Healthcare versus Mutilation

When a doctor performs some procedure that the patient has consented to, then that is “healthcare.” When a doctor performs a medically unnecessary procedure without the patient’s consent, then that’s “mutilation.” This ought to be obvious, I should be able to stop the blog post at this point without any need for further elaboration. Unfortunately, some people still fail to understand the importance of bodily autonomy and informed consent when it comes to people’s bodies.

Female genital mutilation is correctly called “mutilation.” Circumcision is also mutilation when performed on a baby (for whom it isn’t medically necessary due to health complications). However, if a man who is over 18 years old wanted to circumcise himself, then that would be “healthcare.” Every person ought to have a right to decide what happens with their body. Neither parents nor doctors should decide. No doctor should act as the “gatekeeper” who can either allow or deny some procedure. Instead it should be up to the patient to decide how they want to live and what they want to do with their body.

When it comes to intersex children, doctors shouldn’t perform any surgeries on them until they are old enough to decide which gender (if any) they prefer to have. Unless a baby is in immediate danger, keep the scalpels away from their genitals. Once the child gets older, they will figure on their own what they want to do with their body and which (if any) surgeries they want.

Similarly, also trans people should be allowed to do with their bodies whatever they prefer. They should have bodily autonomy. Doctors cannot have a right to decide what will happen with their patient’s body. Doctors shouldn’t be permitted to either allow or deny some procedure that the patient desperately wants.

Moreover, non cis people should be allowed to pick and choose, which procedures they want. A state cannot demand a trans person to sterilize themselves before legally recognizing their gender. A doctor shouldn’t be able to say, “If you only want a chest surgery but no genital surgery, then you aren’t trans enough and therefore I will deny you access to the procedures you requested.” Every non-cis person should be allowed to have only some procedures and skip all those that they don’t want.

What constitutes “mutilation” depends upon what some individual person wants to do with their body. For example, if my body became pregnant, I would perceive that as mutilating. I already dislike the fact that my body is too feminine for my own taste, but I can cope with my existing problems. Nonetheless, the thought of my body even potentially becoming any more feminine freaks me out, and in my mind I strongly associate pregnancy with femininity. Thus for me experiencing pregnancy would be mutilating. A hysterectomy, on the other hand, is a procedure that I really want, therefore for me that would constitute “healthcare.”

Of course, countless cis women want biological children and would be uncomfortable with needing a hysterectomy. People and their lifestyle preferences differ. Thus it ought to be up to each person to decide how they want to live.

The question isn’t whether some TERF believes that the body I happened to be born with is good enough and needs no modifications. Instead, it’s about what I want. Personally, I strongly dislike some things about my body, and I want to surgically fix these problems.

tattoos and piercings

This is a photo of Rolf Buchholz, a person who has hundreds of piercings. I have no doubt that some people perceive these body modifications as ugly and highly unnecessary. If this was done to a non-consenting person, then that would count as mutilation. But in this case we have a person who wanted all those body modifications and chose to get them for himself. That was his choice, his right. It doesn’t matter whether somebody else likes the visual appearance of his body. What matters is that he made an informed choice and likes the result. As long as a person feels happy about some body modification, other people’s judgments are irrelevant.

As feminists have been saying for decades: “My body, my choice.”

TERFs tend to call me delusional. I disagree. I am perfectly capable of understanding that there exist facts. For example, I know that there is a uterus in my body. I am also capable of identifying facts that I dislike. For example, I dislike living with a uterus. When people dislike some fact about the physical world, they seek ways how to change said fact. For example, I have spent the last two years trying to obtain a hysterectomy in order to surgically remove the reproductive organs that I don’t need. The only problem are transphobic surgeons who have been kicking me out of their offices.

In my opinion, TERFs are the ones who are delusional, because they have created in their heads some imaginary world that differs from the reality. For example:

[Transsexual surgery] could be likened to political psychiatry in the Soviet Union. I suggest that transsexualism should best be seen in this light, as directly political, medical abuse of human rights. The mutilation of healthy bodies and the subjection of such bodies to dangerous and life-threatening continuing treatment violates such people’s rights to live with dignity in the body into which they were born, what Janice Raymond refers to as their “native” bodies. It represents an attack on the body to rectify a political condition, “gender” dissatisfaction in a male supremacist society based upon a false and politically constructed notion of gender difference. – Sheila Jeffreys

I am an AFAB person who has no female gender identity. Instead I am an agender person with strongly masculine lifestyle preferences. I usually use the word “agender” when talking about myself, but I could also call myself a “transgender man.”

