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the_fantastic_ms_foxI have an appointment to be assessed for sexual reassignment surgery. AKA "the big switch." AKA "genital surgery."
I am glad that I have an appointment, but I'm pissed off that I have to go through with assessment. Really pissed off. As in having-trouble-sleeping-so-I'm-writing-it-down pissed off.
The present criteria for assessment for genital surgery, derived from the Harry Benjamen Standards of Care (or HBSC) are as follows:
And here is what pisses me off:
1. I have already gone through this, and don't see why I have to do it again.
In order to start hormones, I had to be diagnosed with the mental disorder of "gender dysphoria," and assessed as mentally sound enough to understand what I was getting into, and psychologically, financially and socially able enough to weather transition. This was combined with blood tests to see if my body could handle it (the risks of transition being somewhat overblown - yes hormones can do bad things to your body, but they can do it whether they come from a pill or from your gonads).
So in other words, I have already been assessed for exactly these criteria (by my doctor and a psychiatrist - which fortunately took only three months)
2. This system is billed as "making sure we do what's right for the patient" but is mostly designed to cover doctor's asses.
Their fear is that a surgeon will remove healthy tissue* and:
- look bad
- be branded a quack
- get sued because someone will change tehir mind later
Wait. Sued? But don't most transgender health lawsuits stem from transsexuals who were forced to go outside of the legitimate medical system, to use fly-by-night hacks. That is where the lawsuits came from, not changing their mind. Admittedly shady surgeons frame these lawsuits as transsexuals experiencing regret after the fact. Regret? As in "I regret going to see a surgeon who said he'd remove my breasts, but who half of one intact and won't go back and fix it?"
It bothers me that the medical community's response to this has not to been to try to investigate what motivates these infrequent lawsuits, nor to seek out clarification to contract and malpractice laws, but rather to offload the burden onto the patent.
* i.e. "gonads." The rest of your genitals aren't "healthy tissue." Of course not. The only important parts are your ovaries or testes. This reproducitvely-centred we-know-better-than-you attitude may sound familiar to anyone under the age of 45 who has tried to get a vasectomy or tubal ligation.
3. This system is arbitrary
It's often billed as preventing people from doing somethig irreversable which they will later regret or otherwise be unprepared for. But if this is the case, why can and have I simply paid out of pocket for hair removal and surgery to change the shape of my face , neither of which can be undone, and which combined could be a hell of an obstacle should I decide to go back to living as male.
And haven't I already been assessed for making permanent changes? Haven't I grown breasts? Can my sperm count ever recover from this?
Or consider transsexual men going through this system. They've been on testosterone for a year: deep voice, male pattern baldness, facial hair, body hair. Those ain't going away.
And now I have to see a doctor to see if I'm really serious about modifying my body?
4. No. I mean really arbitrary
Have you heard of such a process being used for any other kind of surgery?
"I'm sorry, but in order to have that giant cyst removed, you will have to live in role for one year as someone who is not perceived by others to have a giant cyst."
Or think of all the other things you can irrevocably change about your body without seeing a shrink, and which, unlike genitals, are maybe not such a good idea: bad plastic surgery, facial tattoos; alcohol abuse; crystal meth; using power tools; staring at the sun; working at a job that destroys your health; living downwind of an oil refinery; eating two dougnoughts a day...
5. Really, really arbitary. Or should I say "homophobic?"
If you're not transsexual, getting a lot of "transgendered body modification" isn't that hard. Penile enlargement? Labia reduction? Hymen restoration? Clitoral reduction? Okay!
Breast reduction/augmentation? If you want bigger or smaller-but-not-below-a-C-cup and you have a vagina, that's okay. If you want them gone and you have a penis, that's okay too. If you want them bigger and you have a penis, or want them gone or smaller than a C and you have a vagina, then you need to see a shrink and find a surgeon who "specializes in transgender medicine." I'm not sure what exactly makes someone a "specialist in transgender medicine" when it comes to performaing regular surgeries on transsexuals, other than if you're going the FtM route, that the surgeon may take out part of your nipple so it will look and feel smaller. May.
Or are you an intersexed infant? We'll perfom genital surgery on you without even asking you what genitals you want!
