A Fly on the Wall.

by Ganymede

A Fly on the Wall is the story of Savannah Martin, a ten-year-old fashion model, and the journey to change gender. With surgery in Mexico depending on meeting certain conditions, the responsibility falls on Grampa.


To read the rest of the story, click here: Contents

To read other Ganymede stories, click here: Ganymede

Copyright 2019

The responsibility falls on you, the reader, to support Nifty.

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< < < Savannah is nine years, five months, and seven days old > > >

 

The valley of Los Mochis, Sinaloa, produced mangoes year round, at their best in summer. Frank Martin stopped the car at Mango Land, a roadside stall, purchased six ripe ataulfo, and peeled three of them right there.

“Savannah must be texting a friend,” he observed, tossing bright yellow peelings into the brush, hoping they’d distract the constantly buzzing black flies.

June 4th anywhere in Mexico was hot. It was 86 degrees and headed to triple digits before the sun set. It made sense to stay in the shade. Instead of staying under a struggling tree and slapping at black flies, Savannah wandered aimlessly, either typing one-handed on her iPhone, or picking hogweed flowers.

“My bet is she’s embarrassed. Fashion Brat insisted on wearing her thong,” Karen said. “I made her take it off when you stopped for gas.”

Frank shrugged as if it wasn’t important; however, it was to Savannah.

“It gets uncomfortable sitting so long in a car. You’d think I was torturing her from the way she carried on about it.”

“It’s not like Savannah has to hide what’s down there from me,” Frank said, a little exasperated.

He was used to seeing Savannah in TOMBOY Wonder underwear, yet when it came to his grandkid wearing a custom-made thong he was still of two minds. It was tiny and tight, designed to conceal. Without it, Savannah had barely enough bulge to convey ‘boy.’ With it, there was nothing to see except a genderless hump between slender thighs.

“It’s who she is, Dad.”

Even in Los Mochis, Sinaloa, Savannah was beautifully attired, exuding sexy in heat. Her Range jeans were so low her grandfather could see pretty pastel-purple bikini briefs whenever she bent over. Up top, a shimmering faux-silk blouse, sans buttons, tied at her waist.

It was one of those times it was all Frank could do to drag his eyes away from his gorgeous grandchild.

“It won’t happen this trip, will it? The operation?”

Frank’s thoughts always converged on Savannah. He watched her, still texting between nibbling around the mango seed and licking up juice, savoring sweet creamy mango. So far the flies didn’t seem to notice.

“Dr. Stein’s email said just ‘interview and information.’ I think because of her age.” She beckoned when Savannah neglected her iPhone long enough to glance back.

“It’s a pity she can’t do the interview using her phone,” Frank jibed.

Karen smiled. “I said she could buy a phone if she used her own money. Big mistake!”

Savannah’s iPhone was the latest model, large screen, high resolution. Wide angle and telephoto lenses, with powerful zoom. All the bells, whistles, and do-dads. Over $1,000—after two hours of modeling TOMBOYpre for international buyers, a generous ‘tip’ from Eric Perlmann paid for it.

“If Dr. Stein’s convinced it’s the right thing for Savannah, we’ll be back on the 24th,” Karen added.

“Clip and snip before the end of the month, huh.” Conflicted, he should’ve kept his mouth shut.

“I need a napkin, Mom!” Savannah shouted, dribbling mango juice, and licking fingers.

“Wipes are in the glovebox, Savy,” Karen called. “We’ve been waiting for this for a long, long while, Dad.”

Savannah jogged back to the Jeep Grand Cherokee, designer sneakers kicking dust.

“El Carizo to Los Mochis is less than an hour. We’ll be there before 3:00 pm.” Frank’s happy voice was anything but.

Karen picked up. “I’ll drive the rest of the way, Dad. You get to ride in the back seat and cuddle Savannah.”

Karen didn’t miss much.

Frank wiped his Case Trapper penknife on yellowed grass. Twenty years old and it still looked new. With a sigh, mostly directed at himself for agreeing to go along, he picked up the remaining three mangoes, and followed them back to the car.

As soon as he fastened his seatbelt, Savannah stuffed her iPhone in the seat pocket, flipped up the dividing armrest, and scooted across to the middle seat.

Frank tried to be stern. “You’re not sitting in my lap. You’re all hot and sweaty.”

“I’m hot, Grampa, not sweaty.”

“What if I don’t want your sticky little paws on me?”

Savannah gave him the ‘are you crazy’ look. “I wiped them. I’m taking a nap, Grampa.”

Within seconds, Savannah had designer sneakers kicked off, feet up on the leatherette seat, curled up against her grandfather, head tucked under his arm, clutching one of his fingers with a moist little fist. That close to Savannah, Frank knew the hour would pass quickly.

<<>> 

Frank Martin woke up with a start.

“Dad, the directions said to take the road to Topolobampo, then, the last road on the right. I think I just missed it, so we’re nearly there.”

He had the distinct impression it wasn’t the first time Karen had tried to wake him.

At some point, sleepy Savannah had shifted around, knees drawn up, head now cushioned on his thigh. That moist little hand had relocated, switching from Chinese finger trap to the inside of his thigh, with a curious thumb far too close for comfort.

“Savannah’s still asleep,” Frank said quietly, looking from salty marshes to mussed up hair spreading over both him and the seat.

“Faking it, Dad.”

Savannah burst into giggles.

“What’s so funny, Savy?”

“You know, Mom; what happens to boys. Grampa has a stiff.”

Karen laughed out loud. “What did you expect with you pawing him?”

Shocked more than flabbergasted at his daughter’s reaction, Frank quickly relocated Savannah’s encroaching hand, adding a stern frown to get the message across.

“Sorry about that, Karen.”

“No harm done except to your ego!” She met his eyes in the rear-vision mirror. “You’re such a hermit, I’m surprised it still happens.”

Now, Frank was flabbergasted.

Topolobampo was a grungy hillside town overlooking the bay. With an appointment at 3:00 pm, they didn’t stay longer than it took to make sure the hotel at the marina had rooms available for the night.

Dr. Albert Stein officially titled his clinic, the Stein Center for Gender Research. Before SCGR took it over, it was a small mid-price guesthouse catering to gay men. The locals still called it El Chacal.

