And this was her wise reply…

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.

24 comments for “And this was her wise reply…

  1. April 19, 2009 at 12:17 pm

    More beautiful writing.

  2. The Opoponax
    April 19, 2009 at 1:32 pm

    Agreed. I also find the ideas here (yours and those of people you quote) about body alteration and what it means to have a biologically “real” body of whichever sex very illuminating – it’s something I’ve been thinking about a lot since that ill-fated thread about the stupid Nerve article by the teacher and his Magical Trans Girls.

  3. April 19, 2009 at 2:04 pm

    Yet another great post, piny. Thanks.

  4. April 19, 2009 at 2:31 pm

    That you could discuss such intimate and in some parts clearly painful thoughts and then whip out a sentence like this: The tiny scratches and quirks listed above were more than enough to bring on my long dark telekinetic prom night of the soul. is clearly a mark of genius. Thank you so much for all these posts.

  5. April 19, 2009 at 5:02 pm

    I do have a question, piny, and I hope it doesn’t come off sounding like I’m throwing my cis-privilege in your face — I am genuinely curious — do you identify as a woman, as a man; neither? Both?

    I think of myself as a failed fake ex-transsexual
    I admit that I don’t have any sort of reference for this personally… but I don’t think that someone can fail at gender. Maybe that’s not quite what you mean, though.

    Also, regarding the quote at the top of your post… I don’t know how common this is, but I hope that trans women can benefit from my experience as a cis woman: I experience clitoral erections, and I don’t think that any woman should feel shame from that happening (although, I do see that that might make a trans woman feel as though she had not truly become a woman, which is why I mentioned my own anatomy).

  6. April 19, 2009 at 5:08 pm

    Please never leave Feministe, Piny.

  7. Kristen J.
    April 19, 2009 at 5:12 pm

    Thank you so much for this post.

  8. April 19, 2009 at 5:31 pm

    I don’t know if it’s possible to reason it away.

    It is possible to make it go away.

    In my own case my hangups disappeared because my wife always saw me as a woman and I began to see myself how she saw me.

    She never knew me before I transitioned and I think that was the most important thing.

    The main thing that I learned from that is that how people see gender is incredibly sticky. Its in a part of our brain that is never designed to change.

    The best way to describe it is that you see most daily things from a cache. Your eyes only see tiny pinpricks of light and the rest is reconstructed from memory. So when you see yourself you are seeing your memory of yourself.

    Look up how mirror therapy can fix phantom limb pain http://content.nejm.org/cgi/content/full/357/21/2206

    The same applies to gender.

  9. mk
    April 19, 2009 at 6:43 pm

    I’m so, so very glad you’re back, piny.

  10. April 19, 2009 at 7:22 pm

    You write beautifully, by the way. Is some of the shame of gender reassignment surgery and hormones related to the cultural mythos of the “natural” human body? It seems that the social worship of “normalcy”, as it is defined by the dominant culture, is that which drives the all-or-nothing perception of sexual reassignment. I suppose much as the media mocks celebrities that take the easy way of losing weight, gastric bypass, and iconize those who loose weight “naturally”, gender is taken to be some sort of absolutist binary that cannot be redefined or discarded in the manner in which someone feels would be best for them.

    It seems all very depressing and alienating—both to in a relationship to oneself and to society at large.

  11. Mandolin
    April 19, 2009 at 7:50 pm

    This is so why I read feministe.

  12. Maureen
    April 19, 2009 at 10:14 pm

    No, no problem — I was going off of what you said about your own re-transition; I knew that the actual facts were different for various people.

    I think of myself as a failed fake ex-transsexual (etc. etc.): somebody whose bodily alterations are inextricable from the social construction of transition.

    (hugs) FWIW (my opinion is worth about as much as a copy of Chicago’s free “Red Eye” on this subject, I’m afraid), I’ve always seen you as incredibly brave, first to change sex/gender in the first place and then to change back when you realized it wasn’t what you really wanted.

  13. Maureen
    April 19, 2009 at 10:26 pm

    Also, I feel like a bit of an ass for not realizing that your deepest scars were emotional, piny. (Over a year’s absence? Duh.) I apologize.

  14. jayinchicago
    April 20, 2009 at 12:55 am

    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 realize picking one sentence out and responding to it is rather unfair. I guess I just want to cover the viewpoint that points out “not medically transitioning” is also a choice, and an active one, and can be damaging in a lot of ways too. I will never get the years of my life back that I wasted being unwilling to rock the boat with my family in regards to beginning HRT. I also went from an A cup size to whatever the hell I would be now–maybe nearly a C–in the 6 years I allowed myself to view myself as male but for whatever reason wouldn’t pursue starting testosterone supplementation. Puberty extends into one’s twenties.

