Thanks for your thoughtful answer. I took you as not a terv because I read through your blog and the B section comes across pretty strong in that transitioning does work for a significant chunk of people - just not you and not for alot of others that get swept under the rug. What steps do you think should be taken to improve the situation, as referenced in A? Other than increasing acceptance and normalization of detrans.
Hello again; Iâm linking back to the first ask so people know what âA & Bâ are referring to. (Summary: Medical transition A. harms some people, and B. helps others.)
What concrete steps can be taken to make things better? Truthfully, I have no freakinâ idea. Itâs hard to conceptualize what Better will even look like, much less how to get there.
But I do have one concern in mind:
If trans organizations & advocates want to take steps to make things better... they could start by taking care of their own. By that I mean, their first step could be finding concrete ways to acknowledge and support trans people who regret some specific medical step(s) theyâve taken. Theyâre still trans, theyâre not detransitioning, but some treatment has caused them harm and they regret having done it. Say, a surgery with a permanently bad outcome (more crudely referred to as âbotchedâ), or serious complications from HRT.
If trans people canât even acknowledge the reality of other trans people who are hurting and regretting just one part of their transition, then I really doubt they have anything to offer a detransitioner who regrets the whole kit and caboodle.
I say this as someone who regretted my top surgery long before detransitioning ever crossed my mind. In some ways, socially navigating the pain of top surgery regret was harder than detransitioning was. By the time I detransitioned, I was so jaded that I didnât expect much from others; I was already aware that there was nobody on my side. But when I was trans and seeking support after surgery gone wrong? It wrecked me when I learned that not only did nobody seem to understand or care, they absolutely didnât want to hear about it, because my existence threatened their preconceived ideas. My regret frightened them.
When youâre a trans person who expresses regret over surgery, you tend to get one of these responses:
1.) Bitter disgust. âHow dare you be so ungrateful, you wretch? I would kill to have what you do.â
2.) Concern-dismissal. âYou know, you shouldnât say those things about your body, itâs very invalidating. You should look on the bright side.â (Iâve had someone say this to my face, Iâm not making it up.)
3.) You-should-have-done-X and Did-you-try-Y, the most common and annoying combo of them all. People are so convinced that these procedures are harmless and without risk, that when something does go wrong, they do everything they can to blame it on the patient. Of course surgeons do it, but what shocked me is that other trans people do it, too. And they do it without knowing literally anything about what you did or didnât do. They just assume and assert that if it went wrong, itâs your fault. âYou should have picked a different surgeon, should have worked out more before surgery, must have not followed the docâs instructions, ...â It goes on ad nauseam.
There is no widespread acknowledgement that you can do literally everything right, and still have a poor outcome with permanent complications, including chronic pain.
And there is no support to be found when youâre navigating that. At most, you get quickly shut down with a recommendation to âTalk to a therapist about itâ, aka, âPlease go away so that we donât have to hear about this, because this isnât what we want to hear. Come back when you can smile and repeat the party line. Hearing about your pain makes us worry that weâll end up like you.â
As mentioned in the previous post, instead of offering acknowledgement or support, people say anything they can to alleviate their own cognitive dissonance about your existence.
There is no community support or organized care available for those who are struggling with regret, which makes the idea of regret even scarier. Most trans people are scared shitless of surgery-gone-wrong. There is information aplenty about how to shop for surgeons and minimize your risk of complications. But this info often comes from surgeons themselves, and rarely accurately discloses just how risky things really are.
The pervading attitude holds regret as a rarity, a myth, nothing to worry about, and so there is no momentum to build structural support for those going through it. Why make resources for something that doesnât exist?
Surgical regret is a taboo, and that needs to stop. I think the reason we donât hear about it much is because there is so much pressure to keep it to ourselves. Itâs such a taboo that itâs hard to even admit to yourself that you regret it. Itâs as if the big R-word is a forbidden part of the vocabulary.
Iâm willing to bet there are lots of trans people actively struggling with shoddy medical care and surgical complications, and have no place to talk about it or seek solidarity/advice/legal counsel/frickinâ anything. Once you regret anything, youâre on your own, and you have to claw your way through the stages of grief alone. Itâs messed up beyond words.
A trip down memory lane..
Just to illustrate the point, Iâd like to share a few memories of mine.
I was a long-time attendee of the Philly Trans Health Conference (recently renamed the "Trans Wellness Conference".. interesting).
I went to PTHC both before and all throughout my transition. It was free, local, run by my clinic, and a valuable source of information.
One year, the conference happened 6 months after my initial top surgery (and 6 months before my revision). I was still struggling with severe nerve pain, disappointment, fear/anxiety, and a rapidly waning sense of safety/trust. I was hoping to find some community, information, or even just the chance to share my story and find out if I was seriously the only one to go through something like this. Just wanted some reassurance or something.
I canât claim to know exactly why my surgery had so many complications, but I think part of it was due to a decision my surgeon made without my consent. After many consultations, we had gone into the operation agreeing that he was going to do the inverted T/âanchorâ incision. As the hospital staff were prepping me for anesthesia, he drew the incision points on me with a purple marker, and checked in with me to make sure it was all still good.
