"Why?" It’s a good question. In all its aspects, from why do we go on with life, day to day, despite its apparent futility, to why do I feel I am a woman. Way too much for one journal entry. Eventually I hope to share my thoughts on many of these themes, and to return to them as I revise my ideas and reach new understandings. For now, I would like to begin by touching on a theme of great relevance at this point in my life, prompted by a question from a dear friend whose opinions, and evident concern for me, I respect. She asks:
“What made you decide to go ahead with the surgery - you were ambivalent about it in the summer?”
In other words, why have surgery? I’ve been ambivalent for a couple of years, or to be more precise, I keep trying to convince myself that it's not necessary, but the idea keeps coming back. I've talked it over extensively with my psychiatrist, and she agrees that I've given the con side a very thorough run.
I hesitate. Is this going to be ‘Too Much Information’? Do I really need to share all this? Do you need to read it? I think most people will be satisfied to know that I feel I need this operation, that I want it, and that I’m convinced that, like the other transwomen I have consulted, I will be happy afterwards that I have had it. I think, ultimately, it is impossible for me to really explain why, even to myself. Like other decisions I've made, part of the proof is the lasting sense of fulfillment they have given me. But I, and I know some of my friends feel the need to delve deeper, to understand better, to be as sure as I can. And if the purpose of this journal is to try and explain and understand the transitions in my life, I think I should try to be as clear and honest as I can. If, however, you would prefer not to hear graphic and personal details, please, dear reader, STOP HERE!
There’s a lot of prurient interest, as is human and natural, on this subject. The stereotypical, and very impolite question usually asked of transgender individuals is “have you had the surgery”. Official regulations reinforce the popular notion that a sex change is not ‘complete’ until the surgery has been performed. It first received widespread public attention with the 1952 front-page story, "Ex-GI Becomes Blonde Beauty", about Christine Jorgensen’s surgery. Even then it wasn’t new. Sex change surgery was first performed in the late 1920s and early 1930s in Germany, though castration, penectomy and breast removal has been documented throughout history. Everyone seems to know which surgery is being referred to, but there are in fact many possible surgeries that may aid in gender transition, genital and otherwise. The ones most commonly accepted by officials involve sterilization. This fact prompted a human rights challenge in the Province of Ontario that has resulted in them removing the requirement for surgery before obtaining gender changes on official documents. The surgery I am planning to have on March 12 is sexual, or gender reassignment surgery (SRS, GRS), euphemistically specified as ‘bottom surgery’, or more accurately as vaginoplasty.
Some cultures have been accepting of gender variance without any change to the genitals, one of the most well documented examples being what are now called the Two Spirit people of most North American pre-contact aboriginal nations. Many modern transgender individuals challenge the prevailing notions, and demand the right to live in their true gender without changing their genitals, or losing their reproductive ability. What’s wrong with a woman with a penis? Why should there be a problem with a man who gives birth to a child, and nurses that child, as is the case of an acquaintance of mine from Winnipeg? Many transgender individuals reject the idea of a gender binary and choose to be identified as agender, gender fluid, or androgynous. Some radicals even scorn those of us who pander to societal norms by choosing to be women or men. If our society had different attitudes, would anyone need to alter their bodies? In such an hypothetical accepting society, would those of us who experience gender dysphoria, an often debilitating condition where our bodies don’t fit our gender perception, be able to be happy with our physical selves?
Before I first dressed as a woman in 2007, I had never really thought about transsexuals or transsexual surgery. For as long as I could remember, I knew I had a significant female side to my character, which my mother had assured me was normal. I had never really worried about it. My ideas were muddled. I was aware of sex change surgery, and I associated transvestites with fetishism. I remember having prostitutes pointed out to me on the streets of Barcelona in 1989 as being ‘men’ and being confused by them having real breasts. In Barcelona I met my first transwoman; a neighbour of a friend of mine. Being liberal minded, I accepted these people in a confused way as gender deviants and rather pitied them for being maladjusted.
