Disco: same sense of 'yeah, but' here. While it's absolutely not my remit to defend the Harry Benjamin guidelines (I believe they should be just that - guidelines - neither set in stone nor disregarded), they're not universally despised. Individuals at the 'end' of the Real Life Test (and who therefore have relatively little invested in giving their ex-'gatekeeper' what he/she wants to hear) tend, on the whole, to describe the experience as valuable, useful, necessary; this is borne out, to a certain extent, by coarse measures of regret such as suicide statistics (the unfortunate subgroup who feel reassignment surgery was the worst mistake ever). Interpreted with a sufficient degree of flexibility, I think they're a reasonable compromise between the agenda of the gender-dysphoric individuals (change me now) and that of the enfolding health service (minimise risk of harm).
My reference to "authentic"/"trendy" categorisation was at least partly facetious, as indicated by my last post. In truth, a more pragmatic approach is typically adopted, with the emphasis on identifying and addressing those factors predictive of regret. 'Official' diagnostic categories do impinge, however, on an individual's 'right to have surgery' - at least within 'free at the point of entry' State-subsidised healthcare systems such as the NHS - in that is necessary, politically, to quantify a gender-dysphoric person's degree of distress in terms of psychiatric 'disorder'. This is, as I see it, the main reason for Transsexualism continuing to exist as an ICD/DSM category - because if it didn't, the NHS would view endocrinological/surgical treatment as 'cosmetic' or 'non-essential', and would be far, far less likely to fund it. It stinks, but given the structure of State-subsidised (as opposed to private) healthcare systems, it's difficult to come up with a viable alternative.
I don't share your cynicism regarding the reasoning behind standards like the Harry Benjamin criteria; without any such 'gatekeeping' - essentially giving the punter what he/she wants, more or less on demand - I believe there'd be considerably more tragic 'mistakes'. (I've read of one or two of them, and their lot is a miserable one.) I'd reiterate that, within a healthcare system like the UK's, a degree of rationing is necessary for reasons of finite resource. Private medicine obviously works within very different parameters, and the 'right to have surgery' depends much more on an individual's finances.
We probably will continue to disagree on this, but I don't particularly see myself as being on a different side of the notional "fence". My priorities as an NHS employee are different, yes, but I'd argue that my purpose is not merely to enforce farcical standards for standards' sake, but to juggle various agendas to facilitate an outcome no-one will regret. In an ideal world, everybody would possess the resources to "genderfuck" to their hearts' content, and everyone would be happy with the result. We don't (yet) live in that world. |