Community Conversation => Transgender talk => Topic started by: Rachael on February 05, 2008, 10:44:06 AM Return to Full Version

Title: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 05, 2008, 10:44:06 AM
This topic came to my attention from a fellow lgbt/wellfare committee member... and as the trans wellfare officer, i phoned the debating society regarding this... i want the debate to go ahead. its going to be VERY insightful, but i had to remind the secretery of the ramifications of the 'for the motion's argument... and offensivive arguments that contravine the student union's polices (which i wrote ^_^)

They agreed to let me vet the defence and offence arguments, what do people think could come up for the motion?
what sort of sane unoffensive arguments could be rasied?
R :police:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Dennis on February 05, 2008, 11:15:00 AM
If i were arguing for the proposition, I'd look at purpose statements for the NHS (like preambles in legislation) and see if I could argue that the NHS was never meant to be comprehensive coverage. Can't think of anything else offhand.

Dennis
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 05, 2008, 04:14:58 PM
TRUE... but its comprehensive medical health care...
trans is a medical problem...
its like saying, yeah, most people dont get cancer, we wont cover that...
im seeing it as a insta loose sortof thing... and ill have to cut a lot of what else they come up with... i mean, ill have to leave some to the debate, but its not to get to a 'is trans medical or not' debate, which it is... so i dunno...
R :police:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 05, 2008, 05:21:37 PM
god yea, im not about to outmyself for it.... hence my backroom cloack and dagger influence :D
Im sure they will suggest things like its a choice, and 'cosmetic' surgery, unnecesery etc...
the whole 'sex change' walk in one day, walk out a woman....
and ignore f2ms as normal ;P
R >:D
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: SarahFaceDoom on February 05, 2008, 10:17:46 PM
I actually had this debate on another message board the other week.  Though it was in the context of the state paying for Otherkin's to modify their bodies.  And invaribly transgender issues had to be discussed as well.

My feeling on it is that the surgery should be pretty much open to anyone who wants it.  I don't think the state should pay for it, because then that means they can also deny you the surgery and say it's not neccessary.  I would rather it be something you can access without so many gatekeepers.  It is your body, and you should be able to do with it what you want.  SRS can increase someone's quality of life.  So why not let them decide to have it?

I just really do not like how you basically have to get diagnosed as having something wrong with you to get this surgery.  It strikes me as a bit mean.

I also think there should be overarching financial restrictions on how much you can actually charge for these sorts of things.  Or ways that you can finance them better, so that anyone who wants to have a procedure done, can get it done.  It shouldn't be a procedure for only the wealthy.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 06, 2008, 04:39:19 AM
i dont see the problem... it being medical makes it more accepting socially... its a birth defect, wrong body, surgey fixes it, the end?

althought true, it is somewhat overregulated and treated like some sort of deviant treatment program to cure mentally ill men and women.

yeah red, the pain is always ignored, everyone holds a view that you can walk into hospital a man, and walk out a woman... job done...
R >:D
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Jessie_Heart on February 06, 2008, 08:09:55 PM
 What bugs me is how torn society seems to be on this issue. on one hand they seem to think that it is something that can be diagnosed and they make you go through all that you have to couseling and such to get permission to get it done so they can make sure you are "a real T" then they say that it is just cosmedic surgery (or a choice) so insurance does not have to pay for it. doesn't this really amke it damned if you do damned if you don't. I mean in this way it seems that we are discriminated against. because if it is cosmedic we shouldn't need all these permissions and if it isn't then insurance should have to pay for it.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Purple Pimp on February 06, 2008, 10:54:11 PM
Yes, it's absolutely ridiculous (at least, in the U.S.) how SRS works.  On the one hand, it is "cosmetic" surgery that you must totally pay for out-of-pocket (unless you're one of the rare, lucky people who has insurance coverage that will actually pay for it).  On the other hand, you are supposed to go to a therapist and be diagnosed with having a mental illness (for which, strangely, the highest chance for relief comes in the form of a physical change, SRS).  It really needs to be one or the other; either it's all in our heads, it's an "illness," and insurance should cover the "cure," or it should be something you pay for without the stigmatizing, pathologizing medical diagnosis.  Personally, I say don't have it covered by insurance; that way, you are free from the medical gaze and can take your transition into your own hands.

Lia
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: lady amarant on February 07, 2008, 12:11:53 AM
The only seemingly valid argument I can think of for the proposition would be budget - the argument that, since TS is not immediately life-threatening like, say cancer or aids or whatever, that money should go towards those instead, and towards providing better emergency services etc. And against the high incidence of suicide the argument might be that that IS a choice, even if TS isn't, and should be handled by making more therapy, support groups and the like available, rather than HRT and SRS, which should be waited with until the person in question can fund it themselves.

