Surgery and Sterile Futures

surgical-extraction

Trans surgery in Canada involves years of waiting lists, consultations, and institutional scrutiny. What makes this process especially difficult is that there is currently only one clinic in the country that is able to offer official services, i.e. ones that are covered by first-payer insurance and thus accessible to the vast majority of trans people. This very short essay outlines what I would call the eerie nature of this process, the way in which bodies are rendered uncanny and disjointed by gatekeeping and forced visibility.

For me, the sheer impregnability of the system creates a sense of foreshortened future and bodily dread. Because trans people are a tiny minority of the population, our bodies are the subject of a great deal of state scrutiny, especially because our physicians do not have any direct sympathy with our situation. Despite all of our visibility as oddities or freaks, however, our bodies are not well understood and medical procedures and treatments for us are heavily restricted and, in the case of estrogen-based hormone therapy, administered with tools designed for cis people first.

So surgery for me, despite the fact that I want it and need it for my mental health, is attached to so much baggage and bizarro-world bureaucracy that it takes on a horrific aspect. The abject uncanniness of wading through so many forms, so many appointments, so many opportunities for any spiteful physician to deny me access to care, creates a warped sense of how attainable surgery even is. And because of past trauma around my body and because of depression, my sense of the future has been dramatically compressed. The future is so uncertain that, under the lens of depression and the eerie oracular and suicidal feelings that I have, I am utterly convinced that my body will be destroyed either in surgery or well before. I am tutored by despair, possessed of a sense of grim finality.

Of course, my intellect assures me that many other people have gone through the process and come through happier than they were before. Of course this does not make me change my mind about wanting surgery. This is still my choice and I still dream about it. Even though I’m aware that surgery is not necessary for all trans people and rejecting surgery would not put my lack of gender in doubt, there is a sterility and hopelessness that dogs me throughout, an eerie desert where future possibilities either lie dormant or cannot be trusted because of persistent mirages.

I suppose there is no way through the desert except through it. And with luck I will participate in abolishing the system that creates such dread and unease. For the sake of trans people now, the gates have to fall and the bureaucracy must be abolished, along with all other impediments to real bodily freedom.