Frankenstein’s Monster and the Things We Don’t Know

I don’t know a trans guy who wants bottom surgery. I don’t know a trans guy who knows what it entails. I know eight trans guys who did a brief Google image search before clearing their history and slamming their laptop shut. I know seven if you don’t count me. 

It was easy in Maryland because there were so few of us. It was me and Oliver and Xan and Jude and Sebastian and everyone else followed me online. It was easy because Baltimore, like it or not, is small. So small, in fact, that I could feel important. Seen. When I held signs in front of the state capitol, everyone fit comfortably in the courtyard. Everyone was familiar. It was nice. 

Baltimore is a place as much as it’s a synonym for closeness. Baltimore an excursion, a brevity. I loved Baltimore like it was a shitty Mayberry. The appeal is the deciduous forestry and my intimate relations with every queer person in the state. It takes two hours to drive straight through Maryland and I could rattle off every county until it bored you. A love affair. Everywhere else was a drowning—in space and in population; it was a way to disappear. 

I left the East Coast at sixteen. Chicago is a city like Baltimore is a city, except it’s big. It’s an ocean. I promised, like everyone does, to nurture and cling to my hometown friends, but I didn’t. Who can from such distances and while so young? I showed up to the first day of my new school breathing shallow breaths and alone. The hallways were lined with exposed brick. You could hear the L train during English. To exempt myself from the loneliness of it, I forced newfound best-friendship onto Valentine (not Valentine then) during our sophomore lunch period. I’m not exactly sure how it happened. One day I was lonely and then one day I wasn’t. All good things go this way.

It’s been four years since then and I still live here. And no matter how much time I’ve had to grow my roots, my circle is limited. I have excuses of course: it’s a pandemic, and I’m choosy—but it’s not supposed to be like this. Being trans is a team sport. It’s foosball. It’s doubles. It’s ultimate frisbee. 

I think we’re scared of it. Surgery. I don’t know what we think. I find myself in the habit of referencing us as a conglomerate. I forget we’re not all sewn together with the same everything. I think it feels safe and warm and cozy to think of us all that way. Maybe it’s a disservice. Maybe I should care to care about that sort of thing. We’re scared of it because it’s terrifying. We are scared of becoming Frankenstein’s monster. 

When I first started having sex with my cishet girlfriend (pre-top), I always made a point to take her hands away from my chest, her fingers twitching like rabbits as I grabbed them, displacing. It was her limp wrist in my hand, the falter, the consoling smile. It was so heavy—the quiet. It was all so counterintuitive.

I feared she was secretly repulsed by it, me, her precious previous notions of flat or slightly sculpted pectorals made amiss by my small, but no doubt soft, body. I was all tender all over. Rounded edges. She’d never laid next to someone like me, in a bed like this, so close. 

She told me somewhat recently, a year and a half later, that she didn’t understand why I never told her. That is, why she couldn’t touch me there. She said she had read so much about trans people before we even kissed with tongue, so much about dysphoria and unearthing it—accidentally, innocently—that she listened, stayed far away when I displaced her hands and didn’t bring them back until I forced them there. She wanted to be gentle with me, like a snow globe, like a foreign object. I told her I was afraid I sickened her.

Why? She asked. Why would you even think that?

My top surgery anniversary is on Saint Patrick’s Day. I was considering taking my chest out on a nice romantic date, but we had other plans. Guinness, you know. I hardly remember what I looked like before, but I made sure to take pictures and don’t mind looking at them. And now that we’re talking about it, I was so scared that day. The surgery. Not one steady breath the whole morning. I should have taken the Klonopin my mom offered, begged me to take, really. I swear to God I have never felt so young or so scared in my whole life. I was scared up until two weeks later, and dizzy even longer. You walk away from surgery knowing two things: that you’re changed and something else. I know my chest is flat and that I am averse to anesthesia. 

Frankenstein is the doctor. The monster is nameless. 

Most folks get the double incision: two gargantuan-seeming slices made under the pectorals, then of course the (for all intents and purposes) vacuuming of the tissue, and sewing the whole thing back up with a bow. This is the classic, historical choice. The scars are jarring, but I hear we’re trying to progress past physical judgment as a community. 

If you were favored by fate—blessed with small tits—you get to go for the periareolar. There they take off your whole nipple, shape it up right there on the table, and (for all intents and purposes) vacuum most of the tissue up through the hole left behind. There’s selective lipo near the shoulder side of the breasts, but that’s not half as bad. They staple you up after the procedure is done like a proper stack of papers. 

