Why My Story Matters#
The night before my surgery, I had a complete breakdown in a freezing cold shower at 3 AM.
The hotel's hot water heater was broken. A rave in the room next door had kept me awake until four. I needed to be at the hospital in ninety minutes with clean bowels and an empty stomach. I was exhausted, terrified, and standing under ice-cold water in San Francisco's Tenderloin district, questioning whether I could actually go through with this thing I had wanted my entire life.
But when the alarm sounded, I got dressed. When the Uber arrived, I got in. I showed up on time, running on zero sleep and pure determination.
That's all I had to do: show up. The medical team took care of everything else.
I'm telling you this not because it's the beginning of my story—it's closer to the middle—but because it captures something essential about this journey. The path to becoming yourself isn't smooth. It involves moments of profound doubt, logistical disasters, and ice-cold showers at 3 AM. And you take the next step anyway, because the alternative is unbearable.
My name is Andrex , though I go by Axl—it's easier to pronounce. Many people know me as Axl online. I became a nullo on August 9, 2024. Since that surgery, I've dedicated myself to building the resources and community infrastructure that barely existed when I needed them most: the Flat Crotch Collective, bottomsurgery.info, and now this book.
I'm sharing my story for a simple reason: when I was searching for information about nullification, I desperately wanted to know what this path actually looked like for someone who had walked it. Clinical descriptions couldn't answer my questions. I needed stories from real people—their fears, their preparations, their recoveries, their complications. Those stories barely existed. So I'm writing the one I wished I could have read.
What follows is my journey from earliest memories through the present day. Some parts are beautiful; many are brutal. I'm not telling my entire life story—that's a longer book—but I want to show you enough of my raw humanity that you can see your own reflection somewhere in mine.
A note before we begin: your journey doesn't need to mirror mine to be real and worth pursuing. Take what resonates; release what doesn't. This is one map of one territory, offered with love—including the parts where the terrain got treacherous.
Early Understanding of Gender#
I was born in Milwaukee, Wisconsin in the late 1980s, during a time when conversations about gender identity were virtually nonexistent. At three, I taught myself to read through persistent curiosity and what I now recognize as a distinctly neurodivergent approach to learning—there is no force more unstoppable than a queer autistic child's unmitigated curiosity. By four, I was devouring books at a fourth-grade level. After first grade, my mother chose to homeschool me, still relatively unusual in the early 1990s.
Yet even amid this intellectual blossoming, something fundamental about my body felt wrong.
My relationship with my physical form has been complicated for as long as I can remember. Some of my earliest memories involve an overwhelming sense of disconnection from my anatomy that I couldn't articulate but felt viscerally.
In kindergarten, I drew stick figures of myself with exaggerated genitals because they felt so prominently uncomfortable—this overwhelming sense of wrongness I had no words for but felt compelled to express. I was five years old, trying desperately to communicate something important about my body that nobody could understand. Including myself.
I didn't have language for what I was experiencing. "Gender dysphoria" wasn't a term I would encounter for decades. "Nonbinary" didn't exist as a recognized identity. I knew I was a boy because everyone told me so, but I also knew something about my body didn't match something essential inside me. That contradiction lived in my chest like a heavy stone I learned to carry silently.
Early coping mechanisms emerged without conscious planning. I became hyperaware of my body in ways that exhausted me constantly. I avoided activities that drew attention to my anatomy—swimming, locker rooms, anything requiring undressing around others. I learned to dissociate during physical experiences I couldn't avoid.
I also learned the protective power of silence. The one time I tried to articulate that something was wrong, the adults responded with visible confusion. So I stopped trying to explain. I buried the wrongness so deep that even I sometimes forgot it was there—until something would surface the feeling again, and I'd remember: this is still here. This has always been here.
Childhood and Survival#
My childhood was shaped by authoritarian parenting, various forms of abuse, and accumulated trauma I won't detail here—that belongs in another book. What matters for this narrative is that I learned early that survival required constant adaptation, that love could be conditional, and that escape required careful strategic planning.
At ten, I began studying German with serious dedication. My reasoning was practical: foreign languages would give me the means to get far away from Wisconsin. By twelve, I had negotiated my way back into public school after years of homeschooling isolation. By fifteen, I was studying abroad independently in Germany. I began my freshman year at UW-Madison just months after turning seventeen.
