This article examines the various possibilities for making an analogy or disanalogy between cosmetic and trans surgeries, focusing on the suggestion that trans surgeries are medically necessary while cosmetic surgeries are not—a position that has a great deal of rhetorical force. The authors argue that this disanalogy both fails to understand the complexity of the justifications used by recipients of these diverse surgeries and should be seen as symptomatic of various attempts in medical practice to impose particular understandings of suffering, gender identity, and gender politics on trans patients. The appeal to the intense and intrinsic suffering of the trans patient because they cannot become the normatively gendered person they always believed themselves to be, the authors argue, elides the diversity of trans experience as well as coerces trans patients into a politics of ressentiment.

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