NYTimes: A Vagina Won't Make Me Happy - But It's My Right to Get One Anyway

A bit dramatic, isn't he? Time was when people with those sorts of tendencies would have just sat down with friends for a game of Dungeons and Dragons...

When people start demanding that doctors just do whatever someone asks them to do I always find myself wondering if they actually understand what a doctor is.

they're not meant to be service providers who just give you what you ask for in the same way that say Starbucks does.

As long as we apply it to all surgeries then fine. I personally wouldn't be sad to see cosmetic surgery banned, on the basis that it's people demanding doctors do what the patient wants.

Are we talking about this person who regularly ‘mindkills’ theirself to ‘purge’ themselves of ‘impure thoughts?’

deepwatersolo

But often the choices given are based on what that dr is able to do, or what the hospital can do, or what the NHS will provide, not what is available elsewhere.

My dad had an aortic aneurysm that needed repairing electively. His surgeon told him that he needed an operation (big operation very high risk especially considering his cardiac history). I knew that AAA could be treated using a stent. We asked the surgeon about it and he said no it couldn't be done so I showed him the research and we asked to be referred to the hospital where it was done. So that wasn't a real choice was it?

When he developed cancer he was given the option of a large surgery or radiotherapy. Both had lots of risks. We asked about alternatives but they said there were none. Some research discovered cyberknife which he paid for and recovered with no side effects.

To my mind those drs were paternalistic. They made choices on a patient's behalf by limiting the options that they presented.

When people start demanding that doctors just do whatever someone asks them to do I always find myself wondering if they actually understand what a doctor is. I mean granted some of them are a bit shit, but in principle they're not meant to be service providers who just give you what you ask for in the same way that say Starbucks does. The idea of "non-binary surgery" does seem to be built on the Starbucks ordering model.

Melanippe

So do patients going to have cosmetic surgery privately in the UK under go counselling?

I worked at a large private hospital that did cosmetic surgery I never saw this happening. Is it the law?

I agree that there should be much more counselling available for any patient undergoing a surgery that isn't medically necessary but that doesn't happen in lots of areas.

Even for something as potentially traumatic as a TOP counselling is almost seen as a tick box exercise. Time and again I here stories where the counselling was just a quick chat, sometimes just over the phone.

You would hope that for any hugely life changing procedure the patient would be well supported and given every opportunity to investigate what it entails, alternatives, risks vs benefits.

I'm still of the opinion that if the patient together with their dr decides on a treatment then that is up to them.

AAK as long as you don’t expect a doctor to do it, I think that’s kewl!

Surely decent, moral doctors will just start eschewing all disciplines that leave them vulnerable to demanding activists like Chu, pushing the prices even higher in the private sector and the wait times ever longer in socialised systems?

If I want a unicorn horn installed on my forehead then I'm entitled to one, damn it! For free, obvs.

I agree with Bowlofbabelfish.

And quite often, you actually can choose. My Dad (continental Europe) had severe heart problems, and they let him choose between Stents and Triple Bypass (and no intervntion, obviously), with all positives and negatives layed out.

Doesn't mean, he could have chosen it, if the condition had not called for it according to data (just to be sure), or that he could have opted for a Double Bypass and a Stent or whatever. You will often have options in medicine, where it very much depends on a patient's priorities, what is the right way to go.

(My Dad loves sports, so he went for the way more invasive, riskier 3x-bypass with longer recovery times, knowing that this was the only option that he could get back to quasi old form. People with different priorities will make a different choice. Obviously, in a money strapped system, these types of choices get taken away).

This thread is about something entirely demented and of no relevance whatsoever to most people’s humdrum lives except that the activists have to bother us with it.

The lizard man’s mods aren’t done by a doctor, silly!

What should happen is research and data collection creates an evidence based standard of care. That’s the standard doctors adhere to. Within that framework the patient has bodily autonomy - mainly to deny a procedure.

And SRS is an accepted procedure so what is the objection?

C-section: if you do nothing, a vaginal birth will happen, with all kinds of potential risks for woman and child, including the risk of traumatization
And if the risks of a C section greatly out way the risks of a vaginal birth? Does the woman still have the right to demand it?

Make it all ‘informed consent’ and ‘on demand’ and there will be a bunch more of that ‘non binary surgery’ posted on reddit a while back.

But is that any better, or worse, than some of the other more extreme cosmetic surgery?

There's a man who has had surgery to look like a lizard, and had his tongue split, someone else who looks like a tiger or something, others have horns implanted under the skin, the woman who has turned herself into Barbie...