Through all this achievement, through all these milestones of precocious escape, the underlying dysphoria never left. It was the constant beneath the chaos—quiet enough to manage, persistent enough that I never forgot it entirely.
Adolescence and Young Adulthood#
Puberty arrived like a slow-motion disaster. Each month brought changes that felt profoundly wrong. Other boys seemed to welcome these developments or accept them with resigned normalcy. I experienced mine as betrayal—my body becoming something I hadn't consented to and didn't want.
I became skilled at living almost entirely in my head, treating my body as merely something I transported my mind around in. Academic success became a refuge from persistent bodily distress. Every achievement felt like another step toward the freedom I craved—freedom from my family, from Wisconsin, from the confines of a life that didn't fit.
At twenty-two, I graduated Phi Beta Kappa from UW-Madison with honors degrees in Political Science, History, and International Studies. The gulf between my parents and me had grown wider after I came out as gay freshman year. They responded by cutting me off financially, forcing me to work nearly full-time while carrying a full course load. I managed. I had been managing my whole life.
Coming out as gay resolved one piece of the puzzle while leaving larger pieces untouched. The dysphoria wasn't explained by my sexual orientation. I knew who I was attracted to, but that knowledge didn't address the wrongness I felt about my body. The feeling persisted even as other aspects of my identity clicked into place.
More specifically, basic bodily functions like urination and ejaculation caused significant distress. I didn't enjoy how either felt; I often experienced psychological discomfort during these everyday activities. This wasn't something I could discuss openly—even in progressive queer communities, there was no framework for "I hate having a penis" that didn't lead to assumptions about wanting a vagina instead. So I managed these feelings privately, silently, the way I had learned to manage everything.
Career, Loss, and Coping#
The years after college took me through specialty coffee and tea sales, then into professional kitchens. I was driven by curiosity and escape—always moving, always learning, always putting distance between myself and the discomfort I couldn't name. The culinary world offered something concrete: techniques to master, flavors to understand, a craft that demanded full attention and left little room for existential questions about embodiment.
Two books shaped my direction during this period. Matthew Crawford's Shop Class as Soulcraft articulated something I'd always felt: the dignity and intellectual satisfaction of manual work, the way skilled trades engage both mind and body in ways that desk jobs often don't. Anthony Bourdain's Kitchen Confidential showed me the kitchen could be a refuge for misfits—a place where intensity and precision mattered more than conformity, where damaged people could find purpose in the discipline of service.
I cooked and baked in Madison, New York, and Chicago, climbing the industry ladder. Eventually I found myself working for acclaimed Chef Stephanie Izard at Duck Duck Goat and Little Goat Diner. I had climbed from McDonald's at fourteen to one of America's most celebrated TV chef personalities. From the outside, it looked like success.
In December 2011, my younger brother passed away suddenly from an overdose.
The loss was devastating in ways I couldn't process at the time. Grief doesn't follow a timeline—it crashes over you in waves, and I wasn't equipped to ride them. I drank whiskey without restraint for an entire year, my intake tipping from heavy use into physiological dependence. The alcohol numbed more than grief; it temporarily quieted the dysphoria too, though at a cost I wasn't ready to acknowledge.
But I kept moving. Movement had always been my survival strategy—forward momentum as a substitute for processing. I couldn't sit still with what I was feeling, so I didn't sit still at all.
Through all these years, through the restaurants and the drinking and the grief I couldn't face, the bodily dysphoria remained. It was the constant undertone beneath every achievement. Success in my career didn't make my body feel any more right. Neither did the alcohol, though it helped me stop noticing for hours at a time.
Living so much in my mind meant I was always searching for ways to manage my body—to make it more tolerable to inhabit. In my mid-twenties, I discovered that wearing a chastity cage felt better than having my genitals fully accessible. The relief was immediate: containing that part of my body made daily existence more bearable. But it was also revelatory in a troubling way. Most people don't find that restricting their genitals improves their quality of life.
