May 5, 2013
Motherboard: When does a paraphilia become a disorder?
Blanchard: There are two ways by which a paraphilia could be converted into a paraphilic disorder: the individual is distressed by their desires, or they are acting in a way that is noxious to people. So a pedophile could have a pedophilic disorder if the guy is tortured by the fact that he is a pedophile, or he is perfectly happy with the fact that he is attracted to children, and he is molesting a lot of them.
So if someone cross dresses and they are cool with it, then they don’t have a disorder, correct?
Yes, under my proposal you can now be a happy transvestite, or you can have a transvestic disorder.
You coined the term autogynephilia, which refers to a man who is aroused by the thought of himself as a woman. This term is kind of your baby. Is it going to make it into the DSM-5?
That comes under the heading of what I can’t tell you, because of the confidentiality agreement I signed with the APA.
Do you think autoandrophelia, where a woman is aroused by the thought of herself as a man, is a real paraphelia?
No, I proposed it simply in order not to be accused of sexism, because there are all these women who want to say, “women can rape too, women can be pedophiles too, women can be exhibitionists too.” It’s a perverse expression of feminism, and so, I thought, let me jump the gun on this. I don’t think the phenomenon even exists.
Some trans activists object to the inclusion of transvestic disorder in the DSM because they feel it pathologizes gender non-conformity. How do you respond to these criticisms?
To say that transvestic disorder pathologizes all trans people is rhetoric with no logic behind it whatsoever. If you actually open the DSM-4, it’s very explicit that it applies to people who get sexually excited by dressing in women’s clothes. They really object to the fact, (which is a fact established beyond any conceivable doubt), that in a lot of men there is some connection between cross dressing and sexual excitement.
Is the objection based on the idea that it fetishizes gender non-conformity?
Some activists are trying to sell the public on the idea, “We really are women where it matters–in our brains–and women don’t get sexually excited when they put on their bras and panties, so we don’t either.” And for a lot of them that’s just a lie.
So you don’t see a male-to-female transsexual as being female?
I think that a transsexual should be considered as whatever their biological sex is plus the fact that they are transsexuals. That’s how you would do research on them. There’s no other way to do it. If you’re interested in whether the brains of transsexuals are different in some way, you’re interested in seeing if they differ from other individuals with the same biological sex.
So in a way psychiatric research is inherently gender normative?
I would say medical research is inherently gender normative.
Some members of the trans community object to the stigma they feel accompany DSM diagnoses, but because of the impact of the DSM on insurance payments, it’s necessary they be labeled mentally ill. To what extent is a diagnosis from the DSM necessary to receive reimbursement for gender reassignment therapy?
In the US I would say most insurance companies probably require a DSM diagnosis. The point that sticks in the craw of a lot of activists is that in order to get sex reassignment surgery paid for by a third party, it has to be deemed a disorder. The transgender community has tried to get around this in a way that they seem to think is very creative.
Their argument is, “Well, public health insurance plans pay for the cost of child delivery in a hospital, and childbirth is not a disorder. Therefore transsexualism could be covered under public third party health insurance payers without it being a disorder.” That’s how they’ve tried to square the circle.
And have they been successful?
No. How many people do you know regard sex reassignment surgery as part of the life cycle like having a baby?
Do you think that classifying transgender people as having a disorder does contribute to stigma against the trans community?
No. I mean how many people who make a joke about trannies consult the DSM first?
Do you think that transgender identity might get to the point where homosexuality is now, where it is considered offensive and inaccurate to call it a disorder?
I think there are some glaring differences between acceptance of transsexualism and acceptance of homosexuality. Let’s say that a friend comes to you and says she’s a lesbian, you aren’t seeing your friend performing cunnilingus on her girlfriend. All this requires is acceptance of what you don’t have to see.
With transsexualism, if a friend comes to you and says I feel like I’m actually a woman, and starting tomorrow I’m going to be showing up wearing dresses, this is not happening offstage, you are now part of their movie.
