Should there be genetic testing and counseling prior to any gender reassignment procedures?

[Ceece]

Originally Posted by Threerun

I don't know if I can parse out all the emotional issues with your post, but I will try.

1. What 'taxes' are being levied that you describe? I'm not aware of any. Do you have a basis for this assertion? As far as I know it is an elective procedure and some insurance may cover it, some don't.

2. What effect on society are you referring to? Your vision of it?

3. I'm not aware of any physicians or surgeons that are 'compelled' to perform an elective procedure. Do you have evidence to support this claim?

4. It appears you do not wish to share 'space' with a human that doesn't conform to your biological definitions- is that right?

5. He/Him and 'pronouns' are simple. Ask the person for their name and refer to them by their name. It's kinda not difficult.

1. Look at the military, PP, etc. Anything supported by tax money, anywhere in the world
2. Changing language, being made to "pretend", etc.
3. That was a 'what if' situation. If someone has the right to pursue their happiness and people accept that a transwoman is actually a woman then wouldn't it be a crime NOT to perform surgery if they feel they need it? Much like mis-gendering can get you fined in some parts of the world now. Or booted off social media. Or even fired.
4. My biological definitions are BIOLOGICAL. There's no arguing with it.
5. No, I won't say the sky is green either because I'm not going to pretend (ie: lie to myself) because MY feelings are more important.

Honestly, I was pretty clear with my first comment so the only reason I had to respond again is because you were keen to shoot down a reasoned explanation of where I stand. You don't want to accept that people aren't willing to bend to your will I guess.

[Threerun]

Originally Posted by Ceece

1. Look at the military, PP, etc. Anything supported by tax money, anywhere in the world

I don't know what 'PP' is but Tricare (military healthcare) says this-

Intersex/Differences in Sex Development Surgery
TRICARE may cover intersex surgery to correct ambiguous genitalia only when it is documented as being present at birth.

For information on gender dysphoria services, visit the Gender Dysphoria page.

So no- I don't think tax dollars are spent on anything other than hormone therapies, which really isn't expensive.

Originally Posted by Ceece

2. Changing language, being made to "pretend", etc.

Language changes all the time. I don't understand the last part - 'made to pretend'. Are you saying you are being made to pretend?

Originally Posted by Ceece

3. That was a 'what if' situation. If someone has the right to pursue their happiness and people accept that a transwoman is actually a woman then wouldn't it be a crime NOT to perform surgery if they feel they need it? Much like mis-gendering can get you fined in some parts of the world now. Or booted off social media. Or even fired.

I'm not aware of any law that makes it a crime for a physician or surgeon to elect not to participate in gender affirming care. To the contrary- there are a number of states proposing to make it a crime TO perform gender affirming procedure, particularly to minors.

https://www.usatoday.com/story/news/...th/7129101002/

Fourteen other states introduced 22 bills this year restricting transgender youths' access to certain medical procedures, according to Freedom for All Americans, a bipartisan LGBTQ advocacy campaign. Twenty-one bills are still being considered:

As far as being booted off of social media or being fired or even fined- In my opinion this is grossly exaggerated. The large social media sites I'm aware of allow freedom of speech, but when it crosses the line into hate speech, or all out bigotry- that's a different story. In my profession you don't have to agree with your co-workers or even like them, but you can't discriminate or become unprofessional.

Originally Posted by Ceece

4. My biological definitions are BIOLOGICAL. There's no arguing with it.

A lot of people, including health professionals may disagree with you. That's your position to defend. Good luck.

Originally Posted by Ceece

5. No, I won't say the sky is green either because I'm not going to pretend (ie: lie to myself) because MY feelings are more important.

I can certainly see that.

Originally Posted by Ceece

Honestly, I was pretty clear with my first comment so the only reason I had to respond again is because you were keen to shoot down a reasoned explanation of where I stand. You don't want to accept that people aren't willing to bend to your will I guess.

I didn't view your commentary as reasoned, but certainly emotional. Furthermore I'm not asking anyone to 'bend to my will'. I stated very clearly that I believe in a persons right to the pursuit of happiness period. Basically I am a live and let live person.

You show me where I said anything that could be remotely construed that I want you or anyone else to 'bend to my will'.

[RamenAddict]

Originally Posted by Sonic_Spork

I don't vilify anybody nor believe that anybody should be vilified.

