this post was submitted on 26 May 2024
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[–] [email protected] 171 points 6 months ago (1 children)

According to the New Zealand not-for-profit Gender Minorities Aotearoa, the wait time for bottom surgery in the public health system is 10 to 12 years.

Holy shit, that's a long wait time.

[–] [email protected] 75 points 6 months ago* (last edited 6 months ago) (1 children)

That’s cruel. There are more doctors that are qualified and willing to perform these procedures and I would argue that it’s the ethical responsibility of the public health system to do whatever it takes to utilize these doctors.

[–] [email protected] 55 points 6 months ago (6 children)

Tbh I'm always amazed by how trans care is so... whacky.

Like, the US is becoming more and more hostile towards trans people (especially trans women), and US healthcare means gender affirming care can be very expensive (especially surgery-related stuff). On the other hand, adults in the US can typically start HRT within a week of seeing a doctor because the US allows for informed consent; you see a doctor, request hrt, they inform you of the risks and effects, and if you consent, you can begin HRT. Then, if you have the money or really good insurance, you could be """finished""" transitioning (be on hrt and have gender-affirming surguries done) within a year or two. You probably still won't pass because I've been told it can take years for HRT to fully feminize/masculinize you, but at that point the only thing left is waiting for your body to do its thing.

Then you have Canada and European countries, where, based on what I've seen, they tend to be more accepting of trans people and trans care tends to be covered by the government (or so I've heard). However, they have all kinds of waiting periods, from being forced to wait several years to ensure you're "truly trans", waiting again to see if your surgery is approved, waiting again for an opening, waiting again because the doctor decided to take the week of your surgery off to go on vacation, etc.

Then you have Australia and New Zealand where you're forced to wait and there's no guarantee the government will cover the medical costs of transitioning.

Why is this so hard?

Why can't people get their shit together so it doesn't take a decade or more for someone to finish transitioning?

Considering the symptoms and side effects of gender dysphoria, it's unlikely someone suffering from gender dysphoria will be functioning at maximum efficiency. As such, while it might appear more expensive on paper, it seems like the impact of prioritizing gender affirming care (similar to how I assume people with cancer and disabilities are prioritized) would be cheaper long-term. The faster you get them care, the sooner they can start working at their maximum potential; and the sooner they start working at their maximum potential, the larger the benefit they can provide to society.

[–] [email protected] 20 points 6 months ago (1 children)

You've also got to remember the US health system is user pays, but most of the NZ health system is free.

The US system is faster because patients are customers... well insurance is but you get the idea. Ours if free, but prioritised by the needs of the whole. If you go private in NZ you have similar or better wait times.

[–] [email protected] 8 points 6 months ago

10-12 years is a long wait time, even for triage.

[–] [email protected] 19 points 6 months ago (1 children)

Medical gatekeeping is also very much a problem. I started petitioning for bottom surgery 6 years before I was actually able to get it. Not because of any wait list or qualifications or anything like that. Purely because my doctor and my counselor thought I wasn't ready. Getting a new doctor here (Eastern Canada) takes close to a decade. So I had to wait till they decided I was ready. I was repeatedly told that my poor mental health made it so I couldn't get surgery. My mental health never magically got better. They just eventually changed their minds and gave me referrals. Having bottom surgery saved my life and dramatically improved my mental health. I spent 6 years in abject misery when I could've gotten the surgery to begin with and spent that much more time happy and moving forward with my life.

I'm very happy to have had it and I for once in my life see a future for myself and a life that is worth living. But there is definitely a bitterness about the way that multiple health professionals all seemingly misunderstood that my anatomy was a significant contributor to my poor mental health.

[–] [email protected] 9 points 6 months ago (1 children)

That's the real issue isn't it. In an informed consent system if your GP is a transphobe or clueless or ill trained then they can deny you care based on moon logic. Theres similar issues with sterilization on all fronts. It's rarer for vasectomies but still happens depending on where you are for the most part. You have to beg for sterilization because anything under the age of 40 is like " you're too young - you might regret it. So I, a person who doesn't even know you personally will tell you what is best for your situation and you're going to have to live with it because I hold the power over your bodily autonomy in my hands."

Like dude, I'll sign a waiver. It's not your lookout whether I'll regret it or whatever - just stay in your lane and do your bloody job. Made me angry enough I could have bent rebar between my teeth with how hard my jaw was clenched.

[–] [email protected] 5 points 6 months ago

Like those are the practical arguments for informed consent, but I just keep coming back to a different reason: because it’s my body and that makes it my choice and my consequences.