[Images added to this post by me- GM]
March 30, 2013
From the horse’s mouth: listen to one of the men leading the campaign for Medicaid funded “sex-change” surgeries. The profound sexism and belief in “sex-based personality” is a characteristic of transgender beliefs. If you want to understand transgenderism: watch this video.
March 30, 2013
Early in the day Friday March 29 the Centers for Medicare & Medicaid Services issued a ground-breaking announcement. For the first time since 1981, when so-called “sex-change” surgeries were declared experimental and not eligible for government covered funding, the division was considering reversing that decision. HHS declared its intention to solicit public input for thirty days prior to reversing the ban on government funded radical cosmetic surgeries which attempt to visually change the appearance of male genitals to female, and vice versa, on individuals who believe in sex-based personality theory, or who are diagnosed with gender/sex-role based mental illness.
From The Advocate:
“The Center for Medicare and Medicaid Services, which runs the federal government’s national insurance program, is reconsidering whether or not it should cover gender reassignment surgery (often called sex reassignment surgery) for transgender people who have Medicare. It has offered the public 30 days to offer opinions on the matter. Since around 48 million people are covered by Medicare, if the agency decides to allow coverage, the change would have a significant impact on transgender people in the U.S.
The center states that it “considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the topic under review. Surgical Treatment for Gender Identity Disorder is currently noncovered under the Medicare Part A and Part B programs. The existing policy, which became effective in 1981, states that transsexual surgery is considered experimental. Please note that we are making an administrative change to the NCD title under this reconsideration to reflect current medical terminology. The new title for Section 140.3 will be Surgical Treatment for Gender Identity Disorder.”
From the Washington Examiner:
For the first time since 1981, when it dubbed sex-change operations “experimental,” Medicare has opened the door to covering transexual operations, adding to the growing list of operations that would be allowed under Obamacare.
Acting on a new request, the Centers for Medicare & Medicaid Servicessaid it is starting a new analysis that could lift the spending ban for sex-change operations with a goal of making a decision two days after Christmas and on the eve of Obamacare kicking in Jan. 1.
“Surgical Treatment for Gender Identity Disorder, formerly referred to as transsexual surgery in 140.3, is currently noncovered under the Medicare Part A and Part B programs. The existing policy, which became effective in 1981, states that transsexual surgery is considered experimental,” said the notice just posted on the CMS.gov site.
“Please note that we are making an administrative change to the NCD title under this reconsideration to reflect current medical terminology. The new title for Section 140.3 will be Surgical Treatment for Gender Identity Disorder,” it adds.
In supporting letters to CMS, one of the proponents claims that the experimental status of sex-change operations has long passed and that studies confirm it works. “These medical procedures and treatment protocols are not experimental: decades of both clinical experience and medical research show they are essential to achieving well-being for the transsexual patient,” said the letter.
A second letter called the federal policy discriminatory, and added that failure to get the operation by those who needed can cause death. “The net effect is a failure to treat a treatable disorder which in many cases leads to death. The discrimination (is) clearly un-American,” added the letter.“
By the end of the day the entire proposal had been retracted.
An HHS spokesman said HHS’ Departmental Appeals Board is weighing a challenge to the department’s ruling that sex-change procedures are experimental and should not be covered by Medicare and Medicaid. While that challenge works its way through the system, the Centers for Medicare and Medicaid Services has withdrawn its proposal to reconsider the coverage policy on its own.
“An administrative challenge to our 1981 Medicare national coverage determination concerning sex reassignment surgery was just filed,” a spokesperson said Friday. “This administrative challenge is being considered and working its way through the proper administrative channels. In light of the challenge, we are no longer re-opening the national coverage determination for reconsideration.”
Guess the whole “Obamacare funds free cosmetic sex-change” spin didn’t play so well. Perhaps during an economic depression where the have-nots can’t afford groceries and Medicare fails to cover eyesight and dental care -those who are hungry, going blind and losing their teeth didn’t take too kindly to paying for cosmetic surgeries for those who believe they would be happier if they looked superficially more like they had a different reproductive biology than the one they were born with.
