On the Sunday after Thanksgiving 2018, Andrea Long Chu published a heartbreaking and candid op-ed in the New York Times about living with gender dysphoria. while the piece was clearly intended to be a statement in favor of “sex reassignment”, it communicates almost exactly the opposite message, revealing painful truths about many transgender lives. even the title conveys ambivalence: “my new vagina won’t make me happy.”
chu was scheduled to undergo vaginoplasty surgery several days later. “Next Thursday, I will have a vagina,” she wrote chu. “The procedure will take about six hours and I will be in recovery for at least three months.” would this bring happiness? Probably not, Chu admitted, but that’s beside the point: “This is what I want, but there’s no guarantee it’ll make me happier. in fact, I don’t expect it to. That shouldn’t disqualify me from getting it.”
You are reading: Encounter books when harry became sally
chu argues that the simple desire to undergo sex reassignment surgery should be all that is required for a patient to receive it. authentic health and wellness should no longer be considered. no concern about poor outcomes should prevent a doctor from performing the surgery if a patient wants it, and “no amount of pain, anticipated or ongoing, justifies withholding it.” according to chu, “the only prerequisite for surgery should be a simple demonstration of desire.”
This is a pretty extreme position regarding the basis of a medical procedure, and we’ll come back to it later. But as the op-ed reaches this sweeping conclusion, Chu reveals many truths about transgender lives that are rarely acknowledged, truths that we should heed.
1. sex is not “assigned” and cannot be changed by surgery
chu acknowledges that the surgery won’t actually “reassign” sex. on the contrary, “my body will consider the vagina as a wound; As a result, it will require regular and painful care to maintain.”
in fact, sex reassignment is literally impossible. surgery can’t actually reassign sex, because sex isn’t “assigned” in the first place. As I explain in this book, sex is a bodily reality: the reality of how an organism is organized with respect to sexual reproduction. that reality is not “assigned” at birth or at any later time. sex, masculinity or femininity, is established at the conception of a child; can be determined by technological means even in the early stages of embryological development; it can be visually observed long before birth with ultrasound images. and the biological reality is deeper than anything that can be changed by cosmetic surgery and cross-sex hormones.
People who undergo sex reassignment procedures do not become the opposite sex. they simply masculinize or feminize their external appearance.
See Also: Larry McMurtry – Book Series In Order
2. gender dysphoria is deeply painful
chu describes the profound pain of gender dysphoria, the sense of anguish over bodily sex and alienation from one’s own body:
dysphoria feels like not being able to get warm, no matter how many layers you put on. feels like hunger without appetite. it feels like getting on a plane to fly home, only to realize mid-flight that this is it: you will spend the rest of your life on a plane. it feels like grief. It feels like having nothing to cry about.
People with gender dysphoria don’t choose it and they don’t fake it. they are really suffering. and we must take their testimony seriously.
3. “transition” may not ease the pain
chu acknowledges that the “transition” may not make things any better and could even make things worse. “I feel much worse since starting hormones,” chu writes. and continues: “Like many of my trans friends, I have seen my dysphoria grow since I began the transition.”
Would it help to complete the process? not according to the best medical findings. evidence suggests that sex reassignment does not adequately address the psychosocial difficulties faced by people who identify as transgender. Even when procedures are technically and cosmetically successful, and even in cultures that are relatively “trans-friendly,” people in transition still face poor outcomes.
even the obama administration admitted that the best studies report no improvement after reassignment surgery. In August 2016, the Centers for Medicare and Medicaid noted that “the four best-designed and well-conducted studies evaluating quality of life before and after surgery using validated (although non-specific) psychometric studies did not demonstrate clinically significant changes or differences in psychometric test results after grs [gender reassignment surgery]”.
See Also: Best Lettering and Calligraphy Books for All Levels: The Complete List
what does that mean? A population of patients is suffering so much that they would undergo amputations and other radical surgeries, and the best research the Obama administration could find suggests that such drastic measures do not provide them with significant improvements in quality of life.
4. suicide is a serious risk
chu acknowledges a struggle with suicidal ideation that began after transition treatment began: “I wasn’t suicidal before the hormones. now I am often.”
the obama administration recognized that this is often a fact of life after such treatments. In a discussion of the largest and most robust study of gender reassignment outcomes, the Centers for Medicare and Medicaid noted: “The study identified higher mortality and psychiatric hospitalization compared to matched controls. mortality was mainly due to completed suicides (19.1 times higher than in control Swedes).”
These results are tragic. and they directly contradict mainstream media narratives about “sex reassignment,” as well as many of the snap studies that don’t track people over time. Long-term studies are crucial because, as the Obama administration noted, “mortality in this patient population did not become apparent until after 10 years.” therefore, when the media touts studies that track results for only a few years and claim on this basis that reassignment is an astonishing success, there is good reason for skepticism.
* * *
Given these recognized problems with gender reassignment as a treatment pathway, let’s look again at chu’s argument that “the only prerequisite of surgery should be a simple demonstration of need.” What are the grounds for this statement?
why should a doctor perform surgery when it won’t make the patient happy, it won’t accomplish its intended goal, it won’t improve the underlying condition, it could make the underlying condition worse, and it could increase the likelihood of suicide? chu wants to change the profession of medicine so that doctors simply follow their patients’ instructions, instead of using their knowledge to guide patients to healing and wholeness.
See Also: How to read old PopSci magazines in our archive | Popular Science