Wednesday, September 30, 2015

Full text: Sex reassignment needs broader focus.

Letter to the editor published in the Telegraph Journal (paywall) September 29, 2015. (Titled by TJ)

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Trans rights advocates in New Brunswick have been demanding that sex-reassignment surgeries be included in the province's schedule of publicly funded medical services. If you've paid close attention, you will have noticed a dramatic shift in how this demand has been articulated. Motivated by failure and inclusivity for non-binary and indigenous genders, trans rights advocates have shifted from the perspective that access to SRS is an equality claim to a harm reduction argument. 


The harm reduction argument for funding SRS is a refined logic that embraces the fluid reality of gender. Harm reduction also acknowledges that the negative impacts of gender non-conformity are unequally distributed along a socio-economic gradient. 


The Caitlyn Jenners of the world do not need public funds to mitigate their hardships; thus, income testing is a necessary component of a public SRS funding model.

Creating a dedicated budget line for needs-based SRS funding is not, however, the best policy response to reduce harm. This approach would be specific to a point that creates inequalities in access to health services. The complication is that body dysphoria isn't usually treated with surgery, except in the case of gender dysphoria.

Body dysphoria is a psychological pain resulting from deep discontent with one's body. Origins of body dysphoria are unlimited and specific to each individual. If non-essential surgery can appease body dysphoria caused by gender, why shouldn't it for disability or disfigurement? I refuse to argue whether a burn victim's body dysphoria is less worthy of compassionate non-essential surgery than a trans person's.

The prudent way to address the demands of trans rights advocates is allocating a budget for compassionate non-essential surgery. The administrators of this fund would assess impact and ability to pay of applicants seeking surgical remedies for all types of body dysphoria.

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