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Writer's pictureIoannis Ntanos

Art and ethics of gender affirming surgery

After featuring a trans masculine guest on her show, A Wholeness Podcast with The Yoga Barber, Fliss Downes grew curious about the world of gender affirming care. So she invited Ioannis to join her for an episode, to find out more.


In the episode Ioannis shares his experiences around the recent decision to move back to Greece, his country of birth, and his experience in oncology, as well as what ultimately led him to pursue a lasting career in trans healthcare. 


When asked about this return to Greece, he said “the world is changing faster than I’m used to”. Finding he is a different person now than he was when he initially left. His age, he explained, means he is better equipped to cope with the aspects of Greek life that led him to leave in the first place and he is excited about the improved access to care that he will be able to offer to his patients - both locals and those travelling from the UK to access more affordable care.


Ioannis’ career began with treating breast cancer patients. As a surgeon, he explained, there is something incredibly valuable about working in oncology. But even the feeling of helping patients in need can plateau, particularly when those you are treating are experiencing some of the worst times in their lives. “Patients don’t make positive associations with breast cancer surgeons, they are not happy to see you”, explains Ioannis. Gender affirming care brought back that joyous aspect of medical work. 


Trans patients look forward to their treatment, it is a life-affirming process that rarely, if ever, carries with it any negative connotations. It is a very rewarding kind of care, Ioannis explains. He has also been surprised to find how many themes of autonomy and justice, trans healthcare shared with his training as an ethicist. 


He explains that injustice is a key theme which inspires not only his work as a medical professional working in the field of gender affirming surgery but also ensures that his commitment goes beyond just treating individual patients towards the much broader cause of fighting for the community as a whole.


In his more than seven years working as a gender affirming surgeon, Ioannis has seen a lot of change. He specifically discusses the shift away from terms such as sex change and gender dysphoria towards gender affirming surgery and gender incongruence. As he explains “part of learning is unlearning what we’ve been taught.”


Fliss and Ioannis explore the limitations of acting as a surgeon. “I can fix the disease, but I can’t solve the social causes of disease” and the political fear mongering around trans people, which Ioannis explains, requires a more well-rounded allyship, this, he believes should come from trusting trans people to know what's best for them when it comes to their identity.

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