14 ms·

This type of "treatment" is an utter failure and surrender of the fields of psychology, psychiatry, and neurology. The way we used to think was - a sex change

This type of "treatment" is an utter failure and surrender of the fields of psychology, psychiatry, and neurology. The way we used to think was - a sex change surgery used to only be performed because we could not fix the mental problem (patient being unhappy with their body). Now the whole script has flipped and we are talking about how a "transwoman has always been a women" and a "transman has always been a man", which is the newest version of "if theory conflicts with the facts, so much the worse for the facts". Now we actually ponder cutting off people's arms and legs, which is so incredibly bizarre. Not to mention how this opens a huge pandora's box of "recognising" "transabled" people, "transracial" people (see Oli London, Rachel Dolezal, or Martina Big) as, for the lack of a better word - "healthy". As a bisexual dude I suspect a lot of that has to do with the stigma around "conversion therapies", but I worry that term suffered from some really heavy "scope" creep.

deleted 4y ago
[deleted]
JumpCrisscross 4y ago
> type of "treatment" is an utter failure and surrender of the fields of psychology and psychiatry I, too, have an emotional response. But let’s be scientific. If the counselling shows middling success, and the amputation 90%+, why do our feelings, as third parties, overrule the person whose body it is?
- poszlem 4y ago
  I don't say this should be forbidden for consenting adults. I am saying that it should not be sold as "the treatment" but as "we don't have anything better for now, we are working on it, if you can't wait, you can do it".
  - JumpCrisscross 4y ago
    > it should not be sold as "the treatment" but as "we don't have anything better for now, we are working on it, if you can't wait, you can do it" Isn’t this true of all treatments? It’s the best we’ve got. It seems to work. It has downsides. We’re looking for better options. We start with the least invasive option. But we don’t stop midway because something better might one day turn up.
    - poszlem 4y ago
      Not really - we now create stable identities from what is essentially a form of mental illness. We no longer say that someone suffers from "body dysmorphia", instead we say that they were "assigned the wrong body at birth". It's similar to those deaf parents of deaf children who are against giving them a cochlear implant lest they lose their "deaf culture".
      - freemint 4y ago
        > We now create stable identities from what is essentially a form of mental illness. Yes. And? A stable identity is preferable for the sufferers. Can you explain the problem with that?
        poszlem 4y ago
        The problem with that is the same as we would get if we decided that the way to treat anorexia is by allowing the patients to starve themselves to death. They would die thin and happy, but I don't think many people would agree with it being the "preferred solution to that problem".
        fzeroracer 4y ago
        You're comparing apples and oranges though. We know that anorexia can generally be treated with cognitive therapy and help restore people to a healthy and comfortable body weight. Those same treatments fail when applied to people with BIID. And they way they cause harm is different as well, since failing to treat anorexia results in starvation. While refusing to treat BIID results in people taking dangerous risks to amputate themselves. I don't see much of an actual solution to these issues in your arguments other than some hand waving about politics as some sort of root cause.
        freemint 4y ago
        I fail to see the parallel. Anorexia as "starving themselves to death" is not a stable identity, it is an identity in decline with ongoing suffering and temporary highs. Should taking of legs be the first treatment option? No. Should people get therapy, medication and other treatment? Yes. Should those treatments be refined and improved, sufferers of BIID experimented on to improve treatments? Yes. If society is unable to come up with a treatment that works for years should society deny sufferers this radical treatment forever? No. That is imposing the majority world view on a minority when the difference in world view poses no harm. Yes, society would need to address potential cognito hazards/memes and make sure there are no people doing this for economic incentives or other mental illnesses for which treatments exists. If society would let people get the treatment, that would not be capitulation. That would be acknowledging that while society has interest in being able to treat that, that interest can not forever outweigh the benefits the radical operation has for the sufferer. Capitulation would be if society stops trying to find a treatment besides radical operation and handed operations out without scrutiny.
