How Ben got his penis

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Phalloplasty — the surgery to make a penis — has grown more popular among trans men. But with a steep rate of complications, it remains a controversial procedure.

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Ben arrived at college in 2009. There, he started calling himself a “queer lesbian,” a term he used in an attempt to reconcile his attraction to women with his interest in men’s bodies. He joined a campus L.G.B.T. group and met people who seemed to know who they were, who called themselves things like “gender-fluid” or used “ze”/“zir” pronouns. Ben did not feel that these words applied to him, but for the first time he had community and language to help him disentangle himself. This was a stressful and exciting interlude. He went out in outfits from across the gender spectrum, in clothes he wouldn’t dream of putting on today. He had long debates over terms: What was the difference between a butch lesbian and a transgender man? What was the reason to use these words at all?

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In the spring of 2015, Ben got happy hour drinks with two friends at a Midtown barbecue spot. The setup was the usual — sitting at the bar, dissecting sex and gender, putting the pieces together again. They had done this many times before, but this time something clicked, and suddenly Ben understood he was a man. He stood up from the bar and told his friends: “[Expletive]! I’m trans! I gotta go!” Out in the street, he took off his heels and ran five sobbing blocks to the train. That night, he began the bureaucratic work of transition: texting his mother, posting a Facebook status, scheduling a doctor’s appointment to start testosterone.

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There he began his life as a man, working at a hotel, wearing a uniform and smiling when Southern types called him “son.” The state’s so-called bathroom bill drove him back to his hometown; in North Carolina, neither restroom felt safe. 

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but Ben was confident — and had to go. He walked past a guy using the urinal and quickly unzipped to sit on the toilet. The man kept his eyes to himself (the men’s room code), but as he left, he told the people waiting: “It’s going to be a while. That guy just sat down.”

This was hardly an incitement to anti-trans harassment — he just thought Ben was taking a dump. 

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he pictured a more hostile group of drunken men and how they might react to the absence of his penis. Bathroom bills were on the rise, and every day for the rest of his life, taking a leak would mean managing risk. 

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Having a penis would help him feel safe, even if he still had to sit down in a stall. 

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According to the most recent prepandemic data from the American Society of Plastic Surgeons, some 1,100 people in the United States had gender-affirming phalloplasty in 2019. This number is probably low, considering the modular nature of the procedure and inconsistencies in how data is reported. Surgeons at all four programs I spoke with confirmed that phalloplasty is on the rise. All claimed wait lists of over a year. This increase in surgery has set off a frenzied cycle: better access, new techniques and more doctors, but also an influx of less-experienced doctors and urgent calls for better analysis of outcomes to help bring down the complication rate. This narrative unfolds within a mass cultural one, in which America, at a larger scale than ever, tries to come to terms with what defines a man or a woman. In this context, phalloplasty occupies an impossible position, seemingly upholding both the malleability of sex and the essentialist claim that the penis makes the man.

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