6. The in-role period makes no sense
Like I said above, no other branch of medicine requires this. You don't have to play soccer for a year to convince someone that you need to have your broken leg fixed. So why is there this need to police what gender people live in? What does living full-itme in a given gender role have to do with your genitals?
The theory is that living in role as your preferred gender will weed out people who won't be able to adjust to life after surgery, because they'd wake up to realize that they're not actually transsexuals and now they have to live the rest of their life with the wrong genitals for their gender identity. But this makes no sense. It states that it would be a terrible thing for someone to have to go through life with the wrong genitals for their gender identity, then requires you to do exactly that.
Rephrased: Why does the medical system require me to live full time in a role without genital surgery as proof that I need genital surgery?
Rephrased: What does working full time in a female role have to do with my genitals? I could have anything in my pants - my coworkers will never know. Perhaps you misunderstand what exactly is entailed under the job description of "External Relations Officer***. "
And what would be so bad about someone taking breaks now and then to... say... visit their evangelical grandparents? Or travel through a dangerous area? Or keep a job? Or use a swimming pool? Or access gender-specific social services? Or not have their children taken away?
(Doing any of the above is typically grounds for having to start the real-life-experience over again)
It's like there's this fear that someone will get genital surgery and go back to their old gender, but now with the "wrong" genitals. But if that would be so wrong, why am I required to live with the wrong set of genitals now? It seems the only difference is that this hypothetical (and very, very determined and stupid) person is cissexual, and I am transsexual, and so they in their idiocy must be safeguarded at my expense.
Or maybe, what they're really afraid of, is the occasional person who goes through surgery and then happily "reverts" to their old role. It's one thing to encourage people to live temporarily as one gender with the bodies traditionally ascribed to the other, but it's another to produce those bodies. What would the other doctors think?
**Or perhaps, given what happens at CFS conferences, they understand all too well.
7. This process is gratingly slow.
I hope to get this done and over soon, hopefully the period from sorting out the problem to getting surgery to fix part of it will "only" be two and a half years. But I know people for whom "One year in-role period" can actually mean:
0 months -make up your mind
4 months - try to see a doctor
6 months - find a doctor, get put on a waitlist
9 months - start living in-role in some places where you don't worry about getting fired
12 months - get to actually see a doctor
15 months - still seeing a doctor
18 months - still seeing the fucking doctor
20 months - realize your doctor is dragging their feet, find a private psychiatrist ($$$) to assess you
22 months - get assessed for hormones by pshrynk
23 months - start hormones
24 months - start living full time as your preferred gender, get fired
25 months - run out of money for hormones
29 months - find another steady job
36 months - apply for asssement
38 months - get appointment for assessment
39 months - assessed
40 months - get letter stating that period of unemployment is a breach of living in role
41 months - re-apply for assessment
45 months - get re-assessed
46 months - MSP says they'll cover surgery, but there's a waitlist and will need $5000 to cover "other costs"
50 months - government fucks with MSP coverage of transgender medicine
62 months - government unfucks with MSP coverage of transgender medicine
76 months - genital surgery
I shit you not.
Actually this only applies if you're going the towards-female route.
If you're going the towards-male route, you can get assessed and possibly even MSP coverage for chest surgery (AKA, a double mastectomy - which is available to cissexed men with no questions), but not phalloplasty because it's "experimental." I mean it's only been around since the Austro-Hungarians designed special anti-testicular mines in World War One, and all the people who invented it have long since died of old age, so it's still cutting edge stuff.
Okay, phalloplasty isn't actually experimental. Female-to-male phalloplasty is "experimental." If you were born with a penis (this includes me) and have been walking around with a gun in your belt for protection from the aforementoned Austro-Hungarians, and you tend to fidget with things, and accidentally blow your junk off, then you can get phalloplasty, no awkward Austro-Hungarian-related questions asked.
The difference is... uh... FtM phalloplasty involves routing a particular nerve, and post-trauma reconstructive phalloplasty for cissexed men involves much more complicated and unpredictable.... Okay, this doesn't make any sense.
So maybe I should find an FtM gentleman who looks like me (which, given my appearance shouldn't be that hard) and start walking around with a secretly-unloaded gun in my belt. Then we meet in a closed room, switch clothes and (still-in-the-wrong-name) care cards, fire off a shot, and the rest is simple. All the medical establishment needs to hear is "ohmygodhe'slosthisdick" and hopefully they'll ignore anything else - yeah he's got a vagina, but I mean he's lost already lost his dick today - give the man a break and get him some surgery!
