Unlike my V-Day posts on Tumblr, I envision this as more of a quick-start guide to your new vagina, written by a person who has absolutely no authority in the field except some very fresh firsthand experience. If you desire or have recently undergone vaginoplasty, your mileage may vary - but I think you might find some good advice here. For legal reasons, though, don't consider this medical advice. I'd hate to lose the medical license I don't have.

Disclaimer over. Enjoy this edition of Cassandra's Declassified Surgery Survival Guide, which is certified weasel-free.

So you want a vulva and/or vagina. Is that right? If not, I'm not sure why you're here, but I hope you find this interesting in any case.

I'm still early into my journey here - about six weeks as of writing (wow, I sat on this article for so long my legs have gone numb) - but I've learned a lot of what to do and what not to do. Mostly what not to do. This is the listicle I wish I could have read months ago. Do as I say, not as I do, I suppose. Here are some arbitrary number of tips to keep in mind when you get the biggest snip.

Tip #1: Take Their Drugs

You wake up for the second time today, writhing in pain. That's alright, just scream a little and they'll inject happy juice directly into your veins.

Do not, I repeat, DO NOT try to handle the first week without narcotics. It will do you absolutely no good. Sure, Oxycodone will make you constipated, but they already weren't going to let you have solid food for the first day and they'll pump you full of laxatives whether you're taking opioids or not. Everything got jostled around down there - you wouldn't be shocked that your rhythm changed after bottoming, would you? This is extreme bottoming. Plus, if you still had your testicles this morning, this will probably feel like getting kicked in the balls for the last time - not pleasant. Mine were long gone at this point.

Here's what you might not be expecting, though: the worst of the pain isn't in your crotch. That is, if your procedure is laparoscopic like mine was. They pumped your abdomen full of carbon dioxide, stretching it and stressing it. If you had an inflation kink before, this might kill it (not that I'd know, I swear). The only way that gas is leaving your body is via the two most obvious ways, and personally I found burping easier - at least while I was stuck in bed. Enjoy a nice ginger ale, if you can manage to, and think about how that can of soda is less carbonated than you are right now.

When you do decide to stop taking your dealer's-choice opioid, don't go cold turkey. Taper off of the stuff. The last thing you want is muscle spasms from withdrawal, which I'm pretty sure is what happened to me during the second night. You need your rest, especially if there might be other reasons to struggle with sleep.

Tip #2: Take Your Drugs

If you have chronic conditions, like me, you would be remiss to suddenly stop taking all the various medications that keep you in bio stasis. But the nurses aren't going to want to give you any of them.

I know you're tired, I know you're in pain, but you need to advocate for yourself. Bad stomach? Don't let them play keep-away with your Pepcid. Body adjusted to fiber supplements? Get the ball rolling on Metamucil as soon as you're allowed non-clear liquids. Can't sleep? Demand that... Uh... What do people use for sleeping pills nowadays? Ambien?

If you don't assert your needs to the nurses, or if necessary, to the doctors, your stay will be worsened by entirely avoidable additional pain. Their job is to keep you from needlessly suffering, but they're not going to give you anything the people in charge didn't ask them to. And you are one of the people in charge.

Tip #3: Take A Walk

This sounds scary, but hear me out. You're going to feel like you can't and shouldn't get out of bed, and for a couple days you'll be right. Your bowels aren't moving very fast and the catheter handles the rest, so your spaghetti legs can take a load off. But don't get complacent.

You knew going in that this would be hard work. If you didn't, I'm telling you: this will be hard work. But hey, no turning back now. The fact is, you don't want your muscles to atrophy. It'll only make things worse. So as soon as the surgeon will let you, call a nurse to get a walker and a chaperone so you can get moving. After two days of the sedentary lifestyle, it's really invigorating to move at the fast pace of sixty miles-per-fortnight. It's good for your spirits. Go outside if you can.

More importantly, though, it helps get all that damn carbonation out.

Tip #4: Don't Be Shallow

When they rip off those bandages, they're going to hold a mirror up to your construction zone. And you're going to feel light headed, perhaps. Maybe spooked, if it's October. It doesn't look like a vagina. It doesn't look like anything you've ever seen before in your life. That is, unless you tortured yourself by looking at one-week-post-op photos like I did.

