Before I get into my long whine about how painful and difficult and terrifying surgery is, I thought I’d list just some of the ways in which it will not be any of the above.
I am not HIV-positive.
I am neither incarcerated nor on parole.
I have no health problems that make me ineligible for surgery, a poor candidate for surgery, or likely to suffer complications or poor results.
I have no allergies, sensitivities, or other health problems that will complicate the procedure itself.
I am not afraid of being unconscious in the hands of a man I don’t know very well.
I have no health problems–e.g. PCOS, extensive family history of breast or reproductive cancer–that dictate the order of my transition or the specific procedures I may undergo.
My body, my chest in particular, has developed such that I have several options as to which procedure I will undergo.
My ability to function without surgery is not so compromised that I am caught in a double bind between “need for surgery” and “readiness for surgery.”
I am not suicidal nor in imminent danger of doing harm to myself. I do not need to self-medicate such that my health is endangered.
I have an income sufficient to pay for the therapy and referral letters required for surgery, as well as for surgery itself. I will not be forced to neglect my health because of limited funds.
My transition can be roped, albeit lazily, into the official current standards of care. My doctors read my trajectory as somewhat familiar.
I have access to both informed-consent and HBSOC care.
I have access to emotional and therapeutic support during and after surgery.
Nothing about my life–my sexuality, my orientation, my presentation, my gender identity and its history–are current disqualifiers. That would not have been true even twenty years ago, and is still not true in many places and for many people.
I do not identify as genderqueer, ambigendered, transgendered NOS, or anything other than male. While the SOC do not in theory prohibit any of these people from transitioning, I am not vulnerable to any practical prejudice against gendervariant identity.
Although I am not masculine, and although my transsexual status is known to everyone involved in my transition, I look male and am read as male; I therefore benefit from male privilege.
I will pass post-op. This surgery will not make me more visibly gendervariant.
I have not needed to convince anyone that I will pass post-op, or that this surgery is right for me despite my inability to pass.
I do not struggle with alcohol or substance addiction. I have no history of incarceration. There is nothing else in my history that would lead my care providers to mistrust or constrain me.
Because I am not in recovery, and because of my race, class, and income, my access to and use of post-operative pain medication will not be complicated.
Like my therapists, my internist, my nurse-practitioner, the surgeons I have consulted with, the surgeons I am considering, the support-group facilitators spoken with, the guy who developed the standards of care in the first place, and the overwhelming majority of care providers and arbiters with whom I have come in contact, I am white.
Because my cultural background is not distant from theirs, relatively speaking, I speak a language of “male” and “female,” “man” and “woman,” and “masculine” and “feminine” that is not dissimilar to theirs. They read my presentation along a familiar taxonomy.
Because of the cultural capital I have benefited from since birth, I can read and understand the official language of transition, and speak it so as to demonstrate my understanding of it and my place within it–and to make myself familiar to them. I am “articulate,” “educated,” and “responsible.” I get to be a consumer rather than a patient.
I live with no disabilities that would cause my care providers to infantilize me, ignore my wishes, or ignore my body whenever possible. My body, freak status notwithstanding, is in some ways seen as “normal.” Nor do I have any “special” needs in terms of assistants or caretakers or other support; I do not need to argue for their presence.
English is my first language. I have unlimited internet access. I have no impairments that might make reading words in a book or a computer screen difficult, or that might complicate access to or use of a computer. I therefore am able to do all necessary research independently; I have not been forced to seek help.
I also have access to a peer group capable of interpreting medical, therapeutic, and sociological jargon that I might not be able to understand all alone.
I am not homeless. I have a stable home to retreat to after surgery. I have access to the homes of several friends and family members. Failing that, I can afford to stay in a hotel, a recovery center, or a hospital.
I do not need to hide the fact of surgery or its details from anyone in my life. I have a network of extremely supportive friends and family, many of whom have intimate experience with this same process. I will not be forced to purchase post-operative care.
My family did not disown or threaten me, either independent of surgery or after I announced it.
I live close to several surgeons. Were that not the case, or were I unsatisfied with those options, I could afford to travel anywhere else in the world.
I have a supportive workplace. I do not have to choose between transition and my job.
I have a job. I have a job that pays me enough that I can afford surgery. I have a job that pays me enough that I can afford the procedure I prefer, from the surgeon I prefer, on the schedule I prefer. I have a job that allows me to support my health in a way that makes me strong and stable enough to undergo an elaborate, body-intensive procedure. I have a job that is not illegal or dangerous or unbearable. I have a job I do not have to lie about.