Over the following years, I went through roughly two dozen different cages, always searching for the "perfect" one. Each new device represented hope; each eventual discomfort proved that external solutions couldn't fully address what I was experiencing. The cages helped—significantly—but they were management tools, not solutions. Something more fundamental was wrong.
Body modification wasn't new territory for me. My tattoos have won trophies at Milwaukee and Chicago conventions. I'd spent hundreds of hours in tattoo chairs, each piece a way of claiming my body through deliberate artistic choice. Making irreversible modifications that aligned with my authentic self wasn't unfamiliar—though genital nullification would certainly be the most profound.
What I couldn't see yet was that my coping mechanisms were becoming inadequate. The alcohol dependence, the constant movement, the cages, even the tattoos: all ways of managing an unsustainable situation. I was surviving, not thriving. The difference would become clear soon enough.
Rock Bottom and Rebuilding#
The COVID pandemic changed everything. My restaurant career—the world I'd spent years building—vanished overnight. The industry collapsed. Restaurants closed. Teams disbanded. The identity I had constructed around culinary excellence suddenly had nowhere to exist.
In June 2020, I ended my first marriage. This wasn't sudden—it was the culmination of years of dysfunction. I had been married to someone who refused to work while I supported us both, carrying the weight of our household while navigating restaurant demands. The pandemic made it impossible to continue pretending the arrangement was sustainable.
The financial consequences were devastating. I filed for U.S. Insurance, Costs, and Documents bankruptcy. The psychological impact—officially declaring failure, having my credit destroyed—did massive damage to my mental health. I had worked so hard, achieved so much, and here I was at rock bottom.
The stress sent me spiraling back into alcohol. I was drinking a handle of whiskey every two to three days. My body was paying the price, my mental health deteriorating. I could feel myself slipping into darkness with no clear way out.
In October 2020, I contracted COVID-19. I was sick for an entire month—bedridden, struggling to breathe, terrified. The illness hit my already-compromised body with brutal force.
My current husband KJ saved my life. This isn't hyperbole—it's literal truth. We met on Facebook in late June 2020, right after I ended my first marriage. We talked constantly, hours every day, and I realized I had found someone who truly saw me.
After months of building this connection across distance, I took what felt like an enormous leap: I bought him a $35 one-way plane ticket to Chicago. It was all I could afford. He arrived in late 2020, and we've been inseparable since.
KJ loved me through a period when it was exceptionally difficult to love myself. He saw me at my worst—drinking heavily, financially destroyed, professionally adrift, physically ill—and chose to stay. With his support, I got sober. I haven't had a drink since.
In early 2022, we moved to Wisconsin together and got married. During this same period, I completed my MBA in Finance—remarkable given everything I was navigating. Going back to school gave me forward momentum I desperately needed, a sense of building toward something rather than just surviving.
In February 2021, while still living in Chicago, I began testosterone HRT through Howard Brown Health. This was my first concrete medical step toward addressing the bodily discomfort I'd carried my entire life. Starting HRT felt momentous—an acknowledgment that my discomfort was real and deserved to be addressed.
The physical changes were profound: voice deepening, body composition shifting, facial hair growing. Some changes brought relief; others created new questions. HRT addressed certain aspects of my dysphoria while leaving the genital wrongness entirely untouched. I was years from understanding what surgical intervention I would need, still assuming that standard transition pathways were my only options and that none of them fit.
In December 2023, KJ and I relocated to our own apartment in Waukesha, Wisconsin—smaller, more affordable, quieter. We were creating a home, a foundation from which I could finally begin deeper work.
Why Surgery Took So Long#
The path to surgical consideration wasn't straightforward. It was shaped by survival priorities, internal barriers, and practical obstacles that took decades to overcome.
Survival came first. Childhood abuse, my brother's death, alcoholism, a failed marriage, bankruptcy, COVID, getting sober, building a new life—these crises demanded immediate attention. There wasn't space to address deeper bodily wrongness when I was fighting to stay alive. You can't contemplate elective surgery when you're not sure you'll make rent.
Internalized barriers loomed large. I had absorbed cultural messages that surgery was extreme, that it was for "other people"—trans people somehow more certain or more suffering or more deserving than me. I couldn't see myself in their stories because I didn't know stories like mine existed.
