Susan's Place Transgender Resources

News and Events => Opinions & Editorials => Topic started by: Shana A on April 14, 2010, 09:56:12 AM

Title: The Psychopathology of “Sex Reassignment” Surgery
Post by: Shana A on April 14, 2010, 09:56:12 AM
Tuesday, 13 April 2010
The Psychopathology of "Sex Reassignment" Surgery
Zoe Brain

http://aebrain.blogspot.com/2010/04/psychopathology-of-sex-reassignment.html (http://aebrain.blogspot.com/2010/04/psychopathology-of-sex-reassignment.html)

The Psychopathology of "Sex Reassignment" Surgery : Assessing Its Medical, Psychological, and Ethical Appropriateness, R.P. Fitzgibbons, P.M. Sutton, D.O'Leary , National Catholic Bioethics Quarterly 9.1 (Spring 2009): 97–125.

    Is it ethical to perform a surgery whose purpose is to make a male look like a female or a female to appear male? Is it medically appropriate? Sexual reassignment surgery (SRS) violates basic medical and ethical principles and is therefore not ethically or medically appropriate. (1) SRS mutilates a healthy, non-diseased body. To perform surgery on a healthy body involves unnecessary risks; therefore, SRS violates the principle primum non nocere, "first, do no harm." (2) Candidates for SRS may believe that they are trapped in the bodies of the wrong sex and therefore desire or, more accurately, demand SRS; however, this belief is generated by a disordered perception of self. Such a fixed, irrational belief is appropriately described as a delusion.
Title: Re: The Psychopathology of “Sex Reassignment” Surgery
Post by: spacial on April 15, 2010, 03:00:24 AM
When I was reading and working in psychiatry, for a time, I formed the view that the desire to be surgically altered to change the appearance of the body to the opposite gender was a pathological dysphoria. It seemed to be evidence of schizophernia.

I had worked with people with nihilistic dilusions, such as the believe that they didn't have a stomach so therefore couldn't eat or drink. I had also read of people with more obvious dysphorias, such as the belief that one of their legs isn't theirs and wanted it removed. In the latter case, the examples were from case studies, of people who had had a leg removed for these reasons.

There are a number of important points here that need to understood.

1. The notion that medicine should do no harm is fanciful. Ideally, nothing should harm. Ideally, we should all be able to walk the streets in safety, we should all have decent jobs, without danger, no-one should find themselves being socially isolated, there should be no crime and it should only rain at night time.

This notion comes from 18th century thinking which decided that Ancient Greece was the pinicale of human civilisation. They even called the period Classical, turned their hands to slavery, colonisation and invented one of the most tedious music forms imaginable. (Until everything modern of course. :) )

The measure is not to do no harm, it is to weigh up the benefts in comparison to the drawbacks. This is especially evidence in psychiatry, where many treatments have often, horrible side effects.

Medicine should be aimed at making people happy, comfortable and able to lead their lives according to their vocations and abilities.

2. Body dysphoria is a dilusion, in as much as it's is based upon unverifiable belief. But that, in itself, is not a reason to dismiss it.

Clearly, believing you don't have a stomach is a serious problem.

Many people in Asia think the European complexion is more attractive than theirs. While many in Europe believe that having an even copper colouring is very desirable. In both cases, some people go to extreme and unhealthy lengths. (Setting aside the patronising and racist attitudes by the western media toward Asians and Africans who use skin lightening).

Altering the appearence of part of your body is a matter of choice, based upon how you see yourself in relation to society. Dismissing that is arrogant, dogmatic and incredably self rightious.

3. We alter and adapt our lives to make us happy, generally. Our society, on the surface, at least, grants to each of us the authority to live according to our conscience and wishes. We should have the right to make informed decisions about what we do with our lives.

This notion:

QuoteSexual reassignment surgery (SRS) violates basic medical and ethical principles and is therefore not ethically or medically appropriate.

is not just wrong, it is fanciful, randomly applicable and scientificlly unjustifable.



Post Merge: April 16, 2010, 01:51:57 AM

I've just re-read this post.

The article highlighed in the opening post contained two substantive statements. (The third and fourth are, I think, easily dismissed by most people).

Quotetherefore, SRS violates the principle primum non nocere, "first, do no harm."

is, as I hope I have demonstrated, fanciful and inaccurate. This is not the principal of medicine. The principal of all medicine is to weigh up risks and benefits.

The use of Latin here is especially significant. It is entirely unnecessary to the point and adds nothing other than an air of old school intelectualism. A sort of a psuedo intelectual equivalent of name dropping.

My attempts to attack the second substantive point, namely:

Quoteand therefore desire or, more accurately, demand SRS; however, this belief is generated by a disordered perception of self. Such a fixed, irrational belief is appropriately described as a delusion.

Might have caused some offense. I apologise. It was not my intention to suggest that transgendered feelings are false as such. For this I am deeply sorry.


The statement:

Quote2. Body dysphoria is a dilusion, in as much as it's is based upon unverifiable belief.

The defination of dilusion in many dictioninaries is taken as a false belief.

The clinical defination is that it is a false belief not in keeping with the person's cultural or social background.

This may seem to be little improvement. However, the point of the clinical defination is that the belief is unverifiable by others, that is, it is empiracle. And that it is out of keeping with the person's cultural or social background.

Love is empiracle. It can never be verified. To an observer, it could be seen as false, since they have no evidence other than the claim, by the individual.

Indeed, there are some who, based upon conjecture and specious reasoning, claim that love is a biochemical dilusion designed to encourage reproduction.

My point was to attack the attempt by the authors of the opening article who have tried to use apparent, high handed terminologies in place of superior knowledge, to dismiss transgendered. My tack was to reduce the arguments, a sort of logical minimalism.

If we take transgendered to be empiracle, with no apparent medical or verifiable justification, that, in itself, is not a justification to dismiss it.

SRS, for the vast majority of those that have had it, has been demonstrated to provide a permanent and verifiable cure for the anxiety and the emotional and social disturbance caused by transgendered.

It completely satisfies the medical criteria of risks and benefits in as much as the risks, or draw backs are minimal in comparison to the benefit.