This is a clear result of the over-representation of the left in popular media and educational institutes, resulting from the previous over-representation of the right.
Not an easy topic by any means, especially in the context of a culture that so stigmatizes mental illness (even mentioning that it might be an issues is controversial to the ignorant on these topics).
First and foremost, it seems extremely problematic to argue that a female-assigned individual who deeply believes they were supposed to be born without breasts is experiencing a mental state that resembles anything like suicide. Regardless of any legitimate concerns about gender surgery, this analogy immediately breaks down.
Treatments and behaviors surrounding mental illness are usually framed in terms of how adaptive they are, i.e. walking off a bridge leads to death, therefore not adaptive (ever). Having a mastectomy, if it allows someone to live a happier more fulfilling life: potentially adaptive.
Many people still believe that being gay is a mental illness, and that this is an affliction that must be “cured”. Many people still argue that the LGBTQ+ community is essentially leading hordes of people off of bridges by the thousands.
I’m not accusing you of holding this view, but I bring it up here because in the minds of many, both issues lie somewhere on the same slippery slope, and at its foundation, the analogy assumes that these people are deeply ill, and the only cure is to change one’s brain.
As our understanding of consciousness grows and we learn more about the links between our physical bodies and mental states, many avenues of mental health treatment increasingly acknowledge the role of the whole body in this picture.
To your point, this doesn’t make the topic an easy one, and I have plenty of concerns about people making decisions without the proper education and counseling. But it seems that many people project their own inability to comprehend such changes onto those who are not locked into the same world view, and the result starts to look a lot like the rampant homophobia of recent decades past: understandable given the trajectory of culture up to that point, but extremely problematic.
As medical technology advances, such surgeries may become less and less risky. In a hypothetical future, if someone could “try out” the body parts of the gender they identify with without that being a permanent decision, would that change your assessment of these surgeries and their potential utility?
Part of the confusion around this topic might come from the many different perspectives on what it means to help someone in need.
Any parent knows that a child could (and have been known to) kill itself given the option to only eat what they want (candy, cookies, etc.) There are documented cases of near-death experiences of children due to parents who gave in and only fed the child favorite sugar rich-cereal for every meal.
It may seem unfair to the child that their parents are disrespecting their deeply held beliefs about their diet, but they aren’t mentally developed enough to understand what’s best for them.
Another analogous phenomenon is transeablism: “The desire to acquire a disability through choice rather than happenstance”
People suffering from this have been known to band-saw off their arms, or throw themselves into machinery to acquire disabilities to help their body match their internal mental identity/state.
One could imagine a nice doctor helping someone band-saw off their arm to achieve their mind/body peace if the technological cost on everyone was zero in some future, just as today we see well-meaning doctors chemically band-saw off people’s healthy body functions through chemical castration.
Definitely a difficult topic.
Clearly wanting something isn’t enough to justify it, for many reasons.
I think the thing that needs more examination is how we tell the difference between the kind of mind that wants to saw its own arm off for no apparent direct gain from the kind of mind that knows it was born into the wrong body. These are clearly both deviations from the norm, but as a bisexual man, I also realize that a large portion of the population still believes I’m mentally ill, even if wanting other body parts isn’t part of my “illness”, and so I can’t reduce the plight of a pre-op trans person to just a simple matter of wants.
Continuing on the future tech thought experiment, I also wonder how opinions would change if a test were developed that could reliably predict if someone would be happier after an operation. Something that detects/indicates compatibility.
It seems that most opposition to these operations fall into two buckets:
1. The religious one, where this is an abomination and no amount of progress will change the nature of the opposition. I have little interest in arguing against this, since the premise is inherently illogical.
2. The logical one, built on the legitimate concern that an operation can’t be undone, and therefore could potentially cause more harm than benefit in the long run if the patient later realizes that they were mistaken.
Difficult for sure.
For example, I have met utilitarians that have little regard for life that has no economic value, but they are upfront regarding the value of life in economic terms, versus inherent value which a decision one has to make that is inherently illogical.
My point is that I have little interest in arguing against the claims in a book or books, written by men, claiming to be the infallible word of whichever god or gods in a discussion about an individual’s bodily autonomy and pursuit of personal well-being. I think it is as irrelevant as invoking any other random work of fiction.
Someone else can have that argument and I’ll eat popcorn, but as a child and survivor of a dogmatic and traumatic religious upbringing that taught me to hate my own sexuality, I have no interest in wasting more energy on it.
1. Lobotomy was generally not voluntary on the part of the patient.
2. The outcomes of these procedures are in different stratospheres, and gender surgery doesn’t involve changing the makeup of one’s brain and the fundamental structures through which one experiences subjective reality.
3. Given what we’re learning about the fluidity of sexuality and gender dysphoria, there’s at least some argument to be made that these surgeries have at least the potential for net benefit, even if the jury’s out on the actual degree of benefit or the specific circumstances under which benefit is experienced.
