Gender Affirming Surgery that removes your gag reflex

This was originally a horny/haha social media post, but then I did some research.

TLDR and then I’ll go into detail:

– gag reflex consists of base of tongue, tonsils, and back of throat
– about 10-15% of people have a hypersensitive reflex, and there are medical options
– the 3 relevant surgeries are: Tonsillectomy, Uvulectomy, and UPPP
– I’m not gonna tell you how to be a better thrussy, that’s on you – I’m just gonna spill what I’ve learned about the gag reflex in general – and then elaborate a bit on the surgeries
– I am not a scientist, just a horny little catgirl, so please do your own follow up research as well


So, the gag reflex is part of the somatic nervous system – meaning that it is technically a voluntary response. It’s identified this way because the stimuli travels up a sensory nerve to the brain which then sends a motor signal back down to perform the gag (which is why it can be psychologically triggered without stimuli) — as opposed to only needing part of the spinal cord like the knee reflex.

In fact, lack of gag reflex used to be a key indicator of brain death – until we learned more about it.

more recent studies seem to indicate that roughly 1/4 to 1/3 of (otherwise “healthy”) people have no, or very weak, gag reflex. While 10-15% have a hypersensitive gag reflex, or HGR.

The notes on on my oringal post, while too unscientific to confirm the distribution, do confirm this spectrum.

Interestingly enough, babies are born with a super sensitive reflex for about the first 7 months – this is why we wait before gradually introducing solid foods. There are a number of theories that suggest an acceleration, or delay, in solid food introduction can influence the sensitivity of the gag reflex as the person continues to develop, but there is no solid evidence, as there are no formal studies.

The gag itself: they call it “bilateral pharyngeal muscle contraction” – the right and let sides of the throat squeeze inward, narrowing the overall passage. Additionally, the soft palate (roof of mouth) moves upwards – and the rest is basically the same as a cough.

There are a number of further mechanisms that can chain the gag to a retch or full on vomit, but I’m not going into that.

Receptors for the gag reflex include the base of the tongue, tonsils, and back of the throat. The uvula (punching bag lookin thing that hangs down), which technically is not part of the gag reflex system, still plays a role in some circumstances, which I’ll cover in a sec.

Additionally, further down the throat there is an auto-swallow mechanism as well – I suggest this can affect oral performance because the swallow may press the gag receptors, especially the tongue, firmly against the (consensual) foreign object, thus sending additional gag triggers to the brain.

The uvula – The uvula is the flap that opens or closes the nasal passage to the throat. In some cases, such as mine, the uvula can be longer than it needs to be, or it can be misshaped. At rest, the uvula should be quite round at the bottom and have reasonable (varies per body) clearance above the tongue. In my case, the uvula is a bit longer than it needs to be, and it comes to a point at the end, instead of round. This leads to mucous (or other similar substance) retention between the uvula and the tongue, thus activating gag receptors.

There is a surgical option for this, which I’ll get to soon.

Tonsils – the little brain looking things on either side of the throat. The larger these are, the less room there is for getting things past them w/o triggering gag. Additionally, the more wrinkles or folds, the more likely to retain material – thus prolonging the stimulation, and sending more gag signals.

Back of the throat, or “posterior pharyngeal wall” is the least sensitive of the 3, partly by design, and partly due to surface area, and has the fewest options for modification or desensitization.

Tongue – for most of us, this is going to be the primary gag trigger, again partly by design, and partly due to surface area. In my case, I have a very articulate tongue. I can make shapes and motions that I’ve not met anyone else who can. I believe this is because my tongue, especially towards the base, is quite beefy for lack of better word. It takes up a reasonably larger portion of my throat, which also contributes to the reduced space between it and my uvula.

and now the part you’ve been waiting for — what can we do about it?

++ for most people you can absolutely desensitize your tongue with regular brushing – 2x per day brush your tongue, go back as far as you can w/o triggering the gag and brush the full width of your tongue for like 30 seconds. Stop if you start to gag. Most people seem to notice after 1-2 weeks they are going back further before it triggers.

Tonsillectomy Just as it sounds, surgical removal of the tonsils. In cases of tonsillitis, typically indicated by excessive redness and swelling, this procedure can be deemed medically necessary and covered by insurance or treated as “uncompensated care”. While it is considered a routine operation, I do not know if you can get a tonsillectomy as an elective procedure.

note: also may be deemed medically necessary in pediatric OSBD (obstructive sleep-breathing disorder) that does not respond to other treatments

Uvulectomy – also just as it sounds, removal of the uvula. Probably only going to be done when deemed medically necessary. Comes with a number of side effects, like learning to swallow again. This is a major procedure, with many many implications, please do research. Fun part about this one tho, is that upon sudden introduction of more fluid than you can swallow, it’s likely to come out of your nose 😉 — and I highly doubt any surgeon will do this as elective.

Uvulopalatopharyngoplasty or UPPP – a rather complex procedure, designed primarily to treat obstructive sleep apnea, excessive snoring, difficulty swallowing and other major, life-threatening, conditions. This can involve removal or reshaping of the uvula, reshaping of the soft palate and pharyngeal walls, removal of tonsils, and even resizing/reshaping of the tongue ( uvulopalatopharyngoglossoplasty) – if there’s a single procedure that satisfies the original post, this would be it – but also good fucking luck getting this done electively.


For y’all that are gagging on like yogurt and shit – that’s a legit indication of HGR so there may be medical options that (and you might need to embellish a little) can also be deemed medically necessary, potentially granting you access to either insurance coverage, or uncompensated care

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