On her reality show I Am Jazz, transgender teen Jazz Jennings has been more than open about her transitioning process and all the different steps she’s taken. On the Season 5 premiere, she had her final appointment before her gender confirmation surgery — and it was time to talk about all that “sexual stuff” that went along with it. Because the reality star recognized her gender identity and started hormones at such a young age, she’s facing complications that older trans people don’t necessarily need to worry about. But while chatting with her doctor, she was comfortable talking frankly about it all.

“Jazz as a medical case is really a conundrum because her puberty was blocked so well that she didn’t get growth of her genitals in a way that allows us as a surgeon to use a conventional approach,” her surgeon, Dr. Bowers, explained. “And so we have to be very creative to find new ways of getting tissue to line these areas of the body that we create.”

Of the exact procedure, she explained, “For the genitals, for the outside, it’s just the tissue she already has… And for the sensory portions, it’s going to be the head of the penis will become the clitoris. The vagina is really where things are still TBD.” But there is one thing that Jazz’s surgery has going for it: “[It] is a breakthrough in terms of the surgery in being able to harvest this peritoneal lining,” Dr. Bowers shared.

Jazz’s parents, Greg and Jeanette Jennings, were also part of the convo — even when things got a little, well, personal. Most parents don’t particularly want to hear about the status of their child’s first orgasm, but for Jazz, it was something of a necessity. And her parents know how to step up to the plate when they need to. “[It] doesn’t get any easier to discuss it. I still feel uncomfortable,” Jeanette shared, but she stuck it out.

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According to the teen herself, the “big O” hasn’t happened for her yet: “My libido’s still basically nowhere,” she admitted, addressing a subject she’s talked about in the past. Back in July 2017, she shared on the show that her libido is a lot lower than most teens because of the hormone blockers she’d been taking. But when it came to sex, she shared that she was “not worried about suppression having longterm effects on [her] sexual drive.” She said, “I know that once I fall in love and I really admire another individual that I’m going to want to have sex with them.”

But now, Dr. Bowers worries about what that will be like. “Jazz does not know what an orgasm is and it’s very important when expressing intimacy,” she said in the new episode. “And although it is not something that’s going to delay surgery, it’s not going to be any easier for her to have an orgasm after surgery.”

As far as everything else goes, though, Jazz is the one with bigger concerns. “[It’s] a little bit nerve-racking [discussing my surgery] because it just shows how tough of a case I am,” she admitted. She also had questions about the actual physicality of her transition. “How much depth do you expect I’ll be able to get?” she wanted to know. “You just do as much as possible.”

Luckily, we know that everything turned out great for Jazz and that she’s doing well since she had her surgery back in October 2018. “There were some setbacks and complications, but I was able to get through it and now I’m doing wonderful and I’m just so happy to finally be in the body that I’ve always wanted.”