  15. April 20, 2009 at 7:30 am

    I just wanted to put a plug in for the only internet resource (that I’ve found) that provides a support space for people who are de-transitioning or re-transitioning or considering stopping their transitions:

    NoGoingBack Listserv
    http://groups.yahoo.com/group/NoGoingBack

    It’s important to me not to see myself as a “failed fake ex-transsexual.” I get that that’s where you’re at. But for me, my gender identity has remained remarkably stable yet what’s changed over time is my ability to make sense of masculinity without needing to be male. I did what I had to do to survive the intense body dysphoria that was truly killing me and the shame about my body and my gender. It’s just that I’ve discovered new ways to deal with it, ways that don’t require surgery or hormones. I will always have a body that is marked different from my short-lived transition. My identity is still cross-gendered in many ways, I just don’t refer to myself as trans because what I want is to be a masculine woman in a female body living my life and being a role model to younguns who, like myself 12 years ago, thought there was no non-surgical solution to body dysphoria, gender dysphoria or just plain female masculinity. Younguns who wished they had someone to talk to about their doubts about transitioning or about how to handle their feelings about their body without transitioning. (And I don’t mean discouraging people from transitioning! I just mean that there are lots of support venues for people who choose to transition, and I am trying to support people who have made the choice to stop transitioning, for whatever their reason, and providing resources for young people for whom transitioning *isn’t* the right choice.)

  16. April 20, 2009 at 9:34 am

    thanks for all of the really thought provoking writing and sharing your personal experiences with us.

  17. sally
    April 20, 2009 at 9:38 am

    Is there anything written by thoughtful medical ethicists about this?

  18. April 20, 2009 at 10:55 am

    Count me as one trans person who hopes to God that no thoughtful cis “medical ethicist” will touch this issue until there are a lot more first-hand experiences to look at. As far as I’m aware, the most prominent “medical ethicist” to write about transition has been.. Janice Raymond. And in her tradition, you have people like Sheila Jeffreys latching on to the Alan Finch types and billing it as a “survivor movement.” For now, the bottom line is basically that it’s an informed consent issue. The difference is that people like piny take ownership of their lives while a minority lash out at trans people and the people who helped them transition the first time around. There will probably never be a way to “screen out” people who will be unhappy with their results without causing the rest of us a lot of undue suffering.

  19. April 20, 2009 at 12:42 pm

    I really wish some actually thoughtful medical ethicists WOULD write about this. Preferably trans medical ethicists, or trans medical ethicists working with cis medical ethicists in communities where they can truly draw on a lot of first-hand experiences. There are tens to hundreds of thousands in this country alone that could be drawn upon. And there is a gaping, huge hole in medical ethics about what constitutes a “normal body” and a “healthy body” with regards to gender standards (among tons of other things, of course, but that’s what we’re talking about here — it’s worth noting that there is a lot of intersection with disability rights activism too, c.f. Eli Clare’s work).

    And piny, you are amazing, and amazinger still for continue to write about this. Thank you.

    I have more thoughts about “irreparably damaging last resorts,” since I’ve come to think that way about many processes in life, including my own transition, but I will mull on that a while longer.

  20. jayinchicago
    April 20, 2009 at 1:37 pm

    wow.

  21. April 20, 2009 at 9:09 pm

    detransitioning @ 15: i am uncomfortable with your comment, from the standpoint that you seem to be taking your particular experience with transitioning / detransitioning (and to some extent, piny’s) and making it a prescription for everybody experiencing gender dysphoria, hence once again privileging the narrative that genderqueers folks are somehow superior because “hey, look, we don’t have to mutilate our bodies! see? we can be masculine women / feminine men!”, which is just a rewording of classic radfem anti-trans tropes.

    i am glad that detransitioning has worked for *you*. but please stop presenting detransition / genderqueerness as the One True Way.

  22. Aliem
    April 20, 2009 at 10:33 pm

    I don’t have your experiences, piny, but I empathize and draw some solace from you sharing your story. I’m a trans woman, and while I’m not going to get into my personal shit here, I will say that I always find your posts well-written, thought-provoking, and from time to time personally resonant.

    It is truly uplifting to read about someone who detransitioned positively, and it helps me to feel more comfortable in my own skin. Thank you.

  23. Riki Wilchins
    April 24, 2009 at 1:58 pm

    Thanks for the “good ink,” and also the heartfelt post. That section was prbly one of the most difficult parts of that book to write. Since I’m now addressed as “sir” about half the time, I think I’ve somehow detransitioned too. I guees that would make me an M-to-F-to-M genderqueer. In any case, I still pass as myself 100% of the time. “-]

    riki
    http://www.menaceproductions.org

  24. Alex V.
    May 12, 2009 at 6:39 am

    Thank you for sharing. I feel much more informed now. I have a good friend who is trans, and researching medical options; and I’ve read and watched a fair few documentaries on trans people and their families, but I hadn’t heard about de/re transitioning before.
    I’m always glad to hear more about the variety of human experience.

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