Diaries Of A Trans Man: What It's Like To Have Bottom Surgery

In December of 2017, Basil Vaughn Soper looked down at his genitals and saw a penis for the first time. Basil is a transgender man, and co-director of Transilient. For years, he thought that bottom surgery (during which doctors reconstruct a person's genitals to match their gender) wasn't possible for him. He never allowed himself to dream of having a penis, because it just couldn't happen. But then, he learned that his insurance would cover the operation, and that changed everything.

Now, six months after the surgery, Basil is feeling comfortable and confident in his new body. "I feel great, emotionally and physically," he says. "I feel much more comfortable looking at myself in the mirror and being really present in my body."


But, he didn’t always feel that way. The surgery was the most painful thing he'd ever experienced, Basil says. And he wasn't prepared for that, because he's never heard any other trans man talk about the pain. "You're supposed to come off as a really happy person after getting surgery and just be grateful for it, which I am. But, I would like to tell people that you have to be really prepared," he says. "It was unbelievable, the pain that I was in for a month and a half." While he's thrilled with the results of his bottom surgery, it was a long process to start feeling better. And he wants other trans men to know what they're getting into. So, Refinery29 asked Basil to keep diaries before and after his surgery. Follow his journey (in his own words) below.

Photographed by Jonah Welch.

Jonah (the photographer) came and saw Basil for the first time after surgery at Mt. Sinai Hospital. After Basil's first time walking, he laid down. Catheters and a vacuum sucked blood from his genitals for five days.

November 21, 2017 8:38 pm

I’m on my way to Charleston. Emily left a spare key and I’m so excited to have a night sleeping alone without a dog, or a lover, or a roommate. Now, I’m processing my day and blocking out the airport. I had my final pre-op today. It was hard and scary. It made everything real. I had lots of blood taken and was told that I was healthy repeatedly. Something about that, as a trans person and someone who grew up impoverished is still shocking. Like, Wow! I’m healthy!? Absurd.


My partner has been contacting folks who maybe want to contribute words or ideas about me as a human to this project. We reached out to my ex Katie. Katie brings a lot up for me when thinking about transitioning. She started dating me when I was using gender neutral pronouns and coming into my identity. She identified as a lesbian and had a really intense aversion to me using “realistic” looking cocks when I’d strap, she was not supportive of me starting testosterone in the beginning, and my sexual orientation and sexual desires shifted a lot during those first two years.

What she has brought up for me, too, is how many "straight" girls started falling in love with me at a very early age. How I was always a secret. Also, cis people have a real strong fascination with their dude being able to get them pregnant. Will bottom surgery remedy any of these memories? Will it help me with my dysphoria around not being about to create life in a traditional way? No.

November 25, 2017 3:22 pm

My mother didn’t respond to any of my text messages or phone calls. I try not to take it personally. I think it’s weird, being a mom who neglected their child and is now faced with that. There’s weird shame there.


In Myrtle Beach, I did my best to say goodbye to my grandmother. I remembered how one time when I was 6, I spit on the ground in front of my gramma. Her eyes widened, "Jesus Fucking Christ, you spit like a grown man." I remember feeling proud of myself.

I’ve been thinking of getting surgery and how I’ve gotten to the place I am with it now. I didn’t have bottom dysphoria at one point. Pre-testosterone or when I first started transitioning, I sort of had it. I think I was in denial. I think I was overcompensating and inexperienced. I’ve always had dysphoria a little bit. Early on I judged guys who didn’t accept their junk because gender is a construct right? Gender isn’t sex? Now that I’m on the other side I kind of envy trans guys who are fine with their junk. My biggest fear in transitioning is that nobody will ever love me. Nobody will ever love my body and I’ll never be enough.

When having sex with cis men my dysphoria isn’t as loud if I'm a bottom, but I’m pretty dominant. I enjoy being dominant and started to feel fetishized when I’d go to hook up with a gay guy who assumed I was a bottom because of the body I had. I don’t always want to be fucked just because I’m a man with genitalia that isn’t usually possessed by men. I’ve had dudes say the creepiest shit. "We need more boys like you." // "Sorry, I’m not into pussy." // "I'd never be able to tell." The assumptions there are outrageous. I could have a dick, ya know?

