(seems like it's a little puppy.)

a lot of my ritual behaviors are "checking"

self-guided ocd exposure therapy can be as simple as resisting the urge to check if your door is locked more than once and sitting with the discomfort until it passes without engaging in any reassurance rituals.

it can look like sending an email and resisting the urge to re-read it over and over again obsessing over your wording, sitting with the discomfort until it passes without engaging in any reassurance rituals.

some of my rituals are also "avoidance"

in which case it can look like checking your email inbox you've been obsessively avoiding because you're anxious about receiving a specific email you don't want to see.

and YEP! ☝️

!!!

it might be hard to believe, but learning distress tolerance for things like "checking" with emails and door locks actually prepared me for the Big Ones like harm and sexual OCD themes.

I think this article from 2007 is a good introduction to the basic concepts of exposures:

that SAID, a lot has changed since 2007! the idea that exposure therapy can (or even should) prevent fears from every happening has come into question!

now the conversation about OCD exposure has turned to training distress tolerance:

...rather than aiming for the decline of anxiety (habituation) during exposure, the inhibitory learning approach to ERP teaches people how to be open-minded toward experiencing anxiety and fear when these experiences inevitably show up. Indeed, fear and anxiety (and other emotions in OCD such as disgust or guilt) are universal and even adaptive experiences, not something that need to be “fixed” or gotten rid of. Most importantly, even if they can be unwanted, intense, and distressing, these emotions and thoughts are safe. From an inhibitory learning perspective, fear extinction (and long-term improvement in OCD) depends not only on learning that feared stimuli are safe, but that it is also safe to experience the emotional response that is triggered by these stimuli.

And remember at the end of the day I AM NOT a specialist. I am discussing my own OCD journey and referencing the available material on OCD exposures.

I'm not always right, and I can't know what's best for you.

Which is why I haven't recommended any of the old workbooks I've completed, because some of them are old enough that there are better ones to follow that I haven't gotten to trying yet!

I recommend doing your own reading from OCD-aware organizations:

a neophallus can get erect with an implant (this will either be a bendable rod or a device that inflates with saline at the press of a button, usually in the testicles)

both can feel sexual pleasure and experience orgasm

most neovaginas will be able to tolerate larger insertions with enough dilating/training

the nerves in neophalluses take a while to regrow but it is incredibly rare to experience no sexual nerve growth

both can look and feel "normal" if that's what you want, just take good care of your scars and look at your surgeons' results portfolio (and don't be afraid to be picky! its your genitals, you get to decide!)

in fact it's possible for many people to stealth and for their sexual partners to never know. even for phallo, some people with natal penises have erectile implants too, ED is common. neocaginas are often indistinguishable from natal vaginas

many surgeons are starting to offer preservation options for patients who want a more mixed look/don't want to lose what they have

You can get hard without needing an implant, it's usually a smaller one- or two-step surgery and mostly only uses tissue from the genitals themselves (good if you're worried about taking the graft skin, eg if you have tattoos you want to preserve or don't want to do hair removal), and it doesn't prevent you from getting phalloplasty in the future if you want it (it can be done as a first step towards a phallo if you want).

Detailed descriptions of metoidioplasty versions under the cut!

"Trans Lives Matter"