8. The assessment criteria are buggy
Thank god this has improved over time. In the West prior to the late 60's, "transsexual medicine" was a series of isolated events. The occasional doctor or surgeon would do some things under the table - but not much, and usually poorly. The rare doctor would help one or two people through transition properly, then other people would hear about it, and they and/or the body they worked for would get a whole bunch of letters from other interested parties, and then they'd close the doors beforce they developed a reputation for abetting queers.
In the late 60's, the Harry Benjamen clinic in San Francisco, and soon other clinics as well, started doing transsexual medicine on a regular basis. This was fastastic for those who met their criteria, or who colud bluff their way through. They're criteria, which are the foundation of modern transsexual medicine up to and including this assessment, were, officially or not, most or all of the following:
- dresses very "normally" for gender identity
- acts very "normally" for gender identity
- wants a gender-typical career (construction, homemaker)
- wants a "complete transition" (i.e. hormones + genital surgery + whatever other surgeries are applicable + anything else)
- able to get read as your gender identity most of the time
- straight
- hates genitals (but is willing to live with them in order to get rid of them)
- willing to cut off ties with former life (i.e. tell the kids you've died)
- has known since childhood
- willing to submit to medical experts
- stoic patience
It's improved a lot, thank god. A lot. Most of these criteria are less in effect than they were, and if they are, you can usually go somewhere else. But I still read assessment lists that have things on them like 'haircut, attire and behaviour are all approriate for someone of their gender identity.'
Mmm. Now does your list of valid gender identities include soft butches? Walks large dog. Listens to folk music. Trades. Drag king. Yes I know that a few of them are taking testosterone and getting top surgery, but your system won't let them get those, so apparantly, by your criteria, they "shouldn't" be deviating from their female bodies, so it should then support me wanting to have a female body right? Right? Riiiight?
Oh hell, I'll probably be fine. I'll just do what every other tranny does and ever has done who doesn't fit into the system: present just a little more normatively for a couple hours.
Yeah. A bit of a tomboy, yknow, like Pink but without the music. It's okay that I don't release albums right?
Or remember these questions? I will probably get asked these again. Can you tell me what the fuck most of these have to do with my genitals?
Can you imagine asking non-transsexual people these questions when they're looking for medical services?
9. Many assessors act like jerks.
Why? Let's see. You take a usually-poor transsexual patient, and a cissexed specialist doctor whose social circles don't include transsexuals. You put the doctor under the scrunity of queer-unfriendly medical peers, and you put the transsexual under the doctor's scrutiny. Then you make the doctor the final judge of the transsexual's identity. Mmm. Can you say "fucked up power imbalance?"
Because BC is above the grade for this sort of thing, and because MSP doesn't want to waste the time of their doctors and lawyers, I will almost certainly avoid these past themes, but they still come to mind and scare me:
- Excessive scrunity of patient behaviour (you took time off? Better start your real-life experience again!)
- Projecting your gender norms onto the patient (Why don't you dress like this? Act like that? Where's your makeup?)
- Demanding submissive behaviour as a prerequisite for treatment
- Delays "while we further assess you" which sometimes last for years.
- Doing things to anger the patient to see how they react
- Cutting off medical care and preventing them from accessing it elsewhere
- Power games
- Using patients as research subjects on whom to test theories prior to publication without their informed consent
- (In some cases) "You like men? Okay, prove it." (sound of a fly coming undone)
Conclusion:
If I expect to get through this with no problems and have backup plans if I do have problems, and I know that I will be okay, then what's the problem?
1. On some level, I am still worried that this will go wrong; that it will result in another delay. Somehow. That I will "fail" the "test." That it will fail me. That it's opinion matters somehow. Funny that. You'd think I was raised to respect professional medical opinion or something.
2. I'm angry. I resent the fact that I have to go through this. I resent that my money is paying for this and not useful medical treatment. I resent that I am cooperating with a system I believe to be unjust, and which hurts people.
3. I'm disappointed. This system is bloody ridiculous. There are many fine aspects of transgender health care, but this is not one of them. Assessment for sexual reassignment surgery is more concerned with enforcing gender norms than helping patients. In other words, the medical system bends transsexuals into a shape where our existence supports cissexed norms, rather than questioning them.
