“Gender is always posthuman, always a sewing job which stiches identity into a body bag.” J. Halberstam
Yesterday I went to see one of the surgeons who operates in the local Breast Reconstruction program. Do you remember when my GP told me that she would sign me up for breast reconstruction because I was “in denial” when I declined reconstruction at the time of my bilateral mastectomy? Well sure enough, the surgeon’s office called me because they had a cancellation, and I went to see Dr. N because I thought I should explore all the options available to me. And yes, I have been rethinking this reconstruction business generally, and in particular, my strong resistance to the whole thing.
I learned two things yesterday. First, I am sad to say that I am so shallow, and so marked by cultural norms around fat phobia, that I was thrilled to hear that “you don’t have enough abdominal fat to make breasts”. Having grown up as a tormented fat child, this was my very first adult experience of being told that I wasn’t fat enough! <OMG that is SO sick> But seriously folks, I also knew for sure, feeling absolutely alienated by the various breast implants littering Dr. N’s desk, that I could no more voluntarily submit to attaching breasts to my body than to wear a dress. Not me.
As I have commented upon in previous blog posts, breast reconstruction is narrated entirely un-self-consciously as the reparation of a state of injury to restore a woman to a previously uncompromised state of femininity. There are many normative investments in this line of reasoning, including but not limited to a view of the female body as equivalent to the feminine body, and a view of the female body as being made up, symbolically, of essential parts, such as breasts. On this view, there is a whole which can be radically compromised by the subtraction of specific parts. And so most texts about breast reconstruction take for granted that the stigma of mastectomy will involve an injury to femininity that can be corrected surgically. The degree to which this is a symbolic restoration is underscored by the things that are left out of these accounts, like the fact that using the best of current techniques, breast reconstruction can not repair the nerves that provide sensation to the breast.
However, for me (and many others) the fundamental problem with what I will call, the Restoration Story, is that it incorrectly identifies my gender identification in general, and in particular, the role of breasts in my gender identification. And so a refusal of, or resistance to, “breast reconstruction” is, in fact, often not a desire to refuse a reparation to the damage of surgery, but rather, a refusal of the notion that there ever existed a normative relationship with breasts. How do you reconstruct what was never there? It’s one thing to co-exist with breasts that never felt like they belonged on my body. But how could I ever choose to undergo surgery in order to “restore” what never was — which I could simply define as a state of normative femininity?
I have been thinking about my options. I know that they don’t include the recreation of breasts. However, I also know that I am pretty sure that I don’t want to live out the rest of my life with a chest that is entirely unintelligible as a chest. Or at least, I am drawn to the notion that “body alchemy” involving a potent mix of feminine and masculine identifications creates a kind of “gender trouble” with which I feel a deep and familiar affinity. So now what? Well one of the options that I have been thinking about is the form of body modification that f>m transgendered folks call, Top Surgery. Loren Cameron’s gorgeous book of photographs, including his own self-portraits, document this Body Alchemy as practiced by f>m trans folks, wherein breasts become a chest.
I didn’t feel like I could talk about this with Dr. N, whose desk was covered with an array of breast implants and nice diagrams of busty beaming women. There is a plastic surgeon in town who does most of the f>m top surgeries. I have to wait a year to see him, but maybe I can just hunker down and be patient. It is SO not my best trick, but it may be the only trick in my book. It wouldn’t be something to undergo without a lot of thought, in any case. All very interesting to contemplate. I wonder what our public health plan will say to f>m chest surgery in lieu of breast reconstruction. Or in my case, chest surgery as the only genderqueerly-intelligible form of reconstruction. Think the logic will work with the billing bureaucrats?
November 9, 2007 at 4:09 pm
Good on ya!
A trans man pal o’ mine is getting his top surgery (*squee*) in a few weeks. Interestingly enough, plastic surgeons are among the few in BC who are allowed to work in 2 tiers of medicine: public and private. Since the “waiting list” for publicly funded GRS doesn’t really move (low priority for operating room slots), private is the only way he can get this done in BC without waiting years.
I’d bet with the proper write-up, you could get yours covered, and since it wouldn’t be classified as GRS you’d not have to wait as long, if this Dr. would do it for you.
