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Post-Op+ 5

  By By Anne Vitale Ph.D. -- Mar 20, 2022

Notes on Gender Role Transition

T NOTE #16
Post-Op + 5

By Anne Vitale Ph.D.

April 3, 2012
Peer Reviewed

Actually the title should read "Post-Op + 5 and Counting". Over the almost 30 years of following the post-op lives of my male-to-female clients, I have noticed a pattern. It goes something like this. Somewhere about the fifth year after genital reassignment surgery, I get a call or an email message asking for a "check in appointment." I am usually assured --even before I get off the phone -- that they are still happy with having transitioned but there is something happening to them, gender wise, that they can't quite understand and would like to talk to me about it.

Although I am generalizing somewhat here, this is what comes up most often: "After all this time everyone treats me as a woman, and I really appreciate that, but quite frankly, I have come to realize that even after all this time post-op I am still not at all sure I know what a real woman is. Did I screw up somewhere in my transition? I did all the prescribed steps and did them in the right order, why do I find myself perplexed about who or what I have become? I have had several sexual partners, both men and women, since my surgery. I used to consider myself a heterosexual male, but now I don't know what my sexuality is. That has all become a blur."
As life settles into a level of everydayness, new questions as to what really happened to them over the course of their transition and the sequelae, come to the fore. These folks come in fully accepting of the fact that they now have a vagina that works, breast and a curvy female looking body that looks good in a dress and a mind finally free of artificially imposed male expression limitations, yet somehow, feel that they have not fully acquired a level of femaleness that their cisgendered sisters around them appear to express naturally. Deeper philosophical questions arise such as : "What more do I need to do to get there? Will I ever get there? I'm afraid that if the answer to that last question is, no, what does that make me?" This, of course, is the existential question all post-op transwomen face sooner or later. For some the sense of having gone from not really belonging in the world at large as a male to not authentically belonging to the world of women can create disappointment--making for an uncertain future. For others it is a chance to make the final adjustment to a life that continues to be unforgiving. Neither male nor female, all transpersons live in a world of their own. It is an uneasy alliance with society and for some, their own psyche.
Being a transsexual is an everyday experience. Only the tenor of the situation changes upon transition, not the fact that it all had to happen in the first place. Many can set aside their awareness of the divide between themselves and the norm for extended periods but I have yet to hear a post-op claim to have been, in their mind, fully assimilated into the world of the cisgendered….even after decades of post-op life.
Although there are some very "out" transsexuals, (models, athletes, children of celebrities) by and large most trans folk, no matter what direction they have gone, learn early on that the safest and most successful way to navigate a post-op life is to live hidden in plain sight. There is an inherent difference in how people treat a person once they are known to be trans. It may not be especially negative but it is different. The difference can range from a subtle, you-aren’t-fooling-me, I-know-you- are-not-real, kind of way to out-right hatred for breaking some perceived, unwritten gender binary law.
To be treated authentically as one presents is the holy grail of transsexualism. Alas... it can only be experienced when the transperson stays in the hiding-in-plainsight mode or what some transfolk refer to as the "stealth mode". The kicker here is that as satisfying as being treated "authentically" is, it is diminished to some degree by the fact that the transperson is never free from knowing that he or she is purposely being complicit in a sophisticated, lie-by-omission deception. A negative feedback loop is created where the very essence of what being treated authentically is, is qualitatively degraded.
Sexuality issue looms large in many post-op transwomen's lives. This is an especially thorny issue for transwomen hoping or believing that they are expected to find a male companion (as opposed to finding a female partner). Complications for some post-op folk include: "Why am I not automatically sexually turned on by men? Again, did I fail some how in my transition? On the other hand, men have a way of making me feel very feminine--a feeling I love very much--but is that the same thing as being sexually turned on?"
And then there is this: "How stealth should I be? I'll have to reveal my male past sooner or later, so when is a good time to disclose? If I tell him too soon it may chase him away, wait too long and he might think I have been untrusting of his affections". And then there is this: "If he stays after knowing my background, will he ever think of me again as a real woman" Or worse yet, does that make him a tranny chaser? ... Oh God, now I am getting paranoid. "
There is yet another group of transwomen who have a post-op + 5 experience. I am speaking here of the those who were married to cisgendered women at the time of their transition and found a way to stay in the marriage. Although I hear from some of them from time to time wishing me a happy birthday or some other holiday greeting, I don't get the same sort of questioning calls; leading me to believe they make a better adjustment to their new lives.(1) In off-hand conversations with these transwomen, they usually say that by and large their lives have not changed much. The big difference is that they are no longer leading a secret life of crossdressing with all the concomitant anxieties related to the eventuality of facing up to the reality their gender dysphoria would have on their families. The tenor is that even though they are no longer men as other husbands and fathers are, they still serve the same function and play the same role in the family as they did before ... and all things considered, that is OK.
Although it is not generally reported in the literature, some long term (25-30 years) post-op individuals-- no matter what direction they transitioned-- are speaking more and more to each other about how the experience has displaced them from much of what cisgendered folks take for granted...an innate sense of belonging to one pole or the other of the gender binary. Yes, there are some non-transsexual individuals who claim to be gender neutral or otherwise gender non-conforming who find no discomfort in this area of their being but most transsexuals I know are very binary in their thinking and have gone to great lengths to make a hard attachment to the gender opposite to that which they were assigned at birth.
Full gender role transition is a bitter sweet accomplishment. Bitter in that post-op transfolk-- despite moving ever closer over the years toward their intended goal-- come to eventually realize, that in the end, they will still be left an important iota short of ever being totally of one sex or the other. Apparently that is a distance too far for reality to transverse. On the other hand, it is sweet in that the dread of experiencing an unlived life being gender dysphoric no longer burdens them. Fortunately the sweet relief of being free of gender dysphoria and the chance to live a life that is far more comfortable--if not exactly what they expected-- leads a large majority of long term transitioner to say that transition saved their lives…. And, very importantly, would do it all over again despite the hardships many experienced and in some cases continue to endure. In some respect we can say that the long term effects of gender role transition amounts to a net positive but a subtle reversal of misfortune.
(1.) Curiously enough, I did get a call asking for an appointment from a happily married post-op client, who had transitioned in her mid 50s, confessing to me that she had been unfaithful to her wife of 30 years and was not sure how to deal with it. It seems that while her wife was out of town visiting relatives, my client decided to stop in a bar/restaurant for diner on her way home from work. While there she was hit upon by a man who she ended up taking home with her that evening. It was her first time having male/female sex with a man and says that she did it only out of curiosity. I received a Christmas Card showing one big happy family photo this past Christmas so I assume it all worked out in the end. Something tells me that this sort of thing happens far more often than I get to hear about.

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