Author Topic: How medically necessary is SRS?  (Read 7942 times)

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Offline Hypatia

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How medically necessary is SRS?
« on: June 30, 2007, 12:49:14 am »
I was on another message board and the subject of SRS came up. One doctor who claimed to have "experience in this area" -- without specifying exactly what that experience consisted of -- claimed that "it hasn't been demonstrated that gender reassignment is really medically necessary." And further claimed that "there is no decent evidence that gender reassignment surgery works any better to improve the patient's overall situation than support and counseling." When asked for a cite to some published study, he said he "didn't have time to find cites" now, but mumbled something about "similar rates of dysfunction" in post-op patients. Claimed that it had not been demonstrated that SRS had produced any better satisfaction in life than "counseling" etc.

People are expressing skepticism, since this totally flies in the face of research I've read about that shows a very high rate of satisfaction for post-op patients compared with before they got the surgery. I had never heard of any such study as this doctor seems to be claiming exists without offering any proof.

Please post references to any peer-reviewed studies you know of that show greater satisfaction with SRS compared to counseling alone. I am just incredulous and really have to wonder where the guy is getting this from. We need to fight ignorance with facts.
Here's what I find about compromise--
don't do it if it hurts inside,
'cause either way you're screwed,
eventually you'll find
you may as well feel good;
you may as well have some pride

--Indigo Girls

cindianna_jones

Re: How medically necessary is SRS?
« Reply #1 on: June 30, 2007, 01:03:59 am »
Hey, I've never read any studies on this subject.  I sure would be interested if any are available on line.

I'd like to cast my vote for one of those studies.  I've lived a successful and productive life for nearly 20 years since surgery.  I think that proves something.

Cindi

seldom

Re: How medically necessary is SRS?
« Reply #2 on: June 30, 2007, 12:46:38 pm »
The fact he was saying similar rates of dysfunction should discredit the doctor right there.  He is probably a crackpot that either follows Blanchard or have very little if any background with transsexual patients.

Again the evidence and the studies points a 98-99%  rate of satisfaction with surgery.  The triathic treatment method (Therapy, HRT, SRS) remains the most successful treatment for any condition in the DSM, which questions if it is a disorder to begin with.

I could find the site but it will take time.

The whole those who had SRS having a similiar rate of dysfunction (the fact he is using this word is disgusting) is a VERY OLD and OUTDATED way of thinking, and that SRS is not medically necessary is something that has been complete debased by most modern gender specialists.

I could go into the history, but its doctors like him that should have NO VOICE on the issue of transsexuals.  It is Doctors like him that has held us back for decades. 

Call him out.
Find the study that states the 98-99% figure of successful transitions.
Criticize him at every turn on every point he makes.

Doctors like him need to be put in their rightful place: informed, or at least proven to be ignorant idiots who are not deserving of their medical license. 


Keira

Re: How medically necessary is SRS?
« Reply #3 on: June 30, 2007, 01:52:41 pm »

One of the problems in those thing is they're comparing apples and oranges.

TS pre-transition, pre-hormone, pre-SRS are often very depressed, disfuncional, broken down, suicidal.

Its totally normal that SRS will not repair all those years of trauma. Some small number, will have been so damaged that nothing will be able to fix them. But, any other treatment will leave most of us still in despair!!! That's the thing. Nothing else will work even 25% as good!!!

If you take non TS patients with the same rate of deep depression and despair and try to find a long term cure for them (since transition or SRS is not an option for them), I'm quite sure the cure rate will be MUCH MUCH MUCH lower than for TS. In fact, we're "lucky" that we can go from depression to relative happiness while many other people with an existential malaise are left to their own device because we still don't know what causes such depresssion.




tinkerbell

Re: How medically necessary is SRS?
« Reply #4 on: June 30, 2007, 02:50:43 pm »
I can only answer this thread based on my experience.  SRS is a matter of life and death for some of us; therefore, in my case, it was extremely necessary.

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Offline Hypatia

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Re: How medically necessary is SRS?
« Reply #5 on: June 30, 2007, 07:21:19 pm »
the evidence and the studies points a 98-99%  rate of satisfaction with surgery.

Yes, that figure is exactly what I was thinking of. In order to refute that doctor, I will need a cite for published peer-reviewed research. Hopefully somebody here will be able to point us to the cite. Thanks for your responses, ladies, I'm still in shock that anyone could assert such disinformation as a supposed authority.
Here's what I find about compromise--
don't do it if it hurts inside,
'cause either way you're screwed,
eventually you'll find
you may as well feel good;
you may as well have some pride

--Indigo Girls

Offline HelenW

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Re: How medically necessary is SRS?
« Reply #6 on: June 30, 2007, 07:27:31 pm »
Here you can find a repository of trans related research: http://www.symposion.com/ijt/index.htm

It seems this doctor doesn't know about the studies that prove him wrong.  It also seems he's hiding behind his supposed lack of time so he won't have to learn any of those uncomfortable facts that would get in the way of his preconceptions. >:(

From what I've seen and experienced, the need to undergo SRS is as variable as anything else in the human psyche.  For some, it may not be a requirement (it doesn't seem so for me) and for others it is literally a life and death issue.  Making blanket generalizations about any human need or behavior is dumb and this person should really know better.

