kung fu lola, I’m a medical student (eventually I’d like to go into OB/GYN), it amazes me that anyone could refuse to treat a patient because you disapprove of their situation (it’s hardly a lifestyle choice). It’s not like the poor man had a say in whether he got cancer or not.
Some people are…this isn’t the pit…not nice.
First, for many transsexuals, far more important than any surgery is hormone therapy. The current theory is that there are male brains and female brains and male brains operate better in a body with male hormonal levels and female brains operate best in a body with normal female hormone levels.
Now, having been pregnant, I can testify from first hand experience that hormone levels do affect ones ability to think and cope. The hardest part of being pregnant was a feeling of not being myself mentally. It was usually subtle, but sometime not so much. I had trouble reading books. I love to read, but it was just nearly impossible to read a novel. I had trouble concentrating. When I could concentrate, I felt oddly off and reading just emphasized to me that something was wrong in a way I could not readily define. I cried a lot and felt miserable and depressed. The moment I gave birth, it felt like it was me doing the thinking again. I felt more comfortable in my skin, I felt more at peace with myself and saner than I had in months.
KellyM started hormones not long before we met in person. She said that her experience starting hormones was like how I described giving birth. She felt better and more at peace with herself than she has since puberty. Before any physical changes had manifested, she felt much better mentally. She was better able to cope with stresses. She was less prone to depression. Depression and suicide are commonly seen in untreated transsexuals. Hormones therapy seems to be a good treatment for depression due to transsexualism while other more commonly used drugs fail. But taking hormones has certain physical effects as well. For KellyM her breasts and nipples enlarged. She grew a thin layer of fat all over her body. Her skin softened. Her waist narrowed and her bottom changed shape. Her hair stopped falling out and started growing back. Apart from the fact that she did not want to, all the changes would makes it very hard to pass as a normal man. She still had a heavy beard and a bit of hair here and there that is not normal for a woman as well as having some dangly bits. She must deal with one set or the other of inappropriate physical manifestations of sex. She wants to be a woman so for her the choice is obvious. She and I have worked to get rid of unwanted hair. All that is left is SRS. She wants SRS. Now from a practical standpoint if she continues hormone therapy without surgery, she becomes more and more likely to have cancer of the testes. Amputation of non-essential organs that are at high risk to develop cancer is not all that radical nowadays. After years of hormone therapy, there are extensive changes to the genitals. SRS after years of hormone therapy replaces a set of genitals that conflict with other outward sexual characteristics and no longer functions to the same extent that it did with a set of genitals that better match outward characteristics and will hopefully function for most purposes. Not quite the same as chopping healthy organs off willy nilly (pardon the pun).
Mostly for my own thought clarification…
Amputation and castration is the removal of a body part, whether functional or not.
SRS is the reshaping of body parts. An important conceptual difference.
In MtF SRS, the penis is not simply hacked off - large portions of it and the testicales are used to construct a vagina and external sexual organs resembling as closely as possible in both form and function the genitals of a XX natal female. Likewise, in MtF there are techniques that do not simply lop off the breasts but seek to retain nipple sensation, nor is the hormonally enlarged clitoris hacked away but can, at least potentially, be incorporated into a constructed phallus. Again, not a simply cutting away but a re-fashioning.
Now, the success of SRS is a slightly different issue - and there are isssues. But the conceptual basis of amputation vs. SRS are completely different. THAT’s why I can object to amputee wannabes and self-castrators as being symptoms of severe pathological dysfunction but still be open-minded about SRS. It’s the difference between butchery and open-heart surgery. Both are bloody, but one harms and the other can at least potentially heal.
I wish my internet connection had not gone caput yesterday! 
The difference is that transsexuals identify as a type of person which comprises roughly 50% of the population. Apotemnophiles (=wants amputations) have a strong sensual desire to be missing a limb that the vast majority of the population has. An M2F who wants to get rid of her penis and testicles wants that because they are of less use to her than a vagina and clitoris would be. I’ll touch on this some more later in my post.
I do not know if any apotemnophiles want to be pitied, but I do know that is not always the case. It can be a matter of wanting so strongly to have the experience of feeling a stump and phantom limb rather than a whole intact one.
I also grew up taught that the only difference between men and women was in the genes and between the legs. But that is just not so. One of the differences is the way they experience arousal. Essentially, men have the drive to mount and thrust, whereas women have the desire to be caressed and penetrated. It’s a very different set of responses, and believe you me, trying to satisfy the feminine sexual drive with male genitalia blocking the way is very difficult. 
That is what I mean when I say a vagina etc is more useful to an M2F transsexual than a penis is.
I am also going to pretty much echo what Lazz said and point out that it’s the same in reverse. I have often thought, how in the world did I come about having a penis? By what logic am I (how to put this) the type of person who would/should/could have one? I see all these people who have vaginas, why don’t I get to have one too? I don’t like to see any trace of masculinity in that person in the mirror; I strain to keep my speaking voice much higher and of less mannish timbre than a bass is designed to talk, and the shape and hairiness of my body just strikes me as not in agreement with my self image.
