introduction
In weighing the indication for the [genital sex reassignment] operation,
another factor should be considered, namely the physical and especially facial
characteristics of the patient. A feminine habitus, as it existed for instance
in Christine Jorgensen, increases the chances of a successful outcome. A masculine
appearance mitigates against it. Such patient may meet with serious
difficulties later on when he expects to be accepted by society as a
female and lead the life of a woman. harry benjamin, “Transsexualism
and Transvestism as Psycho- Somatic and Somato-Psychic Syndromes,” 1954
The argument of this book is a simple one: as ideas shift about the kind of
thing that sex is, so do the interventions required to change it and the logic
of medical practices intended to do so.
Early surgical procedures that aimed to change a person’s sex focused on
the genitals as the site of a body’s maleness or femaleness and took the re-
construction of those organs as the means by which “sex” could be changed,
that change always from one binarily conceived sex category to the other.
Prospective patients’ declared need for genital reconstructive surgery and
clinicians’ defense of its therapeutic legitimacy anchored the 1950s for-
mulation of transsexualism as a psychological condition best treated with
physical interventions. While genital surgery remains important to many
trans- people, over the past several decades it has been demoted from con-
stituting “sex reassignment surgery” to but one of its possible iterations.1 No
longer exclusively defined by genital form, as treatments for transsexualism
once conceived it, now sex is both spread across the entire body with
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