I have a strong distrust of the medical profession and of the pharmaceutical industry, of the tendency to medicalize natural human conditions and even sometimes to invent them in order to create a dependancy on expensive medical interventions. From my mother, who was an early activist in the feminist movement, I inherited a disdain for the patriarchally imposed trappings of femininity. (Something I have gotten over!) And from society in general, though I would never have endorsed intolerant views, I absorbed some element of the attitudes expressed by many, as exemplified by recent comments collected from internet postings such as the following: “…This is not a ‘politically correct’ or popular opinion, but you have to be very screwed up in the head to … want to be surgically mutilated to playact a sex role.” “If you want to reduce the suicide rate, you need to stop pretending that being transgendered (sic) is not a mental disease.” “Is anyone surprised to learn that [people] who define themselves by their self-hatred and who devote their lives to poisoning and mutilating their own healthy bodies have a high rate of suicide attempts?” (Katherine Cross, http://rhrealitycheck.org/article/2014/02/04/panorama-toxicity-trans-woman-online/)
This conditioning and my attitude made it hard for me to accept sex surgery, which I think I saw as one of the most frivolous forms of cosmetic surgery, and to accept gender transition, as it was so closely associated in my mind with sexual surgery. As my own gender confusion grew, I began to research the subject. I was excited to discover the differences between drag performance, crossdressing, and transsexuality. As an artist, the ideas of Judith Butler on the performative aspect of gender resonated strongly, and I soon began experimenting in my own performance work. I was also intrigued by the political dimension of genderfuck, the presenting of contradictory gender signifiers, such as wearing a beard and a dress, in order to undermine the gender binary.
My boyfriend at the time began educating me about the queer community. He outed to me a woman I knew as a transwoman, disparagingly commenting on how he thought she had gone for cheap surgeries in Mexico that hadn’t turned out well. I hadn’t realized, but looking more closely at her I could see that she had started out with a man’s body. My friend’s veiled warning backfired, as I was moved by her evident dignity, grace and humanity. I began attending a local transgender support group and was surprised to meet a beautiful young lesbian transwoman, my first transman, and another young person who I was shy to ask whether they were a man transitioning to a woman, or a woman transitioning to a man. I learned the distinction between the terms transsexual; generally a person willing to seek medical assistance in living in the opposite gender from the one they were identified at birth, and transgender; an umbrella term for gender variance. I began to track down transgender individuals, who were quietly living in the community; a young woman raising her baby, born to her girlfriend, a woman whose passion was Viking reenactment and battling with broadswords, and a woman who was a construction contractor. My stereotypes were dissolving fast.
Some of the people I met were seeking surgeries. One had a mastectomy, and a couple of friends had orchiectomies; the removal of the testicles. I could see how happy these surgeries made them, and in the case of the man, what a big change not having large breasts made in people’s perception of him. These were difficult times for me. I had begun, so far unsuccessfully, to seek professional help, recognizing that my thoughts of suicide were a danger sign. In my blackest moments, thinking I would never get help, I even planned my own self-mutilation, how I could cut off my own testicles. I met a young trans friend one night as they were about to jump off the Broadway Bridge, and spent a few hours convincing them to at least give life a few more days. A friend, an ally and activist who is not herself transgender explained to me how she had been born with a harelip, and how surgery had made it possible for her to be accepted by other children. I began to realize that the line between ‘unnecessary’ cosmetic surgery, and life improving and sometimes lifesaving surgery was not as clear as I had imagined.
The orchiectomy operation interested me, and in researching I realized some things about hormone replacement therapy (HRT). For transwomen, in addition to taking estrogen, we have to take an androgen suppressor, a drug that prevents the take-up of testosterone by the body’s receptor cells. These anti-androgens elevate the risks of undesirable side-effects, and as the estrogen doses also have to be higher to overcome the effects of the testosterone, the risks of taking estrogen are also elevated. However, after an orchiectomy and the removal of those ‘little T factories’ as a friend described them, no anti-androgens are required, and doses of estrogen can be lower, and safer. I had become rather thoughtful about the effects of testosterone, having observed some young friends after their T shots. For years I had been considering the advice of family and friends that taking anti-depressants might be helpful, but I began to wonder whether an excess of testosterone might be part of my problem. I learned that the early effects of HRT on people transitioning from male to female were reversible, and realized that if it worked for me, I could later decide to have an orchiectomy and thus reduce the risk and expense of having to take estrogen for the rest of my life.
I still had misgivings about going under the knife, and about my ability to heal quickly at my age, but a freak accident gave me courage. In the spring of 2012, while rehearsing for an outdoor dance performance which required me to wear heels, we were trying out variations on an ending sequence, one of which required a running leap in the air, and a change of direction as I landed. One of my heels skidded out from under me. I came down so hard on the pavement, one of the dancers crouched under our rolling ladder said he could feel the impact. I lay in shock, sprawled on the pavement, feeling the bone of my forehead touching the asphalt. After a stunned silence, the whole crew mobilized to transport me to the hospital, while I worried about bleeding on my costume, a white crinoline. Accompanied by our director, choreographer and dancers, a very attractive and competent young doctor put in layers of stitches over my eye, while I joked that I should get him to shave the bone to reduce the eyebrow ridge, a common facial feminization surgery, while he was at it. The wound healed fast and my bride of Frankenstein flourescent blue stitches were removed in time for the performance, a week later.
