November 25, 2014

The Next Step: Surgery

Now that my social transition is well and truly complete, I have begun to think about the next step in my new life: gender-confirming surgeries.

Surgery is a big, expensive, disruptive step, but it’s also an important one. Some sort of surgery is absolutely required in most states before one is allowed to change their legal gender marker; my home state, Michigan, is such a state. Surgery of some kind is also an accepted and generally practiced therapeutic step for gender dysphoria, and my own mental well-being would be improved for having them. For these reasons, surgery is a must for me.

There are generally five surgeries trans women consider (there are a few more uncommon ones, too, but these are the biggies):

Of these, GRS is the not only the most expensive, but also most important from a mental health standpoint (for me at least — some women feel differently). I consider FFS and BA to be more important to daily social acceptance than GRS (unless I plan on going around showing everyone my genitals, which I don’t). VFS can also be important socially, but it’s sketchy and unreliable surgery even in the best of circumstances. An orchi is usually undertaken by women as a half-measure before GRS, especially if one lives (as I do) in a state where orchi is acceptable as a condition of changing one’s gender marker; it’s also the cheapest procedure on the list.

Not all trans women choose to undergo GRS, but for me it’s a must at some point. Given the cost, however, it’s probably several years in my future. Also, any surgery I get is predicated on two things: (1) getting a job again so I can save money, and (2) relying on the tide of social change to open up the possibility of insurance covering some or all of the cost.

I think that it’s not unrealistic to set an orchi as a 2015 goal (again, assuming I find a job). I also think that GRS is a realistic five-year goal. Between the orchi and the GRS, I would like to have either FFS or BA, maybe two or three years out. Both would not be out of the question, as long as I could allow a full year between procedures.

Wait, did I just plan on going under the knife four times in the next five years? Yeah, I guess I did. It sounds intimidating when I lay it all out, but I hate the idea of putting any of them off for more than five years. I wasn’t kidding before when I said that these procedures are an important part of my mental health. The worst thing I could think of right now is going the next five years without having any sort of surgery. If that were to happen, I would probably find myself in a very dark place in 2020.

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