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> No surgeon should be removing healthy body parts, in my opinion. There are a metric ton of medical procedures surgeons do outside of medical transitioning wh

> No surgeon should be removing healthy body parts, in my opinion. There are a metric ton of medical procedures surgeons do outside of medical transitioning where people alter/adjust/remove healthy body parts. This seems like a pretty blanket statement to say; and I say that as someone who would be extremely cautious about telling someone that they "should" medically transition if they feel that social transition would be sufficient for them. I'm all aboard the train of telling transgender people that they're valid whether or not they choose to transition, and I definitely would advocate that transgender identity and body dysphoria are not necessarily the same thing, and that many trans people are blessed to be able to both embrace their transgender identity and celebrate aspects of their bodies that don't "align" with their gender in strictly hetero-normative ways. Even with that perspective, this framing of "we're perverting the role of doctors/surgeons by cutting healthy flesh" -- it just doesn't really match the reality of how many procedures there are in the US that already fit that definition. Everything from the stereotypical examples of cosmetic surgery, to non-essential dental procedures, to limb lengthening, to circumcision, to sex-assignment surgery for intersex infants, the list goes on and on. Many of these procedures aren't strictly speaking medically necessary. Precocious puberty for example is primarily harmful because of its psychological and social effects. The physical consequences of early puberty are comparatively minor (not non-existant, but then-again neither are the effects of puberty blockers. We're mostly talking about stuff like "you might be shorter when you grow up"). And yet, I've never once seen someone advocate that it's morally wrong or that it should be illegal for a doctor to prescribe puberty blockers to a cisgender child with precocious puberty. There's no shortage of conditions that really don't have physical health-effects or side-effects other than that society has decided that we don't really like them or that they're inconvenient to live with (either because of social stigma or because of the increased need for accommodations that society is unwilling/unable to provide) -- and we generally don't tell people with those conditions that they need to just learn to live with them. Instead, we give them choices (including medical interventions) to address both the social effects of their conditions and the internal psychological effects of their conditions. What we don't do is we don't take a purely physical view of things. Heck, one of the justifications for why doctors prescribe puberty blockers to cisgender girls with precocious puberty is because there's limited research suggesting that delaying puberty lowers their risks of being raped. That's about as far into the "its a social problem, not a medical one" category as it's possible for a medical intervention to be. And look, all of this is even taking the most charitable view of the statement statement above and assuming that it is specifically talking about medical interventions among minors. But if I take that statement at its face value as saying that no surgeon should ever operate on healthy tissue, then it just kind of becomes absurd, honestly. There are so, so many medical procedures that fall under that umbrella. I think everyone would love to have less invasive ways of helping people who suffer from gender-disphoria and I think everyone is hoping that as social stigma continues to decrease that some of the psychological downsides of not transitioning might also decrease. That's not to say that medical transitioning is bad; it's not. But it does carry some risks, and obviously it's good to have multiple available paths for the transgender people who don't want to take those risks. But arguments that boil down to "it's in the mind, so treat it that way" sound good at face-value but are ultimately way too simplistic to work even in a purely cisgender world. Our medical profession hasn't really worked that way for a long time, if it ever worked that way at all. So any debate about whether or not a surgery procedure is moral needs to be engaging with the issue on a deeper level than just whether or not there's a physical risk involved.

__pache__ 4y ago
[flagged]
- danShumway 4y ago
  > that's not what they were intending and you know it Yes, I took the more charitable interpretation of what they said (that it was specifically about minors) and devoted the vast majority of my comment to talking about that. I spent maybe one or two paragraphs total talking about adult transitioning. And yet, even under that charitable interpretation, saying "we should not be operating on healthy tissue" is an argument that sounds good but falls apart as soon as you try applying it to the real world and the numerous non-essential medical interventions that are supplied to children. I am trying to be charitable in my takes, but "chopping off their reproductive organs because of a fad" is not an insightful characterization of the current debate. It grossly oversimplifies the full spectrum of medical intervention for transgender youth, and (again) ignores the reality that medical interventions for psychological/social/internal maladies, including interventions based on the possibility of future psychological/social problems, are not exclusive to transgender youth.
  - __pache__ 4y ago
    > "chopping off their reproductive organs because of a fad" is not an insightful characterization of the current debate. literally: yes it is. we should not be castrating our youth because of a fad. all the sudden ~30% of girls think they're boys: https://news.ncsu.edu/2019/11/teen-sexual-orientation/ https://news.ncsu.edu/2019/11/teen-sexual-orientation/ > It grossly oversimplifies no. it is simple. a young boy cannot "feel like a girl" because they have no idea what that feels like, that is not a thing. you are just you. get comfortable. all of this nonsense has lead to mass depression, anxiety, obesity, etc. go outside, get some exercise, have a reason to live, get some sun, etc.
    - danShumway 4y ago
      To be blunt, I think you're honestly kind of proving my point. In order: 1. "Chopping of their reproductive organs" is itself not an accurate representation of the full spectrum of transgender care. A nontrivial portion of transgender people never get bottom surgery, and certainly bottom surgery is not the primary focus of the majority of bills being passed right now about transgender care for minors (many of which go beyond banning medical interventions and ban even non-medical gender-affirming counseling). It's a gross oversimplification of gender-affirming care for minors to focus purely on the rarest and most invasive intervention possible, a procedure that many transgender people will never undertake in the first place. 2. "~30% of girls think they're boys" is not an accurate representation of that study. 26% of teenage girls reporting "some change in their gender identity" does not mean that they suddenly completely flipped genders. Your description misses the subtleties of how many people talk about gender identity and gender fluidity. 3. > it is simple. a young boy cannot "feel like a girl" because they have no idea what that feels like, that is not a thing There is a lot to unpack here, so I'm just going to say that's not a great description of either transgender identity or gender dysphoria (remember, they're not necessarily the same thing). I think this is a giant oversimplification and misrepresentation of the transgender experience. It's also (not to be too nitpicky) kind of an oversimplification of the cisgender experience? But that could be a long conversation. 4. > go outside, get some exercise, have a reason to live, get some sun, etc. This is a massive oversimplification of mental health care in just about every category from depression to gender dysphoria. You can not cure gender dysphoria by getting more sun. Even in situations where gender dysphoria can be either alleviated or partially mitigated with counseling, what's going on in that counseling is going to be a lot more complicated than the happy-go-lucky/"natural" model of mental health that people sometimes propose nowadays. ---- Again being as charitable as I possibly can, I am sure that there are people who are genuinely supportive of transgender rights but who still have concerns about medical interventions with minors, and there certainly are people who have medically transitioned who go on to regret it -- and yeah, of course I feel for those people, of course it would be good to improve our standards of care to minimize post-transition regret. But (again, thinking charitably) I imagine it's got to be pretty frustrating for the people with genuine concerns about youth counseling if every time they try and raise those concerns, they find themselves instantly surrounded by a bunch people saying that transgender youth all just have a vitamin D deficiency. Because that's just nonsense.

