"A penis remained an unlikely prospect"
On the New York Times latest dispatch from the frontier of an unfolding medical scandal
Not to be outdone by New York Magazine, the New York Times Magazine decided to devote part of its Health Issue to a bizarrely lighthearted romp through what it takes to create a fake “penis” out of a troubled patient’s thigh.
At times, the reporter (who also identifies as trans) is remarkably frank about the risks involved. But ultimately, the overall effect is less clarifying than it is desensitizing:
Depending on the combination of procedures, a penis might take a couple of years to complete, involving many surgical stages and revisions and a long-term commitment to organizing life around access to doctors, insurance coverage, time off from work and postoperative care. For trans patients, the risk of complications is high — according to surgeons I spoke with, about 70 percent.
The reporter trafficks in body horror: tubes, pumps, fluids, smells, tissue grafts, catheters and “open wounds,” vaginectomies and scrotoplasties, rectal injuries, necrosis, flayed forearms and thighs, and a splayed “penis” left looking like nothing so much as a “hot-dog bun” for seven months between surgeries.
A reasonable, feeling person must do something with the horror that transition stirs up. But since the real source of the horror can’t be acknowledged—must, in fact, be celebrated as progressive and good—those feelings must go elsewhere. The reporter conjures outrage after outrage and then smuggles the reader’s sense of injustice to the wrong place, as if to say: Isn’t it a medical scandal how long the wait lists for these surgeries are?
Yeah, it’s a medical scandal, alright.
When Ben says, “I felt that any complication that would arise, including dying, was better than the alternative,” the reader is supposed to feel the intense necessity and urgency of expanding access to these procedures. But resist the emotional manipulation and you may find yourself asking: Is a person who would rather die than live without grafting a roll of flesh onto their pelvis capable of consenting to such a serious procedure? What is the ethical thing for a doctor—presented with such a desperate patient—to do: proceed with a risky operation or address a mental health crisis without resorting to knives and sutures?
Within the article, of course, no such questions arise. Everyone involved—reporter, patient, surgeons—agrees on the tone and genre of the story they’re telling, even when the facts of the case balk. The surgeons display a chill, Mx.-Potato-Head mentality toward their profession—“You can do glansplasty, no glansplasty. Scrotoplasty, no scrotoplasty. You can really do a whole mix-and-match thing to meet your goals…”—while the reporter praises the patients’ “unexpected… mastery of capitalist subjecthood.” The future of what surgeons, patients, and ideologically captured media outlets prefer to call “gender-affirming medicine” is front and center.
The thing about transition is that the possibilities for body modification are boundless: there's a lot of money in it (“penises” are $200,000 a pop) and there's no finish line, since no one ever changes sex. That means there's always another intervention for patients to pursue, in an attempt to drag themselves a few inches closer to an impossible and always retreating goal. At first, Ben thought “top surgery" (an elective double mastectomy) would be enough.
What’s next for Ben? It’s hard to imagine that Ben will move on with life or that life as a permanent medical patient will let Ben move on. Is facial masculinization surgery next? Leg-lengthening? Another round of revisions to the “penis” sculpted out of thigh and four years of a young person’s life?
Eliza's writing just gets better and better.
So many great insights and turns of phrase:
"The reporter conjures outrage after outrage and then smuggles the reader’s sense of injustice to the wrong place, as if to say: Isn’t it a medical scandal how long the wait lists for these surgeries are?"
I think this 'industry' has been helped in no small part because of our general squeamishness and unwillingness to talk about things like this. It's hard enough to read about scrotoplasties and splayed penises, let alone talk about them, or raise questions like 'Does the phalloplasty get erect? Does it produce any fluid?' 'Can the person get an orgasm?'
Even typing these words seems rude and intrusive, and I can't imagine asking Ben about this, even if I was a close friend.
And so the juggernaut rolls on, without the necessary proper scrutiny.
I thought the subject’s interactions with other people as the surgeries progressed were pretty interesting - “you wanna see my dick?” when challenged in the bathroom; ostentatiously flirting with nurses, office staff, etc. It seemed like she started feeling pretty powerful.
But it’s also clear that she’ll be clocked anywhere she goes. She appears to assume she’ll be “most girls’ first experience having sex with a trans man” in her rural area - yet I can’t fathom any heterosexual woman wanting to be intimate with a 4’10 bearded woman. I don’t write that to be cruel - hetero women are attracted to men, and I am confident in thinking lesbian women aren’t interested in sex with anyone sporting a beard and a penis. So who’s left? Adult male fetishists looking for a bottom. And later as she’s older, other young vulnerable and disturbed girls who’ll be pressured into experimental sexual experiences because they feel like they’re being transphobic if they say no.