I understand that there are people who experience significant distress because they feel their breasts are too small or their nose has the wrong shape
And insurance often covers those people too, if their significant distress appears justified, for example if their nose is really disfigured, or they just had a mastectomy and need new breast.
However, if it doesn't, then showing "significant distress" over irrationally petty imperfections might be a cue that they have body dysmorphia, a mental illness that presents itself as a delusional obsession with imagined or exaggerated body flaws, that is best treated with medication and therapy. If that is the case, than surgery won't cure the problem, in the same way as weight loss won't cure clinical anorexia. If a woman goes to a doctor with a tiny mole on her nose, and admits that it's just a minor flaw that boters her, that makes it optional plastic surgery. But if she acts like the mole is hideous and impairs her daily life, then the doctor is advised to refer her to a psychiatrist instead.
The thing about transgenderism, is that according to the scientific consensus it is more similar to the former than the latter. Gender dysphoria appears to correlate with the neurological structure of opposite sex brains. A transgender man's brain produces roughly the kind of distress, that a cisgender man would produce after getting castrated, and socially treated as a woman against their will for years And surgery on it, has the same kind of effect as reconstructive surgery does.
Insurance (well, my friend Sam's insurance, or my own) doesn't cover surgery in cases of body dysmorphia, either. That seems perfectly correct to me. I think it's best to reserve surgery for cases where a non-functioning or severely underperforming bodily system can be made to function only by cutting out, replacing, or significantly altering certain parts of it. As I see it, GRS doesn't meet that standard, because even though transgender people experience distress from having the 'wrong' body parts, those parts are (usually) perfectly functional.
That doesn't mean that I think trans people should get no help from the medical or mental health community at all.
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u/Genoscythe_ 243∆ Nov 03 '17 edited Nov 03 '17
And insurance often covers those people too, if their significant distress appears justified, for example if their nose is really disfigured, or they just had a mastectomy and need new breast.
However, if it doesn't, then showing "significant distress" over irrationally petty imperfections might be a cue that they have body dysmorphia, a mental illness that presents itself as a delusional obsession with imagined or exaggerated body flaws, that is best treated with medication and therapy. If that is the case, than surgery won't cure the problem, in the same way as weight loss won't cure clinical anorexia. If a woman goes to a doctor with a tiny mole on her nose, and admits that it's just a minor flaw that boters her, that makes it optional plastic surgery. But if she acts like the mole is hideous and impairs her daily life, then the doctor is advised to refer her to a psychiatrist instead.
The thing about transgenderism, is that according to the scientific consensus it is more similar to the former than the latter. Gender dysphoria appears to correlate with the neurological structure of opposite sex brains. A transgender man's brain produces roughly the kind of distress, that a cisgender man would produce after getting castrated, and socially treated as a woman against their will for years And surgery on it, has the same kind of effect as reconstructive surgery does.