I just wanted to post a brief article about something that just showed up on Women Born Transsexual. Suzan Cooke seems confused that Drew Cordes has a problem with gendered pronouns. The answer is simple. If Cooke just bothered with a bit of research, she would find out that Cordes, who had SRS relatively recently, almost immediately realized that he was not really a woman, and is now, as is sometimes sadly the case, yet another who has gone off the deep end for just that reason. I had doubts about Cordes, and was more than a bit surprised when he announced he had surgery. I was not surprised, shortly afterwards, when he started expressing regrets.
Of course, this sort of thing can be expected as, more and more transgender kooks push for surgery on demand. Like Cooke did not too long ago when she was telling people to "cowgirl/cowboy up" if they make a mistake.
Oh well....
Showing posts with label Standards of Care. Show all posts
Showing posts with label Standards of Care. Show all posts
Wednesday, February 13, 2013
Monday, January 7, 2013
A Truly Moronic Suggestion!
It is one of those truly stupid ideas that simply will not die. Far too often, usually after a news story about how someone has major regrets about having undergone sex reassignment surgery, or in the most recent case, an woman who now regrets having taken male hormones, some fool will pop up and say "If you make a mistake, then live with it!" At times, this is part of a larger demand for "surgery on demand." That is, the idea that the Standards of Care should be abandoned, and people should be allowed to have SRS on a whim. Sadly, there are some unscrupulous surgeons who come close to that already.
The latest incarnation of this idiocy, comes, as it always does, from someone known for taking extremist positions. In this case, not surprisingly, and not for the first time, the source is Suzan Cooke. In a couple of articles, here, and here, Cooke has a hissy fit over the idea that doctors should actually have to be responsible for doing their jobs.
For MTF transsexuals, hormones are a major diagnostic aid. If a man mistaken thinks he should transition it is usually sexually motivated. A few months to a year on a proper dose of estrogen, and his sex drive is reduced, and voila, he begins to lose interest in transition...unless, of course, he is an aging transvestite, where a lowered libido is often the trigger for the sudden desire to become a woman. In the case of an FTM, sexual issues are rarely the cause of a desire to transition, but there is also the issue of the difficultly of reversing the effects of testosterone. For a woman, taking hormones by mistake are far worse than they are for a man. For a man, about the worst possible outcome is permanent sterility (relatively rare, since they probably won't be on them long enough) and possibly the neat to have his breasts surgically dealt with (again, relatively rare).
In the case in England that triggered Cooke's most recent rant, it was a woman who not only underwent testosterone treatment, but who also had a double mastectomy. Interestingly enough, the doctor in this case is the one who replaced Dr. Russell Reid who became mired in controversy when a patient, who had clearly lied and who had suffered from some seriously delusional ideas about how life would be as a woman, had regrets after undergoing SRS.
Now, Cooke's suggestion might seem, at face value, to be reasonable. But, in truth, it is simply wrong. First off, doctors have a responsibility to, as the pledge in the Hippocratic Oath, to "first, do no harm." A surgeon should require that anyone seeking SRS provide verifiable documentation from a competent therapist, as well as a second recommendation from another therapist. The second letter is necessary because, quite frankly, there are some therapists who simply should not be allowed to practice. I know, I saw one early in my transition, and that person contributed greatly to my transition being delayed.
I was dealing with several issues, including coming to grips with my true sexual orientation. Instead of working with me on these issues, the therapist I was seeing simply glossed over them, and pushed me to proceed. I clearly needed time, and she wanted me to move ahead. This led, among other things, to a serious breakdown, and I detransitioned for seven years. In retrospect, I wonder what might have happened if I had allowed her to pressure me into proceeding before I was ready.
I also know of a case involving a middle-aged woman who, more out of loneliness than any gender issues, started claiming to be an "FTM" so should could hang out a research study targeting "transgender" people. She actually seemed to relate more to the MTF staff, but she was being pressured by one of the FTM staff members to "get off the fence" and start hormone therapy. It was obvious that this was not a good idea, but he would not listen to reason. Fortunately, she relocated to Alaska, and escaped from his efforts to get her to do something that would have caused serious problems.