[–] [email protected] 10 points 6 months ago

A thing that is really frustrating about a lot of health care providers is they insist on using outdated "best practice" blood levels for trans fem HRT which puts our estradiol levels significantly lower than cis women.

Im lucky that I have a dr in cali who is good and insists on me having proper estradiol levels but in the past they were significantly lower with other doctors. And I can absolutely tell the difference I feel so much better with my current levels and physically the effects are noticable as well.

[–] [email protected] 6 points 6 months ago* (last edited 6 months ago)

Then you have Australia and New Zealand where you're forced to wait and there's no guarantee the government will cover the medical costs of transitioning.

To clarify, in Australia, you're forced to wait for surgery, and the government won't cover it. But HRT is more accessible, and covered under our public healthcare system, so once you've got your prescription, it's cheap to access.

[–] [email protected] 4 points 6 months ago (2 children)

Just to add, although the US allows informed consent for adults, some of us are still required to do a certain number of months in therapy and/or provide letters from mental health professionals before we can access hrt or surgery, because that's what some health insurance companies require. Even then, ofc, the option does exist to do informed consent and pay out of pocket.

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[–] [email protected] 4 points 6 months ago* (last edited 6 months ago) (1 children)

the cruelty is usually the point. It's not like there's an excuse, certainly not one that can be taken seriously.

[–] [email protected] 6 points 6 months ago* (last edited 6 months ago)

Yeah. Trans people and most of the major medical organizations have been presenting mountains of research and scientific fact to the ignorant and intolerant for decades, and we still have millions of people and most governments who willfully ignore it and oppose it because they have closed off their minds and fear and hate that which is different from them.

[–] [email protected] 82 points 6 months ago (2 children)

My 13-year-old daughter's best friend is trans. His parents will not give him any sort of puberty blockers or hormones, but they do let him use a chest binder, which must be quite uncomfortable. They accept that he is trans and do not deadname him, but won't go any further than that.

He has a lot of psychological issues.

I worry about him a lot.

[–] [email protected] 46 points 6 months ago (2 children)

Sounds a lot like they're hoping it's a phase and will "work itself out".

My oldest is NB, they're 15. I like to think we're about as open-minded as it gets, but I still had the thought that it might be something brought about by seeing people they look up to being a certain way and not from internal, intrinsic reasons.

I hope your daughter's friend ends up ok. If nothing else then knowing there are people out there that think of him might help with feeling isolated and misunderstood.

[–] [email protected] 35 points 6 months ago (2 children)

That's definitely a possibility. I only met his mom once and only for a second, but they seem supportive enough to spend money on boys clothes for him.

I'm more worried about how he's treated in school- they deadname him (and his parents have told the school not to), they make him use the girls' bathroom and locker room, and once a girl was being bigoted, he slapped her for it, and only he got punished.

We took my daughter out of that school and put her in online school because she was bullied so badly it was giving her major psychological issues and she is cis, so I can't imagine how bad he has it. I do know that at 13, he's already vaping and smoking weed. And he cuts himself. If I could, I would take him out of that school and drive him to my house every day to do online school with my daughter.

[–] [email protected] 5 points 6 months ago (1 children)

and once a girl was being bigoted, he slapped her for it, and only he got punished.

Oh so they are capable of treating him like a guy.

[–] [email protected] 5 points 6 months ago

Of course. Trans people are their true gender when it suits the bigots.

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[–] [email protected] 9 points 6 months ago (1 children)

I still had the thought that it might be something brought about by seeing people they look up to being a certain way and not from internal, intrinsic reasons.

Funnily enough, that's very similar to the thought process I had regarding masculinity when I came out to myself as non-binary.

Thanks for supporting your kid.

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[–] [email protected] 16 points 6 months ago (1 children)

I wore chest binders for like 4 years. They're not bad. It's a great way to present masculine while deciding if you want to make a move that will dramatically change the course of your life.

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[–] [email protected] 82 points 6 months ago (2 children)

This guy wasn’t necessarily denied care but similar things could happen with bans in the US

[–] [email protected] 88 points 6 months ago (2 children)

Will happen. The same goes with self-abortions.

And the assholes are okay with that because they’re assholes.

[–] [email protected] 18 points 6 months ago

I feel like calling them “assholes” unfairly defames assholes, but even “murderous fascist monsters” doesn’t adequately convey their sheer, staggering violence and inhumanity.

[–] [email protected] 7 points 6 months ago

They're more than ok with it, they revel in it. This is "god's punishment" or some stupid bronze age bullshit we should've left behind centuries ago.

