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Bullshit Health LGBTQ+

Happiness is not a cold scalpel

Last night I read a post by a trans woman that made me sad. It was intended to be supportive – it was written as a kind of open letter to trans women who compare their appearance to other women and find themselves lacking – which is why I didn’t give it a kicking in the place where it was posted. But I think it’s worth talking about here.

The poster wanted to tell trans women that happiness and self-acceptance are possible. All you need to do is “pass as cis” – that is, look like a particular kind of cisgender woman. And to do that, all you need to do is lose a ton of weight, take a ton of hormones, have facial feminisation surgery and undergo three rounds of vocal feminisation surgery.

That might have been the route to happiness for the poster, but it might not be for anybody else.

Take facial feminisation surgery, aka FFS. The poster had a well paid job and was able to pull together around £15K for their FFS (which suggests they didn’t have many treatments; you can easily spend many times more than that). Some people will never be able to afford that.

And of the people that can afford it, some of them will not get spectacular results because the surgeons can only work with what they’ve got. If you look like me, a chin reshape or a brow reduction is not going to make you look like Audrey Hepburn.

It’s the same with hormones. For some people HRT’s effects are minimal; their effectiveness depends on a whole host of factors, particularly genetics and age. Age is a big one, so telling late-transitioning trans people that HRT will definitely have magical effects is untrue. And even minimal effects may be many years in the future: not only do hormones work slowly but the wait to even start treatment can be very long. In some parts of the UK you can expect a wait of around five years between being referred to a gender clinic and getting a hormone prescription.

Last but not least, there’s weight. The poster asserted that losing weight has a massive feminising effect, but again that depends on the face and body you have. Some people find that losing weight makes them look more masculine, not less.

Of course if that’s the case they could always have facial feminisation surgery… and we’re back to the start again. There’s always one more thing you need to do before happiness is yours.

Let’s pretend I have the desire and the resources for facial feminisation surgery (spoiler: I don’t). What if after a brow reduction, or chin recontouring, or a hair transplant, or a nose job, or a tracheal shave, or a lip lift, or cheek augmentation, I still don’t look or feel pretty?

What if I’m still clocked because of the things surgery and hormones can’t change: the width of my shoulders, the breadth of my ribcage, the length of my torso, my centre of gravity?

What if something goes wrong with the surgery – many FFS providers specifically advertise their ability to fix other surgeons’ mistakes – and I can’t afford to get it corrected?

What then?

I’m not suggesting that FFS, HRT and other things can’t have positive effects on how you feel about how you look. Of course they can. Some people have these things, look amazing and feel fantastic. I don’t endure two hours of painful facial electrolysis every week for a laugh: I do it because having a stubble-free face is important to me.

But the idea that there is a particular standard of beauty (thin, pretty, usually white) and that if you just starve and carve yourself enough to meet it then happiness will surely be yours is a pernicious myth that has caused a great deal of harm to very many women.

Cosmetic surgeries will not necessarily make you any happier or deliver the results you want, and nobody should be telling anyone that they will.