One of my earliest childhood memories was trying to pee with a surgical cast on my penis. I couldn’t stand up due to the pain so my grandmother held me up. She cooed and encouraged me to be brave. I was pointedly uninterested in bravery. I just wanted the burning to stop. And I wanted to feel whole again.

I underwent a penile circumcision when I was a toddler. My family told me I needed a small surgery for “medical reasons.” I trusted this judgment because I had unwavering trust in relatives and doctors. I remember a doctor’s consultation where the grownups talked about it without meaningful involvement from me. Later, I watched hospital ceiling tiles pass overhead as the staff wheeled me into an operating theater. I woke up in pain. That was the next few weeks: of all kinds of pain.

At the time, I didn’t know that I was experiencing a contentious procedure that would leave me physically scarred and emotionally wounded. I did it because I was told I should. Decades later, I learned about assent in a postgraduate research course. As in, children can’t give consent, but they can assent to something by giving unequivocal agreement after being informed. The concept pops up a lot in sensitive research and healthcare. Somewhere in a postgraduate research ethics course, my heart broke. The lecture took me back to my circumcision. I realized that I didn’t assent, much less give full consent.

Circumcisions are commonly performed on children for medical, religious, and cultural reasons. Medical reasons, as a treatment for conditions of the foreskin and reducing lifetime risk of mild infections and STD transmission. Religious reasons, as in many cornerstone coming-of-age practices. And cultural reasons, as in peer pressure from dead people.

None of that information was laid out to me in usable detail, nor was I informed about the procedure and recovery process. To the contrary, my family actively downplayed the scale of the operation and recovery process to convince me to go along.

Therefore, I was misinformed about possible effects. Effects like suture tunnels. See, skin can heal around surgical sutures (stitches). When the sutures are removed, the tunnel can remain partially intact like a piercing. The first time I saw them, I thought I had an infection because there were small holes in my genitals. That horror has passed, but they remain annoying to clean. Narrow tunnels in the flesh have a way of collecting gunk, as anyone with piercings can attest to.

They also didn’t tell me how common it is to end up with more penile asymmetry. My frenulum is a twisty mass of skin that might have developed more symmetrically but was cut and stitched back together. So I’ll never know. I think it looks “weird,” and I’m not fond of it. I would have preferred an intact foreskin, like a little turtleneck.

Both the suture tunnels and penile asymmetry are soft spots in my self-esteem. They make me feel incomplete.

Due to the wide acceptance of circumcision in South Africa, I grew up disliking my penis but didn’t think a circumcision was the root cause of my self-esteem problems. It’s part of local cultural practices. The state actively endorses it to reduce HIV transmission. Even if caregivers don’t care about these reasons, its wide acceptance makes it attainable. I didn’t make the connection between normalization and my self-esteem until I began my gender transition.

Gender transition is an act of agency and choice. Trans people rethink a core part of themselves and build a more suitable life through reflection. We often transgress long-held societal norms while doing so. We do it at risk to our careers, personal lives, and bodily safety.

So when I began picking apart the gendered threads of my body, I had to think about my penis. I had to make some decisions about what I was going to do with it. I chose to keep it. But for the first time, I felt disappointed about the real source of my troubles: that circumcision.

It hurt to realize that someone else made the decisions about my body with so little of my input. Like arriving at a long-anticipated event to learn that someone ordered a meal for you. The wrong meal. I’m not upset about my penis because I’m a trans woman and many of us have genital dysphoria. I’m upset because others made a decision about my body before I could give sufficient input or unequivocally want it.

I’ve had a lot of time to reflect on the differences between a violation of my bodily integrity (circumcision) and changes I consented to (transition). The difference between unequivocal interest and uncertainty is night-and-day. Coming to a decision with reliable information about risks and outcomes is life-changing. Even though I was too young to consent to a circumcision, it would have been nice to be heard.

I haven’t found a happy ending to this experience. Violation of bodily integrity rarely makes sense or leaves room for recompense. It happened. I feel incomplete. It’s something I have to work through in my own time.

I’ll never give up on the hope of peace. There’s too much of myself at stake to give up. But, that peace hasn’t come quickly or easily.

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