# Should taxpayers pay for gender realignment surgery for prisoners? **URL:** \ **Category:** Great Debates\ **Created:** [June 27, 2007, 10:59pm UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697 "2007-06-27T22:59:24Z")\ **Posts on this page:** 20\ **Page:** 6
**Author:** ![Algher](https://avatars.discourse-cdn.com/v4/letter/a/3d9bf3/32.png) [@Algher](https://boards.straightdope.com/u/Algher)\ **Post date:** [July 12, 2007, 2:56am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/101 "2007-07-12T02:56:29Z")
[QUOTE=Broomstick] OK, one more time. Organ transplants depend on tissue compatibility. That is a biological trait of the immune system. If the donor and and recipient have compatible immune systems a transplant can take place. If donor and recipient are incompatible attempting a transplant will rapidly result in death of the recipient. There are occassions where an organ is available _and no one on the waiting list is a match_. So the organ isn’t used. It’s not a matter of simply reassigning the organ to someone more “deserving” (however you define it). [/QUOTE] I get that. NOW, show me that they even looked to see if there was someone more deserving (no quotes needed by me) for that organ. Over 500 people in California alone were waiting for a heart. Are you claiming that NOT ONE OF THEM could have used that heart? A heart that went to waste as the con in question failed to follow the regimine necessary to keep the heart? ---
**Author:** ![Algher](https://avatars.discourse-cdn.com/v4/letter/a/3d9bf3/32.png) [@Algher](https://boards.straightdope.com/u/Algher)\ **Post date:** [July 12, 2007, 3:00am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/102 "2007-07-12T03:00:00Z")
[QUOTE=Qadgop the Mercotan] Most of my patients (inmates all) are clamoring for either opiates or benzodiazepines. Occasionally I find a few with a yen for thorazine, or butalbital, or cyclobenzaprine. A few are abusing clonidine or dextromethorphan. Ritalin is a favorite, as is dextroamphetamine. Very few seem to want anti-depressants in quite the same way as they want the above. Not even close. The modern anti-depressants are pretty far removed from happy pills. If one has a clinical depression, they may help abate it. If one isn’t depressed, they don’t tend to do very much in the way of making most folks feel better. [/QUOTE] Thanks for the clarification in the discussion - I was obviously a second hand source of anecdotal information and your input is appreciated. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [July 12, 2007, 3:01am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/103 "2007-07-12T03:01:17Z")
[QUOTE=Algher] I get that. NOW, show me that they even looked to see if there was someone more deserving (no quotes needed by me) for that organ. Over 500 people in California alone were waiting for a heart. Are you claiming that NOT ONE OF THEM could have used that heart? A heart that went to waste as the con in question failed to follow the regimine necessary to keep the heart? [/QUOTE] Actually, since you’re the one making the outrageous claim (“They’re giving heart transplants to prisoners instead of law-abiding people!”) I believe the onus is on you to demonstrate that there was someone else to whom they could have given that heart. ---
**Author:** ![Johanna](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johanna/32/8318_2.png) [@Johanna](https://boards.straightdope.com/u/Johanna)\ **Post date:** [July 12, 2007, 3:35am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/104 "2007-07-12T03:35:07Z")
[QUOTE=Una Persson] …I’m not endorsing it… > **[Sex changes are not effective, say researchers](https://www.theguardian.com/society/2004/jul/30/health.mentalhealth)** > > There is no conclusive evidence that sex change operations improve the lives of transsexuals, with many people remaining severely distressed and even suicidal after the operation, according to a medical review conducted exclusively for Guardian... [/QUOTE] Not endorsing it, you’re darn tootin. They even acknowledged themselves that the researchers used unreliable data. > [@](#): > > Its review warns that the results of many gender reassignment studies are unsound because researchers lost track of more than half of the participants. For example, in a five-year study of 727 post-operative transsexuals published last year, 495 people dropped out for unknown reasons. Dr Hyde said the high drop out rate could reflect high levels of dissatisfaction or even suicide among post-operative transsexuals. He called for the causes of their deaths to be tracked to provide more evidence. Where do they get off assuming that 495 people they couldn’t track might have killed themselves at a high rate? Instead of just not wanting to be tracked by clinics? How can anyone honestly draw any conclusions from a study so full of