Was ready to die on journey to become true self: trans woman
In 2018, she had two gender confirmation surgeries to augment her breasts and make changes to her genitalia. Thanh says she was comfortable about openly expressing her sexuality. But she never wanted her parents to learn how much pain and loneliness she felt on her journey to find her true self.
Throughout adolescence she simply thought she was a gay man, albeit never feeling comfortable about having a male body. She only learned of transgender people in middle school, when she realized she was a woman on the inside.
She fell in love with a boy in her neighborhood, but never dared to confess her feelings due to her male body. It was then that she resolved to become a true woman inside and out. Once she did, she thought, she would put on her best dress to tell him how she felt.
That day took nearly a decade.
“The boy back then was the biggest motivation for me to undergo gender confirmation,” she says.
But a complete surgery cost at least VND150 million ($6,467), and she did not want to borrow money from her parents or siblings, believing it would only be “worth it” if she paid from her own pocket.
So she gave up her dream of going to university and becoming a journalist, instead settling for a job as a phone consultant for a finance company after finishing high school. She also planned to do multiple minor surgeries, starting with her breasts first so it would be less financially taxing and her body would have more time to heal.
After two years of working, and borrowing from friends, Thanh managed to raise VND50 million for a breast augmentation surgery at a cosmetic clinic in Saigon. She also injected estrogen once a week, wore women’s clothes and lived like one.
The hormones started to kick in, making her breasts fuller, she says.
Her breast surgery finished within a day but she spent the month after that in agony. Her breasts constantly hurt, and doctors had told her to wear a breast-fitting outfit day and night to retain their shape and keep them in place, which left her gasping for breath and uneasy.
But after spending so much money and going through so much, she gritted her teeth and tried to pull through.
Taking care of the surgery wounds was also tough. She had to do it three times a day, cleaning them with cotton and bandages alone in the company toilet. Blood oozed from the wounds for the first few days, but they slowly healed. While her breasts finally looked like how they were supposed to, she had to spend a few more millions of dong to get rid of the scars though they never completely went away.
‘Just do it’
Half a year later Thanh embarked on her next surgery to make changes to her genitalia. She had to travel to Thailand for that.
She could not speak English fluently, nor the money to hire a personal nurse. So she decided to hire another trans woman to take her around, translate, feed her, and give care post-surgery. The woman, who did not have medical qualifications, cost Thanh nearly VND100 million.
The clinic for the gender confirmation surgery Thanh chose was the cheapest available, and popular among Vietnamese transgender people. But it meant the end result might be only be 50-60 percent of that of a cisgender woman, maybe even lower if there were complications.
Doctors remove the testicles and most of the penis, only retaining its skin to create an artificial vagina, and cut the urethra shorter.
If patients opt for a more expensive surgery, doctors could use part of the patient’s intestines instead of the penile skin to create the artificial vagina.
The intestines are more elastic and would feel more natural during sexual intercourse, according to doctors.
But the surgery costs up to VND400 million, Thanh says.
The description of the surgery might sound simple, but in reality it is anything but. Many people have died on the surgery table from blood loss, infection or overdose of anesthesia, Thanh says.
She was well aware of the risk, but her desire to acquire the appearance that reflected her true self trumped her fears.
She refused to look further for information about surgery complications and legal issues, and in fact even concealed the fact from her family both times that she was going to Thailand for gender confirmation surgeries.
She thought if she had to lose her life in a foreign land, so be it, she says.
“Just do it first then think later.”
Before a gender confirmation surgery, patients have to take a series of psychological tests to make sure they do not regret it later. But at her clinic, the tests were largely for show since Vietnamese patients do not speak Thai and have to depend on translators.
But in Thanh’s case it was not much of an issue since she knew exactly what she was doing.
After a six-hour surgery, Thanh was wheeled to the post-anesthesia care unit. The first thing she did on waking up was to check if her genitalia were still there, but all she saw were white bandages.
Seeing the catheter and drainage bags hanging next to her bed, she knew the operation was successful. Following a night’s sleep, she was taken to a nearby hotel to recover.
For 21 days after the operation, she was virtually confined to her bed out of pain. She did not dare eat too much, or drink milk or juice for fear of having to go to the toilet and risk infection.
Even washing herself or simply moving around could have opened up surgery wounds, she says.
“The pain was hundreds of times worse than when I had my breasts lifted. Every time I had to dilate my vagina, I felt like dying.”
Genitalia reconstruction was not the end of the matter, she explains. Transgender people have to use dilators, usually made of metal or wood, to dilate their artificial vagina, a process that begins as early as three days after the operation, when the surgical wounds have yet to heal.
This allows the vagina to retain its shape as the body’s healing process continues.
In the absence of frequent intercourse, a trans woman has to use the dilators for the rest of her life, Thanh explains.
Nguyen Van Phung, a teacher at the University of Medicine and Pharmacy in HCMC, says there are currently no hospitals in Vietnam authorized to perform gender confirmation surgeries.
Transgender people need to consult their doctors before undergoing any bodily changes, and get psychological counseling and health checks, he adds.
*The trans woman’s name has been changed to preserve anonymity.