  - bastawhiz 4y ago
    > it should not be sold as "the treatment" but as "we don't have anything better for now, we are working on it, if you can't wait, you can do it" It's not sold as the treatment. And to your comparison to trans folks, top and bottom surgery is not easy to access (and getting harder by the day!). Talk to any trans person and ask them all the things they needed to do and go through to prove to their doctors that they're trans enough. Besides there not being another option, gender affirming surgery works! The patients are largely satisfied with their outcomes! Why do we need to complicate this with suggesting how they should feel or think? But moreover, who the fuck cares? I had gynocomastea surgery (after years of bodybuilding) and all I had to do was sign a form. Women can elect to get breast augmentation with no evaluation. Why should a trans person have to prove that they deserve a cosmetic surgery that anyone else can get—so long as the outcome is gender conforming? I can get anything I want tattooed on my face today, but someone else can't get their chest flattened for months because...some lab coats don't think they deserve it enough?
- Teever 4y ago
  Well in many countries with socialized medicine it's society paying for the procedure, and in many countries with a social safety net it will be society paying the disability payments for someone who has compulsively had their legs cut off or their eyes blinded with acid. Let's run with your idea, if a vast majority of people felt compelled to do these things would society be better off?
anaisbetts 4y ago
The visceral discomfort you feel about having a surgery to change your body, how uncomfortable and wrong that feels, and how unhappy you would be if someone did that to you? The feeling that you're having, is gender dysphoria. That's what trans people feel all the time, every single fucking minute of their lives, every time they look down getting a painful reminder that their body isn't Right; until they fix it - which is a capital-C Cure. Problem solved, forever. That sounds pretty fucking great to me. Why wouldn't you let people live how they want to?
- NewEntryHN 4y ago
  OP doesn't question the issue nor the necessity to fix it. He questions the solution.
- Teever 4y ago
  Here's a thought experiment. What if we had a simple, effective, and side-effect free pharmacutical treatment for BIID? what if someone could take a cheap pill every morning and they suddenly felt fine with their leg that they would otherwise be compelled to cut off? This would obviously be better than hobbling someone with crutches or a wheel chair and a disability cheque, better for society abd the individual too. Now what if a doctor decided one day to test this treatment on someone with gender dysphoria and lo and behold it worked just as well for them? The patient suddenly felt great about their body, great about their appearance and they stopped obsessing about changing it with risky and painful surgeries. This cheap and effective pharmacuticial treatment would instantly become a first line treatment for gender dysphoria, right? That sounds pretty fucking great to me. Why wouldn't you want people to live their life how they were born to?
  - curious-im 4y ago
    I guess because they feel that they feel like they born to be their preferred gender. The idea that there will be a treatment that will make me feel like a gender I'm not sounds pretty f-cking terrible to me. Try this experiment on yourself and think that there is a treatment to make you think you are woman/man. How's it make you feel? And together with that, reflect on what exactly make you be a man/woman - your body or your psyche. There is a lot parallels between gender dysphoria and BIID, but GD is bit more than just 'this is not my body'.
treffer 4y ago
I skipped right to the conclusion, as I wanted to see what the document says, and it kicks of with "where no other treatment exists", and to prevent self-inflicted amputations. Plus it acknowledges that these people potentially need help _now_, before we find better solutions in the other fields. I can highly recommend to give the conclusion section a read. I think the authors are well aware of these issues, to the point that this scoping (no other treatment available right now / other options exhausted + person needs help right now) makes me slightly supportive.