Gotta get strong, gotta get strong! Exposure therapy!

You're going to feel like a kid on Christmas who just unwrapped a package of socks, except those socks are a bleeding, bruised, gaping wound. I'm sorry if your family was like that... but I digress. The doctors are going to be much more positive about it - in fact, the surgeon will have a proud look plastered on their face. This is because the doctor (like all time lords) can see in at least four dimensions, and they're looking at it a year from now. Don't let this bother you.

This isn't what it's going to look like in a year. This isn't what it's going to look like in a week. It'll change a lot, and I mean a lot, before you're even ready to take it for a test drive. So try not to think about aesthetics yet. I don't blame you if you try not to look at it at all. Frankly, there's no good reason to look until you're out of the hospital. However...

Tip #5: What's That Smell?

You may yearn to serve fish, queen, but that isn't the dinner plate. Unless your surgeon says otherwise, there should not be any sort of foul odor coming from your nether regions. You don't have vaginal flora yet (and the vaginal fauna is way off). You're on a crap ton of antibiotics and the lube you'll use to dilate (we'll get to that) is sterile and bacteriostatic. In layman's terms, that shit is like Purell for your new hole. The only stuff that survives a brush with it is the really scary bacteria that hangs out in the back alley behind the hospital.

You don't want a UTI. I think we can agree that an e. coli infection is neither brat nor demure nor whatever word people have moved onto this week unless that word is "painful." So be on the lookout for some signs:

• Cloudy urine

• Blood in urine

• Foul odor

• Urgency to pee (despite an empty bladder)

• Pinching sensation (and not necessarily on what your brain recognizes as your urethra)

Even if it's only slight, even if you're sure it's nothing, ask for a urine culture sooner rather than later. At least in the hospital they might not make you squat over a cup. I should say, though, that you probably won't be able to tell if you have an infection until the catheter comes out. And the less said about that, the better.

Tip #6: Hello Down There

This time, instead of Christmas, it's your birthday, and the doctors have brought in a clown. You. You're the clown. Why? Because you're hiding a mile of packing bandages up your sleeve. It's really mesmerizing to see it all pulled out, but you'll be distracted by the sensation of it. It's hard to describe, but imagine you're a water slide and a whole lot of people are barreling out of you at breakneck speed. It's like your vagina-in-training is a sub-woofer playing back a recording of your car window rolled down an inch on the freeway. It's like that vibrator setting you always forget about, the one like a little jackhammer, and every time you accidentally press the button, you're like, who uses this?

That'll only take a minute or so, but now you've got a new problem. It's time to learn to dilate. They're going to provide you directions, but the directions are only useful if you can remember them, and there are quite a few turns on the way. It's scary, but here's what you do: first, you gotta locate the hole with your finger. I know it's unsettling, but for now it's necessary. It gets easier. Once you've got more of a hang of it, you can just aim right below the labia minora - that's the pill-shaped lump up top (for now) - to find the entryway. Remember, don't think about the aesthetics yet.

Anyway, you found the hole. Now what? Get the smallest dilator you've got and lube it like your life depends on it. Get it covered. Glaze it like a Krispy Kreme. Then gently, GENTLY, insert it, angled down forty-five degrees. You keep goin' for about an inch, see, and if'n ya hit excruciating pain, then ya gone too dang far. Wiggle it around a little to avoid catching on stitches, and once you feel like you can't go any farther, change your angle to aim right towards your bellybutton, and continue on. It's tighter past this point but once you have the trajectory figured out, you'll be alright.

To be honest with you, my brain has blocked out much of the details of that first time, and as swelling changes, dilating changes too. After enough times, you'll develop an instinct for it. One which you really ought to trust... Put a pin in that.

Tip #7: Make a Friend

Between my grandparents leaving on day zero and my friends picking me up on day five, I didn't speak face-to-face with a single person who wasn't employed by the hospital. I believe this to have been something of a mistake on my part.

