Philosophy Discussion Forums | A Humans-Only Club for Open-Minded Discussion & Debate

[Fried Egg]

As I have explained numerous times already, gender dysphoria (and the medical procedures on offer to facilitate the cosmetic changes to better align their appearance with their gender identity) is unique from other conditions (and their treatments). Only in this case is the proposed treatment to irrevocably damage an otherwise healthy body.

And still, despite numerous repeats, you refer to the treatment as "cosmetic", and yes, we have discussed this too. But your bias toward (or against) trans people and their needs colours everything you say about them. They are not damaging "otherwise healthy" bodyminds, they are getting as close as they can to bringing all aspects of themselves into sync.

Out of interest, do you feel the same way about people with Body Integrity Identity Disorder (BIID)? Should we offer them surgery to remove those unwanted limbs, or sever their spinal cord in order to take away that horrible mobility that makes them so unhappy?

Just as someone born without a leg might choose to wear a prosthetic limb. Even if you don't see it that way, I think that's how it feels to them.

Well, that's where your analogy breaks down. People born with a defect might want some form of cosmetic surgery in order to help them function (or simply fit in) more easily in society. But we are not damaging an otherwise healthy body by giving someone a prosthetic limb. Just as we aren't damaging an otherwise healthy body by giving someone plastic reconstructive surgery when they've had disfiguring burn injuries.

In these cases, their body is already damaged. Yes, we can only treat these with cosmetic procedures but we are not damaging their healthy body parts in order to do so. Hence why sex re-assignment surgery for gender dysphoria is unique compared to all other treatments.

[Sy Borg]

You were implying that sex change ops should be discontinued because there's insufficient evidence that the surgery helps. The fact that post-op transpeople will often just want to move on and disappear as much as possible needs to be taken seriously, not brushed aside.

I am not ready to accept this alleged "fact".

Let's put it this way. With any surgery - if patients return, it's because they have problems. If they don't return, they may or may not have problems. Thus, if people don't return, there's a decent chance that they are not struggling. And, you have to take into account that many transpeople want to move on with their lives. Many have created a clean cut to everyone they knew, so they could start afresh without the baggage. These will logically be the very most appropriate and convincing transpeople since a bloke in a dress cannot start afresh with anonymity since their very presence gives them away.

[Fried Egg]

Let's put it this way. With any surgery - if patients return, it's because they have problems. If they don't return, they may or may not have problems. Thus, if people don't return, there's a decent chance that they are not struggling. And, you have to take into account that many transpeople want to move on with their lives. Many have created a clean cut to everyone they knew, so they could start afresh without the baggage. These will logically be the very most appropriate and convincing transpeople since a bloke in a dress cannot start afresh with anonymity since their very presence gives them away.

You can put it any way you like, and chop logic until you're heart's content, it doesn't change the fact that this is an empirical question. And neither of us have (as far as I know) any evidence either way.

[Pattern-chaser]

Out of interest, do you feel the same way about people with Body Integrity Identity Disorder (BIID)? Should we offer them surgery to remove those unwanted limbs, or sever their spinal cord in order to take away that horrible mobility that makes them so unhappy?

I think this is another situation where the 'right' decision requires careful thought from all involved in the decision of what to do. Simple black-and-white cases are one thing, but gender dysphoria or BIID are quite another. Each case must be considered on its own merits. There is no binary thinking here, and no deciding in advance what we would do. The individual case and its context are our only guides, I think?

Oh, and our (moral?) priorities matter too. For what purpose are we treating the patient? To minimise harm? To offer relief to the patient? There are many ways we might wish to go. Which of them form our guiding priorities here? These are not simple questions; their answers are not simple either. Nor can they be decided in advance, I don't think.

[Fried Egg]

Out of interest, do you feel the same way about people with Body Integrity Identity Disorder (BIID)? Should we offer them surgery to remove those unwanted limbs, or sever their spinal cord in order to take away that horrible mobility that makes them so unhappy?