Transition, hormones, and surgery are not to be taken lightly. To suggest that someone "just live with it" is an incredibly callous view, especially coming from someone who felt the need to transition. If you are a transsexual, imagine being told that. Actually, you probably don't have to imagine. I know I was, more than once. It is not good advice. Now, imagine having undergone surgery by mistake, and actually losing the option of dealing with one's situation. SRS is, especially for a MTF patient, irreversible. There is no real possibility of becoming a full male again.
Mistakes happen. I can think of two well-known cases where the person involved has almost certainly made a mistake, but has refused to acknowledge it. And I know of several causes where the person has made the fact that they made a mistake very well known. In all of these cases, a competent therapist could, and should, have prevented the person from making the mistake. Yes, the person involved lied, and for that reason, they share some of the responsibility. But a competent therapist will do more than simply take a person's statements at face value.
If anything, the Standards of Care need to be tightened. People who really need SRS might be a bit inconvenienced, but they will make it through the process. Those who should not have surgery should be screened out, before a mistake is made.
The latest incarnation of this idiocy, comes, as it always does, from someone known for taking extremist positions. In this case, not surprisingly, and not for the first time, the source is Suzan Cooke. In a couple of articles, here, and here, Cooke has a hissy fit over the idea that doctors should actually have to be responsible for doing their jobs.
For MTF transsexuals, hormones are a major diagnostic aid. If a man mistaken thinks he should transition it is usually sexually motivated. A few months to a year on a proper dose of estrogen, and his sex drive is reduced, and voila, he begins to lose interest in transition...unless, of course, he is an aging transvestite, where a lowered libido is often the trigger for the sudden desire to become a woman. In the case of an FTM, sexual issues are rarely the cause of a desire to transition, but there is also the issue of the difficultly of reversing the effects of testosterone. For a woman, taking hormones by mistake are far worse than they are for a man. For a man, about the worst possible outcome is permanent sterility (relatively rare, since they probably won't be on them long enough) and possibly the neat to have his breasts surgically dealt with (again, relatively rare).
In the case in England that triggered Cooke's most recent rant, it was a woman who not only underwent testosterone treatment, but who also had a double mastectomy. Interestingly enough, the doctor in this case is the one who replaced Dr. Russell Reid who became mired in controversy when a patient, who had clearly lied and who had suffered from some seriously delusional ideas about how life would be as a woman, had regrets after undergoing SRS.
Now, Cooke's suggestion might seem, at face value, to be reasonable. But, in truth, it is simply wrong. First off, doctors have a responsibility to, as the pledge in the Hippocratic Oath, to "first, do no harm." A surgeon should require that anyone seeking SRS provide verifiable documentation from a competent therapist, as well as a second recommendation from another therapist. The second letter is necessary because, quite frankly, there are some therapists who simply should not be allowed to practice. I know, I saw one early in my transition, and that person contributed greatly to my transition being delayed.
I was dealing with several issues, including coming to grips with my true sexual orientation. Instead of working with me on these issues, the therapist I was seeing simply glossed over them, and pushed me to proceed. I clearly needed time, and she wanted me to move ahead. This led, among other things, to a serious breakdown, and I detransitioned for seven years. In retrospect, I wonder what might have happened if I had allowed her to pressure me into proceeding before I was ready.
I also know of a case involving a middle-aged woman who, more out of loneliness than any gender issues, started claiming to be an "FTM" so should could hang out a research study targeting "transgender" people. She actually seemed to relate more to the MTF staff, but she was being pressured by one of the FTM staff members to "get off the fence" and start hormone therapy. It was obvious that this was not a good idea, but he would not listen to reason. Fortunately, she relocated to Alaska, and escaped from his efforts to get her to do something that would have caused serious problems.
Transition, hormones, and surgery are not to be taken lightly. To suggest that someone "just live with it" is an incredibly callous view, especially coming from someone who felt the need to transition. If you are a transsexual, imagine being told that. Actually, you probably don't have to imagine. I know I was, more than once. It is not good advice. Now, imagine having undergone surgery by mistake, and actually losing the option of dealing with one's situation. SRS is, especially for a MTF patient, irreversible. There is no real possibility of becoming a full male again.
Mistakes happen. I can think of two well-known cases where the person involved has almost certainly made a mistake, but has refused to acknowledge it. And I know of several causes where the person has made the fact that they made a mistake very well known. In all of these cases, a competent therapist could, and should, have prevented the person from making the mistake. Yes, the person involved lied, and for that reason, they share some of the responsibility. But a competent therapist will do more than simply take a person's statements at face value.
