Explaining why GCS are not elective surgeries to an ally

[James80]

I'm not eloquent. I know this. So I'm asking for help explaining something to an ally that I never thought about having to explain to an ally.

I don't see GCS as elective surgery. How do I explain that stance to someone (without name calling or burning bridges)? Preferably from a health/medical/wellness standpoint rather than an ideological one.

I know it reduces suicidality. That's valid. Other than that, I don't have a good, logical argument, and I know I should have one.

Also, does anyone know how often insurance companies cover GCS?

I just want to have this conversation more rationally and completely, especially with people who are on our side, but just don't get the surgeries some of us have.

Thanks for any assistance.

[Dena]

While hormones can reduce our dysphoria, body dysphoria often remains even when HRT levels are correct. Surgery conforms our body to what the mind expects helping to eliminate the dysphoria. Unfortunately dysphoria can be dangerous as it drives us to suicide. The combination of therapy, HRT and surgery all act to eliminate dysphoria.

The difficult part is explaining dysphoria to somebody who has never experienced it. The feeling is total irrational and we know it but we are unable to do anything about it without proper medical treatment.

[rmaddy]

I'm not eloquent. I know this. So I'm asking for help explaining something to an ally that I never thought about having to explain to an ally.

If the person is an ally, you probably aren't going to have to explain it all.

I don't see GCS as elective surgery. How do I explain that stance to someone (without name calling or burning bridges)? Preferably from a health/medical/wellness standpoint rather than an ideological one.

If GCS is done under the conditions set out by WPATH, it is generally not defined as elective, and fewer and fewer insurance companies see it that way. 

I know it reduces suicidality. That's valid. Other than that, I don't have a good, logical argument, and I know I should have one.

First of all, reducing suicide risk is quite a lot.  Still, I think it is important to remember that suicide risk can remain above that of non-trans people even post op.  The authors of the 2011 study which presented this data did not interpret this as a reason not to transition, but rather as a caution that transition is not the end of risk.

Also, does anyone know how often insurance companies cover GCS?

Not statistically, but generally speaking you will get let pushback on GCS by far than you will on electrolysis, FFS, breast augmentation--the sorts of things that may help you integrate socially on a day to day basis.

I just want to have this conversation more rationally and completely, especially with people who are on our side, but just don't get the surgeries some of us have.

Thanks for any assistance.

Not everyone wants surgery.  Not everyone needs surgery, but every who needs it should get it.   We are still in a learning area regarding the management of gender dysphoria.  Most of the studies to date compare the wellbeing of those who surgically transitioned with those who are either did not (control 1) or are not trans (control 2).  Where the scientific literature is much weaker is in regards to those who took intermediate steps, for example HRT only, surgeries other than GCS, mental health support alone, etc.  Not nearly enough research is being done on behalf of our FTM brothers.  We need these studies, and this part is important, using fully willing, informed and consenting volunteers.  Meanwhile, the most effective and best studied intervention, GCS, needs to made available for those who need it.

[CursedFireDean]

I think it should be clarified the difference between elective and cosmetic surgery.
Elective surgery is a surgery not performed in an emergency, but instead scheduled ahead of time.
Cosmetic surgery is surgery performed with a lack of medical necessity, but instead for aesthetics alone.

From your question, I'm assuming you mean cosmetic instead, because GCS is actually an elective surgery. Surgery can be medically necessary but still be elective.


As for medical necessity making it not cosmetic-

Top surgery versus bottom surgery I find is (for me) the easiest to justify to allies with physical medical reasoning (as opposed to mental health arguments, which sometimes people don't think is a real reason). Usually once people accept one, they tend to accept both in my experience.

Long term binding (which is necessary for daily comfort and acceptance as male) is detrimental to rib and lung health. Pre-existing conditions make binding every day for the average work day even more difficult or in some cases life-threatening, such as extreme asthma. Broken, cracked, bruised, or warped ribs are not uncommon in people regardless of health. It causes back problems and chronic pain or physical discomfort. "Not binding" is simply not an option for many people, because that would mean not being able to live as their gender at all.

In addition, as a preventative measure, both top surgery and hysterectomies help reduce the chances of trans people having undiscovered problems in those areas. It is NOT because trans people are more likely to get problems, but the fact that it is so uncomfortable for us to even get those parts examined, and they can easily go much longer unnoticed and progress further before treatment. On top of that doctors have been known to mistreat or refuse to treat trans people when they do seek help with those gendered body parts, and if there's difficulty even getting these areas examined, it can be healthier for many people to simply have them removed and be no longer a concern. There's a lot of things people have removed simply because it isn't a necessary body part and it's more trouble than it's worth without it being life threatening.