Let people understand something about trans people

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I did, but I'm not sure what point you're making relative to my post. Could you be a touch more explicit?

Actually, now that I read yours again, I wonder if you could clarify yours.

Perhaps the difficulty lies in the fact I'm not invested in either extreme of the debate.

I think visagrunt touched on the core of it with:



The main concern, in my mind, is whether or not the patient benefits from the treatment given or whether a procedure is physically or psychological harmful. This is, after all, at the core of medicine.

I actually disagree with visagrunt to an extent. Whether you agree with it in principle or not, access to funding for treatment can and will be affected by whether or not treatment is deemed 'medically necessary', with the goalposts moving depending on where you live. Any treatment which is linked to a potential increase in self-harm or suicidal behaviour is something which warrants study. This is why it is important to understand why, for example, gender reassignment patients have a significantly higher likelihood of taking their own lives when compared to the general population. There are so many factors in play that we have insufficient data for, and further study is clearly needed.

The fact that many people with gender dysphoria choose not to pursue surgery suggests to me that they may have received a better quality of treatment than some of those who insist on it. Again, this is something that requires a great deal of study to distinguish causality from coincidence, fact from speculation.

People have been studying the issue for 70 years. Look up Dr. Magnus Hirschfeld.

I genuinely do not understand what the motivation is behind your post. Would you care to elaborate?

Are you saying that further study is unnecessary, that we know all we can possibly learn? Is Hirschfeld the definitive resource on the subject? Is all subsequent study meaningless by comparison?

We've been studying evolution for more than 200 years. Is further study unnecessary in that field too?

I actually think that the current opposition to coverage of sex reassignment surgery (SRS) in the US could blow up in the face of the opponents just as the opposition to gay marriage did.

Congress prohibited federal gay marriage recognition in 1992 with DOMA, which led to legal challenges and DOMA's defeat in The Supreme Court (SCOTUS) in (United States v. Windsor). Because of this opinion, gay couples now have a right to have their marriage recognized by the federal government - a right that did not exist before DOMA. It is also quite likely that they will acquire this right at the State level as well in subsequent legal challenges after the fall of Proposition 8.

Now we have various US policies at the federal level (Veterans, Medicare/Medicaid) and and state level prohibiting the delivery and/or funding of sex reassignment surgery.

The way I see it, sooner or later someone will take this one to the courts on a 5th amendment challenge...

The Denee Mallon case, now supported by the ACLU, looks like a potential candidate:
https://www.aclu.org/lgbt-rights/lgbt-g ... ientswhich

If the Federal government does not budge, this could go all the way to SCOTUS.

Here the scientific establishment will likely (just as it did in United States v. Windsor regarding children of gay couples) file authoritative amicus briefs dispelling all those ridiculous shenanigans that the anti-transsexual crowd are constantly pushing. The Court will then likely (just as they did in United States v. Windsor) side with the scientific establishment and rule the federal ban on SRS coverage unconstitutional under the 5th amendment.

The Hatin' On Gay & Lesbian ended in disaster. I'm guessing that the Hatin' On Transgender will too.

This wouldn't directly affect those hoping to get private insurance coverage for SRS (as the OP is), but it would cut through all the anti-scientific crap being posted about gender dysphoria and SRS. That alone would be a major, though not decisive, victory for LGBT rights.

In that case, you will find the APA report I linked to back on the 3rd page quite relevant.



Again, the APA report: Read it! As for the bolded, you act as though I don't know it, as though it doesn't grate on me every single day.



Or it might just be individual variation. Nah, it can't be that. [/sarc]

Last edited by beneficii on 30 Oct 2013, 12:08 pm, edited 1 time in total.

Yes. Let's just hold off on all funding coverage until we reach some poorly defined point in study (a goalpost that will keep shifting), and just let those damn trannies suffer. [/sarc]

Ja. When authorities or insurance companies have tried to call SRS cosmetic, courts have often ruled against them, saying it's not. That's why insurance companies today have a separate clause in their plans that expressly excludes transition services. Just as late as last year, with a plan that lacked such a clause, a trans woman was able to get a settlement with her insurance company to cover SRS.

