The basic idea is to de-emphasize the significance of Genital Reassignment Surgery as designating the penultimate moment of gender transformation. I call this idea deliminalization.
This word is derived from the terms liminal and liminality, which are from anthropology. Liminality refers to the concept of "rite of passage", or a ritual which an individual undergoes and the community recognizes as designating a new status for that person. Examples include the Australian Aboriginal Walkabout, the Bar Mitzvah in Judaica, and The Order of the Arrow in the Boy Scouts.
The liminal state is the period of spiritual transition. In the Walkabout example, it is the time when the boy prepared, wanders the desert, testing his survival skills and undergoing a spiritual transformation.
Weddings, births, deaths, and religious conversions are examples of other liminal rituals, although the core meaning is the rite of passage. Liminal is also the root of the term "subliminal", which we use to describe messages sent below the threshold of perception by a group.
The "Standards of Care" metaphor of liminal transformation, is to us, familiar: The novitiate undergoes a period of trial living in the new gender, and after approval by an authority, undergoes surgical transformation. The actual liminal state occurs while the surgery is being performed. You "go to sleep a man, and awaken a woman" (or vice versa for FTMs). Mildred Brown, beloved by us all, sends each new post-op a Teddy Bear inscribed with a message "True Self at Last", designating the GRS date as a new birthday.
This attainment of new status via surgery became institutionalized in the 1970s when laws allowing gender change were passed in many jurisdictions. It also brought on the acerbic critique of the process by Janice Raymond in her book "The Transsexual Empire". I would argue that she was close enough to be wrong, for some of the right reasons. [Check out "Sex Changes" by Patrick Califa, for a satisfying & devastating critique of Raymond].
One of Raymond's points was that modern medical science had created a new liminal process in error. I like the way Lannie Rose put it: "SRS does not make you a woman any more than rhinoplasty makes you a rhinoceros". The argument backing this up usually includes the following points:
and finally, and perhaps most importantly,
I have known many TG people who, despite warnings to the contrary by care-givers, still expected some sort of magic result from GRS. I have also known TG people, some no longer alive, who thought that their transformation was "completed" by GRS, and neglected aspects of the crucial aftercare period.
For all these reasons, I advocate for the "deliminalization" of GRS. This means we shift the focus from this one momentous occasion to the broader process of transition. This means changing the laws and changing our own conceptions. How this is to be done is as open as the future. The process is already underway.
Make no mistake, GRS must still be available, and should be accepted as is any other life-saving medical procedure. Research funding should be increased, better follow-up studies done, and techniques improved.
However, "Pre-op or Post-op" should not matter to anyone but the individual involved. That is what "deliminalization" means.