Despite hordes of flies in the parking lot, inside the clinic everything was tidy and spotlessly clean, with the smell of pine disinfectant redolent in the air. While a dark-skinned nurse whisked Savannah off to a changing room, another nurse with passable English conducted Karen and Frank to Dr. Stein’s office on the first floor, and quickly disappeared.

Previously the breakfast room, it had a view of the marshes, a distant crescent beach, and the sweeping expanse of the Gulf of California. Shortly, the receptionist entered bearing a tray. After setting a pitcher of iced tea and four glasses on Dr. Stein’s desk, she went over to a low padded bench. It clearly wasn’t a coffee table, yet she spread out a white cloth. She rearranged four vinyl armchairs around the bench and discreetly withdrew, closing the door behind her.

“It looks clean enough,” Frank observed after a good look around. He’d worried about it for most of the drive.

“Dad, you need to calm. Mickey’s mom speaks very highly of this place.”

“Mikey had less to lose, a lot less.”

Karen let out a long sigh. “Dad, if you can’t be supportive, be neutral, or get the hell out.”

“How about I ‘don’t say nothin’ at all,’ Thumper?”

“Last time, Dad! Savannah needs you to support her.”

They waited another minute, making droll comments about the view, because anything else eventually led back to Savannah, and the reason why they were there. It was like a propane gas leak; it only took one spark.

A side door opened and a dumpy little man entered wearing an old-fashioned white lab coat. After handshakes and introductions, Dr. Stein rubbed his temples, blinked behind thick wire-framed spectacles, and selected a file from a stack on his desk.

“I need to warn you in advance,” he began rather sternly. “These interviews deal with very personal matters. You will likely feel uncomfortable at times, even angry with me. Please know that whatever I say or do, or have Savannah do, it is strictly in her best interest.”

Karen thought his demeanor professional, yet somewhat abrupt, especially given what was at stake. Savannah’s doctor in Boston was far more understanding and supportive. Frank, on the other hand, decided Stein looked like a Nazi war criminal. He glowered, glancing at the window, and the bay beyond. He began to think the tiny black spots on the glass were flies, not dirt. They moved, or seemed to.

“I need to understand Savannah; that is my sole motivation,” Stein went on.

Frank, who distrusted him from the outset, was ready to call him out to the parking lot.

“Please let me do most of the talking. If I want you to be involved, I will say so directly. Help yourselves to some iced tea while I fetch her. We’ll sit over there.” Stein gestured at the four chairs and bench. “I prefer to be face to face with my patient.”

With that, Stein strolled to the side door. He returned hand-in-hand with Savannah, attired in a hospital gown, pale pink with teddy bears, tied in the front. They stopped by the desk to get iced teas. Stein added a teaspoon of sugar to his glass, and stirred it thoroughly.

 He took a seat, with Savannah opposite, opened a cream-colored file, and began.

“Savannah, I see you model for TOMBOY. I looked them up on the internet.  They sell clothes for gender-dysphoric kids. Can you tell me how you feel about it?”

Savannah glanced at Mom and fiddled with a curl.

“The owner of the company, Mr. Perlmann, calls her his Fashion Brat; I’m sure you can figure out why. She likes to wear unisex, especially what I design. In fact, a lot of TOMBOY outfits are done with her in mind,” Karen explained. “Now, you get to tell Dr. Stein about modeling, Savy.”

“Um, I guess I like how I look, all dressed up,” Savannah added self-consciously. “It’s fun to have people looking at me.”

“Well, you certainly look very fashionable.” Stein still shot Karen a cold glance. “You know you don’t have to be a girl to wear girls’ clothes.”

Savannah nodded. “I hate wearing other clothes. TOMBOY feels good, really nice, you know.”

“Do you feel embarrassed if your male friends see you?” Stein asked, his tone mild.

“If you mean straight boys, I don’t really know any.”

“You don’t feel uncomfortable when you’re dressed up?”

“With other clothes, I do. Like this, it feels so right. Sometimes, it’s creepy-good. Getting dressed up makes me go all shivery inside.”

“You get excited down there, too?”

Savannah hesitated, reddening. A panicky, guilty, little nod was enough.

“It’s embarrassing, but perfectly normal at your age.” Stein smiled graciously. “I know it’s difficult to talk about private things; however, everyone here is on your side.”

Savannah twitched and glanced at Mom, a silent exchange directed at her grandfather.

Stein waited until Savannah met his eyes. “Would you be happier if it didn’t get big?”

“I hate when it’s like that.”

“If you have the first operation, it will still happen, only not nearly as often.”

After a quick peek at her mom, Savannah nodded slightly.

“If you really want to be a girl, and have the last operation, it can’t happen. Is that what you want?” he inquired.

“Duh! I’ve been diagnosed with gender identity disorder.“ Savannah peeked at Grampa. “Psychologically, I am a girl.”

“I sent you a copy of her doctor’s letter,” Karen interjected. “It’s in your file.”

“I read it; however, I didn’t need to. Once I saw Savannah’s photos, I could tell.” Stein smiled at Savannah. “I can tell a pretty girl when I see one. There’s just a little problem that keeps popping up.”

Savannah returned a shy smile of her own. “Not after it’s gone.”

“After the first surgery, you’ll be well on your way. It’ll only get big if you make it.”

Frank exhaled; however, he didn’t intend it to be so exaggerated.

“Once you fill out in front, you’ll be a very sexy girl. Are you excited about wearing a training bra?”

Savannah hesitated. “I guess.”

Coming from Savannah, it was a less-than-enthusiastic response. Karen glanced at Frank, not validating, displaying disbelief. He was curious, not as surprised as she was.

“Dr. Stein, our underwear collection is called TOMBOY WONDER.” Karen noted his displeasure at her cutting in; it was hard to miss. “The product line doesn’t include training bras. Tomboys are more interested in flattening; we make Lycra halter-tops for that. Perhaps  a booster-bra would be a good addition for kids like Savannah.”

“Mom, please! I barely have nipples,” Savannah grumbled.

“We’ll fix that when you’re 13.” Stein winked. “Lots of natal girls have significant breast tissue at ten years old; however, I like my transgender-girls to take their time.”

“My friend, Mickey, you did her operation; she has boobs and she’s not even 11.”

