Day 28: Surgery

One of the things that people often asked me, now even more so that I’ve been blogging about my experience, is whether or not I’ve had or plan on having surgery.

As a transgender woman, there are a number of options available to you if you decide to transition. In terms of a medically assisted transition, I’ve been on hormone replacement therapy (HRT) for nearly 6 months now. I’ve seen some amazing changes in my body. My skin is super soft, less oily, and I have virtually no pimples. My muscle mass is decreasing. My body is beginning to redistribute fat into a more feminine shape (more on the butt and thighs). And my boobs are growing!

HRT is literally changing my life. You can read more about it at Day 14: Hormones.

There are a number of gender affirming surgeries available to trans people and no particular structure or order in which they can/may occur. For transgender women specifically, some of the more common types of surgery may include the following…

  • Augmentation Mammoplasty (breast surgery): Inserting implants to increase the size of the breasts.
  • Chondrolaryngoplasty (tracheal shave): Shaving down of the thyroid cartilage / adam’s apple.
  • Facial Feminization Surgery (FFS): This includes making surgical alterations to the forehead, nose, chin, jaw, cheeks, eyes, and lips.
  • Orchiectomy (genital surgery): Removal of the testicles.
  • Penectomy (genital surgery): Removal of the penis.
  • Vaginoplasty (genital surgery): Creation of a vagina.
  • Labiaplasty (genital surgery): Creation of the labia or “lips” around the vagina.
  • Clitoroplasty (genital surgery): Creation of a clitoris.

Broadly speaking, gender affirming healthcare for trans people is very expensive in the private sector. Many people make use of state facilities, which can present it’s own set of frustrations and complications. There are only two centers in the country which specifically deal with transgender medical health issues, and the number of surgical hours assigned to sexual reassignment surgery (SRS) is extremely problematic.

Our public healthcare system only has two trans specific facilities, one at Groote Schuur Hospital in Cape Town and the other at Steve Biko Academic Hospital Pretoria. This means that if you live anywhere outside those cities, it can be extremely difficult to access gender affirming healthcare. And even more so for those living in poor economic and social conditions. Even if you live near these centers, the number of hours dedicated to gender affirming surgeries is so sparse that the waiting list is over 25 YEARS.

I wrote a post about some of the human rights issues faced by the trans community. Uou can read more about that at Day 12: Right.

For me, undergoing many of these operations should be carefully considered as they are major surgical procedures and, like all surgeries, carry risk.

It’s important to note that, in speaking about transitioning, every person’s situation is unique and not everyone may opt for some or any of these procedures. Some trans people opt not to transition at all and that is a completely legitimate decision and in no way invalidates their gender.

That said, SRS is a profoundly personal thing. Some people don’t like talking about it because what person wants to discuss what’s between their legs with strangers on the internet. No cisgender person would ask this of another cis person, but somehow the rules for transgender people are different. There’s somehow a sense of entitlement to our bodies, to the inner most privacies of our lives. We’re tokenized. And made subhuman. These issues are sensitive and deeply personal and needs to be treated as such. This, for me, is so important to understand when talking about trans bodies and trans experiences.

As for my under-the-knife decisions, It’s still very early transition days for me. I’ve only been on HRT for 6 months, so I’m in no rush.

Whatever I decide, it’s my body, and I’ll make choices that are right for me.

And I’ll be no less or more woman than I am today.



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