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August 25, 2007

Rethinking Sex Assignment

Margaret Wente risks the ire of the identity politics commissars and dares to question the wisdom of sex change operations:

Partly at the urging of Dr. McHugh, Johns Hopkins no longer performs sex reassignment surgery. "I concluded," he wrote, "that to provide a surgical alteration to the body of these unfortunate people was to collaborate with a mental disorder rather than to treat it."

Posted by Jaeger at August 25, 2007 8:50 AM
Comments

OK. I have not had a family doctor for over 8 years. My wife's surgical section (she is a RN)cancels 2-3 surgeries a day due to lack of resources. We all know the waiting times at emergency rooms. Can someone please explain to me why we are devoting precious medical resources to the "sex change" freak show? Trans this, bi that, WTF is going on? Fine, if you are gay or lesbo, in a loving relationship, more power to you. But to demand that we accept 100% the he-she, or the bi-sexual is a little over the top. These folks(in general) are sexually disfunctional, and need a little counseling, not surgical procedures. This madness has got to stop.

Posted by: kingstonlad at August 25, 2007 9:28 AM

Once again confirming the fact that sex is 95% mental 5% physical ;-)

Where does this reality leave these poor souls like the chronically disorientated who believe they are women trapped in men's bodies and the trapped woman is bisexual?

Waddaya do there?

Posted by: WL Mackenzie Redux at August 25, 2007 9:35 AM

Good ol' Peggy Wente talking sense again. I'm surprised the Probe and Fail keeps her on, though I guess they want SOME readers...

There are times when I feel that I'm a rich person trapped in a poor person's body or the thin 23-year-old I once was trapped in my 50-something body, but I'd never ask the medical profession to pay for whatever change is needed nor ask or expect the Canadian taxpayer to foot the bill.

Sometimes you just have to suck up your unhappiness, your delusional wishes for yourself. I think it's called growing up, and I think a lot of these I-don't-know-whether-I'm-a-male-or-female folks need to leave their if-I-want-it-I'll-have-it-NOW adolescence and move forward into adulthood.

I'm thinking of the Serenity Prayer, written by Reinhold Neibuhr, which would be a good start for them:

God, give us grace to accept with serenity the things that cannot be changed, courage to change the things that should be changed, and the wisdom to distinguish the one from the other.

Posted by: 'been around the block at August 25, 2007 10:17 AM

Geez..I'm thinking I'd like to be a cocker spaniel,and as spoiled and pampered as mine is.Can someone get working on this problem..I'd like to start a support group for others like me,thinking I'll call it CRAP,for Canine Re-Assingnment Preference..send money please!

Posted by: Sammy at August 25, 2007 10:23 AM

Hmm. Are there three facets of this situation?

My own unscientific opinion is

(1)that gender is genetic, which means it is a bio-chemical system.
(2)The brain, by the way, is also bio-chemical. (3)The sexual expression of this gender is in part but not completely, social and it is directly linked to that biochemical reality.

The transgender ideology seems to also suggest (1) that gender is bio-chemical. It is innate. (2) However, they suggest that the brain connection to gender might be incorrect.
And (3)the surface material expression of this identity
(4)as well as the 'sexual expression of this innate identity' may be incorrect.

So- the argument is over how much of gender and sexuality are innate - and how much is social. The left will always opt for causality as social, which means, open to manipulation. And, the left will always opt for an ideology of an essentialist 'purity' - a basic a priori pure state that with 'revolution' (surgery) can be reached.

The opposite view is that there is no 'pure state' and that we are a complex species, made up of both material and social modes - and must adapt to this entanglement.

Just speculation.

Posted by: ET at August 25, 2007 10:31 AM

If someone wants to pay for this procedure THEMSELVES, it's their body, their money, and their choice (no different than many of the "piercees" I see walking around with the contents of the silverware drawer hanging off their faces). However, there ARE plenty of cases of natural "hermaphroditism", where a baby doesn't form naturally one way or the other, and these people should be aided to the best of our ability, according to their choice.

Posted by: SDC at August 25, 2007 10:49 AM

"that to provide a surgical alteration to the body of these unfortunate people was to collaborate with a mental disorder rather than to treat it."

Whoa!! Wouldn't be suprised if Dr. McHugh is now residing at a re-education camp.

As for Wente, she (and Christie Blatchford,) have larger gonads than most of the male journalists at "Canada's New York Times".

Posted by: Bart F. at August 25, 2007 11:30 AM

'Seems to me that "natural 'hermaphroditism'" is quite a different situation than a person with fully formed and specific male or female genitals and reproductive organs wanting a sex change.

I know a couple who had a hermaphrodite child, and she, for that's what other traits suggested, was treated with medication from her first week outside her mother's womb.

Posted by: 'been around the block at August 25, 2007 11:48 AM

Oh my God, American style sex change medical care!

Posted by: Shamrock at August 25, 2007 12:04 PM

BATB, that 10:17 post was excellent, and funny,"rich person trapped in a poor person's body". lol.

Have to agree, this sounds more like a mental disorder than genetic malfunction.

Posted by: dmorris at August 25, 2007 12:06 PM

What not too may people like to talk about is the very high suicide rate of post-operative transsexuals.