__pache__ 4y ago

[flagged]

danShumway 4y ago
> that's not what they were intending and you know it Yes, I took the more charitable interpretation of what they said (that it was specifically about minors) and devoted the vast majority of my comment to talking about that. I spent maybe one or two paragraphs total talking about adult transitioning. And yet, even under that charitable interpretation, saying "we should not be operating on healthy tissue" is an argument that sounds good but falls apart as soon as you try applying it to the real world and the numerous non-essential medical interventions that are supplied to children. I am trying to be charitable in my takes, but "chopping off their reproductive organs because of a fad" is not an insightful characterization of the current debate. It grossly oversimplifies the full spectrum of medical intervention for transgender youth, and (again) ignores the reality that medical interventions for psychological/social/internal maladies, including interventions based on the possibility of future psychological/social problems, are not exclusive to transgender youth.
- __pache__ 4y ago
  > "chopping off their reproductive organs because of a fad" is not an insightful characterization of the current debate. literally: yes it is. we should not be castrating our youth because of a fad. all the sudden ~30% of girls think they're boys: https://news.ncsu.edu/2019/11/teen-sexual-orientation/ https://news.ncsu.edu/2019/11/teen-sexual-orientation/ > It grossly oversimplifies no. it is simple. a young boy cannot "feel like a girl" because they have no idea what that feels like, that is not a thing. you are just you. get comfortable. all of this nonsense has lead to mass depression, anxiety, obesity, etc. go outside, get some exercise, have a reason to live, get some sun, etc.
  - danShumway 4y ago
    To be blunt, I think you're honestly kind of proving my point. In order: 1. "Chopping of their reproductive organs" is itself not an accurate representation of the full spectrum of transgender care. A nontrivial portion of transgender people never get bottom surgery, and certainly bottom surgery is not the primary focus of the majority of bills being passed right now about transgender care for minors (many of which go beyond banning medical interventions and ban even non-medical gender-affirming counseling). It's a gross oversimplification of gender-affirming care for minors to focus purely on the rarest and most invasive intervention possible, a procedure that many transgender people will never undertake in the first place. 2. "~30% of girls think they're boys" is not an accurate representation of that study. 26% of teenage girls reporting "some change in their gender identity" does not mean that they suddenly completely flipped genders. Your description misses the subtleties of how many people talk about gender identity and gender fluidity. 3. > it is simple. a young boy cannot "feel like a girl" because they have no idea what that feels like, that is not a thing There is a lot to unpack here, so I'm just going to say that's not a great description of either transgender identity or gender dysphoria (remember, they're not necessarily the same thing). I think this is a giant oversimplification and misrepresentation of the transgender experience. It's also (not to be too nitpicky) kind of an oversimplification of the cisgender experience? But that could be a long conversation. 4. > go outside, get some exercise, have a reason to live, get some sun, etc. This is a massive oversimplification of mental health care in just about every category from depression to gender dysphoria. You can not cure gender dysphoria by getting more sun. Even in situations where gender dysphoria can be either alleviated or partially mitigated with counseling, what's going on in that counseling is going to be a lot more complicated than the happy-go-lucky/"natural" model of mental health that people sometimes propose nowadays. ---- Again being as charitable as I possibly can, I am sure that there are people who are genuinely supportive of transgender rights but who still have concerns about medical interventions with minors, and there certainly are people who have medically transitioned who go on to regret it -- and yeah, of course I feel for those people, of course it would be good to improve our standards of care to minimize post-transition regret. But (again, thinking charitably) I imagine it's got to be pretty frustrating for the people with genuine concerns about youth counseling if every time they try and raise those concerns, they find themselves instantly surrounded by a bunch people saying that transgender youth all just have a vitamin D deficiency. Because that's just nonsense.