My View

Problems in Transition, Reasons for Failure

by Ruth Farmer

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The most obvious explanation might be that the candidate does not fit society's expectation of femininity.

Amost distressing situation that arises in gender dysphoriacs is the problem of the male-to-female transsexual who has had Sex Reassignment Surgery and then comes bitterly to resent it afterwards.

It is a puzzling and distressing situation, particularly when the person has in fact lived successfully in the chosen gender role for some time and should surely have a good idea of what they are planning to undertake. For a few, the difficulty arises because of heath reasons, but for most dissatisfied transsexuals, this has not been the reason for their change of heart. I want to look more closely at this vexing subject.

A post-operative change of mind is a situation as distressing for a disillusioned transsexual as S.R.S. is joyful for a successful transsexual. This problem has plagued Gender Dysphoria Teams and some transsexuals, for a long time. I have various ideas on why this happens.

The most obvious explanation might be that the candidate does not fit society's expectation of femininity. This is gender stereotyping, and at the extreme, can cause suicide when a post­-operative transsexual fails to "pass" adequately as a woman. Gender stereotyping is said to be a criterion beloved of the Gender Dysphoria teams, yet it cannot be the only explanation, because I myself pass only indifferently (e.g. occasionally), but I am very happy with my life as a woman.

Another idea about the failures is that some pre-operative transsexuals mix mainly with other transsexuals, and get so much support from them that she thinks that she is quite O.K. as a woman - but she is not. When she has the S.R.S. and goes out into the real world, she finds that she cannot "pass" and so becomes unstuck. It is an interesting idea, but there are M.T.F. transsexuals who live quite successfully as women for the necessary two (or more) years required by the Standards of Care, but who still come to grief after the S.R.S.

Then there is the Irreversibility Syndrome. This proposes that the problem is not necessarily the S.R.S. itself, but the fact that it is so awfully permanent. It's done, you can't go back, and this is it. When that permanence hits the candidate, she has problems. One way to test this prior to S.R.S., would be for the candidate to undergo some relatively minor feminisation surgery (and there are several), which is irreversible, but not catastrophically so, e.g. breast implants. If the transsexual is "real", she will weather that storm and the final S.R.S. will only be a detail.

Only a detail? Yes. Something like that, which can change your whole life? Yes! The S.R.S. does not change one into a woman; it only makes it easier to swim, wear slacks in fashion, or wear slinky dresses. Pre-operative, one finds out whether or not one is a woman, a "true" transsexual is a woman from birth, despite the unfortunate mistake on your birth certificate made by the delivering doctor. If so, then the operation only ratifies that state. Believe me, it changes very little, and nothing at all in your basic attitudes. If you have not sorted out your psychology before the Operation, you are in trouble. That is why the Standards of Care insist that a candidate must be reasonably psychologically healthy.

The fourth theory is just that the trouble occurs because the prospective candidate is not really convinced that the real transition occurs in your head, not in your groin. Without that conviction, the S.R.S. invites catastrophe. With the conviction, the S.R.S. is only a convenience for fashion, and of course, female sex.

I have read that the "success rate" of S.R.S. is now said to be some 70%. What about the people who make a bad transition? I have a deep sympathy for them. It is no use to point a finger of blame. It is only very wise to ensure that if you are contemplating the S.R.S., that you live at least for two years in the gender of your choice, and that you do not depend at all on other transsexuals. You will learn faster if you take the plunge into the "real" world outside of the transgender community. After all, that is where you want to spend the rest of your life.

If, after two years or more, you find that you are not really cut out for transsexuality, you have two choices: you can go back to being a man, or you can go on to be a permanent pre-­operative transsexual, that is, without the S.R.S. The former choice might be distressing, but it would be much less distressing than realising you had made a mistake - after they peeled you off the operating table. Permanent pre-operative status would be for those who could not stand the possibility of going back, but who were distressed or incapable of going on. This is not such a bad choice, actually. Womanhood is largely in the mind. As I have said, the S.R.S. only makes things easier.

To be a woman is only to be a slightly different shaped human being. Your ability to enjoy life does not depend on it. That comes from inside, and without it, life is not worth living " as a man, or as a woman!

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