The trans debate

“Male bodied” people in women’s loos Shock! People with no diagnosis of gender dysphoria! Could they be a threat to women? I commented on the Guardian that I had gone, dressed female, into women’s loos and changing rooms before I committed to transition, before I had a diagnosis. Yet I have a diagnosis now, I am clearly a true trans woman. And someone asked, When you entered women’s spaces in the past, how confident are you that your presence didn’t cause distress or concern to those women who were also present?

I’m not, actually. I can’t be certain. I did get read. I still do. Somebody might be distressed or concerned any time I go into a loo. So, there, is the zero-sum game: do you support my right to be myself, or the right of women, oppressed by patriarchy or being transphobic, to avoid the distress of my presence in women’s space. We have been transitioning and treated as women for decades- should that now just stop? If there are around 20,000 trans women, what harm are we really doing?

There’s an endless harping on about prisons, because some of the trans women in prison have done horrible things. Yet if one allegedly hurts women prisoners, that is not a mark against trans women without a prison record, but against the unfunded, dystopian, drug-riddled prison system. In 2015 there were 89 suicides and eight homicides in prison, as well as a death of a prisoner restrained by officers. In 2016, there were 120 suicides. Trans women, showing fantastic bravery being transitioned in men’s prisons, kill themselves.

The government took nearly a year between announcing gender recognition reform- not any change to the Equality Act, which allows trans women to be excluded from women’s space- and starting the consultation, and in that year the Murdoch Press and others started a sustained campaign of vilification against trans women. Any story, however unimportant, showing a trans woman in a bad light might make The Times or Sunday Times. The Spectator magazine, increasingly the British Breitbart, chimes in.

Yet traditional transition may be dying out. In the Government’s LGBT survey, more people answering identified as non-binary than as trans. If we cannot gain acceptance by transition then living in stealth, as stealth is too difficult, other modes of self-expression become more attractive. The reform necessary is to outlaw discrimination on the ground of gender expression.

Most feminists against trans women, who are being amplified by The Times, would consider themselves on the Left. They are “gender critical”, they say, finding gender norms confused and Patriarchal. Some might admit to being “gender non-conforming”, but often they claim that is trite. No woman really conforms, they say. Yet some do. Feminists make progress, explaining women’s oppression so it changes from just what is, as imperceptible as the air, to things holding women back, a wind blowing against women and behind men. And some women are feminine.

So there are two groups of women, the gender non-conforming feminists and the non-binary AFAB, each transcending conventional femininity, in much the same way, often, but having very different ways of describing it or conceptions to understand it. Rupert Murdoch, upholding the Patriarchy, has set them at each others’ throats. A few of us try to find a way ahead, common cause for people alike oppressed by gender, and we are trampled. The possibility that I might upset a woman in a loo is proclaimed to be far more important. I find the debate utterly wearing and depressing. Rather than finding a way forward, a way to work together to challenge gender norms and make people more free, more caring, more collaborative, the GNC feminists are reduced to crying “No! Not That!”

Orchiectomy III

Testicles have such strong cultural associations. They are the symbol of manliness, in its best sense: the man who toils and does not look for rest, who does all that is demanded of him and achieves his goals. If he doubts his ability to do something he is told to “grow a pair”. Does he have the balls to take on a task? Even women are asked that.

You have committed to transition, and you are taking oestrogen and a testosterone suppressant. My psychiatrist used this as a diagnostic tool: a sexual fantasist would not want to, as their libido would decrease. They would be cross-dressed without arousal, and might get bored of it. Or, the test is whether you like the way you are on this treatment. If you like it, it is right for you.

Unfortunately, some patients don’t see it that way. They have decided that transition is right for them, and they see transition as being a single process, involving set steps. You get hormone treatment, before or after changing your name and ceasing to present male. You have hair removal and possibly facial feminisation or baldness treatments. Vaginoplasty completes the process. We observe that we pass better as we have more practice, so the “real life test” shows life getting better as there is less abuse in the street, and we find presenting male more and more unpleasant.

I was willing to tolerate discomfort, in the belief that life would get better. I also felt that vaginoplasty was part of transition. Now, I want to help others in transition consider it as a matter of discrete steps. It is not just one process, one binary choice, either stay presenting male or change name and have hormones and surgery. It is, what is right for you? One person I knew felt she had to stay presenting male for her career, but had GRS.

I also want it to stop being a question of identity. “I am a trans woman. Trans women need surgery.” I am a human being. Human beings pursue a variety of paths.

The alternatives- transition as one process, involving change of name and presentation, hormones and surgery, where you go through the process tolerating the discomfort believing life will get better, or give up completely and revert; and transition as a number of choices,

Transition is often seen as one process involving surgery: there are reports of people feeling elation after surgery, because the process is completed, only to suffer depression up to a year later, because their lives have not improved.

