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A Hole New World

May 21, 2014

I am a genetic male with questions about my gender identity. Straddling desires to maintain my stature in the professional world, keep my wife at my side, and become who I feel like I am, I have experimented with crossdressing, chastity, antiandrogens, and, prior to all that, steroids. While the matrimonial veto has been enacted for some feminine expressions, my wife and I have reached a middle ground where I can pursue sexual and aesthetic androgyny. I have started wearing unisex clothes, stepped up cardio to sculpt a more feminine shape, and am getting hair removal done. My question: I want to keep my sex drive and sexual organs intact, but I want to urinate like a woman: no choice but to sit. There are body-modification communities out there that showcase this type of procedure (urethral reroute/relocation), but I don't know where to start when it comes to tracking down someone to do it for me. Ideally, a legitimate urologist should do this type of work, but I'm not sure I can put together a justification strong enough for a doctor. Any advice? Do you know any piercers who have done this kind of work?

Seeking Insights That Take Erotic Rerouting Seriously

"Most urologists aren't qualified to do this, let alone piercers—although I know that there are aggressive 'body modifiers' out there. I wind up cleaning up their messes," said Dr. Keith D. Newman, a urologist and a Fellow of the American College of Surgeons. "So my main piece of advice for SITTERS is to have a urologist do this, preferably someone who has experience with this surgery."

The procedure you're curious about—creating a new pee hole on your taint, behind your balls, which would leave you with no choice but to sit when you pee—is known as a perineal urethrostomy.

"It's one of the numerous steps involved in total gender-reassignment surgery, should the full male-to-female conversion ever be opted for," said Dr. Newman. "As such, doing this one thing probably won't preclude further anatomical reassignment in the future. On the other hand, SITTERS has to consider that there are potential complications and consequences that will arise from this altered anatomy."

And the biggest consequence is a heightened risk of urinary tract infections due to your shortened urethra, SITTERS. The urethra, of course, is the tube that runs from our bladders, where urine is stored, to our pee holes, where urine is shared. Women's are shorter, making it easier for bacteria and other bugs to get up into the bladder and cause infections. But urinary tract infections aren't your only worry. "Any artificial orifice has a certain incidence of stricture," said Dr. Newman. "So the opening might need frequent dilations or more surgery if this complication arises."

By "stricture," Dr. Newman means "your new pee hole could shrink, narrow, and start to close up." And by "frequent dilations," Dr. Newman means "you could wind up shoving steel rods up your urethra to stretch your new hole back open—frequently." And there's more!

"There may be less than full diversion of urine (some may still come out the end of the penis) unless the urethra distal to the new opening is closed," said Dr. Newman. "If it is closed, then we run into issues of what is called a 'mucous fistula,' and the urethra beyond the diversion might need to be irrigated from time to time. Similarly, urinary dermatitis may occur—that's diaper rash—so perineal care and good hygiene will be a must."

Assuming you're still interested in relocating your pee hole after reading all that, SITTERS, how do you go about finding a urologist who'll perform this surgery? You make appointments with qualified urologists, tell them what you want, and risk being turned away. "I believe that enough justification for the surgery exists—others may not," said Dr. Newman. "But it's the insurance company that will need convincing. Many institutions (most faith-based, but not always) do not allow any surgery for sexual reassignment in adults, so those waters will have to be navigated. And it sounds as if SITTERS is not yet convinced of the validity of this request, so counseling might be helpful."

One final note...

"Ejaculation will occur through that new hole in a somewhat non-directable way—which could be fun or not," said Dr. Newman. In other words, SITTERS, after you have this done, you'll not only be peeing sitting down, you'll also be coming all over the back of your sack.

I'm a 24-year-old gay male in a three-year relationship with a man I love. I also have a diaper fetish. I told him about it once, nearly two years ago, but have not brought it up since. Recently I have gone out to buy diapers. I don't use the diapers for pee or poop, but I enjoy the feeling of wearing them. I have talked to other diaper lovers (DL) online, but I have never gotten the courage to meet up and experiment. I recently started talking with a guy who lives a few miles away who is also a DL. I don't want to cheat but I would like to indulge my fetish at least once. If there is no sex during the fetish play, would that be cheating? There would be no kissing or anything. I would just change his diaper and powder him, and he would be doing the same to me and whatnot. I don't have anyone I can talk to about this and would love to hear your advice.

Diapered Dilemma

Here's what Good Dan would tell you: Go and tell your boyfriend that you love him, remind him about the conversation you had two years ago about your diaper fetish, and ask if he would be up for exploring this aspect of your sexuality with you. If so, great! No need to see that other guy. But if not, DD, then ask your boyfriend how he would feel about you getting together with someone who shares your kink—not for sex, just for diapering and powdering and, er, "whatnot." If he doesn't mind, great! If he does mind, well, then you need to think about whether staying in this relationship is wise... because sooner or later, you're going to cheat on him. And if you don't want to be the kind of person who cheats on his boyfriend, you'll have to find one who shares your kink or is willing to share you.

Here's what Bad Dan would tell you: Seeing as you're only 24, and seeing as you've been in this relationship for three years, and seeing as you've never engaged in any diaper play... sneaking off to play with that other DL might help clarify things. Either you'll learn that diaper play is something you can't live without (which will prompt you to force the issue with your boyfriend, i.e., he either plays with you or gives you permission to play with others), or you'll realize that diapered reality is a lot less sexy than diaper fantasies and your kink will evaporate (highly unlikely).

