I’m going to be writing about transition regrets and/or reversal of transition (sometimes from folks who remain trans-identified). Before I do, though, it seemed necessary to finish and put this article out there, as it lays the groundwork. I’d written about the decision to be non-operative previously, and had intended to leave it at that, but it remains one of the most hotly-contested and misunderstood subjects that I touch on.
When it comes to genital reassignment, the non-operative word among trans people should not be "sorry."
That’s not a very popular statement in transsexual communities. But as much as I don’t like "rules" for being trans, I have arrived at one guideline:
Do as much or as little as you need to achieve the peace that you need.
It’s not quite that clear and simple, of course, especially given the pressures to conform and integrate as either male or female, which have been idealized as binary opposites in society. Trans (that is to say, both transsexuality and/or transgenderism) challenges those absolutes, but it’s also a lot to ask, for someone to be a life-long challenge to society. Not everyone is an activist, nor should they be required to be. And phrasing it as a "pressure to conform" also oversimplifies something that also includes fears about going swimming or to public places of semi-nudity, going through airport scanners and travelling internationally, being in sex-segregated spaces like homeless shelters or correctional facilities, or the possibility of being challenged in a public restroom.
Relationships can also factor into the equation. Genital reassignment surgery is inevitably going to change a dynamic within intimate relationships, and raise questions about our sexualities and those of our partners. While the decision for or against GRS shouldn’t be dictated or coerced by our partners, when we love someone, it’s inevitably going to be on our minds. Some individuals will be able to consider foregoing surgery as an act of love and sacrifice, while for others it would be far too much to ask -- we’ll see why, shortly.
Another factor that blurs the lines is the fact that we live in a nation where our enfranchisement in society is largely affected by our identity documents. In Canada, only the Province of Ontario has a provision to change a birth certificate without multiple verification of surgery -- and in many provinces, the same applies to things like driver’s licenses. While our Social Insurance card does not display a gender marker, potential employers can do an S.I.N. check which displays a gender marker in the resulting report -- and that, too, cannot be changed without a new or amended birth certificate. When our ID is incongruent, it potentially exposes us to harm and/or discrimination when we’re carded, and at many other stages of just trying to live and work and access services. At no other time is a person’s enfranchisement in society dependent on them having surgery. But because that is the status quo in Canada, it will inevitably be a point of consideration for the time being.
At times, health issues can also be factors affecting whether one can or can’t obtain surgery. This might take the form of a serious medical condition that precludes undergoing other procedures (some of these -- such as diabetes or HIV -- can be worked around by finding surgeons with better hospital access, but some conditions can be completely prohibitive). It might also refer to fear of undergoing a major invasive surgery, an aversion to the medical process overall, a desire to wait until techniques improve, or living in a province where GRS is not funded and not being able to afford it. Occasionally, health care funding is an influence for GRS, such as situations where genital reassignment is funded by insurance while orchiectomy is not.
But for the moment, let’s put all of these things -- health, cost, relationships, social pressures, legal identification and enfranchisement -- aside. In an ideal world, the decision to have surgery should hinge on an individual’s needs and the advice of their doctor.
This may seem a little confusing for people who have read my writing about surgery being a medical necessity. I still maintain that its availability is, and that when surgery is necessary for an individual, it is an absolute necessity. [http://www.gaycalgary.com/u555] Relationships and legal enfranchisement obviously underscore why, but it’s also important to remember what GRS is designed to do: alleviate distress.
Trans individuals sometimes experience an emotional, psychological and/or physical distress and anxiety -- a body squick -- about their genitalia. It’s not always a conscious thing, but can be experienced as a discomfort or aversion to their genitalia, or a sense that those parts are out of place and don’t make sense to be there. At the most extreme end of gender dysphoria, this aversion becomes even violent, driving a person toward self-harm or self-destructive behaviour. For people who experience it less severely, it can be a discomfort toward sexual intimacy in general, or a feeling of being out of place, without being completely clear on why. Obviously, in these situations, it makes sense to align the body with what a person understands that they need to be.
But not everyone experiences those levels of anxiety and distress. Sometimes transition alone, minus surgery, is enough to resolve a person’s dysphoria, while other factors are able to become more significant reasons not to have surgery.
Non-operative trans women (there is often an exception made for trans men because of the limitations of phalloplasty and metoidioplasty procedures) are sometimes considered button-pushing because they challenge the traditional trans narrative, in the same way that some bisexual people are unfairly seen as a challenge to the "born this way" narrative of sexual orientation. The idea that we are fixing a predominantly medical condition seems undermined by the existence of people who don’t want to completely "fix" their bodies through surgery. And yet, individuals exist who genuinely need to transition and live as their identified sex, but don’t genuinely need GRS.
In transsexual culture, there seems to be this perspective that all roads lead to the holy grail of GRS, and that after one has the surgery, one has "arrived." Part of the reason that so many post-operative trans women and trans men leave the community is because once they’ve reached that point, the weighty discussion about GRS is no longer relevant to them. The GRS-heavy direction has also tended to exclude non-operative and other trans people, because of the implication (intended or not) that they "must not be real" if they choose not to pursue surgical methods.
Yet GRS was only ever supposed to be one step toward self-resolution. It’s neither all-completing, nor is it a final endpoint (and this point calls for a discussion of post-traumatic / minority stress), although it does have the ability to bring closure when that body distress / squick exists. By comparison, cissexual (non-trans) women never stop learning what it means to them to be a woman; cissexual men likewise. How can we say that we’ve "arrived" simply from the flick of a scalpel?
The basic reality of the trans condition is that our bodies do not define us. If we allowed that to happen, we’d have never been able to start a transition -- we would still be living in the misery and shame of having to live up to everyone else’s expectations.
The trouble with a heavy (or exclusive) focus on GRS as the "endpoint" of our transition (aside from the fact that the psychological journey never really completely ends) is that we can become so intent on becoming "wholly" female or "wholly" male that we abandon, hide or feel ashamed of characteristics and histories which make us truly unique. It’s important that surgery does not become a case of simply trading one mask for another.
We do need to sometimes sit back and reflect on exactly how unique we’ve become. Not many men can say that they’d sewn their own grad dress. Although our pre-transition lives may have been fraught with their share of difficulties, they’ve also had landmarks, even if they didn’t feel so monumental. On a broader scope, we definitely have an original view of the battle of the sexes, with a far more acute understanding of what hormones do to our moods, of how differently men and women are perceived and treated in public venues, of the different social dynamic dating a man as male, compared to dating a man as a female. Those perspectives are hard-won. It’s a shame to bury them.
From that perspective, the decision not to have surgery can sometimes be like wearing a badge of honour. We’ve gone through the ritual. We’ve done the firewalk. We have the marks on the soles of our feet. While some are comfortable with covering up the burns and never telling anyone about the experience and that’s fine, once in awhile, it’s nice to embrace some of the differences and take pride in them.
More often, though, non-operative-by-choice trans people have arrived at a point of personal resolution from transition alone, and find that they don’t need GRS to feel complete. Good for them. You don’t need to change your genitalia in order to achieve your personal closure? Then don’t. Anyone who doesn’t understand this needs to take themselves out of the comfort zone of their own experiences, for a moment, to remember that one size rarely fits all.
The non-operative word is not "sorry."
In the end, you are who you need to be. No one has the right to invalidate that.