I have health insurance. I have supportive health insurance. I have never been forced to lie, cover, or fudge in order to receive the best care available to me. My health coverage will save me money and effort throughout this process.
I have a primary care physician to whom I have never had to lie. He has been supportive, friendly, knowledgeable, and generous.
I have a therapist to whom I have never had to lie. She has been supportive, friendly, knowledgeable, and generous.
I have consulted with surgeons who have been reputable, knowledgeable, supportive, and respectful.
I have access to a peer information group that will shield me from butchers and quacks. It will also assist me in arranging my surgery in the healthiest, safest, least painful way possible.
My state’s standards for legal gender change, as well as the relevant federal ones, jibe with my own preferences. I do not have to undergo unwanted surgery simply to obtain documents such as a passport or a driver’s license.
I live as a full citizen in a country where being a transsexual is not officially a status crime, transition is fully legal, and transition surgeons are regulated. I live in a state where transsexuals are protected by law from discrimination. I live in a city that could well be the most trans-friendly on the planet.
I hate to the first to comment but… I think it is extremely brave to be facing surgery of any kind and still be so generous as to think of others who are less fortunate. I have undergone several surgeries and I have never thought of anything else but my own fear. Thank you for making me think about my OWN privelige(? I never could spell it) even when it seemed (to me) that I had none.
No, no. You don’t understand. This is me stalling.
You’re welcome; I’m sure there are a great many things I’ve left out, and a great many things on this list that I will never understand as anything but an abstract problem. And like I said, I’m about to do some heavy lifting about this difficulty, because I think I might be dwelling on it in some unhealthy ways. It’s just…I live in San Francisco.
Maybe San Francisco stalling? Sounds like bravery to me.
This is a major thing you are doing.
My goodness, if we could all think of others when faced with the same, surely the world might be a better place ?
Take care and I will be thinking of you. When are you actually undergoing surgery? We are so lucky, even just to able to do this…
Jill.
I saw your photos and you obviously make a attractive women. Although your post is rather cryptic on the subject I took it that you are undergoing transsexual reassignment surgery. My question is what are the ethics of dating and full disclosure to potential romantic contacts? (I ask this because I had a friend who killed himself after an encounter with a previously undisclosed transsexual)
Does this ethic change at all after surgery?
Uh, Fitz, piny’s getting surgery, not Jill.
And Fitz, what the fuck kind of a question is that, anyway? Are you aware that you might make people commit suicide if they have sex with you and don’t know that you’re a transguy? Did you really just ask that? Are you out of your goddamn mind?
I am so horrified and appalled by that question that I’m shaking with rage.
Zuzu, why must you ruin all my fun?
When I read this
I wanted to scream. I don’t know how to respond on so many different levels. it hurts.
It was an honest question.
I love when things go from zero to wank in less than ten posts. (I’m sure Piny and Zuzu are both attractive too, but what does that have to do with the price of cheese?)
On topic: Piny, I agree that this is a fantastic post. I take so much of my health care for granted – my dad’s had the same job since I was a kid, and as long as I’m still in school I’m covered. But it’s not nearly that easy for so many people, and that’s not even counting the myriad difficulties of transitioning people and their own unique issues, not just those around top and bottom surgery but even ordinary medical care. Thank you.
What does this one mean? “I do not identify as genderqueer, ambigendered, transgendered NOS, or anything other than male. While the SOC do not in theory prohibit any of these people from transitioning, I am not vulnerable to any practical prejudice against gendervariant identity.”
I understood most of these, but wasn’t clear what this meant. It seems many of these are indirectly about class and race, but it missed this one. I have thought about the financial aspects gender reassignment surgeries before, and it seems that it would be cost prohibited for most people.
I’d be a liar if I said, the thought if this much surgery makes me comfortable for anybody getting it. I’m not sure if this is my internalized prejudice toward the transgendered or something more, but that is for another post.
you obviously make a attractive women
I wanted to scream. I don’t know how to respond on so many different levels. it hurts.
Quite. Especially since he doesn’t seem to know the difference between ‘woman’ and ‘women’. Tut tut. But anyway, the prejudice this one statement makes is mind-boggling.
Piny, do keep us all updated. It’s fascinating and a definite education for many of us, even those of us who are genderqueer :)
And thankyou.
Well, on an official level, people who identify as, say, “transgender butch,” or “genderqueer,” or anything beyond or between “male” and “female” are supposed to have access to transition. So long as they can show that they really do know and want what they’re getting, they can’t be laughed out of the doctor’s office for being non- or anti-binary. On a practical level, I’ve heard–and can well believe–that more “standard” transsexuals with standard identities have an easier time getting their doctors to believe that they really do want to transition and really do understand the consequences. The HBSOC are totally option for the care provider; it’s not like there’s any prohibition on them bringing their assumptions to work with them. So because I identify as male and will go on to live my life as male, I am privileged; it’s one more problem I will not have.
