What’s it like one month before genital reassignment surgery (GRS)? As everyone points out, it’s a big deal. Oddly, I really don’t feel excited or nervous. I think I’m concerned about upsetting my health and our family’s summer plans.

When I tell people I could take it or leave it, they’re amazed, and I guess the general public equates transsexualism with body dysmorphia, so of course it’s perplexing for the to hear me say I could live without it.

For me (and everyone is different), my transsexual condition is/was about self-acceptance, feeling a part of things. As I took various steps to revise my identity, I felt more and more normal with each step (removing testosterone, adding estrogen/progesterone, removing body hair, removing beard, telling people, venturing out as Joyce, eventually being Joyce socially, psychologically, and physically. To my mind, I’ve finished the job, as I no longer feel any distress about sex or gender.

But what about genitals? Why do people (and other transsexuals) feel genital correction is so important? I can think of many reasons, and perhaps expressing them will help clarify. First, sex is a normal part of being human, and being a woman with a penis or a man with a vagina may not promote a healthy sex life (at least one that doesn’t involve being labeled a hermaphrodite or freak). However, there are also wonderful sexual relationships possible for all sorts of body-identity types, and there’s no inherent reason why genitals need to match psyche.

Second, general body-dysmorphic identity: some people strongly identify their sex/gender with their genitals, and thus could never feel legitimate without all body parts matching. And this is a fair argument, it seems to me.

Third, even without seeking “normal” sexual relationships or a “normal” genital match, one might want their parts to match for others in public and semi-public places like the emergency room and health clubs. A woman with a package may distress others in these places. Their distress is their problem, of course, but it’s the transsexual’s problem if their distress leads them to withhold medical care or call the police. And while I think it’s not my job to fix other people’s biases, I *do* want to live a healthy and relatively hassle-free life.

There must be many sorts of legitimate body-identity-types for different people, and the trick is to listen to your heart to see what you need to do (how you need to be). What is the transsexual community puts pressure on you to have genital surgery when you feel deep down that it’s not necessary? That’s almost like the pressure you used to feel from general society to be your birth sex, isn’t it?

I find myself wondering where body dysmorphia ends and cosmetic change begins — because I can certainly see my upcoming surgeries as entirely cosmetic: no more worries about packages, a whole range of pants and tops I can wear, cleavage, and so on, and there’s no doubt that I expect to feel more legitimate, more at ease in my shell. But is it necessary? No, I don’t think it is.