Once upon a time, surgery was the sine qua non of transsexual discourse. Without surgery, a gender-variant person could be a cross-dresser, a butch, a fetishist, or a drag queen, but by definition that person was not a transsexual because they didn't cut their flesh. It's remarkable, in hindsight, to reflect on the peculiar power modern culture has granted to the surgical as a technique for the production of realness—that is, genital-altering transsexuals are considered (though not without contestation) to have really changed sex, while everyone else who strains against the naturalized pink/blue dichotomy is just dressing up and playing around. What is it about the surgical incision, and the removal or rearrangement of tissue, that historically has allowed it to confer a real change in social status?
In reading the early medical history of transsexuality, it's striking that sex change did not at first refer to the surgical transformation...