Interesting this quote from the idiots at CMS: “”Please note that we are making an administrative change to the NCD title under this reconsideration to reflect current medical terminology. The new title for Section 140.3 will be Surgical Treatment for Gender Identity Disorder” . “Current medical terminology” which becomes obsolete in one month when the diagnosis of “Gender Identity Disorder” is eliminated in the DSM and replaced with “Gender Dysphoria”? Totally clueless.
The link to the HHS public feedback site now gives a 404/error when clicked. Very very interesting. GenderTrender will be following these developments closely as details emerge.
There is no such thing as a pregnant man, ruled Judge Douglas Gerlach in Arizona court today. The judge rejected female “Pregnant Man” Thomas Beatie’s petition for divorce from her wife on the grounds that their marriage was a same-sex marriage, regardless of Beatie’s transgender legal status as “male”. Same-sex marriages are not recognized in the state of Arizona.
Thomas Beatie, 38, was a lesbian named Tracy Lehuanani Lagondino living in the state of Hawaii when she underwent surgical breast removal and began testosterone injections to masculinize herself cosmetically. Tracy had been a model and teenaged beauty queen with a strong belief in sex-based personality theory. There is no national criteria for changing legal sex in the United States and each state determines its own legal criteria. The state of Hawaii allowed her to change her birth certificate from female to male based on a note from her doctor that she had undergone cosmetic breast removal and synthetic hormone injections.
In 2003 Beatie married another woman, Nancy, and after stopping her testosterone injections, gave birth to three children via sperm purchased over the internet. In 2008 Beatie made headlines as “The First Pregnant Man”, appearing on the Oprah Winfrey show and selling her story to tabloids worldwide. The couple moved to Arizona.
Last March Beatie filed for divorce and began selling videos of her wife to tabloids – videos in which Nancy appeared to be intoxicated. Thomas claimed in her divorce papers that Nancy had punched her “in the crotch”, a charge that Nancy denied. The divorce proceedings were delayed because Maricopa County Family Court Judge Douglas Gerlach was unable to find a legal precedent or authority that defined a male as an individual capable of giving birth.
Today’s ruling reflects that reality: Males are not capable of giving birth. Transgender activists had sought to redefine sex as a matter of stereotyped cosmetic appearance or personality type rather than reproductive fact. Instead, the judge determined: “Thus, by urging that Arizona law equates a double mastectomy with a sex change operation, the Parties’ contention, if adopted, would lead to circumstances in which a person’s sex can become a matter of whim and not a matter of any reasonable, objective standard or policy, which is precisely the kind of absurd result the law abhors.”
The judge issued a separate ruling disolving the same-sex union and outlining child custody arrangements and child support. Nancy Beatie has stated that she is pleased with the result. Thomas Beatie and her attorneys will conduct a news conference about the ruling next week.
February 27, 2013
Heart-wrenching post by a man coming to terms with the fact that he drank the gender Kool-aid, got swept up into the “Transsexual Empire” of the psychiatric and medical sex-change industry, and now needs to come to terms with it all.
At the start of the piece Carolynn asks why there are not more voices in the transgender community expressing doubt before undergoing profoundly reconstructive cosmetic surgery on their genitalia? And why are there not more voices expressing the regret and despair that follows?
The answer, he shows us, is clear. Once you have gone that far into the process there is “no going back”. His only choice is to make the best of his life now that what’s been done, cannot be undone. There is no benefit to wallowing in despair. Rates of suicide for post-operative transgenders are high. The only sane choice is to accept what has been done and make the best of it.
From the piece, titled “Did I Make a Mistake?”:
“DID I MAKE a mistake? Am I doing the right thing? Is this the path for me? These are questions we usually ask and, if not, should be asking ourselves. Gender transition is not for the faint of heart. Early in my transition from male to female, I gave little thought to those questions. I was very busy buying new clothes, coming out to family and friends, and getting ready to return to work after a lengthy absence.
