Insurance Exclusions Against Transgender Persons Should Be Eliminated
Debate Rounds (4)
To be clear, the resolution applies to transgender persons who have been diagnosed as having GD per the WPATH standards of care and who have met their obligations for treatment, e.g. appropriate letters from counselor and doctor. The services the ban would cover would be any service in those same WPATH standards of care as approved by the transgender person's medical professional(s).
The round will start after the negative accepts the debate. I will then post my opening argument.
Note that the resolution does not state who should be doing the eliminating. I do not want to get caught up in whether the acting agency is the SCOTUS, federal or state legislation, or simply the insurance companies themselves. The focus will be on the exclusions and whether they should be eliminated by some entity, even if that entity is the insurance company doing, what I view to be, the right thing.
As you may be able to tell, I'm new to debate.org and could not see a way to respond to the comment: "Are you arguing that insurance shouldn't be excluded for gender changes specifically."
Clarification #1: To clarify, as stated above, I'm saying that insurance should not be excluded for all services provided for by the World Professional Association for Transgender Health ("WPATH") to the extent those services are indicated as stated in the WPATH standards of care. For example, a transgender person with GD may only need hormones or t-blockers. The current standards of care do not require that you have gender confirmation surgery if the hormones will treat the dysphoria. The standards of care offer a flexible well thought out approach to the diversity of needs within the trans community. All of those services, if indicated after diagnosis, should be covered by insurance just like any other treatment needed for a medically recognized condition. This is the position I will be taking.
Clarification #2: It's frustrating to be new and unable to directly reply to comments made on my own topic. Oh well, this too shall pass.
I am asked whether I am against the exclusions which the topic proposes be eliminated. Yes. I am against the exclusions by which insurance companies deny premium paying transgender people the services I've described. As the first clarification paragraph states, "insurance should not be excluded."
For context, I am trans. I will be paying tens of thousands of dollars for surgery in August. I pay insurance premiums but coverage is excluded in every policy I could purchase in Oklahoma unless I happened to work for a few large companies which are trying to get the 100% equality index rating of the Human Rights Campaign.
These exclusions, the kind which are costing me tens of thousands of dollars and which put treatment out of reach for much of my community, should be eliminated.
Clarification #3: "It's a shame that you've limited the challenge criteria. Its ironic that someone looking for equality accross medical/insurance spectrum would exclude challenges based on demographic criteria."
I do not believe that your analogy is apt but I'm okay with eliminating the challenge criteria. I put it in because last time I raised the topic a poster went one round and dropped out. I did not want a repeat. In any event, I have eliminated the challenge limitation. Have at it if you wish.
According to the American Psychiatric Association,
1.Sex: "Generally assigned at birth by external genital appearance, due to the common assumption that this represents chromosomal or internal anatomic status."
2.Gender: "Increasingly, the term gender is being accepted to define psychophysiologic processes involved in identity and social roles. Therefore, it is not uncommon to hear references to "gender" by professionals from numerous disciplines, including medicine, psychology, anthropology, and social science."
a.Gender identity: "An individual"s internal sense of being male, female, or something else." NCTE.
b.Gender dysphoria: "A condition in which there is a marked incongruence between an individual"s sexual and gender identity."
The National Center for Transgender Equality additionally defines:
3.Transgender: "A term for people whose gender identity, expression or behavior is different from those typically associated with their assigned sex at birth. . . . "Trans" is shorthand for transgender." "Trans" is a Latin prefix meaning "across," e.g. "transatlantic." Non-transgender persons are sometimes referred to as "cisgender" or, simply, "cis." "Cis" is a Latin prefix for "on the same side," e.g. "cisatlantic." I prefer not to use the cisgender label because it is confusing and, instead, usually refer to cisgender persons as "non-transgender
a.Transgender Man: "A term for a transgender individual who currently identifies as a man (see also FtM)."
b.Transgender Woman: "A term for a transgender individual who currently identifies as a woman (see also MtF)."
c.Transsexual: "An older term for people whose gender identity is different from their assigned sex at birth and who seek to transition from male to female or female to male. Many do not prefer this term because it is thought to be overly clinical."
d.Crossdresser: "A term for people who dress in clothing traditionally or stereotypically worn by the other sex, but who generally have no intent to live full-time as the other gender. The older term "transvestite" is considered derogatory by many in the United States."