holes? How biased is this anyway? The _Guardian_, who initiated and sponsored this study, has at times been accused of a transphobic bias, in fact that article said they deliberately went looking for unhappy post-ops–isn’t that deciding on the conclusion first and then looking for evidence to fit it? But to be fair, they also published a piece [critiquing that study](http://www.pfc.org.uk/node/1249) they reported on, by Christine Burns, who made three surveys of post-op transsexuals, reporting overwhelmingly positive satisfaction. For example… > [@](#): > > Gender reassignment works very well when undertaken by someone who is really transsexual. In a follow-up survey earlier this year I asked 45 transpeople who had changed between 10 and 35 years ago how they felt now, looking back on the long term effects of that step. Finding them wasn’t hard. Transsexual people are closely networked these days around the world. I often wonder why other researchers offer lame excuses that it is difficult to do. > > All 45 respondents presented readily verifiable examples of extremely active and well-integrated lives - both at work and in their free time. I think the long-term nature of the survey was significant, since the University of Liège found that post-op dissatisfaction was short-term. Cite: A Michel, C Mormont, & JJ Legros \*European Journal of Endocrinology \* (2001) 145 365±376 > [@](#): > > Post-transformation > It is impossible to compel the transsexual to follow > long-term assessment (129). Indeed, a major obstacle > in conducting follow-up studies is that it is very difficult > to find transsexuals who have been operated on, and > even more difficult to find those who accept reassessment > (130±132). Therefore, those few who do > agree to participate in follow-up studies do not > constitute a representative sample of the population > of transsexuals who have been operated on. > > A temporary dissatisfaction can be observed immediately > after the sex change. Certain transsexuals and > themselves confronted with various difficulties (postoperation > pain, surgical complications, dissatisfaction > with surgical results, departure of the partner, loss of job, > familial conflicts, etc.) and experience a phase of > dissatisfaction that can lead to regret in some cases. > However, most often this dissatisfaction disappears during > the year following the surgical transformation where no > other intervention was deemed necessary (142). In the light of this, Burns’s research which successfully studied long-term results must be noted. ---
**Author:** ![Algher](https://avatars.discourse-cdn.com/v4/letter/a/3d9bf3/32.png) [@Algher](https://boards.straightdope.com/u/Algher)\ **Post date:** [July 12, 2007, 3:53am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/105 "2007-07-12T03:53:45Z")
[QUOTE=Miller] Actually, since you’re the one making the outrageous claim (“They’re giving heart transplants to prisoners instead of law-abiding people!”) I believe the onus is on you to demonstrate that there was someone else to whom they could have given that heart. [/QUOTE] How is my claim outrageous? Every link shows the controversy that ensued when a prisoner was gifted with a $200k surgery at Stanford, and heart. I showed where there was a long list of people waiting for a heart. I simply claim that in my opinion there are more deserving recipients of the heart. I was challenged with the claim that perhaps there was not another recipient who could use that particular heart. I challenge that claim and ask for proof. The onus is not on me - the onus is on the prior poster to prove that the only possible recipient of that heart was the con in question. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [July 12, 2007, 4:40am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/106 "2007-07-12T04:40:36Z")
[QUOTE=Algher] How is my claim outrageous? Every link shows the controversy that ensued when a prisoner was gifted with a $200k surgery at Stanford, and heart. [/quote] What do you mean, how is it outrageous? You’re the one who’s outraged over it, not me. > [@](#): > > I showed where there was a long list of people waiting for a heart. > > I simply claim that in my opinion there are more deserving recipients of the heart. > > I was challenged with the claim that perhaps there was not another recipient who could use that particular heart. I challenge that claim and ask for proof. You got it all right up until the very end. If you want to challenge the explanation that there was no other match on the list, you need to show where there _was_ a match, or that tissue matching is not an issue in organ transplants. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [July 12, 2007, 10:04am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/107 "2007-07-12T10:04:48Z")