So one of the choices is whether to have an orchiectomy. This is far less invasive surgery than vaginoplasty. It means you stop needing testosterone suppressants. And, though taking oestrogen with testosterone suppressants will reduce your sexual desire, fertility, and ability to sustain an erection, doctors assert that while fertility changes may be irreversible, changes to erectile function and libido may be reversible. Orchiectomy drastically reduces your natural production of testosterone, and is irreversible.

Cordelia Fine asserts that these characteristics of pluck and determination are seen as Manly not because of the effects of testosterone, but because of Patriarchy. It takes balls to have an orchiectomy- it is a sign of courage and commitment.

What I want, for people considering transition or surgery, is to reduce their symbolic power. As a symbol, testicles are a sign of Manliness. But as Germaine Greer said, “I don’t believe a woman is a man without a cock”. Oestrogen and testosterone suppressant will help you pass better. Orchiectomy will help you pass better. But it won’t make you less of a man, more of a woman, or even less of a weirdo. You can’t escape being a weirdo, I am afraid: that you are considering surgery makes you very unusual indeed. But being a weirdo is not a bad thing.

Why would you want the effects to be irreversible? That’s a symbol, again, of your determination and commitment, and certainty that you have chosen the right path. Symbols are expensive. You have a right to be you without bearing so much cost.

Late transitioners

“Late transitioning” trans women are those who have struggled on to make men of themselves, but in later life transition to female. A beautiful example is in Jennifer Finney Boylan’s article in the NYT: People often ask late transitioners, why now, after all this time? What kind of woman do you think you can be, after missing your girlhood and your adolescence? But those aren’t the questions one should ask.

The question is, how did you manage to go so long? What enabled you to keep carrying your burden in secret, walking around with a shard of glass in your foot, for all those years?

If referring to people as “late transitioners” were only a description, it would be unobjectionable. Some people marry and have children, or do not think transition is possible and go on to build careers in which transition is genuinely impossible. However there is a nasty myth that “true transsexual” or “primary transsexual” women transition in their teens, and are primarily attracted to men; and those of us who transition late, or are attracted to women, are in some way not real transsexual. This interferes with treatment for older trans women, and is a cause of argument within the trans community. Some people want to insist they are true trans, and others are not.

If “Late transitioning” is a way of judging someone, or a way of drawing conclusions from a loveless, judgmental stereotype, it becomes a slur, a way of demonising or rejecting people. If I use it of myself, it is simply a description. I transitioned late according to some people, changing my name and going to work dressed female aged 35.

That is what “reclaiming” means. We decide to treat “queer” as a word which we fit, without seeing it as judgmental. I am proud to be queer. Queer identity is inclusive, and resists the obsessive categorisation of the sexologist. I can reclaim “late transitioning”- the negative connotations have no value, I am a late transitioner and I am a trans woman. Others may insist on the negative connotations, but I may reject them, after which they have a lesser and lesser effect on me until they do not matter at all. Then my example may help others free themselves in the same way, just as the example of others frees me.

Other people seek to control me with their judgment. My answer is to apply my own judgment. I am a person of value.

FtM

I consider the issues for trans men are so different to mine that I want to be a good ally, rather than imagining myself able to speak for them. I am blogging to thrash out what I think; that’s a starting point from which I want to get to being an ally. Knowing where I am, I might find a route towards being an ally.

I have been writing about the vaginoplasty, which I find wrongful in almost all cases; only acceptable where sexual activity is unbearable using a penis, and the person can only countenance being penetrated. I consider that so many people have vaginoplasty as a symbol rather than reality- because it symbolises being a real woman, or at least a real transsexual person, for them; because they cannot imagine a person like them as a man rather than a woman, and cannot imagine a woman like them with a penis. Whereas penises are great. And many people are dissatisfied with the result. Several people talk of those who cease dilation (though some keep it up).

I think top surgery, chest masculinisation, is different. It means you can stop binding, and so breathe better, and I understand binding can cause health problems. You have two large scars under where your breasts used to be, so going topless is difficult, but passing when you have a top on is much easier.

The main difference is that T gives you facial hair, male pattern baldness, and helps your voice break. Sometimes people’s voices don’t break well, but generally unless you are cursed with very wide hips, or being particularly petit, or a particularly feminine skull you will pass. You become gentle, caring men. You gain male privilege. Am I envious? Yes. I would like to pass as normal, I crave straight privilege. Passing is not guaranteed, but there is some indication before you start whether it will be possible.

I know we say, it is not a choice. I know we say, it is irresistible. If you think you might, but are not sure, you are not true trans- and such stories help put off those who desperately want to transition but are frightened and not sure they will manage it. Lots of people who are not sure, or who are delaying transition, will make a go of it. And for anyone it’s a lot of time, effort and money.

So it is a choice. People put off transition, or avoid it completely. This does not make them less trans, just means that their circumstances are particularly against transitioning.

Can I be an ally, and hold out the possibility of accepting being yourself in your own body? And, accepting yourself, you find you are accepted by others- at least enough others, in the tribes and the enclaves you discover? Then you would not be dependant on synthetic hormones life long, with the risks that entails. Not transitioning, in other words, would be the better option, rather than the thing you do because you are forced to. Passing makes being trans easier.

