@genessa because it was incomplete understanding based on lack of exposure or knowledge. I stated only current scientific knowledge on the subject but you're clearly not up to speed. Go read some more.

Who "cares" about gender reassignment surgery is whoever pays for it. It is not necessarily hateful or fearful to wonder if it's a good use of resources, if it should be covered by insurance (US, or in some countries where universal health care isn't quite universal) or by one's society.

I'm inclined to think any medical procedure that a patient and their doctor agree should be performed, is the very definition of "medically necessary" and should be accommodated on that basis, assuming we're talking an actual doctor using actual science and an actual, uncoerced patient. Since the distress of gender dysphoria is severe enough to cause suicide, who am I to declare it invalid.

I still would be unsurprised to find that a generation from now when we have a better understanding of this that some form of hormone or gene therapy might simply flip the switches that nature failed to at birth, and remove the need for the surgery. Wouldn't it be great if every child born were guaranteed to feel comfortable with the gender their biology gave to them!

@Biosteelman clearly you have no idea whether or not i am "up to speed" but you're perfectly willing to make that assumption. you're the one who needs to read a bit more. clearly you're not worth my time or effort. 'yawn.

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@OwlInASack PZ Meyers has a different world view I'll give you that. However my stance on gender is quite simple. To say any set of behaviours, dress, or activities is exclusively for one sex or another is sexism. So going from a binary or trinary system who's primary purpose is to determine potential for reproductivity. To a system of linear scale is degrees of sexism. As a result I reject the spectrum in its base that declares a person less of a male or less of a female based on behaviour, dress, or activities. Meaning act how you want, dress how you want, do whatever you want it doesn't change how I view individuals.

Of course if a person goes through the process to be trans I give them their respect as titles desired ie. Mr becomes Ms and appropriate accompanying pronouns etc. <<no different than a legal name change.

What I find find funny in all of this is languages like Mandarin which I used to love the fact gender was removed from their pronoun system and most jobs were genderless. 他 is that perfect little word. But now there is a women's movement in China pushing for gender identification in roles and even written pronoun 他 becomes 她.

Don't even get started on sports. From what I can determine there is no fair system for sports without discriminating on one group or another.

@michaelinlivonia That is why my intuitive take is that there must be a better way to solve the problem (or, better, a way to prevent it). I'd like to see science find epigenetic switch(es) or combination of such factors that can simply be detected and corrected at birth. This is not because there's anything wrong with being trans or gender fluid, but because there's something wrong with people's lives being filled with confusion and distress to no good purpose. Any sane person would prefer to have a clear gender association so that they can develop a clear identity and be spared all sorts of angst.

Note what I did NOT say here: I didn't say such folks should be relieved of their condition in order to spare society any concerns about their differentness. The thing that needs fixing there is society, not those who are different. I'm just saying that from what I understand, gender dysphoria is inherently a source of tremendous psychological suffering quite apart from how society usually exacerbates it. And that, at present, unfortunately, that suffering can only be remedied via expensive, risky, and not very satisfactory surgery.

My understanding is also that this distress is so extreme that not tending to it would be extremely cruel. We're not talking about someone sad at a lost fortune and we're not talking about someone suffering from a treatable delusion of some kind.

@michaelinlivonia But I hear your problem as "I don't want to be inconvenienced when I fill out forms" and "it's way to complicated to get all these pronouns right." I think the better way of thinking would be "I can't imagine how terrible it would be if people kept calling me a he when I know I am a she." It's this ME ME ME mentality we all have that puts us behind in equality. Until you are not equal, you won't be able to fully understand.

I can be selfish too, but I try to put myself in others' shoes when I can. It's a conscience effort we all have to make... if we want to.

Your stepdaughter is wise and I appreciate your honesty. However, as in the link I shared, we are not the only creatures who experience transgender members. I read an article about male Bonobos who took the 'female' role within their groups. There was a question as to whether this was a response to the presence of Alpha males but the researchers reckoned this was not the case. Basically these biologically male bonobos ifentified as female. There are a very small number of people who identfy elsewise, for example I read a story about man who identified as an amputee and considered one of his limbs to be entirely alien. Other people have similarly claimed blindness. Coming from a scientific background, I am less likely to believe 'sociiety' changes us and more that we change society. Certainly is it much more acceptable to be trans than it was. Weirdly (again another uncited ref) I read about the fact that being trans is acceptable in certain countries with majority Muslim populations, I am pretty sure Iran was one. As for it being more common, thats not true Mr. Mordant. About 0.3% of the population is trans. This statistic is more or less fixed.
There are some biological differences between the brains of trans women and cismen, in that they appear to have weaker androgen receptors which bind testosterone. If we accept that some people are born differently then we have to accept trans individuals. Finally your point about reversals. Yes they occur but they are not common and from my reading virtually all are as a result of familial pressure. I am now going on a mad lit search because I hate unref'd information.

@Amisja I appreciate the education. As I stated, I am open but not uncritical.