I think this is another situation where the 'right' decision requires careful thought from all involved in the decision of what to do. Simple black-and-white cases are one thing, but gender dysphoria or BIID are quite another. Each case must be considered on its own merits. There is no binary thinking here, and no deciding in advance what we would do. The individual case and its context are our only guides, I think?

Oh god no! We would end up having to ask people how many limbs they were "assigned" at birth and having activists pushing for society to affirm a child's inner sense of limblessness.

If you honestly believe that there are no decisions that children shouldn't be protected from, then I don't think there's any chance of us reaching any kind of agreement. Thankfully, very few people agree with your position.

[Pattern-chaser]

If you honestly believe that there are no decisions that children shouldn't be protected from, then I don't think there's any chance of us reaching any kind of agreement. Thankfully, very few people agree with your position.

Happily, that is not my position, and never has been. I would assert that children are not the only subgroup of humanity that need special and appropriate care, but that isn't what you're describing here. Whenever someone (anyone) is making a decision with which they need assistance, then that assistance should be provided if it's possible and practical. Thankfully, there are quite a few people who agree with me. Not in detail, and details matter here, for important decisions. But in general, I see no huge disagreement between any of us.

I see and understand your concerns, but I have my own concerns too. As does everyone else. The only thing that we all seem to agree on is that surgical transition is never a decision to be taken lightly.

[Fried Egg]

If you honestly believe that there are no decisions that children shouldn't be protected from, then I don't think there's any chance of us reaching any kind of agreement. Thankfully, very few people agree with your position.

Whenever someone (anyone) is making a decision with which they need assistance, then that assistance should be provided if it's possible and practical.

And I am asserting that there are some decisions that we should not allow children to make, nor adults on their behalf. Some decisions we do not allow to be made on case by case basis. It is not a matter of providing help or assistance to those decisions, it's that certain decisions are simply not allowed.

We don't decide whether to allow children to have sex with adults on a case by case basis. Society has decided, in advance, that it is never allowed and we classify it as "statutory rape".

Likewise, I do not believe we should be deciding on a case by case basis whether to amputate healthy limbs for children with BIID.

Nor do I believe we should be deciding on a cases by case basis whether to administer sex re-assignment surgery to children.

[Sy Borg]

Let's put it this way. With any surgery - if patients return, it's because they have problems. If they don't return, they may or may not have problems. Thus, if people don't return, there's a decent chance that they are not struggling. And, you have to take into account that many transpeople want to move on with their lives. Many have created a clean cut to everyone they knew, so they could start afresh without the baggage. These will logically be the very most appropriate and convincing transpeople since a bloke in a dress cannot start afresh with anonymity since their very presence gives them away.

You can put it any way you like, and chop logic until you're heart's content, it doesn't change the fact that this is an empirical question. And neither of us have (as far as I know) any evidence either way.

At this point you cease to respond to reason. You already said that transpeople must still go to doctors. If they have a major problem, then that will come up in the consultations. Chances are, the situation of most of the struggling transes are known to their treating doctors.

Transpeople will want to move on, maybe move to another state or country to avoid running into people who could inadvertently disrupt their new lives. That appears to be the whole point - they found their former lives distressing and want to distance themselves from it.

[Fried Egg]

Let's put it this way. With any surgery - if patients return, it's because they have problems. If they don't return, they may or may not have problems. Thus, if people don't return, there's a decent chance that they are not struggling. And, you have to take into account that many transpeople want to move on with their lives. Many have created a clean cut to everyone they knew, so they could start afresh without the baggage. These will logically be the very most appropriate and convincing transpeople since a bloke in a dress cannot start afresh with anonymity since their very presence gives them away.

You can put it any way you like, and chop logic until you're heart's content, it doesn't change the fact that this is an empirical question. And neither of us have (as far as I know) any evidence either way.

At this point you cease to respond to reason.

Yes, there are only some answers you can reach by reason alone. This is not one of them. It needs empirical data.