I was working on name changes, birth records. I was preoccupied early in my transition. There was a lot of ground to cover if I was to come out and be my true self. Endless doctors’ appointments. Sometimes I felt as though I should have had a tube from my arm connected directly to the blood lab. I had more blood drawn from me in my first year of transition than I had in my entire life, and I was under the microscope of psychiatrists, every move scrutinized. Should I sit in the blue chair in the doctor’s office? Should I sit in the pink chair? I felt like I was under constant surveillance, and worried my male side would pop out. It didn’t. I did a very good job at covering the male side of who I was. After a few years of this—the real life test—I received a letter saying that I was eligible for and had met all the criteria to move forward and have gender reassignment surgery. To say I was happy would have been a gross understatement. There it was in my hot little hands, the brass ring! The letter I had been working toward for the last four years.
For a brief moment, I hesitated to pick up the phone to book my surgery date. I read and re-read the letter countless times. Then it went into my file, and I didn’t look at it again for at least three months. Those three or so months were when the questioning began. I tried approaching people in my support system. Each of their answers was almost scripted: “Well, if you have any doubts then you’re not really trans!” I thought to myself that “You’re not really trans” was an odd thing to say. My question was still not being addressed. I had a new brass ring to reach for. “Is there anyone who has any doubts or second thoughts?”
One would think this would be a very easy question to have answered. It was my experience that it was the hardest question that I ever asked to find an answer for. It would appear that by the time I reached that stage in my transition, the medical community felt I was ready to move onto the next stage—surgery. I was supposed to be ready to take the final plunge into the mystery of becoming a woman. Hard as I looked for one person to say, “Yes, I had doubts; yes, I was terrified; and yes, I questioned if I made a mistake,” I never found them. That one person never appeared.
I knew they were out there. They didn’t speak. Now I had a new question. Why weren’t they coming forth with their experience? Shortly after I pulled the letter from my file again, I made the call to the surgeon and booked my flight. I was very excited to be on my way to have this correction taken care of, but that one question still haunted me. What haunted me even more was where were the ones that had gone before me, that were supposed to help guide me through this rocky period. It wasn’t long after I had returned home from the surgery that I found the answers I was looking for. I found where most brothers and sisters had gone; I found the answers to those nagging questions. The real work began upon my return home. The rigid schedule of dilating, the inability to get to the bathroom without assistance, the blood, the pain. I’ll never forget the pain. My hips and halfway up my stomach were yellow and black from the bruising. The simplest act of trying to watch television became agony. The deed had been done; there really was no turning back. I couldn’t go home now .
I was now in this surgically created wonderland that I called my female body, laying awake at night still asking, “Did I make the right choice?” Right choice or not, this was where I was! Life carried on seemingly uneventfully, get-well cards came, flowers arrived, people phoned. It was almost like I had celebrity status, but that was short-lived. Then again I was alone with my thoughts. That one nagging question rang through my head. Did I make a mistake? I felt a bit depressed so I made a couple of phone calls trying to find a counsellor to speak with. Oddly no-one would accept me. I called my old shrink and he said, “Our work was finished. I was only there to help you until you had surgery. You’ll need to find another doctor.” The hunt began for another psychiatrist. I thought it would be easy, but it was not. Depression by this time had taken deep root; eventually I was diagnosed with chronic depression. What followed was not at all what I had expected. I stopped going outside, I quit playing softball, I closed my kickboxing gym. I became a recluse, subjugated in my own home by no one other than myself. My depression deepened. My rigid schedule of postsurgical care went out the window. Then another nail struck into my coffin of depression! My surgical area had grown shut!
