Should Doctors be the gatekeepers of Gender?
March 10, 2011 3 Comments
Doctors are in the semi-artifical role of ‘gatekeeper to your new gender‘. Transsexualism is a disorder, and it needs to be diagnosed by a doctor, who then prescribes some treatment. When the treatment goes wrong then you have a legal action, as it was the doctors responsibility to make sure that that the patient didn’t regret the treatment. Most transsexuals don’t like this model, they want to be able to choose what treatment they want and when, some want to go faster and some want to go slower.
Sometimes I wonder whether we should dispense with this model of transsexualism being a ‘disorder’ that requires ‘treatment‘ and instead make it a that we make a free choice whether to have hormones or surgery or not. There would still need to be some medical professionals involved, hormones need to be prescribed and monitored by someone competent and medically qualified, surgery requires both a surgeon and an anaesthetist. I also think that there would need to be some form of screening to check that you were of ‘sound mind’ or something and were capable of understanding the consequences of your actions.
Of course this would have a lot of downsides. Firstly it would mean that if you regretted treatment it would be your own fault, and you would have no one to sue, you would have to take responsibility for the consequences of your decisions about medical treatment. I don’t think patients really get this concept, in general most people don’t understand balancing risks and benefits and like to have someone to blame if things go wrong.
In the UK treatment is sometimes available on the NHS to transition, but it is not available for cosmetic surgery, because that’s a ‘choice’. So if it was thought of that gender reassignment treatment was a choice in that way then there would be no chance of funding being available. So their would be no chance of free treatment.
In the UK we have pretty effective legal protection against discrimination, this is based on the fact that we have a disorder that we cannot change. If I got a facial tattoo I could legally get fired from work, if I had a sex change I do not get fired from work, if that happens I can sue my employer. If it was seen to be a choice then people would be able to fire us if we changed sex.
All in all I think that transsexuals benefit quite a lot from the current model, and it should really remain that way. What do my readers think?
About Z
Personally I would shy away from radical changes rather pushing for more reasonable practices, so rather than “No gatekeeping” pushing for clients without complicating factors should only have one or two psych appointments, clients with complicating factors should still be treated with the the greatest speed which is connected to there health. Ie a patient with underlying bipolar should be stabilised so that zie is able to give informed consent.
I believe the current model has strong merits, but the eventual removal of transsexualism from the DSM as being considered primarily (essentially?) a mental disorder that really can’t be fixed (so the body is altered to better align with the malfunctioning mind) would be a good alternative. Rather that transsexualism be seen more as a hormonal abnormality. Then, changing hormones and reversion of the effects of the wrong hormones via surgery would be seen as just another series of medical procedures to rectify a medical condition. The catch to this is that someone, a doctor and/or qualified therapist(s) would still need to evaluate the transsexual to ensure that his or her mental recognition of his/her own true gender was not hindered by some psychological or cognitive deficit. So, in the end not a lot would really change, but the association of transsexuals with persons suffering from mental illnesses would be severed, lessening what is now really a compounded stigma – as a transsexual, you are not only seen as “weird” and abnormal, but you are “crazy” as well. And if you aren’t, well, then you aren’t transsexual – no HRT or SRS for you!
Just my opinion. Worth what you paid for it (your time)!
Best wishes to all my fellow travelers along life’s journey,
Stacey
are you on crack its not a choice thats religion talking . here in us we finally got our docs to say all the surgeries etc is not a choice but a treatment that should be paid for all by insurance its a humane right you brits are outta your mind its not choice. so would be circumsion then be a choice you say culture religion well then isay transsexualism is culture and religion look at most pagan relgions. i mean what do yo ubase it on as a choice relgion . i mean can most transsexuals function without surgery and or hormones so then your goverment is acting like terrorist terrorisng these poor innconcent souls