With all of that said, encouraging these surgeries nonchalantly and without regard for their permanence and real world impacts is hugely problematic. The problematic parts are amplified when the patient is too young to legally make other life changing decisions.
But to me, comparing these surgeries with lobotomies reduces issues of dysphoria and its potential remedies to a caricature of the situation and shuts down lines of thinking regarding potential benefits.
After all, if these are truly as problematic as lobotomies, all discussion should turn to how we should campaign against said surgeries. Reality is not nearly this simple.
I’m curious how you feel about other forms of body modification, from the routine (nose job, breast augmentation, etc) to the more extreme (extreme jewelry/piercings, tattoos, etc).
It seems to be culturally acceptable (for the most part) to modify one’s body based on other characteristics of one’s identity that are arguably far less innate than sexuality.
It’s puzzles me that people see gender surgery so differently.
In what sense can children consent to genital mutilation, since they do not understand at all human sexuality and the human sex drive, since the have had absolutely no experience with it? Virtually all other forms of body modification are also not legal for children.
As far as parents forcing children into genital mutilation, this is actually very popular and common elective medical procedure, but the word you're looking for is circumcision.
Aside, your user name here is after an organisation founded by one of world history's worst mass murderers. Can I suggest to show empathy with his victims, and not use this term? Using it trivialises his crimes.
I'm just being generous, I'm not technically aware of a single instance.
> even for adult
Is this a theocratic totalitarianism thing or a hatred for humanity and hatred of personal freedom thing?
First, I think it’s important to draw a distinction between the practice of genital mutilation - a practice that is alive and well in various cultures and maims significant numbers of kids every year in the name of religious superstition - from sex change operations.
Regardless of what you think about the appropriate age for such a decision, reducing this to “genital mutilation” trivializes the issue and tries to draw a comparison with a barbaric practice despite there being no connection between the two.
Almost all forms of surgery would appear barbaric on the surface if not for the significant utility of undergoing those surgeries. That doesn’t mean we should equate cutting someone open and removing their appendix with a ritualistic religious practice that appears similar at face value.
That said, I made no claims about the appropriateness of these surgeries for minors, nor do I believe someone at that age is mature enough to understand the implications of such.
That doesn’t change anything that I wrote though, even if it’s an important factor to consider for a subset of potential patients.
(2) the purpose of modern genital mutilation for the mutilatee is to facilitate sex fraud, and for the mutilator is, one imagines, money.
(3) if believe someone at that age is mature enough to understand the implications of modern genital mutilation, you will have to face the question why you trivialise it. Your writing here may, directly or indirectly lead to more modern genital mutilation. Speech has consequences.
That is true whether you're taking advil for your headache, anti-depressants to help you through PTSD, or the removal of body parts that have become toxic to your existence (e.g. your gall bladder).
That doesn't mean that all mind-altering treatments are created equal, and hormonal changes result in fundamentally different outcomes than changing (destroying) the underlying physical structures those treatments are operating on.
Put another way, lobotomies alter the hardware that all of these subjective experiences run on. Other forms of treatment are effectively modifications to software, or modifications to accommodate existing software. Drawing analogies between lobotomies and other forms of treatment is interesting as a thought experiment, but means little in practice.
But the real issue is that lobotomy just doesn't work. If lobotomy worked, it'd still be in the modern doctor's repertoire along with bloodletting and other practices. It's used here to represent a "Bad Idea", and we know far too little about gender dysphoria to relegate existing treatments to the same category.
I'm not attacking your point on whether a lobotomy worked or not. Or whether transitioning works or not. I simply find your point that transitioning is not permanently changing the brain very silly.
Of course it's not like silicon, and that's why it's an analogy. Neither is a lobotomy anything like a sex change operation.
The basic structure of this particular analogy is highlighting that:
- Solution A: Literally destroys the machinery
- Solution B: Brings about changes in how the machinery operates by altering the processes running on that machinery
That these processes are further self-modifying is interesting, but irrelevant to the point.
The implications of these outcomes are meaningfully different whether we're talking about silicon or organic brains.
> I simply find your point that transitioning is not permanently changing the brain very silly.
This is not the point I was trying to make, and as I pointed out in the beginning of my comment, the entire point of any medical operation is to "change the brain", either directly or indirectly.
My point was more about the nature of the change, and how the literal destruction of a brain is a very different kind of change and is therefore an even more problematic comparison to make in the original comment.
Going on a road trip also permanently alters the brain.
> 2. The outcomes of these procedures are in different stratospheres, and gender surgery doesn’t involve changing the makeup of one’s brain and the fundamental structures through which one experiences subjective reality.
And transitioning for sure changes the makeup of one's brain. You can backpedal all you want now but your own words are very clear.
