LBGQT: Or how I learned to stop worrying and read the DSM

[peterbound]

Stag, I'm in the fucking military. I understand the Big Chicken Dinner and the Dishonorable. I also understand the fact that while is under punishment for his crimes, he will be receiving the same type of medical care that any solider would get. You get that, right? That doesn't change. He still get's cared for by Military docs, and they will be pulling from the same funds that I get my treatments/surgeries/meds from.

[Robin Of House Hill]

So...only catatonics or hebephrenics should be permitted to define those conditions? That would be interesting.

Indeed, it would. Seriously, though, I often wonder how much medical professionals know about some things. I have a good recollection of a conversation with my endocrinologist, about a year post-surgery where I mentioned I'd come to the realization I was a lesbian. He looked at me quizzically and asked, "You went through all that, to be with women?" Clearly, he didn't differentiate between identity and preference.

[Stag Country]

Good question. Being born with a congenitally malformed hand isn't an illness. If a procedure to correct it existed, shouldn't it be offered?

It is pretty obvious that nothing that is said, will convince Stag Country. I'd like to borrow from the virtual reality thread and say, I'd like to see him experience what transgender persons feel...and then try to tell anyone that it is an elective procedure.

Interesting that you brought up that analogy, because I actually have been afflicted by a skin illness known as linear scleroderma that actually has malformed my right hand and lower forearm. I've had over 2 dozen surgeries to correct the issues that resulted from contracting it at such a young age. Every single one of them was elective and optional, and none of them would I consider a 'medical necessity'. I could have lived without them with a lower quality of life, without an otherwise ill effect.

If I was convicted and imprisoned for espionage, it would not constitute cruel and unusual punishment from the government to deny me access to those surgeries. The insinuation that you others have here that it would is ridiculous.

[Ormond]

It has always interested me how the DSM gets changed just because a bunch of docs decide to change definitions, or decide that something was a disorder this week wasn't one last week. The utter lack of a truly objective standard always has made me feel that much of it is just a bunch of opinion, with much of the line drawing being essentially arbitrary.

You obviously need definitions for purely legal reasons, even though there's no guarantee they are actually objective or correct, but I'm not sure how much value the damn thing has otherwise outside treatment purposes.

Look, as a psychologist I think sometimes the decisions that go into DSM leave something to be desired, but it is just wrong to say that there are no objective standards and that it's totally arbitrary.

Every time the DSM has been revised, the reliabilities of diagnosis have increased, precisely because the people putting it together DO really pay attention to research that's ongoing in the field.

One can criticize their decisions about particular diagnoses, and it is certainly legitimate to complain that some conditions which really shouldn't be labeled as "psychiatric disorders" are included, but there is a good bit of objective research behind a lot of of DSM.

The example I am most familiar with in regard to the changes made between DSM-IV and DSM-5 is the removal of hoarding from the category of "obessessive-compulsive disorder" and the creation of a separate diagnostic label for it. This was done because there has been a great deal of research in the last decade showing that the same parts of the brain that are involved in OCD are often NOT involved with hoarders, and that the treatments that often help OCD sufferers do NOT work for most hoarders. So removing hoarding from OCD and giving it a separate label was NOT just "pandering to the present interest in hoarding because of reality TV" (a charge I have heard), but was an objective scientific decision which will increase understanding of the condition and better guide research and treatment.

I am not saying all changes from DSM IV to DSM 5 were equally as wise. But DSM is very far from just some completely "subjective" list of labels. It is just wrong to say that it only changes "just" because some psychiatrists had a brainstorm "last week."

[peterbound]

Interesting that you brought up that analogy, because I actually have been afflicted by a skin illness known as linear scleroderma that actually has malformed my right hand and lower forearm. I've had over 2 dozen surgeries to correct the issues that resulted from contracting it at such a young age. Every single one of them was elective and optional, and none of them would I consider a 'medical necessity'. I could have lived without them with a lower quality of life, without an otherwise ill effect.

