You probably don't know Jill. I've certainly never met her. She did, however, serve as my introduction to a new term: "Gender Confirmation Surgery." I figured out what it meant in context, but it still looked a little weird. Time to call in a specialist:

For more than 11 years, I have performed gender confirmation surgery as part of my surgical practice. I call it "gender confirmation surgery" because I believe that out of the myriad labels I've heard for the procedure — "sex reassignment surgery," "gender reassignment surgery," and "sex change operation," to name but a few — none is as accurate when it comes to describing what is actually taking place as "gender confirmation surgery."

For me, most if not all the other names used for the procedure — or, more accurately, the family of procedures — suggest that a person is making a choice to switch genders. From the hundreds of discussions I've had with individuals over the years, nothing could be further from the truth. This is not about choice; it's about using surgery as one of the therapeutic tools to enable people to be comfortable with their gendered self.

From what I am given to understand, there are people who will not be comfortable with their gendered self no matter what medical procedures are performed, but we're getting ahead of ourselves here. Suffice it to say that it's definitely a comfort issue for Jill: "The reproductive organs I have right now are a constant source of stress in my life. There is not a single aspect of my life that isn't affected by it."

And I can see her point: there are hardware issues from the shifting hormonal balance, and there are wardrobe issues from the, um, extraneous hardware. This, though, might be the most important reason:

All women have good reason to be afraid when they walk alone at night. That's no joke. Trans women have even more to fear. 1 in 12 trans women are murdered in their lifetime. When I walk alone at night (which is freaking never if I can help it) I'm worrying about being read as trans and killed. I'm worried about being read as a woman by a rapist and murdered when they see my genitals. When I go on a date, I always tell the person I'm dating beforehand that I'm transgender, because I don't want him to flip out and hurt me. This surgery would greatly improving my chances to be one of the 11 trans women who lives.

One could reasonably question the "1 in 12" figure, though there seems to be little doubt that trans women are being killed at a disproportional rate, and all else being equal, not being killed is far preferable to being killed.

And dating matters more than you think here, since much of the negative material in the press deals with the reactions of those who find out Too Late that there's a hardware mismatch. Tone-Lōc: "So I threw him out, I don't fool around with no Oscar Meyer wiener / You must be sure that the girl is pure for the Funky Cold Medina." Of course, if you're busy trying to get your money's worth out of Love Potion #10, you're probably not paying as much attention as you need to be. And if you're one of the chaps who believes that simply being in proximity to wood, even some girl's wood, will give you Teh Ghey cooties, this belief magnifies your potential overreaction.

Jill decided last year to try to crowdsource the six grand out-of-pocket expense for the services of a name-brand surgeon. She succeeded, and reported yesterday:

I've jumped through all the hoops and have even paid Dr. Bowers off. There's nothing but a plane ride standing between me and my surgery now, and I've got the ticket in my hot little hand! Excited doesn't even do justice to how I feel. It's almost unreal.

Sounds like a happy ending in the making, though of course life carries no warranty worthy of the name. And this isn't any kind of one-size-fits-all situation: there are those who are perfectly happy with the hardware they have despite its assumed inconsistency; there are those who don't feel as though they match up with either of the two Standard Binary Genders; and there are those who might vary their presentation ad lib, for whatever reason. No doubt there are others who correspond to none of these categories.

Much criticism is leveled against trans folk, for various reasons, though the only one I'm inclined to entertain is the obvious one: they're not doing their part for the propagation of the species. Let me know when you see Pope Francis bewailing his lack of issue.

The Vent

#872
  9 June 2014

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