Research, and conversations with trans individuals, both in person and on the internet, has reassured me that while there are risks, the procedures have improved so much over the years, and the care offered in the Brassard Clinic in Montreal is so excellent, that the risks are extremely low. My physical fitness, diet, body weight and the fact that I am not a smoker nor do I drink alcohol reduce those risks even further. I am taking all the steps I can to prepare myself, and to put in place support for my recovery afterward.
I began HRT early in 2012, and was soon convinced that hormone therapy was working for me. It felt right for me in a way I had never imagined possible, my depression had gone and I was experiencing an equanimity that has turned out to be enduring. It wasn’t long after that I asked to be put on the list for the orchiectomy, understanding that it would be a year and a half wait for surgery. I was feeling more and more certain that I would want it. I was convinced there was no going back for me. I had tried for a few years to be a gender ambiguous man, and it had become clear that was not making me happy. I was anguished at the thought of people such as my supervisor at my last job and the mediator I was forced to see while I was being fired going home and referring to me as ‘he’. Having began the process of gender transition, I found that the more aspects of my appearance and behaviour I could make fit my self image as a woman, the happier I was. My surgery date came much sooner that I anticipated, there was a cancellation, and late in 2012 I had the orchiectomy.
Cost is a consideration. Sask Health paid for the orchiectomy, and it was done in Saskatoon, but they only pay a small percentage of the cost of SRS, and the procedure for approval at the moment takes several years, as I will explain in a subsequent post. I’ve decided not to wait, and pay for it myself. I live a very frugal life, often justifying decisions by saying “I can’t afford it”. This is of course relative. I choose to spend little on things most people consider necessities, in order to have more freedom, more time, and the ability to spend what money I have on other things. As a result of my 9 years full time employment at my last job, I have modest pension savings, which I am now old enough to be eligible to access, and the plan allows withdrawals of any amount. The surgery will cost me $20,000. A third of my pension savings. The price of a decent car. Hardly anyone in our society would question my buying a car, but I don’t want one. It would make a difference to the debt my children will have to take on for their post-secondary educations, but I’m already putting aside half of my wages for them, which is not an insignificant gesture. It could be greatly appreciated were I to donate such a sum for good causes, but I already volunteer a lot of my time, and I do think there are individuals in our society in a much better position to give financial donations.
I haven’t suffered the extreme dysphoria that many transsexuals feel about some parts of their bodies. Partly because of the self confidence instilled in me by my mother, I had felt mostly OK about being different. I do remember at an early age wondering why men were so badly designed, with unsightly, inconvenient and delicate reproductive organs hanging outside their bodies, and was envious of women’s streamlined shape, with all the delicate bits safely contained in their abdomens. I disliked my scrotum, which was rather large and dangly. In later years, at the gay nude beach, instead of being happy to have gay men comment on it, and want to touch it, their admiration made me acutely uncomfortable. On the other hand, from adolescence I wanted the acceptance and privilege I imagined would come with being a man, and felt acutely the inadequacy of my hairless slender body, and my inability to grow sideburns or to develop any bulk in my arms and chest, no matter how many pushups and chin-ups I did. As I began to live as a woman, these defects became assets. Except for the bulge between my legs. Over time this has become smaller. My penis has shrunk as a result of the HRT, and after my orchiectomy in December of 2013, my scrotum has also shrunk to a fraction of its previous size, to my great satisfaction.
So why go to considerable expense and some risk to cut off what’s left? Am I so oppressed by my failure as a man, in love and career, that I want to mutilate myself and become a woman, a person without a phallus? Is it, as some radical feminists believe, a way for me to perform the ultimate violation by possessing a female body, and infiltrating women’s space? Have I fallen for the myth of infinite consumer choice, the ultimate self-improvement purchase? Have I fallen into the wrong social and medical circles, grasping at straws after my nervous breakdown? I have seriously considered these theories, not uncommon in our society, and despite seeing some grains of truth in some aspects of these views, they do not describe what has happened to me, nor any other trans people I know.
I feel it’s important to note that women are not just people who do not possess a phallus, and I’m aware that the removal of a penis does not make a man a woman. Likely the paternalistic surgeons who pioneered the sex change surgeries felt that way, and aspects of that kind of thinking are still current, in the medical profession and among some transsexuals. But attitudes are changing, and we know that gender is not uniquely centred in the genitals, and is much more nuanced. We also know that women’s sexual organs are every bit as orgasmic and powerful as men’s. The operation I am planning to have, the vaginoplasty, has progressed since the early days, and rather than a removal, is more of a conversion, reshaping the sensate tissues of the penis and scrotum to create a fully functioning clitoris, inner and outer labia, sensitive inner folds, and for most, a vaginal canal.