Now, if you’re god’s favorite, you get keyhole. The percent of folks even eligible is so low it’s basically written off as a pipe dream. You have to not need the surgery to get the surgery, if you follow. They cut a crescent moon out of your nipple and take out what little tissue your lucky ass was left with. Voilà. These things are all relatively understood. 

The doctor is referenced as “The Modern Prometheus,” too. What does that metaphor say of me? My father, a Greek, and therefore a self-identified expert on the Pantheon, told me there were two ways to view Prometheus—nice or stupid. You choose, he said. Wisely, agapi mou.

Dad was Greek in the traditional sense. Big and mustachioed, longshoreman. He would have me sit next to him in the Orthodox Church once, maybe twice a year if he could swing it. The long-bearded man in the tall hat would raise his voice almost to the point of shouting, certainly to aggression, and the canters would sing out. It was so loud and the vibrato was so defined I saw the air wobble. As they called, I would lip-sync the chanting response of the congregation. It is complicated to lip-sync words you do not know. A language you do not speak. 

I wanted to be Greek so badly, Greek like my father was, all macho Mediterranean, but I didn’t feel anything familiar in the church. The ceiling was too high. Everyone wore black—and Versace—like mourners; granted, wealthy ones. (I was never mourning, not yet, not until I wore his college basketball jersey and felt small, dainty, unlike him in all the ways that mattered.)

He sensed this so he taught me mythology. And then I felt Greek. 

Oh! Everyone gets top! That’s not the problem. It makes sense! There’s tissue here we don’t want; take it out. Cause/effect. Easily compartmentalized. Easily understood. I bet doctors feel the same way, honestly. The nipple stuff is where it gets, you know, surgically tricky—I can’t feel my girlfriend’s tongue anymore, but it’s a small price to pay. I mean, come on. 

But things aren’t so easy in the inverse. How does I want a dick translate to the brain? More complicated infographics. Bigger price to pay.

My top surgery had complications. Well, I complicated it. An accidental Tylenol overdose post-surgery landed me back in the hospital. I laughed while being pushed through long, stark hospital hallways on the stretcher, my eyes half-closed to the fluorescents. 

About the surgery: I wasn’t afraid of anything but the pain. And all its implications.

Valentine came out as trans last summer, about four years after I knew. Proving me right, as I mentioned. I still can see him, sitting there skinny and beautiful on a stool in our lunchroom. I remember how his hands moved. How he moved to and away from me, through space. The way he held his body. The way his shoulders slumped. His haircut. I remember how it felt to be there with him. How it felt to walk up the stairs next to each other. The comfortable discomfort he exuded. But that’s all I can reference. I just knew. 

He did it on my birthday, coming out, and it was the best gift. There was a sort of irony in it too: his newly dyed blond hair and refurbished femininity. It would have been a shock to anyone but me. It was, I’m told. He spent the summer of ’21 doing the same general trans-tivities that I did the summer of ’16, and I relived them beside him. 

Valentine is almost too easy to love. He cut his hair and then picked his name, in the opposite order I did, and continues to challenge the anti-establishment establishment that is the trans community with his fluidity and presentational androgyny. We found ourselves in the other birthday present he gave me, a hammock, on a humid and buggy summer evening. 

I had been reading Detransition, Baby, the Torrey Peters book, and spent most of the warmer months in a haze of queer theoretical quandary. I was taken by it, of course, the first trans-experience fiction to hit the bestseller’s list, though I couldn’t relate to almost any of it. Peters mainly confronts the trans-femme experience, save a few sentences, but its unabridged detailing of gender dysphoria and said dysphoria’s traditional valiant heroes (gender-affirming surgeries) spurred my own reanalysis on the body, my body. More specifically what I wanted from it—want from it. 

I keep asking myself where gender lives. Searching everywhere. There was a poorly received tweet recently that got some traction, something like, sex is what’s between our legs, gender is what’s between our ears. It was trying to be kind—though, I found it dismissive and oversimplified, which is maybe a critique of the form. Even still, it spurred a rather brilliant self-questioning: Where does my gender live? Well, I’m still researching. Honestly, I’m not even sure it’s in my body. It’s not in my head; that I’m sure of. It’s too logical of a place, too many thoughts, too clouded, too stupid. Heart seems too cheesy. Soul? I’m inclined to believe those don’t have a gender at all. Can’t be between my legs or then I’m in trouble. I’m running out of options. 

Where is it? And if I can’t find it, how do I know it at all? I can’t find an answer except for I just do. Which is an answer like because, which is a non-answer. A greater mystery. 

“What even is bottom surgery, like I don’t understand.” Val had asked me, not three inches away from my face, as per hammock. As much as I like to play mentor, I didn’t have his answers, not at that moment. And I told him so. 

