How are Sex Change Operations Medically Ethical?

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Okey dokey.

This isn't quite what I said. You will need to review all of my posts for a better context. What I said is that suicidal thoughts are not rational. So if a person is getting an operation because of this suicidal drive, then the operation itself is not ethical.

"Appealing to authority" is not "a logical fallacy" except in rare cases. No one can know everything- so sometimes you have to quote an expert.

AND we're not "appealling to authority" anyway. We are appealling to the scientific method- studies have show X,Y, and Z. You have to counter with with empiracal evidence to show that XY and Z are wrong. But refuse to do that.

So you're not trolling. You know better than the whole scientific establishment about this issue?

So show us you know more.

Is the issue of ethics so daunting that you feel the need to have others think for you? Has the medical field never been wrong on ethics before? I would like your opinion sir, not the opinion of another individual who you defer to nor to an institution. I want you to use your logic and reason to tell me why youhold these beliefs to be true. Is an organization and popular opinion not developed from the reason of individuals. Why then do you then berate your own?

That's pretty much the conclusion I came to. Treating a mental issue (depression) via SRS is about like addressing an HTTP error code by replacing the mouse. However, a majority (or a very loud minority) of $cientific exper$ $eem to di$agree for $ome rea$on......

Last edited by Raptor on 08 Jul 2014, 4:51 pm, edited 1 time in total.

the scientific method is not the opinion of an individual, it is how one derives observations of reality through painstaking, peer-reviewed research. one examines the observations of reputable research and forms one's opinions based on the evidence therein.

Suicide doesn't drive me toward it. Suicide is simply one of the possible after effects of being denied safe and effective treatment. More so than suicide, perceived lack of access has led to increasing mental instability, driving me down a path to permanent disability. I've known trans people who are years post-op and most of them are glad they went through with it, even though things aren't perfect. Contrast this with the effects of female genital mutilation or genital surgery on intersex infants, which has resulted in much suffering.

There's something else, something animal that drives me toward it, which I first experienced when I first heard of the procedure. Nothing has diminished that drive. I've been repeatedly frustrated in my attempts at surgery (because of the cost), however, which I experience as torment. My health care providers are in agreement that I need this procedure, so I'm hoping the appeals process bears fruit.

Without that drive, why would I want to do it? It really doesn't make sense from a Spock-like perspective, but we're not Spock: We're humans. We have drives and instincts like all animals.

Long-term follow-up studies, as I presented in the Medicare decision (q.v.) have shown that trans people do pretty well post-op, especially if they got surgery after about 1985. Oh wait, you're ignoring them all because they're all tainted. Well, that's your problem. I think you've been tainted by your preconceptions that you refuse to allow for correction of, that you immediately hand-wave away because they don't conform to your views.

Well, I trust those studies aren't made up or lying; I realize that this drive isn't going to go away any time soon and I think my quality of life can improve after surgery, when I would be without these burdensome genitals that I have. My doctors share my opinion.

And that's good enough for me.

As a general rule, if the experts in a field start to coalesce around a hypothesis as the evidence builds for it, you can trust that there definitely is something to that hypothesis. No one here has seen the full research behind sex reassignment surgery, but we don't live in an information-perfect world. Generally, unless you know very well what you're talking about, you should defer to the experts on their opinions of hypotheses in their fields. They come to their conclusions after years of both in situ and research observations.

Unfortunately, Sherlock03 is not interested in educating himself, because he considers any research that goes against his view on this subject to be tainted, and not worth reading. Therefore, he will not read it and will remain ignorant of what can be found in that research. That is his mistake and, frankly, there must be quite a bit of arrogance that goes behind such near-total disregard of the published literature or the opinions of experts, IMO.

Would you be willing to find out why or do you just wish to cast aspersions?

Perhaps a look at that Medicare coverage decision would allow you to understand more deeply why they support it.

Oh wait, that's tainted (/sarc)....

The person is not getting an operation because of a suicidal drive. The person is getting an operation because of an unresolvable and lifelong mismatch between internal and external gender. The guiding ethic of medicine is "first do no harm". Clearly you are seeing this operation as "harm" whereas the people who are getting it and the doctors who are doing it are not. There is no ethical standard that body parts may only be altered if they are damaged or diseased. The standard is that the body part must be something that the patient wants altered (it can't be the doctor's decision) and that the alteration not cause harm (so they won't remove a heart, per your upthread example).

This ethical standard makes cosmetic surgery possible. Cosmetic surgery is by its very definition an alteration of non-diseased body parts. The genital alteration isn't really cosmetic surgery. But the breast augmentation (for M>>>F) or mastectomy (for F>>>>M) certainly is and both those surgeries are done frequently on people who are not getting a sex change. (Women have breasts enlatged or shrunk surgically quite often while remaining women). The genital alteration is a far bigger deal and thus there is the requirement of a solid year of living as the "new" gender and also psychological and hormonal therapy prior to surgery. All that ensures that the genital alteration is truly what the patient needs and thus will not constitute harm.

I don't know all the history, but I think that the issue of suicide came into it as a bid to get it covered by insurance companies (see the link from Aetna insurance I posted upthread). But the possibility of suicide was never the prime driver. The prime driver is the mismatch between internal and external gender. You are arguing that suicide is the prime driver but it isn't. That was (I think) a reason for insurance companies to be pushed to cover it.

It isn't really that weird a thing once you look at how iffy gender can be. Consider intersex:
http://en.wikipedia.org/wiki/Intersex



I bring this up to show how a mismatch between internal and external gender can happen. You are painting it as an entirely psychological phenomenon: a man becomes convinced he is a woman or a woman becomes convinced she is a man. But there is this biological (not psychological) phenomenon that can cause a mismatch between internal and external gender- in some people, there is no clearcut external gender but society has no "third sex" and so the baby will be raised as male or female but the choice made by doctors and parents may be inconsistent with the internal gender. I'm not saying this has anything to do with beneficii specifically. I just want to show that what you are painting as an entirely psychological dysfunction has roots in biology.

Are you talking about ethics?

Seems to me like there's an awful lot of wilful ignorance here.

People get SRS because their gender does not match their sex, and their quality of life improves markedly as a result of making their genitals match their gender.

It is not "mutilation". It is not "depression". It is not "suicide". Depression and suicide can be symptoms (and provide a further reason to treat), but they are not the same thing.

If you want to pretend that gender dysphoria doesn't exist despite the well-documented evidence, then go ahead, but don't act like you're being intellectually honest when you do so.

We are not talking about you. We (or at least I am) are talking about the ethics of a doctor who preforms surgery on someone because of a suicidal urge.

I formally request that you stop disparaging me out of your own anger. Once you have regained your composure I will continue to formally debate with you on the ethics of a doctor conducting a sex change. Until that time I will not encourage your behavior, which diminishes your credibility and degrades the forum as a whole.

The OP has now been recycling the same "irrational suicidal behavior/drive/urge" claim for the last few pages while effectively ignoring replies and counter-claims from multiple posters.

As such, it would seem that the OP has no real interest in actually debating the subject of his own thread.

Thread locked.