If I was convicted and imprisoned for espionage, it would not constitute cruel and unusual punishment from the government to deny me access to those surgeries. The insinuation that you others have here that it would is ridiculous.

Yet if it was on your face, or your dick (If you are indeed a man.. i'm not going to jump to any conclusions) and effected your well being, in a strong fucking way, you'd be much more pressed to get it fixed, so much so, that it might create a strong drive that could be defined as having some dysmorphia, causing you mental anguish. The docs would see it as such, and treat it.

[Fragile Bird]

#373

Posted Today, 10:15 AM

I don't even know where to begin.

You should regard that question to yourself, since my reply was a continuation of a discussion from another thread. Which got dragged here because TP couldn't stay on topic (RE: the discussion was about whether public tax dollars should be used to perform this type of procedure for someone incarcerated to 35 years in prison for treason).

Gender Identity Disorder is classifed as a mental disorder by psychologists and physicians and is listed as such in the international classification of diseases. That is neither offensive nor is it insulting, that is just reality. If you don't agree with that and it doesn't fit your preconceived notion of political correctness, then take it up with science.

The comparison with cosmetic surgery pertained directly to people that suffer from dysmorphic disorder and is entirely valid in the context of the discussion.

Also, I didn't ignore the difference between gender identity and biological sex, quite the contrary I made a rather large point about how they are completely seperate issues. Did you actually read that post or did you find one sentence that you disagreed with and then decide to run with an invented strawman?

Yeah, because thinking its ridiculous for taxpayers to potentially pay for gender reassignment surgery for a man convicted of espionage against our country makes me close minded. Priceless.

If you are wondering why you are getting so much flack, it's because you deliberately misinterpret what people are saying. I asked you to come into the 21st century because of the truly offensive things you have said about trans gendered people. The medical profession is certainly trying to get into this century, as updates to the DSM show us. As for Manning and the cost of surgery, as Peterbound has said, she is entitled to what every other soldier is entitled to. And if you don't like it, take it up with the armed forces.

[peterbound]

[url=http://asoiaf.westeros.org/index.php/topic/92944-lgbtq-the-next/page__st__360#entry4874494]

If you are wondering why you are getting so much flack, it's because you deliberately misinterpret what people are saying. I asked you to come into the 21st century because of the truly offensive things you have said about trans gendered people. The medical profession is certainly trying to get into this century, as updates to the DSM show us. As for Manning and the cost of surgery, as Peterbound has said, she is entitled to what every other soldier is entitled to. And if you don't like it, take it up with the armed forces.

Moot point anyways. Leavenworth has already denied treatment.

[Stag Country]

If you are wondering why you are getting so much flack, it's because you deliberately misinterpret what people are saying. I asked you to come into the 21st century because of the truly offensive things you have said about trans gendered people. The medical profession is certainly trying to get into this century, as updates to the DSM show us. As for Manning and the cost of surgery, as Peterbound has said, she is entitled to what every other soldier is entitled to. And if you don't like it, take it up with the armed forces.

Who have I misinterpreted? And what is your definition of "offensive things" because at face value I find it seriously lacking.

I made the following points:

1) That the public shouldn't be paying for gender reassignment surgery for a prisoner because it's an elective and an entirely optional procedure.

2) That surgical treatment for gender identity disorder is comparable to surgical treatments for general dysmorphic disorder, because both are expensive solutions to mental health disorders. I then backed up why I classified it as a mental health disorder.......and, of course, everyone lost their shit because they don't like the fact that it is still indexed as a mental disorder under some classification systems, and was only recently altered under the one they want to throw their weight behind.

Neither one of those points is offensive. The problem is people like peterbound, mormont, and several others here get irrationally butthurt when people dismantle their arguments in front of them. First it's suggested that I need to "look up the fucking definition", I do that and provide a source, and then the argument shifts to "oh you're just a bigot because [insert bullshit reason]". It's just piss poor debate tact and is a sign of people who aren't mature enough to carry on a conversation on the topic with people that don't agree with their viewpoints.