Good Dan thinks you should take his advice, DD, because Good Dan is an annoying prick who thinks he's right about everything. But Bad Dan thinks you should know that Actual Dan took his advice back when he was your age—about exploring his sexuality generally, not about exploring diapers specifically—and it helped clarify lots of things for Actual Dan. recommended

On the Lovecast, Dan gets a second-opinion assist from Slate's Dear Prudence:

@fakedansavage on Twitter


Comments (87) RSS

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Allen Gilliam 1
Yikes. I'd advise spending some time with a therapist exploring why it's so important to you from whence you pee before you start having your plumbing rerouted.
Posted by Allen Gilliam on May 20, 2014 at 7:04 PM · Report this
I don't understand why moving the uretha would result in ejaculate moving as well?
Posted by DeirdreTours on May 20, 2014 at 7:05 PM · Report this
#2 - Because men only have one urethra and both urine and ejaculate travel through it. The surgeon would only be moving one end of it.
Posted by RealityBites on May 20, 2014 at 7:14 PM · Report this
Well, A UTI in a perineum may be less not-fun than a UTI betwixt the labia, but probably best avoided nevertheless. Good luck!
Posted by beccoid on May 20, 2014 at 7:21 PM · Report this
Fred Casely 5
I try to stay on topic around here, but in light of recent events: You know how we’re not supposed to call weak people “pussies” because it denigrates something that’s strong enough to get a baby squeezed through it?

Dicks deserve the same respect. Henceforth, an instance of behavior such as stringing one’s podcast listeners along in a crass enrichment gambit will be known as a “Dan move.”
Posted by Fred Casely on May 20, 2014 at 7:22 PM · Report this
I really liked Good Dan and Bad Dan form of advice today!
Posted by whittenaw on May 20, 2014 at 8:16 PM · Report this
I'm sorry, but why not just get into the habit of sitting down to pee? My ex always did. Granted it was a habit formed by being a wasted youth, but still.

You know, urinating like a female isn't always fun. Like the first time LW needs to pee when walking in the snowy woods or in the middle of the city. And this sounds like a endless UTIs, which also kinda suck.

Posted by phuni44 on May 20, 2014 at 8:21 PM · Report this
I just wanted to point out that women don't have "no choice but to sit to pee". It's possible to learn to pee standing as a (cis) woman. They also sell funnels and stuff but they aren't required.

Which means that really, he's already like a cis woman in that peeing standing or sitting is a choice for him just like it is for us. Standing might be easier for him, but he doesn't need to make it impossible.
Posted by Avistew on May 20, 2014 at 8:39 PM · Report this
I am somewhat overwhelmed by SITTER, but one thing in Dr Newman's advice really pissed me off. My annoyance doesn't apply to SITTER particularly, but to the circumstances that every trans person who needs gender reassignment faces.

"But it's the insurance company that will need convincing. Many institutions (most faith-based, but not always) do not allow any surgery for sexual reassignment in adults".


The same institutions would recognise that God and/or nature had somehow fucked up if there were a hole in my heart or I had the wrong number of legs, and they'd pay to help fix the problem.

But somehow, God and/or nature are infallible when it comes to genitals? And that's why we shouldn't mess with this. "Oh, yeah. God wasn't always paying attention when it came to the allocation of limbs, so we'll amend His work by giving you prosthetics. His mind tended to wander when he was doing kidneys, so we'll give you a transplant. But when He was working on cocks and minges, He was absolutely dedicated to his job, and he always got it right. He was an expert on the whole pants area. So we WILL NOT INTERFERE WITH WHAT GOD OR NATURE DID when it comes to the down-there area. Fixing that would be AGAINST NATURE."

JFC. Even Ayatollah f---ing Khomenei realised that God was no less fallible on genitals than He was on the rest of the body, and issued a fatwa saying that gender reassignment was OK. You'd think the insurance companies in an apparently-not-extremist majority-Christian country could get their heads around it.

But apparently not.
Posted by sh1331 on May 20, 2014 at 9:33 PM · Report this
Well, at least now we know why Actual Mr Savage thinks it's perfectly all right for the Socially-Only Monogamous to reap all the benefits on monogamy (including the right to pour scorn on the Non-Monogamous) without "earning" them by practising the attendant non-indulgence in outside encounters.

It rather sounds as if the diaper interest is on the increase. But if clarification is going to be more important than a partner's informed consent, then it ought to be reasonably likely that clarification in secret will accomplish something worthwhile that open clarification couldn't. I could see the point of Bad Mr Savage's advice if the interest weren't quite so clear or developed, so that Once and Out were likely. But it really seems to have gotten far enough along to have created serious relationship change. It seems as if starting from scratch is in order, perhaps after a short hiatus during which time LW can work out what accommodation he needs (or not).
Posted by vennominon on May 20, 2014 at 9:58 PM · Report this
I don't know. For someone with multiple annoying health problems, this sounds like a bad idea & not worth it. It sounds like a huge jump from hair removal etc. for someone who just dabbles with androgyny.
Posted by puddles on May 20, 2014 at 10:25 PM · Report this
@11 puddles: I was just about to say that, too.

If one of the noted side effects of urethral reroute / relocation surgery is LW1 (as Dan puts it) "coming all over the back of his sack" upon ejaculation, then I would call that a disincentive for having this surgery done.
But then, I'm neither SITTERS, nor androgynous, nor male.
SITTERS, it's up to you, really, but seriously, I'd proceed with caution about the surgery.
If you're still not quite 100% sure about this, ask your doctor.

Griz is going just a bit off topic here, but in relating to corrective surgery, I had to carefully weigh the risks and possible after effects while contemplating having a uterine ablation done. UTIs truly are not fun, and an undesirable post op consequence for me afterward. After a return trip to my gynecologist, I mentioned also having the possibility of endometriosis. Another new prescription from the local Rite Aid---increased dosage of progesterone, and the "razor sharp barbed wire" pains for the most part as well as the heavy bleeding are mercifully gone. Now this crazy gal can't complain! I'm finally wearing light shorts without worry again, after 37 years!!!

Good luck, SITTERS---should you go ahead with your urethral reroute/ relocation surgery, I hope all goes well for you.
Posted by auntie grizelda on May 20, 2014 at 11:16 PM · Report this
Dan: I thoroughly enjoyed reading your Good Dan / Bad Dan analogy, addressing DD.

