To Cut or Not to Cut?

photo credit: OptoScalpel

Did you miss me?  I expect for the most part the answer to this question is “no”.  If it’s not, I would strongly suggest any one of a million hobbies.

That said, I missed me.

Over the months, I have really enjoyed expressing myself through the forum of this blog.  As I mentioned in one of the few posts that I did put up in the last month I had a little writing project whose conclusion pretty much consumed every ounce of my time and energy for the last month.  Because of this, I had to put certain optional elements of my life on hold.

Sadly, expressing my random opinions into the blogosphere falls well below caring for my boys, looking out for myself and maintaining contact with my friends on the ranking of options in my life.  Since I barely had time for the ones higher on the list, blogging, out of necessity, fell by the wayside.

Well (sound the fanfare here), I finished it!  A year of work finally condensed down to eighty-three pages.  It actually was rather anti-climactic when I finally handed it in.

I also have to accept the fact that, while this has been a large part of my life, for most people it is meaningless.  After all, tens of thousands of students write dissertations every year.  This one was only for a master’s degree, so it will be made available to a much smaller audience that if it were for a PhD.  Ultimately, it will only be interesting to the limited academic audience who specialise in international relations and development, and a few family and friends who are nice enough to read it.

For just this brief, self-centred moment, I am going to pretend that I did something important and offer to share it with everyone who cares.

 The Socio-Economic Impacts of the Peacekeeping Failures in the Balkans

Feel free to read it, ignore it, be bored to death by it, whatever.

Now that it is finished, I do actually have a few things on my mind related to this whole trans thing.  Funny thing happened while I was preoccupied with my work over the past month.

Life went on.

Living life as a woman has pretty much ceased to be a novelty.  Being a fifty-year-old woman who spent the first forty-nine of those years as a man still poses some interesting issues and gives me an opportunity to see things through a very unique set of lenses.  Almost every day I am faced with something new that gives me pause to question how it is that we move through our daily lives.  Sometimes it is in the context of gender, sometimes it is not.  When you are rebuilding your life from the ground up in such a dramatic way, you become rather introspective and analytical.

At least I do.

I have been able to attend the monthly meetings of a nearby support group for the past couple months.  This gives me a wonderful chance to network with a lovely group of girls who represent a wide range of experiences in both life and the trans world.  We come from a variety of backgrounds and represent the whole spectrum of the transition process from waiting for formal diagnosis to five months post-op.

This month we had a new girl with us who is just now coming to terms with her gender identity, well into middle age.  This was her first time going out into public and speaking to others about her situation.  She has not begun any outward transition activities, but she is working hard on crossing that difficult first bridge to accepting her true self.  In this context we all offered her support and shared many of our own experiences with her.

I found myself marveling at how far I’ve come in a few short months from the exact same shy, scared spot to where I am today.  I can honestly say that I got here with a little help from my friends.

We talked about a lot of stuff.  When there is a new person in the group, there is  a tendency to bring up everything on which  someone has an opinion.  I feel pity for the new girl.  She must have left there completely overwhelmed.

One of the topics that came up is one that must be discussed at some level in every support group at one time or another.  One of the girls decided to poll everyone there and get their feelings and plans about surgery.

Yep, the big question.  The one that is most likely to divide a group.  The one that those who feel the need to exclude use as a yardstick.

So what is it about this that is so divisive, yet so definitive?

I’m trans.  I was born with a set of genitals that do not match my gender identity, therefore I want to bring everything into alignment.  The solution to that is medically possible and it involves surgery.  It is really simple.  Isn’t it?

No it really is not.  I, Rebecca Lynn Kent, represent only one person in a world of billions.  Within those billions are millions who don’t fit neatly into the gender binary.  Those millions cover a fluid spectrum from one side of the binary to the other.  No two people occupy the exact same point on the spectrum.  Indeed, each of us don’t necessarily permanently occupy the same spot on the spectrum.  As we travel our journeys, we sometimes discover things about ourselves that we had previously hidden, or failed to understand.  In coming to grips with these things, we often find it necessary to redefine our spot on the spectrum.

