Transgender operations insurable? Beyond Hilarious

[Black Dog]

There are two rational positions one can take when it comes to people experiencing a disconnect between gender and sex:

1) It is defect that requires people to adapt or seek surgery.

2) It is a normal variation which does not require any treatment.

False choice. I give this argument an F.

Gays are not "defective". And unlike you my views are consistent. You are the one arguing that transgender people are defective and need essential corrective surgery (you imply transgender are defective by claiming the surgery is "essential"; if they are normal then the surgery cannot be essential). I say people should accept their nature whatever that may be: even if someone's nature includes a mismatch between perceived gender and biological sex.

Why?

[TimG]

False choice. I give this argument an F.

So what? The argument is valid even if you don't like it. If transgenderism is a defect that requires correction with surgeries then it should be fine to talk about it as a defect. If it is just normal human variations like being gay then surgeries are cosmetic because there is no need to fix what is not broken. This is rational and consistent.

Rejecting it shows you are pushing an argument which is fundamentally ideological and not basic on logic. Which raises the question: why should anyone who is not a follower of your ideology care about whatever spaghetti monsters you have created to help you sleep at night?

Edited January 5, 2015 by TimG

[Queenmandy85]

I know four people who have undergone sexual re-assignment surgery and all four appear happier. That is not necessarily the outcome for all post-op patients, but, for these people, it was profoundly beneficial.

It is easy to present all kinds of hypothetical points if you are not transgender

We all have issues in our lives, but don't judge a person until you have walked 1.6 Km. in their shoes.

[TimG]

I know four people who have undergone sexual re-assignment surgery and all four appear happier. That is not necessarily the outcome for all post-op patients, but, for these people, it was profoundly beneficial.

So you are saying transgenderism is a defect that must be managed and/or corrected with surgery?

[Black Dog]

So what? The argument is valid even if you don't like it.

It's a false choice. Google it if you don't know what it means.

If transgenderism is a defect that requires correction with surgeries then it should be fine to talk about it as a defect. If it is just normal human variations like being gay then surgeries are cosmetic because there is no need to fix what is not broken. This is rational and consistent.

Labeling something a "defect" or "normal" is mere semantics and not really relevant to the core of the issue. I should also point out this isn't consistent with your own opinion on the matter. You've stated it's a defect, but don't believe surgery should be an option. Whoopsy.

Rejecting it shows you are pushing an argument which is fundamentally ideological and not basic on logic.

Nope. I'm rejecting a shitty strawman.

Which raises the question: why should anyone who is not a follower of your ideology care about whatever spaghetti monsters you have created to help you sleep at night?

Ah, you seem to be labouring under the misapprehension that your opinion matters a jot.

Edited January 5, 2015 by Black Dog

[TimG]

It's a false choice. Google it if you don't know what it means.

No - you claim it is a false choice but you have offered no argument to support your claim.

Labeling something a "defect" or "normal" is mere semantics and not really relevant to the core of the issue.

It is pretty fundamental. If something is labelled as a defect then services can be made available to help. I heard that some people are trying to rebrand "autism" as normal variation but are not getting far. I suspect it is because no one dealing with autistic kid wants to give up access to services that comes with the defect label.

Ah, you seem to be labouring under the misapprehension that your opinion matters a jot.

And you seem to be labouring under the misapprehension that your opinion means squat since the system will treat transgenderism as a defect as long as people expect treatment for it. Edited January 5, 2015 by TimG

[Black Dog]

No - you claim it is a false choice but you have offered no argument to support your claim.

I don't need to: you've done that for me by presenting a third option:

3) It is defect which does not require any treatment.

It is pretty fundamental. If something is labelled as a defect then services can be made available to help.

It's pure semantics. Something can be considered in the range of human variation and still require services.

I heard that some people are trying to rebrand "autism" as normal variation but are not getting far. I suspect it is because no one dealing with autistic kid wants to give up access to services that comes with the defect label.

I suspect-nay: I'm certain-that you're full of shit. It has nothing to do with giving up access to services and everything to do with removing harmful labels that contribute to marginalization and stigmatization.

And you seem to be labouring under the misapprehension that your opinion means squat.

Stunningly unoriginal. I give this comeback an F.

Edited January 5, 2015 by Black Dog

[TimG]

I don't need to: you've done that for me by presenting a third option:

Go back and read what I wrote. My argument was always that it is defect that *may* require treatment. So you still have not presented an argument for why it is a false choice.

