The Surgery of Transsexualism and The Three Forms of Modern Individualism

Phalloplasty and vaginoplasty are major surgeries, which require specialized teams, like many other complex surgeries, but which have sometimes the characteristics of being surrounded by doubt about the service provided to the patient, taking into account the relatively recent and sometimes controversial identification of gender dysphoria.

This short paper aims to culturally contextualize the issue of transsexualism in order to help clarify the selection criteria for deciding a surgery.

The search for the truth of sexual identity must be compared to the components of individualism on which our democratic societies are based. Here we will follow Liza Cortois and Rudi Laermans analysis in their article “Rethinking individualization: the basic script and the three variants of institutionalized individualism”, in the European Journal of Social Theory, 2017, 21 (1), pp. 60-78. The two authors in fact distinguish three forms of individualism: moral, utilitarian and expressive individualism, all born from the progressive secularization of Christian ideas after the Renaissance.

The first individualism is linked to the foundation of the theory of human rights on the idea of one’s own freedom and simultaneously the recognition of the freedom of others. It corresponds to the doctrine formulated by Kant of the autonomy of the subject. This autonomy is moral in the sense that it respects the autonomy and rights of other subjects.

The second form of individualism is contemporary and corresponds to the calculating vision of the individual promoted by Bentham’s utilitarianism. The individual is directed by his interest, the maximization of his pleasures, even if the pleasures can vary from one individual to another. From this perspective, respect for others is more linked to a calculation of prudence, in the broad sense.

The third form of individualism is characterized by the search for the truth of one’s destiny, not in Kantian moral autonomy, nor in Benthamite eudaemonism, but in the expression of a truly personal authenticity (as opposed in particular to Kantian subjects which all look a bit similar). We can speak here of expressive individualism. From this perspective, the individual asserts his identity in his own difference, his unique character, but at the same time seeks recognition (cf. Axel Honneth’s theory of recognition) by others of this unique character. We can of course link this expressive individualism to the romanticism of the 19th century, but its popularization was especially evident after 1968 in Western societies with the refusal of conformism and pre-established categories, including those of the Welfare State.

The LBTBQIA+ movement (and no longer just LGBT) is characteristic of this individualism for some « ultimate » since it makes each individual a radically unique and even changing being.

The point of view of this paper is to consider that the choice of phalloplasty or vaginoplasty (also otoplasty) must not forget any of the components of individualism. The patient’s request must consider not only its sincerity (criterion of expressive individualism) but also its rationality and coherence over time (criteria of autonomy and utility).

It follows that these major surgical operations must be reserved, except in special cases, for adults, in order to allow them to build their future career in a socially and even economically sustainable manner.

This also corresponds to the numerous testimonies of women or men, or non-binary people, who have completed their complete transition. They all insist both on the absolutely vital and necessary nature of their approach and at the same time on its extremely methodical and planned character. From this point of view, the “ultimate individual” almost becomes a model of courage and consistency or, in a word, of virtue in the ancient sense of the term.

None.

No conflict of interest.