Should there be stricter checks before gender transition treatment is approved?

[RowsOfFlowers]

Am I being unreasonable in thinking that there needs to be better regulation for those wanting to transition to another gender?

My worry is there are not enough checks, psychological evaluations going on. My friend used to work at a gender reassignment clinic, and she’d regularly tell me about men in their 50s wanting to get gender reassignment surgery. One that she assessed had a history of domestic abuse against their wife.

I find this truly worrying.

And men have been using women’s spaces for years on a self-ID basis regardless of certificates.

Maybe GRCs will gradually become pointless. People definitely shouldn’t be able to change their birth certificates - you were born how you were born.

It should be banned due to it being biologically impossible to change sex, you are born either male or female and this can’t and cannot be changed. Gender is a nonsensical term, that over time will disappear.

I’d like it if all extreme cosmetic surgeries were banned. They definitely shouldn’t be funded by the NHS. A surgeon in Scotland a few years ago was banned from removing arms and legs from healthy patients who asked for amputation. I honestly can’t see the difference between unnecessary amputations and the most serious ‘gender affirming’ surgeries (phalloplasties and vaginoplasties). Treating mental illness with extreme body modification is madness. The phalloplasties especially seem to be beset with complications and end up costing the taxpayer even more because of the necessary revision surgeries, infection management etc.

I could cry when I think that some of our tax money pays for traumatised/confused/ND/mentally ill young women to have flesh removed from their arms and attached to their groins.

I agree with PP. 'Transition' is not healthcare and is absolutely cosmetic surgery (and cosmetic hormonal changes). It should not be funded on the NHS and people who desire such cosmetic alterations should need insurance to cover the cost of complications, revisions and reversals (as should be the case, imho, for all cosmetic surgery)*.

If healthcare is desired for gender dysphoria, then the norm should be psychotherapy, with the expectation of cure being resolution of gender dysphoria and trials carried out to determine the most beneficial form of therapy to this end.

Single-sex spaces/services should be on the basis of biological sex. GRCs should not be a thing, for safeguarding and other reasons. If a person chooses to change name, with or without 'gender' change, the before and after versions should be inextricably linked in every digital system going.

Trying to tinker with the current system is pointless as it is completely incoherent. That is what I was trying to demonstrate in my first post.

Cartesian dualism has a LOT to answer for.

*I do accept that the line between complications caused by cosmetic surgery and coincidental or peripheral is hard to draw and would have to be case by case. Life-threatening complications would probably have to be an immediate exception.

What is this particular surgery a "treatment" for? Especially as it destroys perfectly healthy body parts to create something that doesn't even perform the biological function of the human body parts of the other sex that the new, cosmetically constructed items are attempting to imitate.

Yes. You wonder whether those who think the future will be full of people who won’t believe ‘how mean everyone was to trans people’ ever consider that in the future conversations will go more like.

“They did what to distressed young women?”
”Cut off their tits and filled them full of hormones”
”Even the autistic ones?”
”Especially the autistic ones”.

Older transitioner who have posted here claim that it was made clear to them that surgery didn't change their sex and that results will not always make them look like the opposite sex. I dont know if thats still the case.

We are never going to have a diagnosis process that identifies true trans people, we can only be honest about what the results will likely be and try to filter out people who dont understand this.

I dont know how many people take drugs and have surgery thinking that it will make them the opposite sex or accepted as the opposite sex? Would people go through the process for aesthetic reasons knowing they will still be treated as their sex?

Im losing patience with the number of men who actively seek out these processes then claim not to be able to use male spaces. Do they really believe that they didnt make these choices themselves?

The government should be honest and clearly stated that we are either female or male, that cannot change and some spaces and opportunities are divided by sex. In other words 'transition' doesn't alter anything about sex and nothing is divided by a self determined 'gender'.

It will at least shut up the whining men who think they are now closer to being women than being men.

The government is partly responsible for this by introducing the GRA and creating the PC of GR. The medical profession are also responsible for creating a diagnosis of GD and offering people surgery and drugs. The government, again, are at fault for funding the whole process.

If thats all address, and adults want to privately fund the process, what can anyone else do about it?

But I still think there ought to be safeguards even in the private sector. I shouldn’t be able to go to a cosmetic clinic and have any old procedure done Willy nilly. I’m sure you have to fill out screening forms for physical and mental health.

How will they determine mental health - those who want to remove their cock because they believe they are women, or those who want to remove it because they know they're not women?

There are many other examples of procedures women have asked for but denied because some bloke in an office in the bowels of the NHS has decided they’re ‘cosmetic’. I would love a breast reduction of my H cup boobs on my 5 foot body as they cause me pain and skin issues but can I get one? Yes if I pay £10k.
Its scandalous!

Should not be paid for on the NHS. However, I've read about men travelling abroad for their surgeries, coming back to 'recover' and requiring NHS treatment to save their lives from the complications. I'm not sure what can be done about this. It's, I suppose, no different from anyone doing similar for a hair transplant, Brazilian butt lift or whatever. Or even requiring treatment for any risky lifestyle; drugs, extreme sport, etc. I think the thing is the NHS helps people regardless of the unwise, reckless or foolish things they do to themselves. They should not collude in it.