For Valentine, I’d do anything. I’ve pretended to know more than I do for the last two years on his behalf. Authority is easy but I am boyish despite it. I am boyish and he knows this because I call him when I cry and he is boyish too because he calls me from fitting rooms and libraries. 

Despite myself, I wanted to give him a solid answer, or at least a definitive idea. I wanted to give him peace and comfort and an option that felt safe and comprehensive and normal. I wanted to tell him, Hey, don’t listen to the discourse about surgery. It’s fine. They’re exaggerating. It’s not that bad. It works. But I didn’t know any of those things. We were both in the dark. 

The Johns Hopkins website lists three different options for phalloplasty, but it is by no means the full extensive. Even with just the couple that Hopkins offers, it’s hard to keep track. The surgeries themselves don’t lend well to easy explanation, or quick guides. For doctors and civilians alike, it’s a hard one to break down, or even untangle.

What you’re doing essentially, as a surgeon, is making a penis out of thin air, hooking it onto a body, and then leaving it to said body to make it work. It sounds mythical, and ill-fated, but it’s a genuine undertaking. And because of its continual practice, I’m assuming it’s not quite rare. 

The first option Hopkins lists is the RFFF (Radial Forearm Free Flap), where they take the skin of your forearm to about your wrist and sculpt it (for all intents and purposes) into a penis. The other two, ALT (anterolateral thigh flap) and MLD (musculocutaneous latissimus dorsi flap) follow the same process, but the skin is taken from the thigh and back respectively. 

This is only the first stage, though. The once unfeasible complexity of top surgery seems like med-school-level child’s play in comparison. Around six months after the initial stage comes part two, a multi-step production. It’s pretty “choose-your-own-adventure,” earnestly customizable, but the standard is this: urethral lengthening, scrotum creation, and vagina removal. In this stage, most everything is optional. Though it’s odd to me to think of it like that, especially urethral lengthening. The entire process feels almost unimaginable without it; to go through all that trouble and not be able to piss out of your brand-spanky-new penis seems such a shame to me. But it is understandable; most of the complications that come out of bottom surgery stem from this phase. They’re not necessarily severe, but they’re complications all the same. It’s important to know, though, that the lengthening is first-come, first-served, and not an easy thing to change your mind and reschedule for a couple years down the line. If you get it, you kinda have to get it now.

The process doesn’t even end there. A year from the lengthening and aesthetic detailing comes the most important part, depending on who you ask—erectile prosthetic and testicular implants. Which actually aren’t trans-exclusive. 

Again, it feels cruel to wait a year for a ballsack and a hard-on, but who’s to say. The entire process takes over a year and a half and it doesn’t guarantee sensation. The urethral lengthening threatens the body with fistulas and diverticula and other ways of saying “shitshow” or “bloody piss” or both.

The entire FAQ page is harrowing. 

“That’s terrifying. That’s all a fucking nightmare.” Valentine had said, and I couldn’t do much but agree. Through the bleakness of our research, I was feeling once more vindicated in my genderqueer elitism, escaping the binary’s folds by effectively not squandering for a penis by any means necessary. I forgot about the entire endeavor for four months. 

I won’t reject the notion of a holier-than-thou mentality underlying me. To want to surpass my own body, my own desire, to win the trophy of Purest Most Genuine Queerness. (Funny thing to win, assuming how many other trophies you have to lose to gain it.) There is something to be said for the pursuit of the revolutionary, and as much as we parade our labelless community, we are, in fact, drowning in them. We police each other as much as anyone else does, and with a kind of viciousness that fear gives you. So, I’m grasping at straws here. I’m a good competitor. If I can’t win outside, I’ll win inside. The elitism stuck and it’s helping no one.

I keep thinking about Prometheus and his fire. The rest of that story. Fire being stolen way way back and then gifted and then used to keep warm. To keep us alive. To gather around. When the first rough draft of us found it and how it became the centerpiece of human life. The reason we’re still kicking around. How impossible and unsustainable our species would be without it. Then I think of now, today, of forest fires, of burning buildings, of smoke, of destruction, of chaos. I think of how terrified I am of touching the stove. The heat. The pain. And so I think of the difference between these points, fire’s bastardization. I think of what happened in the meanwhile. I think of intention. I think back to the circle, the hearth. I think of humanity.

Then I think of the poor monster. I think of the Doctor picking out the most beautiful pieces he could find to create his creation. The tenderness it must have taken to hand-select each piece. The human inclination toward care. I think of the monster. 

