This book explores one corner of the rapidly changing transmasculine world, focusing on a group of individuals who underwent chest masculinization on the same day, with the same surgeon. I spoke with Ben, Parker, Nadia, and Lucas regularly for more than a year after we first met, either by phone or Skype, and interviewed friends and family members who accompanied them to surgery. Six months after his surgery, I also visited Ben at his home in Maine, and I interviewed several of his close friends and reinterviewed his parents. To ensure that I represented them as accurately as possible, Ben, Parker, Lucas, and Nadia read drafts of all or parts of the book, and I modified some aspects of my account in response. Other interviewees also checked quotes if they wished.
While many transgender men see top surgery as a key aspect of the process of transitioning, some individuals who identify as transgender do not undergo top surgery because they cannot afford to do so, or because they simply choose not to undertake it. The surgical experience is at times central to what it means to be transgender or gender nonconforming, but at other times it may play little or no role. Focusing on one group of individuals who underwent body modifications means that I under-sample transgender men who cannot (because of financial and other constraints) or choose not to (because of identifications or preferences) masculinize their chests. By recruiting interviewees from among those who are undergoing a medical procedure, I surely under-sample trans-identified individuals who do not choose surgical interventions, such as those who use testosterone only, or those who do not undergo body modifications at all.
Because the surgeon I focus on does not accept insurance and is particularly celebrated, my book represents a more homogeneous group of transgender people than the transgender population as a whole. While there was somewhat greater racial/ethnic diversity among the patient population the second day I visited the surgeon’s office, since I had decided in advance to focus on those having surgery the same day as Ben, I did not interview them. I’ve tried my best to compensate for this shortcoming by including additional voices in the book.
Readers may wonder why I include in a book about transgender men one key respondent who does not identify as such. I do so because she is “masculine of center” in terms of her identity and self-presentation, and therefore grapples with some (though not all) of the same challenges transgender males confront. By flouting gender norms, she pushes up against expectations that one clearly identifies with one gender or the other—while readily admitting that she does not endure the kind of oppression that many trans people face. Moreover, since the boundaries separating butch lesbians and trans men have historically been highly permeable, I believe that we can deepen our knowledge of one group by understanding the other, rather than by reifying these categories.
To help me better understand the role that health professionals play in managing the process of transition, I also interviewed ten surgeons, psychiatrists, and therapists who work with the transgender population. I conducted these interviews in their professional offices. I also attended three transgender health conferences, where experts and activists offered workshops on varied aspects of trans health, and several meetings of gender specialists in the fields of psychiatry, psychology, social work, endocrinology, and surgery at the New York State Psychiatric Institute. Finally, I interviewed fifteen individuals who possess insider knowledge of the transgender world: social scientists who had conducted studies of transgender life, some of whom are transgender; transgender activists; and others who have observed the evolution of the trans community from afar. In all, I conducted in-depth interviews with approximately fifty individuals, and these interviews were transcribed.
Writing about a group one is not a member of, especially when it is a vulnerable one, can be a risky endeavor. There is a danger of exoticizing one’s subjects and making them the object of curiosity, appropriating their knowledge and experience for one’s own ends, or speaking for, or on behalf of them. I’ve tried my best to avoid these pitfalls by being conscious of how I portray people, by getting their feedback on those portrayals whenever possible, and by employing what one might call critical empathy—placing myself in others’ shoes, while understanding that the job of the sociologist is to observe as an outsider, more or less. While I enjoy privileges that trans folks do not have access to, as someone who has at times grappled with not being a “good enough” female, some aspects of transgender experience were very familiar to me. The quest for understanding across differences seems to be in very short supply these days. To the extent that it is possible, I hope that this book furthers that goal.