But that might make a working class trans guy have to wait longer…
November 9, 2007 at 4:52 pm
Do they have to know? Maybe the surgeon would bill it as “breast reconstruction” or “chest reconstruction” or something otherwise vague and/or slightly misleading. I have a friend who recently underwent a f>m lower surgery (the surgeon freed his clit hood from his body, then somehow wrapped the labia around the shaft of his testosterone-enlarged clitoris–his dick–to make a sheath that covered the shaft)… and billed it to his insurance as a “biopsy.”
I have just stumbled across this blog; I hope to read more in time, so don’t be too surprised if comments from me start popping up, if that is ok with you.
Casey
November 9, 2007 at 7:02 pm
Wouldn’t it be nice to think that the bureaucrats wouldn’t presume to dictate what kind of chest reconstruction is appropriate for you? But the cynical part of me thinks that gentle linguistic misdirection/obfuscation is probably called for.
And even with a reasonably uncomplicated relationship to one’s breasts, I think it’s VERY creepy how desperate the powers-that-be are to shove all women back into a box that doesn’t trouble the patriarchal vision of us. As many people from all sorts of marginalized populations have noted, the reasons why those in power want to be able to reliably pick us out of a group are never comforting.
November 13, 2007 at 11:35 pm
I read this post with some excitement. I think what’s exciting me is that you are creating yet another category of gender definition by what you’re considering. It’s a category I’ve never even imagined. I’ve known for years that gender is a spectrum of possibilities, not an either/or choice. But I feel like you just came up with the groundbreaking formula, e=mc2. *laughing* I’m really glad to know you, Mary. You just expanded my ability to think on these ideas.
November 14, 2007 at 1:22 pm
Mary, this is amazing!
If this surgery isn’t covered, well it sure as hell should be. If a breast reconstruction is covered (no questions asked) then the kind of re-construction you describe should be too. The surgery itself is no more or less ‘natural’ and the results sought are the same – to help you feel more comfortable in your skin.
Do keep us posted on how this goes.
And if only we could get coverage for lymphedema coverage, too…
November 14, 2007 at 4:55 pm
I am pretty excited about the concept being articulated here too — it seems like a gap in the healthcare system that is worth poking into and exposing for what it is. And it is likely worth manipulating a bit, to make a point. I think this will make a good legal case, if coverage of the surgery is refused. This would make useful history on two fronts simultaneously — the enforced feminization that saturates breast cancer discourses, and the extraordinary gender-based discrimination enacted against transgender folks.
November 14, 2007 at 5:05 pm
Hiya TJ — So nice to see you here, as it is to see you anywhere — I am curious to know what you think this groundbreaking formula consists of. Say more, if you feel like it. We can both take credit, like Crick and Watson.
November 15, 2007 at 6:46 am
I’ve always been uncomfortable with my body, ever since I started growing breasts. I couldn’t swing the bat as
hard. They were in my way every time I wanted to be active. Several years ago I began looking into transitioning. I concluded that I wouldn’t be comfortable being a man any more than I am comfortable
having a female body.
But one thing I never thought of doing, is getting a masculine chest on my feminine body while retaining my
identity as a dyke. I wonder if that had occurred to me those several years ago, if I would’ve made a
different decision.
As I said, ever since I started looking into transitioning, I have believed that gender is a spectrum. And this is a controversial viewpoint, but I also feel that try as they might, a transgendered
person will never achieve the 100% male or 100% female body that they want. They will always fall short. But
It’s all about being as comfortable as you can, in the body that you are given. I wish that society did not divide us into only two genders. I believe that 100 years from now, the division between genders will not exist.
Maybe it’s a small thing. But when I read that you are considering getting a masculine chest, it expanded my thought process. I saw more possibilities. And I love the idea! For one thing, I just love butch women. The butcher the better. But OTOH, I love stretching the boundaries and rearranging people’s thought processes of who is what. So the boxes no longer fit.
November 21, 2007 at 4:29 pm
Thanks for sharing your story, TJ. The complexities of how genders and sexualities intersect are so fabulous. Would that we were all encouraged to be artists in those spaces of articulation!!!
November 28, 2007 at 7:05 am
[...] even, essential, since I was heading off to see the plastic surgeon about chest reconstruction. Recall, that this is the only plastic surgeon in British Columbia who does chest surgery for fTm trans [...]