[Greywolf2375]

Neither one of those points is offensive. The problem is people like peterbound, mormont, and several others here get irrationally butthurt when people dismantle their arguments in front of them. First it's suggested that I need to "look up the fucking definition", I do that and provide a source, and then the argument shifts to "oh you're just a bigot because [insert bullshit reason]". It's just piss poor debate tact and is a sign of people who aren't mature enough to carry on a conversation on the topic with people that don't agree with their viewpoints.

No, the argument didn't shift to that - one poster posed a reason why he thought you viewed this topic as such, but it wasn't an argument shift since the discussion of the older definition v. the new definition continued after that.

Yes, you did provide two sources - one of which is not considered the book of record for definitions and one was the old version of the updated book that is considered the prime source. Why would either of those two sources you provided be considered a better reference?

[Theda Baratheon]

Aye, unsure why this is a big discussion point for Stag Country, as Chelsea Manning requests hormone treatment and not surgery. Stag Country, what is your view on this? Should she be allowed hormone treatment?

People aren't very happy with you because you've been very obtuse, offensive and stubborn in your opinions.

This is Chelsea Manning's direct quote: ''I am Chelsea Manning, I am a female. Given the way that I feel and have felt since childhood, I want to begin hormone therapy as soon as possible''

no where does she say ''I want the taxpayer to pay for my surgery'' so you're long and exhausted argument about this does not matter because she never asked for surgery.

Also, I hope now that you have read that quote you will stop using the incorrect pronoun and being generally very rude and ignorant with your language. Thanks.

[Former Lord of Winterfell]

Look, as a psychologist I think sometimes the decisions that go into DSM leave something to be desired, but it is just wrong to say that there are no objective standards and that it's totally arbitrary.

I don't believe the standards are actually objective, but I would agree that they are not totally arbitrary. In terms of objectivity, if those who write and approve the DSM decide, for any reason, to change those standards, they are the correct new standards by definition. There is no external truth that can contradict or disprove that. The standard is what they say it is, which is inherently subjective, because the entire field is man-made in the first place.

But I think arbitrary is going too far, particularly with some of the more established diagnoses. My point about arbitrariness was really at the margins.

But DSM is very far from just some completely "subjective" list of labels. It is just wrong to say that it only changes "just" because some psychiatrists had a brainstorm "last week."

But literally, the changes themselve do take effect overnight. A condition is a disorder one day, and not the next, or vice-versa. And the reason I drew a distincton between treatment and just tossing these terms out in internet debates is that I think the full range of subtlety, background, etc., without bias or agenda, is far more likely to be present when you're talking about treatment. Paticularly because it's going to be experts doing the treatment..

But once you get beyond the treatment angle, and are talking about more legal issues and public policy, I am a lot more reluctant to make society's obligations contingent upon how an unelected group of doctors chooses to describe a particular emotional issue.

[TerraPrime]

Re: Stag County

It makes no sense because you are pulling out a false equivalence and then trying to pass it off as a pseudo-intellectual debate. A man being castrated against his will is not even remotely comparable to Bradley Manning's situation, no matter how badly you want that comparison to stick. The military, in this case, is imprisoning someone and treating them as he has been treated his whole life, as a man. Suddenly he wants to be treated differently and it's "cruel and unusual punishment" to continue treating him as a man anymore.

Have you talked to transgender people in real life about his/her journey to transition, or have you paid attention to transgender activists who share their stories online and elsewhere? A man being castrated against his will is probably less realistic than a woman being born with a penis, but the point of the thought experiment is to precisely create improbable scenarios to get at the core of the issue, which is the discordance between a person's sexual identity and his/her external genitalia. You are taking a dismissive attitude towards this discordance, comparing it to cosmetic procedures like face lifts and breast enlargement. This is not what transgender people tell us, and show us, through their emotional anguish and their struggle for a proper self image. It is acceptable that if one is ignorant of these issues that one takes a dismissive attitude to this. But you are being informed, and you are refusing to concede that your understanding of what a transgender identity means is inferior and inaccurate compared to what transgender people themselves explain, and which is backed by psychologists and psychiatrists. I feel like your argument here is an example of someone transitioning from mere ignorance to willful bigotry on an issue. It's like watching a nature documentary.

