I was really repulsed by the amputation wannabe article, which I read yesterday. I don't know a great number of transsexuals (in fact I can only think of one that I knew at all well, a woman who is now a man). I think that there are a lot of people with gender-confusion who probably would regret any transformative surgery if it were allowed to happen on an impulsive basis. I think screening candidates is good, but I can't judge how they should be screened as I am completely ignorant of the issues involved. I really don't see a big difference between castration and amputation of a leg...

It's horrible, that article, and I mind my mind revolting against the whole idea. I did like the point made that as time goes on, newer and more popular "ailments" and "illnesses" come to the fore and suddenly there's a significant portion of the populace with that particular ailment. I think we are too quick to judge, too quick to diagnose, and too unlikely to listen with an open mind.

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This is not the same article I read... the one I read, the link can be found, I think, in anthologie's journal. It's about a woman who did a documentary in full support of voluntary amputation, backed up by willing surgeons.

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I looked there and didn't find it, but I'm not necessarily sorry about this. The article I read was disturbing enough and the one you mention sounds worse. From my PoV, the question isn't "are these people in my opinion really sick?", but more "Is the fact that they are sick sufficient reason to deny them what they want?" My answer is no - I'm not necessarily fully comfortable with this answer, but I'm less comfortable with any of the alternatives.

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Let me know if you want it, I have it in my discard file where I sent the link to my mom.

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Please, send me the link, if nothing else knowledge of the far fringe can be useful in my work.

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http://slate.msn.com/id/2085402/

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Wasn't able to read the whole article you cited ('cause I wasn't in a position to subscribe to the whole bloody magazine), though I'd already been aware of the phenomenon. The Slate article is good in overall analysis of psycho-medical 'trends', but it dismisses "Gender Identity Disorder" as being as much of a trendy issue as the obviously pharma-concocted "Social Anxiety Disorder" (while still not un-"disorder"-ing" it). I'd like it if they stuck to something like the objective facts of these matters....though, call me a capitalist bastard if I say that no employer-contributed health plan ought to ever pay for an employee to have a healthy limb removed. Bad business investment. :P

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There's a bit of conceptual muddle in a lot of the (predominently left-wing) discourse about diversity, and in particular the slogan "Celebrate Diversity" and its ilk. I celebrate the power of choice, and don't at all feel that this compels me to like or even respect the way people actually use their choice. Amputation fetish is deeply squickful stuff, and I also think it's dumb on a bunch of levels - I'm too aware of changing perspectives on life, perhaps, to want to commit myself to much of anything permanent in the way of body modification. I know not everyone changes their outlook as much as I do sometimes, but some do, and irrevocable changes make it all harder. I don't see any contradiction between saying "you have a right to make your choices and, as far as your means and those of people who wish to support you go, try to carry them out" and saying "I think that's deeply unwise, you really ought to pause a while and take another look at your life situation, and I have a deep contempt for some of the bullshit rationales for your fetish".

Of course, too many of the folks who say the latter do want to use the power of the state to shut down those doing the dumb thing, so I can understand someone seeing it as part of the slippery slope to mandated morals. It often is.

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I mostly agree. With something largely reversible like hormones, I think someone should merely have to have a medical exam to see if taking them would be safe and the be periodically monitored for negative health consequences. I see no need for any waiting period.

For SRS, voluntary amputation (I'm still amazed and sickened that anyone would wish to do this), or any other major surgery, I can easily see requiring the person to have a 2-3 month waiting period where they must come in, have the consequences and risks of this decision explained to them (with photos and detailed descriptions to scare off the uncommitted), and then come back after this time and receive the same explanation and then sign lots of paperwork to show that they agree.

Then, if they still wish to have the surgery, they should be free to get it. Naturally, if they later change their mind, they should not be able to sue their surgeon, unless the surgeon screwed up in some way.

The fact that all of the people mentioned in the article who had actually gotten amputations were happy with the (shudder) process indicates to me that this is something that is not unreasonable to treat in this fashion. I don't ever wish to know someone who is into this, but I think they should be free to do it (as long as they do it far away from me).

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Knowing a transgender (F2M) who went through half the psychological and hormonal regimen before her insurance ran out, I think the system is too long for those who want it, in the sense that too long means more money and time than is fair.

As for the amputees, I figure... whatever floats their boat, as long as no one is legally liable for them afterwards. =P That's the trade off for freedom. No safety net.

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Most certainly. Suing a doctor who screw up an operation, performs and operation without warning the patient of the possible consequences, or otherwise is incompetent or abuses their patient's trust is perfectly justified.

However, the very idea that someone could be sued for performing an operation that the patient has requested several times, after explaining the results to the patient is deeply wrong. Both sterilization and SRS (transsexual surgery) would be more easily available if doctors did not have to fear morons getting these surgeries and then suing to doctors for performing them.

I no of absolutely no such cases where someone getting SRS later sued the doctor, but this has actually happened for several sterilizations and if I were a judge and the patient admitted that they requested the sterilization, I'd throw that case out in a second and charge the patient with all court costs and a hefty fine for filing a nuisance suit. Such behavior is unacceptable.

As you said, part of freedom is responsibility.

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There was a documentary about this here (UK) a year or two ago, in that documentary it was explained as a condition caused body dysmorphia and the experts explained it as a function of the internal body image we all have -- body dysmorphics have an internal body image which does not include a hand, foot or limb. In the same way I've seen transsexuals talking about their breasts or penis not being part of their internal body image, body dysmorphics have, sometimes from an early age, an absolute innate certainty that the part of them which is not in their internal image is wrong, 'a growth', 'dead' to them or an abboration. The program showed various dysmorphics most of them had had their 'awakening' around the age of 5-8, essentially going 'that's me!' the first time they saw an amputee.

