After coming out as trans, Finlay Games was adamant lower surgery would not be a part of his transition, but as the years went by, and his gender dysphoria increased, he decided to explore surgical options. We asked Finn about the realities of having lower surgery (phalloplasty). Here, he shares his experiences and gives advice in typical Finn style – with honesty and insight.

At what stage in your transition did you decide to go for phalloplasty and was it a difficult decision?

When I first realized I was transgender, I was very clear about what I wanted. My gender dysphoria was focused on how I looked and therefore hormones (testosterone) and top surgery were a must for me. I was convinced that I didn’t want lower surgery, as I didn’t appear to have any lower dysphoria. and therefore I thought it would have no impact on my life. However, about 6 months after having my top surgery, I became aware of growing discomfort with my genitals.

The increasing genital dysphoria made me realize that I did, after all, need to pursue lower surgery. This was a very difficult decision to come to terms with. All I had heard were negative experiences of lower surgery, which had played a part in my decision against having it in the first place. Even when I finally learned that much of what I had heard was unbalanced and untrue, I still had many more worries to work through. For example, could I cope with the multiple stages and years it would take to complete the surgery? Could I cope with the inevitable complications? And, working through surgical options to come to a decision was confusing and utterly exhausting. After a year of research and self-reflection, I finally knew enough and felt certain enough, to decide on having radial forearm free-flap phalloplasty. 

How long was the recovery process?

RFFF Phalloplasty is performed in 3 main stages. As this is a complicated and intricate procedure, there are often complications, meaning additional stages are needed. I had complications with the urethral hook-up stage, and in the end, I had 6 stages overall. Multiple stages mean many recoveries! The first stage is the longest recovery, mainly due to the large skin graft taken from the arm. It was about 6 months before I felt I was back to my usual self. The other stages were less intense and required less recovery time. I averaged about 3 months of recovery time after each of my other surgeries. The entire process, my timeline from start to finish, took 3 years for me.

Cheeky question – can you stand up to pee?

Standing to pee was my number one priority because I had a huge amount of dysphoria in using toilets. The urethral hook-up, where they lengthen the urethra, was performed in the second stage. After the surgery, I had to wean myself off the catheter and learn to pee standing up. Toilet training at the age of 43 was an interesting experience! Being able to stand to pee has changed my life. I now have no anxiety in using the toilet, making socializing much less distressing. Even at 5 years post-op, the joy when I stand to pee at a urinal is overwhelmingly wonderful!

Second cheeky question – are you happy with how your penis looks?

I love how my penis looks! In deciding on phalloplasty, I knew I wanted a penis that looked like a penis. The aesthetics were important to me so that I could feel relaxed at a urinal, and with potential partners. However, the result is far better than I ever could have imagined. My satisfaction is not really that my penis is perfect, but that he is his own individual version of a penis. What I mean by this, is that pre phallo, I had an image in mind, but now, post phallo, I realize that there is no one version of how a penis looks. Every penis has its quirks. The way it bends, the color, the shape. That my penis has matured into my own unique penis, makes him feel more ‘real’ than I could ever have hoped for.

Third (and final!) cheeky question – how has having phallo affected your relationship with your partner, and your sex life?

The impact of phalloplasty on my sex life has been profound and surprising. I became single after I started my phalloplasty surgery and I imagined I wouldn’t date until the entire process was finished. However, to my surprise, I met someone who completely changed the way I related to my changing body. I found the courage to begin exploring intimacy with others, despite my surgery being incomplete. I went through a healing and transformational inner process as I began to relate to my penis not as unfinished, but as an evolving part of myself.

I met my partner, who is now my fiancé, a few months before I had the final stage of my phalloplasty surgery. He is the first man I have been in a relationship with, since many years before my gender transition. Coming out as gay was only possible because I was feeling comfortable and confident in my body and in my maleness. Before this, being intimate with a man, especially a cisgender man, would have been impossible due to the genital dysphoria I had been experiencing. 

Completing my phalloplasty surgery has allowed me to access a level of sexual pleasure that I had no idea I could experience. Before phalloplasty, I simply did not enjoy sex as it was too distressing. Even trying to enjoy pleasure alone was a challenge. The only way I could cope with gender dysphoria and be intimate was to step outside my body and disassociate. With the dysphoria gone, I can be fully present in my body and fully enjoy intimacy for the first time.

What 3 things did you wish you knew before you had surgery?

I wish I had known how much I would worry! Honestly, I prepared for the pain, I prepared for the low mood, but the intense worry took me by surprise. After stage one, arriving home with a brand-new penis, I was terrified of hurting him, of not looking after him properly and every tiny change caused me great concern! It makes sense because there is so much effort invested into having this surgery so the fear of it going wrong is understandable. I found a group of people who were happy to listen to my worries and reassure me. The emotional support from someone who has been through this journey is incredibly helpful.

I also wish I had known about all the incredible home aids you can buy to make surgery recovery more comfortable. I discovered things on the journey that helped so much. Padded toilet seats, a body pillow, a cooling gel cushion. I always suggest now to spare no expense and adapt your home as much as possible as it will make your home recovery much more manageable.

I also wish I had known what an incredibly positive impact phalloplasty would have on my life, then I may have made the decision sooner!  

Could you explain the difference between phalloplasty and metoidioplasty, and why you chose phallo?

To explain simply, the main difference between phalloplasty and metoidioplasty is the size of the completed penis. Metoidioplasty creates a penis using the clitoris, which although grows in size from taking testosterone, is still a smaller penis. Phalloplasty creates a penis using a skin graft from the body, resulting in a more average size penis. Both have their positive and negative points, but these largely depend on what a trans person needs to feel comfortable in their body.

I chose phalloplasty because I wanted the more average-sized penis. I wanted to be able to have penetrative sex, which is more difficult with meta due to its small size. I also wanted to have something substantial in my hand, to feel the weight of my penis in my palm when using the toilet and feel a decent bulge in my trousers.

What would be your top piece of advice for someone considering phallo?

My advice to anyone considering phalloplasty is to prepare well ahead of time. Having everything in place to support you through this journey and in recovery, is vital. I made sure to put practical and emotional preparations in place. I did things such as putting together a hospital kit for the first stage in the hospital because it is the longest stay. I made sure to prep my home ahead of time so that coming home I had everything to hand. I also made sure to ask friends to help with various tasks such as shopping, helping me to medical appointments, and so on.

To look after my mental wellbeing, I made sure to simplify my commitments, to work and study, to give myself time to heal. I also made sure to have a trustworthy support network of people to ask for emotional support, reassurance, and company. Phalloplasty is an incredibly intense journey so making sure to have as much in place and prepared beforehand, can help to alleviate the stress and make the recovery process smoother, which will ultimately help your end result.

Top to Bottom: A Memoir and Personal Guide Through Phalloplasty by Finlay Games is out now. You can watch more insightful videos from Finn on his YouTube channel.

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