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[–][deleted] 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (4 children)

I'm really sorry about your sister <3

And I never said that you don't consider the consequences of having an abortion or don't try to minimize harm. I don't know what it is like to be pregnant yet but I would want the best for my kid and I would obviously try to find providers that aren't going to cause me problems.

But what shouldn't be the case, is gatekeeping your decision behind whether some random person thinks you've done enough thinking about it. It's your body, and while it's definitely a good thing to try and be safe, there shouldn't be anyone forcing you to go about it in a certain way. You're allowed to do as much or as little consideration as you like, it's still your choice to make.

You're casting me as unaware and callous but I don't even need to know how you make your decisions, just support your right to make them. And I do! Like in taking HRT I'm making a decision for my health as well but I weigh the options and any potential issues are worth it, for me personally.

[–]MarkTwainiac 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (3 children)

Thank you for your kind comment. (BTW, can you fill me in on what the less-than symbol plus the numeral 3 is supposed to mean?)

I am not trying to dictate what you or other adults do. I am just taking issue with your repeatedly expressed view a) that you and others like you know best about what should happen to all children with sex and gender distress, all of whom are other people's children; and b) that what would be best for them is to give them medical interventions when they are tweens and young teens that will have serious, lifelong, irreversible effects on their health. You've ping-ponged back and forth between 1) insisting all these effects are harmless; 2) admitting that many of these effects will cause harm and lead to regret, but saying "so what? big deal;" and 3) claiming that whether they are harmful or not doesn't matter because in the name of "trans rights" everyone, even minors, should be able to do whatever the hell they want to their own bodies regardless of the harms they might suffer, because trans people being able to exercise total bodily autonomy is far more important than trans people being able to experience bodily health and enjoy full function of all body parts.

I am also taking issue with the kinds of sweeping statements you've made that reflect what I believe to be inaccurate assumptions how other people make decisions about medical interventions and other matters that can affect health, diminish fertility and narrow people's life options.

what shouldn't be the case, is gatekeeping your decision behind whether some random person thinks you've done enough thinking about it. It's your body, and while it's definitely a good thing to try and be safe, there shouldn't be anyone forcing you to go about it in a certain way. You're allowed to do as much or as little consideration as you like, it's still your choice to make.

When it comes to medical decisions, or decisions that affect or can affect health and wellbeing, you seem to regard all safeguards; all treatment protocols, standards and guidelines; all ethics reviews and panels; all professional discretion exercised by HCPs and HCFs; and all advice from others suggesting caution as overly-interfering and draconian "gatekeeping." I disagree.

You present medical care, surgeries and other procedures as though they only involve one single person: the patient, or the recipient. You make it sound like getting an abortion, having a GnRH implant inserted like was done to Jazz Jennings, getting a "gender affirming" surgery, getting a prescription for a child to be put on cross-sex hormones and hormone suppressant drugs like Spiro etc as sort of like going to an automatic teller machine and getting cash, or using a vending machine: faceless transactions involving no human interaction.

But that's not the case: in medical care and procedures lots of people are involved beyond the patient/recipient. When someone has surgery, there are many others who actually do all the work: the surgeon or surgeons, the office staff who get the insurance clearance, the insurance company, the intake staff at the facility where the surgery takes place, the prep nurses, the OR nurses, the anesthesiologist, the recovery room staff, the discharge nurse... and so on. You seem to think that none of these people should be allowed to have any say in what is done to patients. You seem to think if I want my legs cut off because seeing the way my once gorgeous, shapely and strong gams look now that I am old, wrinkled, flabby and my joints are swollen due to health problems etc causes me "dysphoria" and grief, makes it impossible for me to look in the mirror, makes me not want to go out, and feeds into my depression and anxiety, then I should be able to rock up to a surgery center and get my legs amputated - no questions asked. And you seem to think that if anyone refused or expressed hesitancy, or recommended I get therapy instead, it would be gatekeeping and a violation of my rights.

Because I have the impression that I am A LOT older than you - and I have a complicated medical history due to lots of unusual health problems personally, along with the usual gynecological issues and pregnancies; serious genetic conditions in my family (had two siblings with cystic fibrosis, one who died when we were kids, the other at 24 when I was 32; then sister who died of cancer; mother also died of cancer in her 50s when I was 24, etc) - I think I have more experience with the medical system than you. And more experience with what you call "gatekeeping." Because of my own experiences, the experiences of many friends, and dealing with the medical issues of my children as a parent, as well as helping friends deal with the medical conditions their kids have faced (such as childhood cancers), I see the whole issue of medical "gatekeeping" as far more complex than you do. I see the pros and cons of it - and I see it from various perspectives, not just from the perspective of patients who believe that whatever medical services a person wants should available and provided with no questions asked. I've also served on two civil juries in medical malpractice cases where aggrieved patients complained that doctors didn't do enough and also that doctors did too much, and what they did was wrong - so I can see these issues from a whole bunch of different sides.

I wish you well, and hope you will not come to regret any of the decisions you have made for your own health as an adult. But you and other adults like you are not my concern. My concern is the kids whose health you want to dictate. But please for heaven's sake consider for a moment that maybe you and other persons like you aren't best placed to be deciding and dictating what everyone else with sex and gender distress should do, particularly those who are children.

[–][deleted] 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (2 children)

Oh, it was supposed to be a heart emoji!

because trans people being able to exercise total bodily autonomy is far more important than trans people being able to experience bodily health and enjoy full function of all body parts.