Check this out from Aetna, a major insurance company:



followed immediately by:



http://www.aetna.com/cpb/medical/data/600_699/0615.html

Insurance companies know it's a medically necessary procedure: They just won't cover it anyway in most of their plans.

The US is as far from a welfare state as an industrialized nation can get. Paying for SRS while not paying for far more important medical procedures is crazy. There's a huge difference between transphobia and NOT wanting a state that's acts as if it's your mommy (or daddy, which is the case with the Tea Party).

The Fifth Amendment goes as follows:

"No person shall be held to answer for a capital, or otherwise infamous crime, unless on a presentment or indictment of a grand jury, except in cases arising in the land or naval forces, or in the militia, when in actual service in time of war or public danger; nor shall any person be subject for the same offense to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation."

Nothing in this amendment says that tax payers are required to pay for gender reassignment surgery. It's relevant in terms of gay marriage because it's specifically about deprivation of liberty rights (a government that pays for everything you want is not a given right). Please read the American constitution before you're refering to anything in it. If you're thinking of the Eighth Amendment (like Chelsea Manning does), that's the one who disallows cruel and unusual punishment.

Gay couples pay the same price for adopting a child as straight couples do. A more fitting analogy to government funded SRS, would be if the government paid for the wedding and the honeymoon of the gay couple, but not the straight couple.

Read U.S. v. Windsor. The 5th amendment requires that the federal government provide for equal protection under the law, under the Due Process Clause. The law prohibiting the federal government from recognizing gay marriages singled out gays and lesbians as a group; such singling out violated the Due Process Clause.

In the case of transsexual surgery, it is medically necessary and part of the accepted standards of care. By arbitrarily refusing coverage for a medically necessary procedure needed by many transsexual people while providing coverage for other necessary procedures, the federal government would be singling out transsexual people as a group. Just like the singling out above, the singling out here would also violate the Due Process Clause.

Does that clarify things for you?

It doesn't matter if it's a part of the treatment. It's still a privilege and not a right--and thus, the government should not pay for it.



No. As long as the US government does not pay for cancer treatment or AIDS medicines, it extremely unfair to pay for SRS, which is still a cosmetic procedure--regardless of how much it improves someone's self-esteem. If the government were to pay for SRS, it might as well fund surgery that changes race, given that many members of ethnic minorities suffer from internalized racism.

Yes. No one has a right to health care in the USA except prisoners. You are correct about that.

However, if the government does decide to provide health care to citizens, it cannot do so in an arbitrary fashion that goes against equal protection. By providing Medicare, the goverment is creating a program to provide health care to a group of its citizens. It cannot arbitarily deny certain procedures in a way that would discriminate against a group.



I think you are being a bit deceptive here. We were talking about Medicare specifically, which does cover cancer treatment and AIDS medicines. Now, you went and expanded the topic to include everyone, and then use that as an argument not to provide SRS under Medicare. I think that you are not really being very serious anymore in this conversation.

In addition, you are subscribing to the philosophy of, One ill turn deserves another. Even if it were true that Medicare did not cover cancer treatment and AIDS medicines, that doesn't mean the fight for coverage of sex reassignment surgery isn't right. It doesn't mean it should be diminished. You are basically saying, Don't solve any other problems until you've solved this one. In reality, however, it means you don't want the problem in question to be solved. You diminish the problem.

And yes, for the umpteenth time, sex reassignment surgery is medically necessary and should be covered. It doesn't matter what kind of surgery it is, for if it is medically necessary, it should be covered. You have failed to do anything to address this and the evidence shown on this forum. Until you do that, then it's clear you are not a serious contender in this conversation.

How nice of you to demonstrate that you have not read (or understood) United States v. Windsor.