This is wrong. I don't like it, and I don't want to enable it.
I am glad that I have an appointment, but I'm pissed off that I have to go through with assessment. Really pissed off. As in having-trouble-sleeping-so-I'm-writing-it-down pissed off.
The present criteria for assessment for genital surgery, derived from the Harry Benjamen Standards of Care (or HBSC) are as follows:
1. A period of living "in role" for no less than one year. This means 24/7 (fe)male while working full time, or going to school full time, or a doctor who knew you at the time who is willing to say "so and so cannot physically work or study full time because some factor (other than transition) prevents them from doing so"
2. Mentally competent enough to give informed consent.
3. Emotionally and socially stable enough to take it well if surgery is postponed.
4. Financially viable (Having $5000 for extra costs associated with surgery which are not covered by MSP).
Admiteddly, this is a huge step up. It used to be two years of living in role to start hormones (yes that's right - you have to cross-live with the wrong set of hormones in your body - and if you tried to buy your own, you'd often have to start again), and then two years to be assessed for genital surgery. And "genital surgery" might require that you have your gonads removed first - which was illegal in some areas, so you'd have to go elsewhere, get them cut out, and then come back.
2. Mentally competent enough to give informed consent.
3. Emotionally and socially stable enough to take it well if surgery is postponed.
4. Financially viable (Having $5000 for extra costs associated with surgery which are not covered by MSP).
Admiteddly, this is a huge step up. It used to be two years of living in role to start hormones (yes that's right - you have to cross-live with the wrong set of hormones in your body - and if you tried to buy your own, you'd often have to start again), and then two years to be assessed for genital surgery. And "genital surgery" might require that you have your gonads removed first - which was illegal in some areas, so you'd have to go elsewhere, get them cut out, and then come back.
And here is what pisses me off:
1. I have already gone through this, and don't see why I have to do it again.
In order to start hormones, I had to be diagnosed with the mental disorder of "gender dysphoria," and assessed as mentally sound enough to understand what I was getting into, and psychologically, financially and socially able enough to weather transition. This was combined with blood tests to see if my body could handle it (the risks of transition being somewhat overblown - yes hormones can do bad things to your body, but they can do it whether they come from a pill or from your gonads).
So in other words, I have already been assessed for exactly these criteria (by my doctor and a psychiatrist - which fortunately took only three months)
Their fear is that a surgeon will remove healthy tissue* and:
- look bad
- be branded a quack
- get sued because someone will change tehir mind later
Wait. Sued? But don't most transgender health lawsuits stem from transsexuals who were forced to go outside of the legitimate medical system, to use fly-by-night hacks. That is where the lawsuits came from, not changing their mind. Admittedly shady surgeons frame these lawsuits as transsexuals experiencing regret after the fact. Regret? As in "I regret going to see a surgeon who said he'd remove my breasts, but who half of one intact and won't go back and fix it?"
It bothers me that the medical community's response to this has not to been to try to investigate what motivates these infrequent lawsuits, nor to seek out clarification to contract and malpractice laws, but rather to offload the burden onto the patent.
* i.e. "gonads." The rest of your genitals aren't "healthy tissue." Of course not. The only important parts are your ovaries or testes. This reproducitvely-centred we-know-better-than-you attitude may sound familiar to anyone under the age of 45 who has tried to get a vasectomy or tubal ligation.
It's often billed as preventing people from doing somethig irreversable which they will later regret or otherwise be unprepared for. But if this is the case, why can and have I simply paid out of pocket for hair removal and surgery to change the shape of my face , neither of which can be undone, and which combined could be a hell of an obstacle should I decide to go back to living as male.
And haven't I already been assessed for making permanent changes? Haven't I grown breasts? Can my sperm count ever recover from this?
Or consider transsexual men going through this system. They've been on testosterone for a year: deep voice, male pattern baldness, facial hair, body hair. Those ain't going away.
And now I have to see a doctor to see if I'm really serious about modifying my body?
Have you heard of such a process being used for any other kind of surgery?
"I'm sorry, but in order to have that giant cyst removed, you will have to live in role for one year as someone who is not perceived by others to have a giant cyst."