The program described the condition in terms of it being something innate in the brain which people who have it may then fetishise during puberty (in much the same way transsexual are prone to do) but which isn't inherently (or you could argue at all) fetishistic in origin. There are people who have a fetish for losing a limb, but those that end up seriously seeking the procedure do so because it is an essential and extremely important part of their internal self-image. One might go as far as to say that they literally are internally born without the hand, foot or limb with the same degree of truth that one could say anyone is born as a gender different to their body.

The actual focus of the documentary was a surgeon in the UK willing to do the operations if given a referral from two therapists (both of which were gender therapist -- one of which was *my* gender therapist!) several people were given referrals in the program (my doctor decided that one leg amputation was just fine but two wasn't (how very arbitary) and also wanted them to have some kind of RLT (it was almost self-satirising)) but at the end we found that no hospital would allow the surgeon to perform the operation in their operating theatres and so everything ground to a halt.

I actually find it hard to see any difference at all between transsexuality and body dysmorphia, perhaps because I at least to some degree follow the social model of disibility where disabled people are inherently as valid as all others but 'disabled' by their environment.

Oh and as for organic dysfunction vs lifestyle choice, I don't think there's anything like such a neat binary for that. I know of people who greatly prefer their minds in the natural state even if others have defined them as an 'organic dysfunction'. There are plenty of people who are happily schizophrenic and plenty who are utterly suicidal because of their uncontrollable same sex attractions. I would shift the view that there are plenty of 'conditions' (including whatever society judges to be 'normal') that people have without any choice at all and whether they are a terrible dysfunction, neutral or something to embrace and celebrate is down to the individual.

Maybe I've come to this conclusion because so many of the 'fringe identities' I hold and 'fringe communties' I participate in (genderqueer, asexual, plural, invisible disibilities etc) are in the mainstream or have in the past been considered disordered, dysfunctional or outright mental or physical illness.

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Of course anyone should be allowed to do what they want with their bodies. But I'd like to make sure they really, really, really want to do it before I start performing irreversible surgery on them. Lots of people go through phases where they think they want something, and change their mind a few weeks later. Take suicide as the ultimate version of this - some people, for whatever reason, want to end their lives. They should, in any reasonable society, be allowed to. However, I know at least 3 people who are now happy and don't want to die, who would killed themselves if it was trivially easy. If someone wants to lose a limb, I'd be happy for them to do so, provided the wish was something they harboured for a reasonably long period of time, and they were convinced they could not be happy without doing so.

Oh, and I don't think that Gender Identity Disorder is a choice, any more than "Liking Pop Music" is a choice. It may not be inbuilt, but that doesn't mean that it wasn something the person actively chose. You don't choose how your experiences mould you, they happen to you.

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Oh, and I don't think that Gender Identity Disorder is a choice, any more than "Liking Pop Music" is a choice. It may not be inbuilt, but that doesn't mean that it wasn something the person actively chose. You don't choose how your experiences mould you, they happen to you.

I completely agree, but I also don't believe all choices are conscious choices.

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But I can't see any relationship between "cultural influence" and "choice" (except that culture influences the choices you make). If I think that Madonna is the best thing ever, due to a mixture of my upbringing and my natural state, I don't see where the choice to like her occured, or what effect it had.

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That sounds rather like the line from Lawrence of Arabia -- "I can bewhat I want, but I can't want what I want...this (tugs at his fair skin) is what decides what I want."

I think that, like one's ethnicity and its cultural/psychological baggage, gender identity is inborn. It does not always emerge immediately as such (though neither does ethnicity), because it may not have yet encountered the examples of self-possibility nor the stringent challlenges/taboos in action that would spur the choice to claim that definition of selfhood.

There are quite a few women that I've met that say "Oh, I'm very masculine myself" and then have proceeded to harangue me over the unnecessariness of my being self-assertedly transgender (or transsexual, as it's a moot point till I have enough surgery and a legal change of status). "Why do you feel you need to do that?" they've argued --"I don't think I need to call myself male in order to feel strong, because I already know that I'm strong"....or stuff like that. Which is all very good for asserting them, but it misses the point of me asserting me, which had no intention of denying them anything by way of connotation or perceived strength. My being what I am is not a choice -- the choice lies in how far I feel that I have to (or am able to) carry out a visible transition so that the rest of the world will take me seriously and not attempt to shove me back into an arbitrary category. It doesn't mean that the category's "bad" -- just that I can't feel right living in it. And that's not something that I "chose", it's something that grew into organic certainty along with my understandings of what sex and gender actually entail and pressure, as before that point I really didn't give much of a damn. The more there's societal pressure to conform against one's instincts, though, the more necessary it is to make up one's mind -- consciously -- whether one's willing to give into that pressure, to play the mindgame of reinterpreting it into power, or to jump the fence altogether and not have to deal with the bullshit anymore.

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I think that, like one's ethnicity and its cultural/psychological
baggage, gender identity is inborn.

I believe very little of personality is innate, at (absolute) most there may be genetic tendencies, and I've not even seen good evidence for that. However, I also believe that much of our personality is set at a fairly early age and while some, or perhaps even most of it can theoretically be changed, in this case, the difference between theory and practice is quite large indeed.

Here are three posts where I go into more detail about my ideas about biology and behavior post one, and post two, and post three, including my general contempt for the entire discipline of sociobiology/evolutionary psychology.