My framework was limited. The binary transition model I knew included vaginoplasty for trans women and phalloplasty for trans men. Neither felt right. I didn't want a vagina; I didn't want a different penis. I wanted nothing—but I didn't know that was an option. I assumed surgical intervention simply wasn't for me.
Practical obstacles seemed insurmountable. Surgery appeared impossibly expensive, geographically distant, bureaucratically complex—requiring years of therapy letters and gatekeeping I couldn't imagine navigating while also working and managing sobriety and building a marriage.
Discovering nulloplasty changed everything. Learning there was a word—nullo—and a procedure—nulloplasty—opened a door I hadn't known existed. For the first time, I could imagine a body that felt right. The configuration I had been unable to articulate had a name, and other people had achieved it.
The turning point came through a pact with myself. I would invest in a custom chastity cage from Evotion Wearables—the highest-quality option available. If this cage didn't work, if even the best external solution still felt inadequate, I would seriously pursue surgery.
That cage arrived and was the best I had ever worn. It still wasn't right. Nothing external could solve the fundamental disconnect between my body and my sense of self.
In May 2024, a family tragedy reminded me that life is finite. Surgery had always felt like something for "later"—when circumstances were perfect, when I had more money, when I felt more ready. But circumstances would never be perfect. I had good insurance through KJ's employer. Waiting wouldn't make it easier.
I was done waiting for perfect circumstances. I was done treating my needs as less urgent than my fears. It was time.
Preparation and Uncertainty#
The hardest part was figuring out where to start. No one had given me a roadmap. The resources that should have existed didn't.
I began by calling my insurance company with a simple question: "Does my plan cover gender-affirming surgery, provided the normal WPATH criteria are met?" They said yes. That single phone call opened everything that followed.
Securing therapist letters happened faster than expected. Before starting the surgical process at the end of May 2024, I hadn't seen a therapist in over two years. But I secured both required letters in less than forty-eight hours through telehealth appointments. Within a week, I was fully prequalified.
Finding a surgeon proved more challenging. I was living in Southeast Wisconsin, where nulloplasty simply wasn't available. Even in Chicago, wait times were absurd—first available consultation seven months out, and they couldn't even confirm whether their surgeon performed nulloplasty specifically.
My timing constraints were inflexible. I had begun pursuing a Master's in Data Analytics after completing my MBA, knowing that after graduation I needed to be working, not recovering. I couldn't afford to wait seven months for a consultation that might not even lead anywhere.
After frustrating experiences with Chicago providers, I contacted the surgical practice in San Francisco directly. The difference was immediate. I reached a friendly, knowledgeable staff member in under a minute. They scheduled a telehealth consultation for days later. The day after that consultation—the week after my thirty-seventh birthday—I received confirmation: August 9, 2024, at St. Francis Memorial Hospital.
Nine weeks from decision to surgery. Every trans person I've spoken with since has told me that's the fastest timeline they've ever heard of.
Getting finances together required unexpected community support. I started with zero dollars saved and knew no other nullos in real life. I created a GoFundMe and began sharing my story on X (formerly Twitter). My account went from three hundred followers to six thousand in those nine weeks. Thousands of strangers contributed.
The outpouring was overwhelming. People I'd never met believed in my journey enough to fund it. They shared my posts, amplified my voice, sent messages of encouragement. Some were fellow trans people seeing their own hopes reflected in mine. Others were allies who simply wanted to help. The experience fundamentally changed how I understood community—not as something you're born into, but something you build through vulnerability and shared purpose.
Starting from nothing, I accomplished far more than funding surgery. Lacking real-life social support, I built a vibrant community on Telegram. Reliable information about nonbinary bottom surgery barely existed, so I created bottomsurgery.info to guide those who would follow. I was building the infrastructure I wished had existed for me.
The Surgery#
Arrival at the surgical center felt surreal. After years of longing and nine weeks of intense preparation, I was actually here. The pre-op area was calm, clinical, surprisingly routine. Nurses confirmed my identity, verified my procedure, inserted IVs, explained what would happen next with practiced efficiency.
The final moments before anesthesia were quieter than I expected. No dramatic revelations, no last-minute panic. Just a gradual drift as the medications took effect, accompanied by the strange peace of surrendering control to people whose job was to transform my body while I slept.