Many are devastated when they go to all the trouble of changing their bodies, just to learn that they're still not happy with themselves despite being promised a "cure".

Posted by: Cool Blue at August 25, 2007 12:38 PM

The "Human rights" complaints are about to start regarding Dr. McHugh (how about Monday?).

He is taking on a very well organized, self-identified, victim group. I am surprised a newspaper actually quoted him - that may make them a party to his "hate" speach.

Posted by: terrence at August 25, 2007 1:37 PM

I have argued for years that one way to reduce health care costs was to quit paying for sex change operations of men in prison. (yes, it has happened).

Posted by: MaryT at August 25, 2007 1:38 PM

I'm guessing this is one field that is seldom re-examined except by partisans, but I'd love to know: has anyone followed up on post-operative patients to see if they're happy? Does the surgery -- even if it's illusory -- make them feel whole at last? Or is something always missing for them?

Posted by: S. Weasel at August 25, 2007 2:31 PM

"The "Human rights" complaints are about to start regarding Dr. McHugh (how about Monday?).
He is taking on a very well organized, self-identified, victim group. I am surprised a newspaper actually quoted him - that may make them a party to his "hate" speach.
Posted by: terrence at August 25, 2007 1:37 PM"

So true! One really has to admire the courage of people like Drs. Bailey and McHugh, as well as the journalists (in the Grope and Flail, of all places) to report or comment on it. There was also an excellent editorial in the National Post the other day on the persecution of Dr. Bailey. For those who haven't seen it, check: http://www.canada.com:80/nationalpost/news/editorialsletters/story.html?id=2945ff5e-5f48-460d-8d66-6b0035c0b36e

My own instinct, in the case of these approved victim groups, is to shut my mouth (except among real friends and on places like SDA) and stay as far away from any of their representatives, official or unofficial mouthpieces, as I possibly can.

Posted by: felis corpulentis at August 25, 2007 2:35 PM

I'm weighing in as a psych person, for starters, transgendered persons are rare. It's not to be confused with gays. And, I never met one that didn't say words to this effect "I was in the wrong body, I knew it as a kid". I never met a transgender person whose life's hardships weren't compelling.

Sexual identity is hard wired in the brain. It makes sense that the body match up can get it wrong sometimes. You can flash pictures of naked girls to gay guys all day and it isn't what sexually arouses them, sexual preference is wired in the brain.

Jan Morris, a wonderful and much acclaimed travel writer now in her 60's, who spent time in the British military wrote the best account of her decision to have sex change surgery in her book "Conundrum". Her behavior was not one of a frivolous person.

http://www.bbc.co.uk/bbcfour/documentaries/profile/profile_jan_morris.shtml

There was a time, as well I know, when left handedness was considered capricious and correctable. We know now that it is hard wired.

The American Psychiatric Association decades ago took homosexuality and transgendered as a dysfunctions out of the DSM. The brain is still the last medical frontier with lots of answers to questions we don't have yet.

Posted by: penny at August 25, 2007 2:49 PM

penny, I hear what you're saying, and obviously, for a person who feels trapped in a body that seems unfamiliar and uncomfortable to them, life is not as easy as they might like it. There will be agonizing times, but, surely, one's gender/sex isn't all there is to life?

The fact is, that a lot of people have heartbreaks in their lives, be they physical or mental handicaps or emotional wounds caused by broken homes, unstable relationships, having been hurt by someone in our family or at work, etc. It's how we deal with these handicaps that defines our humanity, not the hand God/nature has handed us.

When it comes to the use of our health resources, which are under tremendous strain because of technology (and, therefore, what's possible, which is vastly more than even 25 years ago) and due to lifestyle diseases such as STDs, smoking-related illnesses, late-onset Diabetes, and the list could go on and on, we need to be very judicious about where our tax dollars go.

With all due respect to individuals who desire a sex change, I'll quote my cousin, a retired VD specialist in England when a man came to him with complaints about the size of his penis: "Well, I'm sorry. You're just going to have to learn to love with it."

We can love others and live productive lives despite of and in spite of our frailties, disappointments, and limitations. Otherwise, it seems to me, we're all doomed to lives of unhappiness. No one's life is perfect, and to expect that it can be or should be is delusional in the extreme.

Posted by: 'been around the block at August 25, 2007 6:23 PM

*
ah, hey doc... i'm feelin' kinda blue today.

i was wondering if you could cut off my genitals
and turn me into a really freakish approximation
of a woman?

crazy? whaddaya mean?

*

Posted by: neo at August 25, 2007 6:31 PM

"... I'd never ask the medical profession to pay for whatever change is needed nor ask or expect the Canadian taxpayer to foot the bill... Sometimes you just have to suck up your unhappiness, your delusional wishes for yourself. I think it's called growing up.

A great summary of the whole sorry affair.