Being an ally would involve separating out my own feelings about myself and my choices. And supporting the choices people make. They are able to make their own choices. Only if regret rates are significant does regret become relevant. Only if people transition, alter their bodies, and then wish they had not in large numbers is it a reason for restricting treatment. That is a number we need to know, and somewhere between 0.6% and 4 in 13 is not good enough. My own regret is not a good enough reason to try to persuade people not to, unless there is robust evidence of others’ regret.

Or, the number who have transitioned is large enough to show it might be right, and yet small enough that if it is wrong it is not a huge disaster, to support transitioning as a course of action.

In summary I am against vaginoplasty and agnostic/guardedly in favour of chest masculinisation. A person like you should be able to live as a woman; but in the Patriarchy, when certain qualities are disparaged as unmanly and projected onto women, that’s difficult. I want you to have the best life you can, and trust you to decide how you will achieve that. Then I want to be a supportive ally.

Vaginoplasty or labiaplasty?

If you are having GRS, should you have vaginoplasty or labiaplasty? Vaginoplasty creates an orifice, perhaps seven inches long, inside you. Labiaplasty creates an orifice about an inch long, which has the urethra, but not a vagina opening onto it. An alternative name is “vaginoplasty without vaginal cavity”, used by GRS Montréal, which uses the term “labiaplasty” to mean a later alteration to the labia.

The vagina needs to be lined, with the skin of the penis or scrotum. You do not want hair growing inside, so that means either laser or electrolysis hair removal before, or a lengthy procedure removing each follicle as carried out by my own surgeon, which lengthened the time the operation took. GRS Montréal says the surgery without the vaginal cavity takes 1½ hours, with admission on the day of the operation, two days in the hospital after, and returning to sports after six to eight weeks.

Surgery with the cavity in 2004 took seven hours, but in Montréal it is two. That surprised me, and shows I should check the current conditions before pontificating. Anyway. What about dilation? It seems far less onerous than it was 14 years ago. After my op in 2004, I was told to dilate for two hours in the morning and two hours in the evening, on top of time spent preparing and cleaning up afterwards. I did this early before work, and noticed that even though I was lying on my back, it was not restful. I could not sleep with the stent in. After six months, I had been told that I could reduce it to one two-hour session a day, but that immediately resulted in a narrowing of the opening, which I found so distressing that I gave up. A surgeon in England told me “There are no rules”: you find what you need to do to maintain width and depth, or you stop. Those are your choices. If dilating is not keeping the orifice open, dilate more.

Montréal recommends four times a day in the first month, but never more than half an hour in total, and after the first year once a week. This is considerably less. If you are having penetrative sex to the full depth- what a friend jokingly called “organic dilation”- you do not need your stents at all.

You need to keep your orifice clean. To the tune of “Keep young and beautiful”:

Whereever you have been
You must keep your new vagina clean
Hibiscrub and betadine, every morning and night
To help you feel serene
Or only just to feel fit to be seen
Hibiscrub and betadine, every morning and night.

Montréal, however, only recommends salt in the douche, but gives a graphic account of what happens if you don’t do it properly: abundant, smelly and bloody vaginal discharge, deterioration and enlargement of the wound surface, risk of infection.

OMG!!!!

While it is less onerous than it was in my day, dilation and cleansing is still a significant drain on your time. I don’t know what research they do to check whether the dilation times and frequencies recommended succeed. How many people give up? How many still have the full depth and width, five years later?

 ♥♥♥

Yet, unless you want to be penetrated, why would you have this operation? The comments on my previous post give some clue. Joanna referred to it as “full transition”- so expressing yourself female is in some way not enough, the operation completes transition. If you have a partner, could they accept your body without such an alteration? Can you? Can anyone commit to living in the world as their real self, without altering their body?

The person variously known as “trans heretic”, “sock puppet” and “the sceptic” writes she was “surgically corrected”, because of a need deep within me to correct a fundamental physical wrongness with my body. However badly the cultural concept of trans including surgery fits others, it fits her perfectly. It was right for her. Apparently, it still is. “Transgenderism” is my physical reality, wrote someone on facebook. That was what I believed, then. It is not what I believe now. I see no way of being certain if anyone else would cease to believe it, but if it’s tied up with the idea of yourself as fitting into society alternatives would include becoming able to bear not fitting in, or finding your own tribe to fit. I don’t think we are accepted as trans women, not really. No-one who would not accept you as a feminine man will accept you as a trans woman.

If you want male partners, it makes sense to have the orifice. If you don’t, it is less clear to me. Then the orifice is part of your self-image as a woman. You would have a uterus transplant if you could, but given that you can’t at the moment you go as far as you can. So it’s about being genuine, being a real trans woman, rather than about what the alteration will accomplish. It is about ideas and not reality. It is all in your head.