What I remember about anesthesia: not much. One moment I was counting backward; the next I was somewhere else entirely, fuzzy and warm and confused about where the time had gone.
Coming out of surgery brought sensations I didn't expect. Groggy disorientation. A body that felt simultaneously mine and profoundly unfamiliar. Pain, but distanced by medication. And underneath everything else, a relief so profound it made me cry before I was awake enough to understand why.
That first moment of awareness—knowing the surgery was done, knowing my body had been changed in ways I had desperately wanted—felt exactly as transformative as I had hoped. Even through the post-anesthesia haze, I felt something I hadn't felt before: the rightness of existing in my own skin. It felt as though those parts had never existed—that's how immediate and complete the psychological shift was.
The first twenty-four hours were a blur of pain management, vital signs checks, and gradual return to consciousness. The hospital staff were professional and kind, though I was aware of being an unusual case for most of them. My surgeon checked on me, confirmed everything had gone well, and outlined what recovery would look like.
Managing pain and emotions simultaneously was more challenging than I had anticipated. Physical discomfort was significant but controllable with medication. Emotional volatility was harder to predict—tears arriving unexpectedly, sometimes from relief, sometimes from the sheer overwhelm of having actually done this thing I had wanted for so long.
Early Recovery#
Coming home—or rather, returning to our hotel room—began the next phase. We had twenty-eight nights in San Francisco ahead, not nearly enough for full recovery but enough to get through the most acute period.
Physical challenges dominated the early days. The catheter was uncomfortable and required careful management. Drains needed regular emptying and tracking. Mobility was severely limited; even reaching the bathroom felt like an expedition.
What I want you to know about recovery—things specific to this surgery that generic post-op guides won't tell you:
The psychological relief can coexist with physical misery. I felt more at peace in my body than I ever had, even while that body was swollen, catheterized, and exhausted. These weren't contradictory experiences; they were simultaneous ones.
The visual reality of your healing body will look different from final results. Surgeons warn you about swelling, but knowing that intellectually doesn't fully prepare you for looking down and seeing something unfamiliar. Try to observe rather than evaluate during this phase. What you're seeing is temporary.
Genital surgery recovery involves navigating bodily functions in new ways. Urination felt different—not worse, just different in ways I had to learn. The relief of experiencing these functions without dysphoria was profound, even when the mechanics were still healing.
Small victories marked the time. Walking to the hotel lobby felt like achievement. Eating a full meal without nausea was a milestone. The first catheter removal—followed by re-insertion when complications arose—felt devastating in the moment but resolved within days. Each setback was temporary; each recovery built confidence.
My support system made everything possible. KJ handled logistics, emotional support, and physical caregiving simultaneously. He tracked medications, helped me shower, kept me company during long hours of limited mobility, and never once made me feel like a burden. If you're considering this surgery, having dedicated support isn't optional—it's essential.
Processing what I'd done happened in fragments. Sometimes it felt triumphant: I did it. I actually did it. Sometimes it felt terrifying: This is irreversible. There's no going back. Most often, it simply felt right in a way I couldn't fully articulate—a deep settling into myself that had never been possible before.
Settling Into My New Reality#
By August 2025, one year after surgery, the visible healing had largely completed. Scars had matured. Sensation had stabilized. The body I saw in the mirror was the body I expected for the rest of my life.
What changed: The dysphoria that had haunted me since childhood was essentially gone. Daily activities that once caused distress—urination, getting dressed, intimacy—now happened without that constant background wrongness. I looked in the mirror and felt recognition instead of disconnection.
The first time I put on clothing comfortably—pants that fit normally, underwear that lay flat against a body that finally felt correct—I cried. Such a small thing. Such profound relief.
What stayed the same: I was still me. My personality, relationships, interests, struggles unrelated to gender—all persisted. Surgery changed my body and resolved my genital dysphoria; it didn't solve every challenge in my life. That's exactly as it should be. Anyone expecting surgery to fix everything will be disappointed. Anyone expecting it to fix the specific thing it's designed to fix will likely find what I found: profound relief.
