Transgender woman explains what she wishes she'd known before surgery

Lily Carollo underwent hormone therapy, laser treatments and a vaginoplasty to begin transitioning from male to female in 2013.

In an essay for Vox, she's decided to try and debunk some of the myths surrounding the gender reassignment process - namely that vaginoplasties or penisplasties are a one-stop "cure-all" for people who don't feel they fit the bodies they were born with.

While gender-affirming surgeries can make people more comfortable in their bodies, they're not a fix-it for everything wrong in your life. I know this from my own experience with surgery, and from studying the research on it.

While, in the US at least, it is required that people considering gender surgery talk to at least two therapists about the decision and its impact on their lives first, there are no set guidelines in place about what should be discussed or mentioned.

One thing Carollo had been under prepared for, she said, was the physical toll surgery and recovery would have on her body.

The phobia and hatred directed towards trans people, she said, has had a damaging effect on how she thought about her surgery and reassignment. Words like 'frankenpussy', and 'mutilated dickhole' stay with you, Carollo noted.

Despite your best efforts, though, you have to wonder how much negativity has been internalised. My vagina is not a mutilation, but I must admit I might not like it as much as I should after reading so much horrible language directed toward it.

Surgery will not necessarily fix problems like unsupportive family and friends, depression and harassment either - people who have gone through gender reassignment still experience self harm and suicide at a higher level than the rest of the population thanks to ongoing discrimination and stigma, a Swedish study found.

Ultimately, people need to realise that transitioning is a long, hard road, Carollo writes.

Transitioning is one of the hardest, most overwhelming experiences someone can go through. It's the kind of gamble you make when your back is against the wall and everything seems at stake.

The morning of my surgery, the day of my last big step, I realised that right now in our society, transitioning isn't just some process you go through; it's also something you survive.

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