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I mentioned ethnicity as an parallel illustration of identities that shape one more pointedly to acceptance/denial as one realizes them and their ramification, not as an academic thesis.

I'm quite aware that my own nature was influenced both genetically and hormonally before birth. I eventually diagnosed myself as being transgender, in the absence of any personal professional/mentorial input (but with later parental getting-the-point and verification), largely because the previously-promising niche of "butch lesbian" had been taken over by rampant 'womynism' and lost the old connotation of "inversion" -- which had made perfect sense to me up till that point, ever since I'd realized that it fit. I was a tomboy and fairly competitive but not into team sports, and had enough of an attraction to "pretty things" (fairy dolls, dresses, jewelry, art, flowers, long hair) to mask the underlying gender even from myself for a long time -- plus, I had little/no exposure to any broad discussion of sexuality and related issues and the possibilities of what a person could be. But the fact is that a person need not fit a strict stereotype of masculinity or femininity to be sure that they actually belong in a different place than the one they were sorted into by visible biology at birth, and there are many ways to be whatever one is. I wasn't even a diesel dyke (hell, one of my friends even called me a lipstick lesbian, which was outright slander to me), and I still regard myself as bisexual, but that doesn't mean that I haven't found the right place/explanation now that belongs to me and always has. Other people may have different explanations for why they are what they are, including the old "My parents always wanted a boy/girl and treated me accordingly" line, but I see no logical reason to accept that as a reason to discount my own personal findings, since I have applied a great deal of rigour to the entire journey.

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My own take is that a multitude of trivial (in and of themselves) factors come together to create a personality. I'm also guessing that at least some owe more to metaphysics than psychology (although, I am ultimately rather dubious about the entire idea of past, lives as such, and prefer to think about such things more as connections) - apologies for bombarding you with links, I'm still rather amazed to realize exactly how many lj entries I've written.

In any case, studies have shown that gender socialization starts having an influence after only a few days after a child is born (I can dig up info on those studies if you are interested, they essentially involve "mislabeling" wrt gender infants for a week or so, immediately after birth and looking at how they react - ractions differ in marked ways from male-labeled to female-labeled infants, after only a few days of interaction with adults, and are consistent (for both physically male and physically female infants) based on how they are labeled and perceived, not on their physical sex). Given similar results from a multitude of other studies, I'm highly dubious of suggestions that our behavior is biologically determined to any significant degree, in part because of a lack of any clear data, and in part because of the impressively dubious (and highly consistent) regressive social agenda that has been closely associated with genetic determinism for well more than a century.

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I'm just saying what I know to be true in my own case, and there was no case of "mistaken" gender at birth -- though before birth the slowness/steadiness of fetal heartrate led one doctor, later my godfather, to say "It's either a boy or a very stubborn girl." The only (possibly) gender-incongruent detail of my infancy was that I was perfectly happy to play alone and exhibited little attachment anxiety. And most by far of the past lives that I now remember (and that others can read and see as well) were male, whether or not you give that area of perception any weight.

I'm really not that interested in trying to prove/disprove this area for everyone, which is why I'm not following every posted link at the moment -- it's a hard enough process I've already had to go through in verifying things for myself alone, and frankly I prefer to stay on a case-by-case standard for interpretation rather than issuing sweeping conclusions of belief or dubiousness. In my experience, there are enough "internal" and "external" reasons for being transgender (no, I will not use "transgenderism", as it is not a philosophy nor a practice) that I see no point in arguing that it is definitely a "choice", nor that it definitely and always isn't. Like I said, I have every certainty of my basic nature, and the only real choice -- as with many things -- is what I do with it.

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Oh, regarding gender socialization...I had quite enough of that as well that it took a long time to untangle what was "really" me from what was the social-adaptation overlay, and it is still a trial when I'm dealing with people who think they know me well, and to whom I've gotten used to responding in a certain way over most of the past thirty years. But I think I know the difference (in most things at least) between my actual impulses/instincts and the way that socialization has pressured me to behave.

I think that the "genetic determinism" that you refer to has been overblown and repressive precisely because A, people were not working with all the facts and are still loath to admit their insufficiency (preferring to issue general statements instead) and B, the strict binary sex=gender=biological-role model has shoehorned so many people into places where, whether transgender or not, they do not belong. Not every woman is a (pre-)mother, not every man is a father/warrior, and even pushing the seesaw of opposingly-ideological sexual determinisms (such as with lesbian-feminism) does little to solve the matter of whether each person is really in the place where they fit best, with themself and with the world in general.

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(or transsexual, as it's a moot point till I have enough surgery and a legal change of status)

Are the laws different where you are than in Oregon? Here, all you need to change you name and legal gender is a letter from a therapist (the same one to allow them to get hormones, which mostly requires only a couple of visits to most therapists), you don't require hormones or surgery. Legal gender change is pretty much the first step transsexuals take here. I know a rather impressive number of transsexuals in Portland, but I do not particularly know much about how things are wrt transitioning in most of the rest of the US.

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I'm in Illinois, and they're not so openminded so far as documentation. The first thing I have a chance at getting is a legal name change, then I'll need to get a therapy letter before I can get hormones (I was seeing a therapist and had hopes of getting a letter from him but he retired abruptly to care for his wife and then died this past winter). Plus the whole amending birth certificates and such is a bitch and requires surgery (I have no intention of getting a shitload of expensive and unsatisfactory surgery just to satisfy the law), yet rather necessary for passports and such things (geting more repressive there, we are), which is one reason why I consider the current laws regarding this area as being an undue burden on personal mobility in every sense of the word.