It seems to me that if a person with functional limbs develops the notion that one of their limbs doesn't really exist, that is delusion and a mental health issue and not a good justification or corollary to suggest that transgender is entirely nature rather than nurture. Where does it all end if we allow people to decide arbitrary things, even about themselves, that involve things not existing that actually and demonstrably do exist? I am just looking for some kind of "hard stop" so we don't have an infinite regress such that I could suddenly decide that I'm a salamander rather than a person and everyone just automatically starts catering to that and restaurants are required to offer live flies and crickets to me.

Not sure what you're addressing re: "more common", I don't believe I addressed how common transgender identification is vs anything else. I'm aware that it's less common than homosexuality, much less conventional cisgender heterosexuality. That has no bearing in my mind on whether it's something that's beneficial or that we should uncritically accept as purely organic in nature. Understanding frequency is no help there. In fact if it were unique to humans I wouldn't feel differently about it really. It clearly exists, the question is how, if anyone finds themselves feeling that they are (say) a female trapped in a male body, what would be their best response to that?

I kick myself that I did not come up with the hypothesis myself that reversing a gender reversal decision could simply be a byproduct of social pressure of various kinds. Not to mention, financial pressure, e.g., loss of insurance drying up available funds. To understand how much of a legitimate red flag such reversals are, one would have to know the percentage of reversals that are due to various general causes. I can see where reversals due to truly changing one's mind about one's perception of gender might be rare or non-existent. That's an angle I will now pursue.

At this juncture BTW I don't really perceive any downside of all this to society beyond my possibly misplaced concern that life is hard enough without fighting your own biology, and, some concerns about resources expended on questionable things. I wouldn't feel some faux need to "protect my children" from transgender people for example, or be queasy over the possibility that the guy in the next bathroom stall might not actually BE a guy, biologically speaking. My concern is more that we encourage people to do the most functional thing and that society expend health care and other resources in a way that is going to result in the most actual benefit to transgender people and the fairest sharing of resources among all. Beyond that I truly don't give a fig.

BTW the bonobos seem like another somewhat failed analogy. For male bonobos behaving submissively or taking female roles in bonobo society to be a proper parallel to transgender humans, they would need to be distressed about their maleness and simply play-acting as females would not be sufficient to relieve that distress. Correct? Or no? Seems to me that's more like cross-dressing and similar sorts of things that gender fluids sometimes do, moving back and forth between male and female roles according to mood, rather than having a permanent transgendered identification that is distressing to them.

@mordant The bonobos 'became female', for all intents and purposes. (I really need to find the original source, it explains it further). Again I'd urge you to check out the people with the alien leg syndrome (I am not sure that is the real name, I think I just made that up!) these people are not delusional. We do have people who experience single issue delusionals but these are in the context of otherwise disordered thought otherwise. These people believe they are amputees...they are convinced of this.

@Amisja Well if I'm ever convinced I have three eyes or six arms or no legs I hope someone gets me the mental health care that I'd need and deserve. I would hope they would not feed my delusions.

As for the bonobos ... again, I don't think transgender people simply want to change genders "for all intents and purposes", otherwise they wouldn't want gender reassignment surgery. They say, as I understand it, that the only thing that can relieve their distress is to physically become what they identify as. I can think of no other reason someone would go under the knife for such expensive and risky and imperfect surgery, than that this is the only thing sufficient to make them whole. Unless those female-acting bonobos are committing suicide in large numbers I'm guessing they don't need or want gender reassignment surgery. That is where the analogy breaks down for me.

@mordant You know that I am a clinical practitioner in MH? Delusional disorders are very different than this. Look, let me hit the lit search. I am rubbish at explaining in little bits of text. As for the Bonobos, I am not sure but I don't think there are many bonobo surgeons.

@Amisja Yeah those bonobos could be very depressed and unfulfilled and just don't know what the solution is.

I defer to your medical expertise re: delusion not being the same thing as being utterly convinced something is so that is demonstrably not so. However outside of medicine I have found that to be a pretty good working definition. If you feel like doing so, I would love to be enlightened about what does constitute delusion in the mental health field and what thinking you have one leg when you have two IS called.

@mordant This isnt it, but this kinda links to what I am talking about. (#shouldbewritingmyphd!)

@mordant And linking the source
[ncbi.nlm.nih.gov]

@Amisja What this is describing is not someone claiming to have 1 leg when they have 2. It is someone having involuntary movements of 1 leg or foot such that they can't control it. Nothing is said about the patients claiming the limb doesn't exist or that they are amputees. Maybe you read about something more specifically like that somewhere else.

Thank you for this

I think I will...

I know. I tell my friend before coming to a conclusion don't just listen to someone because they have "been well read" on the topic. It means their is a bias towards it. I've told him that theres 3 parts to a story not just a lie and truth. The third is to fact check for yourself, but my friend thinks that Shapiro is so knowledgeable on the topic that he must be the gospel...police told him to research on his own to find the truth, don't just listen to what some dumbass says. Lol