This argument deals with those with Gender Dysphoria as defined above.
Gender Dysphoria ("GD") is recognized by the DSM-V. GD has been studied for over a hundred years and various cultures, even those we like to think of as primitive compared to our own, recognize the existence of this phenomena. Native Americans had their "two-spirited" people and in India the mistreated Hijra. A 2011 Williams Institute study from UCLA found that .3% of the United States population self-identify as transgender. The actual number may be closer to 1%. Many of these individuals may not have dysphoria or require treatment, e.g. the cross-dressers.
Reality for a transgender person with GD is markedly different than most people. According to the American Academy of Pediatrics, a ". . . child's awareness of being a boy or a girl starts in the first year of life. It often begins by eight to ten months of age, when youngsters typically discover their genitals. Then, between one and two years old, children become conscious of physical differences between boys and girls; before their third birthday they are easily able to label themselves as either a boy or a girl as they acquire a strong concept of self. By age four, children's gender identity is stable, and they know they will always be a boy or a girl."
The APA has long recognized the condition. WPATH has promulgated standards of care which are flexible and do not always result in surgery. The American Medical Association has approved WPATH"s standards of care.
Even transgender persons who have insurance are faced with both the hurdle of preexisting conditions and of systematic exclusions which have been upheld in court. The Affordable Care Act will, in large part, address the former but the exclusions remain an iron wall to treatment. Currently, only six states offer trans health care as part of the insurance exchanges under the Affordable Care Act.
Without treatment life is miserable for this population. The suicide attempt suicide rate is ten times the national average at 41%. Virtually all have suicidal ideations in despair of ever finding a path forward. 200% higher unemployment, 41% attempt suicide, 4x more likely to live in with less than $10k in household income, and a growing number of trans young people are resorting to the sex trade to get some forms of treatment. The Hormone Replacement Therapy they get is often black market creating risks for both Transmen and Transwomen. Violence is often directed towards this population which could be avoided if the participants were more physically matched with their self-identity. Just last month, four transwomen were killed three identified as homicides and one as "suspicious." The earlier corrective hormones can be taken, the better in this regard.
Faced with discrimination and poverty, homelessness is rampant. Without any chance of affording treatment, suicide often is considered in lieu of living an inauthentic life. Even those who are older often have difficulty raising the money for this care. They settle into situations which grind at them on a daily basis instead of finally turning off the blaring dysphoric pain which comes with GD.
I will not attack a strawman as to the historical basis for these exclusions which have now been disproved. Suffice it to say that the WPATH Standards of Care provide concrete, reasonable and necessary care for a condition recognized by the APA, AMA and WPATH. There is no basis for denying coverage uniquely to this disadvantaged population.
The harm to those with GD is obvious. Current policy also harms society as a whole which (i) must deal with uninsured transgender people who get no insurance rather than pay for insurance which does not cover their most pressing need, (ii) discourages people from living authentic lives, (iii) sends a message to those who victimize transgender and gender non-conforming individuals that this minority is not legitimate, and (iv) sends a message of conformity to our young people rather than finding value in the unfolding exquisite complexity of the human condition.
Summary: An impoverished, at risk, minority is being discriminated against to their great detriment by the denial of insurance for a recognized medical condition for no good reason. I affirm this resolution.
How is it any different if a person felt like they were supposed to be a different skin color? Should medical interventions to make a person's skin lighter or darker be provided in order to help someone feel more secure about the matching of their identity and their body.
Because we live in a material universe it necessarily follows that even if scientists haven't discovered what it is that there would be psychophysiological differences in the brains of people who feel like they should have a different skin color just like you'd find for someone who wants to be a different gender.