Imho, the main reason to accept that at least some transgender identity is innate (and not to split hairs too finely about where the line's to be drawn) is for the sake of full equality under the law, and for not considering transitioning (whatever the degree) to be so much of an "elective" procedure that it's on a luxury par with cosmetic surgery per se. Why it should cost thousands of dollars and years of time now to achieve what one could formerly do by donning breeches, binding one's bosom and having a sturdy physique/knowing how to use a weapon is not answered so much by humanity's enlightment (afterall, people are still killed brutally for what they are) as by its paranoia, that the law has gotten used to looking closer and closer and demanding clinical satisfaction one way or the other.

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Imho, the main reason to accept that at least some transgender identity is innate (and not to split hairs too finely about where the line's to be drawn) is for the sake of full equality under the law, and for not considering transitioning (whatever the degree) to be so much of an "elective" procedure that it's on a luxury par with cosmetic surgery per se.

That seems unnecessary PTSD is a recognized medical condition, and there is increasing evidence that at least some forms of depression may be related to long-term emotional or physical stress during childhood, and both of those are covered by insurance. The desire to prove things are innate to garner various forms of legal acceptance seems misguided, I would vastly prefer

Heck, all manner of lifestyle related problems are covered by insurance and trans-related treatments are specifically not covered because of special exemptions written into all manner of insurance coverage, not anything to do with it being innate or not. My feeling writ legal acceptance and homosexuality is similar - "proving", no matter how successfully that something is inborn does nothing to make it more acceptable via legal standards or insurance. The law already grants many things like religion that are in no way innate, full protection, and insurance covers all manner of conditions are are caused by deliberate choices like smoking. From my PoV, the key to legal and insurance acceptance is tackling the issue directly, not trying to go after potentially impossible to obtain proof.

In any case, I completely agree that the difficulty of obtaining both treatment and paperwork for Trans people deeply sucks. Portland is especially blessed in this regard, and even here insurance doesn't cover anything.

In any case, speaking of trans issues, I would be remiss if I didn't recommend my best friend's recent book What Becomes YOu by by Aaron Raz Link (my friend) and Hilda Raz (his mom). It's a transition memoir that is one of the best books that I've read in quite awhile.

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I don't believe that it is unnecessary to state (at very least the occasional validity of) an innate component, considering that the costs of transitioning legally and surgically (to one's satisfaction or not) and maintaining hormones are high enough to keep many transpeople economically sidelined, unless they started out in a highly stable socioeconomic position and were able to preserve it over the course of transitioning. If it were accepted that one were attempting to rectify an error, fix a mismatch that actually had something to do with a "real" you inside, yeah, I think that'd help a lot, actually. Even in Roman Catholicism and Eastern Orthodoxy, people don't go off on homosexual orientation itself being a sin (i.e., a choice) but just the acting on one's deviant innate instincts -- therefore, even though some might attempt to use the same argument against SRS and in favour of prenatal screening and childhood hormone monitoring and such to prevent one ever "acting on" one's identity, it still makes just as much choice so far as settling where the crux of the matter lies, and to what extent it ought to be supported as a societal rule-of-thumb.

Anyhow, I'm sure you must have seen/read about that case (should remember the name but can't--anyhow, there was an excellent documentary I saw on PBS) where a boy was raised completely and scrupulously as a girl after his penis was accidentally cauterised off during an in-hospital circumcision. If he, with no masculine socialization (apart from the very first few days of life), and barraged moreover with all the chemical and social pressures of femininization, was still "himself" enough to rebel against it, then where are you going to say that came from, nature or nurture? Apart from a Y chromosome and the original fetal-hormone imprint, he had practically nothing to work with there -- or probably about as much as I did. I'd say that indicates that 'original nature' had the same idea in both our cases. If only my dad hadn't tossed in that damn X chromosome....:-|

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I'm sure you must have seen/read about that case (should remember the name but can't--anyhow, there was an excellent documentary I saw on PBS) where a boy was raised completely and scrupulously as a girl after his penis was accidentally cauterised off during an in-hospital circumcision. If he, with no masculine socialization (apart from the very first few days of life)

And if for many people, psychological sex is something largely or wholly set in the first weeks or months of life (IIRC, in this case, the child was circumcised when they were several months old), then this case proves nothing. Given that gender socialization starts to occur within literally hours after birth, this does not seem impossible.

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"For many people" is not for all people. Fine, it was several months in that case -- traditionally, circumcisions are performed on the 8th day after birth, which is what I was going on in the absence of the biographical data. But are you saying that I (for myself, not for the case above) do not know what I know that I do know? Because it sounds like that's what you're trying to persuade me to agree with, and I don't really see why you're trying to press that with me, seeing as I have my own data well in hand. I've already stated that there was no confusion regarding my sex at birth, and that I was not treated in a manner that would substantiate a 'nurture-only' philosophy -- as a matter of fact, that it took me a long time to find the right tools and terms by which to understand/define myself clearly in contrast to nurturance and socialization, 'myself' being an underlying reality. So what reason is there for trying to disprove my personal self-knowledge, which is hardly an isolated example? All I'm saying is that I, actually being in the category of "transsexual"/"GID" (a veiled insult of a term even when recognised as real), present my own personal facts in opposition to the generalized stance of that condition being a 'choice' of any (post-natal) kind.

