Should cometic surgery to 'affirm' someones gender be banned?

Arabella Scott posted on the last page, about the mental state of the people requesting extreme surgery on healthy bodies. Wanting healthy limbs amputated is one example.

Doubtless anorexic patients would love to be prescribed weight loss drugs, and if possible to have 'fat-reducing' surgery.

It would be obvious that any surgeon or mental health practitioner, or teacher, or anyone else, should not be encouraging these distressed people to continue in their deluded fantasies. Above all, those making money out of them ought to be removed from professional registers.

It appears that men are capable of creating a s fetish out of absolutely anything, so why would autogynophilia be singled out for approval under law, over-riding the safety of women and children, and for public-purse funding?

(Actually, on the creeping mould of approval of s fetishes, others among the most popular are also being sanctioned by 'bewildered' officials, e.g. apparently in some prisons, (Irish??) the men who get s excitement by dressing up in giant nappies, pretending to be babies, are allowed to have guards hold their hands as they walk from the cells, and to have their food pureed and spoon fed to them by guards. They also require two guards with them in their cells, round the clock. Keeping people in prison, with no extra attention at all, costs the public purse a thousand pounds a week. There is a dire shortage of staff. )

If you're an adult I don't care. You do you.

But not on the NHS's dime. Unless it's reconstructive after say, cancer. Other than that you need to fund it yourself. Some of those operations should be over 21 though. Especially phalloplasty.

That is because you didn't clarify in your OP whether you were asking if it should be banned just on the NHS, or banned completely. Your poll is therefore meaningless.
The comments on this thread have been insightful though.

I agree with all this, but woud add two points covered on the previous thread.

One is that the NHS can end up stepping in when private surgeries go wrong, either as an emergency during the surgery or down the line when, the private surgeon washes their hands of any complications. I'm not saying that is right or wrong, but 'the NHS should not fund this' is not possible in an absolute sense.
PP on the other thread suggested compulsory insurance to go along with any UK cosmetic procedure that is not available on the NHS.

Secondly, there is still an issue with people travelling abroad for treatment. Harder to get them to take out insurance for potential future NHS treatment related to their surgery.

To ban it for trans identifying people but still allow it for everyone else is actual discrimination. I don't like the cosmetic industry for obvious reasons but people do have rights to do with their bodies as they please. This is part of the dangerous path I've been afraid we've been slipping down so it's good to see so many people here being sensible and disagreeing with OP.

Banned, no- same as the recent question about breast implants for males: a condition of having it done privately should be the purchase of insurance to cover the costs of any care required if there are complications.

NHS funded, no. But a ban is a different thing.

It's also worth considering the entire cosmetic surgery industry, what drives it, what models it uses and relies on, and the effects.

I'm not generally keen on 'banning' things, but the industry certainly should be questioned.

Maybe worth considering BIID as a parallel issue with perhaps some similar questions.

Should surgeons remove healthy body parts because a patient really wants them removed?

https://pubmed.ncbi.nlm.nih.gov/34237024/

'Body integrity dysphoria (BID) is an intense need/desire to live in a disabled body, particularly due to a limb amputation or paraplegia. The investigators observed that significantly more people affected by BID wish to change their gender compared with the average population.'

Tiny study, but interesting.

'These results indicate a comprehensive disruption of identification with one's own body, which is not limited to legs or arms, but also affects the gender identity of many affected individuals. '

I agree. Most people who are gender critical have openly agreed that consenting adults have a right to do whatever they want to themselves as long as they pay for it themselves and don't force others to "affirm" their gender nonsense. If you want to destroy your body on your dime that's your problem.

I don't think it should be banned. However, it shouldn't be available on the NHS and they shouldn't call it "care". Modification of healthy bodiies is not "care", it's cosmetic surgery. And they certainly shouldn't call it "sex change surgery".

Edit: Actually, I'm not to add to that - some of it is not just "modification of healthy bodies", it is surgery that makes healthy body parts non-functional, or has future health implications. If these types of surgery are allowed, I think both patients and doctors should have to sign that they understand and accept the future health implications.

I’m very wary of banning adults from doing things to their own bodies. Bodily autonomy matters, even when I think someone is making a terrible decision.
So I would not support a blanket criminal ban on “gender affirming surgery” for adults. That feels like the wrong legal tool, because it targets the motive rather than the actual risk. A man getting breast implants should not be treated differently in law from any other adult seeking breast implants simply because his reason is different.

But I also don’t think the words “gender affirming” should give medicine a free pass. Some of these procedures are not ordinary cosmetic tinkering. Mastectomy, removal of healthy reproductive organs, genital surgery and phalloplasty are permanent. They remove healthy function, often sterilise, can create lifelong medical dependency and, in some cases, have very high complication rates.

So:

Adults should not be criminalised for wanting body modification.

The NHS should not fund this unless there is very strong evidence of long-term benefit that outweighs harm.

Doctors should not be allowed to justify their actions by saying they were “just doing what the patient asked”, especially when a distressed patient is asking them to remove healthy body parts.

Any surgeon should have to show proper therapeutic justification, robust consent, independent psychological assessment, full disclosure of complication rates, fertility counselling, alternatives, cooling-off time and long-term follow-up.

No surgery or hormones of any type for those under 18.