I fear that the concept of a woman with testicles makes no sense to us. We say we are women, and some say not trans women but “women with a trans history”- trans is crossing over, and that is in the past. I fear that the operation is seen to complete transition, rather than to achieve what it achieves.

I have been mutilated. I wish I hadn’t. If it was a mistake for me, is it for anyone else? Hormones and surgery reduce libido and sexual responsiveness. That was a relief at the time, and now is aching regret. How can you accept yourself as you are?

Here’s Grace Petrie (pronounce Pee-trie, whose pronouns are she and her). If you are not weeping by the time she bites her lip, I don’t understand you. She is trans-affirming, gender non-conforming, and female.

Righteous anger

When I go to see my doctor, I hope we will be discussing my issues rather than hers.

I told her I was tired all the time, and she sent me for blood tests. The practice wrote to me telling me to make an appointment, so I did. I was ambivalent about discussing antidepressants. I have not found them useful in the past, and feel that my depression is caused by circumstances rather than any brain chemical imbalance, particularly by a series of traumas.

-Why have you come to see me today?
-The practice wrote asking me to make an appointment.

She looked blank for a moment. “Well, you remember I told you that your thyroid reading was slightly lower than normal range.” It took me several tries to convince her. Eventually I said, “I have not seen any doctor at this practice since the blood tests. I made the appointment after getting a letter from the practice. Perhaps you wrote a note of what you were going to say, before requesting the letter.”

That got through to her. My thyroid is very slightly below normal range. It could cause various symptoms- heavy periods was one she mentioned, she knows I am trans surely. Not regulating temperature. Putting on weight. She recommended another blood test in 3-4 months, and if it showed a similar result she might try me on a very low dose of thyroid medication.

No, I don’t want to discuss depression after that. She, however, has something to ask me. Her lesbian friend, who she trained with, asked on facebook whether friends thought the word “queer” had been reclaimed or not. She commented, “Yawn,” and some disparaging reference to “political correctness”, and all the queers piled on her. She wondered what I thought, she said.

Well, I feel the word “queer” has been reclaimed: we do “Queer Studies”, after all. But that’s not what she’s asking: she wants me to say the queers should not have rebuked her.

-You’re straight, aren’t you?
-What’s that got to do with it, she blazed. I am taken aback. She says they would not know that. I am too nonplussed to explain that she does not get the nuances around the word. It has been used to belittle and attack people, including some who might be on that facebook thread.

She says being Jewish she understands all about being part of a minority. Now, me being queer means I want to be a good ally to Jews, BAME etc, and I might say that, but she is saying something different, that being Jewish is enough to understand. Her children are so terribly left wing and right on. She wants pensioners to get enough benefit so that they can afford food, rent and heating, but her children are concerned about things like transgender bathrooms.

“Well, I would love to stay chatting but I have patients to see,” she says, dismissing me.

What would be the point of complaining? I don’t really want to make trouble for her, and I don’t think it would achieve useful change.

I was being sympathetic, but the moment I started to hint that they might have reason to object to her comment she became immediately defensive and struck back. Why should it matter that she’s straight? She does not want an answer, only to be assured that she is right to be aggrieved; and perhaps to take out her grievance. I love her righteous anger. I wish I could do it myself, instead of being quiet then resenting.

-Where’s the hurt, you ask, and I answer in that quiet voice which I think shows my most vulnerable self in our conversations.

It’s just hurt. I don’t think it’s anger, or resentment. There’s some perplexity. I feel disrespected and this feels unfair, and my sense that it’s unfair I immediately judge as pointless, worthless whining. I admire her going on the offensive like that, I don’t think I would.

I noted how easily my mood can go up and down. I was worried about that conversation, “you don’t seem depressed”, and then meeting Mr Corbyn got me feeling so much better. Then something happened and I got down, then I started talking about something I was looking forward to- I said “I will do that well”, and knew in the moment that what I said was true- and felt good again. Being able to say to myself that it was just a mood, like dreich weather, would be a good skill.

Love, truth and trans

Love without truth is… It is such a tempting rhetorical formula that there have been several tries. Love without truth is sentimentality, hypocrisy, cowardly self-indulgence. Truth without love is either brutality, harshness or perhaps imperious self-righteousness. Evangelical Christians, who think Love may be tough, aimed at correction, not sparing the rod, might say Love needs grace as well as truth. The balance of love and truth is the conflict between liberal and conservative Christians, who emphasize one or the other.

Possibly over-influenced by the company I keep, I am nearly able to use the term the “trans cult” for trans theorists, in anger and blaming, but not quite. I am persuaded that humans are divided into two different sexes, but that gender is cultural. Patriarchy devalues some aspects of humanity and projects them onto women. Jung said the man must recognise his anima, the female soul within, and the woman her animus- for the qualities are not divided between feminine and masculine, but all human. The answer is to cherish the qualities of each individual. That is the minimum for love, respect, the I-Thou relationship treating all people as ends not means… there is no truth without love, for only love really sees.

