Once upon a time, surgery was the sine qua non of transsexual discourse. Without surgery, a gender-variant person could be a cross-dresser, a butch, a fetishist, or a drag queen, but by definition that person was not a transsexual because they didn't cut their flesh. It's remarkable, in hindsight, to reflect on the peculiar power modern culture has granted to the surgical as a technique for the production of realness—that is, genital-altering transsexuals are considered (though not without contestation) to have really changed sex, while everyone else who strains against the naturalized pink/blue dichotomy is just dressing up and playing around. What is it about the surgical incision, and the removal or rearrangement of tissue, that historically has allowed it to confer a real change in social status?
In reading the early medical history of transsexuality, it's striking that sex change did not at first refer to the surgical transformation of genitalia in order for one typical genital morphology to come to resemble another. It referred specifically to reproductive capacity and function, and it was imagined in purely negative and subtractive terms. A person's “sex” was “changed” when they could no longer contribute to procreation: vasectomy and tubal ligation were sex changes just as much as penectomy, orchiectomy, oophorectomy, and hysterectomy, while vaginoplasty and phalloplasty (the surgical construction of vaginas and penises) were considered cosmetic plastic operations on par with getting a nose job (Stryker and Sullivan 2009).
This way of thinking about the relationship between surgery, sex, and social status is ancient—castration (orchiectomy) has been practiced for millennia on male human captives, slaves, and laborers as a way to move them closer to livestock in the hierarchies of life, and further from hereditary kingship—but totally in keeping with a modern biopolitical project that attends to the specific biological capacities of each and every body through techniques for managing and directing those capacities for state and statelike ends (Taylor 2002). Seen in the light of transsexual surgery's history, modern reproductive medicine appears as a vast biopolitical apparatus for sex-changing us all, by subjecting reproduction to control and modulation by what Paul Preciado has called the “pharmacopornographic regime,” of which surgery is just one historically significant element (2013). The condition of “operability,” as Lawrence Cohen suggests, can be considered the body's threshold to modernity (2005).
There's something almost magical about the formula of citizenship and gendered personhood that transsexuals historically have been asked to perform: proclaim your desire, submit to diagnostic authority, take this pill, cut here, sign there, and voilà: you are a person of a different sex. That formula has been changing rapidly over the past quarter century, and the status of surgery within the assemblage of transformative techniques has shifted accordingly within it, in ways that make reexamining the surgical a timely undertaking for transgender studies. As guest editors Eric Plemons and Chris Straayer point out in their own introduction to this special issue, the decentering of surgery and medicine as authorizing narratives for trans- identities was causally related to the articulation of a new “transgender” discourse in the early 1990s, in the wake of Sandy Stone's massively influential “posttranssexual manifesto” (2005). If surgery had defined the transsexual, what has its status been within the transgender?
Transnationally, there is a trend toward no longer requiring genital surgery to change legal sex, and in some contexts actually to forbid this requirement in order to comply with post–World War II antieugenics laws and provisions in international treaties that forbid nonconsensual sterilization (Transgender Europe 2017). Some trans people pursue nongenital surgeries, such as facial feminization, as a way of staking their identity claims, while some people who don't consider themselves trans pursue body modification practices once closely associated with being transsexual—as when people assigned female at birth who still identify as women desire a flat chest and have a mastectomy, or inject testosterone to bulk up better at the gym and cultivate a sexy “Lauren Bacallesque” vocal huskiness. And increasingly, “changing sex” is something many people now consider to be entirely nonsurgical: an ensemble of verbal, discursive, sartorial, social, and bureaucratic performances that lend support to a self-proclaimed gender identity that no longer seeks verification through recourse to the flesh. In a technocultural milieu awash with aesthetic surgeries of all sorts, increasingly invasive biomedical interventions into reproduction, and a plethora of emerging nonsurgical practices of gender transformation, it seems increasingly impossible to make a sharp, clean incision between what is trans and what is not, when it comes to the question of surgery and sex.
In our posttranssexual, transgender, biopolitical, pharmacopornographic global order, precisely what relationship now pertains between surgery, self, genitalia, appearance, reproduction, and citizenship? The answer to that question, of course, is that there is not a single answer to that question: to interrogate the surgical in relation to transness is to open up an entire field of inquiry into the technical manipulation of the biological within a regime of power/knowledge that implacably hierarchizes life. Mixed-media artist Juliana Curi, whose sutured plant leaves are featured on the cover of this issue, evokes precisely this sense of the surgical as a craftwork that stitches life together in new ways across the caesurae not just of sex but of species and kingdoms. In doing so, her art helps mark a very large space of investigation within which fall the narrower range of topics addressed by the contributors to TSQ's special issue on surgery. As Plemons and Straayer suggest, the work collected here offers a useful jumping-off point for that broader, deeper, and longer conversation, which we hope will continue taking place in the pages of this journal and elsewhere in the years ahead.
Susan Stryker is associate professor of gender and women's studies and director of the Institute for LGBT Studies at the University of Arizona and general coeditor of TSQ: Transgender Studies Quarterly.
Paisley Currah is professor of political science and women's and gender studies at Brooklyn College and the Graduate Center of the City University of New York and general coeditor of TSQ: Transgender Studies Quarterly.