It also makes no sense how you write off cosmetic surgery as uncomparable (sic). There are people with very real disorders, the most prominent being body dysmorphic disorder, that believe their quality of life is diminished if they are trapped in an "ugly" body.

You're moving the goal post. The cosmetic surgeries you cited earlier were facelifts and breast enlargements, which are typically done for vanity reasons and not always linked to body dysmorphic disorders. For people who do have true body dysmorphic disorders, the treatment is, far as I recall, not to give them more surgeries. Rather, it is to treat the underlying psychological factors that lead to the disorder. Giving patients with body dysmorphic disorder more cosmetic surgeries would make as much sense as giving free booze to an alcoholic.

If we follow your logic here, then the army, and by extension the taxpayers, should shell out money for incarcerated individuals to have elective cosmetic surgery on mental health grounds (that is EXACTLY what you are advocating for Manning in the other thread).

If a female inmate became stricken with breast cancer, and requires mastectomy to treat her cancer, and then afterwards, suffers severe mental anguish to a debilitating degree due to the destruction of an important part of her female identity, then yes, I would support the prison system paying for breast reconstruction surgery. If a male inmate has to have his prostate removed due to prostate cancer and as a result can no longer maintain erection, and this lessening of quality of life is causing him severe distress, yes, I'd support treating the erectile disfunction with either pills or a penis pump implant.

I didn't misinterpret anything. You need to be more careful with your word choices. There is nothing natural about cosmetic surgery in general, regardless of whether it is for gender reassignment or whether it is to conduct a tummy tuck. You also just defeated the point you are attempting to make by rightly saying that not all transgender individuals will seek the reassignment surgery.

You are wrong. The word "natural" in the context is an adjective for "progression." If I say "this is a beautiful frame for the picture" I do not mean that the picture is beautiful.

But be that as it may, I have no objection to describing transgender identity as natural, either, because it is part of human variation. Being transgender is as natural as being albino, or being left-handed, or being born congenitally deaf. What you're struggling here is that you're conflating being natural with being normal in a statistical sense. Being homosexual is abnormal, and so is being red-head, and being color-blind; yet, all of them are still natural. Being transgender is abnormal AND natural.

Is it possible for you to engage in a discussion without this typical elitist bullshit? Seriously? Every conversation I see you partake in on these boards involves you attempting to talk down to people like they don't understand the "true" meaning of a concept, as if you are the purveyor of all accepted fact in the world.

If you'd stop using words incorrectly, then I would not have to do the extra work of correcting you just so we can have a discussion. It is not elitist to point out that your grasp of the concepts is flawed.

First of all. It is not disrespectful to refer to him as a man and to use the male pronoun. He IS a man.

I think it takes a certain kind of obstinate rudeness to insist that word X is not rude when practically millions of people who actually are the recipients of such remarks are telling you that, hey, you know what, it is fucking rude. But do continue to disregard their requests and dismiss their concerns.

The fact that his mental facilities put him in a position where he doesn't agree with that fact doesn't matter.

Why not? Because the desire for self determination by transgender people is less important than your desire to impose the majority view of sexual identity?

If a mentally ill homeless man gets up on a stage and declares himself the 'King of England', it's not disrespectful if I choose not to refer to him as 'Your Grace'.

However, it is disrespectful to trivialize, minimize, and dismiss the lived experience of transgender people. Not that you seem to care.

Second, you just used the male pronoun to describe him. Twice.

Yes, that was a mistake. I am still adapting to the revelation of Manning's trans* status. So I apologize for the slip ups. Did you use the pronouns by mistake, too? Yeah, I didn't think so.

You, yourself, even stated that not every transgender person goes through with it. Yet you want to continue insisting that it is necessary and, most of all, that the rest of us should pay for it.