And I think it damn well ought to be covered by state insurance and community health-management organizations, if they already require the hoop-jumping to prove one's seriousness and sanity anyhow. Either pony up the dough for hormones or loosen the restrictions on legal gender, or even enable dual or triple legal genders for living one's life (we already have SSNs, so what's the bother adding a few options?). I'm tired already of the way that the medico-legal beancounters legislate on things that they themselves have no firsthand experience of and still regard as pathological. Because if it is a "disorder" then it deserves to be funded/insured as a matter of public health and social productivity, and if it's not going to get funded or insured then there's no logical reason to have the gatekeepers testing and deciding who does and who doesn't get to live fulltime in the sociolegal gender that they feel is right for them, with or without hormones and/or surgery. To coin a phrase, they really oughta shit or get off the pot.

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Possibly a few too many italics in there....:-|

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And I think it damn well ought to be covered by state
insurance and community health-management organizations, if they already require the hoop-jumping to prove one's seriousness and sanity anyhow. Either pony up the dough for hormones or loosen the restrictions on legal gender, or even enable dual or triple legal genders for living one's life (we already have SSNs, so what's the bother adding a few options?).

I completely and wholly agree with this. I recently read that in the EU there is at least one case IIRC, Germany) where a MtF young teen went on androgen blockers at age 12 and will be eligible to go on estrogen at age 15 or 16, which is absolutely fabulous. In the US, we need both euro-style state paid for medical care and vastly better, easier, and faster access to services for trans people.

As for the rest, my strong assumption that basic things like gender identify are large set in the first few months of life and that they are often set by a series of seemingly trivial and minor events that have a cumulative effect. OTOH, telling the difference between that and something inborn is perhaps quite difficult, so agreeing to disagree here seems perfectly reasonable.

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Oh, on the idea of freedom of speech, I have no problem with people being allowed to express any opinion they want to.

The only speech I think should be controlled is:

1) Instructions on how to build lethal weaponry - certain items are too dangerous to allow the general populace to have access to them. If there was a simple one page "how to build a nuke out of household items", I'd want that contained very carefully.

2) Incitment to riot. Expressing the general wish "All black people should be gassed" is one thing. Shouting "Everyone shoot that black person!" is not.

3) Along similar lines, information that would lead to the direct hurt of someone. i.e. publishing the home addresses of abotion doctors. Or the locations of abused women's safe houses.

But unless there's a direct link between the information and people being hurt (against their will - publishing bondage instructions is just fine), I'm happy for any kind of speech to exist. I'd rather it was out in the open, to be honest.

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I have a slightly different point of view on these things given where I live. My tax dollars and those of every other citizen of tax paying age in this country go towards universal medical care. If your choices cause /my/ tax dollars to be spent on something I consider frivolous, unecessary or a combination of both, I feel I have the right to voice an opinion on the subject. A specific example could be not wearing a seatbelt. It is your right not to wear one BUT you should have to be willing to take personal responsibility for your actions. If you are injured in an accident where that injury was preventable if you had worn your seatbelt, YOU should be responsible for medical bills that arise from that. This logic can be extended to include drug use, etc, etc. As for the issue of requiring psychiatric evaluations for transexuals wanting hormones, to a certain extent, I don't have a problem. However, I come at it from a view that this is medically "unnecessary" medication (or surgery as the case may be) and I want to be sure that the person doing the requesting understands the risks and possible ramifications. That said, I feel the same about ALL unnecessary surgery and medication. If you told me you wanted a tummy tuck or a nose job or your arm cut off, I'd feel the same way.

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I want to be sure that the person doing the requesting understands the risks and possible ramifications.

Most certainly, but current guidelines for reputable plastic surgery do this adequately, the pointless and lengthy hoops one must jump through to get hormones or SRS, and the insane difficulty that most people face to get sterilized, especially if they don't already have children, are both IMHO deeply wrong.

I'm all for fully state-funded medicine, and honestly see paying for someone's tummy tuck or SRS as a far more reasonable use of a government's tax dollars (making citizens happy) than funding "The War on Drugs", or paying for more than a fairly minimal military.

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Most certainly, but current guidelines for reputable plastic surgery do this adequately, the pointless and lengthy hoops one must jump through to get hormones or SRS, and the insane difficulty that most people face to get sterilized, especially if they don't already have children, are both IMHO deeply wrong.

Hormones, I don't have a problem with. The are reversible if you change your mind and as you said, with follow up for adverse reactions, shouldn't cause long term issues. SRS is not one I'm familiar with, so I can't comment. As for sterilization, I have some misgivings about making it too accessible. I know I'm not the same person I was 5 or 10 years ago and would hate to have made a decision I couldn't undo. I would, however, happily support a form of male birth control similar to Depo provera or norplants that would provide the same result while still allowing room to manouevre if needed.



I'm all for fully state-funded medicine, and honestly see paying for someone's tummy tuck or SRS as a far more reasonable use of a government's tax dollars (making citizens happy) than funding "The War on Drugs", or paying for more than a fairly minimal military.

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The article about voluntary amputation hits home with me in some powerful ways. I read the article; and I couldn't help but thing during reading that if "apotemnophilia" was replaced with "therianthropy" or "species dismorphia" and some of the personal accounts of those suffering the "disorder" were re-written slightly into the different context, that the overall tone of the article felt about right for how things like therianthropy and species dismorphia would be seen by the mainstream if (or when) they are well known enough. (Though it is obvious that medical techniques to deal with such things do not yet exist, for the most part... yet.)

Now, of course, my reaction to the idea of desiring what is essentially intentional crippling damage to one's physical form, could be described as being as squicked as anyone else at first glance: it's not just a matter of havinga weak stomach at the images it evokes, but for myself especially it's a 180 spin in the opposite direction from my own "thing". (Far from desiring a less functional body, my own feelings lean toward one that is more functional both aesthetically and practically. Given this, I have an extra helping of can't-grok-it when contemplating inflicting damage to the basic human form.)