Sheila Jeffreys is clearly out of touch with reality. I have always been able to “live with dignity in the body into which I was born,” however this is not what I want, instead I want to live as a man, and I have specifically requested certain medical treatments. I couldn’t care less about the fact that Sheila Jeffreys considers my body “healthy,” because it is my body, and my right to decide what I want to do with this body. What she calls “subjection of such bodies to dangerous and life-threatening continuing treatment” is something I consider absolutely necessary medical care that would allow me to have a happier life.

Here’s the thing—in my entire life nobody has ever coerced me to transition. Most people have told me patronizing nonsense about how I am destined to live as a woman. (No, I am not, there is no destiny, and I will decide for myself how I want to live.) A few people have instead told me that how I live is my choice and that they will support any decision I make. Nobody has ever said: “You should get testosterone injections and have a breast removal surgery.”

For now I am not taking testosterone, thus people mistake me for a butch lesbian due to my appearance. I have never been discriminated due to being perceived as a masculine woman. Yet on countless occasions I have been discriminated after stating that I prefer to live as a man. Transphobes have called me “delusional,” transphobic doctors have abused me, they have denied me absolutely essential medical treatments. On top of all that, according to some people, I shouldn’t even be allowed to use public toilets.

In my eyes, assholes like Sheila Jeffreys are the same as patriarchal men who have been telling me that I must wear pink dresses and make babies. I treat sexism (“a woman ought to obey her husband”) and cisgender supremacy (“an AFAB person shouldn’t try to live as a trans man”) similarly. Under patriarchy, cis men (self proclaimed paragons of moral virtue and defenders of traditional gender roles) want to tell AFAB people how to lead their lives. Under TERF ideology, cis women (self proclaimed feminists and defenders of traditional gender roles) want to tell AFAB people how to lead they lives. The similarity should be obvious. I don’t like being told to wear pink dresses. Similarly, I also hate being told that I am just a confused butch lesbian who shouldn’t even think about surgical body modifications. For the record: I cannot possibly be a butch lesbian, because I am sexually attracted to men.

Here is one more atrocious quote from TERFs:

Any correct terminology for the transsexual lobby (in both its commercial and non-profit guises) must address the mental disorder of dysmorphia and the dissociation that drives hormonal manipulation & surgical altering to create a costume out of the physical body – rather than to address the psychological disorder at the root of rejection of the physical body and reliance on lifelong artificial means of sustaining it.

The way I see it, my mind is the real me. My body is just a shell in which I have to live. I could replace parts of my body with robotic limbs, and I would still remain me. I could get a hysterectomy, a breast removal surgery, and testosterone injections, and I would still remain me. Modifying my body in order to make my life more convenient in no way would change who I am. It would just fix some things that I dislike about my current body.

If there existed some miracle pill that could “cure” my gender dysphoria, I would categorically refuse to take it. If my mind was modified and became that of a cis woman, then the resulting person would no longer be me. If such a pill existed, I would absolutely refuse to take it. If I were forced to swallow it against my will, then that would be equivalent to a murder. The real me would be killed and replaced with a different person that would no longer be me.

Human minds change over time. Me twenty years ago (a seven years old child) was very different from the mind I have now. But me as a child and the current me are at least compatible. The latter is what developed from the former. But me and the mind of a cis woman are absolutely incompatible. Turning my mind into that of a cis woman would require mentally murdering me (luckily, something like this would be possible only in science fiction or fantasy books, so I am safe).

It’s not my mind that I want to change. Instead I want to change my body. I really wish I were born with a male body. I have never in my life wished to be a cis woman. Even before I realized that I want to live as a man (I was 23 then), I never wanted to like feminine things, I never wanted to want to be a more feminine person.