It's pure semantics. Something can be considered in the range of human variation and still require services.

Only if you want to jump through hoops and redefine the meaning of words.

Everything to do with removing harmful labels that contribute to marginalization and stigmatization.

But fundementally people who want services need society to agree to pay. Society will only pay if they feel there is defect that requires fixing. Trying to turn around and claim that it is not a defect is exercise in absurdity akin to Monty Python's dead parrot sketch.

[Black Dog]

Go back and read what I wrote. My argument was always that it is defect that *may* require treatment. So you still have not presented an argument for why it is a false choice.

No one has argued it doesn't require some form of treatment. The debate is entirely over the semantics of the term defect.

Only if you want to jump through hoops and redefine the meaning of words.

Happens all the time. You remember that homosexuality was long considered a deviant behaviour to be corrected through methods from therapy and castration.

But fundementally people who want services need society to agree to pay. Society will only pay if they feel there is defect that requires fixing. Trying to turn around and claim that it is not a defect is exercise in absurdity akin to Monty Python's dead parrot sketch.

If we concede it's a defect, will you shut the fuck up about it?

[Queenmandy85]

For me, the words 'defect' and 'mutilation' are loaded and inhibit reasonable discussion. One of the four people I mentioned, spent north of $50,000 for her surgery. The Menard Clinic used to charge $30,000 for a basic F2M proceedure. That is a large sum for most people.

[Keepitsimple]

OK - lets move on a bit. Does anyone want to take a stab at the "B" in LGBT? Bi-sexualisum. What physical/mental elements are in play here?

[eyeball]

All of the physical elements are in play I would guess. As for the mental, probably the usual ones that go along with feeling stigmatized.

I suspect bi-sexual men are mostly regarded by other men as being deviant where bi-sexual woman are mostly regarded as being hotter. This leads me to think there are probably millions of men who hold conflicting views on bisexuality that are expected to weigh in on what's appropriate public policy when it touches on sexual matters. This underscores the need to defer to experts who can probably separate their personal feelings from their professional when deciding on matters of real import, such as medical prescriptions or treatments.

[TimG]

Happens all the time. You remember that homosexuality was long considered a deviant behaviour to be corrected through methods from therapy and castration.

Except gays were not demanding that society pay for services to "correct" the problems caused by their nature. They just wanted to be left alone. With transgender we have the nonsensical situation where they are claiming they are normal but want access to surgeries to allow them to live "normal" lives.

If we concede it's a defect, will you shut the fuck up about it?

If you concede that learning to accept the body one is born with is a viable (if not preferable) way to deal with the defect. More importantly, there is nothing wrong for a parent of a transgender child to encourage the child to resolve any issues in this way. Edited January 5, 2015 by TimG

[Queenmandy85]

If the Canadian Armed Forces pay for sex re-assignment surgery for regular force members, that's good enough for me.

[TimG]

If the Canadian Armed Forces pay for sex re-assignment surgery for regular force members, that's good enough for me.

I personally don't have an issue with paying for changes. What I have an issue with is the culture shift where these operations are seen as a routine way to address gender identity issues rather than a last resort after everything else was tried. I see this shift show up in the media all of the time, the most recent was the case where Vancouver school board decided to pander to kids who claim to have gender issues without telling their parents (can you think of any other defect where the school would refuse to inform their parent?). On top of that you had stories of so called "enlightened" parents putting their kids on hormones "in case" they wanted a sex change. Edited January 5, 2015 by TimG

[Black Dog]

Except gays were not demanding that society pay for services to "correct" the problems caused by their nature. They just wanted to be left alone. With transgender we have the nonsensical situation where they are claiming they are normal but want access to surgeries to allow them to live "normal" lives.

There's no contradiction between accepting that transgenderism is in the range of human variation while still wanting to resolve a conflict between biological sex and gender identity.

If you concede that learning to accept the body one is born with is a viable (if not preferable) way to deal with the defect. More importantly, there is nothing wrong for a parent of a transgender child to encourage the child to resolve any issues in this way.

I've never said otherwise: you are the only one saying there can only be one option and one option alone for dealing with this issue. But that's because you don't actually give a shit about positive results for transgendered people.

I personally don't have an issue with paying for changes. What I have an issue with is the culture shift where these operations are seen as a routine way to address gender identity issues rather than a last resort after everything else was tried. I see this shift show up in the media all of the time, the most recent was the case where Vancouver school board decided to pander to kids who claim to have gender issues without telling their parents (can you think of any other defect where the school would refuse to inform their parent?). On top of that you had stories of so called "enlightened" parents putting their kids on hormones "in case" they wanted a sex change.