And I do think that experts should continue to study these matters, compile information, make recommendations and best practices.... I just really don't like studies that are done for a purpose of confirming a bias, or rules made to prop up a religious or cultural position, in a way that imposes it on others. Like I said, despite being fully in support of trans people's rights to live their lives free from vilification, persecution or harm, I sometimes personally find it a little bit jarring or uncomfortable. Even just adjusting my own mental concept of someone when I know them before and after changes...but this is MY problem. Never should it be a driver for how anyone is treated or what rights, protections or obligations they have. I don't believe that my ~feelings~ have the jurisdiction to be shaping real world rules. Hell, I don't even let such things shape the way I try to treat others, which is just simply with consideration and respect.

But that is part of my own ethics, too.

There are foods that repulse me, but I will never use that as justification to say to someone who enjoys it, "Ew, yuck, gross, how can you eat that?"

There are subjects that bore me to tears but someone else has every right to be passionate about it.

There are insecurities I might have in a relationship that I do not use to behave in controlling or jealous ways towards my partner, whom I trust.

Some discomforts are just one's own problem to deal with. Being a little uncomfortable ain't gonna kill ya.

And that's part of the problem with the "trans debate" is that in my opinion, a lot of people are just trying to cherry pick "science" (from among many sources that in fact just serve different biases) to prop up their desire, truly and deep down, to treat their FEELINGS as grounds for a declaration of right or wrong.

If the scientific community at large studies the matter and finds that many who transition wish to later de-transition, or that transitioning is more likely to cause harm than to resolve a negative state that is causing harm, then THEY need to compile their evidence and use it to inform treatment, and to counsel people who need it.

But frankly, I don't believe that feelings...or religion, much to the chagrin of the very devoted...get to be the ultimate force that shapes objective truth and reality, or that someone who works in a scientific vocation should be permitted to bend the content of their work around their feelings or their faith. In other words, if in time and with much compilation of actual data, results prove a conclusion that does not align with what one might WISH for from a feelings or faith perspective, no, medical professionals should not disregard the upsetting science in favor of their faith...or if they do, then perhaps they should switch their vocation.

There are people whose faith dictates that they avoid technology. There are people whose faith dictates that they must avoid modern medicine and let their lives and deaths be simply in "God's hands." At the extreme. OK? And none of them should be trying to hang a sign and open up shop as doctors, on the premise that they will simply pray for your good health.

I know that's an outrageous piece of hyperbole but sometimes one needs must deploy the ridiculous to explain a point or a position. If an overwhelming body of experts in a scientific community presently stand behind a particular approach, I'm not going to call it a political conspiracy just because it perhaps doesn't align with my feelings or faith. Not that such is the case for me with regard to faith, but just saying.

How this circles back to the OP, is that I don't really see any problem with genetic testing or "counseling" (what kind? There's already a lot of required counseling. Nobody in the US just pops in for a quick gender reassignment with no counseling)...this is the involvement of medical professionals in a medical process. If someone needs to transition as much as they will tell you that they do, then no "counseling" is going to change their minds about it.

There is a consortium of providers who agree to certain ethical guidelines RE gender affirming surgery best practices. I don’t think anyone is going to be “forced into” doing this type of surgery or treatment as it is quite specialized and it isn’t like you’re just going to stumble upon it by accident. I don’t see it is any different from someone going to a provider for pain management who does certain types of procedures but doesn’t want to prescribe narcotics. All they have to say is that they don’t provide that at their practice, but X doctor specializes in that and might be able ot help.

[Atari2600]

I assume you're talking about in the United States?


So, I would say that yes, there "was" at least. If you go back more than 10 years ago, there was a general set of rules that... I forget the organization, but something something of Psychiatry had come up with. I had a friend transition from man to woman back in 2001, and this was basically the way it worked.


For the first couple of years, it required you to meet with a psychiatrist to work out why you believed you had gender dysphoria (which was called something else back then). The reason they did this is because, unfortunately, the overwhelming vast majority of people who sought gender re-assignment surgery, usually had some other psychological ailment, whether it was obsessive compulsive disorder, depression, etc. They needed to "weed out" people who perhaps believed they had gender dysphoria and this just simply became the thing they "hung their hat on" so to speak, as well as people who would be unable to cope after the transition which would lead to suicide. So the vast majority of people who sought to get this surgery were generally denied unless they went through a defined process.


After one to two years, they could start taking hormones or testosterone (depending on direction).



An additional requirement that the psychiatrist usually insisted on in that last year, was living with someone who had already transitioned for a year as a roommate. You would then be required to dress/live as the gender you wanted to transition to during the weekends. I know that tends to be a joke that people say... but this is actually what you were required to do. The intent was so that you would understand the challenges you would face living as someone who had transitioned... such as the looks you might get, or the discrimination, etc. It was to ensure that you could handle it.


