Peter Hyndal wrote an article on trans health care for the October-November 2008 edition of the AIDS Action Council's Newsletter.

Original article is available here.

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A Trans Perspective on Taking Control

10 years ago I ‘took control’ when I decided to ‘transition’; to stop identifying as female and to live my life as a man.

At that time, I was consumed by the completely empowering nature of the decision that I was finally making about my own life and about who I was in the world. But the most personally empowering decision I have ever made in my life also signalled the start of the most disempowering relationship I have ever had - I was completely unaware of how much ‘dependence’ I would have on the medical profession, and just how disempowering this relationship was going to be.

In order to be perceived by others as a man, I required a certain level of medical intervention – specifically I needed an ongoing script for testosterone to affect physical changes (such as male hair pattern and voice deepening) and I also wanted my breasts removed (double mastectomy).

It took 18 months of multiple consultations with GP’s, psychiatrists, surgeons and endocrinologists where I would pay lots of money to tell them what it was that they wanted to hear me say before I finally got ‘permission’ to undergo the procedures that were necessary for me to maintain an acceptable quality of life.

I had always been clear that undergoing these medical procedures signalled the end of my transition from a medical perspective…but the medical profession had other ideas. I felt continually pressured from that point to have a hysterectomy. I resented the degree of pressure that was being put on me to do this when there was no evidence of any need for the procedure. On more than one occasion I have been given ‘information’ that is completely medically inaccurate, in an attempt to ‘scare’ me into agreeing to the procedure. I have also been ‘advised’ that “now your chest’s done you need to have a hysterectomy…” and “you should have a hysterectomy so that you never have to have a pap smear again…” and “if you have it ripped out, then you can’t get cancer in it…”.

So here was a medical profession with an ethical responsibility to treat my symptoms and to cause me no harm, that was obsessed with trying to pressure me to consent to surgery that I did not want, that would resolve no existing health issue, and that would provide me with no health benefit. I remain confused about why these people who had been working so hard to PREVENT me from having the chest surgery which I really wanted, were now suddenly trying to force me to have more surgery which I did not want to have.

Although I consider myself to have undergone “sex reassignment surgery”, and although I pass consistently in all aspects of my life as unquestionably male, in order to be legally recognised as male in the ACT I need to undergo “surgical alteration of reproductive organs”. In practical terms for transmen, “surgical alteration” means “surgical destruction”. For transmen (unlike transwomen) the reproductive organs are internal – their removal does not aid in any way the ability of the person to pass, or the degree to which they will be accepted by society as male. Their removal serves no socially measurable aid to transition whatsoever.

I start from the premise that the right to consent freely to medical procedures is one of the fundamental rights that all people hold. It is a right that is intrinsic to our own bodies and in our society a right that is correctly demarcated as “personal” rather than “political”. It is not reasonable that trans people have to choose EITHER to be legally recognised in our chosen gender OR to retain autonomy and control over what medical procedures are performed upon us.
I do not understand how our government believes that it is equipped to legislate on what medical procedures should be undertaken by a particular group of people. Nor do I understand how ANY medical practitioner could ethically participate in performing a sterilisation procedure on someone for the sole reason that they want to obtain legal rights that non-trans people take for granted. Try substituting any other group of people (people of a particular race, religion etc) and see how it sounds - this situation would simply not be tolerated in any civilised society in relation to any other group of people. My respect and trust in the medical profession has been completely eroded, by their collusion in supporting this ethically unjustifiable legal position.
I choose not to have a hysterectomy not because I might ever use my uterus, but because as a matter of principle I refuse to have a government insist that I undergo a completely medically unnecessary surgical procedure to sterilise myself simply in order to obtain a legal right that I am perfectly entitled to receive, regardless.
I choose not to have a hysterectomy because, for the second time in my life, I am empowering myself and taking control – this time over the role that I allow the medical profession to play in my life and the way in which I allow them to play it.