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Original poster

Ethics of gender reassignment surgery

83 replies

mids2019 · 09/04/2023 07:34

I was thinking about the ethical implications of any form of gender reassignment surgery and I wonder if ultimately some surgeons bypass the ultimate stance of 'do no harm' that governs the medical profeesion.

we absolutely rightly stand against FGM (illegal) because it frantically reduces the ability to experience sexual pleasure (as well as introducing other health issues) but we legitimately consider doing surgery with similar implications with the only difference it is done on a voluntary basis? A surgeon who is about to dramatically and irreversibly damage someone's genitalia would want immense assurance that it is in the patient's best interest including evidence of psychological assessment but don't TRAs argue the assessment itself would be considered 'conversion therapy' and therefore not a part of the process?

There was a weird case in Europe where a gay man cut off another man's penis in an extreme and commercial fetish act but the person committing the act was still liable to prosecution. Is there such a massive moral divide between this situation and that of gender reassignment surgery?

We also have to consider that GR surgery unlike other surgeries impacts on the rights of others. By making a man superficially anatomically similar to a woman you are facilitating the invasion of safe spaces for women and making it notionally harder to prevent make access to women's sports. There is also the dilemma of sexual relationships and whether in reality any sexual partner is truly consenting to a GR partner when they assume they are of a biological sex.

As for puberty blocking drugs where are the large scale clinical trials and longitudinal studies to bring this practice into safe evidence based pracrice. Anyone involved in clinical trials know these things take years nd to my knowledge such normal development process has not been undertaken in the extremely interventional practice of altering body hormone concentrations?

I guess the upshot is whether medics in this field and their employers feel really sure footed legally and why would medics necessarily engage with this activity?

OP posts:
BlooDeBloop · 09/04/2023 10:28

Surgeons and endocrinologists that enable young people to self harm really ought to be struck off. I wonder if that day will ever come?

DojaPhat · 09/04/2023 10:03

I think this is the biggest issue for me. I'm not entirely convinced especially where puberty blockers and or other hormones are used that parents/caregivers or even the teen concerned understands the magnitude of what they're ostensibly opting in for. The irreversible damage is like no other. There's a good article about this in which it was said that aside from the physical changes or lack thereof these puberty blockers also affect the cognitive changes thus leaving the kids who take them in a sort of limbo state of not quite developed but still 'under-developed' in comparison to their peers.

Heartbreaking stuff all round. Apart from anything else aren't these surgeons also concerned about the inevitable legal cases later down the line when people start connecting the dots and realising their bodies are now in some essence completely dysfunctional.

Helleofabore · 09/04/2023 09:03

It is why these procedures have to be framed as ‘life saving’. And why so much focus is placed on the potential for suicide.

The reality is that both studies looking at whether there is improvement after these treatments and clinician feedback is that the mental health improvement may only be for a short time, if at all.

EmpressaurusOfCats · 09/04/2023 08:53

I strongly recommend Time to Think by Hannah Barnes for more information on what’s been done to kids.

Original poster
mids2019 · 09/04/2023 08:48

Also what are the long term.endocrinological impact.of having testes removed?

Remember also castration is as old as the hills and is an ancient punishment for many cultures......Is voluntary self harm still harm?

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Original poster
mids2019 · 09/04/2023 08:42

@BlooDeBloop

It is strange. I would very much hope medics act in the patient's best interest? It is insteresting the mention of cosmetic surgery because ultimately isn't gender reassignment. surgery just that, cosmetic; it does not allow you to change sex.

my concern would be with removing genetalia you severely compromise the ability to gain sexual pleasure again and I wonder how many patients really do understand that ramification? If a medic tells a patient 'I can remove your penis but you will never again derive sexual pleasure front that area' is that actually comprehended or does the gender dysphoric patient blank the information out of feel the advice is simply a barrier to their dream of becoming a woman? I wonder if some actually believe that a false vagina is an erogenous zone (similarly with nipples). I think there are some real psychological and ethical issues to address here.

OP posts:
BlooDeBloop · 09/04/2023 08:32

I've felt this about surgeons and endocrinologists for some time. They have a duty to do no harm. Is there a parallel with cosmetic surgery? We've all seen the programs/celebs with chronic body dysmorphia hooked on life long plastic surgery addiction. Who ethically works on these individuals? Perhaps ethics don't exist anymore.

Original poster
mids2019 · 09/04/2023 07:35

Consensual not commercial

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