The Unexpected Peace of Gender-Affirming Surgery

On 11 July 2024, I received gender-affirming surgery at Yanhee International Hospital in Bangkok, Thailand.

Although I never wanted to go to Thailand for surgery, my hand was forced when my insurance company denied my claim for surgery in the United States. I knew I could not afford surgery in the US, and Thailand appeared to be a viable - and affordable - option.

But I was upset with my country for forcing me into what I thought was a bad position. In a very passive act of revenge, I began documenting my path to Thailand in over 100 short videos published on YouTube and TikTok.

I hoped my crummy experience could help others avoid the dissatisfaction I felt with the US health care system.

As it turns out, the decision to travel to Thailand was the best idea I had in my gender transition. The care I received was almost certainly better than that in the United States, and the experience opened my eyes to cultural patterns in Western society I would never have observed otherwise.

In the weeks leading up to travel to Thailand, I took a long retrospective look at my life and how it prepared me not only for gender transition, but for surgery. Looking backward, however, did not prepare me for the depth of insight I experienced after surgery.

How profound could surgery be?

Before I left for Thailand, I tried to hear as many stories about gender-affirming surgery as I could. I wanted to prepare myself for the worst. Some accused me of worrying too much, but I had reason to collect as much knowledge as possible.

The procedure in Thailand marked the first surgery of my entire 54 years of life. I had never even endured a prolonged stay in the hospital (at least, not for physical reasons).

One story that stands out occurred at lunch with a friend. As she related how she felt waking up directly after surgery, the story began with:

Obviously, I couldn't see anything because of the bandage…

Then she paused and turned away. Her eyes became distant, pricked with tears. My breath caught in my throat, and I felt the pounding Mexican techno music fade as I waited for her to finish.

All she said was:

But I knew…it was all over.

I exhaled, feeling possibly a bit deflated myself. I knew how emotional she was, and I respected her story.

In the back of my mind, however, I considered her response. "All over?" Isn't that a bit melodramatic? It's surgery.

I went to the operating room believing my results would be "good." Not having to worry about those parts any longer would be "nice."

But life-altering? How profound can a surgical procedure get?

A week of recovery in the hospital

The surgery - according to my surgeon, Dr. Worapon - was a "complete success." Frankly, I had no idea what that meant other than I wouldn't have to worry about a second surgery in the near future.

Instead, I spent the next week of my life in an uncomfortable bed with guard rails I couldn't let down on my own. I never received clothing for my bottom half, as I had a catheter installed. I relied completely on nurses and my wife for care.

At first, I felt like a cat trapped in a bag. I couldn't move my left arm for fear of breaking the IV needle. I couldn't roll over at night for fear of pulling out the catheter. I couldn't even get out of bed and walk around - especially not outside my room - for fear of frightening others with my lily-white bum hanging out.

To be clear, every other aspect of my week of recovery was wonderful. The food was amazing Thai cuisine. I saw my surgeon every day except one (his day off). Nurses were available 24 hours a day to help me if I needed it (perhaps to drop the guard rails and allow me to expose my lily-white bum).

I credit how quickly I healed to that week bound to a bed. I did not enjoy being unable to do things on my own; I viewed myself as a burden to my nurses. But I healed, and on 19 July 2024, I was released from the hospital.

Initial lessons from gender-affirming surgery

I was excited to leave the hospital, and bidding goodbye to the nurses who cared for me was bittersweet. As we drove away in a van, I looked out the window at a world that had never stopped during my recovery.

Colors were brighter, the stiflingly humid Bangkok air was sweeter, life felt fragile and precious. I felt my eyes grow distant as the pounding Thai techno music faded into the background.

Because then it hit me.

Never again will I see the bump in my clothes caused by those parts.

Never again will I feel those parts stick to my leg or get sweaty or get caught in my underwear.

Never again will I experience the uncomfortable stiffness and stickiness I wanted to associate with love and celebration of my body and life.

Never again will I feel the shame caused by those parts.

Tears pricked my eyes, because right then, I realized.

It was all over.

A lifetime of fighting myself with no chance of victory…over.

Is the change after gender-affirming surgery that profound?

Yeah.

The alignment gender-affirming surgery brings is indescribable. Because it isn't just the moments I saw the bump, felt the sweat, or experienced the shame that are gone. The moments in which I dreaded those experiences, or ruminated on those experiences, or hated myself because of the experiences are also gone.

It really is all over.

And the world is different now. I am different now.

That's what gender-affirming surgery brought - freedom from inflicting pain on myself.

Social lessons from gender-affirming surgery

The sense of relief I experienced from gender-affirming surgery extends outward as well. It dovetails with the accusation that transgender women are "just men" invading women's spaces to prey on the "real" women.

First, some background: I understand what it feels like to be victimized by men.

I understand what it feels like to be physically assaulted by a man.

I understand what it feels like to be sexually assaulted by a man.

And I knew both by the age of 13.

Some may laugh at those experiences, claiming I still can't understand what it feels like to stand powerless before the systemic injustice of a patriarchy while ignoring my rape and abuse - both symptoms of the systemic injustice of a patriarchy. But I know.

And I also know I would never inflict these feelings upon another woman, because there is nothing worse than the fear caused by being powerless, by never being able to win in a game we didn't choose to play.

I would never inflict that pain. I know it.

But my body betrayed me. I still carried parts with me that others across human history had used to inflict that pain. I carried those parts into every bathroom and locker room I entered.

I found I was welcomed in those spaces as a Sister. No woman screamed and accused me of invading her space. No woman feared I was there for the express purpose of inflicting pain on her.

But every self-righteous right-wing politician erroneously declaring my intent in his spit-flecked sermon increased the danger I might someday be perceived as he had portrayed me.

I know I was not and never would be a danger to other women. I know it…but they never did. And the sense of relief I feel now at never having to experience those parts and the emotions that came with them extends outwardly - to all women - as well.

I feel relief that no woman I encounter in women's spaces can believe I would inflict pain on her with those parts ever again - and not for my sake. For hers.

That's what gender-affirming surgery brought: freedom from the worry I could incite fear in others, even when I knew I would not.

The cycle continues

I went to the operating room hoping for "good" results that felt "nice." I sit here today deeply and entirely transformed. There was no preparation possible for the effects gender-affirming surgery brought. I had to experience it.

To be clear, however, I don't recommend gender-affirming surgery for any other person. I do not feel qualified even to advise how to make the decision. Each of us must make the decision on our own, from our experience.

In that regard, those 100 videos I published are an abject failure. I documented a process particular to me, not general to humanity. In the process, however, I believe I uncovered truths about humanity I would never have found otherwise.

This surgery granted me no special status. I am no more validated as a human or a woman. Being able to afford surgery is not the measure of a woman; identity expands past physical structure alone. Receiving surgery, however, shined light into corners of my existence I believed filled only by a vacuum.

My gender transition is complete. I have transitioned socially. I have transitioned medically. There are no further tasks to check off my list.

Now there is only to live my life - in bright colors, in sweet air, recognizing it as fragile and precious. The rest of my life is still unknown, save one aspect: it will be more luminous moving forward.

Gender-affirming care saves lives. I know that - I am one of those who is saved.