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Altersex FAQ

FAQ

Welcome to the FAQ.

I know you're all impatient as all hell to learn about doing something, so I put surgery first.

Surgery Related

General Applicability

  • Do I need to be on hormones to get surgery?

    • If hormone replacement therapy doesn't apply to your body/gender identity mix, then no. There are explicit carve outs in the new transgender care guidelines that make the HRT requirement not applicable to people who don't need HRT.
  • How much does surgery cost?

    • This is HIGHLY variable. Many US insurance companies will cover surgery and so far all surgeons accept insurance. Cash price may exceed 100k USD.
  • Does it feel as good as a natal penis/vagina after surgery?

    • No one has yet answered this because people with penises don't tend to get more penises, and people with vaginas don't tend to get more vaginas. Most people who get any form of bottom surgery end up sensate and orgasmic. Truthfully there isn't much point to comparing against natal genitalia as you can't obtain any more than what you're born with.
  • Where can I get surgery in my town?

    • You probably can't. As of now, providers are scattered around the country. Be prepared to travel.

For people with a natal penis

  • Can I get a vagina without removing my penis?

    • Yes, you can. This is called Penis Sparing Vaginoplasty and multiple surgeons provide this.
  • Can I keep my testicles?

    • Yes. You can keep them where they are, as-is. Moving them internally has not yet been approved by any surgeon known to the wiki author. Surgeons typically cite the inability to check for cancer.
  • Can I have labia? Will it look like natal labia?

    • Yes, you can have labia. Surgery has improved over time and labia are now possible, but may require two stages. Any labia can look natal because nature makes all kinds of labia, see the Great Wall of Labia project to see why pretty much any labia, or even no labia, is possible by birth.

For people with a natal vagina

  • Can I get a penis without removing my vagina?

    • Yes, you can. You can get meta, phallo, or both. Be sure to be explicit with your surgeon about NOT wanting vaginectomy. Urethral lengthening is more difficult in phalloplasty without vaginectomy because the vaginal tissue is usually used to lengthen the urethra. This means lengthening almost always requires additional surgery. DON'T LET THAT STOP YOU! Just keep future repairs in mind when you are scheduling and planning.Citation
  • Can I get testicles without removing my vagina?

    • Yes, there are options for testicular implants without vaginectomy.
  • Can I keep my clit/t-dick?

    • Yes. Phallo can be done with or without burial. Opting not to bury your t-dick does technically mean you'll have two penises.
  • Can I keep my vulva?

    • Yes. The only surgeries that would impact this are scrotoplasty and metoidioplasty if you want the vulva foreskin-ized. Some creative salmacians have combined their scrotum and vulva.

For people with (a) natal genital(ia) that isn't explicitly a penis/vagina

  • Can I get surgery too?
    • Yes, probably. It is best to contact one of the known surgeons and discuss your specific situation with them. They can create a care plan that meets your needs. You can also ask on the discord and we can try to help guide you to a surgeon.

For people who already got a bottom surgery that removed and replaced a genital

  • What can I do?
    • I'm not sure yet. The FAQ author is also in this category and is always looking for solutions.

Identity

  • Do I belong here if I'm cis and just want a penis/vagina added?

    • Yes. Your gender isn't important to salmacian identity. Just the number of genitals.
  • Am I still salmacian if I haven't/can't/won't have the surgery

    • Of course. Circumstances may vary, but your identity is your own. The only requirement is that you prefer to have a mixed set of genitalia.
  • Am I trans?

    • If you're trans, then yes. If you're not trans, then no.
  • I'm not trans?

    • That's not really a question Q&A strawman, but that's totally fine. Many cis people are salmacian.
  • Does cis and trans even mean anything if you just leave it up to self identity?

    • It's a useful shorthand for most communities. Unfortunately, salmacians in general don't do very well to being told to pick one. In our spaces, your self identification is probably the most useful role of these terms.
  • Am I salmacian if I want no genitals?

    • No. That is called nullification.
  • Am I salmacian if I want new/novel/xeno genitals?

    • Depends. Do you want more than one? We have decided to be as accepting as reasonably possible, so if your setup involves 2 or more genitals then we think so.

Other Groups

  • Isn't this perisexist (anti-intersex)?

    • We do not believe so. Some salmacians are intersex. Some intersex people are salmacian. We are separate groups with overlapping membership. The mods also believe that solidarity and mutual aid with the intersex community is extremely important to ensure both of our communities are safe in a world that holds perisexist and isosexist (anti-trans/salmacian/gnc) views.
  • Does getting surgery make me intersex?

    • No. Intersex people are often misrepresented as having full sets of both genitalia. Genitalia is not the end-all-be-all of the intersex experience. Intersex people have a medical condition that can impact genitalia, hormones, childhood development and much more. A perisex (not intersex) person getting a genital surgery does not become intersex.
  • Futa/futanari is a slur against trans women?

    • That's not actually a question, strawman-question-asker, but we do get that a lot. We DO NOT approve of the label being used on someone without their consent. Large portions of our community identify as transfem, MtF, as trans women, etc. and some use the term futanari as their identity. Futanari roughly means "someone of two kinds" and is not specific to feminine people. Masculine people can be futanari as well!
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