Spanish doctors have found a succulent market niche. Camilo Erasso/Long Visual Press/Universal Images Group/Getty Images

June 1, 2022   5 mins

I have the strangest feeling that my body has been stolen from me. When I started my transition, I was not aware of any options besides medical treatment to modify my body. Years later, I still ask myself why no one told me that I could have left my body the way it was; why no one ever explained that sexuality in that body was possible. There was no violence involved, no threats were made.

But I feel that I was robbed of the possibility to experience my body any other way. I don’t believe this is a universal truth for all trans people. It’s simply something that I feel, something that pains me.

I am not oblivious to what many of you must be thinking: how could it be a robbery when trans people themselves choose to undergo operations? To compare the medical treatment of transgenderism to theft is certainly risky because it makes it seem as if trans people have been forced to accept these treatments when in reality we see the exact opposite: people fighting for the right to receive hormones and have surgery. It certainly doesn’t appear like anyone is forcing us to do anything.

This is true, but from my point of view it is also true that the conditions under which we make these decisions have been and continue to be very complex. Without refuting trans people’s agency and autonomy, I think it’s worth mentioning the role these medical professionals have played in this story. Starting in the late Eighties, the health professionals who worked with trans people touted the famous threefold treatment method (psychological or psychiatric evaluation, hormonal treatment, and surgery). They doled out diagnoses explaining to people that they had “an incurable illness, with chronic treatment options”, which consisted of hormonal therapy and surgery. And these treatments were not publicly funded until almost 25 years later. The results: trans people became a succulent market niche. (They tell us that we have the wrong body and then we pay them: it has to be admitted that this is a brilliant business model.)

Among the surgeons in Spain leading the field in so-called “gender reassignment surgery”, a few figures stand out in terms of how they’ve built their practice on the myth of the wrong body. These are professionals with dubious reputations: surgeons who have been working for decades and have treated thousands of trans people, and whose businesses are booming, despite their appalling reputations among the trans community. In my experience as an activist, I’ve heard terrible stories of extremely questionable results sold as infallible cures, claims from patients who wanted to report malpractice but had signed multiple documents that impeded them from later filing complaints, and tales of trans people being called by their original gender pronouns on the operating table.

And, as the icing on the cake, some of these doctors have become the public face of trans advocacy: there’s not a panel discussion, debate, TV news report, or documentary on being transgender that they’re not a part of. There they are in their offices, sitting in front of their computers with screensavers showing pictures of our bodies before and after we lie down on their table, saying that the problem with people who have gender identity disorder is that they were born in the wrong body.

How did these professionals manage to become such “experts”? Well, in some cases they formed part of the medical teams of Gender Identity Units — consultation teams which tell people that in order to be cured they have to have an operation but, unfortunately, the treatment wouldn’t be covered by the public health system. And then they tell them that there’s a place they might be able to go.

Guess which place? To these surgeons’ private clinics: they refer patients to themselves. And that’s how it went for many years.

Some of these medical professionals have taken other, even more slippery paths. They’ve learned how to monetise trans people’s need for sexual reassignment, mainly women, by creating an extensive catalogue of bodily modifications that go far beyond what could be considered any form of treatment.

To prove this, a colleague of mine went to one of these clinics explaining that she was a trans woman who wanted to have a vaginoplasty. She walked out with a €70,000 estimate for the procedure, after the doctor had added on multiple retouches for “feminisation” of her face and body. If you want to be a woman you will need a pinch of this, a splash of that, and a large dollop of that over there. It is easy to become trapped by the myth of the wrong body because it doesn’t specify when treatment will end. The reality is that treatment never ends: neither trans people nor anyone else can ever have a perfectly male or perfectly female body because that body does not exist.

The websites for these clinics show that the catalogue of treatments for trans women is significantly more extensive than for trans men. Does this have anything to do with the fact that we live in a sexist society that is constantly imposing impossible demands on women’s bodies? Of course. In this sense trans women are a much more interesting business prospect than cis women (women who are not trans) because to the former we’ve said that corporal modification is the chronic treatment for our incurable illness and to the latter we’ve said they are frivolous.

It is truly shocking that I was taught to hate some parts of my body while there are people who literally make a living from that hate, who get rich modifying our bodies and bathing in an aura of progressivism. And although, of course, there are some well-meaning professionals, the end result is the same.

This notion that trans people’s disconnect with their bodies is created by social pressures is a very unpopular argument within the trans community. In my opinion, trans people born on a desert island wouldn’t be trans: our gender expression would not be associated with any fixed gender identity and less still to a concrete social corporality. If we’d been born on desert islands we’d never dream of operating on ourselves.

Right now, it often seems that the end goal of trans movements in some parts of the world is the right to access hormonal treatments and surgical interventions in order to alter our bodies. But holding the right to bodily modification as the only solution to our suffering is problematic. Of course, trans people can, should, and must have this right, but centring all trans political aims on it distracts from a question which, from my point of view, is more relevant: what actually causes the suffering that trans people feel and how can that be addressed?

Our bodies are fine — the problem is how certain parts of us are interpreted in our society, the meanings and connotations assigned to them. And due to this, unfortunately, many people might feel the need to alter themselves.

It’s like we’re being assaulted by all these ideas and yet we exonerate the thieves, shouting: “No one has stolen my body, I abandoned it of my own free will because it was never mine!” But yes, it was yours. It was and is the only body you have.

Extracted from The Myth of the Wrong Body by Miquel Missé, published by Polity.

Miquel Missé is a Barcelona-born trans man and activist. He is the author of The Myth of the Wrong Body published by Polity.