“Since Mickey’s mom referred me to you, I expect you know she’s a special case. Mickey started estrogen early for other reasons. Everything I’ve seen so far says you’ll be on the slow track.”

“So no boobs for until I’m 13. That works.” Savannah sounded relieved.

“Savannah, I’m glad we’re having this conversation. Do you know why?”

“You want to find out more about me.”

“Exactly. I need to know what is going through your head.” Stein sipped iced tea. “The more open and honest you are about really private things, the easier it is for me to see if transitioning is right for you.”

“Okay.”

 “We’re going to have a test, Savannah.” He sipped again, letting his words sink in. “The most private thing any boy or girl can do is masturbate. I want you to tell me how you do it.”

“I kinda squish the tip of my boy-thing,” Savannah whispered.

Stein flicked pages in the file and jotted down something. “Just the tip?”

“Um… yeah.”

“The tip, the glans as we doctors call it, corresponds to a girl’s clitoris, did you know that?”

“My clitoris got messed up when I was inside Mom’s tummy.”

Stein smiled slightly. “Is there anywhere else you touch when you want to feel good.”

 Savannah glanced at Frank, not Mom. “Sometimes, I rub behind; inside, you know, where it feels weird.”

“I know exactly.” Stein leaned in and confided, “There’s no need to be embarrassed. Most of my patients insert. So, you masturbate only by squeezing on the tip, right?”

Frank was certain his face was bright red. He watched flies on the glass, anything but look at Savannah. She nodded nervously.

“Now, I’m going to ask a very personal question. I don’t want you getting all embarrassed.”

“I’ll try not to.”

“What you think about when you masturbate?”

“Um.” Savannah chewed on her bottom lip.

“It’s okay. I know it’s difficult to say outright. I’m going to say some possibilities. When I say the right one, you nod. Okay?”

“Okay.”

“Whatever you do, don’t get embarrassed. Ready?” Stein nodded reassuringly. “Do you think about girls your age?”

Her head twitched, just enough.

“What if they’re older? Like teenagers?” He smiled at her second twitch. “I doubt we’re talking about an Oedipus complex, which leaves us with…” He winked. “I’ll say it so you won’t have to, okay. Do you like boys?”

Savannah cringed.

“Are there any boys from school who you’re especially fond of?”

“There are some gay kids I hang out with. Not like that, though.”

“They’re friends; I understand. How about a teenage boy?” He hesitated when Savannah shrugged. “Sometimes a young girl thinks about men, oftentimes a certain man in her life… Perhaps?”

Savannah blinked, a barely discernable nod.

“Did I pass the test?” she peeped.

 “Good enough.” Stein rubbed his chin, glancing at Frank. “You’re almost nine and a half,” he continued. Now, he sounded serious, his gaze fixed on Savannah. “That’s very young for a decision affecting the rest of your life.”

Visibly anxious, yet right off the bat, Savannah made good eye contact. “I want to transition more than anything, Sir.”

“You wouldn’t be here if you didn’t.” Stein leaned forward. “My question is, are you ready to start the process?”

“Yes.”

 “We’ll see. How old do you think most of my patients are?”

“Older than me.” Savannah giggled, glanced at Grampa, gave a nervous little shrug, and said, “I don’t want to go through puberty, Dr. Stein.”

“Trust me, all of my patients want the same thing. Have you started puberty?”

Savannah shrugged, clearly expecting Mom to answer. She didn’t.

“Are you embarrassed about being seen naked?” Stein asked.

“Uh uh.” Savannah managed a weak smile. “I guess I’m used to doctors looking at me down there.”

“Well, you have two people here who love you very much. I’m sure they’ve seen you naked before, so they know things are kind of messed up.”

Savannah nodded, her gaze lingering momentarily on her grandfather.

“If you want you can just open the front of your robe. However, given what’s at stake, Savannah, I want you to be really brave, and do something for me.”

“I’ll try.”

“I’d like you to stand up and show us what doesn’t belong on your body. You don’t have to look at it, just point,” Stein added reassuringly.

Sucking in both cheeks, and glancing between Karen and her grandfather, Savannah stood, unknotted the cords on the hospital gown, allowed the sides to apart, and pointed.

Stein reached across the bench, a lone finger stroking Savannah’s bare thigh. “You’re very beautiful. It would be a pity to waste what Nature has provided so generously.”

Of course, unwanted boyhood wasn’t what Dr. Stein meant. Savannah was beautiful, without flaw, Not even a freckle dared to spoil perfection.

For a moment or two, Frank feasted his eyes on Savannah’s nearly nude body. He quickly looked away, focusing on window spots until the urge to peek took over.

Still immature, Savannah was as much girl as boy, except for down there. What nature provided in the boyhood department was adequate, not overly generous. An inch and a half in repose, it hadn’t grown much, if at all, since toddlerhood.

It was then, with Savannah standing up, still pointing, exposed for the world to admire, that Stein finally turned his eagle eyes on Karen.

“This is as good a time as any. I need both parents to consent to Savannah having the initial operation.”

“I agree,” Karen said simply.

“You do realize the consequences?”

“The outcome is absolute. We’ve talked about it a lot. Savannah and I agree.”

He glanced at the open file, flipped to the next page, and looked directly at Frank. The last time he’d seen saw her naked, he hated the thought, maybe worst thing that could happen.

“I’m waiting to be convinced it’s in Savannah’s best interest,” Frank said.

“Good enough.” Stein hesitated as if Frank should pay particular attention. “Savannah’s very worried about starting puberty. You attended her last examination, Mr. Martin. Is everything about the same?”

Forced to look again, a tremble in Frank’s heart produced a heated flush and a sudden surge of blood. He leaned forward, inspecting Savannah’s gorgeous body. A perfect little penis confronted him. Still limp, Savannah’s boyhood was circumcised more than halfway down, a full half-inch of pink inner skin preceding the glans. Cut so tightly, the tiny helmet was very exposed, nothing like his acorn-ringed glans.

“I think his… The balls are slightly bigger,” Frank got out, on the edge of mumbling.

Perfect smaller-than-peanut testicles dangled underneath.

“They were one milliliter in December,” Stein read from his notes. “Savannah, I’m going to examine the parts that don’t belong on your body. Some of my patients look at their cellphones to take their minds off it. If you like, you can, too.”

