For years, I really hated this little spot on my body. I shared my concern in support groups and recovery meetings, sobbing and unable to hide my shame. It was a small portion of my penis. To create my clit, the doctor had transplanted the head of my penis between my newly formed lips, waited a few months, and then carved it down to look “real.”
The fact that I still had this part of my penis, including a section just below my urethra which got distinctly hard when I was aroused, that my glans had actually lived between my labia for three months, humiliated me. I overate because of it. I tried to ignore my body when I masturbated. Of course, it’s much harder to masturbate when you’re ignoring your body. But in my mind’s eye, I could still see that glans, implanted like some creature from Alien, about to burst out of my groin and attack Sigourney Weaver.”
Riki Wilchins, Read My Lips: Sexual Subversion and the End of Gender
Maureen made this comment in the thread on “Post Mortem: On Beyond Galloping Zebras,” and I hope she won’t mind if I use it as a springboard (the comment was fine, Maureen, just so that’s clear).
I was trying to figure out my thoughts on this this afternoon, but I couldn’t ( I was thinking about writing something about how “doctors hate uncertainty”, but that’s kind of trite), so I just went about my day, and eventually came upon Nick Kiddle’s place, where he’s bitching that the NHS won’t let him get testosterone without agreeing to chest surgery. Kind of the “well, if you don’t want to go all the way, then you’re not really committed, and then you could change your mind, and then OMG you’ll be a woman who’s undergone a year of testosterone treatments and that has so many side effects…” implicit in there.
But you mentioned that your post-re-transition body isn’t very different from what you remember your pre-transition body being. Yes, you underwent electrolysis to remove facial hair, but that’s not even a surgical procedure. And apparently Thomas Beattie’s ovaries and uterus haven’t been overly adversely affected by his past use of testosterone. So the effects of testosterone seem to be relatively reversible. (Even the IOC’s allowed transwomen to compete at the Olympics as women provided they’ve had two years of post-gonadectomy hormone treatment.)
So… what’s the real problem? Is it doctors’ discomfort at not being able to predict everything? Is it fear that the presence of people who have switched gender twice will lead to a world where people switch gender out of more “frivolous” reasons? Or is fear of a world where gender doesn’t matter very much in most social/economic/political/cultural contexts?
I didn’t have electrolysis–although some transitioning people do still need to use it to get rid of unwanted body or facial hair, and I might have needed it if I had been, say, blonde or old enough to have a graying beard. I had laser hair removal. Fifteen hundred dollars’ worth.
Before I go any further, I need to point out that my transition was unusual. Because I was so thin, and because I devoted so much time to bodybuilding, and because I was on testosterone for over two years prior to surgery, my chest contours were such that I could get liposuction without reconstruction. Even though I started transition as a C-cup, I was well below A by the time I had my final consultation.
This is not normal; most trans men who get top surgery get a specific kind of mastectomy that involves some masculinizing reconstruction of the chest. (Michael Brownstein has typos on his website! I’ll just go with Jamison Green.) Bear in mind that he was writing in part to warn trans men against rushing into surgery; he also doesn’t mention that the usual solution to “awful” aesthetic results from keyhole is a revision procedure to remove excess skin, or that keyhole is usually only feasible for small-chested trans men. And if you follow the link, the article is more than a decade old, and the cost estimates especially are outdated.
Chest reconstruction is usually done as an outpatient procedure using one of two predominant techniques. The bilateral mastectomy by double incision technique is most effective for contouring the masculine chest in cases where there is a large amount of breast tissue. In this method, large incisions are made below each breast and the mammary glands, and fatty tissue are exposed and removed. The excess skin is cut away and the incision closed below the pectoral muscle. Chest musculature is not touched. The original nipples and areolas, removed with the excess skin, are used to shape new nipples, and these are grafted onto the chest in the proper position relative to the pectoral muscle. Drawbacks of this method include prominent scars on the chest and some (often complete) loss of nipple sensation. Sometimes the nipple grafts may be lost (the tissue dies and cannot be replaced), the nipples may be improperly located, or their shape may lack aesthetic quality.
