LogFAQs > #886036215

Callixtus posted...

Do you really think there are no values being promoted in medicine?

Overarchingly sure. You bring up a great point about how changing societal values reflect in different classifications of mental illness.

But I guess I was speaking more on an individual level of medical ethics in that patient autonomy is more important. A physician is trained not to impart their values in terms of treatment options. They only help the patient make an informed choice with regards to risks/benefits.

So theoretically if a treatment came out that "fixed" someone's gender identity, we've already reached a point societally where advocating for that treatment on the basis of an idea that's the "right" way is imparting a value. A physician might advocate for that treatment if the literature later supports better outcomes, but it would be purely from that basis, not a desire to "fix" it as a disease process when society has said otherwise. Because then it could open up an ethical can of worms with regards to future developments in other behavioral modification. If we could alter one's temperament, should we cure all introverts to become extroverted? The way one would classify transgenderism as a disease process could very well just as easily say the same with regards to introvertedness.

That is actually a big issue in mental illness. Where do you define normal? Our current answer is harmful dysfunction. We treat depression because it affects one's quality of life or impairs their work/relationships. We treat OCD because it affects quality of life or impairs their work/relationships. Insofar as someone isn't bothered by their introvertedness, it isn't any more fair to classify that as mentally ill as it is transgendered if they aren't bothered by it. But when they are, the idea is to provide as much restoration to occupational function or alleviating distress. In the case of someone who claims they identify as another gender, hormone replacement (as long as they are informed of risk/benefit) seems like a perfectly viable treatment option in light of not having definite answers as to the underlying neuroanatomy/physiology or "pathophysiology" of it.

I don't doubt a subset would choose a treatment to be congruent with their birthsex if that were an option. Maybe that will be developed down the line. But until then, the social issue of accepting someone going through something like that seems paramount and the way people treat transgenders now seems needless cruel all for what in my head is a very pedantic argument.
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"He has two neurons held together by a spirochete."