All of these things have compounded for me over the years. Then there was just the scary stuff like locker rooms, urinals, packing my underwear, and the TSA always stopping me. When the TSA pulls me aside because my dick shows up on the X-ray thing and the dude doesn’t find drugs; he’s always mad.


When I moved to New York, I realized New York covered trans health care. Before that, bottom surgery wasn’t even an option. Then I became a patient at the Center for Transgender Medicine with Mt. Sinai. Having surgery took me so long to think about because I couldn’t believe it was an option and I am really afraid of the outcome. I am afraid to lose sensation. I am afraid to change my body so much.

November 26, 2017 11:56 am

It’s my last full day in South Carolina. It’s my last day with my partner Laura until post-surgery.

I don’t get to have sex for some time after surgery. I’ve talked to her about it, but I’m afraid she’s not going to like me post-surgery. Like I’m some sort of Frankenstein man who had to be put together. She gets upset by this notion and kindly does the emotional labor to reassure me that she loves me and my body now and will like it later, too.

Sex. Though. One of my fears surrounding this surgery is losing sensation or having to maybe even re-learn how to have sex. I’m probably cocky (pun not necessarily intended) but I’m great in bed, and I love sex. This surgery isn’t going to give me everything I want. I won’t be able to penetrate my partner the way I want to. I still won’t be able to get someone pregnant. Will I ever feel comfortable in my body?

Photographed by Jonah Welch.

Laura, Basil’s girlfriend, came to help take care of him from Chicago. Basil was three days post-op and had just came home the night before in an ambulance. Basil struggled to sit up straight as Joel brought him breakfast.

December 11, 2017 9:28 pm

I am six days post op. I am so so so insanely touched and grateful for how much people have done for me in this process. Joel, who is the sweetest most endearing loving man, has been quite the overbearing Jewish mother of a caretaker I have needed. I’ve been slathered in care by my three main caretakers and checked up on by so many in my community and my friends in South Carolina. But, amongst all the love of Joel, Laura, and Jonah, I woke up really angry and frustrated. I was tired of not being able to move.

Today was an interesting day.


I was in a lot of pain because I’ve had a vacuum suction thing connected to my dick since I got out of surgery. Since today was the last day and my swelling has gone down, it was nothing but sheer pain until I had it cut off. Then, I finally saw the very swollen and bloody penis created for me by Dr. Ting.

I was grumpy though. I was tired of not being able to leave bed or do anything on my own. And over the course of the past two nights, I’d experienced some extreme pain before sleep and wondered if I had made the right decision. I’d cried to my girlfriend, wondering if she’d still love me if I looked weird. I’m upset that the testicular implants are happening separate from the rest of the surgery and feel dysphoria around that. I’m afraid I’ll lose sensation. I’m afraid I’ll look more like a freak then I was in my mind before.

But, my dick looks great and I can’t wait to see it heal.

December 15, 2017 1:46 pm

I’m grumpy.


I want to get out of bed and be doing anything other than healing and I still have awhile to go. But, I’m grateful too. I’ve been thinking about this whole process and how my insurance attempted to cancel the surgery last minute and how lucky I was to have Mt. Sinai advocate for me. I spent the days leading up to this massive surgery worrying and freaking out. I spent my days leading up to surgery unsure if I would get it and maybe I’d have to tell my loved ones to cancel their flights, show up to classes that I got a doctors note for, and start the entire year long process I went through over again. Dr. Ting was apparently, all of the sudden, out of network. People helped me fight though and sadly, that’s a huge privilege.

However, I’m out of medicine. I was given a week’s worth of Tylenol mixed with codeine and that’s gone but my insurance won’t cover anymore of this controlled substance. So, I’m not even allowed to buy it out-of-pocket and am just working with ibuprofen right now. I have two catheters in me. One is in my new member. It’s uncomfortable and bureaucracy is so violent. Because I don’t have good reception in my bedroom, I’m going to have to go stand outside in 24 degree weather on my porch and call my insurance company to see when I can have access to more meds or if that’s even an option.

