Non-binary healthcare offers a transformative journey of discovery and understanding in a world that has traditionally been viewed in binary terms. When I began providing gender-affirming care six years ago, my perspective was rooted in traditional transformation procedures. Like my peers in healthcare and surgery, I was born and educated in a binary world. And so my patients have been some of my greatest teachers. Through conversations and open dialogue with patients about their goals and desires, and how they view themselves fitting in a largely binary world, my patients have expanded my understanding, revealing a wide range of gender identities and needs.
Can You Share Your Experience in Non-Binary Healthcare?
I am grateful to my patients for providing some of the most profound learning opportunities of my life. Through their willingness to express their true needs and desires, I learned that not everyone conforms to a strict binary understanding of gender.
For example, some individuals identify with certain feminine attributes but may not want to undergo a complete body transition. Others may not want specific procedures, like sexual reassignment surgery, and may feel uncomfortable with certain aspects of their bodies. Some individuals may seek relationships that are loving but not necessarily centered around sexual desires. Patients might want procedures like vaginoplasty but with specific goals, such as preserving original sexual function.
My ongoing work in gender-affirming care has introduced me to non-binary surgery options that serve needs beyond traditional binary transitions. Understanding each patient's unique goals is crucial to providing personalized and affirming care.
What has surprised me the most is the contentment expressed by patients after their procedures. It is a feeling they have longed for nearly their entire lives - to feel comfortable in their bodies. They are relieved to find a sense of self and identity, and I am grateful each time a patient challenges me to adapt to better meet their needs. It is evident that there is no one-size-fits-all approach in this field, and flexibility and open communication are essential.
My experience in non-binary healthcare has been marked by continuous learning, understanding and adapting to individual needs, and witnessing the profound impact of gender-affirming care on patients' lives.
What Trends Are You Observing in Non-Binary Healthcare?
The journey begins with language and education. I've noticed that people are becoming more conscious of pronouns, beyond the traditional "she" and "he" to include "they" and "them." The emphasis is on educating people about the significance of using these pronouns, particularly in a world that often sticks with traditional binary habits. By raising awareness and challenging the conventional perspective on gender, we're making strides in promoting inclusivity. This extends into healthcare, opening the door to conversations between patients and physicians to better understand and respect each patient’s unique needs. While the collective medical community is making great strides, we must continuously seek to understand and educate about the diversity of gender identities.
Are There Any Common Questions You Receive from Individuals Seeking Non-Binary Transformations?
Prospective patients often ask if I'm able to do certain procedures and if so, would I be willing to do them for them. I'm also asked how many of these procedures have I done. Mostly, it comes down to connection with the patient. The patient has to be comfortable speaking openly with their doctor and feel confident in the care they're receiving. Oftentimes, these individuals have been searching many years for a doctor who will listen and understand. They want to know that I recognize their pain, see them for who they are, and can help them live their authentic lives.
What Influences Do You See in Decisions to Pursue Non-Binary Surgery Options?
I've had patients tell me that they knew they wanted to transition back to when they were five or six years old. Living in a binary world, some individuals innately know they don’t identify as traditionally male or female. Oftentimes they know they want to transition, but they may not be aware of the healthcare options available for non-binary individuals. They may not know they have non-binary surgery options as well.
My approach is to always seek to understand their goals. We openly discuss the possibilities. We compare procedures and discuss how they help to achieve their goals. My job is not to dictate the transformation journey. Rather, I show them what the possibilities are and make sure they have the information needed to define their own path.
What Are Common Non-Binary Procedures?
I find that each non-binary transformation is unique, and patient needs vary significantly. Procedures for non-binary individuals may include facial feminization or facial masculinization, top surgery, bottom surgery, or a combination of procedures. One individual might want to soften or sharpen their facial features, while another may desire gender nullification surgery to remove external genitalia and create a smooth transition from the abdomen to the groin. Some individuals want to remove their testicles to decrease testosterone. Others may desire a phallus-preserving vaginoplasty to create a vagina while preserving original sexual function. There are even variations within the procedures, such as a traditional vaginoplasty that creates a vaginal canal, compared to a zero-depth vaginoplasty that creates external genitalia only.
What is the Consultation Process Like with Non-Binary Surgeries?
Every transformation is unique, so it’s important to understand goals and expectations. Some individuals come to a consultation well-informed and know exactly what they want. Others know the desired outcomes but may not know what’s possible or how to start that journey.
The first focus of the consultation has to be the individual’s goals - what is the desired outcome of this procedure? From there, I also want to understand more about their lifestyle - who they engage in relationships with and the fluidity of their gender and sexual identity. This helps inform the options available to each individual, specific surgical techniques and procedures, and the steps to help them achieve their goals. I also discuss expectations with each patient, ensuring they are at a time and age in their life where they can fully understand the action of choosing to permanently change their body.
Lastly, I make sure that each individual has mental health support, the right access to other healthcare such as hormone therapy, and an established support group of friends, family or allies in place before proceeding with surgery. Then, together we move forward with their journey.
Non-Binary Healthcare at ART Surgical
ART Surgical plays a pivotal role in supporting individuals on their non-binary journey. Based in San Francisco and serving patients throughout California and across the country, our practice offers a range of gender-affirming surgeries to meet patient goals. We are committed to understanding the experiences of non-binary individuals and provide a safe and inclusive space for all. My team is dedicated to personalized consultations. Our goal is for patients to openly share their goals and concerns, so we can discuss options and empower each individual to make informed decisions on their unique transformation journey. If you are interested in discussing the next step in your non-binary journey, I would welcome the opportunity to meet with you. Please click the link below to schedule a consultation.