There is a conflict in my mind and it's this - I don’t want the state telling competent adults that they may not alter their own bodies. But I absolutely do want the medical profession held to the normal ethical standard: first, do no harm. If a doctor cannot honestly say the operation is likely to benefit that patient overall, they should not do it.

To come at the question from a different angle, a rational one:

Attempted definitions of gender - and one of the problems with this issue is that there is no one clear definition - use terms like 'aspects' 'behaviours' 'roles' 'socially constructed' 'manifestations' and so on. These are all abstracts, and have different meanings for different people, groups, cultures, historical eras.
'Gender' is challenged and rejected all the time, not least by many posters on here
It isn't rational to claim that taking a scalpel to a physical body either 'affirms' or denies a contested abstract concept such as 'gender'.

It's not so much should, but does it: does it do what it says on the tin?

Surgery is unnecessary in order to change the abstract concept of gender. Surgery can never change sex, as that is impossible.

Leaving aside the fact that gender-affirming surgery is also dangerous and has life-long implications, the question remains: does it even deliver on what it claims?

It’s interesting because there are surgeries that remove your fertility, such as a vasectomy, or having your tubes tied (I don’t know if anyone still does that, or what the correct term is, probably a fallopian ligation or something) which I would not be happy at all to have banned.
Both of those are not really available on demand though, there’s a lot of age and have you had children and future family discussions first.

Well then the ban shouldn't be framed as something targeting "gender affirming" procedures. It should be on any cosmetic procedure with unacceptably high risks of harm/fraud/etc. What I don't understand is why you are phrasing the ban in terms of its motivation, rather than in terms of the specific risk profile of specific procedures. False breast insertion, for example, is a relatively safe procedure.

It just seems performative - a desire to perform disapproval of a certain set of body modifications with a certain set of motivations. That's not what the law is for.

Essentially, the law around cosmetic surgery should be written as consumer safety legislation. And there are probably more people currently being endangered by non-trans-related cosmetic surgery than trans. Especially by 'cosmetic surgery tourism" -- "holidays" in e.g.Turkey, with some risky surgery bolted on.

When you fixate on trans-related surgery, you seem like one of those people who suddenly cares about animal welfare in slaughterhouses but ONLY insofar as it relates to non-stun slaughter, ignoring the many other abuses because they don't tie in nicely enough with Islamophobic (or anti-Semitic) agendas

Mastectomies, gonadectomies, and genital surgeries are not merely cosmetic: they affect function (and can have other adverse consequences, as can any medically unnecessary procedure).

Ordinarily, a doctor who deliberately injures and functionally disables a patient at the patient's behest is at risk of being struck off or of criminal sanctions, see:

https://pdfs.semanticscholar.org/716b/f0d8a3dd01fdfe00a7a958a7238700e46818.pdf

But gender reassignment is a special exception, because it's framed as medically necessary. And, if it's medically necessary and not a lifestyle choice, it follows that the NHS/insurer must pay.

Other exceptions:

Elective male circumcision - the religious requirement and relatively minor nature mean this is treated as legal and ethical: but there is no reason for insurer to pay.

Elective sterililisation - can be treated as part of an overall reproductive health strategy: NHS pays.

I hope so. You see some still shots of TW on social media, where for a very small portion of them, they do look like they might look like women in real life, so I hope as you say you can still tell.

People are allowed to have procedures that take away their reproductive ability though.

There are three separate issues here.

1. Should the NHS pay? Or should the patient pay, as for general cosmetic surgery. I'd argue the latter. IF the NHS had plenty of money, AND it could be shown that the long-term mental and physical health consequences were very beneficial for the vast majority of patients, I'd be open to the NHS paying. But neither of these things currently apply.

2. The oath taken by doctors to do no harm. This depends whether it can be shown that these operations lead to better mental health outcomes long term in the majority of patients, balanced against long term physical harms from the surgery. Unfortunately there seems to be little attempt to research these long term outcomes in an independent and meaningful way.

3. The right of others not to be deceived. Tbh I can't see how this is different to any type of impersonation where the person is trying to seriously get away with tricking people. Eg your next door neighbour tells you he's called Fred, but his actual name is John and he's hiding his real name as he's previously been convicted of burglary. John is not breaking any laws by telling you a false name. He may be breaking laws if he attempts to pass himself off as Fred in certain official situations, but not in casual/social interactions. As a former burglar, he probably is a slight risk to you, and it would be better for you if you knew who he really was, but you still have no right to that information.
   The Fred example is actually more deceitful, because Fred would get away with his deception. No TIM can successfully pretend to be a woman, so the deception won't ever genuinely trick people anyway. The TIM is free to pretend to be a woman so long as he doesn't attempt to access services/jobs from which he is barred due to his sex.
   If you wanted to ban any deceit/lies at all in social settings, we would need a new law, and it would have immensely wide ranging consequences.

And I'm asking why these should be treated differently in law from other cosmetic procedures.

TBF a man could have extensive cosmetic surgery to make him look more feminine but you'll still be able to see him coming because of his male gait, longer arms etc
That sort of thing is always the giveaway and impossible to cover up.

Dying is also a fairly major side-effect. A number of people have died as a direct result of invasive, dangerous and pointless cosmetic procedures.

Not sure why loss of reproductive capacity should be the key determinant as to whether a procedure should be legal. Provided there is full info, counselling, etc., and the patient is an adult, I don't see why it is categorically different from other outcomes of the surgery.

They should be paid for in private hospitals, the NHS shouldn't touch them