When Blubond-Langner began his tour, he says, the elderly surgeons warned: “Be careful what you know.” Ignoring this, he began to gather the training needed to perform upper surgery, vaginoplasty, phalloplasty, and metioedioplasty (a lesser-involved surgery that builds a smaller penis using only the clitoral tissue of the uterus). This training took her all over the world, to Thailand և Canada to study vaginal plastic surgery և Mexico City, where she studied microsurgery, a technique that facilitates the transfer of skin folds by connecting nerves and vessels on a microscopic scale. He began performing complex surgeries on his genitals, including phalloplasty for micropenis և trauma. In 2016, she underwent her first sex-confirmed phalloplasty at the University of Maryland. As far as he knows, the operation was successful. (She’s lost contact two years later.) Rodriguez moved to NYU Langone a few years ago to become head of plastic surgery. He eventually recruited Bluebond-Langner to come up with a transgender surgery program.
The NYU Transgender Surgery Program occupies its own room on the sixth floor of a Manhattan glazed office building. I first visited in March 2021. Leaving the elevator, I immediately noticed how luxurious everything was. The lounge had Keurig machines, orchids in vases, and iPads with futuristic palm printing scanners. The names of the benefactors were plastered on the wall away from the age of a separate secret site. Sitting on a medieval sofa (or a reclining leather bench or chrome-plated armchair), a transgender journalist can be forgiven for more than just a little cynicism. American trans people are in a complicated relationship with a medical institution. On the one hand, there is the call to expand and improve care, which has been historically rejected. On the other hand, many of us are not blind to the fact that our bodies do good business in a for-profit system. “We get paid,” said Blubond-Langner, explaining that he does not receive more money for more patients. “Although they encourage us a little. “They will give us more resources.”
Bluebond-Langner is smiling, straightforward, and generally immune to the surgeon divine complexion. When he came to NYU to start the program in 2017, he had only two partners, Zhao Jamie L., a microsurgeon. Over the years, the team has grown to include administrative staff, a research department, a physical therapist, two social workers, and two nurses. More than half of the team is identified as trans, including two trainee surgeons who Blubond-Langner hopes will one day succeed Zhao.
A medical transition is a never-ending list of things to do. To be approved for phalloplasty, candidates must obtain separate referrals from two mental health providers. They need laser hair removal at the donor site of the skin և Support կրկն in the repeated (և often immobilizing) stages of treatment. “Unfortunately, many of our patients are marginalized,” said Blubond-Langner. They may not always depend on their job or family for support. He sees the program care team as the key to achieving a healthy surgical outcome. Although trans rights have progressed on paper, many of its patients are still living in misery – poverty, unstable housing, social alienation, which makes recovery more difficult. “If it’s hard to find a job because you are transgender, it will not help you with surgery.”
“People understand the compromise. But we would not necessarily accept this level of difficulty in other procedures. ”
Walking down the hallway to the Blubond-Langner private office, we pushed past people rushing back and forth in NYU Gender Surgery jackets. (The symbol of the program is a fig leaf.) Inside, above the conference table, hung a poster with the autograph of “Pos” actress Dominic Jackson. The numbers on the bookshelf were Plastic և Rehabilitation Surgery’s sloping next to coffee table books: The Bible of the Vagina, The Great Wall of the Vagina, The Feast of the Vulva Diversity. Bluebond-Langner makes three vaginas for each penis. She sometimes finishes three vaginas in one day; Each penis usually has at least two surgeries, but often four or more. “The demand for vaginoplasty is much higher,” he said. “I think this goes back to the fact that it is a reducing, one-step procedure. The risks are less. “
The NYU program has performed more than 150 phalloplasties to date. During the initial surgical consultation, Bluebond-Langner tries to understand what kind of sex the patient likes, to better advise what combination of procedures can best improve the quality of life, minimizing the risk of complications. In the early days of official transgender medicine in the United States, from about 1960 to 1980, phalloplasty was a rare, almost universal, procedure designed to replicate the idealized egg and function of an imaginary standard. American penis. Whether it is still the hope of many individual patients, Blubond-Langner himself, and medicine in general, have begun to move away from this benchmark as an objective measure of surgical success.
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