The second most common procedure is called periareolar, sometimes keyhole:
The “keyhole” procedure was developed to combat these drawbacks. Some surgeons feel that good results may be obtained with this technique regardless of original breast size, while others feel this technique is most effective when applied only in cases where there is a small amount of breast tissue. In this method, a small incision is made near the areola and the breast tissue is removed by liposuction. In some cases the areola is reduced somewhat without removing the nipple or resecting the nerves that carry erotic sensation. Advantages of this technique include minimal scarring and retained erotic sensation in the nipples. Disadvantages are that the nipples may end up in the middle of the chest instead of properly related to the pectoral muscle, or breasts may be reduced but not eliminated in appearance. In other words, the results may be aesthetically great, or tolerable, or awful.
Both surgeries involve the removal of all breast tissue and a significant amount of skin. I lost fat. My liposuction was aggressive, and I had a male chest post-surgery, but it is possible for the body to redeposit fat if it thinks it’s supposed to. Mine thinks I’m supposed to have fairly large breasts–that probably won’t happen for years if ever, but it’s doing its best. You don’t regrow breast tissue, and post-mastectomy contours are permanent barring additional reconstructive surgery. My reconstructive regime was carbs and prayer. If I had undergone either of these two far more common procedures, or if I had been small-chested, my rack would never have returned on its own.
Bear in mind as well that reconstruction is not free–I have no idea whether any provider would help cover it (mine didn’t offer, and I didn’t ask), but I expect the response would be callous. Even removing unwanted hair is hugely expensive; procedures like breast implants are another order of financial burden.
I also have not undergone any genital surgery or any surgery to remove reproductive organs. That’s all another order of permanence.
These are the residual physical effects of transition, more than two years post-testosterone and nearly three years post-op. I grew extra extra hair, some of which read masculine rather than hairy. I removed that hair, and left the rest alone. The hair on my head did not thin, but my hairline adjusted a little bit. This is not noticeable to anybody but me. My voice deepened, and now sounds remarkably deep and husky for a woman’s voice. While I am frequently mistaken for a man on the phone, and told often that my voice is very low, I am not self-conscious about speaking. I am still muscular, but not in any striking way. I don’t seem unusually built for a woman. I have clitoromegaly. My breasts went from large to medium to small. I have small light liposuction scars under my armpits and at the base of my cleavage. I also have a little bit of convex liposuction scarring. When my nipples are erect, there’s a slight shaving of the curve around the nipple. Most of the time, it’s shallow enough to be completely invisible.
Every night for months, and still occasionally when I’m tired enough to be depressed or tipsy enough to be maudlin, I have lain awake thinking about how humiliating, how heartbreaking, how excruciating it is to have areolar bevelling.
If I had actual problems to solve over the course of transitioning back into a recognizably female body? If I had gone bald? If I had no uterus any more? No breasts? If I had to take exogenous hormones to feminize my body because my body didn’t produce them any longer? If I faced extra scrutiny because of these or any similar permanent changes, or if I had to deal with any significant amount of assigned genderqueerness? If I really had difficulty presenting as unambiguously female without major surgical or sartorial intervention?
You should see the mileage I got out of a widow’s peak. The tiny scratches and quirks listed above were more than enough to bring on my long dark telekinetic prom night of the soul.
And I think that’s the issue. The problem is not what these things are–as Riki Wilchins put it, “To have the actual surgery, I just had to be able to breathe deeply, count at least partway backward from one hundred, and fall asleep with a semblance of dignity.” The problem is what they mean.
I do not think of myself as someone who has a tiny bit of tit flattening, not any more than Riki saw herself as someone who had a small amount of tissue moved a small distance. I think of myself as a failed fake ex-transsexual (etc. etc.): somebody whose bodily alterations are inextricable from the social construction of transition. This is where the sense of being ruined comes from, I think, and why my meagre collection of embedded artifacts takes on such disproportionate gravity. I myself believed that transition was an irreparable damaging last resort. On some levels, I still do. I know that my doctors influenced some of this despair; I don’t know if it’s possible to reason it away.
I do not believe that every transitioning or re-transitioning person is like me. I don’t doubt that different reasons for transition could create a different relationship with re-transition. I know that different people relate to androgyny or genderqueerness in very different ways, and that “going back” means different things to different people.
But I don’t think that we can argue for autonomy based on the idea that each person has a deeply individual relationship with their gender and gendered body, and then argue for autonomy based on the idea that transition is objectively trivial. If we deserve to make these decisions ourselves, and if gatekeepers can be much more static than signal, it is because we are the only people who can understand how they resonate.