Happy Memorial Day Weekend, everybody!
Posted by auntie grizelda on May 20, 2014 at 11:26 PM · Report this
Registered European 14
The same institutions would recognise that God and/or nature had somehow fucked up if [...] I had the wrong number of legs, and they'd pay to help fix the problem.

If you have two legs and you try to convince them that the right number of legs for you is one, I doubt that they will pay to help fix the problem.
Posted by Registered European on May 21, 2014 at 12:16 AM · Report this
LW1-Before you undertake ANY elective surgery I recommend strongly that you make an appointment with a mental health professional. You must be sure that this is something you truely want and are ready for emotionally. You might be intrigued with the IDEA of urinating like a woman but the actual act day in and out might not be what you are ready for. Also, physically the dr can reroute your plumbing but you are not naturally build for what you want. Meaning there are no labias to help protect from dirt and germs from entering the hole and you will not naturally lubricate to wash the nasties away. These are going to be complete lifestyle changes which will alter your life in ways you can not fathom.
While it is not the same exact situation, a year ago I had weight loss surgery. I was required to attend regular group and individual counselling to prepare me for the reality of the changes post surgical. Even then each person reacts differently after the procedure and you can dramatically change your life in negative ways. I am using this as an example because while both surgeries should be considered medically nesseacery, they are elective and dramatic. I hope you are able to find a way to be comfortable with who you are.
Posted by bxtorr19 on May 21, 2014 at 12:24 AM · Report this
@9 -

I think you'll find you've got your analogies the wrong way round. What I'm talking about is someone who appears to have been born with one leg, but who feels he or she could function rather better with two.

Posted by sh1331 on May 21, 2014 at 12:27 AM · Report this
Eva Hopkins 17
Echoing the thoughts of 11, 12 & 15 -

I'm friends with folks who've had gender reassignment surgery done. It's a huge deal. Although what SITTERS describes isn't taking quite that far, it's putting a hole where it doesn't biologically need to be, in an area that's tricky to keep clean & will almost certainly result in increased rates of UTI's & bladder infections - as well as all the other fun stuff Dan & the doc describe above.

I usually fall squarely in the camp of chasing your bliss. Certainly, I'm not in SITTERS' shoes, so I can't say how strong his need is for this desire to become physical. Definitely talking with a head doctor before embarking on such a serious body modification, & maybe also consider couples counseling with a sex-positive therapist. It's great that SITTERS' wife is supportive, but maybe there's a way to get the dynamic & sensations SITTERS is after without surgery?


Surgery is serious stuff & I can't see getting it unless you have to, but that's me. My pals who had gender reassignment surgery, they *had to*, they were in the wrong gender identity & body for them.
Posted by Eva Hopkins on May 21, 2014 at 12:37 AM · Report this
Dear Good Dan, Bad Dan and Actual Dan,
I hope the three of you will return soon - I was laughing out loud.
Posted by compagno on May 21, 2014 at 12:40 AM · Report this
I think what it comes down to is this: if the LW needed to pee sitting down to feel good about his (seems he still identifies as a he?) body AND was unable to do that without the surgery, the risks would be justified. If the LW was a transwoman who wanted her genitals to match her gender, the risks would also be justified since there are hardly other options except surgery.

But the LW writer just wants to have no other choice than to pee sitting down which sounds a bit silly to me. He would still be peeing with a penis (which he doesn't seem to hate), just out of a different hole. For one thing, he could try a less radical way to have no choice by wearing a special chastity device - like the one recently featured on Dan's blog. Or he could just pee sitting down while keeping his health free of unnecessary and annoying problems. Especially since frequent UTIs could affect his sexual health which he seems to value.

Of course it's his body and his choice but IMHO it's not worth it.
Posted by puddles on May 21, 2014 at 1:16 AM · Report this
phuni44 got to the point faster than I could, as a guy you can sit and pee as long as you have urine and the day is long. no surgery required. I'm guessing SITTERS feels he has to NEED to sit. shit try being pee-shy at a (stand-up) public trough-style urinal, that'll do the trick.
Posted by sludge77 on May 21, 2014 at 2:13 AM · Report this
Since Dan didn't mention it to SITTERS, and SITTERS didn't mention that he had, he might want to pass his idea by the missus before he leaps into a urologist's office assuming she'll be okay with it.
Posted by madcap on May 21, 2014 at 2:40 AM · Report this
For the person with the insurance question- it's about what will cost te insurance company money. Things like holes in hearts and such are life-threatening issues and must be covered. But any necessary medical apparati? Screw you, you have to buy that brace.

But, you ask, what about birth control? Those aren't necessary. Again, it saves the insurance company money as babies are expensive and birth control isn't.

Then, when an individual comes in wanting gender reassignment or cosmetic surgery, the insurance company doesn't feel any obligation to pitch in because that was the person's choice (from a conservative point of view) rather than a necessity for life. Even laser eye surgery is not covered by most insurance companies.

The key here is to convince society that transgender people wanting gender reassignment surgery are not just crazy, and that it is necessary to their overall health and well-being.
Posted by Grammastola on May 21, 2014 at 4:40 AM · Report this
For the person with the insurance question- it's about what will cost te insurance company money. Things like holes in hearts and such are life-threatening issues and must be covered. But any necessary medical apparati? Screw you, you have to buy that brace.

But, you ask, what about birth control? Those aren't necessary. Again, it saves the insurance company money as babies are expensive and birth control isn't.

Then, when an individual comes in wanting gender reassignment or cosmetic surgery, the insurance company doesn't feel any obligation to pitch in because that was the person's choice (from a conservative point of view) rather than a necessity for life. Even laser eye surgery is not covered by most insurance companies.

