Moving Beyond Psychiatric Gatekeeping for Gender-Affirming Surgery

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    • #135003
      DeeAnn Hopings

      For 2 reasons, I believe this approach has some flaws.


      From the Fenway Health link:

      “If there is concern that uncontrolled mental health problems in patients may interfere with a patient’s capacity to consent to surgery, the surgeon should require evaluation by a mental health provider prior to surgery.”

      Doctors enter the field of surgery in order to become surgeons. Developing some useful degree of mental health expertise is not what they signed up for.

      I agree that statistically the number of people who regret transitioning is low. There are some anti-trans activists who would like you to believe that it is much higher than what it is, but it simply isn’t true. However, without some degree of gate-keeping, I suspect the numbers will rise. The downside to that it that is give anti-trans activists more ammunition.

      It used to be that some places required that a person live as their target gender for a year. Exclusive of any therapy, if you were not reasonably successful during that year, you probably shouldn’t go any further. In effect, it’s similar to doing an internship. If therapists can be fooled in there evaluations of trans people (Walt Heyer, for example), I would think that anyone else would be less effective.

      1 user thanked author for this post.
      • #135004
        Michelle Lawson

        DeeAnn, I do agree with you on the vast number of people/patients. In my case, the therapy was merely a formality as I had already done my due diligence in learning about the who, what, where, & how of why I felt the way I did, and what needed to be done to get things on the right track. And I’m certainly not some remarkable person, but I do think there is a segment of the transgender community that could be in similar shoes as me. But for the vast majority of people/patients, there probably does need to be the therapeutic path as a first start. Maybe a joint therapist/surgeon process. I guess only time will tell. Michelle

    • #135270

      Oh, not at all, Rikki!! Please speak your mind with aplomb and zest! 🙂

      Ah, yes… what about the kids…? Another “the other side” tactic to demonize the trans community. This is why the immensely popular Drag Queen Story Time in public libraries is attacked by “those guys”. They fear the normality of alternative lifestyles that will one day become the norm.

      Is anyone here on TGH a demon?

      In my world, I’ve never seen an example of someone from the LGBTQ+ community denying anyone the right to self-express or identify, not that I’m saying it doesn’t happen, it’s just never been a point of conversation here at home. Perhaps another myth? In fact, self-expression is encouraged in my community!

      Education is the key to acceptance and love, and that’s why some jurisdictions are vehemently and wrongly cutting LGBTQ+ programming in their schools. Pity…


    • #135265

      Ooooo!! An excellent repartee!

      However, even if someone has a mental disorder, that doesn’t make their need to transition any less valid. A clinical narcissist may have a few screws loose, but they may still have a legitimate need to transition.

      Moreover, the notion that anyone would alter their bodies for illicit access to services (like women’s prisons and bathrooms) is a scare mongering tactic by “the other side” to suppress trans rights and vilify the community.

      The BIG question for Canadians is “who pays for it?”. Since we have a universal healthcare system that is supposed to ONLY pay for life-saving procedures, it has morphed into much, much more, like adding mental healthcare to the mix. Many Canadians, however, don’t like to publicly pay for things like breast augmentation, tummy tucks, electrolysis, and things like that that impact the trans community. So, trans folx here need to oftentimes push their medical practitioners to sigh off on their surgical procedures since the public-purse is currently stressed.

      :B đź’—

    • #135236

      “…there are plenty of dumb people out there.”

      True that! LOL!!

      I think gender-identity and self-identification are human rights. The only ones to presume otherwise would be your medical practitioner without any political restrictions. That’s how it is in my world up here in Canada.

      When you include “safeguards”, you’re presuming that trans people are inherently inferior in some way. They are not. We are beautiful!!

      We ain’t perfect, but we’re getting there…


    • #135207
      Michelle Lawson

      Rachel, you have helped answer that question. The answer is discussion and education through our personal perspectives. And I thank you for that. My wish is that all of the controversial issues could be dealt with in a similar manner, then they wouldn’t be so controversial. Hugs, Michelle

      1 user thanked author for this post.
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