And, of course, anecdotes are the very best data.

Edited January 6, 2015 by Black Dog

[TimG]

There's no contradiction between accepting that transgenderism is in the range of human variation while still wanting to resolve a conflict between biological sex and gender identity.

Several posters in this thread have expressed outrage if someone wants the transgender to learn to accept the sex they have. Why? If we agree that it is a defect that needs treatment then learning to accept one's biological sex is not only valid approach - it should be the preferred approach.

I've never said otherwise: you are the only one saying there can only be one option and one option alone for dealing with this issue. But that's because you don't actually give a shit about positive results for transgendered people.

Where have I said there should be no surgeries? From the beginning I have argued that they are a last resort to be avoided like prescribing heroine to a perpetually relapsing drug addict is a last resort. The trouble is I do not believe your claims that they are seen as a last resort by many. The example from Rolling Stone of a 16 year old committing suicide because she was denied access to a sex change. There is no way a 16 year old can have enough life experience to know that a sex change is the only option. The more likely explanation is she was encouraged to pursue that option by "internet social groups" that do see sex changes as routine (or worse, looking to validate their own choices by pushing others to do the same).

And, of course, anecdotes are the very best data.

Anecdotes are more than sufficient to establish a reason for a concern. You do offer not evidence to show that the anecdotes are bad examples and not reflective of general trends in society. Edited January 6, 2015 by TimG

[Black Dog]

Several posters in this thread have expressed outrage if someone wants the transgender to learn to accept the sex they have. Why? If we agree that it is a defect that needs treatment then learning to accept one's biological sex is not only valid approach - it should be the preferred approach.

1) people are "outraged" because you are suggesting only one treatment option be considered, regardless of the particulars of an individual situation. Whatever personal circumstances or biological factors, your one-sized-fits-all solution is "suck it up."

2) You've never once answered the question of why that should be the preferred approach. Indeed, I've asked many times across different threads and ...nothin'.

Where have I said there should be no surgeries? From the beginning I have argued that they are a last resort to be avoided like prescribing heroine to a perpetually relapsing drug addict is a last resort.

Your words, this thread (all emphasis mine):

People are born with the bodies they have. Mutilating it to conform with someone's view of their identity is never justified.

From a previous thread:

The first and only choice for people with no biological basis for gender identity issues should be learning to live with their body as it is.

Pretty cut and dried.

The trouble is I do not believe your claims that they are seen as a last resort by many.

Of course you don't. You're easily swayed by sensationalistic media reports. The fact is, transitioning is a extensive and costly process that is out of the reach of a great many people. The idea that anyone would take on years of hormone treatments, extensive and expensive surgeries etc etc on some sort of whim defies all logic.

The example from Rolling Stone of a 16 year old committing suicide because she was denied access to a sex change.

If this was the recent story from a couple of weeks ago, sex change weren't even the issue, which you'd know if you actually paid attention to the story. If it's a different story, a link would be helpful.

There is no way a 16 year old can have enough life experience to know that a sex change is the only option. The more likely explanation is she was encouraged to pursue that option by "internet social groups" that do see sex changes as routine (or worse, looking to validate their own choices by pushing others to do the same).

Oh Jesus Christ.

Anecdotes are more than sufficient to establish a reason for a concern.

No: which is why they're called "anecdotes" and not "data". They are certainly sufficient for getting people to jump to conclusions about social conditions that don't always jive with what data shows.

You do offer not evidence to show that the anecdotes are bad examples and not reflective of general trends in society.

I'm not the one claiming any huge "cultural shift" is underway. If you have actual data that's not news clippings, that would make a better case. I would add that there's undoubtedly a social shift underway in terms of awareness of transgender issues, which no doubt contributes to your perception and a likely uptick in the number of people willing to come out as trans and seek treatment (including surgical transitions). But that doesn't support your claim that "these operations are seen as a routine way to address gender identity."

Edited January 7, 2015 by Black Dog

[WestCoastRunner]

Oh Jesus Christ.

Yes? I'm here, but I can't think of any better way to respond to Tim than how you already have.

[Bonam]

2) You've never once answered the question of why that should be the preferred approach. Indeed, I've asked many times across different threads and ...nothin'.