The key here is to convince society that transgender people wanting gender reassignment surgery are not just crazy, and that it is necessary to their overall health and well-being.
Posted by Grammastola on May 21, 2014 at 4:42 AM · Report this
Why not simply sit down to pee? My husband does because he's really tall and it's a lot tidier. There doesn't seem to be any problem with it.
Posted by jlyle on May 21, 2014 at 5:25 AM · Report this
@9: It's considered elective surgery, just like if someone wanted a different nose or breasts. Most insurance companies will cover facial reconstructive surgery for someone disfigured in a car accident, but not for someone who just feels they were meant to have a different nose and cheekbones.

And what @14 references, feeling that you should have a body part amputated, is an actual thing. An actual thing not normally covered by insurance.

Given that the elective surgery seems likely to increase rather than improve other medical issues (e.g. increasing risk of various infections), it seems particularly unlikely an insurance company would consider this reasonable.
Posted by IPJ on May 21, 2014 at 5:37 AM · Report this
I've gotta echo @8. Women absolutely don't have "no choice but to sit." I feel like if that is the LW's biggest reason for wanting a seemingly dangerous elective surgery, he should reevaluate why he wants to emasculate himself so badly in the first place. Honestly, I take offense at the idea that I must sit to pee and it makes me question how much the LW even understands what it's like to be female. But to each his own. I won't tell him to not carve a hole in his taint if he's convinced it will make him happy.
Posted by carrot on May 21, 2014 at 6:10 AM · Report this
Sitters should also consider the long term consequences, as in how does this play out at 70 or 80. To a young or middle aged healthy person a UTI is an inconvienience. Go to any assisted living or nursing home and and ask them about UTIs; you will get an ear full. There, they are a whole different animal- very common, harder to control and in some cases life threatening.
Posted by gonzo on May 21, 2014 at 6:21 AM · Report this
Tim Horton 28
@9, 16 - It's disingenuous to compare life sustaining surgery (PFO correction, transplant of an anephric patient) with body modification surgery to alter otherwise functional body parts. I am sure the small breasted or big-nosed individual can sincerely advocate their need for plastic surgery to counter-act insecurity, i.e. feeling "normal." That doesn't make the surgery medically necessary, which is the standard that insurance companies generally apply.

FWIW, I am agnostic. Not sure what god has to do with the discussion.
Posted by Tim Horton on May 21, 2014 at 6:38 AM · Report this
As a female urethra-haver, UTIs at any age can be simply horrible - very difficult to get rid of, and can long-term screw up the nerves down there, so you're frequently in pain long after they've been dealt with.

I don't consider the way I pee to be a reflection of my gender identity. As a thought experiment, I'm assuming that someone pursuing a FTM transition wouldn't particularly want to experience the more inconvienent features of the male prostate.

Do you think the LW maybe wants to pursue some kind of surgical procedure to strengthen his gender transition, and feels this is the only one available to him? In which case, perhaps it could be helpful to seek more counselling and thought about changes which would make him feel stronger in his identity, without large risks of horrible discomfort and inconvenience.
Posted by misspiggy on May 21, 2014 at 7:26 AM · Report this
I rarely read letters here that I just completely don't understand. This is one of them. I've read about many kinks that left me shaking my head, and a few that piqued my interest that I gave them a whirl. Some stuck, some didn't.

While I don't get this guys particular desires, i feel for him, since it doesn't appear that there's really a responsible, safe, healthy way for him to indulge it. You can be flogged until you're bruised, but those bruises will fade away. This guys options are permanent, and are going to lead to chronic health issues.

Good luck to him no matter the choice he chooses.
Posted by Global Traveler on May 21, 2014 at 7:39 AM · Report this
It does not sound like this hole is something crucial to SITTERS' happiness. It sounds like a compromise, since he doesn't want to flout the "matrimonial veto" or lose his "my stature in the professional world."

He seems to think this surgery is a good next step because, like wearing panties, it's something he can do without being outed as weird.

On another board I read, a genetic guy wanted to skip right to MtF facial surgery and hormones, without ever having gone out once in public dressed as a woman, because he couldn't face the embarrassment of being seen as a transsexual.

I think SITTERS needs to take the time to look at all his options realistically, with the help of an experienced gender therapist.
Posted by EricaP on May 21, 2014 at 8:06 AM · Report this

Before performing surgery I recommend looking into something that forces you to use a private stall and forces you to sit down. Personally something like a modified chastity device with which you must take time to unlock with a physical key, followed by you being forced to squat in the covered stall just to pee would be right up your alley. I seem to not be the only one who thinks so for number (puddles) also had the same idea.

Good Luck
Posted by Roland00 on May 21, 2014 at 8:39 AM · Report this
* I seem to not be the only one who thinks so for number #19 (puddles) also had the same idea.
Posted by Roland00 on May 21, 2014 at 8:40 AM · Report this
nocutename 34
I feel for SITTER, but I have to wonder why he wants to do this. I don't feel defined as a woman by the fact that I sit to urinate.

In fact, I often wish that I could pee standing up with as much ease and as little risk of splashing on myself as men. (Yes, I know some women can pee standing more easily than I can, but it is a skill I don't think worth bothering to try and master. While woman can pee standing, it still involves taking pants all the way down (unless we're talking about using funnels and whatnot), and in my case, since I've not bothered to perfect the art, I have to remove one foot from the pant leg entirely, so as to be able to assure that I don't get urine on myself or my pants.) One of the reasons that the women's rest room always has a longer line is because sitting down to pee is a more cumbersome procedure and takes longer. I frequently envy men, especially if I need to pee while out in the woods, or as I view the lengthy queue for the bathroom especially at intermission. I have to weigh my need to pee against the possibility that I'll miss the beginning of the second act and have to step all over everyone as I make my way in the dark back to my seat. But I digress.

It's the "no choice" aspect of his desire that sort of bothers me. It's perfectly possible, as others have already pointed out, to sit to urinate, even if the urine comes out of your penis. Why does the lw want to remove the aspect of "choice?" Is is afraid he'll backslide and pee standing for convenience occasionally and he won't respect himself for his weakness, or is it grounded in some sense that being feminized means being more limited in options, more constrained, more hampered; somehow "less than" or weaker?