The doctor makes a great point: many of these people likely DO need therapy and not a scalpel to help them, regardless of who's paying the tab. But as long as we're talking about paying the tab, considering the de-listed med services in Ontario, the limited resources and long waits for surgery, how the h&ll can anyone justify paying for gender reassignment surgery on the public tab? It's beyond belief, really, and the philosophy (if not the actual dollars spent) sends a disturbing message.

mhb23re
at gmail d0t calm

Posted by: mhb at August 25, 2007 9:50 PM

"The American Psychiatric Association decades ago took homosexuality and transgendered as a dysfunctions out of the DSM."

For purely political reasons, and not scientific as several conservative psychiatrists, psychologists and one liberal psychologist have noted.

Posted by: Herr Freud at August 26, 2007 10:34 AM

What's it matter their motives decades ago, it was flying against the face of much of public opinion, the point is that psychiatry doesn't consider homosexuals or the transgendered as deviant behavior.

The medical reasons are still in dispute. Clinical observations, which I'm sure were factors in the APA decision, until that spot in the brain is identified, lends itself to the conclusion that it is hardwired.

Posted by: penny at August 26, 2007 11:10 AM

Hardwired or not, we still have choices as to how we deal with our hardwiring. Some people have violent tempers hardwired into their DNA, though I'm clear they don't all vent those tempers.

Because we are HUMAN beings, not animals, we are not prisoners of our DNA, though certainly our impulses and way of being in the world are extremely closely related to our hardwiring. I still don't buy the conclusion many come to, however, that if we're hardwired in a certain way then we HAVE to behave in a certain way, that it's inevitable that we behave in a certain way.

We have to account for a great many variations in individuals who are hardwired in the same way, and, IMO, how we react to our hardwiring has to do with the fact that not only are we thinking beings we are also spiritual beings, something which posits the possibility that we, in fact, can change and are not simply slaves of our biological makeup.

But that brings us to a whole new topic...

Posted by: 'been around the block at August 26, 2007 11:24 AM

"Once again confirming the fact that sex is 95% mental 5% physical"

Geeze, never thought I was zo smardt...

Posted by: tomaxu at August 26, 2007 1:12 PM

been around the block, you are viewing homosexuality through moral prism. I don't, because I do not see it as immoral behavior. The sexual preferences and behavior of consenting adults isn't anywhere that I'd care to make a moral judgement call unless you are a pedophile. Pedophiles are sexully deviant because there aren't two consenting adults in that situation. They've made a very immoral choice if they act out on their impulses.

Homosexuality has been part of the human story, across all cultures, for a long, long time. My guess is that there are evolutionary reasons for this. Same with left-handedness, it has stayed about the same percentage since the stone age when the angles used to cut tools are examined. Both groups are over-represented in the arts. Got to wonder.

Posted by: penny at August 26, 2007 4:16 PM

Sex change operations should be banned and clonning people should be banned we dont need another BILL CLINTON or AL GORE

Posted by: spurwing plover at August 26, 2007 9:20 PM

It occurs to me that no matter what general patterns are observed in human sexuality there will always be individual exceptions: human brains and personalities are capable of amazing variations within what is rather uselessly labeled "the norm".

However, one vital contradiction in sexual identity politics has always puzzled me.

If the issue under discussion is your personal sexual orientation and the actions you take to find sexual happiness within that orientation, somehow sexual identity is "hardwired" within the brain and totally beyond anyone's control. But if the issue under discussion is how sexual identity differences may signify tendencies towards different focuses of skill, education, social role or capability, then somehow sexual identity is "a construct imposed by society to force classification" or "fluid, personal, ever changing throughout life".

I'm not qualified to make psychiatric pronouncements on a condition I don't possess, but I like to think I have a pretty keen eye for goalpost-moving and invisible cat logic. I have a profound suspicion of something that becomes rigidly inflexible when people want to claim they can't be held responsible for it, but something that becomes conveniently fluid when people want to avoid being challenged on their inconsistencies.

Posted by: Stephen J. at August 26, 2007 11:00 PM

Cross-posted this at my blog, with additional commentary.

Guess who replied?

Posted by: ken at August 28, 2007 9:23 PM

penny - "psych person" - you have now recited verbatim the conventional wisdom from the 1990's in our profession, because it is what is socially acceptable among us. On that basis alone, you might want to expose yourself to other ideas.

Because I work in acute psychiatric emergencies, most people from any group that I meet are troubled, so it is a highly biased sample and not reliable evidence of the happiness of the transgendered. I can, however, confirm that the transgendered staff I have encountered are universally angry and unhappy. And it's someone else's fault.

Posted by: Assistant Village Idiot at August 28, 2007 10:27 PM

been around the block, you are viewing homosexuality through moral prism. I don't, because I do not see it as immoral behavior.

This is all well and good, penny, except that we haven't yet settled the question of whether homosexuality (or transsexuality) should be viewed through a moral prism or not.

In other words, your amoral stance on the issue is loaded with just as much preconception, pre-judgement, and baggage as a viewpoint that does take a moral stance on the issue.

The sexual preferences and behavior of consenting adults isn't anywhere that I'd care to make a moral judgement call unless you are a pedophile.

Pace what you follow this sentence up with, pedaresty "has been part of the human story, across [many] cultures, for a long, long time." Who are you to take a moral stance against trans-age relationships? Are you ageist or something?

;)

Posted by: ken at August 28, 2007 11:21 PM
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