“I’m okay.”

He reached out. Right in front of Frank, he fondled Savannah’s little pink scrotum. Savannah didn’t seem to care, even with both testicles caught between the doctor’s thumb and first two fingers.

“Two milliliters on the right. The left is slightly smaller,” Stein remarked offhandedly. “Savannah is still prepubescent, what we doctors call Tanner Stage One. However, for a natal boy, the first outward sign of approaching puberty is a slight increase in the size of his testicles.”

“So it’s starting?” Karen asked.

“Getting ready to start is more accurate. Technically, a boy needs four milliliters to start puberty. I’ll check today’s bloodwork with her previous hormone levels to be certain. With your permission, I’d like to examine her further. It can be rather invasive.”

Frank was about to say ‘so is lopping off his genitals,’ until Karen glared at him

“You have my permission to do whatever is necessary to stop her from maturing, Dr. Stein,” Karen said, her eyes unwavering. “Including an orchiectomy.”

Stein twitched. “According to the latest research, puberty blockers are the preferred treatment…”

“I don’t want shots; not until I’m older, and then I don’t want big boobs,” Savannah interrupted.

The look on Stein’s face was worth every second of the 12-hour drive from Elgin.

“Other than stopping puberty, we think blockers make transition riskier, Dr. Stein,” Karen explained quietly.”

“I’m also of the mind that removing a child’s gonads is preferable,” Stein allowed. “However, it’s a big step, and irreversible, so we need to be absolutely certain.”

All this time, he fondled Savannah’s superfluous genitalia. His fingers invaded everywhere, prodding into scrotum, ascertaining internal structures, feeling around the penis, examining the shaft skin for elasticity. Fortunately, Savannah’s penis stayed limp.

“Can you fix it so I look right?”

Stein looked up, seeming pleased. “Don’t worry! By the time you’re ready to start dating, you’ll have the right body.”

“From what we’ve read, there may be neurological development issues if blockers are used long term,” Karen continued.

“Also, true. While the rest of the body keeps growing, certain parts don’t grow. When the times comes for her to fully transition, there’s less to work with.”

Sooner is better,” Savannah said with an uneasy giggle and a quick glance at Mom. “I’ll be all healed up when I go back to school, right Mom?”

Dr. Stein indicated for Savannah to sit on the bench while he turned pages in the file. “I see you’ve been examined by my ex-colleagues in Chicago. I can imagine how that went. Boston and Philadelphia, too? They do cutting-edge work with adolescents.”

Savannah’s head dropped at hearing ‘Chicago.’ Karen never talked about what the doctor said to her in private, only that it wasn’t good.

“Are you saying Savannah should wait six more years, plus skin grafts, to have a gender identity with a marginal sex life?”

As soon as Frank finished, he asked himself whether he’d really said it. Dr. Stein stopped making notes in the file and turned his gaze on him. So did Karen. Only Savannah’s head stayed down.

Unable to remain neutral, Frank grasped at straws. “Transitioning either way, at any age, the surgical outcomes mostly concern physical appearance, not performance.”

“Ouch!” Karen said under her breath.

“To a transgender child, aesthetics are crucial, Mr. Martin. It’s appearing to be the wrong gender that bothers my clients most of all,” Stein declared. “It becomes critical in certain cases. In Chicago, I attended several natal boys not much older than Savannah, who’d cut themselves. A friend’s son tied fishing line around his private parts.”

Karen blanched. Savannah blinked, determined lips pressed tightly together. Frank’s stomach turned.

“Self-immolation is not common; however, the possibility is always there. With kids communicating on Internet, it’s becoming problematic. It’s the only justification for early transition accepted by the medical profession, and the courts.”

“We’ll go to Thailand before that happens,” Frank said as calmly as he could

Stein broke the silence. “Savannah, I want you to lie back and bring your knees up. I want to show you what surgery involves. Then, you can tell me if it’s right for you.”

Savannah scooted to the center of the bench, assuming a laid-back position, feet lifted up and placed near her bottom, a position all too familiar for a transgender child. Stein took a black Sharpie marker from his shirt pocket and leaned forward.

“As you know, Savannah, to transgender successfully we need to eliminate gonadal function prior to puberty. Do you understand what this means for you?”

Savannah nodded, having heard doctors describe it any number of times.

“I have to get ungendered before I change genders.”

“Ungendered is a good way of putting it. For the next six years, you’ll be in transition. With your clothes on, everyone will think you’re a girl. Undressed, you’ll still look like a boy.” He nodded down. “If it’s done with hormone blockers...”

“I don’t want blockers.”

“I understand. There’s an alternative, as I’m sure you know. For a natal male, the testicles are removed by bilateral orchiectomy with a single mid-line incision. You’ll be medically castrated.”

She nodded again. Frank closed his eyes, inhaled, and let it out slowly.

“The incision is closed with micro-sutures and Cyanoacrylate, surgical glue, so there’s almost no scar. Later, your scrotum is converted into labia, which we call ‘Stage Two.’ However, most of my patients opt for vulva conversion of the scrotum in the initial operation.”

“Mickey’s at Stage Three already.”

“She’s taking hormones to develop breasts and a female body type. Her penis will remain intact until Stage Four.”

“I want a vulva like Mickey’s,” Savannah declared.

“In that case, the primary incision will be a partial circumferential….”

He drew a U-shaped line beginning near the junction of Savannah’s perineum and thigh, to the underside of her penis, and ending on the opposite side. The ‘U’ included all of Savannah’s scrotum.

“The scrotum is retracted to expose the testicles. A simple orchiectomy costs $2,000. It’s included in the deposit you paid.”

“Just to remove the testicles?”

Stein looked down his nose. “I’m sure a vet charges a lot less. Our Stage One is a subcapsular orchiectomy, which is considerably more difficult. Some doctors will do a radical orchiectomy, removing the entire testicular structure though the inguinal canals.”

“I don’t want scars on my tummy.”

“Neither would I, Savannah,” Stein said.

He took a page from the file; a copy of Plate 1144 from Gray’s Anatomy displaying the male genitalia in detail.

Male genitals, Plate 1144. Gray's Anatomy of the Human Body, 1912








“It’s a little old-fashioned, however, it serves the purpose. Plus no one can accuse me of providing pornography to a minor.”

