Transgender Individuals and Genital Reassignment Surgery: Is the Personal still Political?

“The personal is political.”  This is a well-known slogan used by the Second Wave Feminist movement which served to politicize women’s experience of sexism in their personal or private lives; this politicization of experience- or the re-coloring of incidents with an eye for power dynamics- was meant to show women that their individual encounters with oppression were in fact part of a systematic and institutionalized prejudice.  (great article about personal/political within feminism and also analyzes the Monica Lewinsky scandal (-: )

“To say that ‘the personal is political’ is to say only that private life is implicated in networks of power;” in the case being dealt with during Second Wave Feminism, the most concerning network of power permeating the private space was a gendered network of patriarchal power.  In the specific case of transgender individuals seeking GRS (Genital Reassignment Surgery), personal realities are often determined by underlying dynamics of heteronormative and patriarchal power.

            Another implied meaning of this slogan is a little more aggressive: if “the personal is political,” then every personal action can be interpreted as an enactment (subconscious or intentional) of political convictions, and the personal sphere becomes the setting for political change.  For example, say a heteronormative, feminist woman is told by her husband that she is terrible at driving; she protests, and he responds, “It’s not your fault- all women are bad drivers!”  Her reaction to this, whatever it may be, is political: if she acknowledges that what he says is true, she is acknowledging his power to define her reality; if she confronts him for being sexist, then she is challenging the (patriarchal) power dynamic he is trying to set up.  The idea that “the personal is political” would suggest that the woman’s personal decision about what to do in the described circumstance ought to be determined by her political convictions about how power dynamics should be set up in the world.  Thus, if the woman is a feminist and believes in the equality of men and women, she ought to challenge sexism (rather than accept it or ignore it) when it is encountered.  This interpretation suggests that there is a symbolic political meaning or weight attached to personal actions. 

            I began thinking about this idea of the personal being political while reading Janice Raymond’s “Sappho by Surgery.”  In this article Raymond shows a shocking loyalty to the bizarre and paranoid notion that transexual women (especially those that identify as lesbian-feminists) are secret male agents attempting to infiltrate lesbian-feminist organizations and halt the progression of women’s liberation.  Obviously, Raymond starts inviting problems long before she reaches her strange dystopian conclusion.  What interests me more than unraveling her strange brand of crazy, though, is to explore what on earth makes Raymond so eager to interpret a highly individualized life choice like GRS as an organized male attempt to attack femininity and feminism. 

On page 153 of our reading for this week, Raymond writes that just because MTF transwomen transitioned “does not mean that they are un-men, and that they cannot be used as ‘keepers’ of woman-identified women when the ‘real men,’ the ‘rulers of the patriarchy’ decide that women’s movement should be controlled and contained.”  Raymond’s language and suggestions in this passage betray her ultimate paranoia: not only does she seem to believe that there is some organized collective of “real men” who might “decide” to control things out there, but she suggests that transwomen are the duplicitously oppressive (ultimately male) agents of this organization and that they only seek out lesbian group formations as a way of keeping tabs on feminist activity. 

Obviously, there is a lot of room between the trope “the personal is political” and the way Raymond interprets the choices of individual transwomen to pursue GRS as an organized, political attack on femininity and feminism.  However, the question remains: regarding this choice to change one’s body, is the personal political?  When a person undergoes GRS, is there a larger political significance to her action?  I could truthfully answer this both ways and not at all.  There is so much stigma attached to GRS in Western culture that it seems unbelievable that any individual would undergo it without being incredibly personally compelled, and accounts of transpeople considering suicide after being repeatedly denied surgery evidences this compulsion.  Beyond cultural stigma, individuals seeking GRS often encounter obstacles like medical bureaucracy or flatly unwilling doctors, and they must intensely persevere in order to achieve their goal.  These factors suggest that despite any political implication others might try to impose upon the act, choosing GRS is a fundamentally personal and private action.  But this need not necessarily be true: I think it is important to leave the negotiation of meaning to the person who undertakes the action.  Thus, just as GRS can be personal (and not necessarily political), GRS can be simultaneously personal and also political in the sense of allowing for trans agency and self definition. 

-Roz Rini


The Economics of Gender Reassignment Surgery

Watching TrinidadI was struck by the way in which the rationale for communal tolerance of trans women in Trinidad was so often reduced to the money they poured into the town’s economy. Several times during the documentary, we hear resident testimonial that runs along these lines: it would be misled to treat visiting and resident trans women with anything less than a limited tolerance given the fact that they are the reason our hospital is still open. In other words, the establishment of Trinidad as the ‘sex change capital of the world’ has created a booming surgical niche market that is keeping the health care industry in Trinidad afloat (this, although one resident mentions that the hospital only receives $2,000 from each procedure, the pricetag of which floats somewhere around $20,000).

What’s striking to me about this repeated assertion is the notion that the town’s economic bottomline dictates the affective responses of the citizens. We accept you, but only if you’re financially contributing.  Trans tolerance (I’m pointedly not using the word “acceptance” here) has a price, in other words – and that price is somewhere in the ballpark of $20,000.

Which leads to another concern: the large out-of-pocket expense of transition, and genital reassignment surgery in particular.  The Human Rights Campaign, as part of their yearly Healthcare Equality Index, had 122 top medical providers fill out a survey that addressed LGBT healthcare issues – partner visitation rights, sensitivity trainings, and the like. Only 12 respondents out of these queerly enlightened 122 service providers offered trans-inclusive benefits to their employees.  That number, though, is significantly higher than in other industries. The HRC also publishes a Corporate Equality Index each year, with a special section on Transgender-Inclusive Benefits; the stats aren’t great. It turns out that, until the mid-1970s, genital reassignment surgery was often covered by insurance; then, as, an informational site for trans women, puts it,

 a couple of medical articles came out in the late 1970’s showing high suicide rates among post-operative women. This came at the same time a couple of prominent gender clinics were closed, notably Johns Hopkins. The insurance companies pounced on these events as a chance to decry the procedure as elective, cosmetic, or experimental. It’s been an uphill battle since.

It is precisely these arguments that the HRC document responds to, framing GRS as a physically and psychologically necessary procedure that is safe, well-researched, and quite well-developed (an art, as Dr. Marci Bowers puts it).

The Jim Collins Foundation, a non-profit that assists trans folks in paying for gender-confirming medical procedures,  has been established in order to fill the gaps in insurance coverage; this effort, while enormously well-intentioned and important, is not a big enough band-aid, I suspect. The real issues are employment discrimination and insurance discrimination.  What matters is having enough money to pay for gender confirming procedures, having stable employment throughout transition, and having coverage that understands gender-confirming procedures as integral to health in a holistic sense; even limited research into the economic status of trans subjects reveals markedly high rates of poverty and financial instability.

So how do we begin to ameliorate this situation? What other efforts are currently underway to address this web of medico-socio-economic injustice?  Consider these general questions for the course.


– Hilary Malatino