OPINION: Sam Trans Man on the internet

Phalloplasty surgery wasn’t lightly undertaken. This was the first and hopefully worst of three surgeries to get my working penis. A decision I neither undertook lightly, nor wanted to undertake at all for the most part. I mean – who would, right?

Being trans is a constant battle for me; since my mid-30s I’ve been fighting the urge to ‘change sex’. Of course, it all started long, long before that, in my earliest memories a missing penis was a constant reminder of the shame I felt about my body, betraying me the moment my genitals were revealed to me or anyone else. I managed to keep a lid on it for half a lifetime, but eventually gave up fighting about 10 years ago. Exhausted by my own shame, I came out. And now, well now, everything has changed.

For the past few months, even while I was planning a date and negotiating with the surgical team, and I was pretty certain I had to do this, I was still going round in circles asking myself the question, “Is this the right thing to do?” As a person with experience of gender dysphoria and the treatment thereof, I forged ahead, knowing from the previous steps I’d taken in transition that this too would catapult me into a better, more wholesome and functional life.

But as a clinician and a scientist, I have and do struggle with justification for these life-changing, expensive and sometimes dangerous treatments. Like most doctors, I’d rather not do anything to my body that isn’t essential for health and wellbeing. Despite my own first-hand experience of vast improvements in self-esteem, mental and emotional health, capacity to function and ability to concentrate on my family and career, still I hesitated to take this final step.

Some of my reluctance was related to my conservative Catholic upbringing and the deep-rooted beliefs I have had to grapple with these past 10 years. Further hesitancy stemmed from knowledge of the surgical risk, pain, failure of the graft, scarring and damage to my arm, which has become the donor site for my precious new penis. Still, more of my musings were about the morality of this kind of surgery and whether this would really make a difference to how I felt about myself – surely what was in my underpants wasn’t really going to change my life to any degree? No-one else knows or needs to know, right?

But I knew. I’m the one who felt like a fraud, masquerading as a man but not fully male. Who knew? This is a ridiculous way to think, I know. But I did think this and it crippled me. Now, after just the first operation, my shame has gone. The simple act of looking down at my genitals and seeing my penis, has healed this lifelong burden.

I’ve long been an admirer of Dr Michael Dillon, one of the earliest documented people to transition from female to male, also a physician, who pioneered genital surgery as a guinea pig in the 1950s. We’re still guinea pigs, with genital surgery for female-to-male people very much a poor cousin to male-to-female in terms of expertise and development, and difficulty of access. The techniques are crude and in need of further research and investment worldwide, although we are fortunate in this country to have a team of surgeons working in this field.

As a doctor, I know I have a more detailed and intimate understanding of what is involved than most, and I’m able to talk about the surgery I’m having in a dispassionate and medicalised way that facilitates the education of others and fosters a better understanding. I had flirted with the idea of speaking up in a public forum for a time, but right up until the morning of surgery, wasn’t sure I had the balls for it. Suddenly I was imbued with enough conviction to post on Facebook as I waited for, woke from, and wondered about the consequences of my decision. I would open myself up to the world in the interests of changing how people think. It was my time to step up.

Of course, this kind of vulnerability, the kind that the internet has afforded us, is risky. The worldwide web is a cruel place, we live in bubbles, it’s largely unpoliced, it’s easy to see it as more real than the ‘real’ world, and we can be badly hurt if we’re not prepared or emotionally robust enough to cope with the backlash when it comes.

Even if we are prepared, sometimes the price is just too high. I worry about all the trans people who are speaking up at the moment, in their homes, schools, towns, city halls, at regional and national government elections, in the media, in private and public sectors, in the NHS, the armed forces and in celebrity circles. I worry that a backlash is coming.

I worry that with the increased visibility we trans folk are enjoying, with the rising up of Trans Pride that corresponds with the loss of shame we feel as we step up to the plate, with the freedom that comes with being out, also comes the vitriol, the hatred, the discrimination, both overt and covert, the micro-aggressions, the unwarranted personal attacks and widespread vilification of whole communities of people just because they are ‘different’.

I worry that we haven’t even seen half of what is coming our way in this country. Dirt lifting to the surface. The political shift that we have seen these past 10 years is terrifying, and the internet is the place where the battle for what is right will happen.