Trans fits people in society as we are now. No, I am not a woman: I am a trans woman, a product of the culture, trying to find my way as best I can, find peace, find a place I might fit. Some people make a success of it: after a period of drifting they transition and make their way in the world. I don’t think it should involve surgery, perhaps not even hormone treatment. I see no point in surgery. It makes us infertile, and if it makes us more acceptable to others it is by proving we are sincere rather than proving we are women, or proving we have the doctors’ confirmation, which I don’t think we should need. Surgery seems the final stage of transition, the Holy Grail. It holds out hopes to at once make you a woman, win acceptance from others, and complete the transition journey. Your life will be wonderful. It is a thing to celebrate: we send each other cards marked “It’s a Girl!” Yet it’s still you with your same problems, and the problems of dilation and recovery from surgery as well.

While trans people have surgery, we will want surgery. Of course some of us will be able to make a go of life post-op, and some might even imagine it’s because of the op. But it does not do anything for you. A woman with a penis makes no sense, but me with a penis does. You are born in your own body. We will want surgery the more if we are aware of hostility in society, because we will want to prove ourselves. But genital surgery is only a symbol. If you want to wear a swimming costume or tight jeans, tuck.

Top surgery for trans men is quite different. It means you can stop binding- breathe freely, free of discomfort- and is essential for passing. I do not criticise any trans man for wanting top surgery.

Yet, we exist. Trying to live with my gifts and characteristics, I find presenting female more congenial. The qualities patriarchy devalues and projects onto women, I have. I have no wish to revert. I am a trans woman. So trans women should be treated and accepted as women.

That’s too subtle for many. If, as the Labour party asserts, trans women are women, we should be accepted and treated as women. If we are not, then we should not.

To avoid surgery and hormone treatment, trans women should be treated as women. We have transitioned. We are not dangerous, and should be treated as individuals, not blamed for each others’ wrongdoing.

Cross-dressing and gender queering should be welcomed, to subvert gender expectations, which harm both sexes. When someone wants to transition permanently they should be helped to value all that they are, for everything that is, is holy. Perhaps then transition will not seem necessary. This is the opposite of conversion therapy. The only problem with all this is feminism and the rights of women- and the wrongs women suffer from others.

Don’t have GRS

Personal stories of why people wanted genital surgery, and why they regret it.

The way transgender is understood in Anglo-American culture, in the theory and practice of law and medicine and in the way trans people understand ourselves (until it’s too late) puts overwhelming pressure on trans women to have genital surgery which is not in our interests. When we regret hormone treatment and surgery, there is pressure on us not to say that in public. I regret surgery, so I have an interest in this- to save others from my mistake, as I cannot rectify it- but I am not alone, evidence of regret is suppressed and evidence of satisfaction exaggerated.

The circumstances of MtF and FtM around motives for surgery are completely different.

The diagnostic criteria for gender dysphoria in the DSM and gender incongruence in the proposed ICD-11 both require a strong desire to be rid of primary and secondary sex characteristics and to have the characteristics of the opposite sex. The Equality Act protects people who want their sex reassigned, or have had their sex reassigned, though the heading is “gender reassignment”.

At the time I changed my name and went full time, I was ambivalent about surgery, but a year later I passionately wanted it. Why would you want surgery? I believe I wanted it at the time because I wanted social acceptance, or possibly to accept myself. Where a person male by genes gonads and genitals wants to dress as a woman, there were two categories they could fit- transvestite and transsexual. The transvestite is considered to be a sexual fetishist, which I found unattractive, but the transsexual had a medical condition, which I found more congenial. I felt my personality was feminine, a concept which now I consider meaningless.

If there were more acceptable categories, protected against discrimination by law, not involving surgery, perhaps I would not have wanted surgery. Medicine tends to categorise health problems which require the intervention of doctors to cure, but possibly we could reconceptualise gender dysphoria. Gender incongruence type 1 is a desire to live in the role of the opposite sex. The treatment is to live in the role of the opposite sex, using an appropriate name and clothes. Gender incongruence type 2, a distinct condition which may or may not co-exist with type 1, is a desire for hormones. Type 3 is a desire for surgery. Type 4 is a desire to subvert gender, by not fitting any particular gender role, and the treatment is to be allowed to present as you want, male, female, androgynous.

There should be the freedom to present as you want anyway, without the need for medical affirmation, but I did not feel free and medical affirmation, or a category defined by doctors, might have helped me accept myself. The health problem would be shame and distress rather than cross-gender behaviour, and the treatment to alleviate the shame and distress rather than to change the behaviour. As the medical model is about desiring cross-sex characteristics, the GICs can’t cope with non-binary people. They still demand change of name, as Charing Cross did when I first went there in 2001.

I would have said, I want surgery because I am transsexual. I am a woman and my penis distresses me (it did). In the bath I want bubble-bath to hide it (I did). I now feel I wanted surgery to be classed as transsexual and so to be socially acceptable, as demonstrated by the available legal and medical categories. If there had been different types of gender incongruence recognised by medicine and protected by law, I might not have wanted surgery or hormones.

