Should I tell my new school im transgender?

#15

Postby Richard@DecisionSkills » Tue Sep 10, 2019 1:08 pm

Diametrically opposed on the issue? I do not see it that way. I believe we are more closely aligned on the issue than you might think.

Candid wrote:And yet there are the Guevedoces of the Dominican Republic, girls who turn into boys at puberty, as documented by Julianne Imperato in the Seventies. Which brain would one of them be born with? Or does the brain change when the genitals change?

These aren't choices, Richard. They're the reality for about 10 per cent of the population, and I consider myself lucky I'm not one of them.


I did not say how you are genetically born is a choice Candid. I am talking about using ‘causal myth’ to explain a genetic mutation.

The below article ref the geuvedoces is fantastic. Maybe John was born with a 5AR deficiency! Now wouldn’t that be progress! Instead of speculating about the type of mind she has as “the cause”, there would be a solid biological explanation.

https://www.latimes.com/archives/la-xpm ... story.html

What I find interesting is that you informing me of this research is the first time I have heard about it. Why? Most certainly every single person even considering such a huge life decision as reassignment surgery would have heard about it, and been tested for 5AR deficiency, right? No medical professional with any sense of ethics would ever prescribe hormone replacement therapy without first testing for 5AR deficiency, right?

I don’t know.

I can only conclude at this point that more is taking place genetically that we don’t yet understand. Do you fully understand it Candid? I sure don’t. And when we don’t understand something, why not just admit we don’t know if A causes B? Instead we create causal myths to explain things. Instead of a 5AR deficiency we say, “I was born a mind different than my body.”

It doesn’t even make sense, yet we are going to have body altering surgery?

In the research, are these people born with the mind of a child, an adult, girls, boy, male, female, a guevedoces mind, or a Caribbean mind? No, they were born with 5AR deficiencies. They were born with a genetic mutation.

Why I do not believe we are diametrically opposed is because I think we both want similar outcomes. Neither of us want or wish harm on anyone. Neither of us believe it is an easy issue for these people to reconcile. We both agree how a person is born is not a choice.

I think the main difference is in how we frame the concept of choice. I’m not saying a person chooses their genetics or biology. I am saying that a person chooses whether or not to have surgery. And I’m saying a person chooses their “cause”. A person chooses their reason or rational for having the surgery.

The choosing of “cause” is where I think we differ. My opinion is that having gender reassignment surgery based on the belief you have a ‘male mind’ is not a very well informed decision. Feelings as “cause” is also not a very well informed decision when the stakes are major surgery.

Previously, correct me if I’m wrong, your argument is an assumption that people don’t take reassignment surgery lightly and therefore conclude that the decision is well informed based on the natural desire we all have of self interest. Anyone that has decided to go through with the surgery has most certainly done their research and is making a well informed decision, almost by default.

I disagree. I agree with the self interest and the idea a person will have thought about the issue deeply prior to deciding to get surgery. I do not agree that this makes the decision well informed.
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#16

Postby Candid » Wed Sep 11, 2019 5:15 pm

Richard@DecisionSkills wrote:Diametrically opposed on the issue? I do not see it that way. I believe we are more closely aligned on the issue than you might think.


Not when it comes to people looking for gender reassignment. If they've been unhappy for years I say yes, it's your decision to have the surgery and godspeed. You say no, you were born with either a male or a female body and that's it.

Maybe John was born with a 5AR deficiency! Now wouldn’t that be progress!


Would you then propose he take whatever drugs would stimulate the production of 5AR? Whether he wanted that or not?

I can't help comparing this to the issue of homosexuality. Until relatively recently that was seen as a sickness to be 'fixed', with the administration of electric shock whenever the subjects lingered on same-sex photographs.

All the gays I've met have been happy with their sexuality, largely thanks to a more enlightened society. It would be insulting to offer them a 'cure', because they don't perceive themselves as sick.

I can't imagine what it would feel like to believe I was a man and want to be recognised and treated as one, but there have probably been a small percentage of people 'born in the wrong bodies' since the dawn of time.

My brief has never been to tell a client "you're wrong about yourself", but to try to get in their skin, see the world through their eyes, and advise them how to go about achieving what they believe will make them happy. One thing counsellors learn early on is to bracket our own feelings and prejudices. It's not easy, but person-centred counselling is all about letting the client lead the way. Any 'cure' imposed by the worker's feeling of what would be right just isn't likely to stick.

