Thursday 4 June 2015

Quote of the Day: 'On this premise, it’s wrong to even consider something like a gender change...'

"According to most conventional or traditional approaches to morality, you must accept yourself as God or Nature made you. On this premise, it’s wrong to even consider something like a gender change, even if it were even easier to attain than it currently is.    "I reject this premise, as must anyone who benefits from tampering with nature as we know it. Human beings alter their bodies and their environments in ways to achieve better results for themselves all the time. That’s the whole point of both science and capitalism: to enable personal growth and human advancement, for the sake of human beings and the things that they value. We utilise fossil fuels, despite the disadvantages, because on the whole it makes life immensely safer, longer and more comfortable than the alternative of going without fossil fuels. We fly on airplanes despite the risks because, on the whole, it makes life far more efficient, enjoyable and comfortable than would otherwise be the case. More personally, some of us engage in plastic surgery (rationally and responsibly), wear make-up, get hair transplants and do other things to alter our body and/or bodily processes in order to attain more personal happiness. If you do such things out of anxiety or mindless compulsion, they won’t bring you happiness, and the same applies to something more dramatic such as gender change. But I see no reason to rule out gender change on principle, any more than to rule out any of these other things, which I have seen, many times, can and do contribute to a person’s sense of well-being and happiness."- Dr Michael Hurd, from his article 'Is Bruce / Caitlyn Jenner Happy?'

6 comments:

Duncan Bayne said...

The more I read about it, the more it looks like an attempt to fix mental illness through surgery, at least most of the time.

http://www.firstthings.com/article/2004/11/surgical-sex

"I have witnessed a great deal of damage from sex-reassignment. The children transformed from their male constitution into female roles suffered prolonged distress and misery as they sensed their natural attitudes. Their parents usually lived with guilt over their decisions—second-guessing themselves and somewhat ashamed of the fabrication, both surgical and social, they had imposed on their sons.
As for the adults who came to us claiming to have discovered their “true” sexual identity and to have heard about sex-change operations, we psychiatrists have been distracted from studying the causes and natures of their mental misdirections by preparing them for surgery and for a life in the other sex. We have wasted scientific and technical resources and damaged our professional credibility by collaborating with madness rather than trying to study, cure, and ultimately prevent it."

One can categorically reject the idea of "natural" or "in God's image"
humanity, and still conclude that some attempts at improvement are in fact wrong-headed.

Anderson said...

Duncan Bayne:

There's a world of difference between imposing a sex change operation on a child who is too young to decide for themselves, as unfortunately happens with intersex children, and a grown adult making an informed decision to surgically change their sex. I doubt any adult signs up for a sex change without being absolutely certain it's what they want, and they will have had years to think about it. Of course it doesn't follow that the sex change will necessarily make them happy or fix any mental health problems they have, but I fail to see why that matters. Nothing in life is guaranteed to make us happy, the important thing is that we have the opportunity to live our lives as we choose.

Duncan Bayne said...

Anderson,

I think we may be talking at cross purposes here.

I'm not arguing that consenting adults should be prohibited from seeking gender reassignment surgery. If you want cosmetic surgery to look like a man, or a woman, or a meerkat then go ahead and purchase it. Likewise, if you're a surgeon who wants to provide it because you think it will improve the health of the patient (or if you just don't give a damn), that's your prerogative. Or at least it should be, in a free world. Money will exchange hands, surgery will be performed, and perhaps you'll be happier at the end of it.

Where we disagree is, presumably, on whether it's a good idea.

You wrote: "Of course it doesn't follow that the sex change will necessarily make them happy or fix any mental health problems they have, but I fail to see why that matters."

That's where I disagree. It matters because the purpose of medicine is to improve the quality of life for the patient, either by curing or mitigating health problems.

http://www.theguardian.com/society/2004/jul/30/health.mentalhealth

"There is no conclusive evidence that sex change operations improve the lives of transsexuals, with many people remaining severely distressed and even suicidal after the operation, according to a medical review conducted exclusively for Guardian Weekend tomorrow."

Basically, there's growing evidence that the desire to change sex is actually itself a mental illness. If that is true, gender reassignment surgery is medically equivalent to cutting off a paranoid patient's arm because he's convinced there is an alien spy probe in it.

Duncan Bayne said...

And even if it *weren't* - i.e. if we were to assume that people are actually born with the 'wrong' sex - the evidence is that gender reassignment surgery doesn't help anyway.

In the best possible case, it's a misguided attempt to surgically treat a real problem.

In the worst possible case, it's aiding and abetting the denial of reality with surgery.

Peter Cresswell said...

Duncan, you appear to be arguing averages against individuals. Perhaps you should read Dr Hurd's commentary ..?

Duncan Bayne said...

Peter,

I've read Dr. Hurd's article and I agree with him. The relevant question in that context is "is Caitlyn Jenner happy" and the only way to answer that question is with reference to her, either by asking her, or observing her other behaviours.

That's not the point I'm trying to make, though.

Gender assignment surgery is, when assessed like you'd assess any other medicine, worthless. There is simply no evidence that it is any more beneficial for people than homeopathy or any other form of witchdoctery.

This leads to one of a few possible conclusions:

* we're not studying the effects of reassignment surgery properly (which is entirely possible; medical studies have proved notoriously hard to replicate in the past)

* sexual dysphoria is a mental illness that is unrelated to the sex of one's body, in the same sense that paranoid schizophrenia isn't fixed by amputating the limb containing the 'alien probe'

* sexual dysphoria is what its suffers claim - they're the 'wrong' sex - and reassignment surgery isn't an effecacious cure most of the time

My personal suspicion is that a lot of people are jumping on this bandwagon because it presses a couple of politically correct hot buttons:

1. people want to believe that gender is a social construct, and not in any way related to one's actual sex

2. oppression of LGBT is still rampant throughout the world, and refusal to perform reassignment surgery on sexual dysphoria patients is seen as similar oppression

What if you were the surgeon, and a patient came to you and said "I want you to perform gender reassignment surgery on me." Would you? Knowing that there's no evidence that it actually works? That you'll be subjecting the patient to a fairly extensive surgical procedure where the expected outcome is zero improvement?

How about, in your current profession, if someone came to you and asked you to redesign their house in keeping with Feng Shui principles?