Yet, I feel the need to reign my reactions in, to some degree; on one hand, I do consider what such people as the "devotees" of amputation do as being extremely unwise, even if they don't change their mind and scream in horror 6 months later. I also feel that they might indeed have serious and deeply-set issues - which is of course a value judgement on my part, where I am deciding "whole and functional" in a very broad and basic sense is something people naturally desire, if something else doesn't get in the way, or twist their perspective around.

On the other hand, I feel I should not allow the squikiness of "the alien" to affect my judgement on the matter. This topic is a mirror for me - many people who have encountered the concept of therianthropy (and specifically, therianthropy in the context of literally desiring or feeling more "right" with the idea of a different physical form) have claimed it evokes massive "squickness" in them, and is a horrible "perversion" and must be a "disorder" for which a treatment should be administered immediately to correct the thought patterns of the "sufferers". And this reaction is evoked by something that doesn't even involve the desire to chop of perfectly good body parts. Something I ponder, is that entirely aside from the exact nature of the body dismorphia, what is squicking people and causing them to place everything in the point of view of a disorder, ailment, dysfunction, etc, is that it is a deviation from their expectations of "normal".

Which is why I am careful with how I treat things such as the amputee concept myself; and of course, just because a xenophobic impulse might try to label anything different as wrong or bad, doesn't mean that something in particular might not actually have some negative parts or real problems.

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A few extra, funny thoughts:

It used to be that dental work was considered a perversion and blasphemy because it was an alteration to the "purity" of the Human Form. While the objection to it was often phrased in religious terms, I have to wonder if the mindset that inspired the objection has not survived today, easily justifying itself using whatever language a particular person supports - religious, pscyhological, objectivist, etc

I also found it amusing, in a way, and ironic, that in the particular article linked, that one thing that was mentioned was how the amputees fully realized that the alterations to themselves would cause new challenges in life, new problems, and they would have to adapt virtually every tiny detail of how they lived to deal with it - since really, the exact same description could be applied to my own desires, should it ever become possible, to literally realize them. For all that my personal ideals don't involve losing anything like a limb, there would be differences, and those differences would cause a cascade of effects in my life.

Which is, of course, judged against the concept of a "normal life" in the world around us. Since, at some level, normal is mainly a setting on the dryer.

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I got the article from postmaudlin's journal, and someone else left a comment there saying that she herself has wanted body parts removed ever since her early childhood.

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Thought I should point you and your readers at this page, where your top-level post has prompted further discussion.
http://www.amptoons.com/blog/000684.html
(Note that "Amptoons" means "toons by Ampersand" and not "toons of amputees)

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Personally, I think that the main objection I have to voluntary amputation, and the reason why I'd tend to persuade/inveigh against it, is that it unnecessarily reduces a person's basic functionality -- not like reproductive functionality, which tends to be a very shallow social concern anyhow, but real physical mobility and capability. I see no reason why anyone should be allowed to do that/have that done to themself on their own initiative unless they are dead certain (and preferably can prove via both legal and financial evidence) that they will be able to maintain their living independence (or have others care for them reliably) and will not become a public burden because of something that they decided to do. And I would not permit it to be done with public/government funding, nor to be covered (as if it would be) by any insurance plan. And if they decide to go ahead and try it anyhow, then I've no pity for that. Because there are enough amputations and maimings that occur involuntarily, without consent or control, and under the most horrific of circumstances, that I see no reason to allow them to be carried out for the mere reason of satisfying a matter of 'body image' -- gender and species in general, I've no argument with, as I'm in that area myself, and think that the going standards for hormones and SRS are ridiculous.

I think that people who fall into a sense of 'familiarity' with amputation may be vastly overrating its usefulness to their psyches, and that the general human trend of not having to fight to maintain one's physical wholeness and survival has laid them open to, if not a delusion, than a delusionary anticipation of the physical reality healing their non-physical malaise...when really it's the precise opposite. Sexual transitioning, imho, deserves far more support and medical/financial enablement because it enables people to be more confident and productive in their lives and careers as themselves -- the costs and delays, however, can severely undercut or destroy that fulfillment. By contrast, elective amputation has no positive/enabling benefit to a person's life or career, and as such strikes me as a merely selfish and self-absorbed desire that needs a harder dose of reality and a far more stringent verification of intent than anything which does not impair the basic mobility and everyday-functional "wholeness" of the body. And so I'd have no compunction whatsoever about legislating against it and imposing very strict conditions -- afterall, there are enough stupid things that people do accidentally in life without adding to the list.

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I can definitely see not having state (in anything remotely resembling a humane or civilized nation) or private (ugh) health insurance cover such surgery, but I also firmly believe that such surgery should be everyone's right. I equally firmly believe that every citizen of every first world nation should have (in addition to free healthcare and education) a basic living allowance sufficient to cover the most basic needs. OTOH, paying the disabled more than this basic allowance makes sense, but in such a system I do not believe that these people should be able to collect such disability payments. However, it's not my (or anyone else's) right to dictate what people can or cannot do to their own bodies. You and I may both see absolutely no benefit to having such surgery, but clearly some people do, and I very strongly feel that this is their choice to make.

Also, with luck, in a decade or so, such things will be reversible anyway - limb regeneration tech is actually doing surprisingly well, driven in part by the vile results of the current mad and horrible war.