For a more realistic analogy people often feel that body weight, pimples, lack of muscles, their nose size, etc... are incongruent with their identities. These feelings of discomfort are also physical things in people's brains. Shall insurance companies be required to cover every single thing that a person wants modified to be more close to how they identify? If gender identity disorder is recognized then there is no discernible reason not to recognize all of these other identity-body mismatches as being treatable disorders as well. Many of these things may even go back to early childhood. Quite early a person may associate a certain nose size with certain personality characteristics passively through observation and then they may grow up wanting their nose to be different. Usually they adjust and realize they can still be who they are even with the nose they have. Some choose to get nose jobs. That's a fine choice but insurance shouldn't have to cover it.
I'm all for people having the right to pay their own money for a sex change operation, for a nose job, or even to change their skin color. In fact I think approval should be easier. But use your own money. This is something you want not something you need. Plenty of people who want to have the body of the opposite sex live their day to day lives without surgery or hormones and function fine. They would be happier if they got an operation sure but so would many people be happier if they were to change other aspects of their bodies.
==The Effects of Language on the Brain and Neuroplasticity; And Evidence Gender Identity Can Change==
Given the ubiquity of gender terms in human conversation it's not surprising that children get into the conversation both inside their heads and when talking to others. In the course of this it's no wonder a small number wind up producing sentences like "I am a boy" or "I am a girl" when it doesn't match their physical form.
This does not mean they were born transgender. It is quite possible that the use of language and one's everyday identifications with various objects and concepts may shape the brain in one way or another. Language is afterall physical and so are our thoughts in response to it. All social interaction is a physical process. Hence physical differences in the brain do not prove that social interaction did not have a great deal of effect on the outcome. Children could passively pick up that "boy" and "Girl", the words are associated both with certain types of bodies and certain personality traits. They then may think that they should have a certain type of body just because they match certain personality traits. This may happen passively, subtlety just like how a child may want a certain looking nose from similar influences.
Science shows that talk therapy for depression causes changes in brain chemistry. Hence language effecting the brain.
The brain can change. This is known as neuroplasticity.
Also there are transsexuals who later regret having surgery.
Even when they thought of themselves as the opposite sex since childhood later after the surgery they found it to have been a mistake and wanted to go back the way they were.
Clearly this indicates that's one's gender identity can change. That it has fluidity. I am not saying you should have to change. If you have the money for it and want to transition it should be your choice. It is your body. But since you could change that's less of a reason why insurance should cover it.
And I know you can't change by snapping your fingers, but neither can someone who for instance has poor body image. A fat person who hates being fat can't just suddenly make themselves feel good about being fat but they can start trying, tell themselves good things about being fat, and over time change how they feel about their body and even grow to love being fat.
I know that if I woke up tomorrow and I was a woman and if it was cost prohibitive for me to transition back into being a man (and absent being filthy rich it would be, I can think of so many things that are more important to me than what gender I am) I would get used to it. I would think of ways in which having female parts was good and in time would come to enjoy being a girl. I would probably be a very butch tomboyish girl but I'd still learn to love being a girl.
Con does not dispute the miserable impacts of GD if left untreated. He finds anecdotal evidence of some people who have regretted transition. This is a fraction of the total who transition and Con does not even claim that the number of those who regret transition outweighs those who benefit. For example, a 2002 paper in the International Journal of Transgenderism citing a 1992 study, observed that "the incidence of postoperative regret is generally extremely low...less than 1% in female-to-males and 1"1.5% in male-to-females." Even if a contrary study is presented, we need to know the cause of the regret. It may be that society treats trans people so shabbily, e.g. by denying insurance exclusions, that this fosters regret. They may regret the $20k-$80k in debt they had to take to get the work done.
In any event, certainly WPATH, AMA and the APA based on the latest data agree that treatment, including surgery, is effective in treating dysphoria. The web site provided by Con on this issue is a hack advocacy rag. I give the leading medical and physiological organizations along with the entity which puts more study into this issue than any other.
Con gives you a web site which is obviously slanted and gives no mention to the credentials of those who put together these anecdotes. The author does not even know the proper terminology, calling us "transgenders." There are few source materials to back up the claims. Anonymous posts pepper the site. In fact, the person providing these "facts" admits his own extreme bias, saying he has regret for his operation. Maybe he had an operation or maybe he didn"t.
