Tag Archive | rants

The Myth of Post-Op Regret And Suicidality

Jan2

There is a popular myth going around that attempts to quote from this 2003 Swedish study:

Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden

People using this study do so selectively. Let me explain the statistical manipulation going on with gender surgery detractors and the myth they try to construct.

First they note that general population rates for suicidality are around 1.6% in the United States. Then they note that suicidality rates for post-op transsexual people are about 4.1%. They then claim that since this is “hundreds of percent higher” that surgery does not work.

But let’s talk about the reality. What is that reality? It is that the pre-op suicidality rate for transsexuals is 41%!!!

Yep, that’s right. Pre-op rates of suicidality for transsexuals are 1000% higher than post-op rates. How do we know this? From the UCLA Williams Institute study Suicide Attempts among Transgender and Gender Non-Conforming Adults. (Warning! PDF!)

And the Swedish study actually supports gender surgery. Their conclusion?

This study found substantially higher rates of overall mortality, death from cardiovascular disease and suicide, suicide attempts, and psychiatric hospitalisations in sex-reassigned transsexual individuals compared to a healthy control population. This highlights that post surgical transsexuals are a risk group that need long-term psychiatric and somatic follow-up. Even though surgery and hormonal therapy alleviates gender dysphoria, it is apparently not sufficient to remedy the high rates of morbidity and mortality found among transsexual persons. Improved care for the transsexual group after the sex reassignment should therefore be considered.

Note what is said very, very gently and in careful scientific language: “This highlights that post surgical transsexuals are a risk group that need long-term psychiatric and somatic follow-up.”

So what detractors are doing is selective statistical selection to “prove” their biased point. When we take the entire picture, we see that gender surgery actually reduces suicide rates to 1/10th of what they were pre-op. And, as the Swedish study concludes, what trans people need is more support, not because they are trans, but because too many people in society today are just ignorant assholes.

Transgender Day of Remembrance 2014 – The Day After

Nov21

TDOR-2014And… not a word from the official Republican side of the aisle. The number of Republicans speaking about TDOR was small – like an aide to Christie Whitman read a letter from her at a TDOR event.

I tire of hearing that there are “good people” in the GOP. Where are they? Why do almost none speak out even on TDOR? Why do they remain silent in the face of blatant hateful bigotry that celebrates our deaths?

The Republican Party is a moral monstrosity. A hate machine dedicated to subjugation and demeaning of human beings who do not fit their white Republican Protestant middle class ideals. Blacks know this, Hispanics know this, Asian-Americans know this, gays and lesbians know this, and transgender people ought to know this though it seems a few of my brothers and sisters have their heads buried deeply in the sands.

Todd Kincannon, former executive director of the South Carolina Republican Party, says “There are people who respect transgender rights. And there are people who think you should all be put in a camp. That’s me.”

Where were the Republicans when that statement was made by a former high ranking GOP official? They were silently applauding in the background and promising to gut ENDA if any transgender protections were included. That’s where they were.

Meanwhile, in the past we’ve had statements like this from Republicans in Iowa on 2010 when the governor recognized TDOR that year:

IFPC Action President Chuck Hurley commented on the Governor’s proclamation by saying, “Governor Culver not only failed to keep his promise to the people of Iowa concerning the defense of marriage, but now is using the power of his office and the dignity of the state of Iowa to promote sexual confusion and deviant behavior.”

Hurley added, “Iowans know that Governor Culver does not share their values. As if the Governor’s unwillingness to exercise the influence of his office in the defense of marriage wasn’t evidence enough, we now know that he is spending his time creating special days celebrating sexual disorientation. The question that Iowans ought to be asking is why Governor Culver wasn’t proud enough of his work to make his actions public?”

So if you tell me again that there are “good” Republicans in office out there, I’d like to ask you to point them out to me. And if you do, you will find that their numbers are astonishingly small.

I leave you with this thought on the day after TDOR:

“The hottest place in Hell is reserved for those who remain neutral in times of great moral conflict.” — MLK, Jr.

The silence of the GOP shines with a bright heat and I know from whence that heat comes.

