Dilation: What The Hell Is It?

Few people know much about post-op transsexuals and how it all works, even fewer know about dilation. There is a lot of disinfo out there about it. The surgery involves primarily the construction of a pseudo vaginal canal out of our male genitalia, however it is not a real vagina and therefore does not have some of the important features real vaginas have, particularly what lets them maintain their shape. The vaginal canal that is built is essentially a tunnel of skin or maybe more like a skin cave that goes several inches deep into the body where a vagina would be on a female. However unlike females, the trans vagina has nothing to connect to at the deepest end. In a woman, that would be the cervix, which is the point of entry to the uterus. The average woman's vagina, from the opening to cervix, ranges from 3 to 5 inches and can change size with sexual arousal.

For trannies, most surgeons provide more depth. Some do even better, deeper upwards of 7 or more inches. For me, I have about 5.75" of depth. For the first several months the tissue used to create this tunnel needs to be maintained daily. Like with muscles for example, if you don't use it, you lose it and muscle begins to atrophy away. The vaginal canal will do the same over time. This is combined with the effects of the vaginal canal being squished by the constant pressures of internal organs and muscles that contributes to more rapid tissue atrophy. The first couple months are critical in this process. To maintain the depth and girth of the vaginal canal and stretch it wider and potentially deeper, we use medical devices called dilators.

A dilator is basically a dildo made of medical-grade plastic. It is solid plastic, not floppy or soft. A set of dilators is used over time, each one slightly girthier than the last. We start off with a small dilator, in my case, a purple dilator that is about 1.1 inches (2.75cm) in diameter and 9 inches in total length. The dilator is smeared in lubricant first. Waterbased lube is recommended by the hospital. I use plain waterbased KY jelly. For the first week or two, the hospital provides a prescription lubricant called Metronidazole gel aka MetroGel, which is also a vaginal antibiotic. After the MetroGel runs out, you switch to normal plain lubes. With the dilator lubed up, it is slowly inserted into the vagina until it reaches the end of the tunnel. For me, that's about 5.75 inches. The dilator must remain inside at the full depth and held in place with some slight inward pressure for 20 to 30 minutes. I do 30 minutes. After the time is up, the dilator is slowly removed and you can clean up. I must do this three times a day as of writing this (two months post-op). I was started at twice a day, one week after surgery.

For the first month dilation can be uncomfortable. For the first couple weeks, it's like a chore you just really really do not want to do, but you MUST do it and it is both uncomfortable and slightly painful. I have a decent pain tolerance, so maybe it's not as bad to me, maybe for others it'd be pretty sucky. It is very tight going in at first. After a couple weeks, the vagina is already adapting. The dilation is doing its job loosening it up and stretching it out. Dilation should be pain free after the first month.

Dilation is not as simple as I just made it sound. There's a bit more involved to make it less uncomfortable and to allow for the dilator to slide in more easily. The first week, the doctors recommended laying in bed, on my back, with my legs spread in a "froggy" position. I used pillows to help prop them up a little so they could rest more comfortably. After a month I changed my position as the vagina got looser, making dilation easier. Now, I get into a comfortable laying position on my back, preferably in bed with coffee and Netflix, and sit with my legs up and spread a little... almost like missionary position for sex. I insert the dilator slowly starting at a 90 degree angle to slide in the tip. The dilator is curved inward to a 45 degree angle as it begins to fully enter the vaginal canal. For the first few weeks, this can be tight and somewhat painful as the dilator transitions from 90 degrees to 45 degrees, squeezing around and under the pubic arch (a part of your pelvis), squishing and pinching the swollen urethra and other tissues inbetween against the bone. This was no longer a problem by four weeks post op. Tylenol helps make this less painful. Take it like an hour before dilation. Another issue is learning to relax your muscles. Dilation can make you tense up and all those muscles in your pelvic area are tightening up the vagina. This makes it harder to get the dilator in. However understand that this is not a bad thing later on when you can have sex. Yes, we trannies can tighten our vaginas when having sex, making things feel better for our partners. I had to learn to try and relax those muscles, relax my body, breathe out slow as I insert the dilator to help loosen those muscles and allow it to enter easily. Once the dilator is in, it must remain in for 20 to 30 minutes. It has to be held in with a bit of inward pressure to help things stay stretched. While the dilator is in I have to be sure to control myself if I feel the need to cough or sneeze. That shit sucks. Go ahead and cough and feel your crotch muscles as they spasm. Now a solid dilator is in there when you do it. Ouch. Avoid coughing or sneezing. If you feel a sneeze coming on, try and remove the dilator first.

Link to photo: The dilator set I was provided by the hospital: https://i.imgur.com/ndD8v1V.jpg

Eventually I will have to size up. As I stated, the purple dilator is about 1.1 inches (2.75cm) in diameter. The next size up is the blue dilator at 1.25 inches (3.25cm). Then some months on the green dilator at 1.3 inches (3.5cm) and finally the biggest dilator I was given, the orange at 1.5 inches (3.75cm). By approximately one year post-op, the dilating process will have ramped down from 3 times a day at 30 minutes each time to once a week. What happens if you don't dilate? Well, contrary to internet disinformation and anti-trans memes, it is not meant to keep an open wound from healing closed. The vaginal canal and vulva is fully healed within three to four weeks. It does prevent the skin or tissue used to create the vaginal canal from atrophying. This means that without dilation or neglecting to dilate as scheduled, the vaginal canal will shrink in terms of depth and girth, leaving it shorter and tighter until it is too short and too tight to use sexually and could be so far gone that you cannot regain the loss. This would end up requiring surgery all over again to rebuild the vaginal canal. For about a year the dilation process is necessary to ensure the body adjusts and the vagina won't shrink away. Skipping even a day during the first couple months can result in the next dilation session being tight and uncomfortable. Depth is lost faster than girth and is harder to regain. Initially post-op I had 6 inches of depth, however I dilated once day for the first week instead of twice and dropped to about 5.5 inches. It is important to stick to the dilation schedule. That first week is a bitch, painful, annoying and I really didn't want to do it. But it must be done. Bleeding also only lasts for the first two weeks post-op. The dilator should be coming out clean, except for the lube, by about three weeks.

Does it feel good after the pain is gone? It doesn't really feel like much. I can feel it all the way in, a painless stretching and pulling from the inward pressure as I hold it in. We don't need to move it around except to adjust to get maximum depth. Sometimes if you have gas while dilating you can feel the dilator being pushed as the pressure moves through your intestines and into the rectum. The dilator moves back again after you pass the gas. Kinda funny. If you take a vibrator and hold it tightly against the portion of the dilator that sticks out from the vagina, the dilator will absorb the vibration and begin to vibrate inside. That does feel good. If anything, it's a good diagnostic way to test your nerves and sensation in there while you're still not allowed to have sex.

Currently at two months post-op, dilation is painless and easy to do. I just get comfy in bed and do my thing. The entire process from prep to clean up is maybe 40 minutes. Doing this three times a day now, that's a good two hours of my day just sticking a medical dildo in my vagina, every single day. It is time consuming and for several months, makes certain things harder to do, like school or work. Some surgeons have their patients do this for longer, like 40 minutes and up to four times a day. Things become simple as you near one year post-op and it's only needed once a week. I just can't wait to get this down to at least once a day.

And that is dilation.