Photographed by Jonah Welch.

Basil had to shower with bandages on because the vacuum was still connected to his body along with two catheters. He didn’t get service in his apartment and had to walk outside (with the catheter still connected to his penis) to call his insurance company.

December 18, 2017 8:05 pm


I’ve been reeling from the “forbidden” word list sent from the Trump administration to the CDC a few days ago. It’s weird and sobering to be immobile and feel so powerless. I’m not safe here. Trans people, so many people, are not safe in the United States.

I try really hard to give the world the benefit of the doubt. I’ve spent so many days in bed watching Boardwalk Empire, reading about the current political sphere, and seeing my community pointedly try to be banished from statistics and existence. And all of us are too stunned to do anything. We’ve been in shock for a year, it seems.

I want it to be known that, while I am grateful for the services Mt. Sinai has provided and the surgeons who worked on me, I feel like the medical industry at large have made my recovery harder. The last time I was at Dr. Ting’s office, I was seen promptly but sent away without any of the required medical tools. I didn’t wear underwear there because of the vacuum and nobody told me to bring any. They didn’t have any either, so I had to wear Jonah’s home. They told me to take the foley off the catheter but didn’t have a plug for it. They told Jonah to pick one up at a pharmacy. Jonah went to three pharmacies and St. Jude’s hospital and still didn’t find one. We had to order a plug from Amazon and use binder clips to kink the catheter until it arrived.

I also wasn’t given any care procedures for home. I was in severe pain from the removal of the vacuum, but also before putting the vac on my body nobody shaved my thighs, butt, or legs and the intense tape, some of which is still stuck to my body, had to be ripped off. I was in a lot of pain and didn’t really get to say much or ask many questions.


I feel jaded from my experience around the doctors and insurance in this surgery. It’s exhausting. On my ride home, I thought about when I got top surgery and how insane it is that trans men are just thrown into a car immediately after they wake up after top surgery. How I didn’t know I was allergic to anesthesia and vomited for hours non-stop in the car and hotel room in Florida. Is this what it’s like for everyone? Or just trans people?

I feel disposable.

To have a surgery done, that feels so fly-by-the seat is painful. Where people around you, who aren’t trans, don’t have a protocol and make the rules up as they go shouldn’t feel shocking to me. That’s what it feels like to be trans in any situation, but especially in the medical field. None of us are treated the same and we are supposed to just feel grateful that someone, anyone, has made an effort in focusing on our community, fixing our bodies, and normalizing us. So, we sit on a conveyer belt and are forgotten about as soon as we’re tinkered with.

Here’s hoping the doctors that have a monopoly on our bodies use some of the money they make off of them to help us in the fight for trans rights and make sure that we're not "forbidden."

Photographed by Jonah Welch.

Six months post-op: Basil looked up at the sky while walking his dog, something he struggled to do for the first six weeks of surgery. He has almost completely healed and is happy with the outcome. He says he feels more confident.

December 20, 2017 9:08 pm

I may have jumped the gun in totally feeling un-taken care of in my process and post-op recovery from this surgery. Dr. Grotas came in first thing this morning and removed my catheter from my dick. WHAT A GOOD DAY. WHAT A RELIEF.

So, I’m peeing without a catheter and it’s hard! But also fun. I kind of have to learn to pee again. I spent the day in bed kind of feeling sick after having the catheter removed. I peed a lot and I felt sort of detox-y. More Empire Boardwalk and Bob’s Burgers.


I saw my penis in the mirror today, without any catheters or tape, and I got really happy. I don’t think I realized how bothered I truly was by my genital dysphoria until today. When I looked in the mirror and really saw the results for the first time, I felt a weight lift from me that I didn’t know was as heavy as it was. I’m finally seeing the results and feel closer to myself and my body. It’s alleviating a lot of the frustrations and pain I’ve been experiencing.

I’m grateful and exactly two weeks post-op. I feel like things can only keep improving from here as I learn my new body. I’m stoked and nervous to start having sex again. But mostly stoked.

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