Notes on Transsexual Surgery

"I have undergone surgery four times in the past four years. The first was a thoracotomy to repair a spontaneous pneumothorax, or a collapsed lung. I don't think of the surgery to repair this as any different from the others. In some ways, my lung repair should be considered gender-affirming too. To be gendered, one must be alive. A few months later, I got facial feminization surgery. A year afterwards, I got breast augmentation surgery."

"Many trans women I know debate which surgery is "the hardest." By this they mean which procedure has the longest, most physically arduous recovery period. I usually vote for facial feminization surgery, a form of plastic surgery that often includes a cornucopia of procedures like rhinoplasty, brow lifts, and tracheal shaves. Navigating slurping up yogurt and soup with a puffy, bloody face is sheer terror. Taste and sight become body horror-esque experiences, your eyes caked in dried blood as fresh goo fills up your gums."

"I'm still nervous every time I go under anesthesia. Just because these surgeries are born out of desire does not mean they are foolproof-but not in a way that would give conservatives ammunition. No one can really be certain of anything. We make choices; doors open and close. Certainty is a blunt instrument, a moral vicissitude that visits us very rarely."

A trans person underwent four surgeries in four years: a thoracotomy for a spontaneous pneumothorax, facial feminization, breast augmentation, and vaginoplasty. The thoracotomy is framed as gender-affirming because survival enables being gendered. Facial feminization often combines rhinoplasty, brow lifts, and tracheal shave and can produce traumatic, messy recoveries that alter taste and sight. Vaginoplasty is also complex and demanding. Persistent anxiety about anesthesia remains despite desire-driven choices. Surgical choices open and close doors and carry uncertainty. Gender-affirming care faces political attacks while bodily change is treated as mundane and fungible.

Read at The Nation