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It's precisely the vileness of the horrible things that can happen to people against their will (such as having hands and limbs chopped off in civil war) that makes me want to ensure that they don't do things stupidly with their wills. Don't expect amputees in Sierra Leone to have any sympathy with "wannabes" and their desires -- those who have had things forced on them by violence do not have the illusion that that is the state they ought to be in, because it isn't, of course -- they have nothing in common. Admittedly, one can't stop people from doing everything that's self-destructive/self-maiming, but I think there should be a more "challenging" set of counseling and exploration of options (like occasional chemical numbing of one's limb/s, for example) that would not be so permanent. One could say that it's an insult to the people who do suffer against their will, that anyone would be so attached (ha) to taking themselves apart in order to "feel" whole...how could that be "real" wholeness, when it parallels torture that is imposed to this day in brute hatred and without reason, and parallels that even more closely than ornamental tattooing evokes Auschwitz or than transwomen evoke Oriental slave-eunuchs?

I can see where society would probably evolve to accept or at any rate tolerate these things...at the same time, it may react against them (and with belated discernment against the whole "anything goes" of self-modification), to the point of re-segregating levels of society to exclude the voluntarily self-mutilated -- hypocritical, perhaps, but there are some general functions of (humanoid) physical wholeness that one may accept the loss of with age or accident but cannot easily stomach the sight of as a "personal choice."

Personally, I'd think it less of a shudder-factor if at least these people were aiming to impersonate another lifeform through amputation, rather than just an incomplete human. That'd be more "creative" as opposed to merely destructive....making it something other than maiming pure and simple would make me feel less sickened and outraged.

Like I mentioned earlier, I think humans have too much free time on their hands not having to constantly fight/survive/use their bodies...makes 'em more liable to do things that are not actually useful to their survival, whether they seek them out like extreme sports or feel them as a bodily dysphoria (or get impulses to stab out their eyes just to see what'll happen). And it may be a modern heresy to say so, but imho some dysphorias are far more useful than others. But then, I tend towards Pragmatism and Utilitarianism, and have no great fondness for regarding all deviancies as ultimately relative and equally valid/meaningless in value.

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Like I mentioned earlier, I think humans have too much free time on their hands not having to constantly fight/survive/use their bodies...makes 'em more liable to do things that are not actually useful to their survival, whether they seek them out like extreme sports or feel them as a bodily dysphoria (or get impulses to stab out their eyes just to see what'll happen).

In vivid contrast, I celebrate our lack of connection to previously difficulties of survival. As an ardent transhumanist and neophile, at bare minimum I want to see a society where as many survival necessities are taken completely for granted - where food, shelter, medical care, and education are as free for the taking as we can possibly make them and where lifespans are as long as possible, and get medicine to the point where it can repair almost any injury. Then, you completely separate sex from reproduction (tech under development + a good advertising campaign about how painful and incapacitating pregnancy is compared to artificial wombs (which are actually in the (very) early stages of development) and then let humans of all sorts free to see what they will accomplish without limits or fear. Sure, some people will do horrid and pointless things to themselves just to see what they are like. However, I also expect all manner of fascinating social and personal experiments and some of them will produce nifty and positive results. I'm interested in radical physical and cultural freedom of a sort that has never existed, in large part because I want to see what humans and posthumans can create. If that means communities of voluntary amputees who hobble around on elegantly made silver prosthetics or ride around on gilded automatic carts and mock people with two arms and two legs, so be it. From my PoV, as long as people are not forced to do or not do anything, the more freedom and opportunities for diversity that sentient beings have the better. For me, diversity and intelligence are two of the most important and sacred principles in my own rather ad hoc and highly idiosyncratic personal philosophy.

On a more pragmatic front, I know several people who would prefer to be physically neuter. I have no interest in such a change (OTOH being a hermaphrodite sounds fairly nifty and is definitely something I'd like to try), but I can see absolutely no reason that they should be prohibited from such choices or even given significant difficulty in accessing services to accomplish this, and given that people would consider such changes to be as (or often more) horrific and mutilating as someone cutting off a limb, I'm not at all prepared to judge what others wish to do to themselves. I'm certain that when the time comes, there will be plenty of people who will object to the various transhuman mods I will want to obtain when they are available.

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That's your choice, including the choice to look ahead to a transhumanist future....I've always said, too, since this trend came up as a popular goal, that the ones who are most likely (and financially able) to take advantage of those things are not the sort in whose company I would want to spend a radically attenuated lifetime.

There are already enough people on this earth who are merely consumers, and I have very few illusions that their number will decrease and the number of creative, generative people increase as they're mutated into forms that have no pressure of time and mortality upon them. Biological/reproductive pressure, I'm all for relieving that, as I think there are too many of us already as a general species. I see a different turn to the plot, though, than the triumph of benevolent technology, as I see a massively uneven development of ethics and of technology, and too many ideological schisms, even if such radical transhumanist technologies are developed, to guarantee that those living with them live in an idyllic post-modern milieu.

In my opinion, diversity of lifestyle and opportunities are worth very little unless they are available to all -- not just the "First World", not just the "upper middle class" and upwards. I'm not interested in shiny silver mechanoid brain-chariots.

....but must run, am on foreign computer and it's getting light here. Later.

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There are already enough people on this earth who are merely consumers, and I have very few illusions that their number will decrease and the number of creative, generative people increase as they're mutated into forms that have no pressure of time and mortality upon them.

