GenSculpt® FTM Top Surgery®

This isn’t my surgeon I’m talking about here, just to be clear. I went to Dr Curtis Crane in San Francisco. I’m talking about another “big name” in transitional surgery, Dr Garramone. I went to go doublecheck the spelling of his name yesterday (I always think it’s Garramond for some reason) and got a look at his website. Which… like, damn.

From his website:

ManSculpture® Body Masculinization: Transgender Surgery ManSculpture® Body Masculinization is commonly performed at the same time as the FTM Top Surgery® Procedure. This consists of shaping the body to a more “masculine” form with the use of Power Assisted Liposuction techniques. By lipocontouring the abdomen (stomach), love handles (flanks), and the “saddle bag” area of the outside hips or thighs with ManSculpting, Dr. Garramone can give your body a more streamlined and masculine appearance.

This is an attempt to up-sell… Garramone’s special trademarked manly lipo (you’ve got to specify it’s masculine, because getting fat removed from your body is culturally coded as feminine) costs $2500 to $6000 extra. With the use of the derisive terms “love handles” and “saddle bags”, he’s using the “problem-agitate-solve” advertising strategy. This is used most transparently in infomercials for quick fix products. Here’s a rundown of the structure from a marketing blog:

Problem: Identify your reader’s pain point.

Agitate: Stir it up so it hurts to the point of discomfort.

Solve: Deliver a solution.

The problem readers are having is profound, life-altering levels of disconnect and/or distress with their bodies. The language here is intended to agitate these feelings by using words that connote disgust for body fat, particularly disgust for typically female patterns of body fat distribution. The solution is liposuction.

Deliberately playing on the emotional problems of those who seek transition in order to “move product” should not be considered acceptable conduct from someone providing a surgery that’s thought to be the only way to avoid death by suicide. If you think transition is essential to surviving the desire to transition, you should be horrified to see this shit. Somebody offering you a lifeboat shouldn’t be saying “hey, for $2500 to $6000 more, I’ll throw in some water bottles, and by the way, you look fat from up here.” That is not the kind of help anyone should be grateful for. The fact that this guy is still getting paid a shit ton of money to remove healthy tissue, despite a clear lack of empathy for his patients, speaks to the chronic low self-worth and desperation that tends to drive business for any cosmetic surgeon.

It’s worth noting here that an awful lot of people who are seeking transitional surgery (myself included) spend months obsessing over their prospective surgeon, reading and rereading every relevant page of their website. For me, this was true from the very early phases, when I was really just fantasizing, all the way up to right before my operation. My impression from the time I’ve spent in both transition and detransition community online has led me to believe I was very typical in this respect. Garramone almost certainly has a huge amount of repeating traffic from the same viewers, which has to heighten the emotion impact of the strategically misogynistic language chosen.

The phrases “love handles” and “saddle bags” aren’t just agitating to FTMs. They’re a part of the language of self-disgust that all women are taught. One of the patriarchally-approved techniques we are given to soothe ourselves is externalizing this shame, so it’s also how many women talk about body fat in general. I googled “love handle liposuction” for a minute and that’s apparently how an awful lot of plastic surgeons refer to the flanks. Really? It’s coercive to deliberately activate shame in order to convince people made vulnerable by an incredibly toxic society that removing healthy tissue will solve their emotional problems.

Cosmetic surgeons, including those offering transitional surgery, are trying to move product. Like most people in sales, they prey on emotional vulnerabilities. When I went to Curtis Crane’s office for my double mastectomy consult, I couldn’t believe how nice the staff treated me. As a teenage butch lesbian with learning disabilities who was unable to perform male-defined femininity “correctly” and pretty much always perceived as “weird” or outright pegged as a dyke, I was not used to strangers being that kind to me. I haven’t had strangers treat me with that kind of impersonal sweetness anywhere else except church.

The last time it happened at church was while I was working a couple weeks ago and taking a man to a sign language service at the Kingdom Hall. I got offered two different jobs, they made sure I got seconds (my food/body issues have improved in a lot of ways but I still have a real weakness for anyone who indicates they don’t want me to starve until I look “better”). A part of me wanted to go back following their dress code, the first time I had even thought of going out in public wearing clothes I hated in years. That’s how lovebombing makes you feel- it makes you want to do whatever’s necessary to keep that attention coming.

Another experience that reminded me of Crane was going to the dermatologist who prescribed me Accutane when I was 14, a woman who had visibly had a decent amount of elective procedures on her face. She looked at my (moderate and typical for my age group) acne with such pity and she promised she was going to help me be the beautiful young woman I was meant to be.

The concept of a life-changing makeover is not a new one to any woman. As someone who has a trauma response to dressing “like a girl”, the pressure to be beautiful (according to male standards) has been painful in a specific way. Lots of women have tried to help me look more like them all my life. My degree of compliance varied by situation, but I consistently experienced these efforts as a rejection of me as I already was, whether or not I let on about it.

How did I convince myself that trying to transform myself into a man was going to feel any better than trying to transform myself into a type of woman I never had any interest in being? Sometimes I can follow my old logic, sometimes I can’t. Neither made sense without the basic assumption that I needed fixing. Neither made sense without a fundamental lack of faith in the ability of butch lesbians to live meaningful lives.

I don’t know. Fuck Garramone, and fuck Crane.


One thought on “GenSculpt® FTM Top Surgery®

  1. As a psychotherapist doing research for clients, I called Garramone’s office, and was not impressed by his stance on insurance, or the abruptness of the woman I spoke to. The tone of his web page on insurance was troubling, as well. This is an intriguing post, which raises some issues I hadn’t considered. I would appreciate if you could talk to me privately, to give me suggestions/advice for building resources for the local trans community.



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