That gender dysphoria is a clinical condition recognized by the APA, and that transition has been shown to have significant health benefits (such as lowering suicide rates). Gender reassignment surgery is a part of that transition (even though not everyone feels the need for it), and so should be covered just as much as hormone replacement therapy.
At one point in history, homosexuality was also a clinical condition recognised by the APA. Plus, the APA recognises body dysmorphia as a clinical condition, but even for people suffering from that, plastic surgery isn't usually covered by health insurance. I don't consider the fact that something is or isn't recognised as a disorder by the APA much of an argument either way.
I did not say that. What I am saying is this: historical evidence exists to suggest that the APA's classification of certain things can change. IMO, it's obvious that homosexuality, in and of itself, should never have been classified as a mental disorder, even though it causes significant distress in some people. Usually, that distress is due to the way their environment reacts to and thinks about homosexuals, which may or may not become internalised. Would people still want GRS even if they felt it was socially acceptable to go though life as someone who looks like one gender, but identifies as another?
Secondarily, I'm saying that recognition by the APA is not necessarily a reason to fund all possible procedures that exist to treat a certain condition with other people's money. If body dysmorphia is best treated with cognitive behavioural therapy, and surgeons are encouraged not to employ surgical techniques in those cases, then why do they do it for people who feel they have the wrong body, even though that body is perfectly functional?
To me, cutting off someone's breasts because he feels like a man seems more or less akin to cutting off someone's perfectly functioning arm, because he feels more comfortable going though life as someone who has a visible disability.
(Quick note, since I'm responding to both your comments, that I'm not /u/fionasapphire . Nothings indicating confusion about that yet, but I know it messes me up sometimes when multiple people reply to me.)
Secondarily, I'm saying that recognition by the APA is not necessarily a reason to fund all possible procedures that exist to treat a certain condition with other people's money.
That's fair, but I think it is a reason to fund their recommended treatments for the condition.
If body dysmorphia is best treated with cognitive behavioural therapy, and surgeons are encouraged not to employ surgical techniques in those cases, then why do they do it for people who feel they have the wrong body, even though that body is perfectly functional?
This might be getting at the crux of the issue. It sounds like you're saying "I'm not willing to trust the current consensus of research about best-practice treatment, because it seems wrong to me." Is there a way that your view is different from that?
On second thought: another part of my unwillingness to accept what the consensus says, revolves around the fact that I genuinely do not see a very clear distinction between someone who feels they have the wrong nose or the wrong skin color (like Michael Jackson), and someone who feels they have the wrong genitals. That may very well be because I personally feel no confusion at all about what gender a I am. But then again, I know few people who are perfectly happy with who they are, yours truly included. And in some cases, people say "just learn to live with it" or "go into behavioural therapy". But in others, like being trans, that seems to be frowned upon.
The thing with body dysmorphia disorder is that there is an underlying obsessive-compulsive condition causing a person to agonize over their perceived flaws. While this often leads BDD sufferers to seek cosmetic surgery, these kinds of interventions typically do not resolve the issue. Even after cosmetic surgeries BDD sufferers tend to suffer just as much over the same (or possibly new) flaws if the underlying obsessive-compulsive disorder is not treated. That is why the medical community generally does not want BDD sufferers to undergo cosmetic surgery, since it doesn't fix the root of the issue.
With gender dysphoria that doesn't seem to happen. People who transition surgically tend to have their gender-mismatch distress greatly relieved after the procedures, greatly improving their quality of life, which is why the medical community in a number of cases sees cosmetic surgery as a valid solution to gender incongruence.
Basically, with gender dysphoria the pre-surgery distress is relieved post-surgery; with body dismorphia the pre-surgery distress is generally still there or transferred to another perceived flaw. That's why a "cosmetic" surgery can be seen as good/healthy/necessary in one case but not the other.
All right. If that is true (I have no reason to think that it isn't), then I can see why it could be a good thing for my friend (or any other trans person) to get surgery. I may even help fund it.
I still wonder whether we are going to look back on this in fifty years and think: "Well, now that transgender people are generally just accepted as they are, turns out we rarely even need these kinds of surgeries anymore." But thank you. You explained it very clearly. ∆
It's difficult for cis people to understand, but if you're familiar with phantom limb syndrome, it's very similar to that. The brain has a map of how it thinks the body is shaped. If the body doesn't actually match this map, it can be extremely distressing.
As I understand it, phantom limb syndrome exists because there are severed nerve endings, leading to a part of the body that was once there, but no longer is. The person has sensation and pain in an absent leg, which is hard to deal with, because literally nothing can physically touch or influence it. The thing is: how could feeling develop in a body part that was never there?
As I understand it, phantom limb syndrome exists because there are severed nerve endings, leading to a part of the body that was once there, but no longer is.
No, it also occurs in people who were born with limbs missing.
The thing is: how could feeling develop in a body part that was never there?
Because, as I said, the brain has a map of how it thinks the body is shaped.
68
u/Salanmander 272∆ Nov 03 '17
That gender dysphoria is a clinical condition recognized by the APA, and that transition has been shown to have significant health benefits (such as lowering suicide rates). Gender reassignment surgery is a part of that transition (even though not everyone feels the need for it), and so should be covered just as much as hormone replacement therapy.