What I wish I'd known: How normal it would feel. I had expected to spend months marveling at my new body, constantly aware of the change. Instead, within weeks, my body simply felt like my body—unremarkable in the best possible way. The absence of dysphoria isn't a constant presence of euphoria; it's the freedom to stop thinking about your body all the time and just live.
What I'm glad I didn't know: How hard the recovery would be. If I had fully understood the exhaustion, the limitations, the frustrations of healing, I might have been too scared to proceed. Sometimes ignorance serves us.
But new concerns emerged. Palpable densities appeared under my skin—hard spots causing pain during intimacy and triggering waves of dysphoria. What were they? Scar tissue? Cysts? I knew I would need to address them.
The Revision and Its Aftermath#
The decision to pursue revision came after months of hoping these issues would resolve on their own. They didn't. During intimacy, the hard spots caused significant pain and—worse—brought dysphoria flooding back. A cruel irony after everything I'd been through.
My surgeon, the surgeon, agreed intervention was warranted. The differential diagnosis included calcifications, epidermal inclusion cysts, scar tissue, or neuromas. We discussed that removing these masses might not fully resolve the pain and could recur. But living with the situation was untenable.
What was supposed to be simple became anything but.
I was already in San Francisco for another reason. In late October 2025, I had flown out as primary caregiver for a friend undergoing his own nulloplasty. Days before I was supposed to leave, I managed to get my revision scheduled for November 12th—a quick outpatient procedure.
November 12, 2025: During pre-op, the anesthesiologist noticed my oxygen saturation was low—readings between 89 and 95 percent. Concerning enough to halt everything. Hours of ER tests followed. They found nothing conclusive, thought it unfortunate they hadn't just done the surgery. Rescheduled for Friday.
November 14, 2025: The revision. the surgeon performed excision of an epidermal inclusion cyst, removal of calcifications, excision of scar tissue, neurovascular island pedicle flap, complex closure in layers. Everything went smoothly. Discharged to recover at my friend's home.
Pathology confirmed I had calcifications, a cyst, and excessive scar tissue. Why not all the bad possibilities at once?
The two weeks that followed seemed normal. Manageable pain. Gradual improvement.
November 26–27, 2025: Something changed. Pain that had been improving suddenly worsened—acute, escalating, uncontrolled by medication. Overwhelming fatigue hit. Even under blankets, I was freezing. Temperature check: 103 degrees.
November 28, 2025: The Friday after Thanksgiving, we went to the ER.
Triage noted heart rate 105, low-grade fever. Sepsis screening triggered immediately. CT scan revealed a rim-enhancing fluid collection—an abscess at my surgical site. Extensive cellulitis had spread through tissue. White blood cell count 21.2, more than double normal.
The diagnosis: sepsis.
IV antibiotics started immediately. The abscess was drained.
That night was one of the longest of my life. I spent two nights hospitalized. November 28th was also my five-year anniversary with KJ. Instead of celebrating, I was lying in a San Francisco hospital bed, septic, thousands of miles from him. Thousands of miles from our senior emotional support dog.
In my darkest moments, drugged on IV opioids and alone in that hospital room, I didn't want to be alive anymore.
If you are currently experiencing thoughts of self-harm or suicide, please reach out: Trans Lifeline (US): 877-565-8860, (Canada): 877-330-6366. You can also text HOME to 741741 (Crisis Text Line).
But even lying in that bed, even in despair, I knew I would become a nullo all over again. The surgery wasn't the mistake. My body developing an infection wasn't proof I'd been wrong to pursue what I needed. Knowing that intellectually didn't stop the despair from crashing over me—but it was still true beneath the waves.
What helped, in those darkest hours, was small things. A text from KJ that made me cry. A nurse who brought warm blankets without being asked and called me "honey" in a way that felt genuine rather than clinical. A phone call with a friend who let me be silent when I needed silence and didn't try to fix anything. These moments of connection broke through when everything else felt impossible.
What Complications Taught Me#
Complications don't mean failure. This is the hardest and most important lesson. My body developed an infection. That's not a moral failing, not evidence I made the wrong decision, not proof I should have left well enough alone. Bodies are complex. Surgery is invasive. Infections happen even to people who do everything right.