As another example, one study (i) is dated, (ii) contravenes current medical views as evidenced by the recent scientific data submitted to Medicare and (iii) the authors admit, their "researchers lost track of more than half of the participants." The bias of the researcher was illustrated by his excuse for losing his research subjects: "Dr Hyde said the high drop out rate could reflect high levels of dissatisfaction or even suicide among post-operative transsexuals." No evidence just an excuse with a baseless assumption that surgeries cause suicide. Not very credible, certainly not when compared to the organizations who with the most recent evidence are lining up to support the coverage of transition related care.
Even if a small minority regret the transition, that is a challenge to counselors to do a better job in their diagnosis, not to ban treatment for all. I once had heart surgery due to a congenital defect. If I had stroked out on the table, I would have regretted the surgery. This does not prove that heart surgery is not indicated or, more importantly, should not have been covered by my insurance.
Con asks, "How is it any different if a person felt like they were supposed to be a different skin color?" Allow me to answer that question, although the answer should be obvious by now.
There is no medical diagnosis of Skin Color Dysphoria ("SKD"). There is no etiology as to how Skin Color Dysphoria might come to exist. I provided a study from UCLA"s William Institute from 2011 showing that .3% of the U.S. population self identifies as trans. This is just the number of those who are out to themselves and willing to identify themselves as trans in a survey. Even using this most conservative number, we are talking about roughly a million Americans.
The differences between GD and SCD are:
1. GD exists whereas SCD does not.
2.GD is a medically recognized condition whereas SCD is not.
3.People with GD suffer increased suicide attempts, violence, discrimination of all kinds and are, generally speaking, impoverished, no such data exists for SCD. Racism causes such things, although not the suicide rates but not the dysphoria between a person"s racial self identity and actual race.
4.Considerable research has been conducted on GD whereas none, that Con cites, has been conducted on SCD. In 1981, when Medicare first provided a National Coverage Determination banning surgery coverage, only nine studies were presented in that hearing. This year, over a hundred studies were considered - the latest science - and Medicare determined that the 1981 National Coverage Determination banning surgical coverage should be reversed. No such research exists for SCD because SCD does not exist
Con"s other examples " body weight, pimples, lack of muscles " (i) trivializes the suffering of transgender persons and (ii) fails to provide the weight of authority to back up that any of these conditions come with an adverse dysphoric impact. Do people really believe in their deepest recesses that they were meant to have pimples. I quoted the American Pediatrics Association which shows how gender identity forms from ages 1-4. Does Con provide any similar causation mechanism for pimple dysphoria? Con fails to consider that treatment for pimples is covered by most insurance policies.
I know this is getting silly but that is Con's analogy taken to its absurd conclusion.
I cited several adverse impacts to society in addition to those of the person suffering with GD. Just one example is that Transgender people may forgo insurance at all if they do not get their primary need (and it is THE primary need) met with insurance. Other societal impacts were ignored by Con.
There is a basic point of fairness raised by Con. Why should he have to pay for my gender confirmation surgery? Why should I have to pay for a person who needs counseling for a variety of conditions in the DSM-V? This argument proves too much and ignores the dire need I proved in the opening post.
Con does not argue that on balance providing coverage would increase premiums. Had he made such an argument, there is plenty of counter evidence. His argument seems to be "it"s just not fair" that he has to pay for correction of a recognized condition whereas I don"t pay for to help insurance to pay for a teenager to get rid of pimples (even though I really do).
As Con says plenty of people with GD do live without treatment. This manifests in the impacts on my community which I described and which Con does not bother to dispute. His own advocacy web page source accepts the 41% suicide figure.
At the end of his argument, Con finally makes a half hearted attempt to deny the existence of transgenderism or GD. He says that the brain has a condition called neuroplasticity. He cites to examples dealing with depression. What he doesn"t do, except for the non-credible site to anecdotal evidence of surgery regret, is provide information or studies re transgenderism. The American Pediatrics Association says Gender Identity is fixed at age four but this doesn"t mean that gender expression cannot change as children experiment. Con confuses gender identity with malleable gender expressions.
