Hours later, in late February, 27-year-old Linh, a beauty blogger and TikToker, was wheeled into the operating room. She recalls the bright lights shining directly into her eyes and the clatter of surgical instruments. Her whole body trembled from the cold; her heart raced, and she struggled to breathe. Linh took deep breaths, silently praying to make it through the gender confirmation surgery.

The surgery lasted 13 hours—the longest hours of her life, Linh remembers. The surgeons performed a complex and meticulous procedure, incising the scrotum, removing the testicles, and then stitching the area to create a vulva. The goal was to ensure future functionality and help transgender individuals experience a complete sense of womanhood. The process of cutting the wires that secured the vaginal area felt like "dying and coming back to life," Linh said.

Post-surgery, Linh followed the doctor's orders, lying motionless in bed, afraid to move or scratch the healing skin. The wound unfortunately reopened twice, forcing her to return to the hospital where doctors used skin grafts from her thighs. "I underwent two more rounds of anesthesia because of this complication and took numerous medications. I had never felt so weak," she recounted.

Linh when she was male. Photo: Provided by the subject

As the wound healed, Linh had to dilate the newly created vagina with three wooden dilators of increasing sizes for an extended period, while also receiving high doses of antibiotics. The recovery process was arduous, affecting everything from walking and sitting to personal hygiene. The surgical site became infected three or four times, causing her skin and hair to become dry and fall out more than usual.

Male-to-female gender confirmation surgery is a complex and lengthy process involving multiple stages. Before the main surgery, transgender individuals typically undergo an extended period of hormone therapy and psychological counseling to prepare mentally and physically.

The main surgery focuses on creating feminine physical characteristics, including breast augmentation, facial feminization, and most importantly, genital reconstruction. This process involves removing the penis and testicles and then using skin tissue to construct a vagina, labia majora, and labia minora, ensuring both aesthetics and functionality. After surgery, patients must adhere to a strict post-operative care regimen and continue hormone therapy for life to maintain feminine characteristics, ultimately leading to a fulfilling life aligned with their gender identity.

Doctor Nguyen Minh Man, Head of the Clinical Psychology Unit at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, explains that gender confirmation surgery is a major invasive procedure with significant risks that impact a person's life. Potential risks include infection, blood loss, allergic reactions to anesthesia, swelling, pain, and long-term scarring. Some studies suggest that transgender individuals may lose 15 years of life expectancy after this major surgery. Therefore, before undergoing the procedure, in addition to endocrine and general health checkups, individuals seeking surgery require thorough psychological counseling.

Linh is considered quite feminine after her transition. Photo: Provided by the subject

With nearly 600,000 followers on TikTok under the name Yul Daily, Linh is a familiar face in the Vietnamese social media community. Last July, she emerged with a completely new look, marking the end of her years-long journey to answer the question: "Who am I?".

According to the World Professional Association for Transgender Health (WPATH), an estimated 0.3-0.5% of the global population may experience gender dysphoria. In Vietnam, this figure has not been officially recorded, but experts estimate that thousands of people are living in bodies that do not align with their inner selves.

"Since the third grade, I knew I was different," Linh recounted. "While the boys played soccer, I just wanted to play with dolls and sew clothes."

Linh's journey to adulthood was marked by societal prejudice. Starting in elementary school, she was often bullied with derogatory terms. A 2015 study by the U.S. National Transgender Discrimination Survey found that 54% of LGBTQ+ students experienced bullying at school, a rate almost twice as high as that of other students.

Societal pressure continued to follow Linh into adulthood. "I was often rejected from jobs because 'only women can review this product,'" she shared.

The turning point came when Linh was 25. After six months of psychological counseling—a mandatory step according to WPATH standards of care—she decided to begin her transition. This decision wasn't easy, as the cost of gender confirmation surgery in Thailand ranges from 200-500 million Vietnamese dong (VND), equivalent to the average 5-10 year income of a Vietnamese worker.

"I had to work all sorts of jobs for eight years in Ho Chi Minh City," Linh recalls. "From selling bird's nests and working as a salesclerk to reviewing cosmetics on TikTok, I saved every penny for this dream." She also paid off debts and rebuilt her family's house before undergoing surgery.

The first stage was hormone therapy, lasting a year at a cost of about 2-3 million VND per month. "Hormones are crucial but can affect the liver and kidneys if not closely monitored," Linh explained.

At the end of 2023, Linh underwent breast augmentation surgery in Ho Chi Minh City at a cost of approximately 80-100 million VND. "At that moment, I knew I had completed 50% of the journey," she said.

According to the Thai Society of Plastic and Reconstructive Surgeons, the success rate of male-to-female gender confirmation surgery is 95%, but complications occur in about 10-15% of cases. Linh was not immune to these risks.

"Every time I look at my body, I know I'm closer to my true self," Linh shared.

Linh now, after successful gender confirmation surgery. Photo: Provided by the subject

Societal attitudes toward the transgender community are gradually changing. The 2015 Civil Code recognized the right to change one's gender, a significant legal milestone. However, detailed regulations regarding eligible individuals, authorized medical facilities, procedures, and the process for changing identification documents have not yet been enacted. This makes legal recognition of gender transitions virtually impossible, creating numerous obstacles in their lives.

Currently, only individuals with specific physical characteristics (such as males with a uterus), as diagnosed by a doctor, are permitted to have surgery domestically and change their legal documents. Consequently, most Vietnamese transgender individuals still have to seek surgery abroad, leading to discrepancies between their legal gender and physical appearance, causing difficulties in daily life.

"I hope transgender people won't have to go abroad for surgery. For those considering transitioning, thorough preparation in terms of health and finances is crucial. It's not a hasty decision," Linh expressed.

Now, with nearly 600,000 followers, Linh continues to use social media to share her story. "I want to inspire the community. Everyone deserves to live authentically," she confided.

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