If they can all do that then why should other choices not be allowed?

As long as the patient is fully informed about the surgery, including limitations and risks, then I have no problem. I personally think that SRS probably shouldn't be available on the NHS given how much is already not available, but I have no problem with patients being offered the surgery, in line with what else is available.

This is a free country and we allow people to make their own choices, even if it isn't something we would choose for ourselves.

(I typed this before the goalposts moved yet again, so the thread has moved on, but still)

No feminist would suggest that plastic surgery on demand was a good thing. It plays into patriarchal nonsense about women's worth being tied up with their fuckability quotient, and that being tied up with youth and big tits. Any ethical plastic surgeon would refer anyone coming to them for outlandish purely cosmetic treatments to a psychologist who would explore the whys with the client, and help them to move to a place of bodily acceptance if possible. Although, given how much private cosmetic surgery is done on the cheap on the continent or in India, the point is fairly moot. Especially now when the NHS has removed a tranche of plastic surgery from the list of approved procedures, even procedures such as breast reduction which have research and clinical rationales to them, but that's a different discussion.

The point is, that under the present regulations, psychologists and therapists are not allowed to explore "comfortable in my own skin" options with 'gender questioning' patients. The only avenue available is affirmation of feelings. It's the only issue I can think of offhand where only a single avenue of exploration is available to professional therapists (there may be others). At the moment, the post surgical transition suicide rate spikes at 10 years post operative, and those figures are from a time when psychologists could explore bodily acceptance models, I dread to think how high those figures will rise now they can't. Especially as the average age for surgical transition must be by necessity getting lower.

Either we accept paternalistic " dr knows best" treatment (as described by the gate keeping dr above) or you allow patients autonomy over their own bodies.

Neither of those as extremes are good, or what actually happens.

What should happen is research and data collection creates an evidence based standard of care. That’s the standard doctors adhere to. Within that framework the patient has bodily autonomy - mainly to deny a procedure. Autonomy doesn’t mean ‘do everything I want’ it means having fully informed choice over whether to deny a procedure or where alternatives are available within the standard of care, to choose which is best for you. The latter case for example applies to birth choices.

This is not a choice between a surgical free for all and paternalism

Make it all ‘informed consent’ and ‘on demand’ and there will be a bunch more of that ‘non binary surgery’ posted on reddit a while back.

Any doctor that will happily give a person a second set of faux genitalia beside their actual genitalia needs a serious ethics review, as far as I’m concerned.

In a U.K. context, the days of getting a boob job due to to being unhappy with your small boobs are long gone -trusts don’t pay for stuff like that anymore. Most people take out credit to get private surgery. I think it’s largely revolting myself - but at least a nose job does what it advertises (makes a big nose smaller) where gender reassignment surgery doesn’t make an actual vagina or an actual penis. No wonder so many are still unhappy after surgery.

I don't see a material difference and a C section isn't plastic surgery.

Plastic surgery: if you do nothing, nothing will happen.

C-section: if you do nothing, a vaginal birth will happen, with all kinds of potential risks for woman and child, including the risk of traumatization.

(Yes, a C-section has all kinds of potential risks, too. But it is easier and less traumatic to live with the consequences of one's own choices than with the consequences of something foisted upon you agianst your will and better judgement).

A science driven treatment is obviously adviced, which weighs patients autonomy and their mental health and ability to understand options, risks and consequences.

Exactly.

deepwatersolo

I think a lot of decisions taken within the NHS are dressed up as ethics but are actually financial.

Drs hiding behind the ethics argument, when actually the decision is driven by money is unethical in my view. A dr has no right to mislead a patient.

Either we accept paternalistic " dr knows best" treatment (as described by the gate keeping dr above) or you allow patients autonomy over their own bodies.

A science driven treatment is obviously adviced, which weighs patients autonomy and their mental health and ability to understand options, risks and consequences.

Arf arf!

There is a difference between a replacement knee surgery and plastic surgery

I don't see a material difference and a C section isn't plastic surgery.

I just find it odd how different criteria is being applied depending on whether it's something that you agree with or not. So procedures or conditions that you or PPs agree with or may need yourself are fine. But SRS, because you don't agree with it, not fine?

What is your criteria for surgery on demand?

Honestly, I had better "debates" with my nephew when he was 4.

Well, Weetabix, if you suffer impairment and pain from your knee, which could be alleviated by a knee implant, I am sure the objections of the NHS are not ethics but money. I will happily campaign against austerity and for well funded health care systems, wherever such circumstances arise.

There is a difference between a replacement knee surgery and plastic surgery