I wouldn't agree with those arguments, but it would sway many, I think.

By this line of reasoning it would come down to, as Dennis said, a question of purpose: Is the NHS' primary purpose to improve quality of life, or to save quantity of lives? Sadly it might be tough to find a response if it's reduced to a numbers game like that.

Posted on: 06 February 2008, 23:57:02
The only counter-argument I can come up with at the moment would be to agree with it:

Yes, the NHS is first and foremost about providing emergency and primary care for everybody.

However, and here we could go two ways: Argue that providing transition and eventual SRS IS primary care because mental health is a primary care issue (Not to say that TS is a mental health issue, but the dissociation and depression caused by it is) and show how not addressing it costs the economy more in the long run, or alternatively argue that the only reason this would be an issue is because the NHS is underfunded/badly administered, and that it boils down to a societal problem of misplaced priorities.

Nebulous I know, but I only woke up 30 min ago...  :icon_dizzy:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 07, 2008, 04:52:53 AM
transsexuality IS iminently life threatening... considering that 75% of trans teens attempt suicide, and 50% of those attempts are sucessful, id say its got a fairly iminent life threat...

anyway, aids isnt life threatening these days if treated, neither is all forms of cancer....
aids is nolonger a death sentance.
meh, broken arms dont threaten lives, lets just not treat them. not fix the spines of children wit hfuzed vertibrate, or help people to walk again...
R >:D
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: lady amarant on February 07, 2008, 06:04:18 AM
Quote from: Rachael on February 07, 2008, 04:52:53 AM
transsexuality IS iminently life threatening...

I absolutely agree, but consider that this is going to be debated by non-trans people, many of whom consider suicide itself a sin, never mind TS. Even if not, suicide is seen as a pure mental-health problem, whatever leads up to it. TS itself isn't life-threatening, but the inevitable depression and sense of dislocation that stems from it is. That's what a good debater would argue, anyway.

Anyway, I wasn't stating my opinions on the matter. I am trans, I've been at suicide's door a few times, I know what it is like. But sometimes you have to be able to put yourself in another person's shoes if you're ever going to understand them and have a chance of convincing them.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 07, 2008, 07:50:37 AM
i dunno, if you were paralised from the neck down, wouldnt you feel like there wasnt much going?
R >:D
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: lady amarant on February 07, 2008, 08:40:41 AM
Quote from: Rachael on February 07, 2008, 07:50:37 AM
i dunno, if you were paralised from the neck down, wouldnt you feel like there wasnt much going?
R >:D

I don't know if I'm following your point exactly, but assuming you mean that people with paralysis, MS or whatever feel the same kinda suicidal thoughts we do, then yes. They do.

I work as a carer. My last client before the present one is 25, and fell off the back of a motorcycle while on holiday in Pakistan. C5 full fracture. he can move his shoulders nad his neck. That's it. I was his first live-in carer after he left the hospital. At least we have options as far as treatment goes, however inadequate. Until stem-cell research starts producing miracles though, the best my last client can hope for is to "learn to live with it". Fortunately he has - unfortunately by taking up militant Islam. My current client has MS, and has had to watch himself decline from a strong, confident young man to the point where he can barely move his head.

Some would argue that, if somebody in that position has to just "learn to live with it", so should we. I don't agree, but it does make me thankful for the options I do have, however screwed-up my life is at the moment.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Jessie_Heart on February 07, 2008, 10:07:08 AM
 I am just wondering is treatment of persistant mental conditions covered on NHS? if they want to look at this as a mental condition for the purpose of the debate maybe you should debate it on thier terms. you could argue that if treatment for a condition like bi-polar (or whatever is covered) disorder is covered than so being TS should be. and argue that if there were a cure through surgery for a bi-polar disorder were offered that it would be covered. if they want to look at it as a mental disorder then it would be just as life altering as bi-polar disorder and it would be wrong and creul to refuse a cure to someone with a mental condition. if they want to look at this in light of a mental condition then they couldn't very well call it a choice people with mental conditions do not make the choice to have them. in and of the idea of this as a mental condition you could state that only the most severe cases get referals to an srs surgeon so the mental health care proffesional must deem it to be a nessacarry procedure. just a suggestion hope it helps.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 07, 2008, 10:15:04 AM
yes they are
but its also not classed by the nhs as mental anymore... it IS medical.
R
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Jessie_Heart on February 07, 2008, 10:36:15 AM
ok are the only medical conditions that are covered imediatly life threatening? do you still need the referals? if you need to be diagnosed as T and you need referals to get surgery then wouldn't it still be nessacary and not a choice. (sorry I can't spell). if someone has a tumor that is non-cancerous is it covered? if so you could argue that most tumors like that are not life threatening. I don't know much about the health system there I am just trying to give some possible help.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 07, 2008, 12:48:15 PM
ofcourse... not just lifethreatening is covered. its comprehensive healthcare...
R :police:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Purple Pimp on February 07, 2008, 05:42:21 PM
Quote from: Rachael on February 07, 2008, 10:15:04 AM
but its also not classed by the nhs as mental anymore... it IS medical.