Con"s confident statement that if he were suddenly morphed into a woman, he would "just get used to it" is easy to say when he has not experienced this mental state. Would Con embrace his new gender identity? I doubt most non-TG men or women would be so sanguine. Would con "just get used to it" by conforming to female roles, wearing dresses, conforming to societal expectations? People with GD are pushed in childhood to conform to the roles of their biological sex. Even if Con were able to magically become a female, this is not analogous to a person who has felt dysphoric since the age of 3 or 4.
The "just get used to it" approach has led to many harms. Con's "just get used to it" position should be rejected.
Literally every minor variation in human thought and behavior is based on physical events in the brain. Yet often this is all they point to as justification for including something in the DSM. This shows that categorizations are primarily political-based, or based on what scientists are able to get funding for in order to examine. If Gender Identity Disorder is to be considered a valid diagnosis so should Skin Color Dysphoria and so should basically any type of Body Dysphoria since it's bound to have some physical correlation in the brain because this is a material universe and nothing of the mind or how we feel happens without something physical in the brain. This would overtax the insurance companies, so a better solution is to just regard all this as someone wanting their body to look different, give them the right to go through with it if they wish, but make them pay with their own money just the same as if you were getting a tattoo.
As to surgery being effective in treating dysphoria I'm sure it would also be extremely effective in treating a person's "dysphoria" or feeling bad about the way it is in relation to other aspects of bodily appearance.
Since Obamacare's mandate you can't forgo insurance so this point is moot.
==Coverage for Pimples==
If the insurance companies want to cover pimples, tummytucks, or even sex changes that should be up to them. There are things necessary in order to stay alive and have one's body be in good physical condition and there are things a person may want for their body. A distinction has to be made. A line has to be drawn, or else the day will come every manner of plastic surgery is required to be covered by insurance and is considered its own disorder.
==Fixed Gender Identity doesn't even make sense==
I could easily change any of my identities just by doing it. I could decide from now on to introduce myself as a black man, I could decide from now on to introduce myself as a hyena. More realistically I could change my identity and introduce myself as an expert on fashion which could either be counterproductive if I don't actually have the knowledge and I get called out on it or could be justified if I had actually learned about it. I could introduce myself as a "proud resident of such and such a city" and tomorrow I could change the identity to "I hate living in such and such a city".
Likewise I could tomorrow just decide to start identifying as "female". Given that I have a male body and have no plans to surgically alter myself it wouldn't make any sense, but I could do it.
==Men and Women Can Do What ever We Want, No Need to Conform==
A person can identify as "female" without having to wear dresses, lipstick, or to generally conform to gender expectations. What about a woman with a butch haircut, who wears clothes from the men's aisle, and has generally stereotypically masculine interests BUT who considers herself "female". Are you going to go to her and say that she is wrong, that because of her behavior she must really be a man deep down and that she should get treatment for "gender dysphoria".
That's the problem with the whole idea of gender identity it promotes gender essentialism and rigid gender roles. Why not just stay in the body you have but behave the way that you want?
If people were allowed to do as they want with their bodies then the whole diagnosis of "gender dysphoria" probably would've never came to be, because it would've been politically unnecessary. It was pushed as a 'valid' diagnosis so people would even be allowed to get the surgery. I support the right of people to have their bodies molded as they please. It is your body and it should belong to you, not to the state. But it doesn't mean you have a disorder, you have a preference for how you want your body to look. That they find brain correlations means nothing because every preference people have has brain correlations or they wouldn't have the preference.
==One last thing==
Pro brings up that transsexuals are pushed into conforming to gender norms as children. I bet this reflects her experience and the experience of other transsexuals. And I bet this has to do with wanting to transition. If you naturally tend to have behavioral and personality traits of the opposite sex and you are taught that those are only appropriate for the opposite sex then it makes sense you might come to think you should be the opposite sex. Perhaps in an environment with no gender norms, no expectations based upon gender we would see transsexuality disappear or at least greatly shrink.
It's interesting that you never hear about transsexuals who act like their birth gender but just wanted to have the body of the opposite sex so they could be a non-conforming member of the opposite sex. If transsexuality were really independent of wanting to transition just to be seen as conforming to gender norms then you'd expect there to be plenty of examples of gender nonconforming (after the transition) transsexuals. And I mean to the point where they'd be considered conformist if they had stayed in their original sex.