I had less than two inches of depth. I was horrified. What had become of that soulful, full-of-life woman that I had known at the beginning of my transition? Where did she go? How could I get her back? The question of whether or not I had made a mistake was secondary at this stage; my priority now was to find the real Carolynn again. This was a daunting task to say the least. I was lucky enough to have been referred to a doctor by a dear friend of mine. He saw me, and I would love to say that we got off to a great start. We didn’t. He called me obese and said I needed to exercise. I didn’t see him again for at least a year. When I finally did return to see him, I was a complete train wreck. I had put on 40 to 50 pounds, and I was depressed. I still had the problem of the surgical area having grown closed. After some time with this doctor, things started to look a little better. Over the next few years things began to change. I felt my old self returning, I re-opened my kickboxing school, and started to socialize again. Then my doctor threw this at me one day in a session. He said, “Carolynn, you know you can go for a surgery revision and get that fixed.” My jaw hit the floor. I was in shock. I thought it was a one-time shot, and if, like me, you screwed it up—well, you were screwed forever after.
I felt this little fire of hope begin to burn in me again. I had purpose in my life again. This time, I wasn’t going to screw it up! I jumped through all the hoops, made all the phone calls, and reattached the tube from my arm to the blood lab. Honestly, I felt happiness shine again in my life. Finally, the day came for me to head off and have my surgery revision. I remember arriving at the recovery house and seeing another group of me’s from six or seven years ago. They were all driven. They were all happy and they all had no clue what was going to happen after.
Not from a place of ego, but rather a place of a caring sister, I took it upon myself to inform the other guests that this was not my first time. I had to go around and return their jaws to the closed position. I became very close with two of the girls there. One very young woman was maybe 17 and there with her mother, and another was my own age and all the way from the U.K. They listened intently as I told them my story and the pitfalls to be aware of. My young friend even went so far as to take notes. Our surgery days came and went. We all returned to the places we respectfully called home. A few days later, I got a phone call from my friend in the U.K. She was in tears and panicking, saying, “I don’t know what I have done.” We talked for what seemed like hours until she said she was feeling better. It’s been some time since I have heard from her. As for my young teenage friend, I got a call from her mother on several different occasions telling me what her daughter was not doing, and how she was feeling depressed. Considering myself somewhat of a hip person, I started to text my young friend. We worked out some things via texting and email. My life continued fairly normally. I was again into my routine of dilating and postsurgical care. Only this time I had a new-found appreciation for what I had been given, and the question had finally been answered.
Did I make a mistake? The answer is No! I did not make a mistake. Do I have regrets? Yes, of course, I have regrets. I do not feel I would be classified as human if I didn’t. Do I miss my old self? Sometimes. The question of whether or not I made a mistake at this stage is irrelevant. The more pressing and more important question is, am I able to be happy living as I am? At time of writing, I have an afternoon appointment coming up with a personal trainer at the gym. Later this evening, I’m going out for dinner with some friends and there is this very handsome man I met who asked me on a date.
The answer is, yes, I am happy and can live this way. The question I had chased and tried to have answered was the wrong question. After a few years of wrestling with it, the question “Did I make a mistake?” became irrelevant. The question I should have been asking myself all along is, “Can I be happy after I have made these final choices?” People have surgery everyday. Most don’t ask themselves, “Did I make a mistake?” If my own personal experience is of any use to anyone, then ask yourself the right questions first. Don’t ask “Did I make a mistake?” or “Am I doing the right thing?” Ask yourself, “Can I live happily once these decisions have been made?” That question is far easier to answer than the others.
Insurance coverage of medical treatments for “sex changes” is very controversial. Medicaid coverage of gender identity related conditions is practically a legal field of study unto itself.[i] Like the various definitions of "gender identity,” the rules that control driver’s license and birth certificate amendments, and whether violence against someone is considered a hate crime; health insurance is governed differently in every state.
January 6, 2013
Dr Richard Curtis, the 45 year-old woman in charge of London’s largest private “sex change” clinic is under fire as accusations of misdiagnosis and malpractice pile up. Dr. Curtis is a heterosexual female GP (General Practitioner) who underwent medical and surgical procedures in 2005 to “affirm” her belief that she was a “gay man trapped in a woman’s body”. She was the first transsexual practitioner to be registered by the General Medical Council after passage of the UK Gender Recognition Act.