deleted 4y ago

[deleted]

JumpCrisscross 4y ago

> type of "treatment" is an utter failure and surrender of the fields of psychology and psychiatry I, too, have an emotional response. But let’s be scientific. If the counselling shows middling success, and the amputation 90%+, why do our feelings, as third parties, overrule the person whose body it is?

poszlem 4y ago
I don't say this should be forbidden for consenting adults. I am saying that it should not be sold as "the treatment" but as "we don't have anything better for now, we are working on it, if you can't wait, you can do it".
- JumpCrisscross 4y ago
  > it should not be sold as "the treatment" but as "we don't have anything better for now, we are working on it, if you can't wait, you can do it" Isn’t this true of all treatments? It’s the best we’ve got. It seems to work. It has downsides. We’re looking for better options. We start with the least invasive option. But we don’t stop midway because something better might one day turn up.
  - poszlem 4y ago
    Not really - we now create stable identities from what is essentially a form of mental illness. We no longer say that someone suffers from "body dysmorphia", instead we say that they were "assigned the wrong body at birth". It's similar to those deaf parents of deaf children who are against giving them a cochlear implant lest they lose their "deaf culture".
    - freemint 4y ago
      > We now create stable identities from what is essentially a form of mental illness. Yes. And? A stable identity is preferable for the sufferers. Can you explain the problem with that?
      - poszlem 4y ago
        The problem with that is the same as we would get if we decided that the way to treat anorexia is by allowing the patients to starve themselves to death. They would die thin and happy, but I don't think many people would agree with it being the "preferred solution to that problem".
        fzeroracer 4y ago
        You're comparing apples and oranges though. We know that anorexia can generally be treated with cognitive therapy and help restore people to a healthy and comfortable body weight. Those same treatments fail when applied to people with BIID. And they way they cause harm is different as well, since failing to treat anorexia results in starvation. While refusing to treat BIID results in people taking dangerous risks to amputate themselves. I don't see much of an actual solution to these issues in your arguments other than some hand waving about politics as some sort of root cause.
        freemint 4y ago
        I fail to see the parallel. Anorexia as "starving themselves to death" is not a stable identity, it is an identity in decline with ongoing suffering and temporary highs. Should taking of legs be the first treatment option? No. Should people get therapy, medication and other treatment? Yes. Should those treatments be refined and improved, sufferers of BIID experimented on to improve treatments? Yes. If society is unable to come up with a treatment that works for years should society deny sufferers this radical treatment forever? No. That is imposing the majority world view on a minority when the difference in world view poses no harm. Yes, society would need to address potential cognito hazards/memes and make sure there are no people doing this for economic incentives or other mental illnesses for which treatments exists. If society would let people get the treatment, that would not be capitulation. That would be acknowledging that while society has interest in being able to treat that, that interest can not forever outweigh the benefits the radical operation has for the sufferer. Capitulation would be if society stops trying to find a treatment besides radical operation and handed operations out without scrutiny.
- bastawhiz 4y ago
  > it should not be sold as "the treatment" but as "we don't have anything better for now, we are working on it, if you can't wait, you can do it" It's not sold as the treatment. And to your comparison to trans folks, top and bottom surgery is not easy to access (and getting harder by the day!). Talk to any trans person and ask them all the things they needed to do and go through to prove to their doctors that they're trans enough. Besides there not being another option, gender affirming surgery works! The patients are largely satisfied with their outcomes! Why do we need to complicate this with suggesting how they should feel or think? But moreover, who the fuck cares? I had gynocomastea surgery (after years of bodybuilding) and all I had to do was sign a form. Women can elect to get breast augmentation with no evaluation. Why should a trans person have to prove that they deserve a cosmetic surgery that anyone else can get—so long as the outcome is gender conforming? I can get anything I want tattooed on my face today, but someone else can't get their chest flattened for months because...some lab coats don't think they deserve it enough?
Teever 4y ago
Well in many countries with socialized medicine it's society paying for the procedure, and in many countries with a social safety net it will be society paying the disability payments for someone who has compulsively had their legs cut off or their eyes blinded with acid. Let's run with your idea, if a vast majority of people felt compelled to do these things would society be better off?

anaisbetts 4y ago

The visceral discomfort you feel about having a surgery to change your body, how uncomfortable and wrong that feels, and how unhappy you would be if someone did that to you? The feeling that you're having, is gender dysphoria. That's what trans people feel all the time, every single fucking minute of their lives, every time they look down getting a painful reminder that their body isn't Right; until they fix it - which is a capital-C Cure. Problem solved, forever. That sounds pretty fucking great to me. Why wouldn't you let people live how they want to?

NewEntryHN 4y ago
OP doesn't question the issue nor the necessity to fix it. He questions the solution.
Teever 4y ago
Here's a thought experiment. What if we had a simple, effective, and side-effect free pharmacutical treatment for BIID? what if someone could take a cheap pill every morning and they suddenly felt fine with their leg that they would otherwise be compelled to cut off? This would obviously be better than hobbling someone with crutches or a wheel chair and a disability cheque, better for society abd the individual too. Now what if a doctor decided one day to test this treatment on someone with gender dysphoria and lo and behold it worked just as well for them? The patient suddenly felt great about their body, great about their appearance and they stopped obsessing about changing it with risky and painful surgeries. This cheap and effective pharmacuticial treatment would instantly become a first line treatment for gender dysphoria, right? That sounds pretty fucking great to me. Why wouldn't you want people to live their life how they were born to?
- curious-im 4y ago
  I guess because they feel that they feel like they born to be their preferred gender. The idea that there will be a treatment that will make me feel like a gender I'm not sounds pretty f-cking terrible to me. Try this experiment on yourself and think that there is a treatment to make you think you are woman/man. How's it make you feel? And together with that, reflect on what exactly make you be a man/woman - your body or your psyche. There is a lot parallels between gender dysphoria and BIID, but GD is bit more than just 'this is not my body'.

treffer 4y ago

I skipped right to the conclusion, as I wanted to see what the document says, and it kicks of with "where no other treatment exists", and to prevent self-inflicted amputations. Plus it acknowledges that these people potentially need help _now_, before we find better solutions in the other fields. I can highly recommend to give the conclusion section a read. I think the authors are well aware of these issues, to the point that this scoping (no other treatment available right now / other options exhausted + person needs help right now) makes me slightly supportive.