It is quite possible, if not likely that what gets set by age 4 is most of our personality traits and only because society largely preaches gender norms to children does this then turn into a "gender identity".
Regarding the DSM, transsexuals have been covered since the DSM-III. This is not a new condition which is added due to any political pressure. Con intimates politics were involved but provides no proof. Con suggests that everything gets in the DSM but I sure do not see any reference to pimple dysphoria. If you have even read through the table of contents, it is a well thought out and organized document.
Con"s says being transgender is a "minor variant in human thought and behavior." Note how Con does not go back to saying he would be okay with having his gender flipped or that this would be the normal human response. Con likewise ignores that this dysphoria is occurring to children at their most vulnerable and ignores the statistics provided re suicide, discrimination, etc.
The notion that gender identity is a "minor variant in human thought" is not true. Cultural expectations are shaped by gender but, wishing you would wake up female every night as a kid, is no small thing. Con shows his unfamiliarity with the issue at best or, worse, an inability to empathize with kids in a confusing and terrible situation.
If a child does not receive support for being transgender or, worse, gets slapped down when he or she works does express her true identity, then every action has to be scrutinized before being expressed. Even more damaging, such a person can get quite good at fictionalizing herself and, at times, overcompensates. If you read Kristen Beck"s book, Warrior Princess, you will learn of a Navy Seal who did everything "he" could to fit in but the dysphoria never went away. Finally, after a distinguished career, Kristen is at peace.
This is the type of internal struggle which has led 41% of us to attempt suicide. Imagine looking at a girl when you are a teenager and thinking, "I want her almost as much as I want to be her." Without support, how is a teen to process these feelings. Many don"t.
Con finally raises the issue of cost of coverage. This is a bit late in the debate and again Con gives no support for his position. The Williams Institute at UCLA studied 34 employers who provided transition related coverage in their insurance plans. The study concluded, "overall, we find that transition-related health care benefits have zero or very low costs, have low utilization by employees, and yet can provide benefits for employers and employees alike." The utilization rate for employers with 10,000-50,000 employees was .005%. http://williamsinstitute.law.ucla.edu... Factor against these small costs the increased productivity of happier people, the reduced pain from not having suicidal ideations and the productivity of the people who do commit suicide, and any humane cost/benefit analysis will mandate coverage.
Con presents a slippery slope argument that if we cover trans benefits we have to cover pimple dysphoria. This is a strange argument without any support. It took over thirty years for Medicare to change its own position on coverage " 1981 to this year. Medicare looked at the most recent research from over 100 studies. If these non-existent conditions described by Con were analogous, e.g. Pimple Dysphoria (I can"t believe we are really arguing if this is analogous), then it will take many years and organized efforts to get movement on those issues.
Con says we should use our own money ignoring that this is an impoverished group which either (i) is already paying for insurance which sucks down money we could use for surgery or (ii) takes the penalty for not having coverage. Con says no one will forgo insurance but I know many in my community who don"t, particularly the young. The penalty is not greater than the premium they would have to pay and they want the premium for their trans health issues.
I do not understand this sentence of Con: "As to surgery being effective in treating dysphoria I'm sure it would also be extremely effective in treating a person's "dysphoria" or feeling bad about the way it is in relation to other aspects of bodily appearance." If explained, I will be happy to respond.
Con talks about line drawing but the lines he draws are without basis. He compares non-existent dysphoric conditions to Gender Dysphoria. Honestly, I do not know why this argument is being made.
Con argues that "fixed gender identity does not make sense." Con confuses sex and gender as I defined the terms in the opening. You can change your sex to be the same as or even different from your gender identity. So what? Please remember Con accepted my definition of gender identity as "an individual's internal sense of being male, female, or something else." Con indicates the sex can be externally changed which has nothing to do with changing Gender Identity.
Con raises another entirely new argument. He claims, "Men and Women Can Do Whatever We Want, No Need to Conform." We can pretend we have no gender identity but most do. Those who do not have a gender identity or believe their gender identity is fluid will probably be among the 99.995% of insured people who would not use this coverage.