If anything, the Standards of Care need to be tightened. People who really need SRS might be a bit inconvenienced, but they will make it through the process. Those who should not have surgery should be screened out, before a mistake is made.
Wednesday, July 15, 2009
Things that make a gender fascist go hmm....
While checking out the latest silliness from Mr. Sandeen over at Pam's House Blend I found a post about the Endocrine Society releasing guidelines for treatment of transsexuals. These guidelines include recommendations for hormone therapy, surgery and long-term care for all ages.:
Now, this is all very significant. I have downloaded a copy of the 72 page article, and plan to read it in depth as soon as I have time. So, what was Sandeen's response to all of this?
New guidelines from the Endocrine Society call for close and continued collaboration between endocrinologists and mental health professionals for the treatment of transsexual people.
The twentieth century marked the beginning of a social awakening for men and women whose bodies imprisoned them in the wrong gender," a task force of Endocrine Society-appointed experts wrote.
The guidelines include recommendations for safe and effective hormone regiments, genital sex reassignment surgery and long-term care for adolescents to adults.
The evidence-based guidelines were developed using the Grading of recommendations, Assessment, Development and Evaluation (GRADE). The quality of evidence was generally low or very low.
"Prior to 1975, few peer reviewed articles were publishing concerning endocrine treatment of transsexual persons. Since that time, more than 800 articles about various
aspects of transsexual care have appeared," the task force wrote...
Now, this is all very significant. I have downloaded a copy of the 72 page article, and plan to read it in depth as soon as I have time. So, what was Sandeen's response to all of this?
Hmm. Just hmm.I guess he was upset that, like most medical articles dealing with transition, makes reference to "transsexuals," not "transgender people." Sadly, such distinctions are lost on gender fascists like Sandeen who insist that everyone has to accept the label of "transgender" whether they identify that way, or not.
Monday, March 9, 2009
A Cautionary Tale...
A few weeks ago, there was another story about another man who had a "sex change" and who now regrets it. This story, like some previously, came out of Australia. This is not the first such story to make the headlines, and it probably won't be the last. But this one should serve as a warning sign for both therapists, and those who might be considering such surgery.
Given the details of the story, it is not that surprising that the man has regrets. Of course, a lot of transgender activists are scrambling to try to control the damage. The idea that someone might actually make a mistake is one of the biggest secrets of the "transgender community." But this is exactly the sort of thing that happens when "transgender people" get carried away and proceed with surgery.
First off, the man, now 66, came to regret the surgery five years after having it. Now, that would seem to indicate that he was 61 when he had the surgery. Now, age alone is not an indicator of surgical outcome, but it should be considered. I mean, why did he wait so long? What was his life like before he transitioned?
One of the statements made by him seems to indicate that he did not have a childhood history of issues with his sex being contrary to his gender. That alone is the single major red flag in a case like this. It is entirely possible for someone to encounter delays before actually achieving surgery, so a person might, in rare cases actually have HBS but be relatively old at the time they finally have their body corrected. But if there was no history from childhood, then surgery is almost certainly not advisable.
Perhaps the biggest warning flag was the fact that this man did not find his genitals abhorrent. In a person with HBS that is a major symptom. Of course, this is a common refrain among transgender people, who will often say, "I don't my penis. I would not be terribly concerned if it were to suddenly disappear, but I don't hate it." That sort of statement should raise concerns for a therapist. Once it is gone, it is gone for good. After surgery is not the time to suddenly realize that you miss it.
It is also interesting that this person claims that a previous therapist advised against surgery. In a sense, it seems to come down to a question of who was the most at fault? The doctors who clearly failed to adequately evaluated this patient? Or the patient himself, who clearly failed to make these things known to his therapist.
I know, early on in my transition, I saw one therapist who seemed more interested in chalking up another patient referred for surgery than in actually helping me deal with issues I was struggling with. If I had been a bad candidate for surgery, I don't know that she would have caught it.
Another case that sent the TG activists into a tizzy became known in October of last year. Mike Penner, a sportswriter for the Los Angeles Times announced in April, 2007 that he was going to begin transition and would now be known as Christine Daniels. He began writing a column featured on that paper's web site about his experiences. Then, in October, with little fanfare, Christine disappeared, and Mike returned to the sports pages.
