Surgery Permissions
I’m in “Clinical Issues in Transgender Communities” right now for one of my classes, so be ready for more posts on trans and genderqueer issues than usual.
Why do trans patients need these special “gatekeeper” (ie, psychologist letters) to get surgery? To get top surgery (breast removal) or hormones, trans people need to jump through a bunch of hoops (including living as their true gender for a certain period of time, going to a certain number of sessions) and present at least one letter of recommendation from a licensed psychologist that they are ok to get this. For bottom surgery, it’s the same deal, but they need a longer period of time for each, and two letters (one must be from someone with a Ph.D). Bottom surgery is known as sex reassignment surgery, but I’m going to start pushing my friend’s new term for it; gender alignment surgery.
I understand the argument that it is a big and usually permanent change, a medial procedure, and all that jazz. Fine.
What about optional, non-medically necessary, elective plastic surgery? Breast augmentation, breast reductions, rhinoplasty (nose jobs), calf implants, liposuction, etc…these are all elective (like gender alignment surgery is supposed to be, although I beg to differ), yet they require no notice from a psych person. You don’t need to live wearing a bra stuffed to a D cup for 6-12 months before having your breasts altered to that size, to see what the impact will be like…and let me tell you, many more people are going to be looking at your breasts (or nose!) than at your genitals on a regular basis.
So why the difference? Why does gender play such a big role? Why can someone get an entirely new face in order to assume a new identity, without needing to even get one psych evaluation? Why can someone get “stomach stapling” and lose hundreds of pounds, in essence, creating “a whole new them,” without ever setting foot in a psychologists office, yet a trans person cannot have their gender aligned with their identity without passing all these Standards of Care and possessing a letter (or two) from a psychologist (or two).
I’m not saying the trans person should not have to go to therapy, or that the person wanting plastic surgery should per se. I’m just saying we need to look at the hypocrisy of this situation, and maybe do something about changing this double standard we have for trans and cisgender people who are searching for surgery.
Thoughts?
Essin’ Em
5 Comments so far
Leave a reply
this was my entire yesterday.
-bf
having the psychologist requirement is one thing, but if it is going to be required, then psychologists need to be trained for this. i have a trans friend who was told “so you want a dick?” by the first psychologist he visited. well, it’s just fucked up to make it a requirement when many people’s only option is going to be that unprofessional (assholic, transphobic, or maybe just that uninformed)!
on the other hand, the idea of plastic surgery totally freaks me out. mostly i mean the “elective” stuff you mentioned. but even the more neccessary type (like reconstructions and such – and maybe gender surgery) weirds me out quite a bit…although i understand it a little better, and would likely do it myself if i were in a bad accident or something.
also, what’s cisgender?
oh, okay =)
Personally, I think people electing for plastic surgery like your examples SHOULD have SOME sort of therapy or something beforehand.
I agree the hoops that transgendered people have to jump through are a bit ridiculous, but I’m not opposed to every single hoop.
I can understand the psycologist requirement. I can see it being with someone who understands the feelings of the individual who is looking to complete the change surgically. I am certain the feelings are overwhelming with the need to be the person he/she knows they are, that they realize the importance to be that complete person or they would not even be cosidering surgery in the first place.