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Emelye
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Offline Hypatia

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Re: How medically necessary is SRS?
« Reply #7 on: July 03, 2007, 11:10:27 pm »
Hmm, here I was hoping that someone around here would have the cite with the 98% figure ready to hand. We need to be prepared for times when we're challenged by such opposition.

Here is one cite I found with Google of "sex reassignment surgery" "studies" and "satisfaction":
Sex reassignment surgery: a study of 141 Dutch transsexuals.

After a lot of Google searches, I think the study that denied greater post-op satisfaction was Meyer & Reter (1979). This paper has gotten considerable criticism, been called the "most noted and disputed" such study, and overall the response has not been favorable. Sample criticism: "Because this publication is cited frequently by the professional and lay literature it seems important to us to demonstrate extensively why the results of this work are not very enlightening and cannot support the conclusions derived from them."

Quote
Sex Reassignment is Effective and Medically Indicated in Severe GID. In persons diagnosed with <not allowed> or profound GID, sex reassignment surgery, along with hormone therapy and real-life experience, is a treatment that has proven to be effective. Such a therapeutic regimen, when prescribed or recommended by qualified practitioners, is medically indicated and medically necessary. Sex reassignment is not "experimental," "investigational," "elective," "cosmetic," or optional in any meaningful sense. It constitutes very effective and appropriate treatment for <not allowed> or profound GID.
.pdf cite: http://wpath.org/Documents2/socv6.pdf section 10

A judge agrees, in a ruling based on "substantial expert medical testimony." The losing side "failed to provide 'a factual basis for its position,' instead merely continuing to claim that in its opinion the procedure was not medically necessary" and "made "misdirected and unsubstantiated claims" that gender-reassignment surgery 'is controversial, risky, and experimental'."
Here's what I find about compromise--
don't do it if it hurts inside,
'cause either way you're screwed,
eventually you'll find
you may as well feel good;
you may as well have some pride

--Indigo Girls

Maud

Re: How medically necessary is SRS?
« Reply #8 on: July 04, 2007, 10:34:20 am »
necessary enough that in court it was proved that that the NHS is obliged to fund it.

though personally IMO surgery is not necessary to live successfully as your chosen gender in the same way that cisgendered people who loose their genitalia for whatever reason can still do ok, though it's not exactly preferable to stay in that state.

Hazumu

Re: How medically necessary is SRS?
« Reply #9 on: July 04, 2007, 10:51:42 am »
AMEN!

But facts alone will not free us.  Even the most rigorously conducted studies, with unassailable-seeming conclusions will not free us. 

That is the biggest mistake Liberals/Progressives have made -- believing that we (all) are rational beings, and that as rational beings we can be shown rationally-derived facts and accept them and replace our truths.

FACT: Evolution.  Species evolved over millions and millions of years and generations.  Adapting to the environment, subsequent generations of organisms developed increasingly complex mechanisms and behaviours to adapt to and survive and thrive in the environment.  The universe came into being billions of years ago, in an event colloquially named 'The Big Bang'

TRUTH:  God created the earth and the heavens around 6,000 years ago.  In a 6-day period, He designed each and every species we see today.  He Designed Adam last, and left Adam in charge of the earth, to do what ever Adam wished to with God's earth, subject to obeying God's Directive. As Adam was all alone, God created from him and gave to him a subordinate companion, Eve, and left Adam in charge of her, too.

You get the idea.

Rockridge Institute (a Liberal/Progressive think-tank,) has pointed out that about 40% of the population will accept the Truth and reject the Fact.  But they're not stupid or ignorant.  It takes great mental acumen to defend the Truth against untruths.

We are not Rational Beings -- we are ruled by emotion.  (An old marketing axiom goes, "We buy on emotion, then justify the purchase using reason.")

If we want the religious/conservative fundamentalists to view SRS as medically necessary, we ain't gonna' win 'em over with FACTS.  It'll take an emotional argument that's tuned to resonate with THEIR belief system.  Then the facts will justify their buying in to it...

Karen

Offline Julie Marie

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Re: How medically necessary is SRS?
« Reply #10 on: July 04, 2007, 12:25:03 pm »
You can find anything to support anything if you look hard enough.  When someone is on a mission to prove something they will find the "facts" to prove themselves right.  One thing all these studies fail to address is each one of is an individual and thus have individual desires and needs.  No one can tell you what's right for you.  Ignore the "experts", shut out all the outside noise and listen to your heart.  When you are truly in touch with your inner self, you'll get the answers to your questions.

Then tell everyone else to mind their own business. 

Julie
When you judge others, you do not define them, you define yourself.