Or think of all the other things you can irrevocably change about your body without seeing a shrink, and which, unlike genitals, are maybe not such a good idea: bad plastic surgery, facial tattoos; alcohol abuse; crystal meth; using power tools; staring at the sun; working at a job that destroys your health; living downwind of an oil refinery; eating two dougnoughts a day...
If you're not transsexual, getting a lot of "transgendered body modification" isn't that hard. Penile enlargement? Labia reduction? Hymen restoration? Clitoral reduction? Okay!
Breast reduction/augmentation? If you want bigger or smaller-but-not-below-a-C-cup and you have a vagina, that's okay. If you want them gone and you have a penis, that's okay too. If you want them bigger and you have a penis, or want them gone or smaller than a C and you have a vagina, then you need to see a shrink and find a surgeon who "specializes in transgender medicine." I'm not sure what exactly makes someone a "specialist in transgender medicine" when it comes to performaing regular surgeries on transsexuals, other than if you're going the FtM route, that the surgeon may take out part of your nipple so it will look and feel smaller. May.
Or are you an intersexed infant? We'll perfom genital surgery on you without even asking you what genitals you want!
Like I said above, no other branch of medicine requires this. You don't have to play soccer for a year to convince someone that you need to have your broken leg fixed. So why is there this need to police what gender people live in? What does living full-itme in a given gender role have to do with your genitals?
The theory is that living in role as your preferred gender will weed out people who won't be able to adjust to life after surgery, because they'd wake up to realize that they're not actually transsexuals and now they have to live the rest of their life with the wrong genitals for their gender identity. But this makes no sense. It states that it would be a terrible thing for someone to have to go through life with the wrong genitals for their gender identity, then requires you to do exactly that.
Rephrased: Why does the medical system require me to live full time in a role without genital surgery as proof that I need genital surgery?
Rephrased: What does working full time in a female role have to do with my genitals? I could have anything in my pants - my coworkers will never know. Perhaps you misunderstand what exactly is entailed under the job description of "External Relations Officer***. "
And what would be so bad about someone taking breaks now and then to... say... visit their evangelical grandparents? Or travel through a dangerous area? Or keep a job? Or use a swimming pool? Or access gender-specific social services? Or not have their children taken away?
(Doing any of the above is typically grounds for having to start the real-life-experience over again)
It's like there's this fear that someone will get genital surgery and go back to their old gender, but now with the "wrong" genitals. But if that would be so wrong, why am I required to live with the wrong set of genitals now? It seems the only difference is that this hypothetical (and very, very determined and stupid) person is cissexual, and I am transsexual, and so they in their idiocy must be safeguarded at my expense.
Or maybe, what they're really afraid of, is the occasional person who goes through surgery and then happily "reverts" to their old role. It's one thing to encourage people to live temporarily as one gender with the bodies traditionally ascribed to the other, but it's another to produce those bodies. What would the other doctors think?
**Or perhaps, given what happens at CFS conferences, they understand all too well.
I hope to get this done and over soon, hopefully the period from sorting out the problem to getting surgery to fix part of it will "only" be two and a half years. But I know people for whom "One year in-role period" can actually mean:
0 months -make up your mind
4 months - try to see a doctor
6 months - find a doctor, get put on a waitlist
9 months - start living in-role in some places where you don't worry about getting fired
12 months - get to actually see a doctor
15 months - still seeing a doctor
18 months - still seeing the fucking doctor
20 months - realize your doctor is dragging their feet, find a private psychiatrist ($$$) to assess you
22 months - get assessed for hormones by pshrynk
23 months - start hormones
24 months - start living full time as your preferred gender, get fired
25 months - run out of money for hormones
29 months - find another steady job
36 months - apply for asssement
38 months - get appointment for assessment
39 months - assessed
40 months - get letter stating that period of unemployment is a breach of living in role
41 months - re-apply for assessment
45 months - get re-assessed
46 months - MSP says they'll cover surgery, but there's a waitlist and will need $5000 to cover "other costs"
50 months - government fucks with MSP coverage of transgender medicine
62 months - government unfucks with MSP coverage of transgender medicine
76 months - genital surgery
I shit you not.
Actually this only applies if you're going the towards-female route.
If you're going the towards-male route, you can get assessed and possibly even MSP coverage for chest surgery (AKA, a double mastectomy - which is available to cissexed men with no questions), but not phalloplasty because it's "experimental." I mean it's only been around since the Austro-Hungarians designed special anti-testicular mines in World War One, and all the people who invented it have long since died of old age, so it's still cutting edge stuff.