First of all, the 5th Amendment doesn't mention marriage either. In fact, the word is nowhere to be found in the US constitution. Yet, here we are, with a constitutional right to have the federal government recognize gay marriage.


I am not thinking of the 8th Amendment. I am thinking of the 5th Amendment. Now, here is a quick lesson in US case law. Class is in.

United States v. Windsor ruled a ban on gay marriage unconstitutional on *this* basis (and I quote the official opinion by Anthony Kennedy):

"The power the Constitution grants it also restrains. And though Congress has great authority to design laws to fit its own conception of sound national policy, it cannot deny the liberty protected by the Due Process Clause of the Fifth Amendment.

What has been explained to this point should more than suffice to establish that the principal purpose and the necessary effect of this law are to demean those personswho are in a lawful same-sex marriage. This requires the Court to hold, as it now does, that DOMA is unconstitutional as a deprivation of the liberty of the person protected by the Fifth Amendment of the Constitution.

The liberty protected by the Fifth Amendment’s Due Process Clause contains within it the prohibition against denying to any person the equal protection of the laws. See Bolling, 347 U. S., at 499–500; Adarand Constructors, Inc. v. Peña, 515 U. S. 200, 217–218 (1995). While the Fifth Amendment itself withdraws from Government the power to degrade or demean in the way this law does, the equal protection guarantee of the Fourteenth Amendment makes that Fifth Amendment right all the more specific and all the better understood and preserved."

Source (page 25):
http://www.law.cornell.edu/supct/pdf/12-307.pdf

So, the issue is whether or not the ban on sex reassignment surgery violates equal protection. Since the US government has enacted Federal tax-funded health care policies, and it is explicitly and arbitrarily excluding individuals with gender dysphoria from relevant treatment, it will be extremely difficult for the government to ward of an equal protection violation, as the singling out of sex reassignment surgery has no valid scientific basis.

The difficulty of defending the exclusion of SRS in court is actually made even worse by the fact that the exclusion was originally based on medical concerns. Since the opinion of SRS in the medical establishment has shifted massively in the last 30 years, upholding this exclusion becomes even more difficult to justify...

I was already familiar with the case--and thus, I had no need to click your link. Saying that transgendered people should have SRS at 30,000-something-something USD (plus facial feminization surgery, which is just as expensive) covered by the government because a ban on gay marriage violates personal freedom, is a false equivalency. If the government were to ban gender reassignment therapy altogether, we may talk about the fifth amendment.



You're pretty much demonstrating that you can't apply knowledge here; you merely find stuff on Google and use fallacies as a desperate mean to discredit anyone who disagrees with you.

The fifth amendment is about personal freedom. Since gay marriage is about individuals and their right to marry who they want--and since gay marriage isn't paid for by tax money, a ban on it would be unconstitutional. On the other hand, not wanting the government to fund gay marriages when they do not fund straight marriages, is not by any means unconstitutional. Since the founding fathers did not distinguish between personal and economic freedom, using tax money for cosmetic surgery would violate the fifth amendment.



And this is relevant because...? Where precisely in this thread did anyone speak out against gay marriage?



Someone with cancer will die without treatment, someone with GID won't. Nobody in this thread has said that SRS should be banned altogether; funding it without funding more important medical issues first would just be unfair to someone with more severe problems.


The difficulty of defending the exclusion of SRS in court is actually made even worse by the fact that the exclusion was originally based on medical concerns. Since the opinion of SRS in the medical establishment has shifted massively in the last 30 years, upholding this exclusion becomes even more difficult to justify...[/quote]

On what do you base this theory? Would individual variation support more use of reassignment surgery or less? Why do you think that is it appropriate to respond with sarcasm to someone who genuinely wants to understand the problem rather than apply bias?



By responding on behalf of apple, I must assume that you also support snark as an appropriate means of communication in lieu of actually making a legitimate point. [/interest in thread]