Shhhh, it’s a Secret! How we don’t talk about surgery.

Surgery, more specifically, gender confirmation surgeries, is often the elephant in the room when it comes to talking about trans experiences and stories. We talk about access to the various types of surgeries trans people may or may not have. We talk about why it is important, and the myths about it. Yet because of the sexualization of trans bodies, especially trans women’s bodies, discussion of the lived experience of those who have surgery tends to be put to the side and not often discussed in public forums. Media and many people often thinks it’s okay to ask trans people about what surgeries they may or may not have had, usually in a way that identifies and objectifies the trans person based on what is presumed to be between their legs. This video with Janet Mock turns it around and she asks the same questions of a woman who is not trans. We are also facing proposed legislation in a number of jurisdictions that would define which washrooms we can use based on what is current genitalia, or even worse in some cases, what genitalia we were born with. Therefore, most do not discuss surgery except in broad terms that tend to leave out the stories and lived experience. We self censor in order to, in my opinion, avoid the disrespectful, objectifying, and all too often hateful articles, coverage, and comments. A major drawback to this is that it can, and does, put up barriers to healthy conversation and education. If one considers that there are barriers to healthy conversation and education a question that immediately comes to mind is, “What does healthy conversation and education look like?

First and foremost healthy conversation and education normalizes the topic of surgery without sexualizing, objectifying, shaming, or judging trans people for their choices. These choices include, but are not limited to, how a trans person chooses to transition, whether or not they have surgery, and, most importantly, how much or how little they want to disclose about their gender journey. All too often when trans people do disclose aspects of their transition they are judged by their choices and why they may have made them. If one chooses to have surgery, the criticism is that one does not need surgery to be a man / woman. For those who choose not to have surgery the critisism is reversed, you are not a man / woman if you do not have surgery. A no-win situation, and one that can be confusing for people who are trying to figure out what is right for them.

Healthy conversations are also respectful of those engaging in the conversation. As a facilitator I will put parameters around discussions to allow for questions, yet maintain respect for all involved. When educating about the problems with trans health care adding a human component to the discussion helps people to understand the real impacts on people’s lives. Yet, we also need to be respectful when listening to the stories of others, and when discussing various cases and expereinces of others that we have encountered in our work. This also means that one respects each person’s boundaries around discussing their health situation.

One way to look at normalizing the discussion is to look at how we talk about other types of health care. There was a time when one did not talk about having cancer. It was kept a secret often from one’s family. They types of treatments one may or may not have had were not discussed, and there was a stigma attached to it. Now, it’s fairly common for friends and family to know when one has cancer. Often some of the specifics about treatment are also discussed. For many people, the details and specifics are kept to a close group of friends and family. At the same time it is common for people undergoing treatment and surgery to need time off from work, possibly with a long leave of absence in order to deal with the physical effects of treatment. We should be able to talk about the various aspects of a medical transition in the same way. “Oh, Nancy is going to be on leave for a month or two for health reasons.” Or, if the person is more open about it, “Nancy is going to be away for a while recovering from surgery.” With transition related care, as with cancer, it is not appropriate to then gossip about the person and what they have chosen. Just like with other medical procedures, it is not appropriate to second guess or judge the person’s decisions when it comes to their own care. Unfortunately, it happens all too often. Normalization of the topic helps to increase support and acceptance of the decisions people make while on their gender journey.

Curiosity is also a factor when looking at how we have various discussions. For most people discussion of trans people, and the various health care options that may or may not be available, is a relatively new one. Since I started to actively embark on my own journey in 2009 the discussion of trans issues in media and in culture has grown significantly. Being curious about trans people, and what we may or may not be going through, is natural. I am curious about a lot of things myself, and often have questions about a wide variety of topics and ideas I come across. With the internet, there is a lot of good information about options for medical transition, as well as what is referred to as social transition. There is also a lot of poor information, badly biased and outdated information, and some information that is downright hateful and intentionally misleading. Internet information is also more impersonal, especially when it’s purely text based, and it can be difficult to engage in meaningful dialogue. It is therefore natural that when one encounters a trans person, and one is curious about trans experiences, surgeries, etc for one to want to engage in one on one discussion. It is at this point one must pause before engaging in asking a slew of questions.

I have said it before, I will say it again, and I’m saying it here, now. Not all trans people are educators. Those of us who are educators are not here to educate on a 24/7 basis. When we are in crisis or seeking support, we are not there to be educators, we are there for help.

If you are truly interested in learning, find some good online sources, and if you know a trans person and want to ask questions, be respectful. Ask if the person is up to answering questions. If they choose to share information with you about their own journey, honour that choice. If they state that part of it is not to be shared with others, do not share it. When in doubt, keep information confidential. When someone chooses not to talk about all or part of their journey, honour that decision as well. Many of us, myself included, have been guilty at times of pressing for more information when someone has stated they do not want to talk about something. We do not have a right to demand that others tell us their stories, or share information about themselves.

As someone who has chosen to be an educator, I am willing to discuss trans health care. When and how I do this varies depending on the situation. If you would like to have this discussion with me, just ask. I may be willing to talk about it right away, or ask to talk about it another time. If the discussion is about my personal journey, I may not want to talk about it at all. When the request is honest and respectful, I will do my best to be honest and respectful in return. My choices on this will be different from others who identify as trans and are not transferrable to them. They will express their own choices on what they will and will not discuss with others.

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