The problem is that without funds we cannot "do whatever we want" or, to be accurate, need. For those who go through the WPATH standards of care, they are doing exactly what they want to do. They are gender non-conforming; therefore I am mystified as to how Con can claim being trans and wanting your body to conform with your internal Gender Identity is an act of conformity to society. We are conforming to our own internal sense of self. When I grew up in an Oklahoma town of 4,000, nothing whatsoever was pushing me to "conform" to be a girl. I, however, always knew my gender identity. Trust me on this one.
Con makes more assertions , e.g. that gender dysphoria was pushed for political reasons. Although we are more vocal now, we have not been a potent political force as evidenced by the exclusions which existed even in Medicare as far back as 1981. Con needs to supply some proof .
In Con"s "one last thing" argument, Con bets my statement about gender being pushed on kids flow from my own childhood experience. True, that but then Con then makes a wild unproven leap: He thinks my belief when I was 3-4 years old that I was meant to be a girl flows from being forced to act as a boy. Con then speculates that if we had no gender norms, transsexuality might disappear or at least greatly shrink.
Con has zilch for authority on this point and would deny coverage on the grounds that society as a whole needs to do something which it shows no sign of doing, i.e. eliminate gender itself. In short, without providing any qualifications for himself, or citing any other person, Con rejects the American Pediatric Association, APA, AMA and WPATH.
His social experiment of eliminating gender expectations, (kind of a counterplan) while nice, does not help those of us who have had our gender identity set, for whatever reason, in a manner inconsistent with our sex. The counterplan would only have prospective impact and, if effective, would further reduce the cost of providing coverage.
All Con does with this argument is propose a different mechanism for the cause of gender dysphoria. This is not an argument against coverage.
Con argues that transsexuals should not conform with their gender identities. We have varied ways of expressing but Con does not explain why he expects us to deny our identities after transition as we express.
Perhaps the pimple analogy was not the best analogy. Still in a world where there were only one kind of transsexual say mtf would pro be arguing that that invalidates gender dysphoria? Furthermore I gave plenty of other analogies such as weight. There are people who want to be fat. If they can't afford enough food to be fat but have enough to live should they get their medical insurance to buy them extra food? For hair color should hair dye be covered as a medical expense?
"Con intimates politics were involved but provides no proof. Con suggests that everything gets in the DSM but I sure do not see any reference to pimple dysphoria."
The evidence is that they try to justify putting it in there on the grounds of "it"s a brain condition" but if you want to get technical so is every variation minor or major in human thought or behavior. So why aren"t the other variations considered treatable medical conditions when they obviously are physically different in their brains in some way? We live in a material Universe so any and all variations in human thought, human behavior, human personality must come with brain differences. Picking which ones are medical conditions and which ones are not is completely arbitrary. They just make it sound scientific by selectively carrying out studies that show brain correlations and not bothering to mention that every single variation must have its own correlations. They even apply double standards. For instance introversion shows brain differences but it"s not considered a treatable disorder. It would be easy to argue that introversion causes distress or functional impairment i.e. reduced chances at climbing the social ladder as effectively. One could also make that argument for extraversion i.e. some people are so extraverted it gets annoying. The people who write the DSM pick and choose what to consider a disorder arbitrarily, they are not reliable.
"Con"s says being transgender is a "minor variant in human thought and behavior.""
You misread. I didn"t say that it was a minor variant I said that every minor variant in human thought and behavior must have brain correlations just in order to exist.
"Note how Con does not go back to saying he would be okay with having his gender flipped or that this would be the normal human response."
I admit I would not prefer it. Menstrual cycles and pregnancy sound terrible. But I"d adjust. I wouldn"t get a sex change operation back to male unless I was really rich. I see no difference between that preference and my preference that I have more muscles. I would not think either way that I had some right to demand insurance companies pay for it.
"Con likewise ignores that this dysphoria is occurring to children at their most vulnerable and ignores the statistics provided re suicide, discrimination, etc."
Then to be consistent if there was ever a case of a child saying "I"m supposed to be black" when the child is born with white skin and the child suffers suicidal thoughts and discrimination we should say that at least in this child"s case there is a real disorder and the child should get treatment to darken their skin and it should be covered by insurance.
