Okay. You might ask, “What’s up with Robbi? She refers to herself as transsexual, but she hasn’t had any surgeries yet? I guess she just isn’t that serious or maybe she’s not bona fide transsexual. If she were really TS, wouldn’t she rather be dead (hyperbole) than live without surgical alignment? Is she pre-op or non-op? Is she TG or TS?”

This “labels” argument has been bandied about in the trans world ad nauseum. I, for one, am really tired of this exercise in mental masturbation. Our obsession with nomenclature has become so overwhelming that it may actually interfere with being trans. Following last month’s column about biology and missing the forest for the trees, maybe we need to simplify our penchant for labels and classification.

Regarding surgery, there are no easy and formulaic strategies which factor into decision making. Just like anything else — even though we may share some similar histories and experiences and even though we seem to fight similar battles and confront similar adversaries — each of us walks a singular path. Sometimes it’s better to just be and not invest so much time and energy into cerebral mindgames.

And, is it really anyone’s business what we choose to do with our bodies anyway? What I divulge, and to whom, is solely up to me.

But, back to the point. When I try and answer the question, “Why haven’t I had my surgeries?”— the answer for me is extremely simple. Insufficient funds. And, for the most part, that covers my rationale. There are others who desire surgery, yet can’t afford it, like me, but that might not be the case for everyone. There are other situations where reasoning differs.

Because gender diversity manifests in many ways, not all individuals may desire surgical procedure(s). And, not all people can even have surgeries.

So what might someone consider before making any kind of decision? Well, the gatekeepers ostensibly want us to be sure about our choice — at least that’s what they say, and I can’t deny that serious thought is required before any surgical procedure. How sure we need to be will vary from individual to individual, but I think it’s safe to say that the percentage of those who have surgery and are happy far exceeds the percentage who may have experienced post-purchase anxiety. Probably, by a factor of 20-to-1, I’d surmise. Or, more like a 100-to-1. So, either we, as trans individuals, have a pretty good understanding of ourselves or the clinicians are really good at their jobs. I’ll leave you to determine which is closest to reality.

Surgical decisions differ, obviously, between trans men and trans women. For the former, options include breast reduction, hysterectomy, and phalloplasty. For the latter, considerations are generally vaginoplasty, breast augmentation and facial feminization surgery (FFS). Surgical options are not limited to these procedures, but these are most common.

For trans men, many might choose to have a breast reduction and/or hysterectomy, but might decline a phalloplasty. For trans women, a person might not want vaginoplasty, but might opt for breast augmentation and/or FFS. The choices and options are, again, not formulaic, but up to each person to decide.

And, the same is the case for persons who opt to have no surgeries.

Not everyone is transsexual and there are trans persons whose gender identity is unique to themselves. Whatever it is that they see within and manifest without may make surgery moot. Some trans people who identify as crossdressers may self-define as bi-gendered. Whatever it is that helps people to make these choices, it cannot be reduced to any kind of systematic super-structural theory which clinicians and therapists like to superimpose upon reality.

And, that’s essentially the problem I have with many clinicians: They don’t see the necessity for treating each person as a unique case with unique circumstances. It’s easier for them to try and fit people and their individual choices into ready-made scenarios. That would be akin to selling clothing in only mediums. No tailoring necessary; one size fits all. Logic and intuition tell us this is neither a reasonable nor effective approach.

Of course, medical complications can make surgical considerations impossible. Any person who has had liver problems will not even have been able to take on a regimen of hormone therapy. And, some cases of high blood pressure, as well as heart disease and any number of other medical conditions, may preclude an individual’s options. Sometimes dreams need be compromised for the sake of survival. These can be hard decisions to accept, but they can, unfortunately, be a stark reality.

As much as some of us find surgery to be a vital part of the process, it also must be said that the mental and emotional part of gender and/or sex alignment is undeniably a critical part of the process. Nothing changes until our minds and hearts are ready. Be that as it may, my mind and heart are ready. I find myself dwelling on surgery numerous times throughout any average day, daydreaming various scenarios. I envision myself before surgery and after surgery. My mind’s eye can see the post-op me. Many of my post-operative friends have said that as much as they pondered their surgery(ies) before, they rarely give it a second thought afterwards.

I’m not really sure what that implies, as much as I am uncertain regarding the relative differences between “wanting” surgery and “needing” surgery. I would have to say that I both want and need it.

What I do know is that I feel incomplete, incongruous and misaligned. It’s not that I hate my anatomy, more like I am indifferent to my penis as a functioning organ. It’s superfluous. After years of hormone therapy, some degree of atrophy has set in. It’s almost like a vestigial organ — like an appendix — there but neither necessary nor critical for survival.

Oh well, I know I’ll continue to fixate on surgical realignment until the day after, at which point I suspect I’ll be like so many others who now give it no more than a passing thought on rare occasions. : :

— Comments and corrections can be sent to editor@goqnotes-launch2.newspackstaging.com. To contact Robbi Cohn, email robbi_cohn108@yahoo.com.

4 replies on “Surgery?”

  1. Robbi;

    Although our respective frames of reference are similar, tey are also completely different. To that point, your observations are, for the most part sound, speaking from my own “unique” perspective.

    With that said, it should be self-evident to any intelligent (keyword) adult that human beings, being the delightfully diverse lot that we are, CANNOT be defined simply by their genitals.

    Therefore, any reasonable (keyword) person would KNOW that the whole “surgery” question should NEVER enter the discussion, unless one is conversing with either a medical provider or a potential sex partner.

    Sadly, “common sense” is not as common as one might hope.


  2. Robbi, I would tend to agree with you! I am a biological male with little desire to be one and I am, on the other hand, very much the femme. I’m one of those persons who will not have “the surgery” and I feel I’m “lucky” because while my male appendage is of little use it’s also quite small. I do not participate in HRT because I may not understand it but I simply do not feel a need for it either! I do quite well without it. While growing up and being my true self I have lost many who called themselves my friends because, in their minds, I’m merely another queer! Guess I’ll go to my grave not understanding why people seem to feel they need labels. Thanks for the article!

  3. Ms Cohn, thank you for this writing. I could not have written it any better, and I see you seem to concur, “identity politics” has no place in one’s transition.

    I happen to be one of the few within the Intersex community working towards convergence of the mind and body. And I’ve had more than a few Trans women try to dictate to me how to bring my body and mind into alignment. Fortunately, my doctor agrees with both thee and me. The SOC has to be personal, tailored to the medical needs of the individual patient.

    That, as a given, again thank you for writing this.


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