Transsexual support groups enforced the desire for surgery because it differentiated us, the real TSs with a medical condition, from all the weirdos and perverts, just as law, medicine and the wider culture did.

Hormones can reduce fertility, possibly permanently. I wanted to reduce my sex drive because my attractions shamed me. Self-acceptance would have been a better way.

Surgery is irreversible. I mourn being mutilated, and the pain is keener because it was my choice. That choice was socially constrained, and I am moving from self-blame to rage against those constraints.

A great deal of research reports high degrees of satisfaction with treatment, and low rates of regret of surgery. I am unsure why. Possibly it involves people surveyed shortly after surgery, when I and others experienced euphoria; possibly people feel shame about our regrets. I certainly do. People are unwilling to score below Neutral in a satisfaction survey, marginal people are less likely to complain of bad treatment, and while we might open up to a qualitative researcher we might not on a survey. In my case, I have been loath to speak out because I don’t fit the accepted understanding of trans women, and might spoil it for those wanting surgery now; and I want to maintain links to trans groups. Though Johns Hopkins stopped doing GRS as they decided it did no good.

 ♥♥♥

Sylvia Morgan undertook qualitative research, trying to find difficult to reach trans people rather than using the customary routes of gender clinics and trans support groups. Post-op, most people lose touch with those sources and that might be a reason why some research reports such high satisfaction rates. Four out of thirteen post-op trans people expressed regret. That is a huge figure.

People report long waiting times to see gender clinics, and long waiting times for surgery referral once there- perhaps seven years. A friend waited longer. Another friend said the psychiatrist kept challenging her desire, saying that it won’t grow back once it’s cut off, as if she did not realise that. Of Dr Morgan’s research subjects, Lady G who wanted penetrative sex had to wait many years because she had to work in male role, as a lorry driver, and the protocols demanded the “real life test”. She also refused to fit the stereotype of a “woman trapped in a man’s body”- “I don’t know how women feel. I just know how I feel. I’m definitely not trapped. All I want is the wee operation down there.” She passes as a woman, unlike most of the MtF research subjects, and has a strong sense of being one.

Kylie, though, felt hurried. She was not sure how she felt and questioned the conclusion of her first half-hour consultation that she had “insight” and an “excellent understanding” of the transition process.

People used The Script, saying they felt trapped in the wrong body, felt they were not of their assigned gender from very young. “People play the game to get what they want.” Dr Morgan reports that discussions in support groups are dominated by medical procedures and visits to the GIC, and I observe that on facebook, with regular delight at getting surgery or despair at the delay. It is a way of getting status in the groups, that you are seeking surgery. Four said they had never considered medical procedures before joining support groups.

Phoenix felt pushed through a process. She had said she did not particularly want surgery, but had it three years after her first referral to the GIC. She drifted through the process and does not know how she got where she is, post-op.

Vida first went to the GIC in March 2010, and had surgery in October 2012, having pushed for it. She was processed quickly because she demanded progress. There appears to be little consistency in procedures and protocols. Waiting times appeared arbitrary. One psychiatrist was described by many participants as condescending, patronising, clock-watching. Trans women felt disrespected, as I did.

We want medical recognition in order to get legal recognition, so we have surgery as that is what the medical model requires. The participants wanted a vagina in order to “feel fully female”, rather than for what one would do with it: gynephile trans women still go to surgeons who can give depth. The psychiatrists generally did not attempt to dissuade them. (We would hate it if they did, denouncing them as cruel gatekeepers.) Yet the surgery is a symbol of being a woman or truly transsexual, rather than a choice because of what the penis and testicles can do, or the neo-vagina can do.

Dr James Bellringer, who does NHS vaginoplasties, said the backlogs were “spiraling out of control”. In 2013/14 they received over three hundred referrals yet did 180 operations. “The nature of gender surgery is that the vast majority of these referred patients will go on to GRS,” he said.

Iain, a gender queer trans man, thought better of it. The effects are irreversible… there’s so much that can go wrong… it sounds like a world of pain and struggle and scarring and infection.

Oestrogen is a symbol too. Subjects perceived it as enhancing emotions and gentleness, but one reported that her powers of concentration were a lot worse, another that she was considerably weaker, making her job more difficult.

As hormones and surgery are primarily symbolic, that one is really trans, entitled to legal recognition, others as well as I feel euphoria after finally having surgery. But then Carina reported that reality hit her like a big sack of potatoes. Surgery does not mean social acceptance, necessarily, and the body has to heal its effects. The neovagina is in effect a wound, so you have to fight the healing process with dilation.

Vida felt recovery took two years, and had further depression ten years after surgery, “because there is no aftercare or support”. Dolores said she had not understood how difficult and time-consuming dilation would be: “A lot of girls just don’t bother with the dildo, they just let the vagina close up”. Lily agreed. “Nothing really prepares you for what happens afterwards.” I think when some people go for the gender reassignment there is a hope for changing your life, starting a new life, but then it’s still just you with your same problems, and after the surgery you have more to worry about… Some of them just give up, they stop dressing in female clothes and everything.

