Is Transgender Surgery Empowering?

I ’m not in the business of telling editors what they should or should not publish. Nevertheless, for those seeking to normalize transgenderism, the recent New York magazine cover story “My Penis, Myself” — about the author’s completed female-to-male transgender surgery — was a curious choice.

The story, a first-person account by Gabriel Mac, recounts in gory detail the process of undergoing masculinizing surgery, after the author perceived the choice to be “penis or death.” It ought to be noted that this is not the first piece of this kind that Mac has penned. In 2011, when Mac was presenting as a woman and going by Mac McClelland, she wrote an article for the online magazine Good about partaking in a staged violent rape that supposedly cured her of post-traumatic stress disorder.

The surgical construction of a penis, known as phalloplasty, involves grafting the forearm or thigh for skin, fat, nerves, and veins, then wrapping this tissue around a plastic tube which is surgically attached to the groin. It is a grueling surgery; much can go wrong (and often does).

Typically, the more unpleasant aspects of transition are euphemized or overlooked by transgender activists. Commendably, however, the New York story lays bare the reality. Mac writes:

“The whole process is constant body horror,” Berrian [a nurse] said at one point — after he’d told me that the penis-tip discoloration I was worried about might just be sloughing tissue that’s dying off, which is also fine. And this was a recovery with no complications that required surgery. The overall proportion of phalloplasties that need surgical revision, while lower for some surgeons (including mine), is about one in two. The highest number of corrective follow-up surgeries needed by anyone I know personally is 12.

But while the facts of the story suggest one conclusion — i.e., this is not an advisable treatment for gender dysphoria — the author repeatedly boasts of its empowering capabilities. Indeed, the overarching narrative is that the new penis is salvation, a deliverance from torment, a redemption that’s worthwhile no matter the cost (even death).

As gripping as such testimony often is, the objective evidence tells a different story. One of the few long-term follow-up studies looking at transgender surgery was done in 2011 by the Karolinska Institute in Sweden, in which researchers examined outcomes for over 300 patients over 30 years and found that both mental-health problems and suicidality increased around ten years after surgery. Other researchers and psychiatrists have cited an additional concern — that life outcomes for the transgendered are not proven to improve post-surgery. Why, then, inflict damage on healthy body parts when it’s not even clear that doing so confers any psychological benefit?

The answer is ideology. In the final paragraph, having complained of systemic transphobia and the dangers of internalizing it, Mac concludes that “there isn’t anything . . . wrong with me.” If so, why did Mac undergo surgery in the first place? Surely you don’t want to cut off healthy body parts unless there is something wrong. Mac acknowledges this conflict in the piece:

I could not have gotten my boobs cut off fast enough, and I spent weeks before my 2019 hysterectomy up late in bed, hot and sleepless, fantasizing about the moment the medical-waste-disposal team at UC San Francisco would batch-incinerate my uterus, which swirled with dysphoria like nausea from the depths of my soul. But just as you might feel an automatic no if a doctor offered to cut one of your healthy arms off for you, when I thought about cauterizing, excising, and sewing closed my vagina, my whole body cringed: wrong.

Elsewhere, Mac speaks of nurturing her neo-phallus by singing it lullabies and “watching over it, as if it were a troubled newborn.” By the end, you don’t get the impression of an empowered transgender person but of someone who has lost touch with reality.

Of course, no one doubts the sincerity of those who dislike their bodies so much that they want doctors to permanently damage them. What is in serious doubt is whether this kind of severe transition does anything at all to address deep-rooted mental-health problems.