Mass. judge orders taxpayer-funded sex change operation for convicted murderer

[Rathji]

Originally Posted by Azure

And why should we care whether or not this person has a higher chance of committing suicide if he doesn't get the operation?

Considering he murdered someone, suicide seems like a pretty decent outcome to me.

Either you provide medically necessary treatment for people in prison or you don't.

If the medical profession at large decided that GRS wasn't medically necessary, then your point would would be totally valid, and I would certainly agree with you.

[Azure]

Can it be proven beyond a medical certainty that if he doesn't get the surgery he will commit suicide? Because a 'valid' reason for surgery in prison, especially for a convicted murderer, should be that if a certain operation isn't done, the prisoner will die.

Just as an example, being highly at risk for a heart attack is a valid reason for bypass surgery. Even for an inmate. And the state should be responsible for funding that surgery.

But it seems rather subjective to say that if prisoner x doesn't get GRS, he will commit suicide, if prisoner x is a convicted murderer.

[Red Potato Standing By]

Originally Posted by Rathji

Suicide rates are about 3times higher for people with GID than the general population, so quite possibly.

Either way there is real pain and torrment. In the same way that surgery for back pain could be considered a real alternative, along with other treatments like Chiropractic, Physio, massage, etc. it's not like your life is in danger if your back is sore, but it would severely reduce your quality of life.

So put her on suicide watch, I agree that inmates should receive treatment if it is life threatening. Unfortunately the fact she has the wrong parts in and un itself is not going to kill her. When she serves her sentence then she can get the right parts. She can still view herself as female cause really in reality the outside parts are not going to make much difference where she is in.

[monkeyman]

I say treat the medical necessity, which comes after he tries to commit suicide. everything before that is not necessary. it's about quality of life before that. This guy gave up that right the second he murdered his wife. I'm sure the last thing on his mind was her medical necessity as he strangled her with a rope and wire and left her to die in his car.

[Ashasx]

Suicide rates are already extremely high in prisons.

Should we consider letting convicted killers loose so that they don't attempt to kill themselves behind bars? I figure it's a necessary procedure to save their lives.

[Rathji]

Originally Posted by Azure

Can it be proven beyond a medical certainty that if he doesn't get the surgery he will commit suicide? Because a 'valid' reason for surgery in prison, especially for a convicted murderer, should be that if a certain operation isn't done, the prisoner will die.

Just as an example, being highly at risk for a heart attack is a valid reason for bypass surgery. Even for an inmate. And the state should be responsible for funding that surgery.

But it seems rather subjective to say that if prisoner x doesn't get GRS, he will commit suicide, if prisoner x is a convicted murderer.

So certain death is the only reason that medical treatment should be administered to inmates?

I will repeat again, I am totally for inmates receiving medical treatment by paying for it, but that's not way the system is and as a result all medically necessary procedures should be covered, not just the ones that don't make people uncomfortable when they hear about them.

[WhiteTiger]

Originally Posted by Rathji

I will repeat again, I am totally for inmates receiving medical treatment by paying for it, but that's not way the system is and as a result all medically necessary procedures should be covered, not just the ones that don't make people uncomfortable when they hear about them.

I guess that's part of the problem, but it's still a hard sell that it's a "required" surgery for this person. I have no problem with the surgery or folks who want to get it, I am just not certain of the "need" for it. Reading through this thread, that's the common issue. Those who are against it (aside from the murderer part) aren't convinced that it's medically necessary. I have to admit that I am mostly of the same mind, though I also admit that I'm not sure what would convince me that such a surgery IS medically necessary.

[Rathji]

Originally Posted by WhiteTiger

I guess that's part of the problem, but it's still a hard sell that it's a "required" surgery for this person. I have no problem with the surgery or folks who want to get it, I am just not certain of the "need" for it. Reading through this thread, that's the common issue. Those who are against it (aside from the murderer part) aren't convinced that it's medically necessary. I have to admit that I am mostly of the same mind, though I also admit that I'm not sure what would convince me that such a surgery IS medically necessary.

I am not a doctor, so I will leave it up to the medical community and peer reviewed research on outcomes to determine what is medically necessary. AFAIK, medical professionals in most major western countries agree that it is, although I certainly have not done an extensive investigating into it, to be able to say which ones exactly.

I am going to take their medical opinions on it, rather than someone who complains about it because it is icky, or some other nonsensical reason.

[Nage Waza]

Originally Posted by Rathji

The difference between GRS and a rhinoplasty would be that under normal circumstances a rhinoplasty would not be deemed medically necessary by the medical profession, whereas the GRS would be.

I am sure there are exceptions to both though, and that's where the stringent and exhaustive diagnostic processes that are in place for GID come into play.

If a sex change is deemed medically necessary because it makes someone feel better about themselves, then let's lobby to get rhinoplasty in there as well. I am sure there are lots of people who wish their noses were different and have had their lives affected negatively due to it. In fact, how many people have killed themselves due to image problems?
I was just reading a bit into this, the suicide rates are not reduced from the sex change surgery.