The reason that most people in the first world are merely consumers is that the vast majority of first world work (including the vast majority of office work) are essentially unrewarding and meaning-free activities that should be automated as soon as possible. Much factory work was automated decades ago and the trends toward doing this further continue. Meanwhile, projects to automated low-level service work (like fast food) are doing well, and it's increasingly being possible to automated low-level paperwork. The only humane answer (which is naturally being adopted in the EU, especially Germany, but which naturally has yet to reach the US) is to reduce work weeks while keeping wages the same. Within 15 years, I'm absolutely certain work will look considerably different and most of the first world will need to fact the fact that much of their population has only minimal employment. I'm all for that transformation (assuming this is dealt with in a humane manner) because the jobs that are lost largely have no meaning and offer nothing to those doing them beyond a paycheck.

I'm hoping that people can be trained into exercising their creativity more and am made hopeful by the explosion of homemade yutube videos, fan fiction, and similar creations. I consider these endeavors ultimately far more valuable and important (regardless of their quality) than 90% of paid work. A truly vast number of people do marvelous things with their hobbies. I'm utterly uninterested in 90% of what they do, but I don't have to be. Give people more free time and a culture less focused on the vile and destructive Puritan Work Ethic and things can get even more interesting. I spent a fair amount of time in Britain in the 1980s, and over there hobbies are discussed with a degree of passion and interest that was rare in the US until the growth of some internet subcultures, and is still uncommon among the general public. People want to do interesting creative things, it's just that many people have no idea what to do or how to do it, and US culture in particular discourages both creativity and spending too much time on "hobbies", which are regarded as irrelevant because they do not contribute to income. Give people time and resources and stop whacking them with puritanical sticks whenever they show an interest in such things, and I'm certain that there will an explosion of creativity. Sure, you and I won't like most results, but they will make people feel good (and is there really anything more important that that, once people's physical needs have been met?) and some of the results are certain to be quite impressive indeed. Heck, in Japan, the line between fan-made and professionally drawn Manga is completely blurred and the results are fascinating and cool.

Beyond that, if (as is looking increasingly likely) at least some degree of intelligence enhancement via implants, gene therapy, drugs, and etc... actually works, I'm absolutely certain that this process will aid both creativity and self-reflection.

I see a different turn to the plot, though, than the triumph of benevolent technology, as I see a massively uneven development of ethics and of technology, and too many ideological schisms, even if such radical transhumanist technologies are developed, to guarantee that those living with them live in an idyllic post-modern milieu.

It's fairly inevitable that humanity will splinter, and being a fan of diversity, I'm all for that. We live in an era of increasingly separate subcultures, and that's only going to accelerate. I also think that intelligence enhancement is going to aid the spread of humane ethics, because anything that encourages self-reflection will help most (but admittedly not all) people overcome selfishness and short sightedness. Perhaps I am naive, perhaps not, time will most certainly tell. That in no ways means that the next 2-5 decades won't be impressively turbulent and difficult.

continued in next post...

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continued from previous post...

In my opinion, diversity of lifestyle and opportunities are worth very little unless they are available to all -- not just the "First World", not just the "upper middle class" and upwards. I'm not interested in shiny silver mechanoid brain-chariots.

I agree with both statements to a fairly large extent. However, tech spreads. As I mentioned in my recent post on 3-d fabricators, the limited fab-unit tech we have now offers hope for the 3rd world, and that's only going to improve. If any of the promise of nanotechnological manufacturing comes to pass, then the situation becomes even better. I'm hoping for a post-scarcity economy, and if the first world develops that, it will reach the 3rd world. Obviously, this will happen later, and that sucks, but it's also pretty much impossible to change. Also, if people in the first world are leading exceedingly idyllic lives, then I'm fairly certain that appeals to aid the 3rd world will be increasingly popular. The less scared and overworked people are, the more inclined they are to aid others. The problem with the modern US is that we are awash in both fear and overwork (being by far the most overworked nation in the first world).

As for silver brain chariots, I much prefer the idea of an immortal, highly durable biological body with enhanced intelligence and senses, and direct neural wireless communication. Uploading and robot bodies might be interesting and if the process of doing either was reversible, I'd certainly try them, but I'm rather a fan of the pleasures of the flesh.

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"how painful and incapacitating pregnancy is" You've been fooled. Pregnancy is only "painful" and "incapacitating" in white America right now because it is socially groovy to be less capable. This is our modern version of "the vapors" - the more upwardly mobile, upper class, rich, etc. you are, the less "animalistic" and capable of having a baby you should be - classism (as well as upper-crust wannabeism) at its most evident. When I was pregnant, people around me were dropping with flu - I got a sniffle. I had more energy and stamina than my unpregnant friends. The "pain", which wasn't as bad as the muscle-frozen back aches I used to get, lasted 4 hours. BFD. The labor WAS work, worse than hoeing a garden, which is the heaviest I had labored at anything to that point (and which I do poorly and most important, hadn't developed the muscles for). The human organism has been refining its design for several million years to grow and drop kids without undue ill effects - if 50,000 generations of your ancestresses hadn't done it exactly right you wouldn't be here now. This is one for the profit-driven big Med and Pharm - create problems and then "fix" them with surgery and drugs. The invasiveness and extensiveness of the helpless/hapless pregnancy and birth model also takes away from women when they do have problems and need help. I would go into detail about medically caused problems in birth, which I know you will never research, but you sqick too easily and will blow it off with your wish for a purely technical "birth". We haven't even been able to trust commercial infant formula - when exactly do you see "science" (which within a pathetically closed belief system is rarely practiced) coming up with a non-damaging artificial womb? Because it's a no-brainer that any chemicals/hormones/enzymes etc. that researchers don't know why they would be in the mix, they will leave out, and anything they "think" should be in there will be added. Unscientific and hubristic, and typical.

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