I don’t think it’s shocking for me to say that I am a total dumbass when it comes to this kind of thing, but since I have the opportunity, I’ll ask. Why is requiring surgery to declare yourself a male or female a bad thing? From my perspective, it seems like the logical thing to do, if a man is defined as being, you know, biologically a man, and a woman the same. I don’t mean to be provocative, I’m just genuinely curious.
TL;DR: It’s an expensive and laborious process with a lot of checks and balances to keep it from being easily accessible, while some trans people don’t need it to feel comfortable, but do need the legal system to acknowledge them as their preferred gender.
For a lot of trans people it is a concern they want dealt with, but not for all of us. Some of us don’t necessarily feel strongly one way or another about our genitalia. Some might actually like the apparent mismatch. I don’t have hard statistics on this front to say how many of each category exists, though; I just know from knowing other trans people that it’s a wide pool of what needs to be done in order to feel comfortable in our bodies.
For some of us, however, it’s a low priority on the to-do list compared to everything else we need in order to be seen as our preferred gender identity. Unless you intend to get in bed with them, what’s between your legs isn’t going to be how people judge you, so much as what’s on your ID, how your face looks, body shape, etc…
Not only that, but there’s a lot more gatekeeping with bottom surgery than with the other steps in transition (though stuff like laser and facial feminization surgery will often end up being classified as “cosmetic,” and not be covered by insurance.) Currently, the Standards of Care published by WPATH puts it at being forced to wait at least a year after beginning HRT in order to qualify. Depending on where you live, you also have to be out and presenting as your preferred gender for a year before you’re allowed HRT, which is… dangerous. Now, my area isn’t like this, but I still had to wait an annoyingly long time between first talking to a psychiatrist and being prescribed hormones, because of some other dumb red tape like requiring at least two psychs to sign off on your papers in a province where if you don’t live in the city everything’s a multi-hour drive.
Luckily on that front, there’s been “informed consent” clinics popping up, which are more about telling you what the effects and side effects of the hormones are without judging how “trans you are,” and therefore skips a lot of the stress and anxiety on that front. However, the year between starting HRT and being able to procure surgery is still part of the global Standards of Care for transgender individuals.
Oh, and on that part about how things like FFS and laser being cosmetic. Guess what? Insurance companies might not necessarily cover bottom surgery anyway, so you’re SOL if you can’t afford to get it done yourself. Again, in my part of Canada, it sounds like it might be part of our healthcare plan, assuming you fly to Montreal (the other end of the country from me) to get it done, but I’m not sure if they cover the flight expenses.