Ethics of gender reassignment surgery

It’s different surgeons for breasts versus genitalia. You’d never go under the knife for both at once anyway because it’s too long to be under.

I think you have a point about stove piping, different psych doctors, different surgeons there is no joined up approach for each transgender person and every medic is assuming that all checks and assessments have been done.

does them both! Not born.

Yes there is a difference, but the surgeon who does them born doesn’t get more money or power for one over the other. So I don’t think that money and power is really a motivation for surgeons who do any gender affirming surgeries in countries with universal health care.

There is no extra power or money doing breast implants on a woman who has had a mastectomy for breast cancer vs a transwoman wanting fake breasts. At least not anywhere that has universal healthcare, which is most countries.

IMO medics commiting these atrocities are not doing so in the patient best interest but do so because of power and money. If they did it for the patients best interest they would be evidence led.

This is true, but castration and FGM existed millennia before antibiotics so those minor surgeries were occurring, and in some cultures were not unusual.

I have wondered about the commonality between eating disorders and self-harm. Over/under eating and bulimia do harm you, can even be life threatening. As can other forms of self harm from physically hurting yourself, to recklessly endangering yourself to neglecting yourself to over-exercising.

Self-harm is often interpreted as a cry for help. An outward demonstration of psychological agony/pain using whatever means is within that persons control.

There are other psychological reasons why people have disordered eating or self-harm, but I think the cry for help, the wanting to be seen as unwell and in need of help may be a commonality in some cases.

Gender stereotypes existed 100 years ago. I'm sure people felt constrained by them in some way.

Dressing in a different way, probably did happen.

But crucially surgery just wasn't even on people's radar for anything, even if necessary to health. Before antibiotics removing part of your body was extremely risky. It only started to be widely available during WWII for surgery which I find quite remarkable. And anesthetics were really primative and also dangerous until the 20th Century.

A hundred years ago, you could die from a simple cut on your finger.

We do take for granted that we can perform surgery and expect to live. Scarily, that might cease to be the case during the course of the next century too.

So asking what people would do about surgery 100 years ago, is a bit like asking them whether they'd consider flying to the USA next week.

There was an interesting article on woman's hour today, talking about anorexia. Hadley Freeman talked about girls wanting to be seen as ill. They needed the attention and care that would come from being seen as being as desperate as they felt.
I wonder whether some of the medical steps have the same effect, demonstrating outwardly the distress and confusion that's felt.

There were surgeries attempted 100yrs ago. Even some Roman emperor wanted to be changed into a woman. He changed his name to a woman’s name. He dressed as one. Had a lover who he made address as his “wife.” (Some charioteer who were the sports celebrities of the day, think a Beckham boyfriend). He offered a big reward to any surgeon or magician who could turn him into a woman. There wasn’t much time for any attempts as I believe this Roman emperor was stabbed to death by assassins at a very young age…I want to say early twenties?

When Mermaids started up, their assumption was that most kids with gender issues would grow out of them, turn out to be LGB etc. And in those days, far more of them did.

I can’t help but think that if these surgeries and hormones etc. weren’t available that there would be a lot less people with ‘gender dysphoria’.

What did people do 100 years ago?

It is a difficult thing to discuss. However, injected contraception or other contraception in girls are not without side-effects either. They can be quite severe.

Young people with severe autism can be very interested in sexual activity, and like the boy in this article, may have no sense of boundaries either for themselves or for the other bodies in their vicinity.

The alternative is to place them in self-contained units with 24/7 care, which is also a high risk situation.

I can’t help but think that if these surgeries and hormones etc. weren’t available that there would be a lot less people with ‘gender dysphoria’. They’d probably have some other kind of dysphoria or their unhappiness would find another way of manifesting, but it is mainly because they see other people doing this and they know it can be done (to some extent) that they that it becomes such an all encompassing desire.

If it’s not possible, then you won’t give it much thought. If it appears possible, if only you had more money or the world would just bend to your will, then it becomes a goal just out of your reach, and so becomes an obsession.

The human spirit is quite an amazing thing. You give it hope and it will strive. The diet and beauty industry use it against us all the time.

www.tandfonline.com/doi/full/10.1080/24750573.2018.1462038

It's a very sensitive and difficult area. It's noted that it's damages the bones and other factors.

Slight derail, but I would be interested in reading that paper @WarriorN

The provision for severely autistic young people in my area is mixed sex.
If my DD got pregnant that would be catastrophical, apart from everything else that would be catastrophical about such a scenario.

on topic: it is odd that the medical treatment and healthcare that are so necessary are in fact hugely damaging, but this do not seem to be communicated clearly at all.

I was blissfully unaware until a friends adult child wanted to transition and they talked about the difficult procedure.
Then another friend explsined how «neovaginas» are actually made and how they must be maintained and it was such an eyeopener.
When it comes to the skingrafting to fashion the skinroll they attach to transmen, it is horrible. It in no way approximates a penis.

It seems someone is very keen on selling a lie

Gender affirming surgery and hormones, ie transitioning is an ethical minefield and already the subject of thousands of pages of ethics debate.

The key difference between cosmetic surgery (which gender affirming surgery is), and genital mutilation (male or female) is willing and enthusiastic consent.

It’s the same difference between good sex and rape. So I would not minimise the importance of consent.

The ethical minefield is more about informed consent. Anything medical- cosmetic surgery, taking hormones the requirement isn’t just for consent but for informed consent and that is one area where I think the medical professionals currently fall short.

I just saw this from MrMenno and it made me think of this thread:

Giving hormones and performing this kind of surgery on children is abuse. There will be court cases in the future.

Where are all the trans children from earlier generations before this was a fashion?With the exception of a very tiny minority, most were just going through a phase.

Yes the NHS fund them.

Does the NHS ie WE pay for such surgeries?

Or are they privately funded like other cosmetic surgery?