Because some women are stronger than others; some excel at typical gender-normative activities (cooking, sewing, decorating, scrapbooking, what-have-you), while others suck at those things. Some women are auto mechanics, or plumbers and they're still women; many are even "feminine" by anyone's gender-normative standards. Unless they are trans, women who do historically "male" things or are not adept at historically "female" things don't necessarily feel like they're not fully female or real women. Not all female bodies are the same, and the ability to pee standing or the necessity of peeing sitting doesn't mean some women aren't stronger than many men or more fearless, or more aggressive.

Surgery has many potential risks and complications, as are being pointed out. Insurance won't cover any surgery considered medically unnecessary (depending on the insurance company and the plan, a patient may be able to successfully argue that the surgery is necessary for his or her mental health and well-being). I understand that the lw wants to feel as if his body (maybe at some point, her body) behaves as a female body, but perhaps he could think of his body as one that is a bit different from the typical female body, but still acts like one, and simply sit to pee.

Finally, the lw describes a marital situation in which it seems important to his wife--and perhaps to him as well--that he stays functionally male and typically masculine when it comes to sex, in desire, drive, and performance: He says he wants to "keep my wife at my side, and become who I feel like I am . . . . While the matrimonial veto has been enacted for some feminine expressions, my wife and I have reached a middle ground where I can pursue sexual and aesthetic androgyny. . . . I want to keep my sex drive and sexual organs intact."
I take this to mean that if he should lose the ability to have erections and to have sex like a man he risks losing his marriage. If the procedure he wants will result in his inability to ejaculate out of his penis, if he stops being able to shoot, and instead dribbles all over his balls when he comes, I doubt that his wife is going to view that as honoring the limits of the "matrimonial veto," if not on "some feminine expressions," than on the unacceptable termination of "some masculine expressions."

It seems that this is a problem without an easy solution, and I wish the lw and his wife well as they grapple with it.

Posted by nocutename on May 21, 2014 at 8:44 AM · Report this
@34, you said everything just right. Very thoughtful and thorough response. I can pee standing up, but only in the shower. And have my guy get cum behind his balls instead of in me, no thanks.

Its maybe not nice of me, but perhaps the LW should get his very full and aching bladder into one of those gas station toilets where there's dried shit on the seat, no TP, no running water and then see how delightful it is to "have to sit".
Posted by phuni44 on May 21, 2014 at 8:58 AM · Report this
nocutename 36
@35: Its maybe not nice of me, but perhaps the LW should get his very full and aching bladder into one of those gas station toilets where there's dried shit on the seat, no TP, no running water and then see how delightful it is to "have to sit." Yes, good point. Although I don't think I've ever encountered the dried poop on the toilet seat, thank goodness. A pee-covered seat is gross enough. Suffice it to say I can think of a number of situations, mostly involving public restrooms, where anyone who had the ability to pee without touching anything would be damn grateful.
Posted by nocutename on May 21, 2014 at 9:21 AM · Report this
@28: I agree that gender reassignment surgery can't be compared to surgery that is directly life sustaining. It is more in line with surgery to fix a non-life threatening condition that still severely impacts quality of life - someone above mentioned facial reconstruction after an injury as an example. I do not know to which degree medical insurances in the US cover such surgeries, but I would hope that they generally do. Gender reassignment surgery really is quite imperative to the quality of life of many transsexuals, as far as I have gathered.
Posted by Thomas on May 21, 2014 at 10:29 AM · Report this
@37 But this LW is not really looking for gender reassignment surgery.
Posted by puddles on May 21, 2014 at 11:22 AM · Report this
Re LW1: Didn't we get over biological determinism in the 1970's? I thought who were counted for more than our genitals - or did we lose that argument and no-one told me?
Posted by cassiemc on May 21, 2014 at 11:43 AM · Report this

Is that true? I don't know. I thought I read that post op TG people were often an unhappy lot, and that has been my personal experiences as well. Unhappy before and after.
Posted by Hunter78 on May 21, 2014 at 1:10 PM · Report this
Thank you for saying that Thomas (#37) and it bears repeating SITTER you should do everything in your power to be happy, and I understand from my own personal biological issues (which are not connected in anyway with my gender) that sometimes biology creates us in a way that we can not be happy naturally unless we as individual take actions to change the natural status quo and find our own happiness.

I suggested looking into the modified chastity device because it is easy to perform, is cheap, and is reversible. I am assuming surgery will be hard to perform, is expensive, and is hard to reverse. I am merely suggesting try the easiest options first. If it doesn't work try something else, if surgery is what you need to be truly be happy then do the surgery.

Finding happiness in this world, something that is mystical and ethereal; yet is EVERYTHING in importance, should not be limited via the transitory and temporary nature of the physical things of this world.
Posted by Roland00 on May 21, 2014 at 1:31 PM · Report this
Rob L 42
As the former partner of a diaper fetishist I think you should take bad Dan's advice and if (when) you find out that diapers are so exciting that they are going to be a MAJOR part of your sex life, then you have to tell your partner that the MUST be a major part of your sex life, or you should remain friends but part as sex partners. This may seem harsh, but it will be much better for both of you.
Posted by Rob L on May 21, 2014 at 4:01 PM · Report this
@EricaP, vennominon, & seandr, Dan, and others: While I know it's a new week, and a new Savage Love column, I just wanted to briefly mention I had posted a late-in-the-game comments on last week's slog [Hookup Shookup, from May 14th] in response to EricaP, vennominon, and seandr.