You already said that transpeople must still go to doctors. If they have a major problem, then that will come up in the consultations. Chances are, the situation of most of the struggling transes are known to their treating doctors.

Indeed they will. But that doesn't mean that the gender clinics are collecting and studying the data. And this is exactly what some of them have been accused of not doing with their post-op patients.

Remember how we got to this particular point of contention? That various reviews (such as the Cass Review) have lamented the lack of evidence on the effectiveness of treatments and you responded with something along the lines of we can't expect much evidence because all the successfully treated people just disappear so the data can't be gathered. But however much you think that stands to reason, you can't be sure that this is correct; it's ultimately just an assumption on your part. And given that we've seen reports from some regretful post op patients that the gender clinics simply aren't interested when they come back to them, and that some of the clinics have been criticised for their lack of effort in even attempting to gather and study the results of their former patients, there's enough reason to bring your assumption into question.

In effect, you're arguing that the lack of evidence in this regard should be interpreted as evidence of the efficacy of sex re-assignment procedures but that is only a valid assumption if the treatment providers made a genuine effort to gather the data from those that did remain in contact and study the results. And from the reports I've seen, they didn't (or at least some of them didn't).

At this point I think the only responsible thing to do is to make a renewed effort to fill in this evidence "black whole". Which is what I think that some people are actually trying to do...

[Good_Egg]

... the medical procedures on offer to facilitate the cosmetic changes to better align their appearance with their gender identity...

And still, despite numerous repeats, you refer to the treatment as "cosmetic"...

"Cosmetic" seems accurate, within a philosophy that holds the sex of a body to be something objectively real. We're talking about surgical alteration aimed at making a body resemble a body of the opposite sex, to facilitate a pretence.

If someone has a facelift so as to look 10 years younger, would you not describe that as cosmetic surgery ? Regardless of how strongly that person feels that they are a younger person trapped in an old body, or experiences feelings of identification with a younger age group ?

What's the difference ? Maybe only that you see gender identification as a stronger feeling ? Deeper, more fundamental to one's sense of self ? Which is a matter of degree ?

So your philosophy can be summed up as -"it's different if I feel strongly about it" ??

[Pattern-chaser]

I am asserting that there are some decisions that we should not allow children to make, nor adults on their behalf. Some decisions we do not allow to be made on case by case basis. It is not a matter of providing help or assistance to those decisions, it's that certain decisions are simply not allowed.

Yes, you have made this clear. For you, this seems not to be philosophy, but a simple moral imperative. That's OK, of itself, but it does seem to mean that you are not open to discussion. You simply repeat your pre-existing view.

[Pattern-chaser]

"Cosmetic" seems accurate, within a philosophy that holds the sex of a body to be something objectively real. We're talking about surgical alteration aimed at making a body resemble a body of the opposite sex, to facilitate a pretence.

If someone has a facelift so as to look 10 years younger, would you not describe that as cosmetic surgery ? Regardless of how strongly that person feels that they are a younger person trapped in an old body, or experiences feelings of identification with a younger age group ?

What's the difference ? Maybe only that you see gender identification as a stronger feeling ? Deeper, more fundamental to one's sense of self ? Which is a matter of degree ?

So your philosophy can be summed up as -"it's different if I feel strongly about it" ??

That seems a little unfair. And I'm not sure it's just a matter of degree, although I could be mistaken.

To me, it's like autism — when people say "oh, we're all a little bit 'on the spectrum'", but we aren't. There is a threshold which, when crossed, introduces a *qualitative* difference. I suspect it might be the same here? That there is a point beyond which a qualitative difference has emerged, and it is no longer 'just a matter of degree'. But this, in the end, is just my opinion.

Precise evidence does not exist. Not that there's no evidence — that clearly is not so. But I cannot see sufficient evidence of a suitable standard to warrant the phrase "precise evidence". I.e. conclusive evidence.

