Choosing a penile implant (TMI)

Pre-amble: I wrote this prior to getting my penile implant. The 20% I cite below was based on figures provided by my surgeon for the implants he provided at the time. You may come across different, equally valid, figures. I’ve added a post-mortem at the end./

In no particular order, my 3 options are:

i) no penile implant

+ No more surgery!
+ Risk free! (physiologically speaking, bets are off on mental health over time)
+ Zero maintenance (not including the management of dysphoria/mental health)
+ No more incurred debt over my body
– Tugging hurts (this isn’t a common problem but it’s my reality)
– Can’t penetrate
– Some dysphoria, penis perpetually flaccid

ii) semi-malleable rod now, potentially no implant down the line

– 3-4 surgeries over the rest of my life (best case scenario/presuming no complication)
– 20% risk per trip to the OR, and inconclusive data on longer term risk
– Some additional debt incurred over my body
+ Tugging doesn’t hurt
+ Can penetrate
~ Less dysphoria, penis constantly hard, albeit malleable

iii) inflatable rods/pump now, potentially semi-malleable or no implant down the line

– 4-5 surgeries over the rest of my life (approximate best case scenario)
– ~20% risk per trip to the OR, some risk longer term
– some maintenance (in the form of regular cycling, nothing major)
– Most additional debt incurred over body
+ Tugging doesn’t hurt
+ Can penetrate
+ Least dysphoria, penis can be flaccid or hard

Photo by Charles Deluvio 🇵🇭🇨🇦 on Unsplash 2

[Picture by Charles Deluvio on Unsplash. Description: a measuring tape showing the length of a cactus against a pink background.]

I find it virtually impossible to attribute weight to the different components. It’s not as straight forward as “which has the most pros/cons?” Intellectually, I want to go with option ii, it seems like a more reasonable approach. But emotionally, it feels like it’s the worse option for me.

Emotionally I want to go with option iii but I worry about things like “what if I leave Canada, thus losing insurance coverage for future implant replacement surgeries” and/or “what if my surgeon retires?” and/or “what if OHIP delists coverage again?” (it did in 1998, granted now we have human rights but I put nothing past elected bigots.)

Option i is the only one that allows me to change my mind to another option without any drawbacks, at a physiological level. But my fears around coverage access apply to changing my mind if I don’t stick with option i for good.

Photo by Erica Nilsson on Unsplash

[Picture by Erica Nilsson on Unsplash. Description: Sign by a body of water that reads: DANGER THIN ICE KEEP OFF.]

Sidebar: I love (sarcasm) the trans guy who said that if I go with a semi-malleable rod, I’ll have to disclose cause I won’t be able to get a full on hard-on. Buddy, I already disclose that I have an ED, and no one to date has asked me which ED I have, nor have they lept to the conclusion that it’s due to my medical history. Semi-malleables were developed (as were the pumps for that matter) for cis guys. Trans guys aren’t the only ones who use them, in fact, proportionally speaking, we’re the exception.

The other thing I’ll have to disclose some time whether I get an implant or not, is that I won’t be shooting sperm. Also does not necessitate disclosing my medical history. Many people will assume I drank too much, or had a Tylenol, a vasectomy, or whatever.

The shit some people project is infuriating. Especially when it comes from an absence of relevant lived experience and thus is based in a series of wrongful assumptions.

I continue to be excessively grateful I stuck to my “over protective” guns and haven’t included any significant other in my surgery making decision process. It sucks enough to deal with unsolicited shit from trans guys when I’m pondering my options./

Photo by Abigail Keenan on Unsplash

[Picture by Abigail Keenan on Unsplash. Description: 2 rainbows over a hilly landscape.]


In the end, I got 2 inflatable rods and a pump. It was the easiest recovery of all my lower surgeries, least painful, least wound dressing to do, so on. I have zero pain at the anchor site, even when I’m having rough sex. Overall, I give this implant an 8 out of 10. I love it, and I hope it lasts many more years yet.

I casually keep tabs on newer models becoming available, including the Zephyr models that were not available when I went for mine, and remain open to swapping to something else when the time comes for this implant. Quick sidebar: having attended a webinar with Zephyr reps and one of the surgeons putting the new devices in, I have learnt that they are not an option for me. As all implants do, they have limitations, and circumstances in which they are a better option./ For me to switch to a different device, it would have to be something proposing improvements over the one I presently have, no drawbacks from what mine already offers, with a similar or better longevity record. Given what’s currently available, if I had to get my implant replaced tomorrow, I would choose to get it replaced by an identical model. It’s a nice place to be, genuinely satisfied with what I have.

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