Not always. They have a say, surely, but the decision to have surgery should not be left open to someone who is suffering from mental illness. I’m not saying it should be absolutely closed to them either (I say this in haste to avoid some idiot excluding the middle.)
We have a medical profession for a damned good reason. The patient’s views should carry much weight…but they are not usually the best informed views.
Oops, then my apologies to you.
How do they diagnose that their experimental brain-damaged monkeys have BIID?
I do not regard your contributions as worthless. In fact, it is plain that you have done a lot of reading and research and presented it in an admirably clear manner. I appreciate what you write. I also appreciate what other people write and do not accept that a study has been widely discredited just on one person’s say so. The summary you give–and I have no reason to doubt that you summarize these papers accurately–shows a majority of the research found improved quality of life after surgery or hormones, but a significant minority found otherwise. The sample sizes listed are small for most of the studies. Overall it seems to support what Cecil said, that more research should be done.
(That said, labeling anyone who doesn’t embrace surgery as “haters” and so forth won’t advance your cause. Someone can have concerns about a procedure without being hateful.)
I for one am.
If spotted my fellow worker trying to sever his own arm, my reaction would be to stop him in any way that would be safe for both of us.
If I heard about a young lady planning to undergo an unsafe abortion, I would do everything I could so that she would be assisted by skilled professionals.
If some of my fellow citizens attempted to surgically modify their bodies due to psychological disorders that they claim to suffer from, I would be at least cautious because, for example, these conditions may actually be factitious disorders feigned by attention seekers.
No one is arguing in favor of do-it-yourself surgery. When I say that individuals should be in charge of their own health care decisions, I mean–obviously, I should have thought–in conjunction with the appropriate medical personnel and in accordance with best practices as currently understood.
Gender reassignment surgery is not a choice left up to an individual. The gatekeeping is quite extensive, involving, at a minimum, several years of therapy, at least two letters from therapists, the involvement of multiple medical doctors, and a long period of living as the gender with which the person identifies prior to surgery.
One cannot go to a hospital and order up some genital reconstruction.
Could you please produce such a mountain?
Note that I am asking for objectively measurable outcomes, for surgery, which is what you said. For instance, what is the clinical evidence that suicide rates for post-surgical transexuals are lower than for transexuals without surgery?
Valid, peer-reviewed evidence, please.
Regards,
Shodan
Incidentally, here is the linkto the Cecil column, which also lists its cites. It contradicts Una Persson’s assertions.
Regards,
Shodan
Who do you think gave Cecil the cites?
People on this message board take great pleasure in arguing that Cecil is wrong, wrong, dead wrong about any and all subjects. It’s odd that you take this specific column as gospel when you haven’t done any research yourself other than Googling to that tired sooper-sekrit British study in the past. How unfortunate for you.
Anyone who reads Cecil’s column and isn’t scared by the wall of text will see I reference all the same cites, and many more. And I show the findings out there for all to see. I’d ask you to stop misrepresenting the findings, but (shrug).
You also have never fessed up to the fact that the medical establishments of most developed nations disagree with your opinion. How’s that working out for your argument?
There you are again on your obsession with suicide, ignoring the mountain of evidence about improvement of quality of life. I suppose you don’t even take Tylenol for a headache without first carefully studying peer-reviewed studies proving that it reduces suicide rates. :smack:
With respect to you, I fail to see how this conclusion can be read as being in opposition to surgery:
The vast majority of people who are opposed to treatment of me and mine are people who hate and fear us. I’ve been spat on by them, threatened with violence by them, even twice assaulted by them. I work right out in public facing them. Online it’s couched in more polite terms, where people demand 6-sigma certainty before they would allow a transgender person surgery - while handwaving away innumerable cosmetic or elective procedures undergone by cisgender persons with no complaint whatsoever.
Yes, when my experience, from the alleyways where I work with the trans prostitutes to the city council meetings to the churches to the schools to my radio program is that those who are opposed to surgery and transition do in fact hate me and my people, it’s a conclusion I draw based on personal experience, and it is not an assertion of scientific fact nor metaphysical certainty. It is a **personal opinion **only; I just want to make that clear.
I was under the impression that you did.
I wasn’t aware that I was given to arguing that Cecil is wrong about any and all subjects. Did you have a few examples where I so argued? If you don’t, then the unfortunate one is the one who did the research and then rejected the conclusions because it didn’t confirm something heartily desired.
I didn’t misrepresent the findings. You allege that they prove that objective outcomes are improved; someone who is less emotionally involved disagrees.
:shrug:
I don’t believe that the medical establishments of most developed nations agree that SRS has been shown to improve objective outcomes. If they do agree, I would expect that there was sufficient hard, peer-reviewed evidence available. I haven’t seen such evidence, and your cite does not show it.
As I have explained before, suicide rates are (IMO) a more reliable measurement of improvement of quality of life than surveys, and it makes more sense to rely on objective measurements. If you are suggesting Tylenol as a treatment for improving quality of life in a patient group highly susceptible to suicide, and it has no measurable effect, then I would not agree that Tylenol has been definitively shown to be an effective treatment.