[wittynickname]

Originally Posted by Lchoy

Wow, didn't expect people to read my post

Seoulfire:
1. I'm not a medical professional, I just did a lot of research into the literature to come up with briefing notes, so these are just my best opinions.
To answer your first question, I think gender disorder just has a larger body of evidence, and seemingly more common than in the other types of dysphoria you are thinking of (be it all of these disorders are still exceeding rare in the population). I'm sure if it can be shown that people suffering from amputee syndrome (sorry, I can't think of the correct term right now) were suffering from similar rates of depression and suicides, maybe the policy for surgical interventions would be similar.

2. I was referring to Biological gender as the body type the patient was, but maybe it isn't the best term. For this individual, there was a difference between the body (in a man's body) and the brain (female identifying brain).

3. Gender is a a developing field and terms and the science will continue to change. I hesitated in using "biological gender" since even what makes one a man or a woman can be a little complicated. Traditionally, chromosomal XX = Woman, XY=Man. However, there are XXY people (usually born male) and X (usually born women). There are people that have androgen insensitivity, so they are born XY, but because their bodies don't respond to testosterone and developed as women instead. I guess the easy way would be determine a person by their reproductive parts.

4. The problem with determining gender that way though is what the French has shown, and is being backed up by other scientist. When you take a cross section of the brain from a transsexual person and compared it with the cross section of a man and a woman's brain, the transsexual brain much more closely resembles a female brain than the male one, despite being born XY and having all the male parts. What this tells us is that for these people, their brains are literally hardwired differently than their cis-gendered peers

5. Hence the debate, is it a brain issue or a body issue? In my opinion, it's probably a genetic thing and the brain is wired as female, and the body develops as male. You can't fix the neural wiring, so the next best thing after therapy is the physical option. I would imagine that is there was a magic pill that would re-write the brain to the proper body gender, these gender dysphoria patients would definitely take it over invasive surgeries and chemical rebalancing

6. The other interesting thing is that gender and sexuality are 2 different things. Transsexuals are usually attracted to the opposite gender they choose to be (Male to Female would be attracted to men, and vice versa) but that is not always the case.

Badger Bob:
7. I'm not as familiar as the US health system so I may be mistaken. I would expect if John Bobbit got it sliced, and went to the emergency room right away, the surgeons would re-attach it as part of his emergency surgery. The bill would then go to his insurance or to him if he didn't have any.
If he decided a time later that he needed an artificial one, it would no longer be emergency and cosmetic, and I guess it really depends on his insurance if they cover it or not. For prisoners, like in Canada, their health care is covered by the state and they are insured by the state. In this case, she was she successfully had her treatments covered by the states including the final operation as she was able to document that it's a legitimate procedure. As a civilian on private insurance, I can see how that might not be fair, but such the way the system works. In theory here, a prison is covered by the Federal system rather than provincial, and they can have much faster access to MRIs and other procedures. In fact, I think there already has been a Canadian precedent where a prisoner got SRS while serving a jail sentence.

8. I think you got the counsellor and the patient confused , it's the patient that has to convince the counsellor that they are living in the room gender and to be given treatment to transition into their new gender. Transition is not something just anyone can do (well not medically transition, as I suppose anyone can just start living in the other gender if they wanted to, just not with hormones and surgeries). In fact, for these people, more often than not, it involves the complete destruction of their family life, their careers, and social life. However, that's something they are willing to risk to finally be able to be themselves.

8. With such a stigma and the risks that come with gender issues, are you surprised that people wait until so late in life to transition? Transsexual have literally hit the breaking point that they either transition, or they do something detrimental. There are people who get married, join the army, try to be a manly man, all to try to suppress these feelings of wanting to be a woman. Many who transition would say that it was the first time they ever felt like they can be themselves

9. As for precedent, I really don't think there will be a rush of prisoner getting SRS

LChoy

I just wanted to point out the exceptional additions to this thread from you. Well done!

[monkeyman]

Originally Posted by Rathji

I am going to take their medical opinions on it, rather than someone who complains about it because it is icky, or some other nonsensical reason.

So the fact that he murdered his wife with a rope and wire is nonsensical? you are right i do find that icky! I am disgusted with people defending this. He strangled his wife, left her to die!!!

[Weiser Wonder]

Originally Posted by Azure

Can it be proven beyond a medical certainty that if he doesn't get the surgery he will commit suicide? Because a 'valid' reason for surgery in prison, especially for a convicted murderer, should be that if a certain operation isn't done, the prisoner will die.

Just as an example, being highly at risk for a heart attack is a valid reason for bypass surgery. Even for an inmate. And the state should be responsible for funding that surgery.

But it seems rather subjective to say that if prisoner x doesn't get GRS, he will commit suicide, if prisoner x is a convicted murderer.

You shouldn't be part of this discussion if you won't use correct pronouns. It's gross and bigoted.

[Daradon]

This case is, as many have argued before, rather simple to figure out. Inmates get healthcare, this is a health procedure, the inmate is entitled this procedure.