Using the Sharpie as a pointer, Doctor Stein continued.

“I incise the parietal layer of the tunica vaginalis to expose the inner testicle. I peel away the epididymis, here and excise the testicular gland, leaving functional cremaster muscles. Along with the spermatic cords, they provide fleshy tissue for the labia. I could create the shape and texture with silicone implants, but without any sensitivity. Leaving it intact is worth the extra effort, and the cost.”

Scared stiff, Frank reacted. “I didn’t realize he’d have micro surgery to become a she. No wonder it costs so much”

As bad jokes usually go, his fell flat; absolutely flat.

Without showing any emotion, Stein looked at him. “You ever asked yourself why Savannah wants to be a girl, Mr. Martin?”

Frank tried to shrug it off. Stein was a urologist/physician, not a psychiatrist.

Despite what you think, gender dysphoria is not a superficial mental disorder. It is a human anomaly with profound neurological differences behind it. Living in the wrong body causes extreme anxiety and social isolation. The good news is that so far Savannah has escaped the loneliness and harassment most T-G kids go through.”

 “I don’t see the need for surgery when blockers can slow everything down,” Frank injected.

I don’t want blockers,” Savannah murmured.

Puberty is only part of the problem, Mr. Martin. Her natal parts contradict her self-image. That’s why 95 percent of my gonad-removal patients also have a vulva conversion,” Stein said flatly.

So some kind of gender hybrid; neither boy nor girl at age nine. I keep asking myself why. Why not in a few years?”

She despises her private parts, Dad. A vulva is a big step in addressing that.”

She’s nine, damn it!”

Puberty could start any time. Why punish her when there’s an alternative.”

Frank inhaled. “I agree it makes sense to slow things down.”

I don’t want blockers, Grampa!”

I know, but just for a year or two. Why is keeping them so bad?”

Dad, why put it off any longer? We both know it’s the best thing for her.”

What if she changes her mind in a few years?”

I won’t!”

He shifted uncomfortably. “There must be an alternative to lopping them off.”

Stein frowned. “Mr. Martin, if we’re only concerned with the permanent loss of testicular function, it can be done by injection. There’s some swelling immediately afterwards and a little discomfort, but that’s all.”

Frank stared back at him. “Sounds like it’s an option to think about.”

 “Subcapsular orchiectomy removes the actual testicles; an injection does not. Savannah’s fully aware that boys have testicles and girls do not. Even though injected testes are about half-to-two-thirds smaller, negative body image issues remain. Believe me when I say castration is essential for Savannah’s mental well-being; now, or six years from now.”

Frank cringed at hearing ‘castration.’ He stared down, unable to look at them.

“Trust me, Savannah will be a great deal happier, and less anxious afterwards.”

“The same reason geldings are calmer.”

I offer vulva conversion with castration for a reason,” Stein continued. “Whether from an orchiectomy or injections, the scrotum eventually shrinks and flattens.”

“Isn’t that enough for body image? She’s a kid, for God’s sake.”

Stein closed his eyes momentarily. “Her body image is the issue, Mr. Martin, not your perception of what she should, or shouldn’t look like. By using the currently available skin and the orchiectomy remnants, I can fabricate a very attractive vulva.”

“Why couldn’t you do that when she’s 16?” Karen asked.

“There needs to be enough scrotal skin to form both inner and outer labia.”

“Labia; that’s important, huh?” Even saying the word was hard for Frank.

Savannah grinned. “Mickey’s vulva’s is sweet, isn’t it Mom?”

“And it’s functional, too,” Stein said. “Because the scrotum is developmentally homologous to the labia, it’s ideal. The smooth skin and fatty tissue feel the same. The testicular remnants and scrotal skin make most of the outer labia, while the dartos fascia, that’s muscular tissue under the skin, makes excellent labia minora. It’s also very sensitive, so it’ll be a continuing source of pleasure for her.”

“So, $2,000 for no balls, $5,000 for parts left over, or $15,000; after which my grandson’s scrotum becomes labia, which supposedly feels good.”

“Dad!” Karen nearly shouted.

Still, he felt better after saying it. “What about his penis?”

“Grampa, please don’t get upset,” Savannah whimpered, trying to sit up.

Stein remained calm, one hand on Savannah’s upper arm to keep her down.

“Stage Two works around it, Mr. Martin. If you opt for vulva conversion, secondary incisions are made here, and here, to complete the pudendal cleft.”

He drew indelible curved black lines on either side of Savannah’s penis.

“Using the excess scrotal skin, I extend the labia and create a small clitoral hood above the penis. Essentially, her entire external vulva is fabricated. It’ll be quite sensitive, more than enough to make a young lady happy.”

Savannah made a face, silly enough that both Karen and Frank smiled.

 “Leaving Savannah’s penis until Stage Four looks a little strange until you get used to it. However, at this point in her life, its role is minor. She just needs to be careful who sees her.”

“What if vulva conversion isn’t done at Stage One?” Karen posed.

“Gender conformance is the issue.” Stein regarded Savannah. “If she opts for injections or a simple orchiectomy, the scrotum will shrink.  ”

“Noticeably?”

“Within a year, it’s unobtrusive, in some cases, inconspicuous.”

“So a positive self-image?” Frank posed.

“It’s possible it will be small enough.  However, her vulva will be minimal as a result.”

“I’m okay with a small one,” Savannah peeped.

“If for any reason she elects to remain male, there’s usually sufficient skin for restorative surgery and testicular implants.”

“What about erections?” Karen asked, clearly a prickly issue.

 “All my patients tell me they’re happier afterwards,” Stein chuckled. “The frequency diminishes after orchiectomy, especially spontaneous erections.”

“Why not all of them? If there are no male hormones…” Frank inquired.

“The sensitivity remains. The penis will still respond to physical stimulation. If it happens, it’s best to ignore it.”

“There’s an idea,” Frank grumbled.

Stein took a breath. “In Stage Four, the penis is removed and the urethra is relocated. The penile sheath creates her vagina. I use the glans to make her clitoris. So around 16, her masturbation becomes even more enjoyable.”

“And if she has a sex partner before that, their pleasure comes from what, exactly?” Frank began, ready to go again.