Because it is less radical and less invasive. In any kind of medical treatment, the preferred approach is almost always the least radical, except in cases of an immediately life-threatening condition. Only when a less radical approach is shown not to be effective would one then proceed to the next. For example, if a person has an infection, you might first try antibiotics, rather than immediately amputating the limb where the infection site is located. That is, amputation is a last resort, because it is radical and irreversible. The argument that TimG is making is that the same is true of gender change operations... these medical procedures should be made available only when it has been concluded by medical professionals that no other less radical options are effective in addressing the issues the individual in question is suffering from.

Seems like a fairly reasonable argument to me.

Certainly, there is also the counter-argument, that adult individuals are generally able to ask for and receive various types of cosmetic operations for any reason. These cosmetic operations need not be medically necessary, although in some cases they can be helpful (and in others damaging) to the individual in question. That individuals should have this freedom is hard to argue against (side-stepping the issue of who pays for it), and one can certainly make the argument that gender change operations should fit into this category, rather than of medical procedures that are performed only on an as-needed basis given the judgment of medical professionals.

This also seems like a fairly reasonable argument to me.

What TimG is pointing out, and I think I am inclined to agree with him, is the semantic inconsistency in saying that a gender change operation can be "medically necessary", while refusing to acknowledge that if something is medically necessary, it must be addressing a problem/defect/abnormality of some sort. Medically necessary procedures are carried out to fix problems, not to change something from one normal state to another normal state. Transgendered people want access to what they view as a medically necessary procedure to "fix" their biological sex to be what it is "supposed to be", but also don't want to be seen as "defective" prior to the procedure. This semantic criticism is a valid one... but in my view not really an important issue in the grand scheme of things.

The real question here is whether a gender change operation is a procedure that is in some cases medically necessary and should be prescribed by doctors at their discretion (like an amputation), or if it is cosmetic and should be selectable by adults that simply wants it (like a breast implant).

Given the expense, risk, and permanence of the procedure currently, I would tend to think of it as more akin to an amputation, and like TimG says, it should be employed when medically needed, which means after less radical treatments have been tried. But I think the long term trend, especially as technology progresses and all of these things change from being painful, dangerous, and irreversible to safe and easily modifiable, will be that it will be seen as a cosmetic, and very likely increasingly common, procedure. How many people haven't idly wondered what it would be like to be the opposite gender for a day? If you could take a pill before you go to sleep and painlessly wake-up as the opposite sex for 1 day (and then revert back to how you were), how many people would try it? Technology in a few decades may make it that easy, and then it will very much be a cosmetic procedure.

And that suggests that rather than being some fundamental moral/ethical issue which people get really passionate and ideological about, it is instead a simple matter of technology, much like so many other things in our society.

[Black Dog]

Because it is less radical and less invasive. In any kind of medical treatment, the preferred approach is almost always the least radical, except in cases of an immediately life-threatening condition. Only when a less radical approach is shown not to be effective would one then proceed to the next.

And here's the kicker. I've asked before and received no answer, but is there any evidence that transgenderism can be "cured" by psychotherapy alone? Seems like a pretty important thing to know. TimG has claimed that transgenderism is a "treatable mental illness." Yet I've seen no evidence to support this claim in multiple threads on the subject. Indeed, the more I think about it, the more I'm surprised this discussion has gotten so far without such evidence being presented.

What TimG is pointing out, and I think I am inclined to agree with him, is the semantic inconsistency in saying that a gender change operation can be "medically necessary", while refusing to acknowledge that if something is medically necessary, it must be addressing a problem/defect/abnormality of some sort.

It's the nature of the issue that there's a problem. The issue is entirely one of framing. Tim uses the same rhetoric that was previously used to describe homosexuality and justify discrimination. That's what is getting people's back's up.

[Keepitsimple]

And here's the kicker. I've asked before and received no answer, but is there any evidence that transgenderism can be "cured" by psychotherapy alone? Seems like a pretty important thing to know. TimG has claimed that transgenderism is a "treatable mental illness." Yet I've seen no evidence to support this claim in multiple threads on the subject. Indeed, the more I think about it, the more I'm surprised this discussion has gotten so far without such evidence being presented.

It's the nature of the issue that there's a problem. The issue is entirely one of framing. Tim uses the same rhetoric that was previously used to describe homosexuality and justify discrimination. That's what is getting people's back's up.