I’ve always found female-to-male (FTM) bottom surgery interesting because I, and the greater part of the community, know nothing about it, and yet have unanimously decided not to touch it with a thirty-nine-and-a-half foot pole. It is the infamous creature of the deep, the blob, the rare uncelebrated cryptid in our midst. To be sure, newly post-op pictures aren’t easy on the eyes, and the original mental image of a penis—perhaps shown the light of day too soon—becomes an immovable forever association, regardless of its long-term legitimacy. Its long-term legitimacy is not one the viewer (or beholder, for that matter) is yet to understand. 

It’s certainly not one I claim to.

Zeus punished Prometheus because he gave what did not belong to him. Who gave me to the Earth? Who punishes God?

I’m confused with myself. I had never even approached bottom surgery as an option due to a presumed dismissive distaste for it, and its results. I was, and am, afraid of a lack of sensation during sex, of a disenchantment with my body even more severe than ever, and the permanence of really anything. 

I’ve read a hundred articles (articles is an unfair usage—diary entries? blogs?) of success stories. People are happy with what they have received from ol’ John of Hopkins, from others—doctors, plastic surgeons. “I’ve spent the weekend being [redacted] and [redacted] by my boyfriend just enjoying all the sensation and my overall body,” one Reddit user notes. I find myself distinctively yearnful in this moment. In fact, in the moments since I’ve begun reading, I’ve only grown more so. Knowledge fuels want, it seems.

And do I? Want? I’m not sure how to answer you. I’m not sure how to answer myself, who is the one true inquisitor. I’m afraid to be Frankenstein’s monster. Is this transphobia? It took me three years to make peace with the fact that I wanted top surgery. It took me another to heal from it. What do these years mean to me? What is time but something that leaves, and quickly? 

I am scared of the deep chiseled scars gouged into the sides of the phallic muscled creations. They are frightening to behold in the first days, weeks even, months maybe, after operation. The pictures look monstrous and I am aware of my cruelty and generalization. But I am grieving. I am grieving a fantastical world I want to exist in where Spock or Mary Poppins can zoop! a penis onto my body in full actualization. I am grieving the years I spent without one, the years I am spending. What is chilling, really, down to the core, is the fact I didn’t even know to want one. That I just did, so deep, under all of it. That I may not be as modern-queer as I thought. That maybe, after all this time, I wanted to be a white, cis man teetering just enough on bisexuality to slip under the hurdle of self-assessment. That I’m not winning the trophy—that I am damn near last place. Is that a cruel fate? Is that selfish? Did something go wrong in the creation of me? 

I want a penis but I am unsure if I want that penis. I want to be born with one or I want to snap my fingers and have the whole thing rearranged on command. I am so frustrated with the reality of this. I may just slip back into fantasy just to beguile. 

In my fantasy, I am five-foot-eleven and my girlfriend is smiling beneath me and she has her mouth around me and me is a penis and it’s stately, or unassuming, or whatever they’re supposed to be, I forget. In my fantasy she is so enthralled with the ordinariness of it and its untattered edges, and it is so un-presumably sized and shaped. In my fantasy, I won the big football game so maybe this is about more than my just-now-discovered dysphoria or maybe it isn’t at all. Maybe I should go back to therapy. Maybe I should get a phalloplasty. 

I’m unsure of the implications of my emotions nearly all of the time. This is uncharted territory for everyone, especially me. Where is the mentor’s mentor? 

Frankenstein’s monster wanted to be loved so badly. This is the central theme of the story. 

If Prometheus is God, I’m not sure what that makes Zeus. I would say something cliché like the patriarchy or cultural norms, oppressive conventions, but those things can’t punish a god. Maybe through guilt, if you believe in a god capable of such a thing. In this metaphor, I do. 

So Prometheus is punished by Zeus to eternal torment. In my fleshed-out human version, that would mean God is cursed to watch his children be ostracized, and demonized, and abused. Again and again. This is dismaying because the eagle never stops. 

Yet even on the cliff, liver plucked, pain to a degree unfathomable—the myths portray Prometheus free of regret. Earnestly. He never wishes to undo his gift to humanity; he never doubts that fire was essential and worthwhile to humankind; he was selfless and certain. And so that makes God… 

I guess what I’m trying to say is, why carry a shame that was never designed for us? I guess I’m saying, we are no accident.

Valentine and I spent his birthday in a tent in my backyard some two months before. He had long hair and he slept undisturbed by any single sound. I must admit I briefly watched him in his unrestrained sleep; how peaceful it seemed he was, his easy, thin body growing roots and finding their way into the core of the earth. I wanted so deeply to understand that sort of peace, that kind of rest. It surprised me most of all to know it never truly existed.

Photo by Marek Okon on Unsplash