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.

TRANS TURBULENT AIRLINES

 Hello Friends,

I’m back to continue my deep expose on the current state of the LGB  TQ community. The recent Dave Chappelle comedy special set the table for a huge discourse on issues surrounding trans women in particular — what kinds of jokes are transphobic? [answer: mostly the ones told by non trans people]

who is more marginalized, black folks or trans folks? [answer: black trans folks]

what was the true nature of Dave’s friendship with trans comedian Daphne Dorman? [answer: token trans friend]

What did it really mean when he said he was “Team TERF”? [answer: I am still transphobic but I’m trying to understand things]

Friends, I’ll have to admit that for the past couple of years I was cruising along not even thinking much about “trans issues” at all. During the year that I hid my face under a mask, something magical happened. I finally grew some facial hair — enough to earn “passing privilege” and to forget a time when the horrific slur “ma’am” was hurled at me everywhere I went, even if it was not meant to be hurtful. Some weight gain and some hair loss also contributed to my overall masculine presentation. I was thrilled, and because things were going so well for me transition-wise, I ass-umed all was fine in the community at large.

WELL, I WAS WRONG!!! There is a lot of shit hitting the fan, and some of it is of valid medical concern. Some of it is of valid social concern. And some of it is just pure transphobia rising to the surface because these valid medical and social concerns have started popping up.

I will give an overview of some of the turbulence affecting the trans community, and then I will give direct attention to some of the very special TERFs I have encountered.

First of all, it turns out that a lot of the people who were coming out as trans in 2015 are not really trans. Even back then I thought, is it possible that there are this many transes?? I mean, when I was a kid I knew, like, 2 people who were gender non-conforming, including me. And even we would never admit that we felt the need to live as the opposite gender full time. But in 2015, it seemed like a sizable portion of the human race had been secretly harboring feelings of gender confusion/dysphoria. And it was mostly young people. Kids, teenagers. Not as many people my age were transitioning, but they were out there too. And I felt pretty excited about this — a kind of I-am-not-alone euphoria to counteract the decades of I-am-so-alone dysphoria that had plagued me.

And most of the kids and adults who came out c. 2015 were choosing to medically transition (hormones, surgeries) as well as socially transition (wardrobe, name and pronoun changes). Not only that, but they were being celebrated for their bravery, their self-knowledge! Their journeys seemed like “success only” stories (I felt like I was the only person who wasn’t having a successful transition).

I first heard the term “Detransition” early this year. I saw it on some random youtube channel that had a transphobic tone to it so I didn’t pay much attention. I’ve known people who had to stop their hormone treatments for health reasons, but they still identified as trans. After the Chappelle special, as I was searching for info on Daphne and other trans comedians, I found a slew of “Detransitioners.” These are mostly young folks who were born female, transitioned to male for a period of time, then stopped testosterone treatments and returned to identifying as female. They sometimes call themselves FtMtFs. There aren’t as many MtFtMs going public, but there are a few of those out there too, and they tend to be older. I was surprised to see how many of these detransitioned kids were making youtube content. I know it’s possible they are “plants” from the neo-con universe, but it doesn’t seem like that is the case. They seem very sincere in their confusion and regret. [Keeping in mind that transgender people make up only about 13 % of the world population, these detransitioners make up only 5% of that 13%, but detransitioning was not something that was being talked about in 2015, 2016…].

So…more on detransitioners later. Now let’s talk about Autogynephiles.

A dubious psychologist named Ray Blanchard came up with a typology for transsexualism in males. One type is the homosexual male who is so effeminate he might as well just get castrated and live as a woman. The other type is the heterosexual fetishist who gets turned on by himself as a woman.

I can honestly say I don’t know any trans women who would describe themselves as either.

But apparently the latter type exists, and they are hijacking the whole trans rights movement with their male privilege!! They are taking over women’s spaces, and erasing the whole idea of what it means to be a woman! They are insisting that (biological) women define themselves with new language like “uterus havers” because transwomen are women even though they don’t have uteruses!  They are the force of evil known as Autogynephiles!!

They are the ones who would dress as women to get into the women’s restroom, or the changing room at the gym. And yes, there are documented cases of this happening, unfortunately. There was an autogynephilic transwoman in the UK who got sent to a women’s prison and raped someone. There have been several reports in the US of autogynephiles undressing and exposing their pre-op anatomy at women’s gyms or other women-only spaces. There are accounts of autogynephiles who troll lesbians for not wanting to have sex with them — dick & all. That’s transphobic, they say! Their main goal, it seems, is to play the victim and to make cis women feel uncomfortable.

Again I feel like I should state that I’ve never met any trans woman who fits this description, I’ve only seen/heard about them on the internet, so I am going out on a limb to suppose that they constitute a small percentage of the already small percentage of people who are trans. But they do exist, and that is cause for concern in some areas.

But more about the Autogynephiles later…let’s talk a moment about surgeries.

