Bottom surgery
Genital surgery as part of a transition. An umbrella over several procedures.
Bottom surgery is the general term for genital surgery undertaken as part of a transition. It is an umbrella: the specific procedures have their own names, including vaginoplasty, phalloplasty, metoidioplasty and orchiectomy.
Like top surgery it is plain language rather than clinical vocabulary, which is why it appears in conversation and almost never in a medical record.
The proportion of trans people who have any form of it is a minority, for reasons that are overwhelmingly practical: cost, waiting lists measured in years, surgical availability, health, and wanting different things.
It is the single most intrusive question a trans person gets asked, and it is asked constantly. Pre-op, post-op and non-op exist as words mostly because strangers keep wanting to sort people into them.
This entry explains the term. The medicine belongs with clinicians.
Bottom surgery is not what makes someone their gender
It is treated as the definitive step, the thing that settles the question. It settles nothing, because the question was never open.
Pre-op, post-op and non-op are categories invented largely by people outside the conversation, and most trans people find them useful only for describing waiting lists.
Saying it well
Say this
- Bottom surgery is an umbrella term.
- Not something I am discussing.
- Some people want it, some do not, most cannot get it quickly.
- She had surgery. Which one is not my business.
Not this
- Have you had the surgery?
- So what do you have down there?
- Are you pre-op or post-op?
- Does everything work?
Questions people actually ask
What is bottom surgery?
The general term for genital surgery as part of a transition, covering several specific procedures.
Do most trans people have bottom surgery?
No. It is a minority, for reasons including cost, waiting lists, health and simply wanting different things.
Is it appropriate to ask about it?
No. It is the most intrusive question a trans person is routinely asked.
What does non-op mean?
Not seeking genital surgery. It is a description, not a lesser category.