The transgender world was shocked. They rushed to make excuses for why someone might decide to not go forward with transition. And the one reason they wanted to downplay the most was that it might ust have been the right thing. They seemed to want to avoid admitting that not everyone who thinks that transition is the right path is going to succeed. That is why the Standards of Care requires a Real Life Test that lasts a minimum of one year. In many cases, one year is probably not enough. There are two many examples of people who rushed through without considering if they were doing the right thing, and who wind up with the rest of their life to regret it. I know of two for whom this is clearly the case, though neither would be likely to publically admit it. Still, it is clear that their transition has been less than successful.
It is possible that Mike Penner will go on to transition. Many people, myself included, have backed off from transition and returned later. This can be caused by a number of factors such as pressure from family, lack of proper preparation, and even a bad therapist. All three of those played a role in my case. But it can just as easily be that the person realizes that their gender really does match their body.
The bottom line is, this is not a game. A mistake can be tragic. There is no going back...which is a source of joy for those with HBS, but a nightmare for someone who is not. One's transition should not be delayed any longer than necessary, but it should also not be rushed. Therapists need to make sure that the person is not making a mistake.
Given the details of the story, it is not that surprising that the man has regrets. Of course, a lot of transgender activists are scrambling to try to control the damage. The idea that someone might actually make a mistake is one of the biggest secrets of the "transgender community." But this is exactly the sort of thing that happens when "transgender people" get carried away and proceed with surgery.
First off, the man, now 66, came to regret the surgery five years after having it. Now, that would seem to indicate that he was 61 when he had the surgery. Now, age alone is not an indicator of surgical outcome, but it should be considered. I mean, why did he wait so long? What was his life like before he transitioned?
One of the statements made by him seems to indicate that he did not have a childhood history of issues with his sex being contrary to his gender. That alone is the single major red flag in a case like this. It is entirely possible for someone to encounter delays before actually achieving surgery, so a person might, in rare cases actually have HBS but be relatively old at the time they finally have their body corrected. But if there was no history from childhood, then surgery is almost certainly not advisable.
Perhaps the biggest warning flag was the fact that this man did not find his genitals abhorrent. In a person with HBS that is a major symptom. Of course, this is a common refrain among transgender people, who will often say, "I don't my penis. I would not be terribly concerned if it were to suddenly disappear, but I don't hate it." That sort of statement should raise concerns for a therapist. Once it is gone, it is gone for good. After surgery is not the time to suddenly realize that you miss it.
It is also interesting that this person claims that a previous therapist advised against surgery. In a sense, it seems to come down to a question of who was the most at fault? The doctors who clearly failed to adequately evaluated this patient? Or the patient himself, who clearly failed to make these things known to his therapist.
I know, early on in my transition, I saw one therapist who seemed more interested in chalking up another patient referred for surgery than in actually helping me deal with issues I was struggling with. If I had been a bad candidate for surgery, I don't know that she would have caught it.
Another case that sent the TG activists into a tizzy became known in October of last year. Mike Penner, a sportswriter for the Los Angeles Times announced in April, 2007 that he was going to begin transition and would now be known as Christine Daniels. He began writing a column featured on that paper's web site about his experiences. Then, in October, with little fanfare, Christine disappeared, and Mike returned to the sports pages.
The transgender world was shocked. They rushed to make excuses for why someone might decide to not go forward with transition. And the one reason they wanted to downplay the most was that it might ust have been the right thing. They seemed to want to avoid admitting that not everyone who thinks that transition is the right path is going to succeed. That is why the Standards of Care requires a Real Life Test that lasts a minimum of one year. In many cases, one year is probably not enough. There are two many examples of people who rushed through without considering if they were doing the right thing, and who wind up with the rest of their life to regret it. I know of two for whom this is clearly the case, though neither would be likely to publically admit it. Still, it is clear that their transition has been less than successful.
It is possible that Mike Penner will go on to transition. Many people, myself included, have backed off from transition and returned later. This can be caused by a number of factors such as pressure from family, lack of proper preparation, and even a bad therapist. All three of those played a role in my case. But it can just as easily be that the person realizes that their gender really does match their body.
The bottom line is, this is not a game. A mistake can be tragic. There is no going back...which is a source of joy for those with HBS, but a nightmare for someone who is not. One's transition should not be delayed any longer than necessary, but it should also not be rushed. Therapists need to make sure that the person is not making a mistake.
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