[QUOTE=Algher] I get that. NOW, show me that they even looked to see if there was someone more deserving (no quotes needed by me) for that organ. Over 500 people in California alone were waiting for a heart. Are you claiming that NOT ONE OF THEM could have used that heart? A heart that went to waste as the con in question failed to follow the regimine necessary to keep the heart? [/QUOTE] Given confidentiality laws, there is no way you or I could ever make that determination. But yes, it is quite possible that he was the only person who could use that heart, particularly if the convict in question was a racial minority or of mixed racial ancestory. You’re _assuming_ that someone else could have used that heart. I am not. It’s that simple. ---
**Author:** ![Malacandra](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Malacandra](https://boards.straightdope.com/u/Malacandra)\ **Post date:** [July 12, 2007, 10:17am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/108 "2007-07-12T10:17:56Z")
[QUOTE=Johanna] How biased is this anyway? The _Guardian_, who initiated and sponsored this study, has at times been accused of a transphobic bias, [/QUOTE] [chiming in from the bleachers]By whom? Given its reputation as a left-leaning-intellectual newspaper, the _Guardian_ would be viewed over here as the paper most likely to be trans_philic_, by a furlong.[/ciftb] ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [July 12, 2007, 1:50pm UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/109 "2007-07-12T13:50:38Z")
[QUOTE=Algher] I simply claim that in my opinion there are more deserving recipients of the heart. [/QUOTE] Maybe so. But courts have ruled that being in jail or prison alone cannot be used to take someone off the transplant list, nor change their place on the list. So if you want things done differently that that, you’ll have to lobby your legislatures to change the law and possibly amend the constitution. That “cruel and unusual” clause has been interpreted as guaranteeing access to the same standard of medically necessary care available to an unincarcerated person (with really really really good insurance, or significant wealth). I personally have excluded some inmates from being sent out for transplantation evaluation. But that was based on medical, not inmate, criteria. I’ve also approved more than a few for kidney transplant, because medically they met the criteria. ---
**Author:** ![Algher](https://avatars.discourse-cdn.com/v4/letter/a/3d9bf3/32.png) [@Algher](https://boards.straightdope.com/u/Algher)\ **Post date:** [July 12, 2007, 3:37pm UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/110 "2007-07-12T15:37:02Z")
[QUOTE=Qadgop the Mercotan] Maybe so. But courts have ruled that being in jail or prison alone cannot be used to take someone off the transplant list, nor change their place on the list. So if you want things done differently that that, you’ll have to lobby your legislatures to change the law and possibly amend the constitution. That “cruel and unusual” clause has been interpreted as guaranteeing access to the same standard of medically necessary care available to an unincarcerated person (with really really really good insurance, or significant wealth). I personally have excluded some inmates from being sent out for transplantation evaluation. But that was based on medical, not inmate, criteria. I’ve also approved more than a few for kidney transplant, because medically they met the criteria. [/QUOTE] I am aware that the issue has already been decided in the courts, and to change it could be rather difficult and would no doubt head back to the Supreme Court. I still personally believe that if someone is incarcerated, their place on the waiting list should be adjusted. This ties is with the initial thread topic regarding elective surgery (or possible elective, depending on which side of the debate you fall on) for cons. I also believe that the entire organ donation system is flawed - but that is another thread. ---
**Author:** ![Algher](https://avatars.discourse-cdn.com/v4/letter/a/3d9bf3/32.png) [@Algher](https://boards.straightdope.com/u/Algher)\ **Post date:** [July 12, 2007, 3:41pm UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/111 "2007-07-12T15:41:06Z")
[QUOTE=Broomstick] Given confidentiality laws, there is no way you or I could ever make that determination. But yes, it is quite possible that he was the only person who could use that heart, particularly if the convict in question was a racial minority or of mixed racial ancestory. You’re _assuming_ that someone else could have used that heart. I am not. It’s that simple. [/QUOTE] Thanks - i agree - we are BOTH making assumptions. Given, (as another poster said), that we can not see the list as it existed at the time, we must make educated guesses or assumptions regarding another potential recipient. Not ONE article that I have read on the subject quoted someone saying that this prisoner was the ONLY candidate for the heart. What they all stated was that the courts have ruled that convicts do not lose their place on the waiting list. If he was the only viable candidate, that would have been brought to light. ---