“Until her vagina is functional, I recommend she focuses on her partner’s body. If he desires access to her privates, I advise fondling and intercrural rubbing on her labia, or the scrotum if it’s still intact.”

“How long is Stage One recovery, Doctor?” Karen asked, anything to get off the topic.

“It isn’t major surgery like Stage Four. A basic orchiectomy requires a day in bed. She’ll need to be careful for a few days.”

“And a vulva conversion?”

“I recommend a week in bed, and another week taking it easy. After two months, you can’t tell there was an operation.”

“And how long with injections?” Frank posed.

“She’ll be sore for a few hours afterwards; nothing a kid’s aspirin can’t take care of. The same when the testes are swollen. There’ll be almost no change in her normal activity.”

“What about sexual activity, Dr. Stein?” Karen inquired.

“It’s a crazy world when I can do the surgery, yet it’s illegal for me to advise you.” Stein had a nervous tic, enough to make his head shake. “Just between us, okay? Stage one, light play is fine. Once the sutures come out, back to normal.”

“And Stage Two?”

“The stitches will be gone by the third week. After a month, if she needs to, she can masturbate by rubbing her labia. She should apply an antibacterial ointment beforehand.”

“I didn’t mean when as much as generally?”

“When she’s ready, if her boyfriend wants penetrative intercourse, oral sex is the recommended way to go.”

Maybe Karen was happy with that; Frank certainly wasn’t.

He lost it. “What about Stage Four, Doctor? There’s a world of difference between pussy and penis skin turned inside out.”

He stopped, aware he’d gone way too far.

“You’re absolutely right, Mr. Martin. Savannah’s sexual fulfillment, and her partner’s, is a matter of great concern to me, and I’m sure to you and Karen, as well.”

“I hope other parents are as concerned,” Karen said, very abruptly for her.

“Unfortunately, there are several problems with fabricating a working vagina, not the least being a lack of natural lubrication. As young as she is, the Cowper’s Gland will never develop so there’s no preseminal fluid.” Stein cleared his throat. “Also a natal male has poor muscle control in the genital region compared to a female.”

Savannah made a face at her mom.

 “As you’re well aware, without testosterone, Savannah’s penis won’t develop. At 16, it won’t be significantly larger than it is now. Without skin grafts, her vagina will be rather small. That’s the tradeoff for terminating puberty before it starts.”

“How small, Doctor?” Karen asked, never so unsure of herself.

“It would be longer if Savannah hadn’t been circumcised. The high and tight style makes it worse. With regular stretching, her vagina will be big enough to insert a finger, definitely not a mature penis.”

“Mom?” Savannah peeped.

Stein gave Savannah a reassuring smile. “Personally, I’d recommend leaving her penis intact. I know that’s not what you want to hear. Still, it’s not the end of the world.”

“So I can’t have sex in front?” Savannah blurted.

“Your rectum can provide a satisfying alternative. However, there’s no guarantee.”

Frank very nearly cheered. “Honesty at last!”

“Most gender-change doctors won’t tell you; in terms of sexual satisfaction, it’s far better if she’s gay,” Stein said seriously.

Frank felt his cheeks flush. “Why?”

“I’m surprised. She knows, but you don’t know.” Dr. Stein smiled at Savannah and took a breath. “Anal sex is satisfying, extremely satisfying with practice.”

“You’re saying she’ll have orgasms back there?” Frank asked, reddening further.

“Jesus, Dad! It’s why gay guys do it.”

“Even now, Savannah’s prostate gland, while a long way from maturity, is very sensitive.” Stein hesitated. “I’m a little worried this conversation is confusing Savannah.”

“Trust me, she knows almost everything there is to know about anal sex, Doctor,” Karen interjected.

“I’d still like to go over the basics.” Stein lifted another page from his file, holding it so Savannah could see. “This represents a boy a few years older than you, assuming everything stays as it is right now.” 

Savannah nodded, sufficiently detached not to blush.

“A boy’s penis and testicles grow bigger once he starts puberty,” Stein pointed out.

“I know. I don’t want that!” She was adamant; even Frank could hear it.

“There are other changes, too, so he’ll look like a man.”

Savannah exhaled. “It’s why having the operation as soon as possible is so important.”

“You’d like a boy to fall in love with you, though, wouldn’t you? Maybe marry him, when you’re older, of course.”

She shrugged, her head down.

“You know all about being gay. Can you show me how two boys do it?”

Savannah’s index finger pointed. “It goes in here.”

“How far in?”

“Pretty far.” She glanced at Mom. “Until it stops.”

“Well, the basic idea is right.” Stein smiled encouragingly. “It’s important you understand what’s involved in transitioning sexually. Is it okay if we talk about it?”

When Savannah offered a noncommittal shrug, Stein turned to Karen.

“I don’t know how much you’ve told your daughter. There’s a big difference between theory and practice when it comes to anal intercourse, and orgasms, too, for that matter.”

Karen promptly nodded. Stein looked to Savannah, who wasn’t about to say anything. Even pointing at the picture was embarrassing.

“A lot of my patients are already having anally induced orgasms before they see me,” he confided.

“I haven’t, but my friend, Mickey, she has them,” Savannah confided.

“She’s a very lucky girl in that respect. Would you like to have one? Just to see what it’s like.”

Savannah looked at her mom, who nodded again for her.

Then, Stein turned to Frank.

Frank exhaled. “Do you really have to do this? Can’t we just assume it feels good, or whatever, and move on?”

“The ball’s in your court, Mr. Martin, whether you like it or not. I require both parents to agree to anything involving the child.”

Frank almost said no. Only Savannah’s desperate look stopped him. “Please,” he said simply.

Stein stood. “Savannah, if you want to do this, you’ll need to remove the gown and get on the bench. You’ll probably want to be facing the window so you don’t get embarrassed.”

He walked to his desk, took something from the drawer, pulled on a pair of blue neoprene gloves, and returned. Savannah was already naked.

“I need you on all fours for this; that’s knees and elbows.”

She got into position, long golden curls flopping on the padded bench. Stein sat on the edge of his chair, each hand cupping a pale little buttock, both thumbs pressing into Savannah’s crack.

“Hm, that’s interesting,” he murmured.

Karen was quick to ask, “What is?”

“Nothing really; it’s just a bit dark, that’s all.”