Rationalizations, Exploitation, and Selfishness

Oct5

Today I read a discussion elsewhere that attempted to rationalize the decision to not transition when someone clearly wanted to transition. Excuses included relationships with people who could not accept the truth. This specific argument bothered me greatly.

The argument that “I can’t transition because [insert family member here] can’t accept it” is a rationalization. It marks someone who is in a dependent relationship, not a healthy relationship. It also marks someone who knows very well that they are not loved unconditionally as a human being but instead is “loved” very conditionally. This is called being in a codependent relationship. It’s not healthy.

I experienced all this and looking back on it, it was pure and utter nonsense. How do I know this? How would these same family members react if I said I had cancer? Well, I know the answer to that question because I had and beat cancer eighteen years ago. And for that medical problem, people constantly urged me forward, to not give up, to have hope, to get well. The exact same people who today openly, viciously, and cruelly condemn me for addressing this health issue supported me when it wasn’t a health issue that challenged their own world view.

And you see, that is the height of selfishness.

“Selfishness is not living as one wishes to live, it is asking others to live as one wishes to live. And unselfishness is letting other people’s lives alone, not interfering with them. Selfishness always aims at creating around it an absolute uniformity of type. Unselfishness recognises infinite variety of type as a delightful thing, accepts it, acquiesces in it, enjoys it. It is not selfish to think for oneself. A man who does not think for himself does not think at all. It is grossly selfish to require of one’s neighbour that he should think in the same way, and hold the same opinions. Why should he? If he can think, he will probably think differently. If he cannot think, it is monstrous to require thought of any kind from him. A red rose is not selfish because it wants to be a red rose. It would be horribly selfish if it wanted all the other flowers in the garden to be both red and roses.”

― Oscar Wilde, The Soul of Man and Prison Writings

Oscar Wilde’s comments ring true today too.

It’s not the person transitioning who is selfish. That person is simply addressing a verified medical condition as per the American Medical Association and American Psychological Association. Transgender people aren’t mentally ill. It’s a treatable medical condition.

And yet the exact same people who urged me forward, who supported me as I sought treatment for cancer to become well again, have treated me with deliberate, cruel, vicious disdain for seeking treatment for gender dysphoria caused by an accident of birth.

I do not question those who choose to not transition out of fear of reactions of “loved” ones. I understand that fear all too well. But what I would question is whether those people truly love you or whether you are a mere convenience in your current form for them who would become an inconvenience in another form.

Because, having lived this, it sure looks to me like a lot of people who claim to “love” their transgender relatives do nothing of the kind and instead are selfish individuals who are using their transgender relative for their own purposes, whatever those might be and who fear losing whatever convenience that relative currently provides.

Those of you who are trans need to ask yourselves whether you are really loved or whether you are just being used. I suspect that you’ll find that you’re just being used. I certainly discovered that sad truth and I sacrificed hugely for what turned out to be nothing in the end.

I hit a nerve, didn’t I?

Jan21

Because that’s all some of these people have – is raw nerves.

I never said that I supported Michelle Kosilek. I never said that I was happy that this lawsuit was filed. I never asked for such to be filed. But it’s there and we cannot ignore it.

What one particular voice wants to ignore is that if the state decides that GCS is medically not necessary, then you can bet that every insurer in that state and in any state where that precedent can be used (which is likely to be many because of the nature of the federal court system) will use that decision as a basis for claiming that transgender health care should be excluded from coverage.

Yes, yes, some companies negotiate to cover that now. But open heart surgery isn’t a negotiated item. It’s required, because it can be medically necessary. The reason that we have this entire patchwork mess was because back in the 1980s, certain other shrill voices managed to convince the Reagan administration that GCS was not a medically necessary procedure, and even to call it “experimental” despite the fact that it had been in use successfully to treat GID since the 1930s.

For the federal courts to agree that it is a medically necessary procedure provides reference and precedent when reviewing the status of Medicaid coverage of GCS, which just so happens to be under review this year. And if Medicaid says it is medically necessary, most insurers rapidly fall in line and agree with the federal government. This has happened on all other manner of health care before – a federal decision which prompted the health insurance industry to stop treating something as optional. So your assumption  that this decision can’t be relevant elsewhere flies in the face of things I’ve been directly told by people with legal training.

