Matt Kailey

Yesterday’s discussion of trans guys and phalloplasty inevitably leads, as such discussions do, to two implications that can have rather serious consequences if they aren’t addressed in any public discussion of transition surgery.

The first has to do with that infernal inference of “choice.” If I don’t have any type of genital surgery, does that make genital surgery a “choice”? Can trans people “choose” not to have genital surgery, and, if so, does that mean that it’s not medically necessary?

Let me make one thing perfectly clear (just testing to see who’s old enough to remember President Nixon) – transition is not a choice. There are several surgeries that can be involved in a transition, and for many people, those surgeries are not a choice. They are medically necessary, as those people who have mortgaged their houses, taken multiple jobs, and attempted suicide or lived with crushing depression will tell you.

Those who have successfully committed suicide are unable to speak for themselves – but, in a way, they have.

The idea that surgery must not be medically necessary because some people don’t have it is just so much garbage. Certainly, there are people who do not have surgery, for a variety of reasons. There are people with many life-threatening conditions who do not have treatment, for a variety of reasons. Some survive and some do not. But because certain people with certain medical conditions do not have treatment, that doesn’t mean that treatment isn’t called for.

Should we deny everyone a life-saving treatment because some people can’t afford it or because some don’t have it for other reasons? I think not. (What we actually should make sure that everyone has access to that treatment, whatever it is, but that is another discussion.)

You don’t need me to tell you this. Transition surgery has been deemed to be medically necessary by the U.S. Tax Court, which carries far more sway than I ever will. So I think that, in and of itself, makes my point.

The second issue is that, if trans people who do not have surgery reveal that they have not, will that hurt our quest for our rights and “delegitimize” us in the eyes of others? Since genital surgery has been deemed, in many situations (including changing legal papers, being “qualified” to use a certain restroom, and so on), to be the end-all and be-all of the trans experience – at least legally, if not socially – then does it damage us to let others know that we might not all have it?

I have argued this at length before, so I will summarize: My opinion is that, if people (and particularly non-trans people who have the power to make decisions about our lives) believe that everyone who transitions is happily having genital surgery to “complete” the process, then there is no need to push insurance companies to cover it or to act on discriminatory regulations that define people’s rights by their genitalia (such as public restroom use, locker room use, legal paperwork changes, and so on).

Individually, we have absolutely no obligation to discuss our own body in any way, shape, or form. Collectively, I believe that our bodies become political, because people other than us make decisions based on them – and those decisions are often unfair and unrealistic.

So while I see both sides of this issue, I lean toward the side that says that everything is not so easy, breezy, and by-the-book, and everybody needs to know that – because that’s the only way that we’re going to bring about policy change that will help and protect us.

Thoughts?

(On an unrelated (but not entirely) note, check out my guest post over at Womanist Musings – and while you’re there, take a look at the other interesting stuff Renee has there.)