General Question

Zissou's avatar

Is gender dysphoria a disability?

Asked by Zissou (1747points) January 6th, 2017

Should gender dysphoria be considered a disability that would be covered by the Americans with Disabilities Act? If it were, allowing persons diagnosed with this condition to use the bathroom of their choice could be a reasonable accommodation per the ADA (this might have to be tested in court).

Since this accommodation would only apply to those who have been competently diagnosed, maybe this approach would address the concerns of those those who are worried about perverts pretending to be transgender in order to use the “wrong” restroom for nefarious purposes (I am not saying these fears are based on facts).

Too easy? What am I missing?

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83 Answers

zenvelo's avatar

No, it isn’t a disability, and trying an end run around stupidity by discounting one’s self identity is a false way to guarantee equal rights.

elbanditoroso's avatar

I think what needs to happen is for someone to be a test case – someone needs to actually be arrested for going to the “wrong” bathroom. Then we will see how a state would defend these laws, and the arguments they would try and muster.

Right now, as far as I know, the only ‘test cases’ have been in schools, which have their own sets of complications when it comes to the legal system.

Otherwise, it’s all about ‘potential harms’ and such. But ultimately the law needs to be broken and tested.

Zissou's avatar

@zenvelo I think you may have misunderstood. Classifying gender dysphoria as a disability does not necessarily deny that one’s gender identity can differ from one’s physiological sex. On the contrary, if we accept that gender and sex can diverge, then that would be all the more reason for recognizing that persons with this condition face a special burden and might require accommodation.

Perhaps you are concerned that classifying gender dysphoria as a disability might be construed as asserting that those who have a gender identity that doesn’t match their sex can or should be “cured” so that they accept a cisgender identity. That would not necessarily follow; recognizing that someone has a disability is not the same as prescribing a particular therapy for that disability or presuming to understand the underlying causes of it.

Mariah's avatar

I’m interested in this question, because I know the trans community has worked very hard to have gender dysphoria removed from DSM as a mental illness, but I’ve never fully understood why. I guess they want to distance themselves from the stigma of mental illness, or the idea that it’s their heads that should be treated rather than their bodies. If being trans is not considered an illness of some sort, however, what is the precedent for allowing medical costs associated with transition be covered under health insurance?

zenvelo's avatar

@Zissou My thinking was for the the reasons @Mariah outlined. Treating is as a “disability” makes it a problem to be addressed. Better for us as a society to address treating all people as people.

BellaB's avatar

Couldn’t gender dysphoria be renamed and then treated as a physical disability rather than a psychological one?

Interesting to follow this American discussion from a country that seems to have already moved past it.

Coloma's avatar

I agree with @zenvelo
I’m a slightly ADD, left handed, right brained blonde. Should left handed blondes be considered disabled?
I have a really hard time making simple decisions sometimes, is it a disability if it takes you 20 minutes to choose a salad dressing in the grocery store?

Seriously, no, everyone faces challenges and short of serious physical or mental health issues the umbrella of disability needs to be lowered not expanded.

JLeslie's avatar

@Mariah Being gay used to be in the DSM. In my own family this was a problem, because there was an instance where a young person in the family, early teens, said something about her friend being gay, and adult member of the family went on and on in an angry voice that it’s a psychological disease and that person needs to be treated. It was as bad as the holy rollers these days who want to “fix” gay people. This same teen, who actually was thinking she might be gay herself at the time when she mentioned her friend, now knew never to speak of it again. She was afraid she’d be locked up in a mental institution.

At the same time I see the argument the other way. I’m always a little conflicted about singling out groups to protect them. Everyone should have equal protection under the law even without specifying a group.

Mariah's avatar

@Coloma Well, there are tangible reasons to have things labelled as disabilities. Like if you need to spend a lot of money on medical expenses related to that thing, you might not be able to get it covered by health insurance unless it’s considered a legit disability. I’m guessing your left-handedness isn’t too expensive, but transition surgery is.

@JLeslie Totally makes sense.

Coloma's avatar

@Mariah I understand but I also think that we need to be careful about incorporating every life challenge as a certified disability.

Mariah's avatar

I don’t think anyone’s suggesting that we do that, but in this case sex reassignment has very significant costs associated with it and so has reason to be considered a disability.

Coloma's avatar

@Coloma True, but I’m not sure I agree with picking up the tab for sex reassignment, people can still live as the gender they feel they are without surgical intervention a lot of the time.
In a way it is like cosmetic surgery, it might be nice but is not necessary. The question is where do we draw the line?

Mariah's avatar

The suicide rate is so high for pre-operative trans people that I would argue it’s just as important as treating depression, certainly more important than cosmetic surgery.

Coloma's avatar

@Mariah Yes, that may be true, but it is also true that many people have disturbed body images and all sorts of issues that could cause suicidal thoughts as well. I’ve had suicidal thoughts after being financially devastated in the recession and I am not eligible to be given a million dollars to facilitate a happy retirement. Being financially destroyed could be considered a disability too. I’m just asking where do we draw a line on government handouts?

