Mad Honey

by Jodi Picoult

Jordan approaches the witness stand. “Dr. Powers, did you know Lily Campanello?” “Yes,” she says. “I performed her gender affirmation surgery.” “As her doctor, were you aware of the process she undertook to transition from male to female?” “Yes. Lily followed a fairly typical course of transition. Around age thirteen, a trans female would start taking estrogen and spironolactone, which serve as puberty blockers. Since we typically start puberty at that age, this ensures that a transgender girl won’t develop facial hair, voice change, or the growth of an Adam’s apple—anything you’d associate with secondary sex characteristics. Following that, some individuals—like Lily—choose to have gender affirmation surgery.” “What is that?” Jordan asks. “Lily had what is commonly referred to as bottom surgery. In scientific terms, it’s a vaginoplasty, in which the testicles are removed, and the skin of the foreskin and the penis is inverted—preserving blood and nerves—to form a fully functional and sensitive vagina. The glans of the penis forms the clitoris, with all its nerve endings. There is no cervix, and no uterus, and no ovaries. Trans women do not menstruate or get pregnant.” I think about how, when Braden and I went for our ultrasound of Asher, the technician asked if we wanted to know the sex. She had pointed to the tiny thorn of a penis on the grainy screen. Had Ava Campanello had a similar experience? If so, how

Gender affirmatiokn surgery