If there existed some treatment, some miracle pill that could change a person’s sexual orientation, most homosexual people who live in progressive countries probably wouldn’t want to use it. After all, for them being gay or lesbian is part of who they are. Erasing that would mean destroying a part of them. By the way, I qualify as bisexual (albeit, in general, I am sexually more attracted to masculine people), and I would not want to change my sexual orientation even if it were possible.

Changing my body is something I want to do, therefore that’s “healthcare.” Changing my mind, however, would be mentally murdering me or at least severely mentally mutilating the person I am. When transphobes say that a psychiatrist ought to fix my mind and cure my gender dysphoria, I perceive that as threatening, as a desire to erase the real me.

In my opinion, I am not mentally ill. Yes, gender dysphoria is a medical problem that makes my life somewhat inconvenient. For example, I am legally forbidden from getting a male name in the country where I live. Thus I am forced to live with two names, one that is real for me, and the other a deadname that is real for my country. That’s inconvenient. Being referred to with the wrong pronouns is also inconvenient. And being treated as a woman is overall annoying. So yes, having a gender dysphoria causes problems for me. But the problem is not my gender identity. It’s not my mind that is wrong. Instead the problem is a transphobic society that tries to forbid me to live as a man. The other problem are some things that I dislike about the visual appearance of my body and its reproductive organs. I don’t want a psychiatrist to change my mind. Instead I want a surgeon to fix my body.

But here’s the thing—I do not see myself as mentally ill. In my opinion, my gender identity is not an illness. I do not like being pathologized by therapists, mental health providers, and society. For me, being an agender person with strongly masculine lifestyle preferences feels just as normal and natural as being cisgender feels for non-transgender people. Being diagnosed with a mental health or medical condition is therefore unpleasant. Just because non-cis people are a minority of the society doesn’t mean that we are sick freaks.

Psychiatrization of gender variability is nothing more than social control. Basically: “If you were born with a female body, you must live as a woman.” Gender variance is normal. There exist transgender and transsexual people, agender and genderqueer people, non-binary and genderfluid people. There is an entire spectrum of gender identities that are not exclusively masculine or feminine—identities that are outside the gender binary. That’s how things are, thus it is normal. It’s oppressive to claim that not being cis is somehow a psychiatric illness.


  1. says

    The worst part for me was that where I live I had to get two psychiatrists to say that I had a ‘condition’ to get my trans related health care approved. Basically I had to say I had something wrong with me when I didn’t feel like anything was wrong me. We are mentally healthy people who just have unique health care needs.

  2. anat says

    How do transgender people feel about the current DSM approach of using the category ‘gender dysphoria’ rather than some kind of ‘disorder’? Is this a better reflection of ‘I am a healthy person with some specific needs’? When my son needed a letter from a therapist for his surgery the contents of the letter ended up being about how well my son was doing once he took certain steps towards transitioning and how some aspects of his body stood in the way of some things he wanted to do, which I think also fits this framework.

  3. says

    anat @#3

    It is accurate to say that the discrepancy between how my body looks like and how I feel causes emotional discomfort for me. So yes, I have special medical needs. It’s just that I don’t like being labelled as mentally ill.

    Speaking of letters from psychiatrists, at least for trans people who are older than 18, those ought to be abolished. Instead we should be able to get the healthcare we need simply by signing the consent forms.

    Firstly, what I do with my body is my choice, no doctor should have the authority to act as a gatekeeper capable of denying me bodily autonomy.

    Secondly, while many trans people do benefit from counseling, making it mandatory is highly problematic. Under normal conditions, if a patient benefits from counseling, they will schedule the next appointment. If the conversation with a doctor makes them feel worse, they won’t schedule more appointments. Trans people are turned into hostages who are forced to keep on going to some mental health professional also when said visits don’t help or even make them feel worse. For example, I know that talking with a therapist who considers me mentally ill and tries to encourage me to live as a woman would feel like torture for me. Yet this is the kind of barrier my country creates for me so as to keep me away from obtaining the procedures I need.

    Thirdly, turning trans people into hostages of some doctor creates an opportunity for abuse of power. For example, a therapist who has few patients and needs more income can force a trans person to pay them thousands of dollars for doctor’s visits with the promise that “soon I will give you the letter you want.” I have even read online about the experiences of a trans man who was coerced to have sex with his therapist in exchange for the letter.

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