I’ve not cheered on Michelle Kosilek. I’m not carrying any torch for her, despite your misguided attempts to paint me in that light.

As for your fear of answering those who questioned, you answer them honestly. Every single prisoner under the care of the state is entitled to medically necessary care. Even Charles Manson. That doesn’t mean anyone “supports” these people. That’s an absurd attempt to twist this into an emotional argument so you can maintain your faux moral outrage about this case.

You claim that I am supporting this when I never said any such thing. What I am saying and will continue to say is this decision is pure black and white due process. If the doctor’s diagnosis is medically necessary, then the state has no choice, no matter how much you, I, or your neighbor may dislike it.

Unless, of course, Jennifer, you want to amend the constitution to permit cruel and unusual punishment? Because that’s the alternative here. Deny medically necessary treatment, an act which is already deemed cruel and unusual punishment by prior US court cases, and which therefore violates the Eighth Amendment to the US Constitution.

You can’t have it both ways, Jennifer. I wish this case had never come before the courts. But it did. It’s here. And either the law has to be blind or we’re not a nation of laws.

It seems you no longer want to be governed by law but instead by moral outrage. Such a pity.

Faux Moral Outrage Among Shrill Transgender Harpies

Jan19

A federal judge upheld the right of a transgender inmate to receive gender confirmation surgery at the expense of the state. As usual, a particular crowd of transgender voices arise at this “outrage”, about how the “community” brings “shame” upon ourselves because some of us supported this decision. Since I cannot post my unfettered thoughts elsewhere, where these harpies gather like shrill ravens shouting down anyone who disagrees with them, I’ll post my thoughts here. What follows is what I would have addressed to these irrational, illogical, constitutional defying shrill voices of faux moral outrage had I been allowed to say it where it should have been said.

Some of you seem to hold the notion that prison should be cruel and unusual punishment, despite a clear constitutional prohibition against the same.

Some of you seem to want to pick and choose what the government is allowed to call “medically necessary”.

Some of you seem to want to deny that the AMA and APA have stated that GCS can be “medically necessary” in specific cases.

Some of you seem to want to deny the long standing legal finding that anyone in prison is thus a ward of the state and the state is therefore mandatorily obligated to provide “medically necessary” health care, because the state has removed the opportunity for the individual to do so themselves.

Given the above, the decision of the judge follows in clear black and white logic.

Some of you seem to not give a damn about the US constitution, two hundred years of legal precedents, the advancement of modern medicine, and the formal recognition by the scientific community that being transgender is a medical condition.

Here’s a hint – if GCS is medically optional for this prisoner, it is medically optional for every single one of you too. If it is medically optional for this prisoner, and not covered, then it should legally not be covered for you either.

I don’t care of you like or dislike this human being. I certainly don’t. I think what she did was reprehensible. But you cannot play the selective game with medically necessary treatment without also establishing legal precedent that it is therefore selective for everyone else,  including you.

There is a word for the short-sighted thinking you present and that word is hypocrisy. I would suggest you reconsider the legal and logical ramifications of your short sighted position, but I know better than that. That’s simply impossible for those motivated by such hypocrisy. Your quasi-moral outrage appears to be more important to you than consistency of legal application of the law in light of the AMA’s position on transsexual surgical health care. Your faux moral outrage defies facts and logic before the law but you’d rather “feel good” about your faux moral outrage than have consistent and fair legal precedents.

And yet some of you wonder why we have so much trouble getting insurance coverage for GCS for the rest of us? Go look in the mirror. You are why so many of us have such trouble. YOU  are the problem! You! Because as soon as you argue that this procedure is not medically necessary for Michelle Kosilek, you have argued that it is not medically necessary for you either. If you, as a layman, call into question the diagnosis of medical professionals in one case, you have created the legal basis for a layman to question that diagnosis in every other case.

So the next time a trans brother or sister wonders aloud why getting coverage for GCS is such a legal mess, please have the courage to stand up and say, “Me! Me! I’m the one who screwed you over, for my faux moral outrage! You’re welcome!” But I’ll bet not one of you has the guts to stand up and take responsibility for what you represent. Not one.