CHRISTOPHER RUFO: Oregon’s Castration Machine.

The gender surgery program at Oregon Health & Science University, a public teaching hospital in downtown Portland, provides a productive tableau for analysis. The program is led by Blair Peters, a self-described “queer surgeon” who sports neon-pink hair, uses “he/they” pronouns, and specializes in vaginoplasty (the creation of an artificial vagina), phalloplasty (the creation of an artificial penis), and “non-binary” surgeries, which nullify the genitals altogether. Peters and his colleagues have pioneered the use of a vaginoplasty robot, which helps efficiently castrate male patients and turn their flesh into a “neo-vagina.”

Business is booming. According to Peters, OHSU’s gender surgery clinic has “the highest volume on the West Coast,” and his robot-assisted vaginoplasty program can accommodate two patients per day. His colleague Jens Berli, who specializes in phalloplasty, boasts a 12- to-18-month waiting list for a consultation and an additional three- to six-month waiting list for a surgical appointment.

This openness marks a revolution in manners and morals. In the past, transgender theorists acknowledged that their surgical transformations were disturbing and anti-normative. “I find a deep affinity between myself as a transsexual woman and the monster in Mary Shelley’s Frankenstein,” wrote the male-to-female transgender theorist Susan Stryker in 1994. “I will say this as bluntly as I know how: I am a transsexual, and therefore I am a monster.”

Such views no longer prevail. Today’s transgender medical providers conceal the barbarity of their practices in euphemisms. They are not postmodern Dr. Frankensteins but providers of “life-saving, gender-affirming care.” The model patient is no longer the middle-aged autogynephile but the troubled teenager, sold a new identity, mediated through technology, that promises to resolve deep-seated sexual anxieties—and advance the political cause of transgender activists.

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