And yet, when I went to his office a few weeks later to have the bandages and drains removed, I was greeted by an unpleasant surprise during The Big Reveal. He didnât do the inverted T at all. He did the lollipop technique instead. (Essentially, the anchor but without the large double-incisions underneath.) The lollipop technique was likely to leave excess skin on breasts my size... as we had discussed in our consultations. That why we decided on the inverted T. And yet, after I was unconscious and under the knife, he made the decision to do a different technique with higher risks.
And, of course, the results were bad. There was excess skin, a lot of pain, and he had to do a major revision (literally a second surgery under anesthesia at a hospital, not a quick in-office touch-up) a year later to add in the double incisions he left out.
He never even acknowledged the decision he made without me or explained why he did it. And I was too shocked and disturbed to even ask. I kept my mouth shut and hoped the revision would be better.
AT ANY RATE, I went into PTHC that year while struggling with this. I was as healed up as one could be, and the appearance spoke for itself. I was still in physical pain, and the excess skin made it almost seem as if my chest could wink, like it had eyes. I can laugh now, 5 years in hindsight. But I couldnât laugh then.
I didnât find any workshops or groups that were of help. But I did make the decision to go to the âTop Surgery Show-and-Tellâ. It was a panel they had done for several years, and I had attended in the past as an observer. It was a closed event where trans men could go to share their results and experiences with other trans people considering top surgery. I thought maybe Iâd find some catharsis by sharing my experience, by making space for this kind of experience to be known, so that maybe if it happened to someone else, theyâd know they werenât the only one.
I didnât even plan on sharing the whole story. Was afraid to say anything too honest, like, âA surgeon who speaks and advertises at this conference did this to me, and made major decisions while I was unconscious and unable to consent.â I was just going to stay positive and express my (genuine at the time) optimism for my upcoming revision.
I went in the huge conference room, got over my stage fright of the huuuge crowd of people sitting in the chairs (âweâre all in this together, and I was once in that chair tooâ), and joined the line of 40+ shirtless (mostly young, thin, white, hairless) trans guys lined up along the wall. Comparing myself to them, I felt like a literal bear (to this date, Iâm still the hairiest person I know. Hair on my chest, stomach, shoulders, back.. it was even thicker back then when I was on T). Definitely felt like the odd-one-out with my forest of hair and winking chest. But I figured maybe thatâs a good thing. My existence is just as much a possibility. Thatâs the point of a show-and-tell, right?
We each wrote the name of our surgeon above our heads on the whiteboards behind us. The moderator carried a mic around the room, going down the line. Each person spoke briefly, sharing who their surgeon was, and anything they felt was relevant about their surgical experience. My anxiety mounted as he got closer, and closer, and then, when the person on my right finished speaking... the moderator skipped right over me and handed the mic to the person on my left.
I donât know how to tell you how confused and mortified I was. In that moment, some part of me died in embarrassment. I understand it was busy, time was limited, there were lots of people, etc, I can make excuses galore (maybe he just.. didnât see me..?). But nothing can change what that moment felt like.
The mic made its way to the end of the line, and everyone was told they could get up from their chairs and were free to wander off, or hang around to ask questions one-on-one with the people showing off their results.
I stood around a bit, but nobody talked to me. Nobody asked any questions, or even said âHello,â or âThanks for being here.â Some people glanced at my chest, but nobody looked me in the eyes.
I put on my shirt, and went straight home.
Even funnier to me, my experiences with PTHC donât end there.
A year later, I was a few months into my decision to detransition. It was new and scary. When I heard that there were going to be two panels about detransition at that yearâs conference, I was delighted. It was like, wow... people are actually going to talk about this! It might be rocky as hell, but people are trying!
Aaaaaaaand then those workshops were cancelled after it was deemed too controversial. I was crushed. Not particularly surprised, but deeply disappointed. I wrote to the event coordinator, expressing why this mattered to me as a local patient navigating this experience, and asking if there was anything that could be done in substitution. âIs there a way to at least organize a meetup, a roundtable discussion, anything? Even if not at this year's conference, what about the future years?â Never heard back, of course.
I still went to one day of that yearâs conference, though. There was a gathering for Autistic trans people, and I was interested in hanging out there. Need to spend more time with people like me, ya know? Iâll take community anywhere I can get it.
While I was there, one trans guy brought it up. âHey, did any of you hear about the detransition thing they cancelled? Whatâs up with that? I wanted to go! I wanted to hear what they had to say!â âYeah, that was really messed up!â Made me feel a little better to overhear people talking about it.
When the workshop was over, before I left, I made one last walk around the convention center, looking at the people, the vendor stalls, the info booths... and I stumbled upon a table covered in stacks of handouts and flyers. One stood out as familiar, one I had seen in past years, an infographic: âThe Myth of Trans Regretsâ
I took a flyer and walked out, mulling over the idea that maybe I am, in fact, an actual cryptid.