Kate

Re: How medically necessary is SRS?
« Reply #11 on: July 04, 2007, 12:43:06 pm »
You can find anything to support anything if you look hard enough.  When someone is on a mission to prove something they will find the "facts" to prove themselves right.  One thing all these studies fail to address is each one of is an individual and thus have individual desires and needs.  No one can tell you what's right for you.  Ignore the "experts", shut out all the outside noise and listen to your heart.  When you are truly in touch with your inner self, you'll get the answers to your questions.

You've reminded me how much I miss your posts :)

~Kate~

Jonie

Re: How medically necessary is SRS?
« Reply #12 on: July 04, 2007, 01:59:37 pm »
"didn't have time to find cites"

I once heard that the moon was made of cheese, I can't remember just where I heard that, I'll have to get back to you when I conviently remember. You're just going to have to trust me until then.

Offline Hypatia

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Re: How medically necessary is SRS?
« Reply #13 on: July 04, 2007, 05:40:22 pm »
The argument is over the case of a convicted murderer requesting SRS. Sentiment is heavily against allowing it. They're taking it as axiomatic that SRS is elective, nonessential, etc. If suicide is certain to result in the case of untreated level 6 gender dysphoria, my question is-- how is refusing treatment any different from extrajudicial execution?

The debate hinges around whether SRS is necessary to save a life. What bothers me is the assumption that it always isn't. How do they know? They just take it for granted.
Here's what I find about compromise--
don't do it if it hurts inside,
'cause either way you're screwed,
eventually you'll find
you may as well feel good;
you may as well have some pride

--Indigo Girls

katia

Re: How medically necessary is SRS?
« Reply #14 on: July 05, 2007, 03:24:10 am »
like giving cpr to someone who has just collapsed.  it should be automatic, without question, right then and there, capiche?

Lori

Re: How medically necessary is SRS?
« Reply #15 on: July 05, 2007, 07:23:54 am »
You can find anything to support anything if you look hard enough.  When someone is on a mission to prove something they will find the "facts" to prove themselves right.  One thing all these studies fail to address is each one of is an individual and thus have individual desires and needs.  No one can tell you what's right for you.  Ignore the "experts", shut out all the outside noise and listen to your heart.  When you are truly in touch with your inner self, you'll get the answers to your questions.

Then tell everyone else to mind their own business. 

Julie


Wow, you beat me to it. I sure have missed you and your wisdom.

Offline Hypatia

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Re: How medically necessary is SRS?
« Reply #16 on: July 05, 2007, 10:30:06 am »
You can find anything to support anything if you look hard enough.  When someone is on a mission to prove something they will find the "facts" to prove themselves right.  One thing all these studies fail to address is each one of is an individual and thus have individual desires and needs.  No one can tell you what's right for you.  Ignore the "experts", shut out all the outside noise and listen to your heart.  When you are truly in touch with your inner self, you'll get the answers to your questions.

Then tell everyone else to mind their own business. 

Julie

Thanks, but inner answers aren't what I need in this debate, I need medical research to point to. I've heard that these studies exist, don't know why they're so hard to find online. I've been looking through the medical and psych literature reviews that Susan has posted, and jeez... there have been a lot of hostile MDs out there with an anti-trans agenda. Where is the research that supports us? I'm fine as far as my inner knowledge of self goes, but in this debate we need to cite solid published research as trans people fight for equal rights - that is the only sort of knowledge that will work in a public debate. In this case I'm not dealing with personal feelings but science.
Here's what I find about compromise--
don't do it if it hurts inside,
'cause either way you're screwed,
eventually you'll find
you may as well feel good;
you may as well have some pride

--Indigo Girls

Rachael

Re: How medically necessary is SRS?
« Reply #17 on: July 05, 2007, 11:11:19 am »
Oh its neseccery, counceling can help some, personally, i dont need counceling, i know what my problem is, i know how to fix it, and  'counceling' wont make my knickers or jeans fit better will it?

Offline Andrew

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Re: How medically necessary is SRS?
« Reply #18 on: July 25, 2007, 10:43:15 pm »
Who cares about "rates of dysfunction"? Nobody thinks that SRS is going to change their personality or make them a better person. It's a happiness issue. I'm sure that removing a facial deformity on an otherwise normal person isn't "medically necessary" and wouldn't make them less dysfunctional, but looking and feeling normal is important.
Lock up yer daughters.

tinkerbell

Re: How medically necessary is SRS?
« Reply #19 on: July 25, 2007, 10:45:35 pm »
Who cares about "rates of dysfunction"? Nobody thinks that SRS is going to change their personality or make them a better person. It's a happiness issue. I'm sure that removing a facial deformity on an otherwise normal person isn't "medically necessary" and wouldn't make them less dysfunctional, but looking and feeling normal is important.

Let's keep in mind that you are talking from a FTM perspective. ;)  I believe things are different for some (not all) TS girls.

tink :icon_chick:

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