Now, I'm not sure what the protocol for this should look like, but I think it's a good idea to at least attempt to get in contact with someone else at the facility who has had the same surgeon do the same work at around the same time. Either you're both having the same problems (and misery loves company) or you act as control for one another and can figure out when something is wrong much sooner. It's easier than asking your care team questions every five minutes.

But that's just the practical side. It's really important not to feel alone when going through this, because you aren't. Thousands have come before you and thousands will come after. When an acquaintance of mine reached out and told me she had hers done a few days before I had mine, I was overjoyed to be able to talk to someone who really understood what I was going through. And I think it helped her, too.

Tip #8: Go Home Already

The doctors and nurses have taught you everything they can (as far as they know) and they think you're ready to leave the nest. Just as well, you can't stomach the hospital food anymore. So go back where you came from, and don't forget to detour through the Taco Bell drive-thru. Maybe keep your distance from the Seasoned Beef™ for now though...

Now, technically what I'm about to tell you is something you should have done pre-surgery, but you're reading this ahead of time, right? If not, I hope you have someone to rely on to get you some supplies. Actually, you really need someone to take care of you for a while anyway, but I'm getting ahead of myself.

1. You're going to have a lot of pinkish discharge coming out of you, and it stains. Get overnight pads - a lot of them - and change them regularly. These aren't foolproof, so wear panties that you don't care about, and get over-sized ones if the pressure is uncomfortable. I've found applying pressure to reduce discomfort, personally, but I stuck with the XL ones for a couple weeks to be safe. Eventually you should get period panties that can be washed and reused, since they're much less abrasive to the delicate skin.

2. Put up railings everywhere. Your bed, your toilet, the shower, you name it. Standing up is going to feel awkward, like you tucked too tight, and your body, holistically speaking, is still reeling from the fight it just lost with a scalpel-wielding robot. You need all the help you can get when it comes to getting up. Basically, right now, you're disabled. Use any mobility aids you can get. A cane is rather fashionable, too.

3. Always have a towel. That is, when you're dilating. Surgilube gets absolutely everywhere and when it dries it gets sorta flaky. You don't want that spilling on anything you care about.

4. Stock up on comfort food. Snacks, frozen dinners, candy, whatever. A good homemade meal from a friend is especially good for the soul... I assume. If your stomach can handle eating something and it makes you happy, go for it. But probably stay away from alcohol until you aren't maxing out the dose of Tylenol and swallowing prescription painkillers like House MD.

5. Watch something lighthearted to keep yourself occupied. Don't watch Bojack Horseman while you dilate. Why would you do that? I'm currently making my way through Seinfeld start to finish, which I've never done before. Maybe I'll see an episode I've missed for all these years (update - I didn't). It's possible (not according to the pigeon-hole principle. wait, maybe that should be the name of this article...). Movies are also good, but maybe don't go to all the trouble of getting Ultra HD Blu-Rays to work on your computer. You will not be able to tell the difference in this state.

Tip #9: Take Their Drugs (But Know What You're Taking)

You were sent home with several prescriptions, all for very good reasons, but you'd better know what those reasons are. Phenazopyridine may say on the label that it's for pain, but it's only effective on bladder and urinary pain. If you're taking it without a UTI or similar problem, you're wasting pills and staining your toilet for no reason. Likewise, you don't want to confuse pain meds and laxatives. Look up what they gave you and take only what you need.

Now, I do realize 'need' may be a vague term, but let me spell it out for you: if you're on opioids, take the damn stool softeners. Or else. And you should be on opioids if dilation is otherwise too painful. You need to dilate. I got away with not dilating for about five days, but you aren't guaranteed to be so lucky. If the painkillers don't do the trick, you can ask for muscle relaxers (though they didn't help me a whole lot). You aren't driving, anyway.

As mentioned before, you're going to need a lot of extra-strength acetaminophen. At six pills a day, it goes fast, so get a Costco card and stock up. This stuff does most of the heavy lifting. Ibuprofen is also good so long as you haven't got a restraining order against NSAIDs. Oxycodone is just, like, the foreman. I don't know, I've never worked in construction or manufacturing. That reminds me: don't do any heavy lifting.