A staunch anti-feminist, Curtis’s public statements have long reflected a profound belief in sex-based social roles. About her own “sex change” she has said “”I’ve never been particularly in touch with my emotional side. I’ve never wanted children, or a white wedding like most women dream of, or a man to take care of me. Instead, you were more likely to find me fitting a kitchen or tiling the bathroom.” Curtis on the purpose of her own “gender change”: “It’s to stop people being confused about who and what you are.”
In 2006 Dr. Richard Curtis took over the private practice of the infamous psychiatry consultant Dr. Russell Reid, once the UK’s best-known expert on transsexualism. Reid was found guilty of gross professional misconduct for authorizing inappropriate surgeries for gender dysphoric and body dysphoric clients, including the amputation of healthy limbs for BIID clients. One of Reid’s clients was authorized for “gender treatment” because she wanted to “become Christ”.
From The Guardian today:
Doctor under fire for alleged errors prescribing sex-change hormones
A woman who alleges that she was inappropriately prescribed sex-changing hormones and then wrongly underwent a double mastectomy is one of several complaints being investigated by the General Medical Council about the doctor who oversaw her aborted gender reassignment, the Guardian has learned.
The GMC, the doctors’ professional regulator, has received at least three separate complaints against Dr Richard Curtis, a London GP who specialises in the treatment of gender dysphoria, particularly transsexualism, concerning the alleged inappropriate administering of sex-changing hormones to several patients and at least one allegedly unsuitable referral for gender reassignment surgery.
It is claimed that Dr Curtis, who provides private treatment to patients seeking gender reassignment, has failed to follow accepted standards of care and breached conditions placed on his practice by the Medical Practitioners Tribunal Service (MPTS), the GMC’s arm’s-length disciplinary body.
The allegations include commencing hormone treatment in complex cases without referring the patient for a second opinion or before they had undergone counselling, administering hormone treatment at patients’ first appointments, and referring patients for surgery before they had lived in their desired gender role for a year, as international guidelines recommend, with one patient allegedly undergoing surgery within 12 months of their first appointment. He is also accused of administering hormones to patients aged under 18 without an adequate assessment, and wrongly stating that a patient seeking gender reassignment had changed their name.
One of the most serious cases concerns a female patient who regrets switching to a male role. She underwent hormone treatment and had her breasts removed. The woman is one of the complainants in the current GMC investigation.
Other cases include teenage patients who were allegedly prescribed hormones when they were just 16. Although the Tavistock and Portman NHS Foundation Trust in London, which specialises in the treatment of gender identity difficulties in children, does offer hormone treatment to under 18s on the NHS, it is alleged that Curtis lacks the specialist knowledge and skills to adequately treat such patients on his own.
Read More Here:
November 21, 2012
“I’m trying to just get off of it at this point. And my reason for that is because I am not wanting any more changes than I’ve already had. I think the changes that I did have snuck up on me pretty quickly and I hadn’t really thought about what it meant to pass at that point. And now I do pass. And I’m still at a crossroads with that in terms of it being something that I am comfortable with, and it being something that sort of negates an old identity that I am comfortable with that I still feel like I am. Like I still very much feel like a dyke. And so it’s hard being read as a straight white male. It’s got its privileges but it’s also- it’s been hard for me to relate to people just because – I look a little different now. And I think a lot of that was because I had insecurity about being butch enough in the queer scene and also I feel like a lot of people were taking T and I was- I wanted to fit in, so I took T too.”
November 13, 2012
From today’s NPR article “Inmate Sex Change: Should We Pay And Does The Surgery Actually Work?” by award-winning journalist and syndicated health columnist Judy Foreman:
“As the controversy continues to swirl over sex change surgery for convicted murderer Michelle Lynn (formerly Robert) Kosilek (there’s a hearing this month on whether taxpayers should pay for her electrolysis), I got to wondering about some of the questions this case raises.