Do you not have to see psychiatrists for approval under the NHS system?

Lia
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 07, 2008, 09:32:09 PM
yes, but then, its a physical condition, that manefests in such a way, it can only be detected by talking to the person, ie psychiatrists...
Mentality is the accesss. but that doesnt make it the root...
R :police:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Purple Pimp on February 07, 2008, 09:41:41 PM
That doesn't sound right.  What medical condition out there has to be diagnosed by a shrink rather than a doctor?  Doctors diagnose medical conditions, psychiatrists diagnose mental illness; they don't have the proper training to cross-diagnose.  Methinks some bureaucrat is trying to have his cake and eat it too.

Not that this is any different from the American system; however, if in the US G.I.D. were diagnosed as medical rather than mental, that would set off a lot of changes, since the "cure" would not be "cosmetic" surgery.

Lia

Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 07, 2008, 10:16:34 PM
how come your so set on it being mental?
im perfectly happy with the uk system...
its a condition, the treatment, is grs... a physical surgery cannot cure a mental problem...
R >:D
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Purple Pimp on February 07, 2008, 10:45:05 PM
Quote from: Rachael on February 07, 2008, 10:16:34 PM
how come your so set on it being mental?
im perfectly happy with the uk system...
its a condition, the treatment, is grs... a physical surgery cannot cure a mental problem...
R >:D

Actually, I am in agreement with you, it isn't a mental problem.  At the same time, does it not strike you as odd that one is diagnosed by a shrink rather than a doctor?  I'm saying that it's a mismatch, if the NHS is claiming it to be a "medical" problem.  Psychiatrists, therapists, psychotherapists: these people are not qualified to diagnose a medical problem, only a mental one.  I'm arguing that the diagnosis should be taken away from shrinks since it's incongruous with a "medical" problem.

Lia
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: tekla on February 07, 2008, 11:01:37 PM
The argument against it that I would take is that being a self-diagnosed problem (a unique situation in both medical and psychiatric practice), with a really expensive (perhaps even cosmetic - after all here, if you can self-diagnose the problem, they can self-name the cure) solution, the people at large should not be forced to pay for it.

In the immortal words of the great American anthem, "It's your misfortune and none of my own."  (You want to move here, that's pretty close to our national motto.  And you just will not live it in the States, you will learn to love it - or, as we say - leave it)  Why should I pay (i.e. be forced to work) for your problems?  It's not a matter of national security.  It's not a matter of public health (like treating tuberculosis or cholera would be).  It's not a matter of the public welfare.  It is you, and you only, and in the States, that dime is on your bill alone.

Given that the budget of the National Health is a zero-sum game like almost all budgets (if you give to x, you are taking from y) then, ethically, you have to look at doing the greatest good for the greatest number, of making what little money you have do the most work, and that gets tough real fast.  For what it would cost to treat 100 TS persons you might well be able to treat thousands of others with different problems.  I have a very easy time making a choice between the few and the many.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 07, 2008, 11:34:48 PM
the debate isnt about me, or anything to do with me, OR the us....
its about the uk system, where we do care about others problems...

'hey you has cancer, lol your bad!'
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: tekla on February 07, 2008, 11:58:10 PM
Well I'm sure that the argument still comes down to "we can treat 20 TS or provide better pre-natal health to 400 women"  - easy choice.  Money is the same everywhere when it comes to budget decisions. 

And dear, do remember that before you cross the pond.  You get cancer here, and don't have coverage - oh well.  Nobody lives forever.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: lady amarant on February 08, 2008, 12:02:08 AM
Quote from: tekla on February 07, 2008, 11:58:10 PM
And dear, do remember that before you cross the pond.  You get cancer here, and don't have coverage - oh well.  Nobody lives forever.