Listening to my body saved my life. When pain worsened instead of improving, when fatigue felt unusual, I took my temperature. Over 103 degrees. I went to the ER immediately. If I had waited, if I had been back home in Wisconsin, I might be dead.
Being in the right place mattered. My decision to extend my San Francisco stay—originally to support my friend's recovery—meant I was still there when symptoms became acute. I had immediate access to my surgical team and excellent medical infrastructure.
Mental health during crisis is its own battle. The physical infection was one challenge. The emotional devastation was another entirely. Being far from my support system, maxing out finances, missing my anniversary—all compounded into something that nearly broke me. If you face complications, struggling emotionally doesn't mean you're weak. It means you're human facing something genuinely hard.
Where I Am Now#
As I write this in early January 2026, it's been six weeks since Thanksgiving. I've been quiet on social media—the quietest since before my initial surgery. It's taken this long to wrap my head around what happened.
Writing this guide is part of that processing. Putting timeline into words, translating medical records into lived experience, acknowledging that I didn't want to be alive anymore—these acts bring some closure.
Today, I'm still picking up pieces. For months, I've battled multiple health issues while rushing to build income as a creator with student loan payments looming. The calcifications had done damage before removal—sharp edges damaging nerve tissue. I'm still dealing with electric-like sensations from nerve healing.
If I'm being completely honest, part of my hope for this book is that it helps offset the $8,000 in revision bills. I try to be the best community leader I can, but I'm also just a person trying to solve my own problems. Sometimes helping others is how we discover our real purpose.
What I know for certain: The initial nulloplasty was the right decision. The revision was necessary. The infection wasn't anyone's fault. I would do it all over again, without hesitation.
What I want you to know: If you're considering surgery, don't let my complications scare you away from what you need. Complications are possible with any surgery. What matters is having a qualified team, understanding that revisions are common, staying attuned to your body's signals, and having support systems in place.
And if you're navigating your own complications, or your own dark nights: you're not alone. Even when it feels like you are. The despair doesn't mean you made the wrong choice. It means you're going through something genuinely terrible, and you're still here.
I'm still here too.
What This Book Offers#
When I started searching for information about nullification, I found almost nothing. No comprehensive guides. No personal narratives beyond scattered forum posts. The binary framework structuring most trans healthcare resources didn't include options like mine. I often felt like the only person who wanted what I wanted.
That's why I built bottomsurgery.info. That's why I founded the Flat Crotch Collective. That's why I wrote this book.
The guides that follow give you what I wished I'd had: foundational concepts for thinking about dysphoria and embodiment; practical preparation covering hormones, surgical options, insurance, finances, and fertility; detailed information on surgical pathways including nulloplasty, vaginoplasty, phalloplasty, and more; and everything I learned—often the hard way—about recovery, complications, and building support systems.
I've included the nine-week timeline people called impossible. The questions to ask your surgeon. The signs that something's wrong during recovery. The emotional volatility that's normal and the warning signs that aren't.
Wherever you are in your journey—just beginning to question, actively preparing, currently recovering, or navigating something unexpected—I hope this book serves you.
Reflection Questions#
As you read my story, what moments resonated most strongly with your own experience? Which parts felt unfamiliar?
What fears or concerns about surgery—or about exploring these questions at all—are present for you right now? Can you name them specifically?
How do you feel about the honest discussion of complications? Does it increase anxiety, help you feel more prepared, or both?
Who makes up your current support system? If you pursued major changes or faced unexpected complications, who would be there?
If you were to undergo surgery, who would be your primary caregiver? What support would you need from them?
What would feeling "at home" in your body look like? Can you describe it concretely?
What are your biggest unanswered questions after reading this guide? Which parts of this book might address them?
If you imagine yourself one year from now having made changes you want—including having navigated whatever challenges arose—what does that life look like?
Take time with these questions. Journal if that helps. Discuss with trusted people if available. Or simply sit with them, letting answers emerge in their own time.
References#
Bourdain, A. (2000). Kitchen confidential: Adventures in the culinary underbelly. Bloomsbury.
Crawford, M. B. (2009). Shop class as soulcraft: An inquiry into the value of work. Penguin Press.
World Professional Association for Transgender Health. (2022). Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health, 23(S1), S1–S259. https://doi.org/10.1080/26895269.2022.2100644