Tip #10: Tight Squeeze? Don't Panic.

Dilating is one of the most bizarre experiences I've ever had in my life. Before your brain rewires itself to the new topology, you're going to have a lot of strange feelings. For one thing, a phantom penis, and for another, honestly? Light orgasms out of nowhere. Then again, maybe that was the drugs...

The first time a dilator goes all the way in, it's going to feel like something is touching your "shaft" while a foreign object is somehow inserted into the rectum without going through the anus - I've referred to this sensation as "the back door to the back door." It's uncanny and unnerving. But you have to do this pretty often, so eventually it will stop feeling like that and instead feel like what it is: your recently remodeled vaginal canal.

Still, you just moved in, and the furniture isn't where you're expecting it to be. You may find yourself caught behind a bookshelf and not know the way out. To lose the metaphor for a moment, you're seemingly at a dead end in the canal. Don't panic. Don't throw books off the shelf looking for the secret entrance - that is, don't go all about in all directions looking for the way through. If you jam the dilator into every surface in there, you're just going to get frustrated and bruised. Eventually, you will know deep in your subconscious where you're supposed to go. There's no need to overthink things. Take it slow.

To aid in developing this intuition, always start a dilator smaller than the one you bottom out with (I'd stick with step 1 entirely for the first week at home, but that's just me). Make sure to breathe and relax whenever you hit a wall. That way, the muscles will stop clenching and pushing the dilator out.

Tip #11: Stay On Top of It

You're going to be bored sick of dilation, at best. After all, you're doing it three times a day, and at first it's pretty slow going. But as days melt into weeks melt into months, your surgeon will revise the recommended frequency down to two and down to one. You'll find the time and energy to go out more, and your life will find a new routine that works for you. That is, if you're unemployed. I can't speak on how to fit six hours of dilation, eight hours of work, and another eight of sleep into a twenty-four hour day without losing your mind. I'm sorry if it has to be that way.

But regardless of circumstance, if you care about your results (and I think you do), you need to size up. Regardless of how long you wait, jumping from IntiMD step 1 to step 2 (and especially from step 2 to step 3) is going to sting. You're going to want to give up, but you must not do that. You went through all of this for a reason, a damn good reason, and you can't forget that now.

Having said that, you'll get a lot of mixed advice on precisely how to not give up. Use a vibrator on the base of your dilator during insertion (good advice), use a vibrating expanding dilator that costs $400 (bad advice). Breathe out (yes), force it in (no - but who's saying this anyway?). Lowering down onto my dilator (as suggested by my gynecologist) didn't work for me, since my muscles just tensed up with the fear that I'd succeed in getting it all the way in - a real catch-22. Ultimately, I had to just power through while laying on my back with a pillow under my ass, but there's a limit to that power and it was somewhere between step 4 and step 5. There's nothing wrong with you if you're struggling, these damn things don't provide a smooth slope to ramp up your size.

You could find a sex toy in between dilator sizes and use that to edge your way up, but it's hell to try and find measurements for dildos and they're usually too big for the task anyway. Look, instead, to alternative dilators*. I found that Intimate Rose's Size 7 was the perfect midpoint (and I do mean perfect) between step 4 and step 5, and it got me past the wall (side note - it isn't as long as step 4, so can't totally replace it, and that's why I spent January with three dilators on my bathroom counter). I can get step 5 all the way in now, even though I didn't master this feat until a year and a half post-op, down to dilating once a day. That's right - it's never too late! But I only took so long because I was too stubborn to spend money on extra dilators (even though I spent so much more on that stupid Milli 😭).

*  Hey, I've got great news! Intimate Rose (not sponsored) actually has a lot more sizes than IntiMD does, and you could (but probably shouldn't) buy all of them for less than the cost of a Milli-brand medical squid-shaped umbrella (god I hate that thing). Conveniently, Size 3 bridges between step 1 and 2, Size 4 bridges between step 2 and step 3, and Size 6... well, you see the pattern. You might be able to find similar products from other manufacturers, possibly even cheaper, but I didn't and I wouldn't suggest you waste your time stressing over a few bucks. The whole process is stressful enough. At this point, though, it's gotten easy enough that it's borderline fun. I'm half-tempted to get 8 and 9 to push myself farther...