Most certainly every single person even considering such a huge life decision as reassignment surgery would have heard about it, and been tested for 5AR deficiency, right? No medical professional with any sense of ethics would ever prescribe hormone replacement therapy without first testing for 5AR deficiency, right?


You and I hadn't heard of 5AR deficiency until this thread. You might be surprised what medical professionals don't know. The workings of the human body-mind are a vast and largely unexplored field, and I confidently predict that in years to come people will be as bemused by the lucrative wholesale prescribing of head drugs as we are now about leeches and bloodletting.

As to people like John, I doubt they'd go looking for a 'cure' or be tempted to try it if they stumbled across it. For them, the sense of being in the wrong body has always been there; it's "who they are". They don't want to be 'cured' any more than gays want to be cured, but to make mind, inclination and body align.

Do you fully understand it Candid?


No. The kind of mind I have is not a scientific one. Perhaps it could be made so with regular ingestion of prescribed Einstein Pills... but I wouldn't take them. I like the way my mind works. My mind is who I am.

It doesn’t even make sense, yet we are going to have body altering surgery?


We're not, no. But just because you and I don't want gender reassignment doesn't mean we should ban it for those who do, or make them feel bad for wanting it. I like diversity. It's one of the two main drivers of evolution.

Why I do not believe we are diametrically opposed is because I think we both want similar outcomes. Neither of us want or wish harm on anyone. Neither of us believe it is an easy issue for these people to reconcile. We both agree how a person is born is not a choice.


Yes to all that.

I’m not saying a person chooses their genetics or biology. I am saying that a person chooses whether or not to have surgery.


Yes, of course.

And I’m saying a person chooses their “cause”. A person chooses their reason or rational for having the surgery.


Yes -- but what you can't get your head around is someone knowing they're not the gender that goes with the genitals (and other markers). I don't need to understand. I think you do; or rather, you'd like to link it to something biochemical, so we can 'cure' it and not put healthy bodies under the knife. I'll agree with you as far as that goes, but not if it means obliging people to take 'cures' when they don't perceive themselves as sick. That would insult, punish and degrade what's probably always been our least visible minority group.

My opinion is that having gender reassignment surgery based on the belief you have a ‘male mind’ is not a very well informed decision. Feelings as “cause” is also not a very well informed decision when the stakes are major surgery.


It doesn't matter whether an individual (such as John) calls it 'male mind' or something else. He identifies as male, and that's the end of it. Who are you or I to point to his genitalia and say he's wrong? Is masculinity, and the traits we associate with it, solely based on sex?

Previously, correct me if I’m wrong, your argument is an assumption that people don’t take reassignment surgery lightly
Yes
and therefore conclude that the decision is well informed based on the natural desire we all have of self interest. Anyone that has decided to go through with the surgery has most certainly done their research and is making a well informed decision, almost by default.
No. This is where you and I differ most. I don't believe people going in for a sex change need to be well-informed except about the risks of surgery, and that's standard for any operation. What do you want them to be well-informed about -- that science might be able to 'cure' them with some kind of hormone therapy? How would you feel if someone offered to cure you of being Richard?

https://www.youtube.com/watch?v=h4_eSW6D6sc
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#17

Postby Richard@DecisionSkills » Thu Sep 12, 2019 1:22 pm

Candid wrote: This is where you and I differ most. I don't believe people going in for a sex change need to be well-informed except about the risks of surgery, and that's standard for any operation. What do you want them to be well-informed about -- that science might be able to 'cure' them with some kind of hormone therapy? How would you feel if someone offered to cure you of being Richard?


I agree this is where we differ the most. But, even with the above we are mostly in agreement. I’m curios to flesh it out, because I truly think the differences might not be very far apart. Of course, I could be wrong.

***
In my opinion it boils down to a difference in opinion regarding the responsibility of the community to help an individual make an informed decision verses the freedom of an individual to do whatever they wish with their own life/body.

In my ideal community a person seeking gender reassignment, in theory, goes straight to the doctor that will perform the surgery. Whether or not they are “well informed” at this point is irrelevant.

The doctor in my ideal world has ethical standards. The same as in my utopia a person doesn’t sell heroin to an 8 year old, a doctor isn’t just willing to perform gender reassignment because someone says, “I want it.”

The above paragraph means the doctor must screen the potential patient and decide on a treatment plan. Today this is a growing body of research called “shared decision-making”. I really appreciate this approach. It is the doctor helping the patient make a well informed decision.