A trans person can still dress, live and act as the sex they feel they are without extreme surgical intervention. I just don’t know if I feel that costly, physical, sex re-assignment on the government dime is truly necessary. If one wishes to pursue this route via their own funding fine, but I don’t consider trans people to be truly “disabled”.
I fully support sex re-assignment surgeries but not on the government dime.

Mariah's avatar

Trans people, particularly MtF, are also incredibly likely to be victims of violence if they don’t “pass” through the help of medical treatment like hormone replacement therapy or surgeries.

You facing financial problems is not a problem with your body or brain, so it is not a disability, but there are other government programs to help the poor.

Zissou's avatar

Thanks for your thoughtful responses. I disagree with the bathroom hysteria on the right, but I don’t think we understand this condition as well as some on the left seem to think. I am unwilling to spend tax dollars or even pay higher insurance premiums to pay for something as drastic as sex reassignment surgery when we don’t understand what is going on. It’s not just the money.

I was going to ask whether there might be a relationship between gender dysphoria and body integrity identity disorder, but I found there was already a discussion of that on the Straight Dope forum and a philosophical examination of the issue on Gordon Cornwall’s blog.

Given the incompleteness of our understanding, maybe the Native American approach is the most humane.

Mariah's avatar

Why do we need to understand the condition better in order for them to be worthy of help? We understand that trans people kill themselves if they can’t live as their desired gender; we understand that receiving medical intervention such as hormone replacement therapy and surgery usually stops the suicidal ideation; what else do we need to know? We don’t withhold cancer treatments because we don’t understand what causes cancer.

MollyMcGuire's avatar

No. I feel I should have been born Brazilian. Suck it up and make the most of life. Whining is not the way to do that. And it doesn’t cause me inability to work. So again, no.

Coloma's avatar

@Mariah Well, the argument of being financially devastated and all that goes with it absolutely can effect the body and brain. There are millions of people and children going hungry in this country and going without proper medical and dental care that does effect their bodies and brains. There are thousands of aging people that lost it all in the recession with no hope of re-cooping their losses.Getting medical aide for hormone replacement therapy is one thing but claiming that someone needs a million+ dollar sexual re-assignment surgery to live their best life, well yeah, again, it would be nice but it is not necessary.

Sex re-assignment for those that are unable to earn and save for their own surgeries is just not as important as feeding and funding the truly poverty stricken.
I am not disputing the challenges of a transgender person just saying that sex reassignment surgery is not mandatory to leading a decent quality of life in the same way food, clothing, shelter and medical needs are for the poor and I don’t think that footing the bill for transgender surgeries is a priority when there are so many other, more dire, issues to address in the world. We also understand that poverty stricken people kill themselves too if they are unable to meet their needs and feel hopeless. Depression and hopelessness s not just a problem for the transgender challenged.

There are also thousands of people that have committed suicide during the recession after losing it all.
Having to learn to live with a disability is a challenge many face, and I’d rather pay for a surgery to help a crippled child walk again or aide the elderly that can no longer earn enough to support themselves before I pay for a penis or vagina to be constructed for someone that is not, truly, physically disabled. That’s how I feel about. If you’re a Caitlin Jenner go for it, but if your a gender confused 20 year old that claims you are too depressed to work and save for your own re-assignment surgery, no.

Mariah's avatar

If poverty is making you depressed, you can get treated for your depression, and your disability is depression, not poverty. Poverty is not a problem with your body or brain. Gender dysphoria, however, is.

I am loathe to consider a healthcare system in which we would rank everybody’s various ailments and only treat the worst 50% or whatever. Who could possibly make an objective judgment about which thing is worse than another.

Coloma's avatar

@Mariah So where do we draw the line?
As @MollyMcGuire said, she feels she should have been born Brazillian, what about black people that feel they should have been born white? What about the kid with a big nose that claims their ugly nose is making them suicidal and they must have it fixed on the taxpayers dime to lead a decent quality life? I think we absolutely can make an objective judgment on what constitutes a medical priority.

A heart transplant for someone who has led a healthy lifestyle and falls victim to a rare heart condition yes, a liver transplant for a lifelong alcoholic, no. Sorry, I just don’t think that a pair of boobs or a penis or a vagina is a priority when there are so many other more dire needs in the population.
As you said, depression may be a disability , a side effect of poverty and the same holds true for the transgender person. They may be depressed because of their condition but they can also learn to live with it as do many, and many other disabled people of various conditions do as well.

A pair of boobs and a penis and vagina are not mandatory to living as the sex you feel you are and to live without them is not life threatening. It would be nice but it is not critical to leading a decent quality of life as a transgendered person.

Mariah's avatar

But it is life threatening.