Posted by auntie grizelda on May 21, 2014 at 6:50 PM · Report this
Re LW1: Australian aborigines practice a thing called subincision, where the uretra is cut open and afterward the person has to squat to take a wiz. Then, re: DD, it seems to me that it would almost be impossible to cheat, since he can apply baby powder and put the (disposable?) diaper on without anyone's help. Going beyond that would involve doing all these things together with his kink buddy. That means contact between the two, and if he has a normal 24 y.o. sex drive, they are almost certainly going to do the nasty, if only via mutual masturbation.
Posted by EricNelson745 on May 21, 2014 at 8:20 PM · Report this
My husband always pees sitting down, and no surgery has ever been done. In fact, all males in Sweden pee sitting down, because it's the socially accepted norm there. For goodness sakes, before you think about subjecting your body to all those risks, please think about just plain old learning to pee sitting down.
Posted by JohnQTraveler on May 21, 2014 at 9:44 PM · Report this
My husband always pees sitting down, and no surgery has ever been done. In fact, all males in Sweden pee sitting down, because it's the socially accepted norm there. For goodness sakes, before you think about subjecting your body to all those risks, please think about just plain old learning to pee sitting down.
Posted by JohnQTraveler on May 21, 2014 at 9:49 PM · Report this
I think sometimes insurance will cover gender reassignment surgery but not cosmetical procedures surrounding it, such as facial reconstruction. In addition, the path to transitioning is rather long.

Also, to each his/her own, but does getting your pee rerouted really make you more female? If I was biologically male, I think peeing on my ballsack would just make me remember that I have balls.
Posted by Little tiger on May 21, 2014 at 11:57 PM · Report this
Sitter says he wants to keep his sexual drive intact. Although sexual relations with his wife are not addressed directly, I assume he wants this, at least in part, for her benefit and it would, most likely, be a determining factor in her support of the procedure.

I guess, since ejaculation is discussed as a function of Sitter's relocated urethra, his penis would still be able to become erect in order to achieve said ejaculation. Yes? No? I don't think the doctor mentioned this particular issue.

Posted by gbrooks on May 22, 2014 at 12:56 AM · Report this
persimmon 49
For SITTER--I 100% believe someone would be willing to risk infection and severe inconvenience to satisfy a small portion of the desire to experience life (even the dumb shit) as the correct gender. I don't think having to sit while peeing is super fantastic or anything, but I think SITTER is trying to win a small battle in the greater war on his birth-assigned sex. I don't see any end result except full transition, and he'd be much better off getting it done and over with now, through an experienced doctor--rather than being an old man full of regrets and higher surgery complications. I also strongly support the use of a therapist, and probably a couple's therapist as well, since it looks like the wife might be getting dragged into more than she anticipated.
Posted by persimmon on May 22, 2014 at 8:28 AM · Report this
I have a PA piercing so generally sit down to pee, to avoid a mess. Why not try that out first before something more radical?
Posted by Rmjber on May 22, 2014 at 9:58 AM · Report this
i agree with a lot of the advice given to SITTERS. speaking a female, problems with inflammation, irritation and infection are horrible! I go to great lengths to avoid these circumstances.

I would also be worried that it might screw up the good sex that you're having, which you say you want to keep having.

In my case, I really want to have a breast reduction and lift, but my nipples are an important part of my sexual sensation, and docs can't guarantee that that sensation won't be diminished after surgery. IMO, that is not worth it, so I spend money on bras instead.

Posted by loverly on May 22, 2014 at 10:06 AM · Report this
My straight bf has a penis and he sits to pee...where is the problem?
Posted by Friendly Angel on May 22, 2014 at 2:14 PM · Report this
53 Comment Pulled (OffTopic) Comment Policy
Agreeing with #1 here. I mean he's thinking of getting life-altering surgery to do something he's already capable of doing so it might be best to explore that with a therapist and his wife, before committing to anything.
Posted by msanonymous on May 22, 2014 at 8:14 PM · Report this
Boything's Girl 55
I also hate to post something off-topic, but I have to say "HALLELUJAH" to #5. Dan, that was absolutely the cheesiest.
Posted by Boything's Girl on May 23, 2014 at 1:09 AM · Report this
Insurance companies can point to the numbers. Transgender folks have a high suicide rate, whether they get sex-reassignment surgery or not. Therefore some have concluded that the painful, expensive, invasive and complicated treatment is not effective.…
Posted by Johns Hopkins on May 23, 2014 at 4:57 AM · Report this
57 Comment Pulled (Spam) Comment Policy
#9 right on, except that this is an *apparently* "non-extremist Majority-Christian" country. The extremists want to rule, and they want to control every facet of your life to their liking.
Posted by Elemer Rigby on May 23, 2014 at 9:06 AM · Report this
Being in the same situation as SITTERS, I have a different suggestion than I've seen anywhere in the thread. For some context...

What I told my wife early on: I enjoy crossdressing. As a result, I wear panties, stockings, women's socks, essentially any undergarment I can that can stay publicly hidden.

What my wife didn't know until last year: that I harbor many thoughts about "am I really a woman".

Before I would EVER consider any body modifications (and believe me, I've long wanted to have breasts), I knew I had to open up more to my wife. I couldn't just drop that kind of information on her though, so I thought I'd ease her into it. How did I do that?

Femskin. It's expensive, and it might seem like a big production to get in & out of, but it is a great way to have daily experiences "as a woman" without doing anything permanent to your body. And, really, you can just get one that has very small or no breasts and wear it under your suit & tie (to stay "professional").

It comes with an apparatus specifically designed to allow a man to pee while sitting down.

Speaking from experience, NOTHING else I've tried over the years ever made me feel as physically feminine as wearing Femskin.

So, SITTERS, look it up online sometime, watch the demo video to see how it works, and give it some serious consideration. It just might be the thing that helps you decide what path to take...
Posted by PDX Fem-man on May 23, 2014 at 1:53 PM · Report this
@59, so how did it go, opening up to your wife? I gather you wore your Femskin in front of her? How did she react?
Posted by EricaP on May 23, 2014 at 2:54 PM · Report this

It went surprisingly well. I think the many years of seeing me in feminine undergarments got her comfortable with my body "looking that way", ie somewhat feminized.