On preview: it’s actually the scrotum that is used to shape the vagina, not the testes. I’m sure that’s what you meant but just wanted to clarify.
I fully respect the rights of gays + trans people. I have close relatives that are gay, and I have no problem with that. Of course whether or not I have a problem with that has no bearing to what I feel is the root cause of homosexuality/transexuality.
In my mind homosexuality and transexuality are almost invariably mental disorders/illnesses. Now whether they are caused by environmental or genetic factors is irrelevant, it doesn’t change what they are, mental illnesses.
Before you all bring up the load of irrelevant crap like “homosexuality/transexuality occur in nature all the time!” well guess what, lots of things occur in nature all the time. Cats can be born with 6 legs, a human baby can be born paralyzed from the waist down. Just because that is the way they are born it doesn’t mean it is good, or preferable. Having 6 legs or 3 legs (for a cat) an undersized heart/paralysis all represent problems for those individual creatures born with the deformity.
We should try to correct the deformity if it harms that creature’s life (well, at least if we are talking about humans or maybe pets if the owners are willing to go through the expense.)
Homosexuality as a mental illness in my opinion doesn’t cause any material harm to the persons involved, and it also doesn’t really pose a threat to society (even procreation isn’t really an argument because our species could and would continue even if all of us woke up with a serious case of the gay, lots of gay people want children and children can easily be made without the traditional male-female social relationship.)
If anyone really has a beef with my views re homosexuals they go more in depth and we’ll discuss them if anyone wishes, but right now they are just tangenital and waste space.
Now transexuality as a mental illness does cause harm to the person involved. It causes extreme mental anguish, identity problems et cetera. And these problems cannot be solved via non-medical means for many people. If you’re homosexual you’ll feel repressed and psychologically unhappy if you never allow yourself to pursue relationships with men. So to fix this you can easily just start dating guys. There are social problems involved but medically a fix for homosexuality isn’t needed (enough to devote research hours to it.)
For transexuals it’s very difficult to resolve their problem because they are always going to have the wrong tools. For some dressing up may be enough, and for them their transexuality isn’t that big of a problem. Although it is very difficult to attract men as a transexual I would think. Aside from fringe heterosexuals most aren’t interested in men dressed as women nor would most gays I know be attracted to a man dressed as a woman, they’re attracted to more mainstream males.
So anyways, faux-gender changing surgery (faux because just because the tools have changed imo the DNA is the same so no amount of cutting will change your gender) is the suggested correction? That’s ridiculous.
There are people with a mental illness (name forgotten atm) who constantly believe they have many different afflictions. Deep down inside they WANT these afflictions, they want to be thought of as sickly, they want to stay in hospitals and be taken care of et cetera. Do you think that because these people have diseased minds we should then actually disease their bodies so their disease is then happily consistent both physically and mentally?
Should we strive to actually tell people suffering from psychosis that all the things they “think” are real actually are real? Because obviously if they “feel” that way, we should try to make it so things really match the way they feel.
The focus of medical science for people with the transexual mental illness should definitely be a cure for the mind, not a cure for the body (because the body isn’t ill in any way, aside from the gray matter in the skull.)
If a transexual really wants to effect the surgical change on themselves, this is America (at least here in VA it is) and they should have the right to do so. I think it is medically a bad treatment, I think it should be frowned upon heavily by doctors and friends, and I think everyone involved should counsel these people against it. It’s again, like trying to accept someone who is psychotic and tell them that their delusions are okay and they should entertain them as much as possible.
Then what exactly makes it an illness if it causes no harm?
I feel I should warn you here: calling transsexuality a mental illness here is asking for trouble. There is evidence that male and female brains are structurally different, and when you have a female brain in a male body (or vice versa) transsexualism results.
Not all trans women are straight, so for some of us, attracting men is not the focus. It is more about being who we are. For those who are straight, replace “fringe” with “open minded”. Gay men are not our ideal mates, because they want male partners - that is a role we do not fulfill very well.
Gender is not the same as genetic sex. Surgery to change a person’s physical sex is also not quite the same as changing gender. If a person’s brain is female, and their body is not, it makes sense that the person should be able to exist socially (gender) and physically (sex) as a woman, regardless of their chromosomes.
I strenuously disagree with the characterization of homosexuality and transexuality as mental illnesses. And I think calling something that people consider simply a characteristic of themselves an “illness” is a surefire way to offend people, whether that’s your intent or not. How would you feel if someone said that being of your particular race is an illness? That’s how many gays will feel when you tell them their sexual orientation is an illness.
Martin Hyde, what is your definition of a mental illness, since causing harm clearly isn’t a part of it. Is it any characteristic that differs from the majority? Or that differs from you? If not that, then what?