**Author:** ![Johanna](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johanna/32/8318_2.png) [@Johanna](https://boards.straightdope.com/u/Johanna)\ **Post date:** [July 13, 2007, 3:49am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/112 "2007-07-13T03:49:18Z")
[QUOTE=Malacandra] [chiming in from the bleachers]By whom? Given its reputation as a left-leaning-intellectual newspaper, the _Guardian_ would be viewed over here as the paper most likely to be trans_philic_, by a furlong.[/ciftb] [/QUOTE] By my one of my British trans friends. I’m not a regular _Guardian_ reader able to judge this question for myself, just been reading it online once in a while for news about foreign affairs and stuff, so hopefully my post made it clear I’m relating that second hand. Can you point to anything particularly transphilic about it? ---
**Author:** ![Johanna](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johanna/32/8318_2.png) [@Johanna](https://boards.straightdope.com/u/Johanna)\ **Post date:** [July 13, 2007, 3:52am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/113 "2007-07-13T03:52:04Z")
[QUOTE=Qadgop the Mercotan] That “cruel and unusual” clause has been interpreted as guaranteeing access to the same standard of medically necessary care available to an unincarcerated person (with really really really good insurance, or significant wealth). [/QUOTE] Yeah, and this is where I keep company with most others on this thread, the discrepancy puzzles and troubles me. If the USA had universal healthcare coverage, it would not be an issue for me at all. ---
**Author:** ![mswas](https://avatars.discourse-cdn.com/v4/letter/m/e99b99/32.png) [@mswas](https://boards.straightdope.com/u/mswas)\ **Post date:** [July 13, 2007, 5:29pm UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/114 "2007-07-13T17:29:15Z")
[QUOTE=Johanna] Yeah, and this is where I keep company with most others on this thread, the discrepancy puzzles and troubles me. If the USA had universal healthcare coverage, it would not be an issue for me at all. [/QUOTE] Does Universal Health Coverage in other countries cover sex change operations? ---
**Author:** ![Johanna](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johanna/32/8318_2.png) [@Johanna](https://boards.straightdope.com/u/Johanna)\ **Post date:** [July 14, 2007, 5:52am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/115 "2007-07-14T05:52:32Z")
[QUOTE=mswas] Does Universal Health Coverage in other countries cover sex change operations? [/QUOTE] Canada, Great Britain, Netherlands, Switzerland, and to some extent Brazil, Germany, Iran, Spain, Russia, are ones I know of with publicly funded SRS, soon to be joined by Cuba. There are probably other countries in Europe that I don’t know of specifically. As for the USA, I read that the state of Washington had SRS covered by Medicaid, but only last year moved to end that. ---
**Author:** ![Sunrazor](https://avatars.discourse-cdn.com/v4/letter/s/2acd7d/32.png) [@Sunrazor](https://boards.straightdope.com/u/Sunrazor)\ **Post date:** [July 14, 2007, 6:06am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/116 "2007-07-14T06:06:55Z")
[QUOTE=Miller] How does treating transexuals not fall under one of the first two items on your list? [/QUOTE] I’m talking about basic health care – y’know, fighting infections, suturing stab wounds, curing canter, saving lives – not elective surgery. I cannot imagine that more than two or three percent of Americans see sex change surgery as any different from face lifts, tummy tucks and boob jobs. > [@](#): > > Also, why the scare quotes around gender realignment surgery? Didn’t mean for it to be scary. I refrained from expressing exactly how I feel about the phrase “gender alignment,” but since you’ve pressed the issue: “Yeah, doc, can you take my blood pressure, check my respiration – oh, and I probably need a gender realignment – it hasn’t been quite right lately.” Please, the person is changing from one sex to the other. it’s a sex change operation. ---
**Author:** ![Sunrazor](https://avatars.discourse-cdn.com/v4/letter/s/2acd7d/32.png) [@Sunrazor](https://boards.straightdope.com/u/Sunrazor)\ **Post date:** [July 14, 2007, 6:08am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/117 "2007-07-14T06:08:52Z")
[QUOTE=Miller] How does treating transexuals not fall under one of the first two items on your list? [/QUOTE] I’m talking about basic health care – y’know, fighting infections, suturing stab wounds, curing cancer, saving lives – not elective surgery. > [@](#): > > Also, why the scare quotes around gender realignment surgery? Didn’t mean for it to be scary. I refrained from expressing exactly how I feel about the phrase “gender alignment,” but since you’ve pressed the issue: “Yeah, doc, can you take my blood pressure, check my respiration – oh, and I probably need a gender realignment – it hasn’t been quite right lately.” Please, the person is changing from one sex to the other. it’s a sex change operation. ---