There’s another example: I have never encountered a care provider who cared whom I slept with. Were I elsewhere, and were I straight, my sexual orientation would access another privilege. I would not have to worry about running into a homophobic care provider.
Gender–on some levels–is another way in which I am privileged with regard to other transpeople.
I hear that a lot, actually–and many transpeople are uncomfortable with “this much” surgery when other transpeople are getting it, myself included. I’d love to hear your thoughts as you develop them.
Sorry, dude.
Hey, I’m GAWJUS!
If one is oing to post openly about ones trasguy(ness), one should expect a certain number of honest questions.
The story I told you about my friend is a true one.
What are the ethics on physical intamacy and dating in the transworld?
What disclosure is ethical and when?
The question stands.
If the transworld has no such ethics, then it should develop one, for the sake of people like my friend.
(more than feelings were hurt)
Oh, don’t worry about it. Obviously, the fun’s not over yet.
(Hee!)
Originally I thought you were Jill, her attractivness was relevant because she could easily decieve men. (that is why I thought of my friend).
Thats why I commented on her apperance. (see?)
Regardless, I am truly interested if the transcommunity has even entertained, or debated the ethics of this?
Were else should I inquire?
What do YOU think? Maybe a little mental processing should enter into this.
For some reason, I am much more comfortable with a person living their life MTF or FTM without surgeries. It is somewhat similar to how I feel about multiple plastic surgeries; however, I know there are differences. I worry about the general exploitation of the “plastic surgery industrial complex.” LOL!! Although it is clear to me that in sex reassignment surgeries, people get a tremendous amont of counseling, which I’m sure is not the case for a Pam Anderson boob job. I also think I am uncomfortable with the permanance of it, which completely could be my trans prejudice. And my other discomfort is health related issues. Surgery is risky, hormones are risky too, but the multiple surgeries are not healthy for anybody.
The other thing that troubles me is the whole problem with ambiguity and queerness and my worry that through medicalization some (not all) doctors and a few patients have the notion that they can just “fix this” by fixing the person and not the society. The body of the trans person becomes “the problem,” and our society doesn’t have to be accountable for how gender conformity and biological essentialism is forced upon us and our bodies.
I guess I hit some kind of nerve.
No ethical thoughts on these issues?
I think more of the hunan beings in this position to believe that.
I have no qualifications to comment on transprejudice, but I have plenty of experience with surgery. Everything from major spinal surgery with multiple surgeons of different specialties, to really minor crap that takes about an hour and barely counts as surgery but for the anesthesia. *All* of it creeps people the heck out. I’m about to go in for minor (at least, by my standards) surgery next month – and everyone I know is wishing me well, putting me on prayer lists, etc. etc. They mean well, and I appreciate it, but I’m not worried at all – it’s low-risk, low-pain, and potentially of huge benefit. I really don’t see it as a big deal.
Granted, SRS is a lot more involved, and the risks are much bigger. But the point is, people (especially those who’ve never had surgery before) tend to freak out at *any* medical procedure that involves anesthesia. So while it’s certainly possible that there’s transprejudice involved, I’d be amazed if the “eek, surgery” phobia wasn’t part of that too.
Fitz – all the transpeople I know think about that issue a whole lot, don’t worry.
To start off with, I’m offended by the phrasing of your question:
Have we “even entertained” this? Of course we have, and implying otherwise is condescending. Perhaps you might get more of a response if you phrased your questions differently.
I do sympathise for the loss of your friend’s life – but consider the fact that transpeople are beaten and killed on a regular basis when their gender identity is disclosed. From an ethical standpoint, can you ask that a person put their life on the line every time they want to go out on a date? Why should someone disclose, if saying so might put them at risk of loosing their job, friends, romantic partner, or life?
This is a very real issue, and I can assure you that transpeople do think about it very often. Even in liberal places, like the San Francisco Bay Area, transpeople are killed for being transgendered, and a lot of my friends are spat at and publicly ridiculed if someone suspects that they might be trans.
I’m sort of wondering if The Transworld is anywhere near Schlocktavia, myself. You know, like I could catch a shuttle flight there.
Then, y’know, we could contact the hive-mind of the Transcommunity and ask it if it’s thought about disclosure to other hunan beings–I find, for instance, that when I order Hunan Chicken at my favorite takeout place, it’s important that I inform it of my gender identity and transition status.