Okay, phalloplasty isn't actually experimental. Female-to-male phalloplasty is "experimental." If you were born with a penis (this includes me) and have been walking around with a gun in your belt for protection from the aforementoned Austro-Hungarians, and you tend to fidget with things, and accidentally blow your junk off, then you can get phalloplasty, no awkward Austro-Hungarian-related questions asked.
The difference is... uh... FtM phalloplasty involves routing a particular nerve, and post-trauma reconstructive phalloplasty for cissexed men involves much more complicated and unpredictable.... Okay, this doesn't make any sense.
So maybe I should find an FtM gentleman who looks like me (which, given my appearance shouldn't be that hard) and start walking around with a secretly-unloaded gun in my belt. Then we meet in a closed room, switch clothes and (still-in-the-wrong-name) care cards, fire off a shot, and the rest is simple. All the medical establishment needs to hear is "ohmygodhe'slosthisdick" and hopefully they'll ignore anything else - yeah he's got a vagina, but I mean he's lost already lost his dick today - give the man a break and get him some surgery!
Thank god this has improved over time. In the West prior to the late 60's, "transsexual medicine" was a series of isolated events. The occasional doctor or surgeon would do some things under the table - but not much, and usually poorly. The rare doctor would help one or two people through transition properly, then other people would hear about it, and they and/or the body they worked for would get a whole bunch of letters from other interested parties, and then they'd close the doors beforce they developed a reputation for abetting queers.
In the late 60's, the Harry Benjamen clinic in San Francisco, and soon other clinics as well, started doing transsexual medicine on a regular basis. This was fastastic for those who met their criteria, or who colud bluff their way through. They're criteria, which are the foundation of modern transsexual medicine up to and including this assessment, were, officially or not, most or all of the following:
- dresses very "normally" for gender identity
- acts very "normally" for gender identity
- wants a gender-typical career (construction, homemaker)
- wants a "complete transition" (i.e. hormones + genital surgery + whatever other surgeries are applicable + anything else)
- able to get read as your gender identity most of the time
- straight
- hates genitals (but is willing to live with them in order to get rid of them)
- willing to cut off ties with former life (i.e. tell the kids you've died)
- has known since childhood
- willing to submit to medical experts
- stoic patience
It's improved a lot, thank god. A lot. Most of these criteria are less in effect than they were, and if they are, you can usually go somewhere else. But I still read assessment lists that have things on them like 'haircut, attire and behaviour are all approriate for someone of their gender identity.'
Mmm. Now does your list of valid gender identities include soft butches? Walks large dog. Listens to folk music. Trades. Drag king. Yes I know that a few of them are taking testosterone and getting top surgery, but your system won't let them get those, so apparantly, by your criteria, they "shouldn't" be deviating from their female bodies, so it should then support me wanting to have a female body right? Right? Riiiight?
Oh hell, I'll probably be fine. I'll just do what every other tranny does and ever has done who doesn't fit into the system: present just a little more normatively for a couple hours.
Yeah. A bit of a tomboy, yknow, like Pink but without the music. It's okay that I don't release albums right?
Or remember these questions? I will probably get asked these again. Can you tell me what the fuck most of these have to do with my genitals?
Can you imagine asking non-transsexual people these questions when they're looking for medical services?
Why? Let's see. You take a usually-poor transsexual patient, and a cissexed specialist doctor whose social circles don't include transsexuals. You put the doctor under the scrunity of queer-unfriendly medical peers, and you put the transsexual under the doctor's scrutiny. Then you make the doctor the final judge of the transsexual's identity. Mmm. Can you say "fucked up power imbalance?"
Because BC is above the grade for this sort of thing, and because MSP doesn't want to waste the time of their doctors and lawyers, I will almost certainly avoid these past themes, but they still come to mind and scare me:
- Excessive scrunity of patient behaviour (you took time off? Better start your real-life experience again!)
- Projecting your gender norms onto the patient (Why don't you dress like this? Act like that? Where's your makeup?)
- Demanding submissive behaviour as a prerequisite for treatment
- Delays "while we further assess you" which sometimes last for years.
