• jsomae
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    4 months ago

    I don’t mean any ill but I’d just like to understand better; I apologise sincerely if this is offensive and I beg your patience with me. Supposing a transgender person already “passes,” is there a meaningful difference between FFS and cosmetic surgery? There are cis people with very severe body image issues including with, say, how their nose or brow looks – even suicidally so.

    • marcie (she/her)M
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      4 months ago

      Its medically necessary, and many states and organizations state it as such. Being against it is transphobia.

      This community is not about cisgender people. Body dysmorphia in cisgender people is a different illness from gender dysphoria altogether, and has a different treatment regimen.

      • jsomae
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        4 months ago

        I’m not against it, I want to understand the issue better. I do not understand why being against it is transphobia, but I would like to understand this better.

        No provinces in Canada nor any medical boards consider it necessary, though they do consider other more expensive transgender surgeries medically necessary. (That is not to say I agree with them on account of their authority – but I am curious what analogous organisations in the US differ here.) Edit: I imagine the vast majority of trans people agree that gender-affirming surgeries like top & bottom are necessary, or at least should be covered, but I’d be interested to see if most trans people agree that FFS is medically necessary.

        I can understand the argument that it’s simply a different illness than cisgender dysmorphia. But, why do we not consider cisgender dysmorphia something which warrants medically necessary surgery? It can cause equal amounts of suffering. Perhaps we should fund both.

        • marcie (she/her)M
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          4 months ago

          Its my understanding that body dysmorphia is best treated with anti-depressants in most patients. Anti-depressants have no effect on gender dysphoria. If anti depressants aren’t working, maybe some other kind of intervention is warranted for those patients.

          I do not understand why being against it is transphobia, but I would like to understand this better.

          FFS is a reconstructive surgery. It is hard to compare to anything, but the purpose is to revert disfiguration by having the improper hormones. If cis people had this issue with hormones, then of course they should be covered.

          • jsomae
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            4 months ago

            OK, the argument that it’s caused by improper hormones is very compelling. The state could save money by helping ensure the hormones are corrected as early as possible.

            I do not know if antidepressants help cis dysmorphia, I’m somewhat skeptical about that. Antidepressants aren’t a miracle drug when it comes to this kind of thing, from what I’ve seen.

            • marcie (she/her)M
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              4 months ago

              I’m not sure about it either, I just know that it seems to be the most clinically significant treatment. Most people with body dysmorphia regret their surgeries, rates for trans regret are extremely low. Usually in the range of .5%-2% depending on surgery. For reference, somewhere around 30-40% regret knee surgery depending on the study. Regret rate science is a pretty well established thing.

              • jsomae
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                4 months ago

                Yeah that makes sense, I don’t doubt the regret numbers. I didn’t realize cosmetic surgery regret was that high. Well damn, consider me educated.

                I’ve seen that knee surgery figure before but I don’t think it’s a good comparison at all, and it’s easily attacked. Knee surgery has immense potential for chronic pain afterward, and poor mobility. Dysmorphia regret rates are much more compelling.

        • Elise@beehaw.org
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          4 months ago

          Hey jsomae, thanks for your curiosity.

          Of course everyone can understand that having something like severe underbite is terrible. However, it is still a different thing.

          I am trans and living in the nl. When I am outside for an afternoon I am insulted at least once. On average three times.

          I’m the sweetest person you’ll ever meet, and I’m basically a quaker when it comes to pacifism. Yet I know how to hurt people really badly and carry a knife.

          Any more questions? ❤️

          • jsomae
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            4 months ago

            Thanks for your reply. I didn’t realize the Netherlands had it so bad: I assumed they were open minded about lgbt stuff. My condolences, and I hope your conditions improve.

            • Elise@beehaw.org
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              4 months ago

              Yeah, it’s not as bad here as in many other places. Healthcare covers at least a few things, but it takes years before someone can even take a look at you and there’s still discrimination there too. I pay 250 a month for healthcare plus ‘own risk’ every year, yet I pay my own medicine and have private healthcare from the uk in addition. I use home compounded medicine, otherwise I can’t function. I am close to homelessness and receive 0 support from the state.