Seriously, though, piny, thanks for this post. While my list is different, this list was a refreshing reminder of how very much harder this-all could be. I’m currently leaving a therapist who constantly disregards my orientation as well as my financial, class, and cultural context, but the fact that I can, and that there are a host of better options, is amazing.
Oh, all the time. And I completely agree with you, Fitz. I always disclose my trans status to my potential partners, even if they aren’t suicidal. It’s the syphilis I keep quiet about.
We get some counseling; bear in mind that therapy isn’t cheap. I’ll dig up a link on the current HBSOC. Living non-op is a complicated thing; some transpeople cannot pass without surgery. And most transpeople are simply not interested in doing so, for reasons apart from passability.
Hm. There’s a confusion of “them” and “us” here. I think it’s not at all difficult for people on all sides to see trans bodies as the site of our society’s gender issues, rather than as the proper possessions of those transpeople themselves. I don’t think that attitude is much healthier for transpeople than simple sexism. Plenty of activists in the trans community have been fighting tooth and nail for self-determination in the face of sexism and gender-conformity in standards of care.
I think, too, that it’s an open question whether a transsexual body, post- or pre-op, qualifies as normal–or whether transition turns a queer non-queer, or a body unambiguous.
Good on you, and good luck finding someone who deserves your time and money.
And isn’t it?
piny!
Thank you for taking this one on. I’ve gotten so tired over the years explaining all the ins and outs of HBSOC; therapy; insurance; surgeries; ability to navigate the system; I’ve taking up cartooning.
On a more personal note, I wish for you that you pay attention to as many details, big and small, as you can. I slept-walked through my surgeries and can’t really remember everything I thought and felt and have, consequently, missed out on some great cartoons. More importantly, I think, I missed out on opportunities to be more compassionate to myself and others.
Peace and blessings to you.
Jay
As long as you tell us all (and yourself) how lucky you are you dont have to face how scary it is and can deflect attention by how unlucky you are not to have the body you want in the first place?
Surgery like this and other “extreme” surgeries sound so brutal, so primitive because they mostly still are – we are oh so slowly learning how to perform surgery is the least invasive way possible.
But a lot of people cant handle any surgery – I try not get offended when people (literally) cry when they see my son’s scars.
If there is anything I can do for you let me know. In the meantime, Im thinking of you.
And, oh yeah, feel free to whine or bitch away – that’s what friends are for.
piny, good luck. Have fun while the painkillers last. I had this moment of extreme anger and guilt just after surgery because so many of my compadres here can’t access it (no T, genderqueer, unwilling to do deals, too poor, etc). I think your measured list, written beforehand, is far preferable. And I do remember what surgery was like, so if you’re in any need of last minute detail questions, I’ll answer to the best of. In the meantime, tell me when to send the hippie ‘heal!’ vibes.
Surgery doesn’t necessarily result in a loss of ambiguity or queerness. Also, I think it’s important to respect that for a lot of transpeople, it’s our bodies that are the problem (which is a slightly different, though related, problem, to that of ‘society’.) Fr’instance, I pass a lot more since I had chest surgery, but still not all the time; and I’m enjoying the ambiguity of having the torso of a guy while still, (presumably) looking facially feminine. However I’m read, though, I experience my new flat chest as if it had been there all along, and was meant to be there. But like piny says, self-determination is the governing principle here. People want what they want for all kinds of reasons.
Very excellent point. I’ve had two surgeries. Trust me when I say that when I look in a mirror, naked as the day I was born, I see a very queer body. I see a transsexual body full of all the complexity and ambiguity living in that word and that fact.
All that has happened is that my ambiguity is undercover. Pun fully intended. Surgeries have simply changed the ways in which in my complex and ambiguious body expresses itself.
Oh, and Rachel–wrt how a lot of these seem to be about class privilege. That’s true, in even more ways than I named. It’s also true that a lot of them are about, erm, the privilege that derives from being a transperson in a relatively trans-friendly place. I get to be a transsexual here, not in, say, Texas (which is far from the worst possible place). Now, my class status can’t really be separated from that position, but it’s important to note. I wanted to make sure I pointed that out before writing about this process in my life; I didn’t want to give the impression that things are like this for most transpeople because they’re like this for me.
LMAO!
I had no idea about Piny’s orientation though. Quite surprising.
I live in Texas. I can NOT IMAGINE having a job as great as the job you describe. I am 45 years old and have never worked anywhere that health insurance was even offered. Let alone was GOOD and actually COVERED things. Wow !!
Yup. It’s been pretty incredible. It’s better coverage than I had growing up.