Like many mental conditions - it's not about "curing" - it's about coping. It's about acknowledging and accepting the condition and finding ways to adapt. Chronic depression/anxiety, alcoholism, anorexia - are all conditions that can and do have devastating effects on the lives of vast numbers of people. Most are never "cured" - but they effectively learn to cope and live relatively normal lives. If Tim is saying that in general, people who want to go through the Transgender process are suffering from a mental condition (defect and illness are accurate but harsh), then I completely agree. As with other mental conditions, therapies are available (or should be) to help identify, quantify, evaluate and treat the condition and develop coping mechanisms. While it's true that the radical, extreme measure of body alteration is available - it should be the very, very last resort - one that the best advice should be obtained to ensure reasonable success that the underlying mental condition would be resolved - or quality of life greatly improved.

[TimG]

And here's the kicker. I've asked before and received no answer, but is there any evidence that transgenderism can be "cured" by psychotherapy alone?

Give me a break. The human mind is infinitely adaptable. If an addict can overcome an addiction despite the genetic predisposition a transgender can deal with the mismatch in gender perception. Note that dealing with the issue does not require that one believe that their gender matches their sex - it only requires that they accept the reality that their gender does not match their sex and that is a reality they have to live with like a 5'0" man has to live with being short. The only reason it can't be resolved mentally is because the person in question does not want to resolve it mentally.

Using the would "cure" is also a strawman. I never suggested it could be "cured" - just managed.

It's the nature of the issue that there's a problem. The issue is entirely one of framing. Tim uses the same rhetoric that was previously used to describe homosexuality and justify discrimination. That's what is getting people's back's up.

As has been pointed out: the transgender themselves are claiming they have a defect that needs fixing therefore the analogies to gays is a red herring. For this reason it is perfectly reasonable to discuss different ways to treat this defect and it is reasonable to argue that treatments that do not require radical medical intervention are much preferable to treatments that do. Edited January 7, 2015 by TimG

[Black Dog]

Give me a break. The human mind is infinitely adaptable. If an addict can overcome an addiction despite the genetic predisposition a transgender can deal with the mismatch in gender perception.

So, in your view, all mental illness are basically the same?

Note that dealing with the issue does not require that one believe that their gender matches their sex - it only requires that they accept the reality that their gender does not match their sex and that is a reality they have to live with like a 5'0" man has to live with being short. Claiming that it can't be resolved mentally is an absurd premise.

Then proof should be readily available. And yet, you offer none.

As has been pointed out: the transgender themselves are claiming they have a defect that needs fixing therefore the analogies to gays is a red herring.

An irrelevant distinction. As I've said in the past, your position is identical to those who have (and continue to believe) that homosexuality is a lifestyle choice, that gay people can change their orientation through therapy or prayer.

For this reason it is perfectly reasonable to discuss different ways to treat this defect and it is reasonable to argue that treatments that do not require radical medical intervention are much preferable to treatments that do.

Preferable, if equally effective. Psychotherapy alone may work in some cases, but not others. Some people may find ways of expressing their gender identity without altering their bodies. For others, it is fundamentally necessary for their physical bodies to match their selves, which is why they are willing to undergo what is a extremely extensive process to achieve that outcome. None of that matters to you because your fixation on the procedure betrays your complete lack of interest in healthy outcomes.

[TimG]

So, in your view, all mental illness are basically the same?

No - I am saying that mental illnesses can/should be generally be managed mentally.

Then proof should be readily available. And yet, you offer none.

You are asking that someone show that 1+1=2. It true because it defined to be.

An irrelevant distinction. As I've said in the past, your position is identical to those who have (and continue to believe) that homosexuality is a lifestyle choice, that gay people can change their orientation through therapy or prayer.

More strawmen: one can be gay yet not be in gay relationships so at that level living as gay person IS a lifestyle choice. What is unreasonable is expecting a person to change who they are sexually attracted to and people expecting prayer to change that are completely misguided. The argument that gays have is there is no rational reason for them to not choose to live as a gay person. This argument does not apply to a transgender seeking an invasive, irreversible surgery.

For others, it is fundamentally

necessary for their physical bodies to match their selves, which is why they are willing to undergo what is a extremely extensive process to achieve that outcome.

People with mental illnesses can do serious damage to their body and they simply accept it. The fact that a mentally ill person chooses to damage their body is not evidence that it is best way to manage the illness. It should be obvious that radical, irreversible interventions are much less preferable than purely mental interventions. Edited January 7, 2015 by TimG