After watching Sicko a few days ago, I'm guessing coverage isn't going to help you much either...
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 08, 2008, 02:02:04 AM
pwned ;)
/me high five's Lady
R >:D
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Dennis on February 08, 2008, 02:25:02 AM
Question here, Rachael, did you want to get into a debate or did you want an answer to your question? It seems like the former to me. The answer is there probably aren't any arguments that won't offend a trans person, just as there aren't any arguments for not funding prostate exams that won't offend a bio male over 50.

Dennis
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 08, 2008, 02:30:05 AM
that pretty much was what i wanted dennis... to see what people could say for the motion, not to debate it, but if people want to, thats fine by me...
R :police:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: lady amarant on February 08, 2008, 04:44:59 AM
Hmmm. I think the American system has absolutely NOTHING to recommend it, but I agree with Tekla as to prioritising, as in the example she mentions. At the end of the day, public healthcare does have a limited budget, and it's a valid argument to ask which is more important - treating 20 TS people or ensuring the health of 400 births.

To me though the question should be pushed higher, past the level of NHS funding and decision-making, to ask why so little money is spent on healthcare and education as opposed to, for example, military spending, government administration etc. I read stats in South Africa a few years ago indicating that if just one percent of military spending was redirected social programs, we could have a public healthcare system equal to the likes of France or Canada, in addition to vastly improved pubilc schooling and elderly care. That's an entirely different debate though, and doesn't deal with the situation as it is now.

I think it is going to be a tough call to find a convincing counter-argument to the budget question, as much as it pains me to say that.
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 08, 2008, 04:56:40 AM
something you all miss, is the NHS is very good... and this is one lacking area.... the budget allows for more than they actually treat...
the public view imo, is all that is against grs... as there is PLENTY of money that can be freed up from managerial sludge that can be spread around... neonatal and prenatal facilities are the best of the nhs's operations tbh...
and the nhs gets more money than 1% of the armed forces budget atm id wadger! our health service has a huge budget... the militery? um, not as well funded...
R :police:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: lady amarant on February 08, 2008, 05:28:54 AM
Quote from: Rachael on February 08, 2008, 04:56:40 AM
something you all miss, is the NHS is very good...

Point taken - I suppose my recent experiences have skewed my opinion somewhat, though I understand the PCT's reasoning. (I was denied coverage due to the relatively short duration of my visa)

As a counter-argument then, because a good debater would use budget as his trump card, you would have to prove your position that there is enough money to spread around, and that that money is for some reason NOt being spread to the Gender Clinics. Still a challenge, 'cause you'll probably need to get one of the geeks from the Stats or Actuarial departments to do the figures, but doable.

PS. No offense meant to Stats and Actuarial geeks. As a computer nerd, I find being called a geek a huge compliment. Geeks do rule the world, after all...  :icon_geekdance:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Berliegh on February 08, 2008, 07:45:56 AM
Quote from: Rachael on February 07, 2008, 10:15:04 AM
yes they are
but its also not classed by the nhs as mental anymore... it IS medical.
R

Gender Dysphoria should never have been classified as a 'mental health' condition in the first place.....and the old guard clinics like Charing Cross GIC or 'West London Mental Health' (as they are also called) should be completely blown out...

I'm lucky I have the 'IS' card up my sleeve...

Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Seshatneferw on February 08, 2008, 08:24:24 AM
Quote from: Berliegh on February 08, 2008, 07:45:56 AM
Gender Dysphoria should never have been classified as a 'mental health' condition in the first place.....

Um, why not? Given what was known about the condition half a century ago or so, it was entirely reasonable to classify it as a mental one. No evidence whatsoever that it was something else. This is simply the way science works: if new data don't fit the theory, something ought to be corrected somewhere.

  Nfr
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 08, 2008, 08:35:32 AM
true dat....
ok this guy thinks hes a chick.... well that ain normal is it dr bob?
no dr fred
mentally ill dr bob?
yeah why not dr fred
ok then, any more like this fella and we can send them to the shrinkers for curing dr bob...
sounds like a plan dr fred.
R :police:
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Jordan on February 08, 2008, 11:02:58 AM
^^^^^

Then the shrinkers sent him back to the doctors and said

"He is a woman in his head Dr. Bob."
"What do you mean shrinky"
"I mean you need to help him become a woman dr Bob"
"really are you sure"
"Positive"

"OH, ok then."

We got outsourced and resourced ???
Title: Re: 'Gender reasignment should not be offered on the nhs' a debate at my uni...
Post by: Rachael on February 08, 2008, 11:38:12 AM
wow, your finally learning about the medical profession....
it if lands on your desk, get it off asap... where it goes, doesnt matter, as long as its gone :P
R >:D