This is a deficiency in your studies. Many of them report that post-SRS patients are satisfied with their surgeries. That’s well and good. However, saying “the patient was quite happy with his/her surgery and committed suicide three years later” does not make a lot of sense. If the absence of SRS is what drives suicide in transsexuals, and post-SRS patients still commit suicide, that seems to be an argument that it wasn’t the absence of SRS that drives suicide, and therefore SRS didn’t help.
Regards,
Shodan
Shodan I want to ask you an honest question, with no subtext or spin. I want to ask it respectfully and with an honest an non-rancorous spirit of understanding your position.
Why do you not feel that the studies I’ve linked to in my article which appear to show by 78% that transition, including surgery, is beneficial to transgender people, are not acceptable?
I ask you, have you examined the criteria for such medications as anti-depressants? Suicide is one factor considered, but the overall factors include improvement in the quality of life. Something judged by trained psychologists, even though there is no hard algebraic metric. By your metric, since some antidepressants can increase the risk of suicide, they should be disqualified from use by persons, yes?
Psychotherapy in general does not live or die by the metric of suicide rates. It lives by the metric of “is the quality of life improved?”
I ask you honestly, in a spirit of trying to start the entire conversation over from a respectful beginning and not picking at you, can you explain in detail why you appear to not accept metrics other than suicide for this subject as qualifiers of success? And do you apply this same metric universally, or just to transgender persons?
Honestly, I know you’re a smart and educated poster. I’ve seen your posts on many subjects. I’m asking this in the spirit that maybe I’ve really overlooked something and misjudged you. Because I honestly cannot understand your position.
I think I am probably one of those reflex lumpers. As a physician, my own experience colors my observation, and these folks seem nuttier than a loon to me.
I am not, however, the least bit interested in policing the nutty’s personal choices. If you want a split penis, or a gone penis; a mutilated leg or a gone leg; well, I sorta think you should get to have that.
The emphasis should be on some sort of external psychiatric screening process that a nutcase has to pass before a surgeon can get her knife out, but in general the emphasis should be on promoting personal control of a person’s body, and not on whether or not some Pedant thinks it’s nutty.
(And perhaps a tangent, but I would not be in favor of extending publicly-funded disability welfare to those with elective whack-ectomies.)
I am relatively new to this board, and very new to this topic in the board. I assume from this list you are trans. Please correct me if I am wrong. Also, I would appreciate any other details on your gender and whatnot that you are willing to share.
I don’t think that’s a tangent, I think that’s an important point. People who have gender reassignment surgery can be expected to continue to be able to work in whatever capacity that could work at prior to the surgery. There is no expectation that they will need handouts from society as a result of the surgery.
I know very little about people who want a limb amputated, but I would be concerned about creating a new disability in someone that might prevent them from contributing to society.
[Amputation Desire (BIID/Xenomelia) and the Human Experience of Self – The Phantom Self](V.S. Ramachandran) discusses theories from the neurological perspective on BIID/xenomelia and transgenderism.
These two possibly-related conditions have a lot in common in that, brain trauma aside, most people are aware of their “alien” body part(s) early in life, claim that the offending parts are all wrong and intrusive, they self-mutilate in an effort to rid themselves of their alien body parts, suffer depression, and are willing to endure all sorts of body altering procedures and the use of prosthetics to have their bodies conform to their brain’s image of their bodies.
People who want amputations are very precise and specific about the amputations; it’s not just a “remove this limb” request. It’s more like “remove my right leg 5 centimeters below the knee” or “remove my left arm 3 centimeters above the elbow”. They will precisely tell you how much of the limb should be removed. These folks are otherwise sane and rational with no history of mental illness.
In these cases the offending body parts are normal, healthy, and process sensory information correctly. But somewhere along the line they were not integrated into what the brain considers to be a part of self. After surgery, subjects report how happy and relieved they are to be rid of the alien body parts, even though there are other, perhaps worse, hardships that resulted from the amputation.
Ramachandran theorizes that there is some sort of breakdown in the brain’s body map or, more specifically, the integration of the brain’s map of the body from its various sources in the brain. That integration duty probably takes place in the right parietal lobe and somehow the mapping integration gets altered or truncated, usually early in life. It’s an interesting hypothesis.
To the OP: Since there is no fix other than drastic medical procedures, I vote for getting out of the way and letting them have their procedures, assuming they are mentally and medically fit for those procedures.
You can find more than you can possibly stand about the “me” show in here:
What I think is that I’m perfectly ok with saying, in both cases, that what medical treatments other people take, with the approval and assistance of their doctors, is none of my damn business. Even expressing approval is overstepping my place in other people’s medical decisions.
Thank you, that not only answered all my questions and more, it’s also a really fascinating thread. That was extremely brave of you to do. And useful.
Um, would you mind if I paraphrase some of what you wrote elsewhere, without explicit attribution. (“I ran across this on another message board…”) I have been trying to explain to someone on another message board that transgender people and cross dressers are different, and I think you did a good job of that. I don’t want to be too explicit about the source for complicated reasons that I’d be willing to PM you, but I don’t want to go into here.
You can paraphrase to the extent you want.
I’m pretty much as out as out can be, so don’t worry about using my name.