Male doctors, Roche argues, often see the reconstruction of genitals as being about appearance, forgetting that the genitals are also sex organs designed for the giving and receiving of pleasure. In Roche’s own case, they felt some of the clinical attitudes came from ageism and sexism about middle-aged women: ‘gatekeepers saw a middle-aged woman who they presumed wouldn’t be having sex – because who has sex with middle-aged women, much less middle-aged trans women?’