41% of preoperative trans people attempt suicide compared with 4.6% of the general population. And as I said before, violence against trans people who do not pass means that being able to pass as your preferred gender is a matter of personal safety.

Transgenderism is a known phenomenon that can be shown with supporting data that it requires treatment; I have heard of maybe one case of someone saying they were born the wrong race so that is really not a thing the way transgenderism is.

You’re also suggesting that people should be denied medical treatment if their lifestyle isn’t healthy enough? Where do YOU draw THAT line?

canidmajor's avatar

Personally, I’d rather see all of the above funded by tax dollars than that asinine Wall. Or all the extra security funded by our tax dollars because the President-elect and his family don’t want to bother to follow established security protocols. Or more expansion of an already over-powered military.
The surgeries we’re talking here are barely a drop in the bucket compared to that.
That’s my line.

zenvelo's avatar

My state, California, just paid for the first reassignment surgery for a convicted prisoner. She was convicted of murder, kidnapping, and robbery, and is serving life without parole.

Coloma's avatar

^^^ Yes, insanity at its finest!
@Mariah Yep again, I do not think alcoholics and drug abusers and lifelong smokers should be given expensive transplant surgeries and I certainly do not think transgender criminals serving time for serious criminal offenses or any offense should have their sex re-assignment bills paid for by the taxpayers. I mean come on…really?

Mariah's avatar

So if someone hasn’t always made the best choices in their past we just let them die.

Who makes these decisions about who is worthy enough for life?

A frightening dystopia. Count me out.

Coloma's avatar

@Mariah Why would you give a liver transplant to an active alcoholic or a heart/lung transplant to a smoker? They wouldn’t be a candidate anyway. People are supposed to die, some sooner, some later, that’s the way of nature and yes, I do not think insurance companies or the state should pay for reckless behavior and poor lifestyle choices. That’s not lack of empathy for human err it’s just obvious common sense.

Mariah's avatar

Because they’re a human and their faults don’t make them so evil that they’re worthy of death? If they waited on the transplant list I see no reason why they should be skipped over due to their lifestyle choices. Whatever. We don’t have to agree about this.

Coloma's avatar

@Mariah I never said human frailties mean people should die, of course they deserve care, palliative care, compassion and comfort but a 60 yr. old alcoholic on medicare should not be on a transplant list taking an organ from a 25 year old and a transgender criminal should not expect the state to pay for their re-assignment surgery. I agree we don’t have to agree.

Mariah's avatar

Denying someone care is killing them, and you know the cases aren’t always going to be as clear cut as the examples you’re giving. Again, lines to be drawn, and this is death you’re doling out when the decision is made to deny. It might look passive to you but as someone who needs care frequently in order to be alive let me assure you that denying someone care is a very aggressive act.

I will stop now as the thread is far from where it started. Sayonara.

JLeslie's avatar

I’m pretty sure alcoholics are either not allowed on the list or are low on the transplant list. It’s not even a matter of money, it’s about limited supply.

Coloma's avatar

@JLeslie, Yes, just using that as a possible example of misappropriated medical care.
The healthy person in organ failure is going to take priority over the alcoholic, obviously and I see nothing wrong with that.

@Mariah I’m well aware of your sensitivities and your health issues, what I am saying has nothing to do with denying “care”, but denying extreme treatment in certain circumstances.
I’m pushing 60 in a couple years and I’d rather see you, a 24 yr old get that heart or liver over an older person who has already lived their life or who has recklessly ruined their heath.
I am using rational, objective reasoning here not emotional reasoning and at 7.5 billion humans walking this earth some of them better hurry up and die. haha
Goodnight to you as well.

JLeslie's avatar

@Coloma An alcoholic can be in organ failure too. I think they do do transplants for people who have been dry for a while. Still, the list of people waiting is way longer than available livers. People are prioritized. Two people with the exact same situation in terms of near death, but one was a drinker, the priority I’m pretty sure will go to the guy who never drank. All I’m saying is the rules for transplant basically agrees with you.

Mariah's avatar

Transplant I can concede on because I understand there is limited supply and it is in fact an either or situation. When we start denying people care and drawing lines in the sand about who deserves to live or die and the only sacrifice required of others is they pay a little more tax money, that’s when the situation becomes so inhumanly selfish that I don’t even want to live on this planet anymore.

Zissou's avatar

@Mariah you said
Why do we need to understand the condition better in order for them to be worthy of help? We understand that trans people kill themselves if they can’t live as their desired gender; we understand that receiving medical intervention such as hormone replacement therapy and surgery usually stops the suicidal ideation; what else do we need to know? We don’t withhold cancer treatments because we don’t understand what causes cancer.

I never said they weren’t worthy of help. This is a gross misstatement of my position. This whole thread is predicated on the assumption that gender dysphorics do need help. But if I have to take a position on the nature of this problem, like you I am inclined to view it as a mental health issue. It is possible to treat suicidal ideation in other ways. You offered some figures earlier (source?), but how do we know that antidepressants or other treatments might not work?