Sally hoped surgery would give her psychological relief and social acceptance, but it brought neither. She had had profound ongoing depression since transition. Trans support group organisers told me not to talk about my personal problems, not to talk about being depressed since my surgery.

People determined to get the surgery are kept in the dark and fed on bullshit. Nine out of 28 participants had attempted suicide, some more than once.

While people are taking hormones and having surgery for validation as a true trans person rather than for the actual results treatment will provide, there will be inappropriate treatment, and social pressure to have treatment. I know what the desire for the operation feels like. I felt it. Now, I feel betrayed.

 ♥♥♥

When T-Central linked to this post, Calie wrote, The last two T-Central featured posts were based on very successful transitions. One from Halle, who has transitioned, and the other from The Transgentle Wife, the spouse of one who has transitioned.

This post is from Clare Flourish who has regrets. It is important to read both sides.

I will add that I know many who have transitioned and are happy and I know some who are not. In all cases, it seems that the lack of love in the life of those with regrets, or the lack of a job, is often the case.

Clare mentioned in a comment to her post that there is pressure to physically transition. I have seen this and know several who gave in to that pressure. Some are happy. Some are not. Clare is one of my favorite bloggers. She is just lovely in her pictures and I do hope things will turn around for her.

I am grateful for the link and kind words, but I am glad I transitioned. It was how I found myself. I feel transition could mean something different, that it does not need the monolithic full-time + hormones + surgery. I feel people should be encouraged to find those parts of transition which work for them, without imagining they must come as a package.

Some of the comments below go into these issues in depth.

The idea of the Real Self

A concept of a “Real self” could get in the way of being real. If it is a virtuous concept, and I want to see myself as virtuous, it might nudge me to take action I otherwise wouldn’t; and that could be “The practice of Virtue Ethics” (good) or Hypocrisy (bad). How would I know? More likely, it would make me deny qualities. The idea of onesself as “depressive” rather than “having depression” makes depression harder to heal, I read.

Or again my female/ feminine self must be the Real Me, to make transition as irresistible as it was. I had resisted cross-dressing for a year, once, and then started again. I drew comfort from Carl Rogers’ idea of the Self-Concept and the Organismic Self, but that does not mean the Organismic Self is fixed: it could be responsive, in the moment.

Meeting Jeremy Corbyn made me more hopeful about politics than I have been.

That thesis. The experience of violence or control makes it difficult to maintain an individual identity, and as a child I felt controlled, and now I feel my personality was subsumed in my mother’s, for her desires.

I’m feeling malleable, that my feelings, desires and acts can be moulded by others, and that would be fine if I felt myself part of a supportive community, but a threat when I feel marginalised and of low status. If I am moulded I feel it is not in my interests.

The need to preserve a self-concept will get in the way of other needs, eventually undeniably. That could be part of the Waking-up, Rock-bottom moment: you give up trying to pretend that you are who people told you you were, and seek your own interests. Suffering is the origin of consciousness, wrote Достоевский.

If I am malleable, there is no way of escaping the pain. Not in integrity, I am merely, always, confused and hurt.

-One of my trans friends who is exuberant and bubbly most of the time and withdraws from contact with people at other times fears therapy because she’s frightened there’ll be nobody there. You keep taking the skins off the onion. Take the muddle away and there’s nothing underneath, it’s muddle all the way down.

But it could be freeing. If I have integrity, if I am a lump of iron I need a me-shaped hole to fit into. Being mercurial means I can always fit, just flow into the hole available.

Or that I can’t get a complete handle on it using my own language and conscious understanding does not mean that there is no- I’m using too many negatives. EVEN THOUGH I cannot understand myself that doesn’t mean there is no self to understand, but that self includes

malleability.

I so want something to rely on!

And I had set my heart on having a self-understanding, and relying on that. And having it fixed, rather than having to keep updating it in the light of new information.

Being malleable. That could be bad- there’s no real me and no end to pain, or good- being fluid and able to react.

There should be a Truth, which is comprehensible, except there isn’t.

I see everything in a binary way, and judge it as good or bad. Innate quality is not contrary to social construction, we are nature and nurture. I am a different person in a work situation, and with different friends.

I seek safety, and often it seems to me that I am seeking safety from illusory threats in illusory protection which might be more threatening. I’ve got loads of three dimensional blocks and I’m turning them round and thinking, they must be able to fit together somehow. I’m really intelligent and I must be able to do this. Maybe it does not matter if they don’t- I have partial, inconsistent, and changeable understandings of the world and that is the best I can do, and it’s good enough.

We only assert gender if it is challenged. Most people don’t have their gender challenged. I say I am a woman, and others say no you’re not. But cis women get moulded by the beauty myth into trying to look a certain way.