As part of the shared decision-making process in my utopia, the doctor asks a few questions that establishes the mental ability of the candidate. Hopefully you agree that our ethical doctor does not agree to perform major surgery on someone with the mental faculties of a child.

I think where we differ is that my standard of what it means to be “well informed” is a touch more stringent than yours. In questioning the candidate my ideal doctor would ask, “Richard, should you tell your new school that you are transgender?”

If Richard is confused or stumbles to answer the question, I’m going to hesitate on approving them for surgery. Maybe Richard needs some more time to develop critical thinking skills? Might that not be a better treatment plan prior to major surgery?

But seriously, in my ideal world the doctor does screen the patient for their reasoning abilities. If they can’t work though a simple logic problem then maybe we need to start a treatment plan to work on their cognitive ability rather than conducting major surgery.

The doctor in my ideal world doesn’t only discuss the physical risks of surgery, but offers up a full treatment plan that includes more than one path. The doctor also discusses the potential outcomes, such as the possibility that the surgery does not significantly reduce the risk of suicide. The doctor asks, “Richard, have you ever heard of 5R deficiency?”

So yes Candid, I do believe it is a good idea for a doctor to offer up various options. I do not believe the doctor is to force or push one option over another. In shared decision-making the doctors role is to lay out the options along with potential consequences. The patient ultimately chooses the path they want and then the doctor does their best to make that happen.

Every path alters Richard from being Richard. People choose to get all kinds of elective surgery to align how they feel, to make themselves happy, to make life meaningful for them. People take chemicals to alter the path, they get elective surgery, etc. Future Richard is not going to be past Richard no matter what, so at least provide the latest information and choices available. I see nothing wrong with that.

On a scale of 1 to 10, from having a 1 be totalitarian control over other peoples bodies, forming panels, rationing health care, deciding on euthanasia, to 10 being total freedom with doctor shopping, where an 8 year old with an IQ of 60 can be sold heroin or elect to have gender reassignment, I think you and I are pretty close in opinion.

I do not think you are a 10 or even a 9. I think you are probably an 8, understanding the need for some boundaries on when to allow an individual to elect to have major surgery. And if you are an 8, then I’m a 7. I just think that if Richard can’t work through a simple issue of social etiquette that maybe we need to take a second look at how we best treat the problem.

Note, I use Richard as I don’t even know if the OP is seeking or has had reassignment. This is more about my hypothetical ideal and our differences in approach.

Are we really that different in opinion?
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#18

Postby Candid » Thu Sep 12, 2019 3:43 pm

Richard@DecisionSkills wrote:In my opinion it boils down to a difference in opinion regarding the responsibility of the community to help an individual make an informed decision verses the freedom of an individual to do whatever they wish with their own life/body.


Maybe it does. I balk at 'help' from the community that involves telling members of a minority group they are wrong about their own experience of life, and should take every possible curative chemical until years later they've literally tried everything, and they still want to change gender -- only they've missed the prime pairing-off years and their self-esteem is now in the toilet, having been told by a score of experts that they can't possibly ever have been right about what they needed.

I do believe in the right "of an individual to do whatever they wish with their own life/body". As a card-carrying member of Exit International, I fully support Philip Nitschke's proposal that every rational adult has the right to die at the time of their choosing.

The above paragraph means the doctor must screen the potential patient and decide on a treatment plan.


What do you mean by screening? The doctor, who's as straight as they come and can't begin to comprehend the person's experiences thus far, is going to make the decision? If I were to subscribe to this, everything would depend on a mandatory first question. Let's say it's to our friend John.

"If there were a pill you could take to make you feel a whole lot better about being a woman, would you take it?"

If the answer is no, the next thing is to make John aware of potential surgical dangers, and begin the hormone treatment.

Hopefully you agree that our ethical doctor does not agree to perform major surgery on someone with the mental faculties of a child.


Of course -- although I consider it unlikely that the intellectually subnormal would request it.

I do take your point that John hasn't sat with this issue long enough. I've looked at a number of his unhappy posts, and it appears he began questioning his gender only at the beginning of last year: viewtopic.php?t=106392

But seriously, in my ideal world the doctor does screen the patient for their reasoning abilities. If they can’t work though a simple logic problem then maybe we need to start a treatment plan to work on their cognitive ability rather than conducting major surgery.


