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

[Vegilante]

New opinion piece by "essayist & critic" Andrea Long Chu that says drastic medical interventions such as hormones & genital surgeries should be given on demand to trans people - even when they're so deeply unhappy they feel suicidal, & they're convinced the treatments they're demanding will only make them more miserable.

Why? 1) Because the "true purpose" of medicine's "first do no harm" maxim "is not to shield patients from injury but to install the medical professional as a little king of someone else’s body." And 2) because "the negative passions — grief, self-loathing, shame, regret — are as much a human right as universal health care, or food."

www.nytimes.com/2018/11/24/opinion/sunday/vaginoplasty-transgender-medicine.html

Since many people won't be able to access the article, I'll copy & paste it, with apologies to copyright holder(s).

Ever since I have wondered, whether it is right to not allow women the choice in this (as long as it does not endanger rhe lives of baby and mother, obviously), considering they have to live with the consequences for the rest of their lives

As long as women have the full and correct information to make an informed choice, they should be able to give birth any way they want. I strongly believe c section on request should be a right.

Then if you think a C section should be given on demand, why not other surgery?

How do you draw lines between different treatments? 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.

You can't really pick and choose what treatments will be available to others based on your own needs can you?

I dont think a c section is the same as plastic surgery

I may have missed something though

Because a c section on demand has a rationale for harm reduction, either mental or physical.

Massive plastic tits don’t

Just rechecked the thread

No i havent missed anything

Bowlofbabelfish

It all depends on your definition of mental harm though doesn't it?

And who makes the value judgement as to who can have surgery on demand?

Is it pretendy logic time again, with a sideline in unconvincing analogies?

As long as women have the full and correct information to make an informed choice, they should be able to give birth any way they want. I strongly believe c section on request should be a right.

Yes. I so wholeheartedly agree, Bowlofbabelfish.

And for the record: no it is not comparable to plastic surgery or SRS, the baby will have to come out one way or another. You cannot just not act, there will be 'blood', so to speak.

Yes angry

And youve arrived just in time for it

I need a knee replacement. If I were 20 years older I would be having one.

Because of my age the NHS won't do it yet.

Why can't I just insist then? I want it done. I understand the risks. It will make things better not worse and it's going to have to be done at some point. Why can't I just have it? Why should the dr be able to over ride me?

If it's ok to a C section on demand then it's ok to have any surgery on demand?

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

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.

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

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?

Arf arf!

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.

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.

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

Exactly.

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).

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.

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

(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.

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.

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?