Transsexual
regret

Transsexual
            regret

With the release
of Renée Richards’ latest book, No Way
Renée: The Second Half of My Notorious
Life,
the topic of transsexual regret has once again
come out of the closet. Her book is primarily the
story of her family, career, tennis, and social life.
Yet in a pre-release interview with The New York
Times,
the reporter asked Richards if she regrets
having had sex-reassignment surgery. And even though
Richards said no, the headline was "The Lady Regrets."
Why is there such curiosity about whether post-op
transsexuals regret their surgery?

As background,
transsexual people are but one part of the very diverse
group under the transgender umbrella. Many transgender
people actually do not undergo a gender transition.
But a transsexual person, on the other hand, feels so
strongly about having a gender identity at odds with his
or her anatomy that he or she seeks medical intervention or
physical change. Some transsexual people do not need
sex-reassignment surgery (SRS) to resolve the
incongruity, while others desire it but cannot afford
it.

Renowned trans
woman Lynn Conway, professor emerita at the
University of Michigan, estimates that one in 2,500 U.S.
citizens has undergone male-to-female SRS (there is no
contemporary statistic available for female-to-male
SRS). As one who is included in Conway’s
statistic, I am used to fielding the question about
“regret.” Societal taboos about crossing
the gender binary make any transition seem remarkable,
and so the fact that someone made a seemingly permanent
change (i.e., surgery), then might have regretted it, is
positively tabloid news. (By the way, I don’t
regret mine.)

But how often
does it happen that someone regrets having had SRS?
Research has been scarce because of the stigma of studying
transgenderism and because most of the necessary
subjects (transsexual individuals) have been highly
closeted until only recently. The only contemporary research
I could find, a 2002 paper in the International
Journal of Transgenderism
citing a 1992 study,
observed that “the incidence of postoperative
regret is generally extremely low...less than 1% in
female-to-males and 1–1.5% in
male-to-females.” That’s pretty low. Why
the concern?

Some may view as
an unmitigated disaster the possibility that
anyone—even one single person—had his penis
"cut off" or her breasts removed and then regretted
it. Because of this, trans people must undergo one of
the most rigorous evaluations of any medical procedure in
order to qualify for SRS. This evaluation, unfortunately,
favors those who can best convince “the
system” of their need; thereby it occasionally
disqualifies some who need the surgery while qualifying some
who don’t.

Others may reject
the SRS-regret statistics as being improbably low. If a
story of one person’s regrets makes the headlines,
you worry that there must be other stories, right? You
may even know a transgender person who is unhappy
about some aspect of his or her life and assume that aspect
is their SRS.

But the worriers
need to look at the big picture. Any gender transition,
whether it involves surgery or not, is a major life change.
It impacts details of your daily life far beyond the
wearing of a different wardrobe, especially if it
includes the loss of ties to loved ones, loss of work,
or the need to move. Transgender people respond to any major
change just like the population at large does. Some navigate
change with incredible resilience, many have their ups
and downs, and a few are positively consumed by it.

Transitioning
also makes you a member of a minority group, perhaps for
the first time. Like racial and ethnic minorities,
transgender people often cannot hide their
“uniqueness” and as a result can face
discrimination in employment, housing, education, and public
accommodation. Of course, if you are a transgender person
and a member of a racial or ethnic minority,
expect your challenges to be compounded.

As an LGBT person
you also have a problem unique to our minority group.
That is, few (if any) members of your family share your
status. In a racial or ethnic minority at least the
family stands with you as a minority, while as an LGBT
individual family solidarity is not assured. In fact,
one or more family members may even become the most ardent
“opponent(s)” of your transition, out of
supposed love and concern for you.

There are also
challenges unique to a gender transition. For
male-to-female, it can be frustrating to experience the loss
of male privilege. I’m also guessing that
Renée Richards’s brash personality
probably played better in her former life. For
female-to-male, it may be disheartening to see how
women you don’t know now avoid your glance and
keep their distance from you. And transitioners in either
direction may find sexual intimacy more elusive.

Finally, there
are challenges specific to hormone therapy and surgery.
Medical surveillance is essential. But it’s often not
easy to find care that is both transgender-aware and
welcoming. And if you do find suitable transgender
health care, you may have trouble affording it because
insurance generally does not cover it.

In spite of all
of these challenges, most people who transition genders
remain resolved that living in one’s perceived gender
is an imperative, not a choice. Many will have regrets
about the consequences of their transition, but few
will regret the transition itself. In the unusual case
where the consequences were overwhelming enough to prompt a
“de-transition,” the return to the old gender
is seldom satisfactory either.

Sadly, many of
these consequences are the direct result of the lack of
awareness of and misconceptions of transgender people by
friends, families, colleagues, and
others—misconceptions that led to Largo, Fla.'s
recent vote to dismiss its longtime and capable city manager
before he had even started his gender transition. For
as long as shameful stories like that are in the news,
I promise I’ll keep writing.

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