Yes, I have worn the Femskin in front of her many times. She doesn't have any interest in it being a part of our play together, but she has expressed that she's comfortable with me "doing what I need to do to feel happy".
Posted by PDX Fem-man on May 23, 2014 at 3:52 PM · Report this
Oh man, just sit. Pretend you can't do it any other way. I sit most of the time (not in public washrooms though. No telling who's been there). More hygienic and I'm getting old, aims not so good.
Posted by diz on May 23, 2014 at 8:45 PM · Report this
nocutename 63
@59 and 61: Thank you for the suggestion. I just looked at the website and it seems as if the girdle would be an excellent way for the lw to try out having the body of a woman, complete with urination function. For those who don't read the unregistered comments, and for SITTER if you're reading, PDX Fem-man @59 and 61 recommends something called Femskin, which looks like it might be just the ticket, and surely worth trying out before going the surgical route. If you don't want to read the comments, just google the product.
Posted by nocutename on May 23, 2014 at 8:59 PM · Report this
@61, glad that worked out!
Posted by EricaP on May 23, 2014 at 10:03 PM · Report this
As a woman, I find it really disturbing that the letter writer seems to be defining femininity by disability. "lacking the choice to stand while peeing". I have read accounts by transgendered people who wanted to be smooth and soft and pretty, and those didn't disturb me the same way -- those were people who desired positive aspects of femininity. That they also wanted to remove the penis that announced "MALE" and the balls that pumped nasty masculizing hormones into their systems seemed perfectly reasonable. Leaving the penis there to look at, but cutting a hole in it so it doesn't work, seems destructive in contrast.

If the femskin idea appeals to the letter writer, I think it would be a GREAT idea. That looks like a non-surgical, non-permanent way to achieve a feminine body (including the lack of a functional penis, and including boobs and hips and soft smooth skin.)

Either way, I hope the letter writer finds a good therapist, and includes his wife in some of his sessions, so they can explore what aspects of femininity can be a positive addition to their mutual lives.

Oh, and congrats, PDX Fem-man.

p.s. My straight, masculine husband usually sits to pee. And when I was young and went backpacking, I often stood. (as I get older, I prefer to squat in those situations -- neater that way.) How you pee just doesn't strike me as an especially defining feature of sexuality.
Posted by mother of two on May 24, 2014 at 7:29 AM · Report this
Philophile 66
I usually peed standing up around age 4-5. I still stand up and use a tree when camping. As long as your hips are thrust out past your pants it works. Aiming is a little different, you have to watch the lips, and push stuff around, and can't aim sideways iirc.

Point: Women sit because it's more convenient, not because they have no choice. Some men sit too, esp when drunk or tired.
Posted by Philophile on May 24, 2014 at 8:27 AM · Report this
Congratulations, PDX Fem-man!
Your website promoting Femskin looks and sounds like a much healthier, non-permanent alternative to having urethral relocation surgery that SITTERS is considering.
SITTERS? What do you think?

Elective surgery is a little like putting pavement over what was once a vast wilderness:
Be careful how and where you do it, 'cuz it's forever.
Posted by auntie grizelda on May 24, 2014 at 10:19 AM · Report this
@52, Hunter78... Me old mate/
Gez, charm, style - you've got it all.
Posted by LavaGirl on May 24, 2014 at 1:57 PM · Report this
I don't get it. I always sit for my first pee of the day because that's when I'm most likely to doze off and piss on the floor/cabinet/wall. How much different will it be peeing out a hole behind your sac than one in front of your sac?
Posted by BigIslandPlanet on May 24, 2014 at 8:55 PM · Report this
Sorry. Banana-shaped tits were once a big fantasy of mine. Must have slipped out when I was in a rapable condition.
Posted by Hunter78 on May 25, 2014 at 9:44 AM · Report this
@34: good statement of my concern, as well. And @59/61/63: nice that someone posted a solution. Wanting to be forced to sit down sounds more like cock-cage, denial, or sub fantasies than realignment surgery for a MtF.

A friend (woman) was raised by a single mother who decided early on that with all that was on her plate, she wasn't going to deal with pee splashing or missing the toilet so she toilet-trained both daughter AND her son to pee sitting down. Now in his 60s, he still does. There is the longer wait for a stall than a urinal but has advantages that I take at times: You don't need to turn on the light and ruin your night vision, there is far less back splash on your clothes, metal toilet hardware corrodes because of standing use as does that stale-urine smell around the toilet.
Posted by DAVIDinKENAI on May 25, 2014 at 9:19 PM · Report this
I can totally see wanting to do this. It's the closest his wife will let him get to a vagina. Though Femskin sounds a lot more...non-infection inducing.

Maybe his wife would let him get a vagina/vulva built behind his ballsack? What she doesn't have to see won't hurt her...

I'd be pretty worried about getting the peehole without the vulva. Why not go and get surgery to be a hermaphrodite, if only cosmetically/superficially? I'm sure they can grab some tissue off your ass or thigh.
Posted by gnot on May 25, 2014 at 10:19 PM · Report this
COME ON, people! It really pisses me off (pun intended) that something as trivial as whether you pee standing or sitting down (there's nothing inherently feminine about sitting to pee, nor inherently masculine about standing) can be "altered" with surgery. If gender is a state of mind, no bodily alterations (including acquiring porn star tits, whittling your waist to nothing, or rerouting your fucking urethra) should be necessary. Think about why you are so opposed to your genetic gender's stereotypical traits, and realize that your assumed gender's qualities are equally fabricated by society. Just be. Just pee.
Posted by Littlemuffet on May 26, 2014 at 2:27 AM · Report this
It's interesting that SITTERS doesn't just want to pee while sitting, they want to be unable to do it the other way around (at least without a funnel or something). It sounds like there's a lot of pressure on SITTERS to continue doing things the male way, and when there's so much pressure to do things you can do but really don't enjoy, it's easy to fantasize about losing the options you don't like. "Sorry, it's not my fault for peeing in the female way, as feels better to me. I'm not capable of the male way anymore, see?" Not that SITTERS' wife is literally watching them pee, but I guess it's easy to internalize that sort of thing.