- Doing things to anger the patient to see how they react
- Cutting off medical care and preventing them from accessing it elsewhere
- Power games
- Using patients as research subjects on whom to test theories prior to publication without their informed consent
- (In some cases) "You like men? Okay, prove it." (sound of a fly coming undone)
If I expect to get through this with no problems and have backup plans if I do have problems, and I know that I will be okay, then what's the problem?
1. On some level, I am still worried that this will go wrong; that it will result in another delay. Somehow. That I will "fail" the "test." That it will fail me. That it's opinion matters somehow. Funny that. You'd think I was raised to respect professional medical opinion or something.
2. I'm angry. I resent the fact that I have to go through this. I resent that my money is paying for this and not useful medical treatment. I resent that I am cooperating with a system I believe to be unjust, and which hurts people.
3. I'm disappointed. This system is bloody ridiculous. There are many fine aspects of transgender health care, but this is not one of them. Assessment for sexual reassignment surgery is more concerned with enforcing gender norms than helping patients. In other words, the medical system bends transsexuals into a shape where our existence supports cissexed norms, rather than questioning them.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
no subject
Date: 2008-06-13 10:19 pm (UTC)"Do you want to change your genitals/ take hormones/ have a sex change? Okay, this is how you do it." Prescription, referral, funding. End of story. Finito. Dignity, mental health, and pocketbook intact.
You know why?
Because I have never met a non-cissexual person who would be up for VOLUNTEERING for a sex change. People are pretty competent at deciding a personal sex/gender alignment, I'd say. I don't understand all this fear about "bad" patients who will drain MSP demanding sex changes any which way they want.
Can I link to this on my friends page?
no subject
Date: 2008-06-13 10:37 pm (UTC)How about "the first one is covered; after that, you gotta pay on your own?"
Even if a few people did change genitals frivolously, it would you still probably be cheaper than the current system.
no subject
Date: 2008-06-13 10:44 pm (UTC)Correction: upon rereading, I meant to write "cissexual", of course. ;)
no subject
Date: 2008-06-14 05:49 pm (UTC)I wish there was a way for your friends to say to your doctors what we say to each other when your transition comes up in conversation.
"She seems so much happier, more self confident than I've ever seen her." is what I hear most.
Good luck dealing with the dumb. It's a good thing you've got lots of practice doing so.
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Date: 2008-06-14 10:59 pm (UTC)I'm glad to hear that I come across as happier. I think I am a lot happier.
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Date: 2008-06-15 03:50 am (UTC)Pipkin linked me to this. Said to add my thoughts.
Date: 2008-06-17 10:10 am (UTC)It separates the women from the men. And hat if they had got what they wanted first, then decided it didn't work?
Its there because in the early 70s there were a lot of quacks handing out SRS to anyone who could pay, and there were suicides. A lot of them.
People got srs who shouldn't have. Closet homosexuals with religious guilt who though surgery would make them straight women. Transvestites who confuse their comfort of dressing with their core identities, mentally ill patients with dissassositive disorders and other identity issues, and even criminals on the run.
A year to be sure is NOTHING. Noting at all. From the time I told my therapist to the time I hit the table was 18 months. It wasn't that difficult. You spend your life knowing this is what you need, but you can't wait a year to be sure? If you are having a hard time with a government system don't count on a state system, or a national health to help you. It won't. We are supposed to envy YOUR health care system, what a joke.
I hear so many cry "BUT I WANT IT NOW" "I CAN PAY" they sound like straight male crybabies. There is a reason you can't buy drugs that will hurt you, or of you are unfortunate enough to live in Canada, play with dangerous toys. You may think you know, but till you are THERE you don't KNOW. You may think you do, but you don't.
This is a one way trip, and there is only one way to be sure. living it for a year clears the doubts. You need to see what its like when its not a game or a costume. That's what the RLT is. And if you cannot see that you are a close minded child who wants his lolly NOW.
I'd love to se them hand out SRS like popcorn just so i could watch the drama, there would be a good book in that, heh,
Don't bother to flame me or reply. I wont be back to view this.
A lot of people seem to be linking here
Date: 2008-06-17 07:24 pm (UTC)See this entry for a discussion on these objections. I put them on a fresh page because I didn't want this to get lost in the "comments" page.
http://hundun.livejournal.com/163994.html
no subject
Date: 2008-06-19 02:35 am (UTC)