Tag Archives: Transsexual

Can I be non-binary and transsexual?

I talked in a recent blog post about ditching the term “binary trans person”. I want to talk about another binary in this blog, the TS/TG (transsexual/transgender) binary. This is as a result of an admin of a trans group telling me I shouldn’t comment on a thread because it was for “transsexuals only” and “being TS means you identify with the traditional binary”, that non-binary  people “absolutely cannot be transsexual”.

Obviously, I felt hurt and excluded by these remarks, and wanted to explore them. The subsequent conversation left me feeling unwelcome in the group as a non-binary person, and I left. It’s sad, but there are still many trans spaces that feel unwelcoming to non-binary people.

So here we have yet another binary, but also one created so that non-binary (NB) people can be excluded. We can be trans or transgender, but never transsexual, which smacks of the age-old issue of who gets to be “trans enough” and what it means not to be.

One underlying issue that creates this supposed divide is specific to trans women. A frequent complaint I hear from trans women is about happily-living-as-male crossdressers (CDs) throwing their weight around, as people with a bit of male privilege often do, without understanding the oppression and violence trans women suffer. Because many who might once have been called “crossdressers” have now adopted the term non-binary, this has perhaps created a narrow impression of what non-binary means. Some assume non-binary is synonymous with having less gender dysphoria, desiring less medical intervention, or not needing to socially transition. But none of these things is true.

I will fight forever for a diverse community to be held and protected under one umbrella. But we are not all the same. Non-binary covers a variety of people who don’t fit the prescribed and artificial binary that society currently inflicts on us. It does not mean we don’t transition, or don’t experience gender dysphoria, or have less gender dysphoria, or have less legitimately gendered or sexed bodies after transition.

So can transitioning non-binary people be transsexual? Some folks say that NB people cannot be transsexual because the historically older term was coined at a time when NB was not recognised and we had no civil rights. We are excluded because, well, we always have been.

But what’s the difference between a transitioning trans man or woman and a transitioning NB person? I have what some people call gender dysphoria, both physical and social. I changed my name, live in my identity, underwent medical treatment to change my physical sexual characteristics. Many NB peeps have lower surgery, and I’m not ruling it out. But some insist NB folk can never be transsexual. Our dysphoria is not like trans men or women’s dysphoria. Their gender identity carries some meaning and legitimacy that mine does not. Legally and socially that’s currently true, of course, but it still hurts when the trans community perpetuates this separation, particularly because they are people who have themselves faced a cis society that delegitimises their identities.

But what is dysphoria?

Not everyone likes the term gender dysphoria, because it’s associated with medical diagnosis. The opposite of euphoria, it means the clinically significant distress some trans people feel as a result of being trans. Some argue that in a perfect world, being trans should not cause distress, and a landmark Lancet study agrees that being trans is not, in and of itself, a cause of mental illness, but rather the treatment of trans people in society is.

Looking back at the conversation that sparked this blog, the implication was that having “lower dysphoria”, the desire to change your genitals, is what makes a person TS. But how do we know, when people desire to change their genitals, that it always means the same thing or feels the same way? Or if they don’t, might there also be multiple reasons for this?

Let’s look at how trans guys and AFAB non-binary people feel about their bodies. For a start, dysphoria is not just one thing but many strands of experience. You may feel that having a penis is part of being a man or male, and you will be incomplete/not a man without one. That it is impossible to be a man without a penis. This is an aspect of social dysphoria – a feeling created by the way society sees men and thinks about trans men. If you are surrounded by people who accept trans men fully, whether or not they have a penis, this type of dysphoria is less likely to cause you to need surgery. You may be disabled and fear how you will be treated during personal care, or fear personal care when you are older, if your genitals do not match the way you look. The experience of many trans men with their carers bears this fear out. Again, this would be resolved by feeling confident that carers will always treat you as a man no matter what is in your pants. This, too, is social dysphoria. You may fear being rejected by lovers or partners based on what your genitals look like. Again, that’s social dysphoria, and this may be lessened if you are in validating relationship.

Physical dysphoria is something different. Sometimes likened to “phantom limb syndrome” it’s the feeling that something should be there that isn’t. Or shouldn’t be there but is. This can happen with all kinds of body parts, a wiring glitch where the brain does not accurately map onto the body. So, there are people who, for instance, feel like certain body parts do not belong to them. Brains and bodies are weird and the way people experience their embodiment is diverse. So for instance, there are AFAB peeple who feel agender or woman-identified but have strong physical dysphoria, desiring male-typical anatomy.

For some, physical dysphoria is unendurable and the need for surgery is intense. For others, it can be resolved through the use of prosthetics and surgery is unnecessary. For people like myself who are dissociative or out of touch with their bodies, it may be easy to ignore or we may even be unaware of physical dysphoria, as I describe here.

There is also a third kind of dysphoria some people call internal dysphoria – neither physical nor social, it is about how the person feels inside of themself, outside of a physical or social context. Again, this varies hugely from person to person.

dysphoria diagram

Let’s not forget also that for AFAB trans people reproductive organs are more than just external genitals. Some people, like myself, feel far more physically dysphoric about our internal reproductive systems (owning a womb, having periods, hormone cycles, potential of pregnancy) than we feel about the size of our erections.

Because with or without intervention, AFAB people get erections! We have our very own erectile tissue. And when we take T, it generally grows (a bit, don’t get *too* excited). And for many of us, this growth is sufficient for our needs. Or we might be much more focused on chest reconstruction. Or just hysterectomy. And if we do decide we need more length, or want to stand to pee, there are a range of options from the very simple clitoral release, the more difficult metoidioplasty to the very complex surgery of phalloplasty. And of course, many disabled people and people without access to funded healthcare find lower surgery unavailable to them, however dysphoric they feel.

