Dear Angelina Jolie,
Thank you for coming out. I mean about your mastectomy. You have no idea what this can mean for a transman like me who went through the exact same procedure as yours; well almost!
You didn’t have to come out, but you did. Especially since during your mastectomies you kept it private and carried on with your work. I know how difficult it gets with film producer types. I am a filmmaker in Mumbai and you won’t believe it, but once during an edit session, Mr. Moneybags, finding me alone in the cutting room, asked if we could compare our d*** sizes! He giggled and said he hadn’t ever seen one of someone who has had a sex change operation.
Your piece in the New York Times ‘My Medical Choice’, undoubtedly must have been that — a medical choice. You spent three months, since this February, on a procedure called ‘Preventive Bilateral Mastectomy’ ; ‘Preventive’ since you are the carrier of the BRCA1 gene that puts you at 87% risk of breast cancer and 50% risk of ovarian cancer. I spent several years trying to convince doctors that I needed a mastectomy for preventive reasons too. Years of forced living in a gender identity that wasn’t my own, began to immobilize me. In a society that understands only two genders and in a medical system that sees abnormality in everything outside of it, going on is eventually impossible. But your risk of celebrity cancer turned out to be higher than my risk of a commoner suicide. Still, I am happy for you. The mere idea that someone can remove their breasts, at 87% risk or no risk, is just good enough for me for now.
And of course you wrote this piece for women! And I am hoping that you meant transwomen too, some of who I know would kill to have your new breast implants. How atrocious is the idea being peddled that you wrote it to benefit the Pink Lotus Breast Centre, where your procedure was performed, or for the biotech company, Myriad Genetics, which owns a patent on the BRCA1 and BRCA2 genes giving them exclusive right to develop diagnostic tests for, at a current cost of more than $3000 in the USA. The fact that m o s t breast cancer seems to be sporadic and has nothing to do with a BRCA1 mutation, pales beautifully in front of your sheer courage to talk about your own mastectomy in the media.
It is interesting though that all the media attention has been on your courage in losing your breasts, and not equally on your desire to have them reconstructed. Your doctors could have expected you to simply get back to the business of life without them. After all they were lost to a very high possibility of a most dreaded disease. But they didn’t. If you were non accepting of your loss, they could have put you through that monster of an American psychiatric-diagnostic-manual called ‘DSM-4 ‘ to prove your mental illness and therefore the need to cure you through breast reconstruction. But they didn’t. On the contrary, they became your facilitators. They saw you, as you saw yourself, a women, one with those very definitive markers of femininity : breasts. Why is it that cosmetic surgeries for women skip the pathologisation that is mandatory for trans people all over the world? Why is it that medicine cannot facilitate trans people in the same way and grant them the same dignity of self identity?
Just like many of my trans brothers, sisters and lovers, I become complicit. I agreed to patholozise my gender identity. I agreed to let the psychiatrist issue me a certificate for Gender Identity Dysphoria [GID]. If I was to lose my breasts, I needed those gatekeepers to let me in. You had the BRCA1 to open the big wide doors of reconstructive surgery for you. And I had my GID certificate. I let them say, I am mentally ill. I let them say it on paper. I signed on an affidavit stating this was my consent and that I was totally responsible for whatever the surgeries would result in.
In a world with greater understanding, removing my breasts should have been seen as my ‘aesthetic choice’ ; a choice exercised in the severely limited societal understanding of gender, as being either only male or only female. But you’d agree that medicine being organized on the central idea of disease or, as you now have made so public, the possibility of it, is ill equipped at the moment, for such fine abstractions as mine. I knew success when I saw my psychiatrist scribble on his over qualified letterhead: “Diagnosis: G.I.D.’ Just like you, I too finally, made a ‘medical choice’. That I was as smart in 1997, as you are in 2013, makes me feel rather pleased with myself! Perhaps, this is a sign? Perhaps I will be a celebrity soon! Perhaps I will meet you at the next Cannes film festival and we can rule the world together?! Two Celebrity Bilateral Mastectomy Survivors, with reconstructed breasts on one, is better than none?! No?!
By Satya Rai Nagpaul © 2013, Nagpaul is the founder & facilitator of the Indian Trans Group, Sampoorna