**Author:** ![Malacandra](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Malacandra](https://boards.straightdope.com/u/Malacandra)\ **Post date:** [July 14, 2007, 7:13am UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/118 "2007-07-14T07:13:59Z")
[QUOTE=Johanna] By my one of my British trans friends. I’m not a regular _Guardian_ reader able to judge this question for myself, just been reading it online once in a while for news about foreign affairs and stuff, so hopefully my post made it clear I’m relating that second hand. Can you point to anything particularly transphilic about it? [/QUOTE] No, but while I’m not generally a Guardian reader myself, I’ve read it enough times to be familiar with its general stance, and if you’ll forgive the ugly shorthand, non-traditional sexuality issues are way more likely to be given friendly treatment in the Guardian than in any other English paper. I don’t say you’re wrong, I say I’m surprised. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [July 14, 2007, 5:49pm UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/119 "2007-07-14T17:49:58Z")
[QUOTE=Sunrazor] I’m talking about basic health care – y’know, fighting infections, suturing stab wounds, curing canter, saving lives – not elective surgery. [/quote] Okay, that’s your first item. Your second item was psychological care. It’s been pretty well attested to that transexuality produces significant strain on the psyche of people suffering from it, so they should be covered by your, “Everybody gets free psychological care,” dictum, right? So what do you do, in your utopian national health service, when people suffering from transexuality go to doctors, and those doctors recommend gender reassignment surgery as the best way to treat the condition? > [@](#): > > I cannot imagine that more than two or three percent of Americans see sex change surgery as any different from face lifts, tummy tucks and boob jobs. Well, thank God we don’t settle medical issues by popular vote in this country. I mean, the number of Americans who think people suffering from clinical depression should just, “snap out of it” is also pretty high. Would this be a basis for refusing the administration of Prozac on the state’s dime, under your ideal system? > [@](#): > > Didn’t mean for it to be scary. I refrained from expressing exactly how I feel about the phrase “gender alignment,” but since you’ve pressed the issue: > “Yeah, doc, can you take my blood pressure, check my respiration – oh, and I probably need a gender realignment – it hasn’t been quite right lately.” Please, the person is changing from one sex to the other. it’s a sex change operation. If it makes you feel any better, I believe the use of “gender realignment” in the OP was a typo. The more common term is, “gender _reassignment_.” Any objections to that phrase? ---
**Author:** ![Sunrazor](https://avatars.discourse-cdn.com/v4/letter/s/2acd7d/32.png) [@Sunrazor](https://boards.straightdope.com/u/Sunrazor)\ **Post date:** [July 14, 2007, 8:47pm UTC](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697/120 "2007-07-14T20:47:18Z")
[QUOTE=Miller] Okay, that’s your first item. Your second item was psychological care. [/QUOTE] Whoa, hoss, the word “psychological” was nowhere in my post. If you mean psychiatric care – treating the biochemical imbalances that cause psychosis, and counseling therapy to treat victims of psychological trauma (abuse, attack, etc.) then fine. But surgery to make someone feel better? That’s elective and it shouldn’t be paid for with tax dollars. By the way, apologies to all for the double post – apparently servers got bogged down and I was trying to edit and I fumbled it. I did not mean for my first post, containing the assumption about the overwhelming opinion of Americans, to actually be posted. However, since it has now entered the thread and appears to be staying in, I will respond to Miller’s other contention about medical care being decided by popular vote. What we spend tax dollars on WILL be decided by some kind of vote, and the will of the vast majority of Americans probably is not that tax dollars be spent on sex change operations or any other elective surgery. [Previous page](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697.md?page=5) [Next page](https://boards.straightdope.com/t/should-taxpayers-pay-for-gender-realignment-surgery-for-prisoners/409697.md?page=7)