Tip #12: How's It Hangin', Slick?

There are many things folks will say on the topic of lubricants, and while yes, you should stick with water-based (and quit the Surgilube as soon as your surgeon gives the go-ahead) and it's best you use one with balanced pH and 100% free of yadda yadda yadda, but the important thing is to get a lubricant you can mentally tolerate. I tried X-Lube to save money (too stringy), some healthy clear lubricant that squeaked inside like a squeegee, and even, ironically, Boy Butter. All of these made me cry, but you know what didn't? My old standby, my favorite, Fuck Water (not sponsored, but damn well should be).

If you hate your lubricant, you're not gonna want to dilate. If you don't dilate, you're gonna lose flexibility and have dead skin and such in there that'll cause way more problems than a lube that dries you out a little. If you can get samples of a selection of healthy lubricants and see what works for you, by all means do so and report back. But I only had so many spoons to spend on this topic and I'm sticking with what I know works.

Whatever lubricant you happen to use, you may notice something: you're applying a whole lot of it, but your inside parts aren't that slick and there's a whole lot just spilling out. Maybe you get off on that, but it's costing you money. Believe it or not, a little goes a long way for dilating.

Disclaimer: If you're still bleeding, for the love of our heavenly mother do not skimp on the lube. This is advice for several months in.

Since you aren't moving your dilator in and out a whole lot, that lubricant isn't going to be exposed to the air and dry out, so you need less than you think. But also, since you aren't moving it in and out, it isn't able to spread around. You may be tempted to pull out and add more lube, but try this first: pull out... then just push it back in. You'll get deeper than you think.

Tip #13: Aim For Perfection, Miss

I was pretty bummed out by the scars left behind on my abdomen, so I was lucky to find out my local trans center offers IPL for scar removal. It works pretty well, and I assume home IPL units would do the same over a longer period of time. There are also scars around my vulva, but I didn't feel comfortable letting anyone down there for some time.

For one thing, even after over a year of healing, it doesn't look how I wanted. I would have liked to have more skin, but no, the folds are fairly minimal. It's not as though a cis woman couldn't have one that looks like mine, but it's lumpy and strange and it's probably not going to change all that much. I have mixed feelings about it. But what's more 'woman' than worrying your body isn't pretty enough, right? Right?

Well, everyone other than me who's seen it thought it was pretty great, so I try not to think about it too much. Though about 30% of my surgeon's patients seek revision surgery (which is rather low compared to other doctors), I don't have the energy or motivation to go through all of that. Not now, and probably not ever. I have made peace with my body as it is, which is exactly what 'critics' (read: assholes) would have told me to do before I started my transition. But back then, it was impossible. Now? I think I can manage.

Light at the End of the Tunnel

There were times when I thought I'd never make it through recovery. I thought I'd never heal, that a bedridden waking nightmare was my life now. I thought I'd never live a normal life again and I wished I'd just left well enough alone. But that's not how it went.

There came a day when I was able to go enjoy hotpot with my friends again. There came a day I was able to drive myself around again. There came a day I finally got my ears pierced. There came a day I could move just like I used to, maybe better; a day that saw me jog halfway across Disneyland. There came a day I was able to move out of my mother's house and carry my own boxes. There came a day I could swim in a bikini without a skirt. There came a day I needed only to dilate twice, then only once.

There will come a day I will dilate once per week, perhaps even less. There will come a day that I get to experience sex for the first time all over again. There will come a day I will no longer have to think of any of this. There will come a day: a bright, shining day for me and all my sisters to grow old in freedom we cannot even dream of, in bodies more home to us than any hometown, as a people who despite worst efforts couldn't be buried under the rubble of our civilization. Remember this; remember the future we need and it will guide you through the bleeding dark like it guided me. Like it still does.

If this is what you want... and if you got this far, I think it is...

Join us in the light at the end of the tunnel.