The Surgeries

 Oh dear friends,

I’m clutching my pearls happily — which is not usually how it’s done — because I did receive some statistical data on the things I requested statistical data on! And I will tell you a little bit about it before I start talking about The Surgeries.

First of all the statistical data is still pretty trans-positive. 82% of transitioners do not want to detransition. TERFs and detransitioners are pretty rare creatures — they just happen to be making a lot of internet content right now. They are whining the loudest. They are begging for money to put behind their brands. They’re looking for new & exciting angles w/ which to grab the attention spans of the wholewideworld. And it’s true that the trans-positive narrative had peaked. Especially since I myself was having such a slow transition, I knew there were some not so great narratives to be had.

Now this doesn’t mean I have less compassion for people who feel their transitions were a mistake — it just means I am glad there aren’t as many as I feared. And I want to hate all TERFs equally, but I’ve come to realize even such a specialized group as trans-exclusionary radical feminists is not monolithic. There are women in this world who have a genuine phobia of men (and probably for good reason). There are women who just need space, who prefer the company of women, who actually do feel erased by men. I can understand wanting women-only spaces in this world. What I can’t understand is not wanting to include trans women in these spaces; Not being able to tell a perverted serial killer stereotype from a regular old trans girl; Believing that autogynephilia is the force behind every woman’s transition.

Let me just give you some statistics about autogynephiles and what a danger they are in the western world — about 1% dangerous. There are certainly cases of males identifying as female who have behaved criminally, throughout history. But “criminal autogynephilia” is much more of a problem in places like India, the Middle East, and Latin America — places where there are lots of sexual taboos, and gender roles can be extreme. For white American/Canadian/ British women to be afraid of toilet rape by a dude in a dress is laughable. But not really. I understand white feminism is fragile and loves victimhood, but I also understand the valid fear of owning a penetrable female husk in this world. I think TERFs are 97% more prejudiced than afraid though.

So…there are some statistics for you! Still nothing on trauma being a precursor to gender dysphoria, or pre/post transition suicide statistics.

OK, onto The Surgeries…

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I know “they” have been doing vaginaplasties since the 1950s (or before). Knowing that, I would think that “they’d” have a quick, no fail, peen-to-vag nip & tuck operation perfected by now. Easy-peasy sewn-up covergirl — no such thing as hedwigian botch jobs. But I don’t think “they” do. 

Unlike trans guys, trans girls almost always go for bottom surgery. It’s part of their trans rites. And while most trans girls report being happy with their vag*o*plasties , they also report it is not an easy road to go down. Perhaps it is in fashion now to over-report the negative aspects of being trans, but I haven’t heard of anyone who hasn’t had significant complications after genital surgery of any kind.

It would stand to reason that the anatomical structures that have come to define us as biologically binary would be complex and not conducive to cutting. The pelvic floor of the human anatomy bears some of the most pressure of upright living. It is basically our center of gravity. It is built for standing, coughing, speaking, giving birth, peeing, pooping, laughing…And it’s so full of tubes & ducts & blood vessels & nerves that were some of the earliest structures to develop in utero. To me, genital surgery seems as delicate as brain or heart surgery. 

But it is necessary in some cases. I always come back to Jazz on this — here is a kid who thinks she can have this kind of surgery in June and be ready to start college in August. If there were doctors who led her to believe that, they should be looked into. But I’ve seen too many stories of girls who have blocked out 3 -4 months of their lives for healing, then go through a period of depression as the healing process takes more like 1 -2 years, or longer in Jazz’s case.

But now it’s been 4 years and Jazz is happy she had the surgery. I think she may come to regret that she didn’t wait until after college to do it though. The complications that Jazz had after her first surgery are the kind of stories I keep hearing from other patients — the ripping open of surgical wounds because of the pressure of gravity on the pelvic floor. Not to mention swelling of recently cut tissue. Having to wait about 6 months to find out if the results are aesthetically pleasing…and if they’re not, deciding whether to have more surgeries.