In the UK the cognitively impaired need to be accompanied by carers, familial or supplied, before they can take any legal step. Where do you suppose a person with low-IQ in the US might find the cost of elective surgery??

Reliable statistics are extremely difficult to obtain. Many sexual-reassignment procedures are conducted in private facilities that are not subject to reporting requirements.
The cost for female-to-male reassignment can be more than $50,000. The cost for male-to-female reassignment can be $7,000 to $24,000.
Between 100 to 500 gender-reassignment procedures are conducted in the United States each year.

~ https://www.livescience.com/39170-how-g ... aphic.html

The NHS approach is more like your Utopian proposal, through four pages starting here: https://www.nhs.uk/conditions/gender-dysphoria/

The doctor asks, “Richard, have you ever heard of 5R deficiency?”


And then what? Finasteride therapy can reduce your risk of getting prostate cancer. There's nothing to say that a synthesized version of 5AR/DHT can make someone who identifies as male feel better about the fact that he has a woman's body. It does, however, suggest that possibility (however remote) that a lifelong course of the stuff could turn a person born female into a man. Of sorts.

In shared decision-making the doctors role is to lay out the options along with potential consequences. The patient ultimately chooses the path they want and then the doctor does their best to make that happen.


Of course. Perfect.

On a scale of 1 to 10, from having a 1 be totalitarian control over other peoples bodies, forming panels, rationing health care, deciding on euthanasia, to 10 being total freedom with doctor shopping, where an 8 year old with an IQ of 60 can be sold heroin or elect to have gender reassignment, I think you and I are pretty close in opinion.

I do not think you are a 10 or even a 9. I think you are probably an 8...


Seriously? :shock: When it comes to an eight-year-old with an IQ of 60, I'm a zero on the question of gender reassignment, heroin use, crossing a busy street or making his own breakfast. I'm a big fat 10 on three out of four of those for anyone over the age of 18, of normal intelligence or above, with comprehensive and appropriate counselling.

I just think that if Richard can’t work through a simple issue of social etiquette that maybe we need to take a second look at how we best treat the problem.


Yes. And it appears John's attention has wandered.
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#19

Postby mute » Thu Sep 12, 2019 7:06 pm

im not even replying anymore its pointless to argue with these people. they don't understand logic or common sense
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#20

Postby Richard@DecisionSkills » Thu Sep 12, 2019 7:28 pm

Candid wrote:Seriously? :shock: When it comes to an eight-year-old with an IQ of 60, I'm a zero on the question of gender reassignment, heroin use, crossing a busy street or making his own breakfast. I'm a big fat 10 on three out of four of those for anyone over the age of 18, of normal intelligence or above, with comprehensive and appropriate counselling.


I must not have explained the scale/spectrum correctly.

10 is total individual freedom meaning that even an eight-year-old with an IQ of 60 can do whatever they wish. The community doesn't protect anyone at any age or for any reason from themselves.

1 is no freedom of choice. From birth to the grave the community controls your choices.

It sounds like you are a 9. Outside of an eight-year-old with an IQ of 60 the threshold for making choices that impact your life is entirely yours to make, regardless of how uninformed they might be. Even if there are indirect impacts or costs to the community it is their life, their choice.

But, you did mention that John has not sat with the issue long enough. That kind of starts to sound like you are more an 8. Maybe total individual freedom should have some checks and balances by the community.

Anyway, I think wherever you are on the spectrum our main difference is that I am a bit more on wanting to ensure that the individual has the intellect and the wisdom necessary to come to an informed decision. If you are a 9, then I'm an 8. Point being, we are not that far apart.

I don't buy the argument that because a person has not lived the same life as someone else that they can't understand, i.e. the "you are not a minority" argument. If that's the case, then none of us can give advice to anyone else, because we can all play that less than helpful game. And it is a game. It is an easy way to dismiss what anyone has to say that doesn't identify with your own values and beliefs. It results in silos, segregation, and people making bad decisions based on only accepting the information from people "like them".

And research has even demonstrated that people make better decisions when a group is not homogenous. While a homogenous group typically comes to a quicker decision, a group that is heterogeneous will come to a better decision.

In fact, I would say you and I are a great example. While we have some similarities, there is enough difference between us that we have some solid discussions that offer people alternative viewpoints. There are plenty of times a person might read, "I agree with Candid," or vice versa, but there are other times when we see things differently. That is a strength, not a weakness. Anyone that happens to read the forum arguably gets more out of threads where we differ than where we agree.
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#21

Postby Candid » Fri Sep 13, 2019 6:32 am

Richard@DecisionSkills wrote:I would say you and I are a great example.