The OPs question seems to come down to whether we should be testing who is truly trans and who is not.

But one of the main problems with gender ideology is that there is no way to determine this even in theory.

I guess that’s the issue, but as part of assessment, they could be carrying out thorough risk assessments e.g. offending

It looks like you're seeking a way to ensure that only the safe trans-identifying males are allowed access to female only spaces.

Most people on this board think that the surest way to do this is to exclude all males from female spaces.

Once that step has been taken there is really no issue of "safety to others" in allowing someone access to all the body modification they want. It becomes purely a question of whether it is self-harm and whether taxpayers should be paying for it.

Risk assessments are not based on clever individual psychological insights they are based on very clunky statistics. A risk assessment could say "not if they're a convicted sexual/violent offender" but I don't suppose anyone is gathering stats about the outcomes for all the men who have had a complaint made that didn't lead to a conviction or who were sexually violent but not formally complained about.

The only other risk assessment would have to be along the lines of "if bloke then risky" which we already knew.

There is no special "lower-risk" class of bloke.

Oh, and as someone who watched the Scottish Parliament vote that self-id should specifically not be denied even to convicted rapists, and seen how difficult it was to get authorities in Scotland to remove dangerous men from women's prisons if they have a trans identity (and I believe it's still near impossible in Ireland); having seen all this I would not be amazed if the people who might be expected to do such risk assessments would habitually and obviously get them wrong.

The process is very stringent and regret rates are amongst the lowest for all surgeries. NHS treatment does not depend on the moral qualities of the person who requires treatment. Treatment should be a matter for patients and their doctors (plus their parents if they are children) based on clinical need, and not on whether ideologues don't like their treatment.

Yes, "regret" is another of those outcomes where people often assume that failure to gather evidence properly means that something didn't happen. If you turn a blind eye you don't see and gender clinics have been turning a blind eye to "regret" for decades.

The "process" is not stringent but has more holes than a pair of old undies in a drawerful of moths.

Please can you provide a link to this supposition.

Im willing to believe that middle aged men who get fake breasts hardly ever regret their choices.

Im not so convinced about the teen getting a mastectomy or the men having to dilate.

I wonder what the percentage of 'gender affirming treatment' is men getting fake breasts and if stews the data?

I don’t think we have reliable data for regret rates. As PP said, many clinics have not kept in touch with their patients in the following months and years.

Some patients will not admit that they regret the procedures they’ve had (‘sunk costs’ fallacy).

But honestly, at this point I’ve seen enough traumatised young women on social media talking about the harm that has been done to their bodies, starting when they were very young and very vulnerable. There are dozens of them speaking openly about it just on social media, so presumably they are the tip of the iceberg.

Plus, lawsuits are beginning to roll in. I think you’re completely wrong about the regret rates.

I think GRCs became pointless when gay marriage was made legal, really. No gay marriage was the given reason for supporting them: these people can't marry their true love unless one of them pretends to be the other sex.

Which I can absolutely see, and it was disgusting, and I started campaigning about it in the sixties (and my mother had been muttering about it for rather longer than that), but the GRC was a bandaid on a broken leg and finally the (evil Tory) government legalised gay marriage so it is no longer needed. Except by men (and a few women) who want to live a lie.

Neither I nor my mother ever advocated falsifying official documents such as birth certificates. I cannot see the need for it, except in respect of the feelz of the deluded.

While there are several studies that claim low regret rates, such studies routinely lose 20%-60% of the original group to follow-up, rendering the results at a critical risk of bias. This is because patients who still attend the gender clinic and those satisfied with their transitions are likely more willing to participate in follow-up research.

Full article here: https://segm.org/regret-detransition-rate-unknown

It's only "putting some people at risk of danger (I.e.women; see rape/sexual assault cases in women’s prisons)" if having surgery is ever treated as evidence of someone having "actually" changed sex. The law is that someone who has gender reassignment surgery remains a member of their birth sex. A GRC recognises that someone's gender is different than their birth sex, but they nevertheless are still a member of their birth sex. There is no process that can measure or identify the "truth" of someone's wish to transition or that can guarantee that the individual has no future risk of offending.

The appropriate level of regulations, checks and psychological evaluations would be to ensure that the individual is really sure, that all attempts to reconcile them to accepting their body as it is are hopeless, and verifying that they properly understand that their surgery willnot actually change their sex and they will remain a member of their birth sex. Back in the 80s/90s this last check was in place and was really important. It has been given less weight in recent years, and should be reinstated. However I see no reason why a history of violence against women should be a barrier to treatment if all other indicators are that this is the only treatment that will help an individual. I can well believe that the psychological distress of body dysphoria might - in a disturbed individual - exhibit in a violent way. It shouldn't be a barrier because NO transwoman should be able to use their trans status as some kind of badge of proof of being "not like other men" and trusted in a way that other men wouldn't be.

Which other cosmetic surgeries on healthy tissues are carried out after similar ‘stringent’ assessment processes?

When women are refused tubal ligation for sterilisation because ‘they might change their minds’, is the assessment process as stringent as when younger women are sterilised and put into menopause for ‘gender affirmation’?