What else do we need to know, you ask? Seriously?? How about
1. Is suicidal ideation a necessary concomitant of this condition, or does the ideation result from adverse social pressures?
2. What is gender anyway? Is it a construct as we’ve been told, or does this disorder show that there is a more fundamental basis for it, perhaps neurological? Are there only two genders? What are the implications of this for treatment?
3. Is gender dysphoria a form of xenomelia/BIID? We wouldn’t simply amputate the limbs of xenomeliacs without trying to treat the neurological or psychological issue, would we?
4. Do persons with other disorders, such as dissociative disorders, sometimes claim to be transgender or request reassignment surgery? What are the consequences of misdiagnosis and reassignment in such cases?

And on and on. Looking at question 1, have you considered that maybe it is the rest of us who need to change, rather than forcing these individuals to submit to extreme mutilation in order to shoehorn themselves into our binary gender system?

Whatever gender dysphoria is, it’s been around for a long time, and we ought to look at how individuals and societies coped with it before reassignment surgery became an option. (Once again, the Native American approach is instructive.) There is much that I don’t know about this condition, but is clear to me that reassignment surgery has an ideological basis as well as a medical basis, and that ideology merits scrutiny.

You mention cancer. It now seems that many thousands of men of men have had unnecessary prostate surgery and many women have had unnecessary hysterectomies at great financial and personal cost. More understanding is better!

Mariah's avatar

Obviously I am in favor of continuing to research these conditions, and obviously I am in favor of society in general becoming more open minded about things related to gender. However, both of those things take a very long time, and for people who are struggling right now, I argue we should allow them to seek the treatment that we currently know to be helpful to them. We shouldn’t deny medical care to people now just because we might discover a better way forward later.

Mariah's avatar

If anyone is curious, I did some research about what it would cost the taxpayer to foot the bill for these “extreme” (to quote several people above) treatments.

Anyone want to know what a full gender reassignment costs? It isn’t $million+ as was claimed above. For MtF (which is more common) it is $7–24K. For FtM it can be $50k. Given that MtF is more common, I give a liberal estimate of $30k for an average.

4 million people turn 18 every year in the US. .6% of the population is trans, so 24k trans kids reach adulthood each year. To fund all of their transitions each year, then, the cost spread over the 242 million adults in the US is $3 per person per year.

So to pay 100% of the costs associated with transition for all trans kids each year and prevent 10,000 suicide attempts, you’d have to give up your Starbucks one morning per year.

If the lower 10% of the population truly can’t afford $3 out of their year, I think the upper 10%, who make 143k or more annually, could probably afford $6 a year as substitute.

Put differently, we could shave .12% of the military budget to pay for all of this medical treatment.

Trump could fund 33 complete transitions per day by staying at the White House instead of insisting upon receiving Secret Service protection at Trump Tower.

Just some perspective, if you were interested in the hard numbers.

canidmajor's avatar

^^^ This. Thank you, @Mariah.

JLeslie's avatar

I wonder how many hours is their surgery and how long the recovery is?

canidmajor's avatar

Both of your questions are likely answered here, @JLeslie.

JLeslie's avatar

^^That’s a U.K. site, but I’ll assume the hospital stay is still at least 4 days in America. I didn’t see where it says how long the surgery actually takes. I was just wondering if the price seemed matched to the surgery requirements or if it’s another case of unreasonable fees.

canidmajor's avatar

here

“I wonder how many hours is their surgery and how long the recovery is?”
You’re welcome.

JLeslie's avatar

^^I read it. I saw the recovery time in the U.K. I didn’t notice the surgery time, I must have missed that.

Ok. I just repeated myself.

You do understand days in hospital might vary by country don’t you?

canidmajor's avatar

Yes, @JLeslie, I do. Please accept my most humble apology that my helpful response was not to your exact requirements. May I suggest that you look it up yourself next time. Or do be more specific next time. You didn’t mention “recovery in hospital” you said “recovery”.
Geez

janbb's avatar

@Zissou I think there is a lot to understand and think about gender issues and reassignment surgery. A friend of mine thinks we will look back from 100 years from now and think we got it all wrong.

Coloma's avatar

I’m sorry, but if we’re going to talk about funding trans surgeries I think we should be funding the poor, the homeless, the elderly on fixed incomes, children that are going hungry and don’t have decent clothes to wear to school. I will never support sex change surgeries on the government or taxpayers dollar when there are so many other high priority needs for funding. Get a fucking job and save for your transition. it is not a necessity and if you are able bodied work for what you want.
Bottom of the barrel of serious needs that need to be addressed before I pay for someones new tits and vagina.

JLeslie's avatar

@canidmajor I’m getting sarcasm and a cast of implying I’m lazy or stupid in your last few responses to me. I appreciate the link, I don’t appreciate your insinuations.