Stein seemed distracted as he squeezed a long bead of glistening KY lubricant along his first finger and smeared it over thin, elastic neoprene. Then, with first and middle fingers side by side, he squeezed out a big glob across both fingertips. With his other hand, prizing Savannah’s plump little buttocks apart, he deposited the shiny blob directly on target.

“Cold!” Savannah gasped, burying her face against her forearm.

“Not for long.”

Stein gave a funny little giggle, his fingers rubbing ever so slightly. When Frank finally glanced up, Karen was staring, watching the doctor push KY jelly into Savannah. It didn’t seem to bother either of them, not at all. Now, that was creepy.

“Let’s see what your boyfriend will have to work with,” Stein muttered.

With his fingers apart, he began to massage Savannah’s little anus, stretching the rim one way, and then the other. He wasn’t trying to penetrate, yet any way that Frank looked at it, the doctor was molesting his grandchild.

“Nice and flexible,” Stein murmured. He glanced up abruptly, immediately aware of Frank’s unwavering gaze. “You can stay or leave, Mr. Martin. It’s entirely up to you.”

Frank nodded, reluctantly telling himself that if Savannah didn’t mind, why should he. He would’ve intervened otherwise.

“Her opening’s very small; inside will be too, I expect.” Stein wriggled his finger to demonstrate. “The good news is flexibility is as important as size at her age.”

Intimidated, Frank demanded, “Just how big does it need to be?”

“At her age, three centimeters dilation is adequate for sex play. That’s an inch and a quarter, more than enough for fingers to explore. Of course, the average adult penis is thicker, however foreplay will stretch it.”

“Jesus,” Frank murmured.

“Three’s small for my younger patients, Mr. Martin.”

“Meaning they’re past sex play,” Karen concluded.

“Four centimeters is typical when they’re sexually active. With four, there’s room to move around, really give the rectum a workout,” Stein said, suddenly very unprofessional. “Right now, it’s a major stretch to get near two centimeters. She’s got a long way to go.”

To prove it, he widened the gap, making the skin taut. Skin ribbons replaced pucker until Frank saw crimson. There was a dark void farther inside Savannah.

“Savannah, I’m going to insert my finger into your bottom. You’ll feel it enter your anus. Right away, I want you to take a deep breath and relax. Don’t panic if you feel a little strange. Just relax. Don’t squeeze and it’ll slide right up. If you try really hard, you can control the muscles inside you.”

“Okay. Oh! Ow!”

“That’s my fingertip. It’s barely going in. I want you to focus on the sensation and try to relax.”

Frank placed his hand on top of Savannah’s hand, his thumb stroking gently, his little finger playing tag with the delicate wrist bracelet.

“Tickles.”

“Just relax,” Stein murmured. “Yes, exactly like that.”

“Owww.”

“There it goes. Just relax. Can you feel it inside you?”

“Kinda. Your glove feels weird.”

“Just a little bit farther. Does that feel nice?”

“Uh huh.”

“How about this?”

“Ahhhh. Mm. Mmmm. It’s nice right there.”

 “I’m going to move my finger around. I want you to squeeze on it and move your bottom around to make it to feel good. Yes, like that.”

From where Frank sat, all he could see was Stein’s wrist rotating, his fist pressed into Savannah’s crack. No doubt, his finger was torqueing inside Savannah. Every few seconds Savannah whimpered softly, pushing back, little hips wriggling constantly. One thing was certain; she was utterly content.

Stein had a self-assured smile. “She’s more than sensitive enough. With care and practice, she’ll have anal orgasms.”

“That’s really important, Savy,” Karen said, sounding relieved.

“It’s a good start, Karen. The more important issue is whether she’s anally receptive.”

“Meaning what?” Frank demanded.

“Being penetrated requires not only being big enough; she needs a strong desire to have her partner inside her. Not everyone enjoys it.” Stein chuckled. “Some transgendered girls resist anal sex, or tolerate it. Still, I’m always surprised how many think it’s the best thing ever invented.”

“My friend, Mickey, likes it.”

 He patted Savannah’s shoulder with his free hand, in no hurry to pull out his finger. “I know. She calls it ‘fireworks going off.’”

The same was true for Savannah, who seemed incapable of not twitching erratically. Occasionally, something would make her shudder. The dazed look on her face bothered Frank until he realized. It was bliss, plain and simple.

From that simple act of pleasuring, it struck Frank Martin that Dr. Stein was actually very supportive, a far cry from the kind of fake sympathy he’d witnessed from other doctors. It was more than merely reassuring a young patient, more than understanding the ‘problem’, far more than compassion. Dr. Albert Stein cared, really cared about Savannah’s happiness.

Karen posed the question Frank wanted to ask, but dared not for fear of the answer.

“How does Savannah compare?”

“She’s naturally submissive, so the psychological barrier isn’t there. Other than that, we won’t know until it actually happens.” However, Stein glanced at Frank as if he already knew. “I suspect in Savannah’s case, it’ll depend on who does it.”

“What does that mean?” Frank demanded, holding down panic.

Stein wriggled his finger, pushing in all the way. Savannah twitched and appeared to push back. Stein nipped the other glove with his teeth, and ripped it off with a snap.

“After reading her essay, I’m certain her sexual orientation will be to older males.”

Taken aback, Frank gaped as Stein reached underneath Savannah, grasping shameful boyhood. Highly aroused, it was a stubby bone sheathed in tightly stretched skin.

“Ah. Ahhhh.  Ah.  Ahhh.” Scarcely gasps, the cause blatantly obvious.

 “Essay?” Frank murmured, grasping at straws as panic closed in again.

“Later, Dad.”

“Now, now, Savannah. I want you to relax. It’s not unusual, Mr. Martin. An older partner complicates her situation. It doesn’t change it,” Stein added remotely.

 “And I was beginning to think he might be straight,” Frank blurted out.

Karen glowered back. “For the last time, Dad; *she*!”

Stein also frowned at him, now fondly stroking Savannah’s back with his other hand, trailing fingertips down to the start of her rump.

“Mr. Martin, do you seriously think she’s not sexually aroused by men?”

“You want to know what I think?  Savannah is a great kid who’s a little mixed up,” Frank challenged. He had to resist, for both their sakes.