And to be honest, I can't think of many things worse than feeling you are in the wrong body. People with gender disorders probably go through all sorts of hell personally and publicly. Think about it logically, are you going to carve up your genitals without a lot of thought or on a whim? Probably not. Is it just a case of wanting to look different or better? No. It's a serious problem and health issue.

The big problem is, as a few people have pointed out, is how the American healthcare system is completely messed up. Perhaps regular citizens should get more, perhaps inmates should only get emergency care, who knows. The answer is very complicated with plenty of possible solutions, and you can bet there is going to be a loud outcry no matter what is decided.

But two things. One, this ruling makes perfect sense in the laws as they are set up now and is a good step forward for equal rights. And two, people with gender disorders truly have a serious problem.

[Daradon]

Originally Posted by Weiser Wonder

You shouldn't be part of this discussion if you won't use correct pronouns. It's gross and bigoted.

Dude I understand your point and I agree with the things you said previously, but no need to fly off the handle and make things worse. It's a hard subject/topic/idea for many people to wrap their heads around. There's a difference between being bigoted and just not understanding.

[Rathji]

Originally Posted by monkeyman

So the fact that he murdered his wife with a rope and wire is nonsensical? you are right i do find that icky! I am disgusted with people defending this. He strangled his wife, left her to die!!!

No, as I already stated twice, I am not totally against removing funding for most medical procedures for inmates.

This thread is obviously not about that though, as no one has complained about other medical procedures that inmates receive.

[LChoy]

Originally Posted by wittynickname

I just wanted to point out the exceptional additions to this thread from you. Well done!

Thanks Witty

I use to be in the Health policy side of things with the Alberta government, so I enjoyed writing and explaining to people issues from the government point of view, but without the spin.
Although I'm still in the Health field now, in Ontario, the provincial government here is really difficult to get into for me to continue to have a role in health policy communication, so instead I give my opinions on health issues on CP. Sort of like you and Cowperson in the US political thread, Captain Crunch on all things military, and the various legal professionals on this thread. We're all one big community

That, and the fact I do have some personal experience with people who have had gender dsyphoria kind of makes me a little more informed and knowledgeable on the subject

[Locke]

Well, in light of our usual misanthropes on hiatus, I shall take up the slack!

"Back in my day we knew what gender we were by looking down and we liked it that way!"

In all seriousness however, I think this is ridiculous.

First of all, in deciding that this is medically necessary for the health and well-being of the inmate I think the wrong criteria are being applied. If the ultimate concern is that the mental health of the inmate is at risk and without this procedure he might commit suicide then its wrong.

I see this as little to do with gender dysphoria. Inmates 'could' commit suicide for any number of reasons, what makes this one special? Being locked up 23 hours a day for the rest of your life for instance might be a good reason to commit suicide. It might also negatively affect your mental health.

It seems like this guy has a serious gender problem, and thats unfortunate, but it also seems like it could be one of a great many for him to add to his pile of problems.

Inmates are entitled to basic medical care. Does this qualify? Will he live, will he physically survive without this procedure? Yes. Physically he is perfectly healthy. Job done.

[Badger Bob]

Originally Posted by Rathji

I am not a doctor, so I will leave it up to the medical community and peer reviewed research on outcomes to determine what is medically necessary. AFAIK, medical professionals in most major western countries agree that it is, although I certainly have not done an extensive investigating into it, to be able to say which ones exactly.

You claim that all these medical professional agree, but then admit that you never investigated it. How do you know then?

Originally Posted by Rathji

I am going to take their medical opinions on it, rather than someone who complains about it because it is icky, or some other nonsensical reason.

Yeah, there are medical professionals who agree to do boob jobs to enhance up to 56DDD and there was one who continued fertility treatment for the octomom. A few of their peers might've considered those actions to be "icky" but didn't publish contrary arguments in the New England Journal of Medicine.

[Erick Estrada]

Honestly I simply don't understand this prevailing bleeding heart mentality from young people these days. Four pages dedicated to arguing this guy's rights? What about the rights of this guys ex-wife? She had a right to live a full life but he took her life and rights away. It's easy for the bleeding hearts to talk rights but I hope to hell you never have to deal with the loss of a family member or spouce to a selfish murderer only to be slapped in the face by his rights to do anything but rot in a prison cell for the rest of his life in misery.

Screw the gender identity disorder. This guy has far deeper issues than his identity. He's a murderer! We all only get one shot at life and he made the conscious decision to take that away from someone. I'm sorry but the only thing this guy deserves from civilized tax paying citizens is the bare minimum required to sustain life. If his boyfriend/girlfriend or family wants to foot the bill for the procedure have at it but this guy is no longer part of regular society and therefore doesn't deserve any of the benefits that go with that.

[Weiser Wonder]

Originally Posted by Daradon

Dude I understand your point and I agree with the things you said previously, but no need to fly off the handle and make things worse. It's a hard subject/topic/idea for many people to wrap their heads around. There's a difference between being bigoted and just not understanding.

Yes there is a difference. Not understanding is fine, being disrespectful is not. Azure was being the latter. I'm sorry, I'm always going to call that out.