As a trans man I am familiar with the “trans rites” that constituted a successful FtM transition c. 2015. They included starting HRT (which I did on 12-7-15) a legal name change (which I did on 4-13-16) and “top surgery” aka double mastectomy with nipple grafts (which I did on 10-4-16). Notice I fulfilled my trans rites checklist very quickly — all within a year, and all because I was able to afford all this transformative magic (never forget the privilege!) I say that somewhat cheekily, but I am very grateful to have been able to do all these things rather expediently. It doesn’t happen that way for many trans identified people (and I have my theories about that being the origin story for the whole non binary movement, but we’ll get to that later).

The point is, once I made the decision to transition, I was helped down this path by a team of affirmative medical professionals who questioned me very little. I was under the care of a therapist who hooked me up with an endocrinologist and a “top surgeon.” I was with the therapist and a support group for a year before I made the decision to medically transition. I was 46 years old when I started the “journey.”  Most of the people I met on my way were much younger than me, and they were moving through their trans rites even faster than I was (ie, they didn’t spend a year in therapy first).

Notice I haven’t said anything about “bottom surgery” — which is the surgery everyone means when they ask “Have you had THE SURGERY??”  For FtMs in 2015 bottom surgery was not really part of the package (pun intended). Being on testosterone brings about some magical changes in the lower regions, which I’m sure I’ve mentioned in blogs from that era, and also there are some pretty life-like prosthetics you can buy to use at the urinal. Personally I felt no great need for “bottom surgery.” 

But it seems nowadays, more and more young trans men are opting for Phalloplasty. There is a better, less invasive surgery called Metoidoplasty, which makes use of the natural growth of the clitoris, severs a ligament to let it dangle free and look relatively like a micropenis. This used to be a satisfactory option for most trans men who wanted a little more enhancement down there, and I never heard of any long lasting complications or trouble healing from a Metoidoplasty.

Phalloplasty is a different story. It is a very complicated procedure that does not guarantee great results.

But let’s back up and talk about my own “top surgery” for a minute. I never once heard it called a double mastectomy with nipple grafts. It was always “top surgery” and it sounded so flippantly flamboyant! Everyone was thrilled to schedule their top surgery, including me. In Oct of 2016 I had been on T for 10 months but still did not look or sound very masculine. I was afraid the surgeon would take one look at me and decide that I was not a good candidate for top surgery. But that didn’t happen. I was a paying customer. No one questioned anything.

So I had the surgery and it all went well. I was surprised however by how , uhhh, surgical it felt. It was just top surgery, right? Elective? Cosmetic? I was not prepared for the level of pain and discomfort I felt. Basically I was sliced from the back of each armpit all the way across the chest, with each breast being fully removed, and the nipples traced by a scalpel and grafted back on somewhere higher than they had been.

There was much more healing to do than I was prepared for. They sent me home only hours after the surgery and I was barely able to straighten my spine into full standing position. I felt like I was splitting open. And then I had to get in a car and be driven home. That was scary! I thought, if we so much as bump into anything I am a goner. 

After about 8 weeks of healing I finally felt somewhat normal. I still felt like there was a piece of barb-wire yoked around my chest, right where my nipples had been. In fact, to this day I feel like my chest is tied up tightly with string. One day in 2020 after I finished running, I fell back on my bed and threw my arms up over my head and felt the most acute sensation of flesh ripping. In the days following I saw little pinpricks of blood all around the scar tissue. It has now been 5 years since my surgery and my scars still itch like crazy sometimes. My grafted on nipples itch a lot and I can’t scratch them directly because it’s too sensitive & tingly & weird. So I scratch all around them for relief.

I know this sounds like I’m complaining, or regret having the surgery. But that isn’t the point I’m trying to make. I do NOT regret having a double mastectomy with nipple grafts. I am thrilled about it actually. I could fill many more pages with how much I hated having breasts and how weird it felt to have bags of flesh dangling around & brushing up against my clothes every minute of the day. That I really hated!! I can live with itching and string. 

But I cannot, can NOT, CAN NOT, imagine living with those sensations in my genital area. I cannot imagine having to heal from scalpel wounds and stitches down there. I can’t imagine how much, and for how long, the itching of the scar tissue would affect that region.

I’ve unfortunately heard of so many young people going under the knife —for phalloplasties and vaginoplasties — and having terrible complications. In fact I haven’t heard any account of a phallo- or vaginoplasty that was without complication. These surgeries are not really ready for mass consumption. They are still extremely experimental. The things these kids go through after surgery is beyond anything I’d be willing to suffer. There is an especially cavalier attitude toward vaginoplasties —you cut the dick off and bam! instant woman. That’s how it is portrayed in movies, that’s how it is joked about by idiots. But ask any trans girl who’s undergone a vag-plasty and she will set you straight and hopefully smack the shit out of you for being so stupid.

But enough about THE SURGERIES for now. We will definitely talk more about those later. I can see this blog is getting super long and I haven’t even introduced you to the Triad of TERFs I want you to meet so badly. My god you will hate them…or love them maybe, if you’re hate-reading this blog. But they do deserve a mention in all this mayhem.

So I will mention them. Next time. In the Octopus Diary.

Farewell for now…