We find, as we go along, kindred spirits.  Those whose spot on the spectrum, combined with their attitudes, education and experience allow them to relate to us on the same plane.  Sometimes, if we are really lucky, we find someone who is almost our twin (hiya Sis).  These people give us a starting point from which to assess our own experiences.  They help us to form our own opinions and to make our own plans.

The one thing they can’t do is live our lives for us.  Nor can we live theirs.  When it is all said and done, we each have our own unique experience.  This is why questions like the one about surgery continue to come up.

The girl at our support group embarked on her poll because she had spoken to another trans woman who had a different plan regarding her surgical future, and she was trying to gain some perspective on this for herself.

WARNING!  ICKY MEDICAL DETAILS AHEAD

[I will be discussing male to female (MtF) procedures, as this is my world.  My knowledge is based on reading that I have done and information given to me by women who have had the surgeries.  None of this should be considered an expert opinion and I make no guaranty of its accuracy.  The procedures for FtM are completely out of my area of knowledge.]

Gender Reassignment Surgery (GRS) or Sexual Reassignment Surgery (SRS) are interchangeable terms for a series of surgical procedures in which the male genitalia are converted into a reasonably functional analog of female genitalia.  There are a total of five procedures.  People choose to have anywhere from one to all five of theses procedures performed.

The five include, removal of the testes, penile inversion to create a vaginal cavity, rerouting of the urethra, construction of labia and construction of a clitoris.    Considering that these can be done individually or in conjunction with each other, it is easier to see where this is a bit more than merely a question of “to cut or not to cut”.

Each person who is faced with the decision brings to the discussion their own set of personal factors.  The person who prompted the girl at our meeting to ask her questions had opted for minimal surgery and explained this as being because all she needed was to sit to pee.  We all wondered why she needed surgery for that at all.  Of course, her situation is clearly more complicated than that, she just wasn’t there to explain herself.  I have another friend who has expressed hesitation to have surgery because she still has hope of retaining her marriage and she doesn’t want the temptation to try out her new parts to put her at risk of being unfaithful to her wife.

My situation is different as well.  The best way to describe my situation is probably to frame it in terms of the controversy surrounding the terminology used in the diagnosis of our peculiar condition.

Those of you familiar with the dialog within the trans community are probably aware that the American Psychiatric Association is in the process of updating its Diagnostic and Statistical Manual to the 5th edition due out in May, 2013.  Popularly known as DSM-V or DSM-5 this is the diagnostic reference for all mental health issues in the United States, and has implications around the world.

Whether or not you agree that this is a mental illness (I do not), in the current world, gender identity issues are homed in the realm of mental health.  The current Manual defines our condition as Gender Identity Disorder (GID).  The use of the word ‘disorder’ has caused lots of controversy as we really don’t want to be seen as having a mental disease.  Because of this, it has been considered a victory that the APA has decided to rename the condition Gender Dysphoria.

Personally, I think they have missed the point.  To say that I have Gender Dysphoria means that I have confusion or distress about my gender.  That is simply untrue.  I have been fighting a battle within myself for my whole life because I have always known I am female and my body and the rest of the world keep telling me I am male.  There is no confusion about my gender.  I have been at greater peace the past several months since I stopped trying to conform to a reality that I knew was false.

What I have is Genital Dysphoria.  I can’t figure out why, I as a woman, was born with a penis.  The solution is simple, and imminently medically possible.  Rebuild my body as it should have been in the first place.  For me the process will not be complete until my anatomy matches my identity.  An advantage to my age is that after the surgery I will appear and function identically to a large number of post-menopausal cisgender women.

Clearly, for me, the problem will not be completely sorted until I have all the steps of the surgery.  This does not make me any more trans than someone who wishes to only undergo part of the surgeries, or none at all.  We all have to get our own selves settled in the spot where we each belong.

Indeed, this is really a subject that probably should be left out of most discussions.  When I came out as trans, I opened myself up to a whole lot of questions that many others will never face.  When I started writing a blog, I agreed to talk about more than most.

In spite of all this, I really wonder why what is between my legs is anybody’s business, except mine, my doctor’s and any sexual partners I choose to have.  Aren’t we as a community, by using this as a marker, committing the very same sin that we are trying to correct?  We scream from the rooftops that we should be entitled to treatment because it’s what’s in your head that matters, not what’s between you legs.

OK.  I strongly suggest we practice what we preach.