"If a child does not receive support for being transgender or, worse, gets slapped down when he or she works does express her true identity, then every action has to be scrutinized before being expressed."
Scrutinizing every action before expressing them is a choice. And besides that I used to do that, does that mean I"m transsexual? When I was a kid I went through a phase of worrying excessively about being seen as a "sissy". I grew out of it. Why do we always hear about transgender people scrutinizing and trying to conform but never about someone who never tried to conform to gender expectations who then wants to transition? It seems like a sex change operation may be a way to make up for your regret of wasting so much time trying to conform to society"s expectations.
"This is the type of internal struggle which has led 41% of us to attempt suicide. Imagine looking at a girl when you are a teenager and thinking, "I want her almost as much as I want to be her." Without support, how is a teen to process these feelings. Many don"t."
I"ve looked at guys and girls and thought "I"d love to be that person" just as I"ve looked at black people and white people and thought the same thing. Doesn"t mean I want all their exact physical traits.
"I do not understand this sentence of Con: "As to surgery being effective in treating dysphoria I'm sure it would also be extremely effective in treating a person's "dysphoria" or feeling bad about the way it is in relation to other aspects of bodily appearance." If explained, I will be happy to respond."
I mean that if surgery to change gender is effective in making someone who wants to be another gender feel better then it should apply to all other aspects of physical appearance. If I want an extra arm insurance should cover it.
"Con talks about line drawing but the lines he draws are without basis. He compares non-existent dysphoric conditions to Gender Dysphoria."
So according to Pro gender dysphoria didn"t exist before it became an official diagnosis.
"Please remember Con accepted my definition of gender identity as "an individual's internal sense of being male, female, or something else." Con indicates the sex can be externally changed which has nothing to do with changing Gender Identity."
Internal means the mind. Changing things in one"s mind is easy. Just use different words. Just say "I am a boy" or "I am a girl". It"s easy.
"Men and Women Can Do Whatever We Want, No Need to Conform." We can pretend we have no gender identity but most do. Those who do not have a gender identity or believe their gender identity is fluid will probably be among the 99.995% of insured people who would not use this coverage."
I wasn"t talking about having no gender identity. I identify as male because I have male parts. However I don"t consider me being male to obligate me to anything. It"s just a physical characteristic. That Pro thinks this means I have no gender identity implicitly prescribes the belief that there are proper behaviors for men and for women and if you don"t care about them it means you"re not really a man or really a woman. This is absurd.
"I am mystified as to how Con can claim being trans and wanting your body to conform with your internal Gender Identity is an act of conformity to society."
You are changing your body so that society will be more pleased with how it lines up with your personality and behavior. That"s how it"s conformity.
"nothing whatsoever was pushing me to "conform" to be a girl."
Your personality naturally matched what was expected of a girl so you subconsciously learned to think of yourself as "girl" and only later learned that "girl" meant having certain parts and rather than change your deeply ingrained personality you decided your body was wrong. Others may have had other reactions. For instance another person in your shoes may have just thought of himself as a "boy" who liked acting girly. Because you wanted so badly to fit in you instead insisted you actually were a girl since if you were a girl then you"d fit in.
In conclusion, there is no reason to accord the neurological preference of wanting to be another gender any more rights than having a neurologically-based preference of wanting other body differences i.e. a different weight, different skin color and they must be neurological because all thought and behavior is based on neurology.
Having insurance cover it may push the expectation upon people that if they behave a certain way they should get a sex change operation.
If people want to change their gender let them do that and let them pay for it.
1 votes has been placed for this debate.
Vote Placed by bladerunner060 2 years ago
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Reasons for voting decision: Pro's argument rested on GD being a recognized mental disorder. Con attempted to undermine the DSM, but I don't think Con succeeded in doing so. Con also tried to make a "slippery slope" argument, but as the attacks on the DSM failed (not that the DSM is perfect, by any stretch), Pro wins for referencing a "real" condition. Con would have done better if he could have found a real condition, as well, that he could have tried to appeal to ridiculousness for. He might still have not succeeded, but failing to do so hurt his case significantly. Pro had a real condition noted by the "official" book of the field. Arguments to Pro. Everything else seemed equal enough. As always, happy to clarify this RFD.
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