forward to increase penetration depth to the maximal limit. Full dilation takes about 20min for me to achieve (8.5in depth). When dilating maximal depth hurts the same as allowing about a ½ inch withdrawal to reduce the pain. This seems to be because about 5-15 min later, after easing off the pressure, the Vagina collapses accordingly... So hold the stent at full dilation if you can and bare the pain. I was surprised no one mentioned this given its importance for maintaining the vaginal depth! After 2 weeks I had 8 inches of depth. Depth actually increased instead of reducing, possibly because of this approach. This may be a personal experience though... Pain killers 30 min before dilating really help! Also placing a tissue or another soft layer between the stent and the bottle used to hold it in place helps to dampen down the jarring sensations, which are very unpleasant to start with! You will likely be taught to lie on your back during dilation. This is fine while achieving full dilation but then may become quite uncomfortable. The stent will now be in nearly up to your navel! (8 inches). Bare this until fully dilated and then you can remove the bottle, close your legs completely while holding the stent in position and roll to one side with knees slightly bent. You should find you can naturally hold the stent in with minimal effort even during the first three critical weeks by gently thrusting your hips forward as needed.

4. Urination: I found it hard to sense you have a full bladder for the first few days, as there is obviously no penile feedback. The urethra has been moved and the nerves are still numb so you need to make a conscience effort to check yourself during the nerve re-growth period [aka - these are random (bloody painful) electric shocks from this area... Very much like seismic activity... May get preliminary minor quakes then one or more main ones followed by after shocks]. I found I had to do this especially at night when I woke up. After a few days without the catheter enough sensation had returned for me to know when I needed to pee.

5. Food: The large doses of antibiotics post-op will wipe out any desire for food and only very bland food can be tolerated so don’t expect to get to eat much Thai food! I lost 6kg (1 stone) during my month in Thailand.


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