[Fried Egg]

"Cosmetic" seems accurate, within a philosophy that holds the sex of a body to be something objectively real. We're talking about surgical alteration aimed at making a body resemble a body of the opposite sex, to facilitate a pretence.

If someone has a facelift so as to look 10 years younger, would you not describe that as cosmetic surgery ? Regardless of how strongly that person feels that they are a younger person trapped in an old body, or experiences feelings of identification with a younger age group ?

What's the difference ? Maybe only that you see gender identification as a stronger feeling ? Deeper, more fundamental to one's sense of self ? Which is a matter of degree ?

So your philosophy can be summed up as -"it's different if I feel strongly about it" ??

That seems a little unfair. And I'm not sure it's just a matter of degree, although I could be mistaken.

To me, it's like autism — when people say "oh, we're all a little bit 'on the spectrum'", but we aren't. There is a threshold which, when crossed, introduces a *qualitative* difference. I suspect it might be the same here? That there is a point beyond which a qualitative difference has emerged, and it is no longer 'just a matter of degree'. But this, in the end, is just my opinion.

But the degree to which someone wants / needs sex re-assignment surgery has no bearing on the fact that the treatments are cosmetic.

What makes them cosmetic? It is nothing to do with the degree of "need" for the treatments (which might, I would agree, come down to opinion). It is a fact that no gender re-assignment surgery can actually alter one's sex. One cannot literally reorient one's body to be structured around producing the opposite form of gamete that they are currently structured. The various treatments currently on offer merely alter one's appearance to give that impression to a casual observer.

Of course, technology might one day advance to the point where this is possible. And then such a procedure would not be considered "cosmetic".

"Cosmetic" seems accurate, within a philosophy that holds the sex of a body to be something objectively real.

It is worth noting that if sex is not "objectively real", then sex re-assignment surgery wouldn't be possible anyway as there would be nothing to re-assign.

[Fried Egg]

(an interesting aside):

If we ever manage to develop true (non cosmetic) sex re-assignment surgery, that would probably mean that it would be a reversible process. After all, if you can literally make a functional male become a functional female (and vice versa), there should be no limit to how many times one might go back and forth. This would alter my opinion of the treatments considerably. My claim that these treatments irrevocably damage an otherwise healthy body would no longer apply...

[Sy Borg]

Let's put it this way. With any surgery - if patients return, it's because they have problems. If they don't return, they may or may not have problems. Thus, if people don't return, there's a decent chance that they are not struggling. And, you have to take into account that many transpeople want to move on with their lives. Many have created a clean cut to everyone they knew, so they could start afresh without the baggage. These will logically be the very most appropriate and convincing transpeople since a bloke in a dress cannot start afresh with anonymity since their very presence gives them away.

You can put it any way you like, and chop logic until you're heart's content, it doesn't change the fact that this is an empirical question. And neither of us have (as far as I know) any evidence either way.

At this point you cease to respond to reason.

Yes, there are only some answers you can reach by reason alone. This is not one of them. It needs empirical data.

That is your opinion presented as fact.

I can do that too. There is no great need for empirical data. The system was working until recent scope creep by trans activists attempting to 1) unfairly enter transpeople in women's sport and 2) to give transvestites the same rights as transsexuals created problems for women.

You already said that transpeople must still go to doctors. If they have a major problem, then that will come up in the consultations. Chances are, the situation of most of the struggling transes are known to their treating doctors.

Indeed they will. But that doesn't mean that the gender clinics are collecting and studying the data. And this is exactly what some of them have been accused of not doing with their post-op patients.

There is no need for gender clinics. That is just another layer of bureaucracy added for no good reason - a parasitic group of activists butting in where they are not needed. All transpeople need are doctors and shrinks.

The idea of transpeople revisiting their trauma for the sake of reporting back to a controlling parasitic organisation is absurd and pointless. All they need to do is go to doctors or shrinks, when they need help.

Leave this stuff to medical and psychology professionals, not activists trying to blur the lines between transsexualism and transvestism.