And if cutting my bits off was a mistake, I have got to get over it sometime.
-OhmyGod that was stupid I can never trust myself again

My Rock would be an unquestionable view of myself as trustworthy, always doing the right thing in the moment, and that is illusory. Rather, I do my thing in the moment and do not understand it, but I have survived, so far. I might trust my reactions more than I do, if I did not second-guess them so much. But if there is a Real Me, I do not know her- or at least, cannot describe her with words.

(c) The Foundling Museum; Supplied by The Public Catalogue Foundation

Poststructuralism and trans

Transition makes sense if there is a “real me”, a feminine being with feminine characteristics, ideally really a woman but if that becomes unbelievable at least a personality which fits the ideal of femininity better than the ideal of masculinity. This fits with the experience of trying to conform to masculinity but eventually admitting this was impossible and freeing myself to be feminine; always finding expressing myself female much pleasanter than presenting male, until presenting male became unbearable. If there are no innate characteristics seen as feminine, then I can only explain it by sexual addiction, associating cross-dressing with arousal so dressing to be aroused. But now, I cannot imagine presenting male, though I am rarely if ever aroused by my clothes or presentation.

An Enlightenment Human, thought to be a coherent, stable consciousness with agency, autonomy and rationality, producing language and meaning, gave way to a Modernist idea of an authentic self. Poststructuralism says the self is fluid, fleeting, fragmented, continually formed and reformed by social construction, produced by language and systems of meaning or understanding, and determined by historical, economic and cultural contexts. So says Sylvia Morgan, who appears to accept that Poststructuralist view. I don’t know how it could be demonstrated, any more than nature v nurture. Even if her subjects’ understandings of themselves changed, that might simply mean that they had developed a better understanding, shedding self-concept conventions and better seeing the real personality.

Morgan discusses feminist theory and uses the word patriarchy in explaining it, but it is not clear whether she believes that theory. Elsewhere in her thesis, she discloses 10/28 participants were raised by parents forty or more years older than they are (like me) and most regarded the dominant parent in their family as being their mother (like me). I set myself to write about her explanation of poststructuralist theory, but keep getting distracted by details like that. I might see the submissive male as “feminine”. I only came to see my father as submissive after I had surgery- that is, my understanding changed; but that does not mean the dynamics I was understanding changed.

So I consider the theory of poststructuralism unproven, but interesting enough for me to seek to understand it, which I start by blogging about Dr Morgan’s thesis.

We construct identities and self-understanding through performance. Also I think through others’ understandings- if enough people tell me I am not a woman, I have to take refuge in the idea that I am a transwoman. It is a way of having a sense of self. We exist within society, and use symbols to communicate or demonstrate we belong to particular groups. We desperately need to belong, in order to survive. Morgan describes trans women learning to present as more feminine, for example by consciously making our faces more emotionally expressive, while trans men practice being inscrutable- personally, I still resent how expressive my face is of my emotions, so that others might read them before I am conscious of them.

Pierre Bourdieu produced the concept of habitus, a way of behaving which fitted your background, how people like you behave with others. It could be understood in terms of class, as he was socially mobile from working class to the heights of academe he developed a cleft habitus, different modes of being with parents and with peers. My friend, daughter of a coal miner and a junior lecturer, was in an association of working class academics, whose residual working class presentation might prevent them advancing as far as their talents might justify; many British people speak with the Queen’s English, but revert to a regional accent when they return to their home region. Morgan’s idea that trans folk retain the habitus of their gendered upbringing, unable entirely to fit the gender we choose to express, applies differently to different trans folk. Some, she admits, pass in stealth. I only know the working class origins of some friends because they tell me of them. That some people manage to pass as upper middle class, or as women, does not mean that it is easy.

Dr Morgan writes, Foucault’s revelation was that, rather than being a natural innate human property, sexuality is actually a constructed category of experience and knowledge, with historical and social origins. His focus was on the role of institutions and discourses in the production and functioning of sexuality in society (although he did not totally rule out a biological dimension). Foucault’s work exposed how knowledge claims are simultaneously claims to power – they are inseparable. The question to be asked is: what is at stake in the production of knowledge? Why are certain categories constructed? Whose interests are served? Much as Foucault’s investigations into sexuality revealed constructed categories of knowledge rather than discovered identities, this analysis can also be applied to gender categories. Sexuality and gender become inscribed onto individuals as a function of their practices, and classification and the creation of identities serves the development of regimes of power.

Well. There is biphobia, and possibly most people’s bi attractions are suppressed by rigorous propaganda for Straightness. Then the few people who are solely same-sex attracted are shoehorned into cultural constructs- camp, gay, bear, etc. Elagabalus, the Roman Emperor who proclaimed herself Empress, was not a “trans woman” like I am, she came from a different culture, but she may have had a “biological dimension” which I share. That said, transsexual women’s support groups rigorously enforced the necessity for GRS, and possibly we have it due to our cultural understanding rather than anything biological. A woman with a penis makes no sense.

Or, we have some biological reality, but how we can express it is constrained by the culture.