Certainly, prisoners are entitled to basic health care. But do we really owe her a sex change operation?
Especially if — as some of the evidence I uncovered suggests — it wouldn’t leave her in substantially better mental health than she is in today?
I confess: I’m not sure I would even ask this question if I were sympathetic to her in the slightest. But I’m not. She is a convicted murderer. She is in prison for a reason, and a very good one.
But, that aside, back to my quest for facts: How well does sex reassignment surgery (SRS) work in the first place?
Here’s some data: There was a major study in 2011 by the Karolinksa Institute.
Using data from Swedish registers, they studied 324 people — 191 male-to-females and 133 female-to-males — who had SRS between 1973 and 2003. For each SRS patient, the researchers randomly selected 10 people from the general population who had not had SRS. From this group, two control subjects were matched to each SRS patient — one with the same sex and age as the patient at birth and the other, with the same age and sex as the patient after SRS.
All-cause mortality was three times higher for people who had SRS and deaths by suicide were also higher. People who had the SRS were also at higher risk for hospitalizations for non-gender related psychiatric problems. It’s not totally clear why people who get the surgery get worse. But the authors conclude,
“Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behavior and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism…”
So, in other words, the surgery does get rid of “gender dysphoria,” meaning deep unhappiness with one’s biological sex. But it doesn’t seem to help much with other mental health issues, including suicidality.
If that’s true for Kosilek, I wondered, why should taxpayers foot the bill?
The Karolinksa researchers did caution that for SRS patients their findings didn’t necessarily mean the surgery didn’t help at all: “Things might have been even worse without sex reassignment.”
I wouldn’t be so swayed by this pessimistic study except that it’s methodologically much better than previous research, including an oft-cited 2010 Mayo Clinic study.
Researchers performed a systematic review and meta-analysis of 28 studies of hormone therapy and sex reassignment involving 1093 male-to-females and 801 female-to-males.
The studies were observational and most lacked controls. Overall, in the Mayo review, 80 percent of people who had the sex reassignment reported significant improvement in gender dysphoria, as well as significant improvement in psychological symptoms and quality of life.
But, as the Mayo researchers themselves note, all of these conclusions were based on “very low quality evidence due to the serious methodological limitations of included studies.”
In data-speak: garbage in, garbage out.
Ben Klein, senior attorney for Gay and Lesbian Advocates and Defenders, doesn’t see it that way. “All studies have limitations,” he told me, “but if you look at the overwhelming trend of a significant number of studies, all point to the same conclusion – that sex reassignment surgery is the only effective treatment for gender identity disorder.”
But I’m not buying that — pooling a bunch of bad studies doesn’t yield good data.
It makes more sense to wonder why the surgery doesn’t have better long-term results. One reason, suggests Renee Sorrentino, a Harvard Medical School psychiatrist who runs the Institute for Sexual Wellness in Quincy, is that by the time a person seeks sex change surgery, gender dysphoria has usually been a problem for a long time and is often accompanied by significant traumatic experiences, including bullying. Those deep psychological wounds may not be so easily healed.
That said, I know a transsexual woman, Sara Herwig, who has been helped by the surgery and now feels like a “congruent person.” So I called her.
“The thing to remember about SRS or general reconstructive surgery is that it is not a silver bullet,” she said. “You still have to deal with everything in life that everybody has to deal with. It’s not going to have a big impact on clinical depression or other kinds of mental illnesses.”
Fair enough, but did she believe taxpayers should be on the hook for Kosilek’s surgery?
Herwig has mixed feelings, “My initial reaction is that nobody paid for mine. Health insurance doesn’t cover it. I understand her desire to have the surgery, but … vast numbers of other people I know have had to pay for their own. I do think there need to be reforms in health insurance so such surgeries are covered. But I don’t think the taxpayers should pay for someone to have that kind of surgery.”
In the end, I concluded, neither do I.
And as for this month’s hearing regarding hair removal?
Give me a break. I have a couple of eyebrows I’d like taxpayers to have waxed for me.”