What is “the surgery”?

Whenever trans people are talked about, whether in a private conversation or in a sensationalist newspaper, the first questions often asked are about if that person has had "the surgery", or not.

When this term is used, or when people talk about surgery in relation to trans people, it’s usually referring to genital reconfiguration surgery (GRS). GRS consists of several different procedures that people may have, depending on what they want, what is available, accessible and affordable, and what extant (currently existing) body parts they have.

GRS can consist of vaginoplasty, vulvoplasty, phalloplasty, metoidioplasty, and other more specialised or specific surgeries. For more information about these surgeries, visit our community or clinicians GRS pages.

There are other affirming surgeries too, such as top surgery (or breast removal / reduction), breast implants, facial surgery, and more.

It’s often assumed that trans people must both want and get GRS. In reality, while many trans people want or have had some forms of surgery, many trans people don’t want any surgery at all, and others are still figuring out what we might want or can access in the future.

The idea that gender affirmation (or ‘transitioning’) is a direct path that starts with talking to a doctor and finishes with GRS, has traditionally been encouraged by doctors and legislators. Over time those entrenched assumptions meant it was expected by doctors and medical professionals that every trans person (especially trans women) would want GRS. The reality is that throughout history, right up to the present, many trans people also do not want surgery. Even today, many trans people are happy going their entire lives without having any surgery at all, who are still trans and still very much their gender, and it’s nobody’s business but their own how they live in their body.

While genital surgery is often seen as the ‘last part’ of gender affirmation by cis society, it is just another step along the way of some people’s journeys. It’s important to remember that the configuration of our body’s chemicals and parts don’t define who we are – trans or cis. Surgery doesn’t make somebody trans, and it doesn’t make someone a particular gender – we seek these interventions because it’s essential for our wellbeing as our gender. There’s no right or wrong way to be or embody your gender, regardless of your surgical status.

While on the surface it may seem like someone is just asking about a medical procedure, by asking if someone has had surgery, or mentioning that you know someone has or hasn’t had it. What’s really happening is you are making a person’s genitals the most important thing about them.

This isn’t necessary or relevant in almost every setting, including many medical and surgical contexts.

Trans people are whole, complex, wonderful people, and our genitals are one small part of that. However, the way that they’re focused on allows people to police us, who we are, where we can be (for example in bathrooms), and to let their prejudice take the lead.

If you’re curious about what genitals someone has, think about if you’d be wondering that about a cis person in your situation. Chances are the answer is no, and in fact to do so would be rude or make them uncomfortable.