I have opted to not have the surgeons create a vaginal canal. This is a little known and seldom discussed option. Here, for me, I draw a line. It may seem arbitrary to some, but I think by trying to explain it may help in understanding why I want the rest of the operation. Some people may feel that a vagina is an essential part of a woman. But why is a vagina more important than the organ to which it gives access, the uterus? Some XX women are born without a vagina, and/or a uterus. Many women have their uterus removed. We are all still women. I think the importance of the vagina in our patriarchal culture, outside its reproductive functions, is as a place for male penetration and sexual pleasure. This is fine! I also love being penetrated by men. But I happen to love anal sex. I also love non penetrative sex with women. I don’t see the reason to have a new cavity made in my body, one without the glands and secretions that will keep it clean and healthy, one that never really heals, and that requires regular dilations with special tools because the body is forever trying to close it up on the inside and around the opening. The surgically created vulva on the other hand, once healed, is stable. It will not need special cleaning, apart from the occasional shower. I can smell that the glands of my genitals are already producing the appropriate secretions for external female genitalia, because of my new hormonal chemistry.
Now that I’ve opened up the subject, is my desire for female-like genitalia about sex? Yes, that is an important consideration for me. At the moment I have no sexual partner, and as a rather mannish looking older gal, my chances of finding one are reduced. Having no testosterone in my system, my sexual drive is almost non existent, a change that has surprised me by being a great relief. Yet, like everyone, I do hunger for physical intimacy, and I can, if I’m in the mood, have orgasms. Before I began HRT I did experiment with casual sex, something that I don’t really find satisfying, and I realized that the incongruence of a female identified person having a penis was a big obstacle for most people. I’ve read that many people get over their hangups, and in theory love conquers all. Gay men and heterosexual women aren’t interested in my female behaviour and presentation, with or without a penis. However, gay women and heterosexual men, and even most bisexuals, especially of my generation, do have a big problem with the presence of a penis. What about the lack of a vaginal canal? If I was after casual sex with men this might be a concern, especially if I was trying to hide the fact that I’m transsexual. In that case, I would need other surgeries; facial feminization, breast augmentation and Adam’s apple reduction, and even then I would always be in danger of being exposed. I’ve never liked casual sex, and especially now that I don’t feel the urgent need I would have to know and love someone, and would want them to know about me before becoming intimate. I feel that the kind of women and men who might be interested in sexual relations with me, and who I would be interested in loving, though they might likely find a penis a turnoff, would be able to accept a woman with a vulva, but without a vaginal canal.
I hate to admit, being an activist, that one of the reasons for surgery is that I wish to conform to deep seated and slow to change institutional attitudes. You may think I’m a pessimistic alarmist, but given the fascist tendencies in our society and my activism and poverty I’m aware that there’s a chance I may end up in prison. If not, there’s a good chance I’ll end up in a state supported care institution in my old age. Despite my documentation saying I’m female, I think the presence of a penis would ensure my being treated as a man. Gloomy as these prospects seem whatever gender I’m treated as, I know that it would be much easier for me to maintain my optimism if I’m accepted as a woman.
Unlike many transsexuals, I can’t claim that genital surgery is necessary for my well being, especially under my present circumstances. I’m accepted as female by some of my family, most of my friends and in the workplace. I’ve managed to get government identification recognizing me as female. My penis is an inconvenience, and sometimes an embarrassment, but I’ve learned to deal with it. I have to be careful when wearing light skirts, leggings or a bathing suit, to tuck and compress it with tight elastic garments in order to reduce the bulge. As someone who loves skirts, and who dances regularly and swims whenever I get a chance, this is a nearly constant preoccupation and discomfort, though not as bad as before my orchiectomy. Bathrooms have private stalls, and I sit to pee, but dressing rooms and public showers can be stressful and I no longer feel as free as I used to on a nude beach. These inconveniences are not life threatening. Taken individually they seem minor, but cumulatively, every day, they do add up to an important consideration.
For me, the weightiest reason for having SRS is the one that is hardest to express, the least concrete, and the hardest to justify. I want it, very much. I’ve wanted it, I suspect, since before I can remember, certainly from the time I was deciding to try HRT. I’ve tried to reason myself out of it, but the idea keeps coming back. I know that altering that constant, annoying reminder into the sleek, streamlined organs I dreamed of as a child will give me a deep sense of cohesion. I’m convinced it will add immeasurably to the happiness I already feel at being able to live as a woman. It feels like a compulsion, like an adventure I can’t resist. I feel it is my destiny.