For those who need the surgery, it is necessary, but not all who are transgender requires it to feel well. To make it easier for you to understand, consider this: removing the gall bladder in the case of gall stones is needed for some patients, but not all patients. Some patients can forego the surgery through other treatment, like sonication, and achieve wellness that way. It does not mean that gall bladder removal is an unnecessary surgery for the condition of having gall stones.

I am neither ignorant of these issues nor am I being disrespectful, this is just part and parcel with your schtick of proclaiming everyone that doesn't agree with you as a bigot.

Your protest is duly noted, adjudicated to be false, and put into the garbage disposal where it rightfully belongs.

Says the person who has no idea what constitutes an elective medical procedure.

MinDonner, on Today, 03:21 AM, said:

FYI: "elective" as used for medical procedures only means "not an immediate life-threatening emergency". So the removal of cancerous tumours that can be scheduled for next week, also counts as "elective".

[Stag Country]

Also, I hope now that you have read that quote you will stop using the incorrect pronoun and being generally very rude and ignorant with your language. Thanks.

You'd have to go back to the politics thread to see why it shifted to gender reassignment. The point was brought up about precedent for such a procedure being conducted on the tax payer's dime, and there was an article sourcing that as the potential outcome....which is what we were debating.

As far as hormone treatment and whether it should be paid for by the public. Again, same boat. I say no it shouldnt.

Also, as I've addressed this before. I'm not going to refer to Bradley Manning as a woman because he held a presser and requested it. That was the purpose for the king of england/mental illness analogy earlier. He is biologically a man, he entered military service as a man, he was tried and convicted and sentenced as a man. Until he is no longer biologically a man, then the pronoun is correct. It is not ignorant, rude, or offensive to refer to a man as a him.

[Maltaran]

So you see no difference between biological gender and gender identity?

[Sci-2]

For people who do have true body dysmorphic disorders, the treatment is, far as I recall, not to give them more surgeries. Rather, it is to treat the underlying psychological factors that lead to the disorder. Giving patients with body dysmorphic disorder more cosmetic surgeries would make as much sense as giving free booze to an alcoholic.

My understanding is surgery is an option, though responsible surgeons will limit the number of these surgeries.

It's a balance. I know someone with BDD who got some work done, but was denied further surgeries by the doctor.

[Former Lord of Winterfell]

If a female inmate became stricken with breast cancer, and requires mastectomy to treat her cancer, and then afterwards, suffers severe mental anguish to a debilitating degree due to the destruction of an important part of her female identity, then yes, I would support the prison system paying for breast reconstruction surgery. If a male inmate has to have his prostate removed due to prostate cancer and as a result can no longer maintain erection, and this lessening of quality of life is causing him severe distress, yes, I'd support treating the erectile disfunction with either pills or a penis pump implant.

I wouldn't.

I think it takes a certain kind of obstinate rudeness to insist that word X is not rude when practically millions of people who actually are the recipients of such remarks are telling you that, hey, you know what, it is fucking rude. But do continue to disregard their requests and dismiss their concerns.

I have a problem with this argument, because it is essentially saying that we must delegate our ability to define reality to other people. One day, Manning was referring to himself in the masculine sense as "he". The next day, Manning says only "she" is appropriate, and his first name was Chelsea, and he was no different biologically one day to the next. There's certainly no reason he can't say that, but that shouldn't obligate the rest of the world to adopt his subjective definition of what his gender is, when there is no objective evidence that anything has changed.

I don't see any proof that gender must determined by self image rather than biology. That is a debateble point, especially since the only objective way to determine gender is biological. People are certainly free to argue or advocate that gender should not be determined by biological status at birth, but claiming that such biologically-based determinations are objectively "wrong", and that any other POV is objectively offensive, is just bullying.. And it is wrong to say that holding that position cannot be part of a debate that is otherwise cordial.

Why not? Because the desire for self determination by transgender people is less important than your desire to impose the majority view of sexual identity?

But it is justified for you to impose a minority view of sexual identity?

