The Lifetime Injection
“Are you trying to play word games with me right now?!”
“That’s not what I meant. Please calm down and have a seat. Walter, you too—step back.”
“……Yes, Director.”
I soothed Walter, who had stepped in front of me, and sent him to the back. Minsia began to rein in her rippling blue aura. With a gesture, I urged her back to her seat and continued.
“Theoretically and technically, the surgery is possible. But I’ve never personally performed it, nor do I want to—that’s why I said I can’t do it.”
To be honest, it wasn’t that I had zero experience. I just never initiated it; I’d only done reconstructive surgeries for the complications. But I saw no need to mention that. No amount of money would make me perform a surgery that harms health.
“‘Don’t want to’? What kind of nonsense is that?! Didn’t I offer you a fortune?! Even without experience, if you know the method, just do it!”
As the head of a great family—the supreme matriarch above all matriarchs—her words couldn’t be empty. Which meant I should be the one raising my voice and frowning, not her.
“That fortune……I’d love to have it.”
“Good, then name your price. Just say it.”
“It’s not about the money. Or the technique. The issue is the side effects are too severe for me to perform it.”
“……Side effects? What kind? You saying I’d turn back into a woman afterward?!”
No, old timer. This isn’t a game character—you can’t just switch back.
I let out a silent tear for the gold-scented vibration at the edge of my nose and fixed my gaze on Minsia. It was time for a detailed explanation of the risks.
“Before the side effects, let me give you the basics on this surgery. The official name for what you want is gender reassignment surgery. In simple terms, it changes a man’s body to a woman’s, or a woman’s to a man’s.”
“Heh, surgery to switch genders……Hard to believe even hearing it.”
Her face showed astonishment, and her eyes sparkled with hope that she could return to her original form. Now I had to crush that expectation.
“First, before gender reassignment, you need hormone therapy. Hormones are substances that circulate through the body with fluids, stimulating or suppressing the functions of other organs and tissues.”
“Hmm……Like qi, then?”
“I don’t know much about qi……but the basic principle is similar, so you can think of it that way.”
Schk—schk—Minsia might wield supreme martial arts, but her comprehension was no different from an ordinary person’s. So I pulled out the tablet from my office desk and began drawing a male human figure while explaining.
“Men and women have different hormones. For a man transitioning to female, you inject female hormones. In your case—”
“I’d need male hormones, right?”
I nodded at her interruption.
“Yes. Hormones are incredibly powerful. They affect not just body shape, but personality and drive too.”
I’d started with hormone therapy for Minsia, but in Korea, there’s a prior step: a psychiatric diagnosis of gender dysphoria before hormones. Given her bizarre situation—transformed by black magic—I skipped that explanation.
“Heh……Hormones sound more magical than potions. So the gender surgery comes after hormone therapy?”
“Correct. At least six months, minimum.”
Surgery from male to female is called MTF—Male to Female—and it demands a long, grueling process.
“But that’s the bare minimum; I recommend 1-2 years for near-complete physical changes.”
I’d simplified it greatly, but MTF is no joke. It’s life-risking: facial feminization, Adam’s apple reduction, voice surgery, orchiectomy, breast augmentation, and more.
“Does transitioning from a female body like mine follow the same?”
“Hormone therapy starts it off, same as always. For you, we’d administer male hormones for about a year to reverse female secondary sex characteristics and develop male ones.”
From female to male, like Minsia’s case, it’s FTM—Female to Male. Statistically, MTF seekers outnumber FTM by about 3:1 worldwide. Yet FTM patients are harder to spot post-surgery—they just look like shorter men—while MTF stands out more.
“After a year of therapy, menstruation stops, breasts shrink, fat turns to muscle, and male-pattern body hair grows. Then we proceed to the main surgery.”
“Hmm……How does the surgery itself go?”
“FTM costs far more than MTF. So many opt for partial—like just mastectomy.”
If MTF is a domestic car, FTM is an imported luxury exceeding millions. That’s why some go to Thailand or similar spots. But botched jobs abroad lead to complications needing reconstruction—and that’s where I came in.
“If money’s no issue, like for you, we could combine mastectomy, oophorectomy/hysterectomy, phalloplasty, and urethroplasty. But typically, mastectomy first, recover strength, then lower surgery. And……”
Since FTM was her goal, I went into more detail than for MTF: laparoscopic scars from ovary/uterus removal, nipple resizing, etc.
Damn, talking about it brings back those quack memories.
Reconstruction always pissed me off. Midway through explaining to Minsia, my worst FTM case resurfaced.
She’d gone abroad for FTM, loved men—and ended up pregnant. Her belly swelled; she thought illness, but no.
How do you do FTM without vaginal closure?!
Leaving fallopian tubes, ovaries, uterus intact without closure caused it. No periods meant no natural cleansing; vaginitis and tumors followed. Untreated, FTM risks that highly without closure.
Thank God the baby was fine.
I steadied my spiking vitals from the memory and pressed on.
“Another key is urethral construction.”
“Urethral……construction? Making that?”
“Yes. We use body tissue—traditionally, a tube grafted inside the forearm matching phallus length, then peeled off. Basically, stripping most forearm skin. Painful, and you carry the tube for a while.”
“Hmm……Tube on arm or thigh for a time……”
Old methods scarred forearms like burns—often tattooed over. Now, tech allows thighs, calves, latissimus dorsi—outer thigh preferred.
Plus, FTM or MTF, sex post-op rarely feels like pre-op. Often permanently dulled.
The saying “a man with spoon-holding strength thinks that way” fit, but my Confucian bones rebelled at telling a septuagenarian.
No need. It’s not my main reason for refusing anyway.
Breaking the brief silence, I explained why I don’t do gender surgery.
“That’s not all. Your desired FTM risks hyperlipidemia, cardiovascular issues, hypertension, liver toxicity, sleep apnea, baldness, and more.”
FTM also spikes insulin (diabetes), acne, breast disorders, endometrial/ovarian issues, triglycerides. MTF: clots, hypertension, cardiovascular, breast cancer, nausea, migraines, depression, appetite loss, glucose intolerance, hyperglycemia, gallstones, elevated liver enzymes.
Minsia’s face darkened as I continued.
“But my biggest concern is the hormones.”
The lifelong injections essential to gender surgery have massive issues—whether taken or not.