Tag Archives: Trans criticism

Let’s talk about the challenges of Phalloplasty

I remember when my partner had come out to me as trans, but before he (or I) had come out to anyone else, I began to share more educational information about trans people on my personal Facebook feed. I had already been running the Facebook page “Lesbians and Feminists Against Transphobia” (now, alas, deceased because I was unable to manage the traffic from the 10,000 people who liked the page). I started to migrate some of the content to my own timeline, in the hopes that people would be somewhat prepared for the forthcoming announcement.

At that point, we were at the “I’m transgender, now what?” stage. Because what we are is not what we do. Robin knew he was a trans man, but the thought of transition is daunting, and there are so many options. Name changes and pronoun changes were some of the possibilities. Medically, one option was just to have chest surgery, one was to take hormones and have chest surgery. We weren’t really going any lower than that just yet. For me, there didn’t seem to be any options for “non-binary transition” (little I knew) so coming out (or not) was really the only option I was considering.

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They say when you go through something big you find out who your friends are. This is true, but you also find out which of your friends are bigots.

This was the point at which we discovered that a (thankfully not close) friend of ours was on her way to becoming a prolific and formidable anti-trans campaigner.

I would post something positive about trans people, this friend would come back with a response about how transitioning makes people suicidal. I posted an article about trans men, she launched into a discussion of the dangers of phalloplasty. She was the ultimate concern troll.

So hung up on how what’s in everyone’s pants should determine the ultimate and unbreakable social order, our friend had assumed trans man = phalloplasty. Which is ludicrous. There are so many different surgical and non-surgical options for trans men because what’s in people’s pants should not socially define them. And nobody should have to go through major surgery in order to gain social acceptance and safety.

But her graphic, alarmist response, also made me terrified of phalloplasty in a way that really was unhelpful, because the reality is some people have lower dysphoria, a sense that there is something missing that they cannot reconcile. And dramatic as surgery is, it makes some people feel whole and okay with themselves in a way that benefits how they are able to be in the world. Which is obviously a win/win, because people who are happy with themselves and their bodies generally make for better citizens, friends, partners, workers, lovers.

Admittedly it’s hard for trans people to be happy with themselves, given what a shitty world this is to trans people (hence the suicide stats), but all the evidence suggests being trans in itself isn’t the problem – but rather barriers to acceptance, support, and being able to transition as we need to. Negativity and barriers just make a hard life harder.

Let’s not pretend we live in a perfect world, and that medicalising trans identities is ideal. It isn’t. The media still very much use language that speaks of a process of transforming a person from woman into man, or vice versa, and our community still talks about someone being “pre-op” or of surgery being something that assigns or affirms gender, as if we need the surgery to make us real.

This is awful, and it has to stop.

At the same time, in a world that places so much social emphasis on what is in a person’s pants, it is impossible to ask trans people to feel okay with what’s down there, even if their dysphoria is not fundamentally physical rather than social. I think this varies from person to person and some trans people admittedly feel a profound, instinctive sense of something missing from their bodies long before it can possibly be the result of socialisation.

Some  trans people will cope with their bodies configured as they are, and some will not. This does not make us more or less transgender, it just means we are not experiencing lower dysphoria to the extent that having surgery will be beneficial to us.

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I was going to talk about how hard phalloplasty in particular is to go through, having just nursed my partner through the first stage. It is exhausting, terrifying, psychologically demanding, and I promise you the gaslighting comments from the anti-trans brigade make things a thousand times worse.

But I don’t need to tell any trans person how big a deal this is. We all know. The idea that well-meaning (concern trolling) cis people need to explain to us the demands of this surgery is infantilising and outrageous. No trans person gets to the point where they are signed off for major abdominal surgery that will leave them with visible scarring without knowing what they are about to undertake. Many trans men go for the slightly more straightforward metoidioplasty, or have no surgery at all, content with the growth they gained from taking testosterone, or just content with how their body is configured.

Most trans guys will follow others in groups or on YouTube and typically for men, no gory detail goes undescribed, including the times things go wrong. And they do. Phalloplasty still has only a 97% success rate and that is a scary thought, that you might go through all of this surgery and end up with nothing but scars. All this is heavy enough to deal with without ignorant creeps making you doubt yourself that it can ever be worth it.

Maybe the societal issue of not talking about men’s health plays a part in how we react to phallo. We know about the gory details but we probably don’t speak enough about what trans men and their supporters go through with this surgery. The months off work, the worry about it failing, the overwhelming stress, the involved care required for a skin graft and several wound sites, the two or three equally complicated follow-up surgeries. Maybe it’s still seen as some sort of “optional extra” and so the pain and magnitude of it is somehow disregarded. But for those who undergo it, I don’t think it really is “optional” but rather integral to their wellbeing.

Maybe I didn’t fully understand that until I saw Robin going through it. How alongside the pain there was something else – a sense of confidence and completion. Of rightness.

And just to be clear, this has nothing to do with sex, or dominance, or any other notions we may have about dick-swinging men. It’s more about walking in the world, about being able to use male toilets more comfortably, about what may happen when he is old and needing personal care. And simply about his relationship with his own body.

It can be worth it. It’s not an easy decision, but the reality is, like any self-awareness, dysphoria once acknowledged can’t just be wished away. Demi-boys like me spend a lot of time hoping that the little niggles of lower dysphoria we swat away will never manifest into something big enough to make surgery feel necessary. Nobody wants to need major surgery. But living with a trans man, I see it very clearly – how dysphoria has been taking up too much of his mind, his life. his energy. How this surgery has set him free from that and will allow him to live.