[–] [email protected] 44 points 6 months ago (4 children)

Facing a long wait for top surgery through New Zealand’s public health care system, a transgender teenager desperate to transition attempted a life-threatening mastectomy on himself.

A lack of funds for private gender-affirming care combined with the “significant psychological stress of having breasts at an upcoming pool party, pushed him to try the surgery himself,”

If you have to wait a year or more for medical care, and you cannot afford to jump the queue by going to a private practice, then I would argue that he is, in fact, being denied care.

Delayed care can absolutely be denied care, even if the delays aren’t intentionally weaponized against the patient.

[–] [email protected] 8 points 6 months ago* (last edited 6 months ago) (1 children)

Sounds like they ultimately found a way to jump the queue.

[–] [email protected] 8 points 6 months ago* (last edited 6 months ago)

Omg the worst loophole. They earned it though.

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[–] [email protected] 75 points 6 months ago (2 children)

A lack of funds for private gender-affirming care combined with the “significant psychological stress of having breasts at an upcoming pool party, pushed him to try the surgery himself,” according to the Journal.

The trans teen prepared for the procedure by watching a how-to video on YouTube, planning ways to control the pain and bleeding, and marking out the incisions to make around his left breast.

Several hours into the home surgery, he began to worry about nerve damage and sought medical attention.

In the hospital, the teen underwent a mental health assessment before surgeons completed the left mastectomy, as well as a “symmetrizing” mastectomy on the right breast.

Doctors noted deep cuts around his entire left breast. He was reportedly released the following day.

According to a post-op report a month later, healthcare providers noted the teen’s improved mood and self-esteem.

Wow, that poor kid. I'm glad it worked out so well for him.

[–] [email protected] 18 points 6 months ago

That was a wild ride, good for him it worked out well in the end!

[–] [email protected] 12 points 6 months ago

Task failed successfully.

[–] [email protected] 66 points 6 months ago

Fucking ouch. That poor mother fucker. I'm glad they didn't die and ultimately got the surgery they wanted but Christ that must have been awful

[–] [email protected] 44 points 6 months ago (1 children)
[–] [email protected] 31 points 6 months ago (1 children)

I mean, it has kind of a happy ending that the ER doctors then went and “finished” the surgery.

[–] [email protected] 45 points 6 months ago (1 children)

Not to mention released the next day, and reportedly in good health and high spirits since. Like, talk about best possible outcome.

[–] [email protected] 10 points 6 months ago (1 children)

The takeaway here seems to be 1. Get started on the surgery yourself, 2. Go to emergency room, 3. Have qualified doctors wrap things up.

^/s

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[–] [email protected] 26 points 6 months ago (9 children)

According to an earlier mental health assessment, doctors said the patient didn’t have any previous psychiatric diagnoses and wasn’t suicidal.

Sounds like a failure of the mental health system as much as the medical system. If you were seeing a mental health professional regularly and you had feelings about self harm, I would hope that this would be addressed before it happened.

[–] [email protected] 25 points 6 months ago (5 children)

Except the people who have feelings like these know they can't express them to their therapist (if they have one) without threat of being put into a hospital that's overpopulated and under staffed to the point that people with suicidal ideations are thrown in with people who have schizophrenia or whatever other disorder to the point you can't sleep because a guy keeps screaming about the demons in his head.

[–] [email protected] 10 points 6 months ago

Yeah people don't understand how bad the MH industry can be. Its why these things shouldn't be gatekept, it should just be available under informed consent.

[–] [email protected] 6 points 6 months ago

Also part of the failure of the mental health system

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[–] [email protected] 11 points 6 months ago (21 children)

It's not exactly a suicidal urge. Growing up trans before it was very commonly discussed I very nearly did this myself but ended up going the route of extreme binding, over exercising and eating disorder to avoid putting on weight that would go to places in the wrong distribution. I was in constant physical discomfort for years.

It's more an extreme anxiety. You don't necessarily want to die but management of that anxiety to self soothe means physical pain is less of a problem than the anxiety. A lot of people trivialize that with trans people. They think "oh it is just looks, it is surely not that important." but how your gender is outwardly read colors every interaction you have with strangers. Not passing means you want to go out and participate in life less. The questions they ask suicidal people won't nessisarily catch that because you are dealing with someone who is waiting to finally break out of that place to actually live... not wanting to die. The problem with framing surgeries as self harm is not realizing that the alternative is self harm. This guy just got pushed past the breaking point waiting for someone else's permission to live.

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[–] [email protected] 15 points 6 months ago

Republicans are erect and salivating.

[–] [email protected] 8 points 6 months ago

Christianity almost killed another one.

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