Mariah's avatar

@Coloma We already have programs to support all those people (not that they necessarily work very well).

Besides, my view isn’t that we help trans people at the expense of any of the groups you listed, it’s that we should shave maybe 5% of the military budget in addition to raising taxes and fund all of those things easily, but that makes me a bleeding heart liberal tree hugging hippy communist wacko in this country. Sigh.

Again you seem to misunderstand how much of a necessity medical intervention is for trans people. $3 a year to prevent 10,000 suicide attempts seems like a really small price to pay to me. But, whatever, I see you will not be convinced!

canidmajor's avatar

@JLeslie: You do understand that I was answering sarcasm with sarcasm, don’t you? (Rhetorical)
Pots and kettles.

JLeslie's avatar

@canidmajor Actually, no. To quote someone I rather not quote, “you started it.” I asked a serious question you told me,

“I wonder how many hours is their surgery and how long the recovery is?”

You’re welcome.

While at the same time reposting the same link.

That seemed quite snide.

BellaB's avatar

@Mariah

this

$3 a year to prevent 10,000 suicide attempts seems like a really small price to pay to me.

__

It doesn’t get much clearer than this. Thanks for putting those numbers together.

Coloma's avatar

@Mariah It’s not about convincing me of anything. In a perfect world with unlimited monies sure, give the trans people aide with their transitions but it’s not a perfect world and I don’t think trans surgeries are a priority over many other things. That is the point I am arguing. I also vehemently oppose paying for trans criminals surgeries.

Commit a crime you base medical care not birthday parties and free penises. The trans community has made loads of progress and continues to do so so on many levels as has the gay community over the years and I’d rather see that money go to mental health programs that help trans people learn to love and accept themselves as they are. Not having a penis or vagina is not life threatening in the same way hunger and lack of medical care is for the teeming masses. Suicide among trans people is not any different that suicide amongst the poverty stricken, the elderly, or any other myriad reasons for suicide.

So, for the last time, it is about prioritizing and IMO there are many other, much more important priorities out there and if you want to claim that depression is the problem not the source of ones depression such as poverty, disability, gender dysphoria etc. well then, the same holds true for trans people. Able bodied trans people can work towards funding their own surgeries. That’s the adult and responsible thing to do. There should be no sense of entitlement here, none.

Mariah's avatar

My last comment should have made it clear that I’m not arguing funding trans people’s surgeries at the expense of anyone else’s medical care, so you’re going to have to find a different argument to use against me.

“programs that help trans people learn to love and accept themselves as they are” tells me you don’t understand trans people’s situation at all. Literally their condition is that they can’t accept themselves as they are.

We could go round and round for days, couldn’t we….

Coloma's avatar

@Mariah Yes, it seems we could, my point is that the same argument can be said for multiple groups of the challenged, whether that is the person that is having a hard time accepting they lost both their legs in an accident, or the veteran that can’t blend back into society or the impoverished middle aged person that can’t accept the harsh reality that there is not enough time left to rebuild their retirement fund and are looking at going into their old age in a state of poverty. If other groups need to suck it up and learn to live with their challenges and disabilities the trans population can too. Not being born with the correct genitalia is not any different than not being born with arms or legs. It sucks but this sense of endless entitlement is not the answer. We can’t cherry pick only those causes that are near and dear to ourselves, it’s a big picture scenario and in the big picture I simply do not consider sex re-assignment surgery to be in the top 5 of priorities of where our taxpayer and government monies are spent.

Anyway, it;s been a rousing discussion for sure. :-)

Mariah's avatar

The way I see it, there are theoretically two ways to solve gender dysphoria, make the mind match the body or make the body match the mind. However, I consider the former to be abusive in the same way that gay conversion camps are – it’s trying to deny the person a part of who they are, and is probably the reason why trans people have fought so hard to have their condition removed from the DSM.

Coloma's avatar

^
I don’t believe being a tranny is a mental illness, I absolutely believe it is a genetic anomaly, a congenital, pun intended condition but lots of people have to reconcile a disparity in who they really are vs. what reality has dished out. Money doesn’t grow on trees and nobody is entitled to have their every hardship fixed.
I’m being denied who I really am these days. An independent woman who has enjoyed sipping the nectar of her lifelong contributions until my cup that once ranneth over was dried up like a grape in the desert of the recession.

My outer reality certainly isn’t matching my mind and who I really am these days. In my mind I am still a classy lady with means living my best life, in reality I am an aging person who can no longer earn enough to support a decent lifestyle and handle a few thousand dollar emergency that is worried every day as to how I will manage if one of my pets needs emergency vet care or my aging vehicle blows up that I cannot afford to replace. Existing and surviving is not truly living and thriving. So, again, when one is wounded on the battlefield of life well, triage isn’t always pretty or fair, but a spurting artery takes precedence over a flesh wound.

