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[–]ID10T 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (12 children)

Should a child who has severe body integrity dysphoria be allowed to have their limbs amputated u/hematomato ? What if they say they will kill themselves unless they have their legs cut off? Having laws against children having their limbs chopped off is certainly government overreach! 😂

[–]Hematomato 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (11 children)

Should a child who has severe body integrity dysphoria be allowed to have their limbs amputated u/hematomato ? What if they say they will kill themselves unless they have their legs cut off?

That's a very good question. You apparently think the answer is obvious. I don't.

A doctor's job is to increase the quality of life of their patient. If every day is a living Hell for the patient because they feel like their left arm is this grotesque growth that doesn't belong, and no other treatment is effective, and they don't even want to live with that fucking thing attached to them, well, surgery might be the most reasonable option.

And I just don't think 18 is a magical number. "Oh, you're 16, so you have to have that growth making you crazy and despondent and suicidal for two more years, but after that we're good to go." Why? Because our society decided that 18 is magical? Anyone who's met 18 year olds know that as a group they're not particularly smarter or wiser than 16 year olds.

[–]package 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (10 children)

Chopping off perfectly functional organs is not ever going to improve someone's quality of life.

[–]Hematomato 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (9 children)

Except that we know that isn't true. There are people out there whose quality of life is so low due to dysmorphia that they don't want to live. Which is the absolute rock-bottom quality of life.

If you take someone from "I don't want to live" to "now I want to live," that is an improvement.

[–]jet199[S] 3 insightful - 2 fun3 insightful - 1 fun4 insightful - 2 fun -  (4 children)

Nice try but suicide rates go up after transition, not down

[–]Hematomato 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (3 children)

I checked on this claim. There have been 23 studies about whether suicide rates go up or down. The majority say down; a minority say up; and every single one of them suffers from methodological flaws.

It's a very hard study to do, because people who seek surgical remedies are already suffering from the most suicidiality - so what two groups are you comparing? People desperate for surgery who get it, against people desperate for surgery who are withheld it? And in that case, how and why is it being withheld?

[–]jet199[S] 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (2 children)

[–]Hematomato 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (1 child)

And here's a meta-analysis, which is more useful:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027312/

[–]jet199[S] 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (0 children)

Not if most of the studies have junk data, as you said, better to look at the most rigorous only.

[–]package 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (1 child)

Before chopping off an organ the possibility exists that a patient may come to accept the body they were born with and go on to live a normal life. Even if they don't, the blame for their unhappiness lies squarely on forces outside of their control. No harm has been done.

After chopping off an organ, however, a patient is now locked out of the possibility of accepting how they were born. They now must come to terms with the fact that they have done irreversible damage to themselves and that they themselves are to blame for their unhappiness.

I'm no psycologist but the latter outcome sounds far more unhealthy IMO, and that's not even considering the serious lifelong health implications of these sorts of surgeries.

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

I think it's strictly case-by-case. Of course the ideal outcome is that a patient gets over their dysmorphia and accepts their body.

And sometimes that can happen. Sometimes therapy can help it happen. But sometimes the ideal is just off the table. Sometimes we simply don't have any method or any tech that will make it happen.

And it's a doctor's job to know the difference. Not a politician's, not an Internet armchair philosopher's, a doctor's.

[–]TemporarilyDeceased 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (1 child)

This reminds me a lot of people who are miserable in their current life. They hate their job, their town, their friends, the weather. Everything is bad. But everything in, e.g. LA looks great: fantastic weather, beautiful people, lots of things going on... so they move. And things are great for a couple of years. Then they find themselves back in the same funk as they were before they moved because they never addressed the real problem.

Sometimes we need to treat the symptoms because the patient won't live long enough to treat the problem. This doesn't change the fact that they have a problem which too often is forgotten.

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

And sometimes we have no idea how to fix the underlying problem.

Sometimes it's like saying "Dude, you can build all the access ramps in the world, you're still fucking paralyzed." Sure, it would be better to repair their spinal column, except for the annoying detail that we don't know how.