Why can a transsexual tell a doctor that he/she feels they are the opposite sex, and...?

Question

a doctor will alter sex organs, because they believe the person when they say they felt they have always been the opposite sex, but if a person were to come in and said they've always felt like an amputee, a doctor isn't (as?) willing to remove their limbs and fulfill their wishes?

It seems like it would be the same type of issue to me, as far as ethics go.

Answer 1

That is something that HAS been seen in the medical community before, although it is by no means easy. Yes, there are documented cases in the literature of people having elective amputations after very careful psychiatric assessment to verify that they are not psychotic and genuine are likely to feel better adjusted in their bodies with said amputation done.

That said, it is a different condition for several reasons. Firstly, transsexuality is not a desire for amputation per se. Far from it, it is a desire to live and be accepted socially completely in the gender role opposite to your birth sex. In fact, some transsexuals never feel the need to go for SRS once the social transition has been made successfully, although many will do as in order to function initmately like a member of their adopted gender role there are certain anatomical adjustments that need to be made.

Transsexuality by that token is not necessarily about amputation at all, in fact considering the F2M SRS it is about adding bits on, or breast augmentation for the M2F.

Transsexuality also has discrete evidence that it is not a simple matter of decision, far from it. There is good biological evidence that transsexual brains differ from their native sex and have both functional and anatomical characteristics of their desired sex role.

Admittedly, the two conditions bear similarities, including the deep felt desire to comfortable in your own skin, something purely idiosyncratic that no one other than you can truely know and if some form of surgery is necessary to achieve that then so be it. Neither case can really be dissuaded from this need by psychotherapy or behavioural treatments and certainly not by aversion therapy or drugs.

Transsexuality is a whole lot more common than true requests for elective amputation, which is one reason why doctors are cautious to be sure anyone requesting an elective amputation be carefully assessed to ensure there is no psychotic illness first. Indeed, "transsexuals" presenting to a doctor requesting "penis amputation", which is what I feel you are alluding to, would also be treated with more scepticism than one presenting with the request to be helped to be more comfortable with their gender role.

Doctors can, and have, been sued by malpractice by both these groups of patients simply because the patient has changed their mind afterwards. Hardly fair when the only one who knows what you really want is you, all a doctor can do is facilitate the therapeutic service requested. There is no blood test or xray to confirm these diagnoses.

Also, there is an economic arguement for nations with national health services. Amputees often become a burden socioeconomically due to the resulting disability reducing ability to work and hence dependence on state benfit and rehabilitation services. The successful transsexual on the other hand is often improved in their ability to function psychosocially and becomes more economically productive postoperatively as a result of this. Their dependence on counselling and antidepressants reduced by their greater congruety between mental and physical sex.

Ethics? The priniciples mooted in the medical community as guiding ethical concerns are:
Beneficence: First do no harm. ie be sure your patient is well informed about the consequences of the procedures they are requesting (which psychotic patients never are by definition).
Non-maleficience: the physician has a duty to protect a psychotic patient from self-harm, hence the difficulty being sure to assess said request for treatment is genuine and of sound mind.
Justice: this is why there ARE some cases who have (albeit very rarely) actually succeeded in appeals for elective amputation. This means a patient must be treated in manner which allows them to feel more comfortable in their life situation.
Autonomy: patients must be respected as in control of their own life and have a right to refuse treatments offered; however, the doctor similarly has no obligation to provide a treatment simply because a patient requests it, they must be convinced there is medical reason to provide said treatment first.

Finally, with regard to both conditions we have discussed, the majority of doctors are ill informed about both and many do receive requests from both parties with cynicism and largely due to their own ignorance. This is human nature, and definitely inexcuseable but unfortunately inevitable. Insist on referral to a qualified specialist in all cases. These are rare conditions and they need consideration by those experts experienced in their management. Not by the general practitioner.

I doubt that was the point you were really trying to make but I hope it enlightens you as to the medical viewpoint in this matter.

Answer 2

er it’s long been proven that in-fact it is a birth condition, or if you prefer defect, wherein the individual suffers from a congenital birth condition that helps develop their gender identity and basic brain structure as the opposite from their physical sex. Additionally chromosomes do not dictate an individual’s sex or gender identity. If they did then there wouldn’t be females born with XY chromosomes or even people like myself with 47 XXY/XY chromosomes and a gender identity of a female. So, how else would you explain a gender identity that was different from your physical sex? Especially if you didn’t have the vocabulary and the understanding that gender identity and physical sex are two separate things.. Addendum: So let me see if I have this straight even though there’s scientific proof and that I was personally born with a hodgepodge of chromosomes and secondary sexual characteristics, and that Christianity classified me as abomination and a sin that I should have sacrificed myself for your greater good and so you could have a better understanding without actually doing any medical and historical research. Or in plain English even though I’ll probably never meet you or even have our paths cross on the street, I should have committed suicide, rather than seeking medical treatment? Oh and yes, Transgender is a word play it was originally coined as a way for Transvestites and cross dressers to further separate themselves from transsexual individuals and the negative stigma surrounding the term transvestite. Where as transsexual was coined as a medical term to identify the congenital birth condition. Sadly, due to social political reasons the gay and lesbian community effectively adapted the term while lumping anyone and everyone who does not follow western cultures binary definition of sex. Forcing the legal definition for transgender to become gender expression and identity.

Answer 3

Except there's a sound biological and medical basis for transexualism.

Plus, i don't see an ethics problem here. If i were a doctor, i'd refuse to haphazardly perform an amputation due to the fact that people typically need their arms and legs in order to function.

On the other hand, whether you've got a vagina or a penis is largely irrelevent where your ability to function in life is concerned. If you change a person's sex, they'll still be able to get by just fine.

Answer 4

i have watched a show on heath or history or something and they were thalking aobut this viewpoint They did do an amputation on a female that marred her leg on purpose so bad that it had to be done. (she wanted it that is why she hurt herself) well, after she got it amputated she decided that she wished she never did it. I think (and it might be only me thinking this but) that people who have that problem of wanting a limb of finger or whatever amputated had it done in a previous life and are so used to it fomr the past live that they want to feel the sameway again. just my opinion. But a person who feels like a woman when he is a man or vise versa in my opinion is the exact same.

Answer 5

Potential transsexuals have to undergo a whole battery of psychological tests before a doctor will start any transformations. Also changing sexes doesn't leave a person debilitated. A doctors first rule is do no harm.

Answer 6

I would really think u need your arms or legs to funtion. But really dont know the answer to that.Maybe because the person feels they have the right to be what they want
And the Dr. agrees u know?But as for removeing limbs are whatever its a big issue u know like an arm or leg and stuff .Not sure really.

Answer 7

I am almost100% sure that is not a question that any doctor has been hit with yet. I mean who would wake up one morning and decide, hey I don't like running around, or that my left arm is shorter than my right, then speaks to his/her Doctor about amputation. People who want gender changes want it because something inside them tells them that there happiness and well being would be strengthened by seeing themselves visually as they already do mentally.

Answer 8

Anyone who thinks they want to be the opposite sex needs to see a psychiatrist! It's an insult to God to think you know better than He what sex you should be. We are wonderfully made and we should be grateful.

Answer 9

WHAT DO YOU CALL A FEMALE SEX-CHANGE OPERATION?

AN ADDADICKTOME

I would think that a doctor would remove a limb if they had a lawyer draft a consent form, and if they felt that they were adequately compensated.