The spurting artery of poverty is far more serious than not getting your dream penis. My final musings.

janbb's avatar

@Coloma I’m not weighing in on the larger discussion but just would like to let you know if it matters to you that “tranny” is seen as a derogatory term. I didn’t know and used it once and a trans woman friend let me know.

Coloma's avatar

@janbb I wasn’t aware of that, thanks for the heads up. I will remember to use transgender or whatever the more acceptable term is, gender dysmorphic.

Mariah's avatar

K – I support helping both those in poverty and trans folks – the money is all there, in the military budget, in the bank accounts of our top 1% – life isn’t a zero sum game.

Zissou's avatar

@Mariah There is a third possibility: that gender dysphoria is not really a disorder at all, but is just another way of being, and neither the body nor the mind should be altered. The analogy with homosexuality points in that direction. But the stats you have provided about suicidal tendencies incline me to continue to view it as a mental disorder, either in itself or in conjunction with the pressures they face in our society. (Sources for those stats would have been appreciated.)

I worry that mentally ill people are getting irreversible procedures when they may not be fully competent to make that decision (and yes I do call reassignment extreme regardless of the cost). I understand that everything about this issue is politicized, which makes it difficult for me to evaluate what I read about it, but evidently there are at least some people who regret getting the operation. Maybe some of them attempt suicide too.

@janbb Yes, that is what worries me. The history of medicine and psychiatry in this country has some sordid episodes. Could this turn out to be another such episode? I don’t know.

Mariah's avatar

I’m really quite tired of this thread but suffice it to say that I consider it very offensive to say that trans people are not competent to make their own medical decisions. I have several trans friends and they are all very sane individuals who simply hate the body they were born in. It’s their body – why should anyone else be the one to make their medical decisions for them?

I agree that the suicide rate shows that gender dysphoria is not simply another state of being, at least not a tolerable one, at least not in our current society. Changing society takes decades though and people need help now.

I would really like to be done repeating the same arguments over and over, though, so I’m going to link you to a thread I stumbled upon today which I thought had an amazing amount of synchronicity with the timing of our discussion here, which I hope you’ll enjoy reading through:

https://www.reddit.com/r/changemyview/comments/5my4j3/cmv_gender_dysphoria_may_be_a_mental_disorder_and/

Here’s a particular comment that expresses my viewpoint very well.

BellaB's avatar

Thank you for making those points @Mariah . I first worked with transgender people just about 40 years ago. I was just out of my teens and didn’t know/understand anything about transgender when I started (was it even called transgender then? I don’t recall). In any case, what I learned was that it really wasn’t a mental disorder – the people were not mentally ill. They had the wrong body. It was very much a physical disability for which there were very limited treatment options.

I am happy to see that more/better medical treatment is possible now. I think back to the people I worked with in the late 70’s/early 80’s and wish those options had been available to them. I also wish the social awareness / acceptance by some people (as limited as it still is) was around then. It would have made such a difference.

Zissou's avatar

”...very sane individuals who simply hate the body they were born in”—that’s not quite an oxymoron, but it comes close. By similar reasoning, maybe anorexics are very sane people who prefer be emaciated, and who are we to intervene? It also raises Coloma’s objections as to the necessity of the operation and whose responsibility it is to pay for it. But I will read your links, and I do appreciate the effort you have put into this thread.

Circling back to the OQ, if gender dysphoria really is a physical problem exacerbated by social pressures, not a mental problem, then maybe official recognition as a diagnosed disability could do some good in terms of providing reasonable accommodations and changing attitudes or at least overt behaviors toward transgendered people. Maybe.

Edit: I see now that the anorexia analogy has been addressed in your link.

Mariah's avatar

Yeah the anorexia analogy has holes as you saw; I’ll reiterate what the link says for those who don’t click it: anorexics don’t become “cured” if they act on their impulses. They don’t become happy with themselves once they lose weight. They continue to think they’re too heavy until they starve to death. This is why it is not useful to let them act on their desires with their bodies. Trans folks however are usually “cured” (made happy with their bodies) by HRT and, if desired, reassignment surgery, and taking these steps doesn’t ruin their health the way starving yourself does.

odatin's avatar

One can claim they’re disabled for any type of dysphoria if the experience is of great intensity. Like gender dysphoria, one can make a similar complaint using aesthetics instead of gender. They may claim they’re dysphoric over their own personal appearance and need plastic surgery to function in society. There are unlimited reasons one can use to claim disability because of the extreme distress they’re experiencing of said reasons.

@Mariah, you wrote It’s their body – why should anyone else be the one to make their medical decisions for them?

Out of curiosity, with such an inquiry, why, then, do you have a problem with people who reply to you with the statement It’s their money – why should any else be the one to make their financial decisions for them?

Why do you feel that the money one earns does not belong to them and that others get to decide what is done with it? You don’t hold that sentiment for the body.

Do you believe there is a difference between the statements my body and my money?

