Coming Out to The World… on the Topic of ‘Junk’ and Medical Transition

I’m working on an FAQ, one that I want to make available to co-workers, friends, family, etc. and I asked folks on Facebook to forward me questions that they thought I should address in my FAQ… I’ve gotten some great stuff, sometimes questions my friends wouldn’t themselves ask, but that they figured someone would be wondering at some point.  This is one such:

I honestly have no interest, Casey , but I’m sure people are going to want to know the status of your … ahem … Junk … and your future plans. Not sure it belongs on your FAQ, but I’m sure it will be of interest to others.

My first response ran along the lines of “I’m not talking about my junk or my plans for my junk in a FAQ, that information is ‘need to know’ and there are very few people who need to know.  And then I thought about it some more and posted this:

There is something serious I want to say on the topic of ‘junk’ or, more accurately, ‘medical transition’.. the surgeries and shots that people so commonly think of when they think about transgender people. Here’s a big helping of reality for you: not all transgender people go through medical transition. It’s not a default. Not everyone will get top surgery. And bottom surgery? That’s still a very, very, very young area of medical technology, we can’t just go in and get new junk and have it work perfectly. And hormones? Not everyone who’s masculine goes on testosterone either. In my mind there are three major categories of transition: medical, legal and social. Right now, I’m doing the third one. AND… let’s remember (or be reminded) that not all trans* people are identify with the gender binary (meaning we don’t all identify as strictly male or female) and what that means is that the notion of transition for us is not the same as transition for someone who does identify as either male or female. So.. the whole ‘junk’ question is not only a very personal and somewhat invasive thing to ask a trans* or non-binary person, it’s also not necessarily a question that’s easy to answer.

And later added:

I could have added more like “Sometimes people want medical transition but can’t, because access to surgery and hormones and the doctors who provide those means are not available to everyone. Sometimes people want medical transition of some kind but their health situation prevents it. Sometimes people want medical transition of some kind but they just can’t afford it. Sometimes people want medical transition of some kind but they are not safe to pursue it. Sometimes people are find with the bodies they have but want to transition in other ways, socially and/or legally. There is no single way to transition and that’s something the popular media is truly ignorant about.”

I’ve drafted a FAQ entry on the topic and I’d love feedback.  Keep in mind that my disclaimer on this FAQ is that it reflects my opinions and my opinions only unless I explicitly quote another source and further, though some of the information in my FAQ might apply to others, one should never make assumptions.

So when are you getting your surgery?

a) This is a question a lot of people ask, or want to ask, when they find out someone they know is transgender.  It’s a question you shouldn’t be asking.  It’s very personal and very invasive.  How comfortable are you talking about what’s between your legs to friends, family and co-workers?  Same goes for questions about other body parts.  I understand that medical transition (surgery, hormones, other medical intervention) may be fascinating to you.  My suggestion would be that you do some research on the internet if you’d like to more about the process.  Asking the transgender and genderqueer people you know about their ‘junk’ and what medical procedures they may or may not have will probably alienate them from you.

b) Part two of the answer is this:  not all transgender or genderqueer people go into medical transition.  It’s not a default.  The surgeries and hormones that are commonly associated with transgender people are not requirements for identifying as transgender.  Why might a transgender or genderqueer person not undergo medical transition?  The reasons are many and individual but some are:

     i.      It’s expensive and not all people who are trans/genderqueer have the money.  These procedures are generally not covered by medical insurance.

     ii.      It’s risky.  Some people who would like to transition medically cannot due to their existing health issues.

     iii.      It’s not always available.  Not only is medical transition not usually covered by medical insurance, depending on where a person lives, there might not be providers nearby who could facilitate the process.

     iv.      It’s not always safe.  Being transgender or gender non-conforming is still a magnet for violent response.  Especially for trans and genderqueer people of color, going through transition or even being obviously gender non-conforming may result in violent physical assault and/or murder.

     v.      It may not be what that individual needs or wants in order to feel whole.  The reason for any kind of transition (my opinion) is to become more yourself, to become more whole.  For some people, changing their presentation (haircut, clothing, mannerisms, pronouns) may be enough for that person to feel more authentically themselves.

vi.   Expanding on that last answer, a lot of the traditional notion of transition, especially ‘gender reassignment surgery’ (which we are now calling ‘gender affirmation surgery, btw), is around moving a person’s body from one end of the binary spectrum to another, as well as one can given current medical technology.  When you are a person who does not identify as male or female, what does transition and gender affirming surgery mean?  It might mean using testosterone, it might mean having some kind of surgery, it might not.  Individual needs, desires and capabilities with regard to transitioning to a more authentic version of themselves are going to vary widely.  Throw away what you think you know about transition and open your mind to the variety of paths people take.

     vii.  Don’t believe what you see on popular media.  Do your own research if you want to be truly educated on the topic.  Remember that what gets publicized is what sells and what sells is scandal, intrigue, sex and violence.  


c) So am I going to medically transition?  That’s ‘need to know’ information and the only people who need to know are the people intimate with me and any medical professionals who involved with the parts in question.  I realize it’s fascinating to know what’s going on with people’s junk but it’s really not everyone’s business.

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