Should The Nhs Even Be Doing Tg Operations?...

[ToraToraTora]

http://news.sky.com/story/1622257/nhs-failing-transgender-people-report-says
Lot of moaning here but surely the NHS is designed for real medical issues not for those who have decided they want to change sex. If they are that desperate they can pay privately.

[Peter Pedant]

// pixie374
The problem with that, sqad, is there is no way of comparing the suicide rates if it hadn't been done.//

well done - pixie noticed you need a control group to see what happens if you do nothing. a relevant comment in a otherwise pile of garbage. Very very difficult for operations - only two I know of in fifty years. The New England Jouranl managed it last year on menisectomy

Jim's point that you can look at the unoperated group is that there may be a reason for the existence for this group and that therefore they are not comparable to the operated group

Historically you could look at what happened to a group before they started surgery but time considerations lack of data and changes in the society would interfere.

sorry some very very technical points being made here
The last one I made was Ormerod's analysis of psychological gender thro anatomy of gender and intersex in Corbett v Corbett
was SO technical it got scrubbed !

[ and we havent even got into the observation by sqad that some depressed people are so depressed they commit suicide so dont lets treat them in the first place ! ]

oh and while I am at it
mammlynne point about trasuminab and demand and cost

Irinotecan WAS licensed for use ( New England Journal again ) and gave a longer life of 16 weeks of which 12 was spent in hospital. On this data they licensed and use it. I mean God would YOU have irinotecan if it were indicated ? ( liver secondaries ) . I wouldnt.

[Sqad]

Peter! Peter!, your answers often go round and round in circles until you disappear up your own @..e.

The question is "Should the NHS even be doing TG operations on the NHS?

We know that there is an increase in suicide and mental disorders in these unfortunates and after operation, the study came to the conclusion that:

\CONCLUSIONS:
Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.\\

So.......I ask........what is the point of the operation?

Whether they have the operation or treated conservatively, suicide and mental disorders are greater than in the general population.

[jim360]

I disagree with your interpretation of the study, Sqad -- indeed, so far as I could tell, so do the authors, who it seems to me were saying that the GRS operation was not in itself inadequate but couldn't be seen as an answer in isolation, ie that better care was needed before and after any such operation. The higher incidence of suicide was compared not with pre-op transpeople but with the population as a whole. I don't see that this is a valid control group to draw the conclusion that the operation is un-necessary or counterproductive.

In reality I don't think you can say either way, at the moment, as the world isn't really trans-friendly enough. For some trans* people, though, aligning their body with their perceived gender does make a significant positive difference -- and such people shouldn't be restricted from having an operation that can improve their well-being for want of cash. As long as the procedure for assessing the need for such operations remains fairly stringent (ie that a patient has been properly assessed before being operated on) the operation should continue to be available on the NHS.

The most important thing, though, is that we don't define transgender care solely by a single operation. Again, the over-riding message from this study is that the entirety of care needs improving, from counselling and support all the way through to aftercare. Perhaps because the operation is so iconic it has received more focus (from both sides of the debate) than it should have.

[Sqad]

Jim....I agree with the point that you make about TOTAL care for these people but the question was and i repeat...."Should the NHS be doing TG operations", particularly in the climate of financial restraint and i think that the study adds to my premise, and personal opinion, that they should not.

[ToraToraTora]

well thanks everyone for your contributions, this turned into a very interesting debate.

[bednobs]

in all honesty, i don't want to read the whole post as i can just imagine the spitting from both sides of the debate. However, it's a valid debate. All you need to do is substiture "IVF" for "TG operations" in the op, and i reckon all the sides would shift again