Then there is the prolonged indignity of having to dilate your newly formed vagina so it doesn’t collapse upon itself. That’s right, you have to use a medical-grade dildo on yourself to avoid closure. It has been described as very painful right after surgery, and just uncomfortable after healing. Errr, is it weird that it sounds a little erotic to me? I guess that would be my inappropriately pansexual way of dealing with it.

 

Anyway I have listened to some nightmarish tales of post surgical complications, I have seen depression crop up in the lives of some of the strongest, most charismatic trans femmes after The Surgery…but I have heard of few who regret The Surgery.

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Now onto The Other Surgery…

Phalloplasty. Which “they” have not been doing for as long as the Vag*O*Plasty.. Maybe in the 1970s they started doing phalloplasties?

[I just looked up the first vaginoplasty done in 1930; first phalloplasty 1946.  The Surgeons have been experimenting on our genitals longer than I thought!!]

So…despite the barrage of complications that come with the vag*o*plasty, it usually does heal up in time, with decent sexual and urinary function. Not so with the phalloplasties. Sadly I haven’t seen many cases of phalloplasty that don’t require years of repair and tweaking. The main complication with this surgery is making a urethra that is long enough and strong enough to withstand the pressure of urination. As I watched the channels of young trans guys who are in the midst of post-phalloplasty fall-out, I again have to wonder about the doctors who are willing to take such risks with vulnerable patients. And sure, I know the guy has come to you asking, pleading, begging for a neo-phallus (aka new dick)…but if the risks involve fistulas ( tears in a tubular structure like the urethra), strictures (blockages of tubular structures) and having to wear a catheter for months — years, possibly— is it responsible to perform these surgeries when they are not quite ready for mass consumption yet?

The horrific complications described by some of these guys made me wonder how dysphoria is not aggravated by having so much focus directed at the genitals in their weakened, injured state. Some guys do report increased dysphoria after surgery. Another complication that can arise from phalloplasty is loss of nerve function in the arm that is used for the skin graft. A significant triangle of arm skin is harvested from the forearm (where there is little hair growth). This can get infected, or worse the patient can lose sensation and coordination in the wrist. The scarring is pretty significant and gruesome (but some people are into that).

After listening to all these horror stories about fistulas and strictures and supra-orbital catheters, I had to wonder when getting phalloplasty became a trans rite? I also had to wonder what a successful phalloplasty looked like. So I did a visual browse and found… better results than I was expecting! A nicely healed phalloplasty doesn’t look half bad. I’ve heard the TERFs describe them as “skin tubes” but they look pretty passable to me.

I still plan on waiting until the 3D printed version is a vailable. That should be by the 2030s.

Just kidding — no bottom surgery for me.

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So there you have some fresh perspective on gender confirmation surgeries (remember when it was okay to call it gender reassignment surgery?). What do you think? Is it okay to do experimental surgeries on young people who claim they will die without it? What if they don’t claim they will die, just won’t feel like their “complete selves”? Is it okay then?

I think we’re putting too much emphasis on the negative aspects of healing — it takes a long time! And if you feel brave enough and strong enough to get through it, knowing that it will be difficult, I say it’s okay to do whatever you want with your body. In the 90s we experimented with pharmaceuticals — anti depressants and fertility treatments mainly. In the 00s we experimented with every kind of plastic surgery you can imagine!! Yikes, remember that??  So now we’ve come to gender confirmation surgeries. And people are lining up to get them. And most of them will come through the grueling process of healing and decide they don’t regret their choice.

Folks, I think I will do one more installment of this series. It’ll cover everything I haven’t covered yet. This has been such a SERIOUS series! I hope you still enjoyed it. I need to get back to being silly and delightful. I am on a new art binge, but it’s not ready yet. I’ll have it for you next time, in the Octopus Diary.