Am I defined by my gender or my sex?

I’ve written about how gender and sex are far more interconnected entities than we would like to believe. The reason transgender as a term has gained traction over transsexual is, I think, an acknowledgement of how much trans lives are affected by social gender (including birth assignment) rather than simply the shape of our genitals/size of our gametes. It’s the social consequence of our body shapes that affects us more than our bodies themselves. We are trapped in people’s perceptions of our bodies, as the saying goes.

The other reason the term transgender has gained traction is because more trans people now consider their gender to be something pre-existing a desire to transition – transition does not create us, it helps us be more comfortable. So I, for instance, feel I was trans as far back as I can remember – that my experience of gender, and the way I was treated, is not the same as the experiences of women who are my contemporaries. In other words, transition doesn’t make me trans, I just am.

But the term transsexual persists, usually meaning a trans person who alters their sexual characteristics medically. Let’s take it down to brass tacks – sexually, what am I now, with a male hormonal profile and secondary sexual characteristics, but XX chromosomes? If I can’t be described as transsexual, then how can that term carry any meaning at all?

I have so many questions about how this TG/TS distinction could possibly work in practice, and even more about why it is needed. Of course the reality is, it’s just some people preferring one term and some the other, and the terms thoroughly overlap each other.

Divide and conquer?

We know TERFs want the TS/TG distinction because they are trying to convince trans women that a special exception will be made for them if they have had all the available treatment, that they will be allowed civil rights and be partially treated as women as long as they hold the line against the rest of us gaining any rights. A classic divide and conquer tactic which alas seems to work all too well, playing into a widespread fear that non-binary rights are just going too far. But trans women already have civil rights, and these were never TERF’s to bestow. Whether or not they have surgery, they can have their gender recognised. The Equality Act 2010 defines “transsexual” as “proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person’s sex by changing physiological or other attributes of sex.” Transitioning non-binary people are understood to be covered by this wording.

So in law, I am transsexual. In my gender doctor’s notes, I am transsexual. It’s not my favourite word, and I tend to prefer my trans umbrella to be wider rather than narrower, but if TS is to endure as a term, can we at least make it mean something that isn’t NB erasing? Because saying my transition is so fundamentally different from a trans man or woman’s transition that it needs a separate word is unbelievably othering.

What is the underlying fantasy in all this? That there are clear lines dividing transsexual from transgender, non-binary from trans men and women, and that we can pin everyone down clearly, with no bodies straying over the lines? But many “crossdressers” are “true transsexuals” waiting for the right moment to take the plunge. Many NB people have more medical intervention than people who identify as trans men or women.

Ultimately (trust me on this) when you drill down into people’s experiences, the words they claim to describe themselves are often used in unique and idiosyncratic ways, and we are all still floundering around for the right universal language. So there are people who identify as non-binary transsexuals, some others who see the word transsexual as old hat, and some who think it signifies a binary, because it was coined by people who hadn’t imagined anything more than a binary.

Who gets to decide? That’s always an interesting question. Who are the gatekeepers of any community, the holders of the keys, who get to set the terms? Personally, I believe “transsexual” will remain with us as a term. Some people like it, some loathe it, but as long as it’s alive, and used by some people to self-identify, it’s valid, and we shouldn’t be denigrating its use. Is using it a valid way of creating spaces and discussions that explicitly exclude non-binary people? No, that would be really oppressive.

Do non-binary and other trans people need to reflect whether they have relative male privilege, or whether they are comfortable enough in their assigned sex they will never need to socially or medically transition, and so are exempt from particular aspects of trans experience? Sure. I know I’ve had moments of anger when someone happily living and working as a man has taken a place on a podium speaking as a trans woman.

But we need to remember if we were to exclude those with assumed “male privilege” we might also exclude the most vulnerable of trans women and NB people. I know many trans people who are unable to access trans medical treatment because of other, pre-existing physical or mental health conditions. If you’re homeless, access to healthcare, to clothes, to shaving equipment and all the other means to present in your gender may be inaccessible, not to mention how unsafe it can be to present as trans or gender non-conforming while homeless. Other trans people are awaiting the result of asylum applications before embarking on transition because they would not be safe in their country of origin. Some are not safe to transition for economic reasons (they would lose their income, home, or other security), others are waiting for elderly parents to die, for whom they are sole carers, or for children to grow up. Or perhaps they are children themselves, with unsupportive parents. Still others are in abusive family situations where it would not be safe to come out. Some of us had to work through complex mental health issues before coming to terms with our gender.

Non-binary people have the additional hurdles of trying to live within genders not legally or socially recognised, which restricts our choices and means there is no clear transition pathway for us. Many non-binary people have publicly transitioned and are living in their gender as much as they are able yet their identity is perpetually erased and defaulted back to their birth assignment, and this is certainly not a privilege. So “living as” is not the same as “identifies as” is not the same as “perceived to be”.

Not forgetting that NHS waits are 2 years now, and everyone deals with that wait differently.

There is a variety of privilege, and a range of experience within this community. But is there a TS/TG binary? A TS/CD binary? Is there a clear dividing line between non-binary and trans man or woman? The hell there is. Life is just not that simple. We all exist on a continuum. We are who we are, all our self-identities are valid, but gross generalisations need not apply.

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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.