What To Make of Me
Histories and Practices of Genital Reconstructive Surgeries
The technical practices and surgical strategies employed in the contemporary practice of genital sex reassignment surgeries (GSRS) vary considerably between practitioners. This research project uses textual and visual archives as well as ethnographic research and observation with surgeons in order to better understand the conditions of this variation. Thus far I have conducted ethnographic research—including interviews and OR observations—with surgeons in Argentina, Belgium, and the United States.
In the US, health insurance coverage for transgender-specific medical care has increased exponentially over the past five years. Medical institutions are working to respond to the rapidly growing patient demand precipitated by benefits expansion. Challenged by decades of inadequate medical training, geographically uneven distributions of expertise, and inconsistent state and federal policy, emerging transgender health centers are largely ad hominem artifacts of their local participants, not intentional products of best practice systems design. I am working with institutions across the US to understand current infrastructures--of education, insurance, bureaucracies of diagnosis--and their capacities. This knowledge will provide the necessary basis on which to influence policy and practice to the benefit of trans- surgical patients.
Surgical interventions have long been recognized as best practice treatments for those diagnosed as "transsexual", "gender dysphoric," or suffering from "gender identity disorder." The therapeutic rationale for these interventions is complex. Surgery is performed on the material body, but its palliative effect is in the mind/psyche. As such, clinical means for evaluating the effectiveness of this surgery have struggled not only to define desired outcomes, but how such outcomes can or should be measured. In this study, my research assistants and I have created a database of English-language outcomes studies and are analyzing their contents. The first article to come from this study will focus on the particular role that the category of "patient satisfaction" plays in authorizing procedures and verifying outcomes.
Research is underway that would transform the tissues removed during transgender people’s reconstructive genital surgeries from medical waste into valuable resources. My book project, What to Make of Me, investigates the conditions and interrogates the implications of the uses to which researchers hope these tissues might be put. In this emerging medical research, the historically marginalized trans body is resignified as a source of uniquely valuable material capable of consolidating another’s normative gender in ways that nothing else can. This dynamic reimagines the aims of transgender medicine, upends existing relations of organ transplant, and introduces new and incongruous forms of bodily value.
Facial feminization surgery (FFS) is a set of bone and soft tissue reconstructive procedures intended to feminize the faces of trans- women. I take the animating claim of FFS seriously—that it is through changing their faces that trans women can transform their sex—and contend with the conditions and implications of that claim. Foregrounding the voices of surgical experts and the patients who seek their services, the book argues that as ideas change about what sex is, so do interventions required to change it and the logics of medical practices intended to do so. Anchored to, and justified by, a recourse to the radical self-making of performative gendering, but still appealing to the confirmatory power of recognition, the movement of FFS from the margins of trans- medicine increasingly toward its center, provides a way to understand contemporary trans- medicine as operating on a fundamentally different understanding of bodies and selves that that by which "transsexualism" first emerged nearly 70 years ago. My book on this project, The Look of a Woman, was published by Duke University Press in 2017.
Eric Plemons, Ph.D.