I'll go along with that. :D I also suspect anyone could identify our respective genders by following our debates, even if we didn't have pictures and in your case a male name.

I do always take your thoughts on board, and learn a few things -- about you as well as the subject matter -- whenever we engage.

It sounds like you are a 9. Outside of an eight-year-old with an IQ of 60 the threshold for making choices that impact your life is entirely yours to make, regardless of how uninformed they might be.


Up to "entirely yours to make", yes -- but there's a prolonged course of hormones to be got through before the knives come out. Anyone on the eve of gender reassignment surgery must be better informed that you or I will ever be, even if they're at a 'private facility' where everyone from the receptionist to the lead surgeon has dollar signs in their eyes.

It's not like someone gets roaring drunk at a gay venue and thinks Wouldn't it be a hoot to switch gender?, then pops along to a liberal clinic and gets the deed done before s/he's sobered up next day.

Maybe I should have asked more questions re. how far along in the process was our John. I would have thought I was being prurient, when the question was Should I tell any new friends I make?

That sort of thing is surely addressed in both pre- and post-operative counselling.
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#22

Postby Richard@DecisionSkills » Sat Sep 14, 2019 12:23 am

Candid wrote:Anyone on the eve of gender reassignment surgery must be better informed than you or I will ever be...


I agree, but we are talking about "better informed" in a low information environment. That is different than well informed.

It is like a person claiming that they are well informed about what takes place after death. You can use your entire life becoming better informed than everyone else, yet all of that dedication doesn't equal being well informed. You still don't know what happens and neither does anyone else.

Gender reassignment might have a few steps up on available information than life after death, but it isn't that far off. We simply don't know so being "better informed" doesn't necessarily mean very much.

Regardless, to interpret what you wrote another way, even in the face of low information the person is still better informed than anyone else and therefore is technically in a better position to make the decision. And we agree it is the individual's freedom and right to make that decision, regardless if it is with limited information.

I wonder what you think of the following 30-year study conducted in Sweden? It involved tracking 3240 individuals, of which 324 were trans individuals.

https://journals.plos.org/plosone/artic ... ne.0016885

"Better the devil you know than the devil you don't know - It is better to deal with something bad you know than with something new you don't; the new thing might be even worse. The proverb is of Irish origin and has been traced back to the 1539 Collection of proverbs by R. Taverner.
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#23

Postby Candid » Mon Sep 16, 2019 9:20 am

Richard@DecisionSkills wrote:I wonder what you think of the following 30-year study conducted in Sweden? It involved tracking 3240 individuals, of which 324 were trans individuals.


It suggests that once a depressed/dissatisfied person, always a depressed/dissatisfied person. That would surely come up for discussion in pre- counselling.

many sex reassigned persons decline to participate in follow-up studies, or relocate after surgery

I see both these issues, non-participation and relocation, as statements that most people who go to the trouble, expense and danger of gender reassignment surgery prefer to cut off from their pasts and live fully as a new identity. This preference is also exercised by people who simply change their names but not their gender, and move right away from where they grew up. Feelings of shame or distaste for a former way of life and everyone associated with that life suggest a pre-existing psychiatric condition in both cases.

In this study, male-to-female individuals had a higher risk for criminal convictions compared to female controls but not compared to male controls. This suggests that the sex reassignment procedure neither increased nor decreased the risk for criminal offending in male-to-females. By contrast, female-to-males were at a higher risk for criminal convictions compared to female controls and did not differ from male controls, which suggests increased crime proneness in female-to-males after sex reassignment.

Interesting. Here's one argument for the concept of 'male minds' and 'female minds'!

Yes, a good read and a clear warning against gender reassignment on a whim. One way or another, it's going to shorten your life.
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#24

Postby Richard@DecisionSkills » Mon Sep 16, 2019 11:06 pm

Candid wrote:...a good read and a clear warning against gender reassignment on a whim. One way or another, it's going to shorten your life.


And given your statement that no one does it on a whim, all of the subjects shown to be negatively impacted by gender reassignment in the study would be those that went through the steps to be “well informed”.

What this discussion has helped me with is reflecting on the concept of being knowledgeable in areas where knowledge is limited. Sometimes we are faced with very tough, life altering decisions without having the knowledge required, because the knowledge simply isn’t available.
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