“Jesus, Dad! What planet are you on?” Karen snapped.

“It takes more than modeling unisex clothes to mean she’s queer for men, Karen.”

Stein began poking around inside Savannah, exciting something because she suddenly shuddered and gasped.

“The word is gay, Dad. If you must know, the doctor in Chicago gave her some kind of psych test. He’s 100-percent certain she’s gay.”

“An essay and a test; that’s proof, right there!” Frank grumped, hoping Savannah would poop on the doctor.

Karen rolled her eyes. “Are you that blind? She’s dressed to the nines whenever you come to visit.”

“Mom, you promised,” Savannah muttered.

“It’s okay, Honey.” Karen took a breath. “She wants you to notice her, Dad.”

“She likes dressing up,” Frank snapped. “Always has.”

“And the thing that keeps popping up when you cuddle her?”

Frank gulped, his face on fire. “It happens to all boys, gay and straight.”

Perhaps Savannah could see something funny about the situation, even if her grandfather couldn’t. Still on her hands and knees, with Stein’s index finger jammed up her ass, she giggled strangely.

“Savannah, settle down,” Karen said firmly.

Savannah was sneaking peeks at her grandfather, not even a little bit embarrassed. Frank didn’t know what to say. The very thing that he’d been trying to avoid was now out in the open; however, Karen seemed totally unaware, or didn’t care.

Stein deftly extracted his slippery finger, yanked off his neoprene glove, and twisted it into a misshapen ball.

“The good news is she’s very responsive to stimulation. I could feel her straining down, the usual trembles, a couple of initial spasms. Those are lead-up signs. I’m certain she’d orgasm if I kept on.” He hesitated, a quick glance at Frank. “She’s also not as tight as I expected; which leads me to the next question. Does Savannah have a boyfriend?”

Karen answered. “She’s nine and a half, Doctor.”

“I have gay friends who are boys,” Savannah interjected.

“He means someone older than you, Silly. A lot older than Raoul,” she added, anticipating.

 “Correct me if I’m wrong; I assume she’s never had intercourse.”

“She hasn’t. At least not to my knowledge,” Karen added quietly.

“This is not about prying into her private life; however, with precocious gender dysphoria, anal sex often precipitates identity issues.”

Dr. Stein glanced at Savannah. She abruptly shook her head. Frank kept his head down, afraid he’d blush if he as much as breathed.

Stein rubbed his forehead. “I apologize, but I have to ask. I never undertake transitioning unless I’m absolutely certain the patient will lead a full and satisfying sexual life afterwards.”

Karen gaped at him. “At nine?”

“My patients are usually a few years older.”

Finally, Frank looked Stein in the eye. “What exactly, are you looking for with Savannah?”

“I need to know the operation is right for her, Mr. Martin. That means she’s had anal sex often enough to be fully orgasmic, climaxing often and without difficulty.”

“How?” Karen muttered.

“I should think the how is obvious.” Stein paused. “Unless she’s already sexually active, it’ll take time. The more preparation the better; then, some practice to develop skill. After that...”

“How many times?” Karen asked, not at all embarrassed.

Frank was mortified.

“I never said any of this. There’s a reason why they say three times proves it. Half a dozen would be reassuring, plus it shows her partner’s commitment.”

No longer anxious, Karen nodded, her gaze fixed on Savannah.

“She’ll need an understanding partner to get to where she needs to be. Maybe there’s a gay man in the family. If not, perhaps you have a close friend who is. It won’t be easy; most gay men won’t touch kids.”

“Do you know one who will?” she asked uneasily.

“Karen, it’s better if I don’t know who, or what happens beyond this point. What you and Savannah do when you leave here is not my business. However, I will say my gardener has a thing for boys, mostly maricóns from the beaches. He may have the patience and care to work with her until the pain goes away.”

“I’d prefer he wasn’t a stranger.”

“I agree. Far better, you find someone you can trust, a business associate who knows and understands, perhaps?”

“I understand.” She took a deep breath. “Where does this leave Savannah’s operation, Dr. Stein?”

“She’s as stable as any child her age. However, because of her age, I also have reservations. The good news is the right experience will take care of it. Getting it is entirely up to you. Her T-G Kit will have what she needs to start preparing. The stretching process is key.”

A much-relieved Savannah finally giggled. “T-G stands for transgender, huh?”

“Actually, T-G stands for transgender girl, like you. While there are lots of tomboys, we don’t see many transgender boys. They use a T-B Kit.” Stein turned to Karen. “Patience is key. Even if she starts today, it might take two weeks before she’s ready. Once she is, the rest can occur fairly quickly. A day or two at most.”

Frank stood, ready to leave. “What does that mean?”

“It means whatever you want it to mean, Mr. Martin.”

“You’re not being very helpful.”

“Most of my young patients are in the same situation. It’s one of the reasons why we have an app for both iPhone and Android devices.”

“I have an iPhone,” Savannah declared.

“And so do I,” Stein said jovially. “Just download the app from our website and start using it. It’s like an owner’s manual; plus you can text other kids who are like you. It also allows us to follow your progress.”

Frank fumed. “We get an app? That’s it?”

“The best thing you can do to help Savannah is support her, Mr. Martin.” Stein regarded him with eyes narrowed. “It’s important to follow the directions closely. Very closely.”

Frank exhaled.

“Once she’s had the necessary experience, we can proceed with the orchiectomy, with or without a vulva conversion. I know you’re all disappointed. I’m sorry.”

“What about her surgery on June 24th?” Karen asked.

“Given the circumstances, 20 days is a very tight schedule. More likely, it’ll be a few months before I see her again. If you like, I can provide a GnRH-analogue to suppress puberty.”

“She hates getting shots,” Frank growled.

“In that case, she can use a nasal spray. I have samples so there’s no charge. One squirt twice a day will stop things from progressing. Still, email me right away if you notice her testes getting bigger.”

 

WHO WOULD’VE THOUGHT JUNE 4, 2018, WOULD BE SUCH A LONG DAY?

TIME TO TAKE A BREAK! GET SOME POPCORN! WHACK THE WEENIE!

SEND MONEY TO NIFTY!

WE WILL RETURN TO JUNE 4TH SHORTLY. BUT FIRST, SAVANNAH NEEDS A BARF.