Mariah's avatar

Because most importantly we have an inalienable rights to bodily autonomy. Because you only get one body but you can earn more money. Because what I do with my body affects no one but me, while people use their money to oppress others. Because many people have far more money than they need and the same doesn’t apply to bodies. The two ideas are really not congruent.

odatin's avatar

How does opting out of paying for someone’s sex reassignment surgery oppress them?

Why do you feel it doesn’t apply for bodies? There are several organs in the body that one can live without – a spare kidney, parts of liver, lung, pancreas, intestine, bone marrows. Considering your statement, have you donated these organs to those who have dysfunctional organs?

Mariah's avatar

I didn’t call out that particular act as oppression. I was referring more to things like super PACs buying elections.

Do you really think giving up the money to buy a third vacation home is congruent to giving up a lung? Seriously?

Also, I’m on the bone marrow donor registry but I haven’t matched with anyone yet.

Coloma's avatar

@Mariah But…it’s a free country and it is not up to you to decide that someone who has earned their money is somehow bad/wrong for buying a 3rd vacation home. Claiming that all people of substantial means should not have certain accoutrements of said wealth is not your or anyone elses place to claim. Maybe they don’t NEED 3 vacation homes but they WANT 3 vacation homes.

There is nothing wrong with that and while I am all for altruism I also don’t think that the wealthy should be shamed and belittled for being in the have category. That’s life and I don’t support a Robin Hood mentality and more than I support stereotypes about the poor. I do not think that just because someone is uber wealthy that anyone is entitled to a slice of that wealth.

Mariah's avatar

So you don’t believe in taxes or services for the needy that are funded by money from the populace?

I think people don’t need third vacation homes and that other people do need medical care and, and that it is criminally cruel to leave the ill to suffer, and that the only way to avoid it is to redistribute wealth. And this means taking some of the rich’s excess money and putting it into programs like Medicare. Sue me.

Coloma's avatar

@Mariah Yes, of course, but I support government spending cuts and exhorbitant military expenses for the war machine over taxing the rich into oblivion. There is nothing wrong with being rich and if you look up the greatest Philanthropists of our time you will find rock stars, corporate founders like the Bill Gates Foundation, movie stars and all sorts of very generous wealthy. I, personally, know several people that make between 300–500k a year and they are very altruistic and are constantly giving to others. I do not believe in reverse discrimination and extreme taxing for the wealthy.

If you can earn it you have every right to spend it as you so choose. I have never been in the elite rich segment but when I had money I was very generous as well and I chose to spend my money on good food, travel and art and my animals. Someone else might want that 3rd vacation home and there is nothing wrong with that. We have no right to determine what others spending habits are or whether they are worthy of our approval.

The rich are not all greedy, self centered, assholes that only care about getting theirs. We need to be careful about stereotyping any segment of the population, period.

Mariah's avatar

I don’t think I ever said all rich are greedy? Or that I support taxing them to the point where they’re not rich anymore? I support shaving off a larger percentage of their income than people who are not rich, the way it is already done; I also support majorly cutting the military budget as I mentioned earlier in the thread.

The rich that I have a problem with are the ones who are out there grumbling about their money being spent to help people, not the ones who are out there willingly donating it to help people, obviously.

odatin's avatar

@Mariah

It isn’t what I think, it is what you said. You believe that quantity of something gives you and the public authority over that quantity. Based on that reasoning, I am asking whether you think it is acceptable to force someone to donate bone marrow to you because they can. I’m also asking whether you personally follow this line of reasoning by donating one of your own spare organs to someone in need.

Now you’re telling me that you believe quantity is hierarchical, implying that an extra home has less value than one’s extra organ.

If you believe we have inalienable rights to bodily autonomy then you can’t have a disbelief on the inalienable rights of what a body produces and gets in return for that production. That is exactly why in the Bill of Rights, part of the list of unalienable rights, it says to own and control private property (land, money, personal items, intellectual property, etc.) and to earn a living and keep the fruit of one’s labor.

Finally, I will say that conversations on what is abundant, what is fair, what has more or less value, what is more or less important are arbitrary. My personal take on it is that you shouldn’t be discussing what is to be done with money that you didn’t earn and certainly doesn’t belong to you, in the same way you wouldn’t want someone to have a say in what should be done with your medical issues.

odatin's avatar

There is also a flipside to that point. If one does end up involving public money on personal matters, they can’t complain when the public has a say on the personal matter. Whether it is sex reassignment or abortions, if one feels they have that right, and they certainly do, they can’t tell the public it’s my body, you have no say on the matter. One can’t have it both ways. Either you pay for it yourself and then the public has no say or you force the public to pay and you will never hear the end of what should be done with your personal matters.

Mariah's avatar

You grossly misstate my view based on 1 sentence I wrote. It’s not about straight quantity, it’s about having what you need in order to live a tolerable life. The very rich have far more money than they need in order to live a good life. Just because you can survive without a kidney doesn’t mean your life won’t be vastly harmed by it. Guess what, I have lost a disposable organ. I wouldn’t wish it upon my worst enemy. Nobody’s life is going to be terribly harmed by not having a third vacation home. So yes, an extra home has less value than an extra organ.

