When is surgery for Gender Dysphoria appropriate and necessary? Should a doctor do the sex change just because an individual says they want one? Gender Identity is a person’s own concept of who they are – it cannot be proven by science, so does a person’s word stand as gospel? These are questions care providers specializing in gender must deal with on a daily basis. The rule many are adopting lately is the informed consent rule, while others stick with the WPATH Standards Of Care (SOC).
Let’s look at both to see what works best. The WPATH Standards of Care 7 was just released in 2011. It is put together by specialists in Gender treatment, including physicians, surgeons, psychiatrists, psychologists, and therapists. One of the first things they point out is gender non-conformity is not the same thing as gender dysphoria and should be treated differently depending on the severity of the individual’s condition. It is largely the mental health care provider’s responsibility to guide the individual to a discovery of the extent and intensity of discomfort or dysphoria they are experiencing and if this experience is constant or intermittent. A copy of this publication can be downloaded for free at this link. (http://www.wpath.org/publications_standards.cfm)
“Surgery – particularly genital surgery – is often the last and the most considered step in the treatment process for gender dysphoria. While many transsexual, transgender, and gender nonconforming individuals find comfort with their gender identity, role, and expression without surgery, for many others surgery is essential and medically necessary to alleviate their gender dysphoria (Hage & Karim, 2000).” (SOC 2011) (Italics and Bold added)
Informed consent as I refer to it here is not the traditional form used in all medical procedures for legal reasons, it is simply the verbal understanding between patient and provider of how the individual identifies and then treatment ensues based on the individuals testament. It is used because as stated before no one can prove a person’s gender identity. Even the individual may have doubts about it which are to be taken in consideration by the provider. This is why counseling therapy is so important in my opinion; because if the person has other psychological conditions they may get the idea they are transgender when it is simply a masking by this overlying condition. It is also good to get several different opinions to confirm the person’s gender dysphoria before prescribing hormones or doing any surgery. The big difference is the SOC method recommends a letter from a licensed practitioner and the informed consent method does not. The provider just takes their word for it.
Obviously the question of which works best is still being worked out, so I will leave it to you to decide while sharing my opinion from experience. The SOC have been in use since 1979 and takes a conservative approach to treatment. The informed consent method is more cavalier and puts the responsibility squarely in the hands of the individual which may be the appeal for both the practitioner and the patient; however I question if it is really in their best interest.
To wrap this up it is every individual’s responsibility to ask questions, do research and know as much as possible before reaching any conclusions or taking any actions. Make sure you know which method your provider uses and what is required of the individual in the treatment path. Trust your gut! Or to say that another way, listen to your soul. It knows the path you need take and get a second opinion before making any life changing decisions like living full time, taking hormones, or having surgery. It is my opinion that surgery is a last resort used in the most severe cases of dysphoria. I also believe that everyone, yes even cisgender individuals experience gender dysphoria although it is often a brief experience precipitated by an external event perhaps through someone else’s dysphoria. There are other types of dysphoria also, like the feeling you are from another world or are really a non-human being, but that is another story all together! Those individuals are referred to as Wanderers if you would like to do further research. Till next time readers, Blessings on your Journey of Love ♥