Here's the story about the ABV news guy who had gender identity issues, changed genders, and then reverted back after suffering a two-day bout of amnesia. Unlike Manning, this guy had hormone treatments.

http://www.nypost.com/p/news/national/guy_again_eKq3Jw6LjgsjpBdmZklrtM

I think reality is objective, not subjective. If someone wants to define gender reassignment as have taken place as of hormone replacement, I can see that. If someone wants to define it as occuring at surgery, I could see that too. But I don't see the argument that the only permissible point of view as to gender, and the only acceptable language that can be used, is whatever a particular person claims they want at the time. Especially when the comment is not directed at him/her// I'm not minimizing the severity of it, or anything. I'm simply saying that wanting an objective standard is not inherently bigotted or wrong.

[Roose Seal]

Also, as I've addressed this before. I'm not going to refer to Bradley Manning as a woman because he held a presser and requested it. That was the purpose for the king of england/mental illness analogy earlier. He is biologically a man, he entered military service as a man, he was tried and convicted and sentenced as a man. Until he is no longer biologically a man, then the pronoun is correct. It is not ignorant, rude, or offensive to refer to a man as a him.

"He" is not a man, "he" is a woman who was born with a male body.

The fact that you don't understand the basic principle of trans*ism should effectively preclude you from participating in this discussion at all.

[Theda Baratheon]

You'd have to go back to the politics thread to see why it shifted to gender reassignment. The point was brought up about precedent for such a procedure being conducted on the tax payer's dime, and there was an article sourcing that as the potential outcome....which is what we were debating.

As far as hormone treatment and whether it should be paid for by the public. Again, same boat. I say no it shouldnt.

Also, as I've addressed this before. I'm not going to refer to Bradley Manning as a woman because he held a presser and requested it. That was the purpose for the king of england/mental illness analogy earlier. He is biologically a man, he entered military service as a man, he was tried and convicted and sentenced as a man. Until he is no longer biologically a man, then the pronoun is correct. It is not ignorant, rude, or offensive to refer to a man as a him.

Yes. Yes it bloody well is. Oh my goodness, are you being serious?

Do you not know the difference between sex and gender? Biologically, she was born of the male sex, but she is a female, as she CLEARLY stated in that quote.

I think people are hitting the nail on the head with you when they mention you just seem ignorant of transgender people in general, not just this case. If you deny people their identities because they don't conform to your limited, narrow and ignorant knowledge of sex and gender then yes, that's offensive. To keep insisting Chelsea Manning is a male when she has explicitly stated otherwise is offensive. For you to just insist that you are right and everyone else is wrong and that no you're not offensive (even though many people are offended) is just...ridiculous.

Should you not think to yourself ''wait a second...a lot of people are unhappy with my comments, let's see why'' and bloody work it out instead of acting so stubborn I'M BIG YOUR LITTLE I'M RIGHT YOU'RE WRONG because despite what you believe that is EXACTLY how your comments are sounding.

Chelsea Manning is female, please - if you are going to continue posting about her, stop insisting on being ignorant and rude.

One of my best friends***** has suffered terribly with his identity, he was born of the female sex, and is currently pre-op but wants sex reassignment surgery, but he is a man, NOT a woman, so you are essentially claiming all transgender people pre-op (even though many transgender people do not seek sex reassignment surgery) are WRONG and UNNATURAL and are MENTALLY ILL, a DISORDER that can be FIXED and I'm sorry, but that is disgusting. Think about what you're bloody writing, for goodness sake.

****Seriously, he is one of the loveliest people I have ever met and one of my best friends and the years I have known him he has been male, he IS male, so when ignorant people like you just come along and proclaim that many of my friends including one of my very best friends, along with every other transgender person in the world, are unnatural and wrong and belittle their experiences by fucking comparing sex reassignment surgery and a transgender person ''coming out'' to a deluded homeless guy proclaiming he is the king of the world, of course people on this board will be angry, annoyed and upset by your comments.