Honestly? Yes, this is basically where I'm at. I hate my body and living in it and I have for a long time, I don't get any enjoyment out of being physically functional because I don't want to be a physically functional male. I'm not the only person who thinks this way, it's not very enthusing to be told "oh but don't worry! You'll live longer and your genitalia will be functional!". I'd rather take the health risks and infertility. Exercising that autonomy is how I keep my mental and emotional health kinda stable, and I accept the risk. Really the only scary moment I've had with my health was when I thought I had a breast cyst. Thankfully my doctor was helpful and told me it was just normal lobular growth, but I hadn't really known about that before because trans healthcare is only really standardized in terms of doses and my doctor isn't the most knowledgeable..

make it sound like getting an abortion, having a GnRH implant inserted like was done to Jazz Jennings, getting a "gender affirming" surgery, getting a prescription for a child to be put on cross-sex hormones and hormone suppressant drugs like Spiro etc as sort of like going to an automatic teller machine and getting cash, or using a vending machine: faceless transactions involving no human interaction.

Honestly it really should be...I mean would you rather be frustrated when you need a procedure done but the doctor won't do it? I have a friend who has been trying to get tubal ligation but no doctor will do it for her because she's young and unmarried. I just think that gatekeeping should be minimal and surgery should be more of a service.

You seem to think if I want my legs cut off because seeing the way my once gorgeous, shapely and strong gams look now that I am old, wrinkled, flabby and my joints are swollen due to health problems etc causes me "dysphoria" and grief, makes it impossible for me to look in the mirror, makes me not want to go out, and feeds into my depression and anxiety,

I really empathize with that because I hate how I look in the mirror. I'd support you in getting robot legs or whatever, or if you felt that removing them would genuinely help you feel better. Sometimes patients really do just know what they need.

I'm not close with my family anymore because of past abuse and transphobia etc so yeah I don't have the same experience with loss, grief and the medical system. I'm sorry about that. My experience with trans healthcare has been kind of meh, it's frustrating to have to do a lot of it myself.

In general though...I don't see how more gatekeeping for trans people will really help more people. Yes it would create fewer detransitioners because fewer people would be transitioning, but my concern is primarily for kids who were like me, I don't want anyone to have to go through what I did and wait that long. And it's very hard to believe that this wouldn't affect adults. I've seen GCs who want to raise the age to 25--I'm not even 25 so the thought of that is terrifying. I know no matter what I can just DIY and stay on hormones, but I'm not a surgeon I can't safely do surgery on myself unfortunately.

I want to avoid situations where kids with sex and gender distress want to transition but are held back from doing so by religious families or gatekeeping doctors. That's what breaks families and creates bitterness.

I'm not the best person to decide but even you with your years of experience, you're not trans (sorry if I'm mistaken), we have very different perspectives.

Until we can swap out organs like bracelets so that people can undo any mistakes, there's always going to be a group of unhappy dysphoric people. I guess I'm sticking with the group that I've been in and trust. Oh and I wish you well also <3

[–]MarkTwainiac 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (1 child)

I'm not the best person to decide but even you with your years of experience, you're not trans (sorry if I'm mistaken), we have very different perspectives.

But I never said I was the best person to decide, either.

BTW, many of the doctors and psychiatrists who are best at treating a particular condition do not have that condition themselves. In fact, I'd say this is the case for most. For example, David Redwine MD is an ob-gyn who is incredibly compassionate towards women with chronic pelvic pain, and since the 1980s he's been a world leader in trying to come up with more effective treatments for endometriosis and other forms of female pelvic pain. But as a man, Redwine does not and cannot suffer from the conditions he treats, and he cares so deeply about.

IMCO, it's a fallacy, and a grave mistake, to think that the only people who possibly can have understanding, compassion, intelligence, insight, wisdom about a particular medical or psychiatric issue, social problem, life difficulty or set of life difficulties are those who have firsthand experience with it. Just because someone isn't trans doesn't necessarily mean s/he knows nothing about it and has nothing of value to contribute. Conversely, just because a person is trans doesn't automatically mean they know everything about everyone who suffers from sex and gender distress and should be taken as the ultimate authority "all things trans," including the best way to help children and tweens struggling with sex and gender distress - particularly those of the opposite sex.

I don't think humans will ever reach a stage when we "can swap out organs like bracelets." Having been around a lot of people with major, life-limiting illness and disabilities all my life, I am concerned about how casual so many young people today are about getting medical interventions that can impair health, diminish or destroy function, and shorten lifespans.

But my concern doesn't mean I want to control what you do with your own body. All I am asking for is that you consider for a moment the possibility that maybe you personally don't know what's best for all the kids in the world with sex and gender distress. I hope you will take some time to see that maybe, just maybe your personal experience as an "AMAB" adult transitioner does not automatically make you best placed to decide and dictate what "should" happen to tween and teen girls and young women who have developed sex and gender distress for reasons very different to you - and whose developing female bodies will be much more negatively impacted by taking exogenous testosterone than your body has been by taking exogenous estrogen.

[–][deleted] 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (0 children)

I don't think humans will ever reach a stage when we "can swap out organs like bracelets."

I do! Medical technology is incredible and always improving.

But my concern doesn't mean I want to control what you do with your own body

Neither should it mean you control other people's bodies either. That's what I've been saying all along, that people with gender dysphoria should make our own decisions regarding what to do about it.

Also I actually have a lot of ftm friends and part of why we get along so well is because we can really relate to each other due to transness. We stick together because the vast majority of cis people do not understand.

And with some GCs openly calling now to "reduce the number of trans people", all I ask is that you consider why those people you seem so concerned about taking T should not just be able to make their own decisions.