I do actually see a great distinction between actual fucking body parts and what somebody produces by using their body. That is not inconsistent with my belief in bodily autonomy. The government clearly acknowledges this because I can never legally be forced to donate blood, but I can be forced to pay taxes.

Either you pay for it yourself and then the public has no say or you force the public to pay and you will never hear the end of what should be done with your personal matters.” Then let them bitch and complain, I don’t give a fuck what people have to say about it, I just need my medical care.

“you shouldn’t be discussing what is to be done with money that you didn’t earn and certainly doesn’t belong to you” I can discuss whatever the fuck I want. That’s what Fluther is for. It’s not like I’m a politician and anything I say is about to become law. I’m just stating my opinions.

How do you propose we solve these problems, if money is so damn precious to you? Are you okay with just leaving the sick to die? Medical care is more expensive than most mere mortals, especially the sick ones, can afford without the use of money they didn’t earn. Obviously it’s not ideal that the sick should need to depend on the money of others, but it is reality. What do you want to do about it? You want to leave them to die?

I am literally in disbelief about how much opposition my simple viewpoint of “the sick deserve medical care and therefore financial aid” is getting. Goddamn. How do you people sleep at night.

JLeslie's avatar

So many of the people who don’t want to pay for abortions want people who didn’t support the Iraq war to pay for that. If not that something else.

Don’t sweat it @Mariah. There is so much hypocrisy out there. The majority of the collective knows you well, respects you, and appreciates your POV. You have very sound arguments regarding this topic. I’m not sure exactly where I stand on the entirety of the issue, but you certainly made me think.

Coloma's avatar

Well, in a perfect world all of our dreams would come true, there would be an abundance to go around and everyones wishes and desires would be met, but…we live in an imperfect world, not some Utopia where nobody goes without, whatever their without is.
Money in the bank or the genitalia they feel is there birthright.
Therefore we must prioritize. If it were up to me, we’d have all gotten that Christmas pony when we were 7 and Santa Claus would bring a great big bag of new genitals to the transgendered but, alas, this is not reality and we all have to suck it up in one way or another.

Zissou's avatar

Needs are more important than wants.
Protecting lives is more important than protecting property.

I hope we can all agree on that much even if we disagree about whether SRS (sexual reassignment surgery) is an essential need, or how we should apportion the burdens of meeting essential needs in general.

Mariah's avatar

@Coloma We hardly have to live in a utopian society for people to be able to cough up $3 a year and seriously, you’re not doing yourself any favors in convincing me you have empathy for trans people by comparing their dysphoria to your childhood desire for a pony.

janbb's avatar

I have some questions about the binary nature of our current gender thinking and whether sexual reassignment surgery is the best way to achieve gender fluidity acceptance but I totally agree with @Mariah ‘s position that we should be a society that provides for the mental and phsycial health needs of our citizen without judgment. As @JLeslie‘s says, those of us who opposed the Iraq War still have to contribute to paying for. You don’t get to nitpick each item that you will pay for with your taxes if you live in society. I know trans people whose lives are greatly improved by transitioning and those who have post-surgical problems but it is not our decision to make.

I’ve been following this discussion for a while and to my mind, it is past its usefulness date. Some people seem to have very little understanding or empathy for anyone not in their specific situation and nothing will change that. Continue on if you want but I suspect energies are better directed elsewhere.

Coloma's avatar

@Mariah

I wasn’t comparing my not getting a pony for Xmas with anything, I used that as an analogy of not getting whatever it is one wants, be that a pony or a new penis because we live in an imperfect world. My point is that it is an individual choice as to what one chooses to support and it is perfectly okay to have personal preferences as to what one supports or does not support and a personal level of priority.
The point is that there are thousands of $3.00 causes and they can’t all be met..

I don’t want to be told I have to contribute to paying for a gender dysphoric persons surgery, maybe my passion lies with the world wildlife fund instead and that’s okay.

@janbb One can have plenty of empathy for many causes and feeling that one particular cause is more important than another does not make someone lacking in compassion or self centered. My personal priorities would be tackling poverty, homelessness and the hungry followed by ecological causes before transgender surgeries, and these have been and remain my priority issues regardless of my own experiences.
I agree this discussion is past its useful point but for the sake of discussion, well, that’s what a discussion is, and discussion doesn’t always have to be useful it can be a free flowing sharing of thoughts and opinions which this has been.

Bottom line, we are all free to have our thoughts and opinions and freedom to choose what we consider priorities for our tax dollars and government funds.

bigkitty2454's avatar

Maybe they should invent a pill so at a certain age a person feels like the opposite sex, they can take the pill and immediately change to the other one. This way everyone would stop degrading all the trans people in the world.

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