Q: Why do people use the phrase “gender confirmation surgery” to refer to transition-related surgeries? Plus, post-surgical regret, ethics, and is it necessary?

Why do people use the phrase “gender confirmation surgery” to refer to transition-related surgeries and why isn’t it problematic?

Your question seems to assume that the use of “Gender Confirmation Surgery” should be problematic. Why would it be problematic?

There are many names for the set of surgeries used to address the physical dysphoria that some transgender people face:

• Sex change: problematic because it focuses on the wrong thing. The surgeries are addressing the person’s experienced gender.
• Sexual Reassignment Surgery: same as above.
• Gender Reassignment Surgery: implies that gender is changeable. I was born a woman, but it took me many years to understand that fact. I was assigned male at birth, so people assumed I was a man. But I was still a woman regardless of their assumptions.
• Gender Confirmation Surgery: in my experience, this is the most common name used for these surgeries. The surgery is being used to confirm the experienced gender — it brings the physical body/sex into better alignment with the person’s experienced gender.
• Gender Affirming Surgery: also used fairly commonly, but perhaps less than GCS because of the unfortunate acronym – GAS. Again, like GCS, GAS is affirming that person’s experienced gender.

There are other names which are of varying acceptability: top surgery, bottom surgery, cutting your dick off (that isn’t what happens!), etc. These are more slang terms and aren’t used clinically.

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How come sometimes trans people don’t regret transitioning until they get gender reassignment surgery?

The scenario you mention is exceedingly rare. Less than 1% of post-operative trans people experience regret for transitioning. But when it happens, the reasons are varied – typically falling into one of two categories: the person suffered severe complications with their surgery, or, the person experienced bad discrimination/stigma/mistreatment. Only a fraction of that original fraction experience regret related to determining that they were somehow incorrect about their gender when pursuing transition and needing surgery.

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Is it ethical to give transgender people sexual reassignment surgery?

Is it ethical to provide a medical intervention to a person which has a high likelihood of improving their life and their mental health, and also has almost no negative effects on the person or on others? Yes, of course it is!

We regularly provide medical interventions which have lesser upsides and greater downsides (chemo anyone?) and consider it perfectly moral and ethical to do so. Why would this be any different?

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Can I be transgender without getting a surgery?

Absolutely! Each transgender person’s needs and journey is their own, and there’s no set path for any person to follow. Some trans people need surgery in order to address their needs, and some do not. All experiences and paths are valid.