4 ms·

Glad to hear your close relative is doing well now, and it sounds like she was in a tough situation. If you did more research though you'd understand that the

Glad to hear your close relative is doing well now, and it sounds like she was in a tough situation. If you did more research though you'd understand that the thing you feared is not especially common or even possible under normal processes, so it's not really worth fearmongering about it on a public forum. In most first-world medical systems there are years-long waiting lists for surgeries, or even to see a specialist at all. Most people I know who've seen specialists about gender issues had to wait months to even talk to someone. Getting surgery on a whim within a few months simply doesn't happen unless you're a wealthy person flying overseas for at-your-own-risk surgery, which is also available for many other purposes. This is similar to how you'll see people fear-mongering about things like teenage children getting surgeries, which simply does not happen. The processes don't allow for it because it would be wildly irresponsible, but you can still find lots of people talking about it as if it happens on a regular basis. In reality, adults in their twenties and thirties sit on waiting lists for years. Note also that even if you were to schedule surgery on short notice, in many cases they require you to have been on the relevant medications for a while because if you were to have sex-related organs removed or modified surgically without having adjusted to your own hormone levels it would be a pretty nasty adjustment.

2devnull 4y ago
I’m relieved to hear that. It’s easy to get the impression that many children are now starting the process with hormones and whatnot, without too many barriers in place or a sufficient waiting period. It’s probably the most extreme cases that get the spotlight.
- kevingadd 4y ago
  In general when medical processes are flawed, the extreme <0.1% cases get the spotlight and instead of being used to advocate for process improvements, they're generalized by people with an agenda to claim that an <0.1% case is a 1% or 10% case. It does a disservice to the outliers who suffered and the sensationalized story is (rightly) ignored by people who might otherwise benefit from the cautionary tale.
  - 2devnull 4y ago
    Excellent point. My sense is that this issue, similar to many Covid related issues, has gotten so political that the ordinary scientific processes and discussions have ceased operating as they should. I tend to therefore think greater caution and deference to past practice, and therefore more conservative practices are prudent. That seems to be the currently unpopular view unfortunately. I am very wary of trendy medicine and medical hubris generally. Too many historical examples of trailblazing medicine getting things, often horrifically, wrong.
jtbayly 4y ago
The article describes an 18 year old girl without any money getting her breasts removed and regretting it immediately. You are saying this is impossible, or that she was on the waiting list for years (as a minor).
- kevingadd 4y ago
  You can consult virtually anyone who's gone through normal gender transition processes under government care or insurance care, or examine the process documentation yourself. It simply does not happen through normal processes unless the rules are broken. There are long waiting lists and safeguards, the standards of care don't approve of this. If it happens, it's people breaking the rules and possible medical malpractice - both of which can happen in all areas of care. You can't simply dismiss reality based on one or two outliers. For example, if you look at the typically used standards of care https://www.wpath.org/publications/soc https://www.wpath.org/publications/soc : * Criteria for surgery a. Gender incongruence is marked and sustained; b. Meets diagnostic criteria for gender incongruence prior to gender-affirming surgical intervention in regions where a diagnosis is necessary to access health care; c. Demonstrates capacity to consent for the specific gender-affirming surgical intervention; d. Understands the effect of gender-affirming surgical intervention on reproduction and they have explored reproductive options; e. Other possible causes of apparent gender incongruence have been identified and excluded; f. Mental health and physical conditions that could negatively impact the outcome of gender-affirming surgical intervention have been assessed, with risks and benefits have been discussed; g. Stable on their gender affirming hormonal treat- ment regime (which may include at least 6 months of hormone treatment or a longer period if required to achieve the desired surgical result, unless hormone therapy is either not desired or is medically contraindicated).* This simply does not support any claims that teenagers are easily getting surgeries, if at all. Any doctor following these standards of care would not approve it. People breaking the rules to approve it is tragic, but generalizing based on this is unhelpful because it distracts from the real problems.
  - jtbayly 4y ago
    I don’t see anything in here that would prevent somebody from getting surgery on their 18th birthday, or before that.

2devnull 4y ago

I’m relieved to hear that. It’s easy to get the impression that many children are now starting the process with hormones and whatnot, without too many barriers in place or a sufficient waiting period. It’s probably the most extreme cases that get the spotlight.

kevingadd 4y ago
In general when medical processes are flawed, the extreme <0.1% cases get the spotlight and instead of being used to advocate for process improvements, they're generalized by people with an agenda to claim that an <0.1% case is a 1% or 10% case. It does a disservice to the outliers who suffered and the sensationalized story is (rightly) ignored by people who might otherwise benefit from the cautionary tale.
- 2devnull 4y ago
  Excellent point. My sense is that this issue, similar to many Covid related issues, has gotten so political that the ordinary scientific processes and discussions have ceased operating as they should. I tend to therefore think greater caution and deference to past practice, and therefore more conservative practices are prudent. That seems to be the currently unpopular view unfortunately. I am very wary of trendy medicine and medical hubris generally. Too many historical examples of trailblazing medicine getting things, often horrifically, wrong.

jtbayly 4y ago

The article describes an 18 year old girl without any money getting her breasts removed and regretting it immediately. You are saying this is impossible, or that she was on the waiting list for years (as a minor).

kevingadd 4y ago
You can consult virtually anyone who's gone through normal gender transition processes under government care or insurance care, or examine the process documentation yourself. It simply does not happen through normal processes unless the rules are broken. There are long waiting lists and safeguards, the standards of care don't approve of this. If it happens, it's people breaking the rules and possible medical malpractice - both of which can happen in all areas of care. You can't simply dismiss reality based on one or two outliers. For example, if you look at the typically used standards of care https://www.wpath.org/publications/soc https://www.wpath.org/publications/soc : * Criteria for surgery a. Gender incongruence is marked and sustained; b. Meets diagnostic criteria for gender incongruence prior to gender-affirming surgical intervention in regions where a diagnosis is necessary to access health care; c. Demonstrates capacity to consent for the specific gender-affirming surgical intervention; d. Understands the effect of gender-affirming surgical intervention on reproduction and they have explored reproductive options; e. Other possible causes of apparent gender incongruence have been identified and excluded; f. Mental health and physical conditions that could negatively impact the outcome of gender-affirming surgical intervention have been assessed, with risks and benefits have been discussed; g. Stable on their gender affirming hormonal treat- ment regime (which may include at least 6 months of hormone treatment or a longer period if required to achieve the desired surgical result, unless hormone therapy is either not desired or is medically contraindicated).* This simply does not support any claims that teenagers are easily getting surgeries, if at all. Any doctor following these standards of care would not approve it. People breaking the rules to approve it is tragic, but generalizing based on this is unhelpful because it distracts from the real problems.
- jtbayly 4y ago
  I don’t see anything in here that would prevent somebody from getting surgery on their 18th birthday, or before that.