From my perspective, physical destruction was the primary point, and I was very specifically calling attention to how that destruction is meaningfully different from other kinds of changes.
That the brain is self-modifying was assumed, and self modification becomes a moot point when the brain is no longer capable of the traditional processes of self modification due to physical destruction.
> And transitioning for sure changes the makeup of one's brain.
A point that I acknowledged explicitly above. That doesn't mean that attacking a region of the brain with a metal spike and hammer is somehow the same thing.
> You can backpedal all you want now but your own words are very clear.
Obviously my words were not very clear since you've taken some meaning from them that I never intended.
Hopefully this comment clarifies the original intent sufficiently (which, incidentally is not back pedaling, since nothing about my position has changed).
it’s great anyone can just conjure an an intimidating acronym to give the air of legitimacy, but this is very much not the scientific rigor i’d expect from hacker news
This isn't science.
> Lisa Littman, at the time an adjunct assistant professor at the Icahn School of Medicine at Mount Sinai, created the term based on an online survey of parents on three anti-trans websites who believed that their teenage children had suddenly manifested symptoms of gender dysphoria and begun identifying as transgender simultaneously with other children in their peer group.[6][7][8] Littman speculated that rapid onset of gender dysphoria could be a "social coping mechanism" for other disorders.[1]
Spreading this garbage is grotesque and bigoted. Stop it.
Just because some research challenges your ideological viewpoint, doesn't mean it's bigoted.
You could further make the argument (and people have!) that all spread of ideas and behaviors among people is a form of social contagion.
I can't speak from experience, but what I see often seems like a treadmill of trying to obtain something external (recognition and validation) to make yourself happy and complete.
Does the signifier schadenfreude alone commodity the feeling? That's a complicated question. In the way all signifiers commodify signifieds. See works by semioticists for opinions on this.
It feels like by interplay you might be suggesting is that commodification acts to produce more gender dysphoria. That's a but like asking if the word "anger" acts to commodify the embodied emotion and produce more angry people. I suspect the feeling would still be there, but far fewer people would self-identify as being angry at times because of an inability to recognize and communicate their experience. The inability to identify and communicate the feeling would cause a bunch of nth-order effects.
We've all been taught at a young age that there is a word for being angry, "anger" as explained to us by our parents, but by teaching us this word our parents didn't instill anger in us. Rather we've been taught to identify a pre-existing emotion.
As to the later, you can perform the thought experiment of closing your eyes and imagining how you would react if everyone approached and interacted with you as if you were the opposite gender. How would you reconcile your personal identity with that of people's behavior towards you? Do you suspect it would cause you to turn inwards and modify your internal sense of self or do you suppose your internal sense of self is foundational and that you would attempt to persuade those around you to instead adjust their perceptions?
To extend, personally, I would love to see a treatise on Stoicism as applied to gender dysphoria. My gut reaction though is that if an ingroup is suggesting stoicism to an outgroup, something has already gone very very wrong.
When it comes to gender idendity, maybe the dysphoria and discomfort was always there, and at the same rates. However, social conditions and trends can make the feelings of schadenfrede and anger more or less common, independent of if we have a word to call it.
As an example, if we lived in a society that imbued less meaning into gender, and it was less of an important part of identity, would gender dysphoria be as common? This example is just a tool to ask what goes into a gender label, and why do people want it?
It is basically a the same question I struggle with when I perform your thought experiment and want to be treated as a different gender? What goes into the label, and why do I want it?
I imagine that if I was given the label, but none of the meaningful attributes I ascribe to it, I would still be unhappy.
Im not really trying to prescribe any solution like stoicism, or invalidate the feelings people have, but ask what gives rise to those feelings.
I wish I had a better answer for you. The only emotional model I've come in contact with is the two-factor theory[1] and even that's just a passing familiarity. More specifically, I haven't seen an incorporation of the two-factor model into gender dysphoria.
> As an example, if we lived in a society that imbued less meaning into gender, and it was less of an important part of identity, would gender dysphoria be as common?
Anecdata, but there are many many trans people I've talked to[2] who wish gender played a less prominent role in society(up to and including gender abolition). Given that goal is unlikely to be accomplished in our lifetimes, the very next best thing is to live the rest of their life as the gender they self-identify as.
> What goes into the label, and why do I want it?
Anyone who honestly engages with trying to understand the social ontology of gender[3] has the very difficult task of peeling back successive layers of social questions and answers that most folks foreclose on because it involves unanswerable questions about the nature of reality, knowledge, and truth.
I'd be happy to discuss more, but the sensitivity of the topic leaves me hesitant. Contact info in bio.
1. https://en.wikipedia.org/wiki/Two-factor_theory_of_emotion
2. There's definitely selection bias at work and I fully acknowledge this.
3. As it largely exists in the west.
Gender dysphoria. Body dysmorphia is a very different thing, despite the words being similarly shaped.