[Robin Of House Hill]

Also, as I've addressed this before. I'm not going to refer to Bradley Manning as a woman because he held a presser and requested it. That was the purpose for the king of england/mental illness analogy earlier. He is biologically a man, he entered military service as a man, he was tried and convicted and sentenced as a man. Until he is no longer biologically a man, then the pronoun is correct. It is not ignorant, rude, or offensive to refer to a man as a him.

So, the mind is separate from one's biology? Please enlighten me as to where it is stored. Are you saying biological instead of physiological? Or are you talking about genetic or chromosomal differences, such as XX and XY?

You see, I have a problem with people who speak in gibberish. "If you cannot say what you mean, you can never mean what you say."

[Stag Country]

Have you talked to transgender people in real life about his/her journey to transition, or have you paid attention to transgender activists who share their stories online and............

You have an inherent to derail every conversation into a sociology critique....which is how this argument devolved to the point where it went from a political discussion to LGBT concerns. I don't care about any alleged journey you are attempting to partake on here. It's irrelevent to the issue about whether the public should be paying for an elective procedure, the fact that the procedure in question is hormone therapy or gender reassignment is incidental.

You're moving the goal post. The cosmetic surgeries you cited earlier were facelifts and breast enlargements, which are typically done for vanity reasons and not always linked to body dysmorphic disorders. For people who do have true body dysmorphic disorders, the treatment is, far as I recall, not to give them more surgeries. Rather, it is to treat the underlying psychological factors that lead to the disorder. Giving patients with body dysmorphic disorder more cosmetic surgeries would make as much sense as giving free booze to an alcoholic.

I'm not moving a goal post. That was the original point. You wouldn't expect the public to be on the hook for such operations, but suddenly that expectation is different...in your view....if you apply the criterion that the disorder in question is gender identity. I don't think that's a valid viewpoint.

If a female inmate became stricken with breast cancer, and requires mastectomy to treat her cancer, and then afterwards, suffers severe mental anguish to a debilitating degree due to the destruction of an important part of her female identity, then yes, I would support the prison system paying for breast reconstruction surgery. If a male inmate has to have his prostate removed due to prostate cancer and as a result can no longer maintain erection, and this lessening of quality of life is causing him severe distress, yes, I'd support treating the erectile disfunction with either pills or a penis pump implant.

You are certainly entitled to feel that way. I, however, find it bizarre. I think you are conflating wants with needs here.

I think it takes a certain kind of obstinate rudeness to insist that word X is not rude when practically millions of people who actually are the recipients of such remarks are telling you that, hey, you know what, it is fucking rude. But do continue to disregard their requests and dismiss their concerns.

You can ride that politically correct high horse all day it doesn't change reality. I'm not going to alter the definitions inherent in the english language just because you decided that it should offend someone else's sensibilities. I'm done addressing this point, this has far more to do with you needing to portrary those that disagree with you as bigotted, close minded individuals than it does with correcting an actual preceived offense.

Why not? Because the desire for self determination by transgender people is less important than your desire to impose the majority view of sexual identity?

The majority view? He is by any conceivable test a male human being. Not a female human being. When a person's "self-determination" doesn't align with reality, I think it's ok to disregard their opinion on the matter. For the last time, it is not disrespectful or rude to refer to a man as a man.

However, it is disrespectful to trivialize, minimize, and dismiss the lived experience of transgender people. Not that you seem to care.

When you're done complaining about this imaginary point, feel free to detail how I've marginalized, minimized, or dismissed the lived experience of transgender people.

For those who need the surgery, it is necessary, but not all who are transgender requires it to feel well. To make it easier for you to understand, consider this: removing the gall bladder in the case of gall stones is needed for some patients, but not all patients. Some patients can forego the surgery through other treatment, like sonication, and achieve wellness that way. It does not mean that gall bladder removal is an unnecessary surgery for the condition of having gall stones.

Seeing as how gallstones, if left untreated can be fatal, this is a terrible example. But it is good you are finally figuring out that the meaning of elective and optional surgery.