In my book, it’s not a disease if it doesn’t hurt you. It’s a trait. And in some cases it’s not a disease even if it does hurt you. I mean, things like being left-handed or being unusually fair-skinned can be mildly disadvantageous, but they’re not illnesses, they’re just part of the natural variation of the species, a variety from which, on the whole, humanity benefits. But infliction of harm seems like the bare minimum for something to be called an “illness.”
I appreciate all of the above responses; however, I can’t accept the argument that because amputees are less common than either gender, that those people who feel as if their limb is not “self” are not entitled to treatment. Also, MTF SRS does involve complete removal of the testes, and FTM SRS involves removal of the breasts. There is therefore removal of a functioning body part which unfortunately has a function that is unwanted by the individual because it does not correlate with the intrinsic self-image.
On another note, I fail to see how any doctor could refuse to treat a patient with cancer. I have an ongoing discussion with one of my MTF patients about prostate cancer screening. She contends that since castration and hormone replacement therapy are part of the treatment for prostate cancer, that she has effectively already been treated. I still want her to be screened, just in case she has developed prostate cancer which is not responsive to hormonal treatment. It is a difficult discussion, since I dislike having to be the one to bring up the fact that she still has some male organs despite her successful surgery.
Statements such as this one indicate that you do not know what a mental illness is. Perhaps you should refrain from expressing opinions founded in total ignorance; it makes you look foolish.
Thankfully, doctors don’t listen all that much to the totally uninformed when they decide how to treat their patients; they look at the history of what works and what doesn’t. Your suggestions have been tried before, and they have been found to not work all that well. That’s why doctors don’t follow your recommendations: they simply don’t work, at least not as well as what they do do now.
So, unless you have better credentials than those shared by the members of the Harry Benjamin International Gender Dysphoria Association, I shall stand by their collective knowledge rather than your apparently totally uninformed opinion. Care to provide a reason, grounded in empirical fact, as to why reassignment is “medically a bad treatment”?
Perhaps the difference lies in male vs female being a value-neutral comparison (I’m assuming, here, that you do think it’s value-neutral :)), while fully limbed vs limbless not being so. So in the one case, you have someone wanting to transition from one body type to another, with the second body type not being inferior to the first, while in the other case you have someone wanting to transition from one body type to another, with the second body type being inferior to the first.
If someone wanted to trade an expensive piece of art for a new car of equivalent value (or vice versa) you might disagree with their values, but you wouldn’t think they were crazy. But if someone wanted to trade either piece of art or car for a roll of toilet paper, you probably would.
Make any sense?
I know. It’s horrible. I’ve seen Southern Comfort several times, and he died a long, slow, painful death far, far before he should have, leaving behind a woman he loved, a son, and a grandson, not to mention several friends. All because he had a uterus.
Martin Hyde- SRS is the most effective treaatment for Gender Dysphoria.
It gives these people a good quality of life, it works. Therefore it is not “medically bad”.
BTW no psychiatrist gives a damn if their patient is delusional, only if the delusions affect their functioning, health or emotional well-being. Plenty of people have delusions that aren’t treated, simply because these delusions have no impact on their everyday life. You have some seriously faulty ideas about what constitutes a mental illness and how mental illnesses are (or should be) treated.
Prostate cancer is completely unheard of in post-op MTFs. You are harassing your MTF clients if you persist in making an issue of this.
KellyM, I appreciate your knowledge, but you are wrong that prostate cancer is unheard of after FTM SRS. Unfortunately, some prostate cancers are sensitive to estrogens.
crap-make that MTF surgery.
KellyM, I really don’t think I’m qualified to discuss the mental issues around transexualism with you, but I do have to ask if you have some sort of cite for your statement about prostate cancer being “unheard of” in MtF transsexuals, mainly because being wrong on that issue could have tragic consequences.
If a FtM can have ovarian or uterine cancer, and people of both genders can have breast cancer, I have to wonder why a MtF would somehow be totally immune to prostate cancer. Less likely to have such a cancer, yes, but unless the prostate is removed I can’t see how the risk would drop to zero. Although hormones are a large component of most prostate cancers, it is not the only factor - which is why men who have had their testes removed and are given androgen blockers as part of treatment for prostate cancer can still die of agressive, metastatic prostate cancer.
As an aside, I’m kind of puzzled as to why, when reshaping the genitals and urinary tract, it wouldn’t be standard procedure to remove the prostate. I can’t imagine any use for one in a MtF, and removal would eliminate concerns about potential cancer. Particularly in those transitioning late in life whose prostates have been exposed to decades of male hormones.
But, as I said, I’m not an expert in these matters. It’s just, standing here on the outside, it doesn’t seem an unreasonable or outlandish concern.
I go in for my yearly mammogram and prostate exam (my “M&P”), just to be safe.
True story: about 20 years ago I had what I thought was a bladder infection. I went in for tests to a grandfatherly doctor who actually had a great deal of knowledge in this field. After some tests, he told me I had a prostate infection, and I started laughing. I looked up to see him shaking his finger at me and scolding, “A prostate infection is nothing to laugh at, young lady!”
Prostate removal can often lead in incontinence.