Then, after all of that, you'd get an approval from your psychiatrist, who would then give the green light for the elective surgery. I say elective because you generally had to pay for it entirely out of pocket.



Finally, you were required to take a leave from work and family, something like a few months, and then come-back and live full-time as a post-operative transgender person (which is what it was called back then). After that you'd then be asked to continue to see a psychiatrist, because suicide was always very high.


Another thing that was also required by psychiatrists, which I generally don't agree with, was that you were supposed to separate yourself from everyone you had known previously... basically, you were supposed to give up all of your friends. This was because you were effectively supposed to be living a whole new life, and it should include new friends. The point was to cut back on rejection, but my opinion is that it just caused depression as you were only further isolating yourself.





I don't know to what point this changed, but it's kind of a free-for-all now, and the number of suicides has increased significantly. The first inclination is to believe that it's as a result of bigotry, but that's not the case. That process was meant to weed out the people who "thought" they should have been another gender, from people who actually suffer from gender dysphoria. A lot of people have regrets after going through serious irreversible surgeries.





But you know... to each their own, when you're 18, you get to make your own choices... and that's part of being an adult.

[Nov3]

Originally Posted by Atari2600

I assume you're talking about in the United States?


So, I would say that yes, there "was" at least. If you go back more than 10 years ago, there was a general set of rules that... I forget the organization, but something something of Psychiatry had come up with. I had a friend transition from man to woman back in 2001, and this was basically the way it worked.


For the first couple of years, it required you to meet with a psychiatrist to work out why you believed you had gender dysphoria (which was called something else back then). The reason they did this is because, unfortunately, the overwhelming vast majority of people who sought gender re-assignment surgery, usually had some other psychological ailment, whether it was obsessive compulsive disorder, depression, etc. They needed to "weed out" people who perhaps believed they had gender dysphoria and this just simply became the thing they "hung their hat on" so to speak, as well as people who would be unable to cope after the transition which would lead to suicide. So the vast majority of people who sought to get this surgery were generally denied unless they went through a defined process.


After one to two years, they could start taking hormones or testosterone (depending on direction).



An additional requirement that the psychiatrist usually insisted on in that last year, was living with someone who had already transitioned for a year as a roommate. You would then be required to dress/live as the gender you wanted to transition to during the weekends. I know that tends to be a joke that people say... but this is actually what you were required to do. The intent was so that you would understand the challenges you would face living as someone who had transitioned... such as the looks you might get, or the discrimination, etc. It was to ensure that you could handle it.


Then, after all of that, you'd get an approval from your psychiatrist, who would then give the green light for the elective surgery. I say elective because you generally had to pay for it entirely out of pocket.



Finally, you were required to take a leave from work and family, something like a few months, and then come-back and live full-time as a post-operative transgender person (which is what it was called back then). After that you'd then be asked to continue to see a psychiatrist, because suicide was always very high.


Another thing that was also required by psychiatrists, which I generally don't agree with, was that you were supposed to separate yourself from everyone you had known previously... basically, you were supposed to give up all of your friends. This was because you were effectively supposed to be living a whole new life, and it should include new friends. The point was to cut back on rejection, but my opinion is that it just caused depression as you were only further isolating yourself.





I don't know to what point this changed, but it's kind of a free-for-all now, and the number of suicides has increased significantly. The first inclination is to believe that it's as a result of bigotry, but that's not the case. That process was meant to weed out the people who "thought" they should have been another gender, from people who actually suffer from gender dysphoria. A lot of people have regrets after going through serious irreversible surgeries.





But you know... to each their own, when you're 18, you get to make your own choices... and that's part of being an adult.

Bolded as to understand - How is it choice? In the mind of the afflicted its no more a choice then it was for their body to grow an arm or to have two earlobes.

I assume its the "physical" change that is a choice to willingly sign off on though.?

My former spouse did mental assessments - to affirm certain affects existed to warrant a collaboration with the physicians. This is one circumstance where it is a two part checks and balances.


There is no point of reference though that says affirmatively that yes THIS qualifies for PAT to get that gender re-assignment.

My slight education in tribal history doesn't go on record that this has been a physiological occurrance that was hidden away and is now being addressed. So Perhaps a different back drop to history can formulate the anomaly of gender disassociation - ( pardon as its probably not the politically correct word- )