I also wonder if SITTERS is specifically dysphoric about peeing above all else, or if this is the one thing that SITTERS could probably get permission to do, and they're trying to be realistic and not want anything that'll cause too much trouble.

Obviously we don't know what's going on in the marriage, but it seems kind of clear that SITTERS' wife is holding them back from some things they'd like to try, and even as someone who places a very high personal value on romance and partnership, this whole situation makes me cringe, hard. Being something you're not for the sake of a partner is never a good idea or fair to either party, even if you weren't aware of that side of yourself at the time of the marriage. Eventually, SITTERS is going to resent their wife for having and using the power to veto their gender expression, and their wife is going to resent them for still going farther with it than she's comfortable with.

Please figure out what's going on with the help of a professional gender therapist, SITTERS, and don't let your wife tell you what it's okay to be. It's sad when marriages break up due to incompatibility, but covering up an incompatibility to try to save a marriage very rarely works. If your wife only likes men, and you are not men, it's not going to work no matter how hard you pretend. You won't be happy because you can't go as far from maleness as you'd like, and she won't be happy because you're deviating from maleness at all.
Posted by strangecreatures on May 26, 2014 at 4:27 AM · Report this
I'd also like to add, because this is brilliant - this is a perfect method of male birth control! If you can reroute the ejaculate to behind the testicles in all boys at puberty, what you get is near perfect birth control. No one's hormones or fertility is impaired, everyone is happy. I'm shocked the religious right hasn't thought of this already and is promoting it for young male Christian lads across the land.
Posted by gnot on May 26, 2014 at 6:21 AM · Report this
The perineal urethrostomy surgery is quite commonly done by veterinarians in cats for urethral obstruction. Easy peavey though same risks and complications. My advice: consult a vet.
Posted by Psota on May 26, 2014 at 9:46 AM · Report this
@76 A retired vet. A practicing one won't do it. Or an actual doctor, in Thailand. Take the wife on a nice vk.
Posted by gnot on May 26, 2014 at 11:37 AM · Report this
Sitter, I can very much understand your feelings. For most of my life, I resented that organ that was misplaced on my body, and every urination was a reminder of it. It was only a year ago that I finally was able to correct that error of nature.
But, I was a life-long sitter up to then. I had trained that tubing to point the right direction, and it was just as hands-free as any other woman on the toilet. I still disliked the sensation of urination through it, but at least, I didn't have to touch it.
But, post-operative urination is no picnic! It goes everywhere, and getting oneself dry afterwards isn't easy. If the scrotum was wetted down each time, it would never be dry. Yes, diaper rash would be your friend!
Please rethink your plan, find another way to achieve peace with your genitals, okay?

Thank you!
Posted by RoseNow on May 26, 2014 at 9:38 PM · Report this
If LW1 really wants to have a perineal urethrostomy, he should talk to a veterinarian. The procedure is commonly performed on male cats that develop urethral blockages from urinary crystals. Of course, the ejaculation issue isn't a problem there, since the patients are usually also neutered.
Posted by BeingABear on May 26, 2014 at 10:34 PM · Report this
Allen Gilliam 80
In comment 75, Gnot wrote: I'm shocked the religious right hasn't thought of this already and is promoting it for young male Christian lads across the land.

That's because Christians don't want birth control. They want to breed more little Christians. Why do you think there are so many now? Christians want to have sex; they just don't want to enjoy it.
Posted by Allen Gilliam on May 27, 2014 at 12:19 AM · Report this
Allen Gilliam 81
In comment 73, Littlemuffet wrote: Think about why you are so opposed to your genetic gender's stereotypical traits, and realize that your assumed gender's qualities are equally fabricated by society.

Exactly. Gender reassignment surgery is an extreme act of social conformity. Rather than conforming their behavior, they conform their bodies. The better option is to tell other people to shove their arbitrary assumptions and expectations up their asses.
Posted by Allen Gilliam on May 27, 2014 at 12:29 AM · Report this
The Femskin website is pretty amazing, and it would only cost $200 for him to buy a wearable vagina that can be used to pee or be penetrated. The body suits are more, but that's a really nice starter purchase.
Posted by gnot on May 27, 2014 at 3:50 AM · Report this
@78 "just as hands-free as any other woman on the toilet"

Huh. I really don't think of my toilet experience as hands-free. I wipe every time, and menstrual products require both hands.

I think if someone really hates being reminded they have a penis, that's a good sign that halfway measures probably aren't going to work for long.
Posted by EricaP on May 27, 2014 at 10:28 AM · Report this
mydriasis 84
"Huh. I really don't think of my toilet experience as hands-free. I wipe every time, and menstrual products require both hands."

Posted by mydriasis on May 27, 2014 at 1:05 PM · Report this
Helenka (also a Canuck) 85

I believe the "hands free" was meant to reflect what happens prior to urination ... that one just sits without needing to use a hand to guide the stream.
Posted by Helenka (also a Canuck) on May 27, 2014 at 5:23 PM · Report this
@9 that was the best comment EVER. Thank you.
Posted by Chandira on May 28, 2014 at 3:35 PM · Report this
mydriasis 87

Are you really that naive?

Insurance companies don't give one shit about religion in and of itself, they're using it as a way to - wait for it - not lose money. Your beef isn't with religion, it's with capitalism. Trust me, if Christianity was down with gender-reassignment they'd just as easily take any other reason handed to them. If scientology were big enough, I'm sure insurance companies would use it as a reason to not pay for antidepressants.
Posted by mydriasis on June 1, 2014 at 7:26 AM · Report this

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