[djsumdog]

Gender reassignment surgery. John Hopkins stopped preforming the surgery for years. There are pretty prevalent trans women, like Kate Bornstein, have acknowledged that she couldn't really consider herself a full woman afterwards; that she couldn't experience periods, pregnancy and many of the other aspects of being a woman.

This is a very touchy subject so hear me out. Anorexic can be caused by a type of body dysphoria; meaning you always see yourself as fat -- a disconnect between who you are and what's in the mirror. Same goes for people who feel like they need a part of their body amputated in order to be complete. Some surgeons preform amputations on these people, more out of fear that they'd try to preform amputation themselves. But is this healthy? This gets into a very complex discussion on what is health/mental health.

I'm totally for people changing their gender roles or adding things from opposite gender roles. Throughout history we see major roles associated with either men or women change. From the Greeks to the Sumerians to the Romans, the idea of what men and women do in society can change quite a bit. Today we might acknowledge it's more fluid and we don't have to be locked into these social constructions. We redefine gender as the social construction and sex as the biological XX/XY chromosome types.

When people throw around "mental illness" with "transgender" it is never to uplift, but almost always to denigrate. It's a conservative thing and it's terrible. If they are having trouble identifying with themselves, and want to change their bodies drastically, essentially mutilating themselves (to quote South Park, "You mean I'm just a man with a mutilated penis?") we should ask ourselves .. is that a good thing? Maybe you can look and act and be like a woman/men, but accept what you were born biologically as a man/women.

I wish there was a way to talk about body dysphoria in a way that was helpful and not hateful, and maybe talk about how progressives can be for gender role fluidity and transgendered individuals, yet also acknowledging that reassignment surgery may be a bad thing and a sign people's view of themselves may not be in line with reality or beneficial to their overall well being.

It's a very dangerous issue to touch.

[chc]

What you're describing is the traditional view of gender dysphoria, and the thing is that treating it that way has been a massive failure in much the same way as gay conversion therapy. The data presented above suggest an explanation for why it's that way — because being transgender is not a mental illness like depression, but is instead a mismatch between your mental gender and your outward birth sex. It's true that SRS is pretty drastic, but at the moment it seems to be the best approach we've found to minimize transgender people's dysphoria.

[JimboOmega]

Some people experience regret; the rates are low.

Johns Hopkins got taken over by McHugh, who had a very clear (and stated) agenda to shut the clinic down. The evidence he compiled to do so was very sketchy - it didn't look at things like happiness or suicide rates. It looked at things like having heterosexual relationships (in the new sex) vs having homosexual ones. Nobody can quite figure out how it was scored and it overall feels very much like cherry picked junk statistics.

Also, not everyone who is trans needs or wants SRS, and many are happy without it. There used to be a lot less understanding of this, and it made things more difficult for a lot of people.

And ultimately? Yes, it would be great (and possibly change my own desire for it) if SRS was better, and allowed you to be fertile. This is true of most transgender treatments. It doesn't mean we should stop doing the not perfect things we have and stop pursuing better surgical options.

[Chris2048]

> When people throw around "mental illness" with "transgender" it is never to uplift, but almost always to denigrate.

This is a form of survivorship bias - people who have meaningful things to say don't bother to speak on such a politicized topic. The same kind of reason freenet is full of criminality.

[dhimes]

I care only about one thing: Ten years after the surgery, are the people who underwent sex reassignment surgery happier than they were before? To my knowledge the answer is not conclusive- partially because it's difficult to find the folks for the follow-up survey.

[djcapelis]

The APA, AMA and other APA all seemed to find enough evidence to pass very clear resolutions calling for sex reassignment surgery to be considered a clear and effective medical intervention.

I know we are on Hacker News where everything must be done from first principles with whatever knowledge happens to be rolling around in the head of the person writing the comment, but this stuff is pretty settled folks.

[Orou]

Chemotherapy is a "clear and effective medical intervention". It doesn't mean that there are no meaningful repercussions or that it is right for everyone equally, unequivocally, and unconditionally.

The long-term implications of sexual reassignment surgery are far from settled.

[throwawayknecht]

Individuals undergoing chemotherapy also don't have their treatment constantly second-guessed by message board trolls.

[yorwba]

I wouldn't be so sure about that. I can imagine a wide spectrum of comments from worried family members "Are you sure you want to put yourself through this? Maybe you should just let nature run it's course." to trolls intentionally prodding the insecurities of the cancer patient.

[otakucode]

Too few chromosome types. And you need to factor in testosterone insensitivity syndrome where the chromosomes won't be easy to tell from the outside. And the situation of the people in the original article. And brain dimorphism. And other phenotypic and genotypic variation. Sex is quite complex.

Also, if an individual, for good or ill, cannot be trusted to make the permanent decisions about their body - who can?

[mchanson]

Anorexia has a bad outcome (death).

Being transgender, even if we accept your premise, doesn’t.

[vibrato]

Transgender people have an alarmingly high suicide rate. It appears that about 40% of transgender people attempt suicide, while anorexia results in death for about 4% of those afflicted.

[loeg]

Note that suicide attempts and death are not 1:1. I expect the rate of suicide deaths is still higher than 4% in transgender people, but it isn't the same as the attempt rate.

https://www.hsph.harvard.edu/means-matter/