Trans Surgeries: Self-Reflective

I know, this is a bit of a departure from the stated goal of this blog, but I think it intersects and also helps explain — perhaps tangentially — why I have a hard time exploring sex.

To begin with, I think it is relevant to state that I have OCD. The issues that I am describing here are relevant to all trans people and anyone who surgically modifiers their body, but this particular psychiatric pathology potentially exacerbates the issues I want to explore.

Let’s start with a little history. Starting in the 1930s and 1940s, doctors experimented with sexual reassignment surgeries in order to transform the sexual morphology of transsexuals. In the 1950s and 1960s, these procedures were institutionalized in large gender clinics such as John Hopkins. Thus, the desire for surgery became a distinguishing feature of transsexuals — it helped distinguish us from the other “freaks and geeks.” Unfortunately, these clinical procedures were only available to transsexuals seeking a binary sex/gender outcome. In Harry Benjamin’s “classic” standardized clinical procdures published in The Transsexual Phenomenon (1966) you can find guidelines for screening “real” transsexuals from the “freaks” with questions such as, “If you could transform your body and mind to that of your ideal female form in every conceivable way, save for your genitals, would you do it?” (this is not verbatim.) The correct answer is “NO!” A woman with a penis, “Fuck that,” says the 60s sexologist. By the 1990s things started to change with more clinical outcomes than the standard binary two. Fast forward a few decades and my positionality is valid and common: trying to transition without surgury — freaky, I know.

Despite this position, I also realize that I have a strong authentic inclination towards SRS. Why? Well, I have come along way in my quest to feel comfortable with my lady bit, but she still makes me feel very dysphoric, and over time I have come to accept that I may end up getting the “chop.” I am still inclined to explore using her, but I have a feeling of inevitability in this regard. Fine, I am okay with that, as long as I feel I need it. But, there is a temptation to waver with regards to my no surgery conviction on other parts of my body. I should point out that I have no issues with people getting FFS, tracial shaves, or whatever, I am a strong advocate for doing what feels best for you (my 80-year-old grandma has had lots of work done, she looks fab). But I want to be able to accept my body without altering it as much as I can. I want to be in the Laverne Cox camp: trans is beautiful. But, there is tremendous pressure to conform to cis-beauty standards. This comes from all directions and even from within the trans community. I recently asked a question in a trans feminine only Facebook group. It was to the effect of, “Does anyone else feel the pressure to conform to surgical regimes?” All 15 to 20 responses comprised of either people’s wish lists for surgery, or what they already had. My question was a little longer, it also explained that for myself, I thought I passed well enough, but I still felt pressure to conform. But my meaning fell on deaf ears.

I think there is a good reason for this. If others are like me, then they probably experience their mirror presence as haunted by a man. I exaggerate perceived flaws that I am sure other people don’t see. This is where my OCD comes in. Any sense of a flaw is heightened by obsessive repetition and hyperfocus. When I look at my trans orbital lobe (forehead bump). I see the forehead of a male neanderthal or a Klingon, no one else seems to. Many other women have foreheads as pronounced as mine, but it knaws at me in the mirror. I photograph it and obsess over it — I would be truly embarrassed if someone saw my smartphone picture gallery. Is this normal? If I have feminization surgery will the discomfort disappear, or am I engaging in dysmorphic thinking via OCD fuelled gender dysphoria? I mentioned this to my therapist, who is a trans specialist, and he told me that he points this effect out to all of his clients, the tension between gender dysphoria and the desire for the ideal self. I have a feeling that my forehead belongs to the latter category. It causes me genuine dysphoria, but if I can manage to not obsess over it, then the feeling often recedes, unlike my lady bit or my 187cm of height which genuinely always bother me. My fear is that if I take surgical action to these parts of my body then I will simply displace the discomfort to something else: my crooked nose or jaw.

Trans bodies, traditionally conceived, are shaped and formed through surgery: products of the science of heteropatriarchy, agentially devoid maps of the dispositifs which create them. If you are like the dreaded Janice Raymond, i.e. a second wave feminist, then what is technological is bad (I should note that there is an opposite techno-positive camp too). I am more inclined to take Haraway’s approach as seen through the lens of Michelle O’Brien, we are the bastard children of technoscience, the cyborg, never pure, but betwixt and between biomedical technology, nature, and capitalism, living in and subverting these systems by navigating them by our own means — when we can. Obviously, we are caught in a web of power dynamics where agency is not always ours to have. Surgery offers us a necessary means to conform to binary sexual morphology in states that require sex change for recognition and safety. But as these systems are changing, with some governments electing to allow people to self-declare their gender identities without the need of medical procedures or diagnoses, we are given more power — it’s still vastly imperfect, but emerging. But what do we do with this power? How do we carve out our flesh? How do we maintain the balance between dysphoria and dysmorphia? When do I know that I am changing my body for myself or because I perceive myself to have to? My therapist advised me to go slowly. I guess it’s good then that I have no other choice. Still, being enfleshed as I am makes loving myself hard, which in turn makes the act of love equally difficult.

Next time muffing, I promise.



I am a trans doing her PhD in gender/critical theory.

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