Body Dysmorphia (BBC Horizon)

[Puppycow]

By all means cut off your legs and arms as you desire.

But don't expect to receive a single cent of welfare money if you're then unable to work.

Amen to that.

This is what I was thinking.

Is it our business as a society to tell others what they can and cannot do with their own bodies? My inclination is to say no. But, we also live in a society where disabled people can receive special welfare benefits. If having your legs amputated means that you are now dependent on others to provide for you, then it is our business after all what other people do with their own bodies.

Likewise if you say the taxpayer or legally mandated insurance coverage should provide for "gender-affirming" surgeries and treatments (hormones, etc.) that can add up to hundreds of thousands of dollars.

It becomes my business when you demand that I pay for the consequences. (Or for the cost of transition.)

I'm not against any of these things, I just don't want to be forced to pay for it.

 

[bluesjnr]

Some people just want society to be a perfect system of formal logic, where all questions of propriety resolve to simple absolute binary propositions.

If breast enlargement is fine for some people, it must be fine for everyone. Society cannot possibly evaluate mental health on a case by case basis, and make allowances in some cases but not in others. If we let Evel Knievel indulge his death wish, we cannot possibly prohibit Legless McCrazypants from following her own dream of self-harm.

You know my uncle?

 

[TragicMonkey]

Amen to that.

This is what I was thinking.

Is it our business as a society to tell others what they can and cannot do with their own bodies? My inclination is to say no. But, we also live in a society where disabled people can receive special welfare benefits. If having your legs amputated means that you are now dependent on others to provide for you, then it is our business after all what other people do with their own bodies.

Likewise if you say the taxpayer or legally mandated insurance coverage should provide for "gender-affirming" surgeries and treatments (hormones, etc.) that can add up to hundreds of thousands of dollars.

It becomes my business when you demand that I pay for the consequences. (Or for the cost of transition.)

I'm not against any of these things, I just don't want to be forced to pay for it.

If your concern is public expense then why stop there? Poor people having babies is a public expense. Disabled people are an expense. The elderly are an expense. Do you think those groups are worthy of public expenditure? Should they be denied any benefits? Or perhaps it would be cheaper if those groups just weren't around, eh?

 

[TragicMonkey]

I've been asking that exact question for five years in the Trans thread.

Personally, I'd rather lose a leg than my boy bits, so if anything, genital removal is worse.

It would be "worse" because you personally value your genitals more than your leg? Does it work the other way for people who value their leg more than their genitals?

 

[casebro]

For one a sex change operation doesn't remove a limb. For two transgender is a well known diagnosis with standards of care...

Okay, lets use transsexuals as a model. Evidenced by their HUGE suicide rate, they are not made happy by the changes. Corrinne wouldn't be either.

Corrinne should be required to spend a few day with a double amputee to see what a PITA it is to have a disability. All I've got is arthritis and heart probs, Thank FSM I am not in a wheel chair.

 

[Lplus]

The degree of "support from society" one needs varies with one's personal wealth. Oprah could easily afford to hire platoons of servants to run her errands or indeed carry her about on a palanquin wherever she desires. Would that make the desire to amputate her own legs sane for her, but crazy in a poorer person?

Crazy in both cases, but you asked when society should step in and I gave you and answer.

If your concern is public expense then why stop there? Poor people having babies is a public expense. Disabled people are an expense. The elderly are an expense. Do you think those groups are worthy of public expenditure? Should they be denied any benefits? Or perhaps it would be cheaper if those groups just weren't around, eh?

Yes they are worthy of the expense because none of them are crazy.

 

[casebro]

If your concern is public expense then why stop there? Poor people having babies is a public expense. Disabled people are an expense. The elderly are an expense. Do you think those groups are worthy of public expenditure? Should they be denied any benefits? Or perhaps it would be cheaper if those groups just weren't around, eh?

But Corrine and Trans cause those costs willingly. Your examples do not.

 

[TragicMonkey]

But Corrine and Trans cause those costs willingly. Your examples do not.

Then the missing element is a moral one: to access help one must be judged worthy. Voluntary amputation? Unworthy. Involuntary amputation? Worthy...but what if that injury was the result of a foolish or bad action? Mindy lost her leg in a car accident. Is she worthy of help? But what if she was driving carelessly and caused the accident? Worthy? What if she was drunk at the time? Unworthy?

By introducing the element of judgment you require the existence of judges. Let panels be created to assess the moral worth of each person's claim to public expenditure, and they receive according to their moral worthiness rather than their physical needs!

I realize people get mad at the notion that someone's unfairly getting something but I think the rush to fix that problem leads to much worse ones.

 

[TragicMonkey]

Yes they are worthy of the expense because none of them are crazy.

The mentally ill don't deserve help?

 

[TragicMonkey]

I really dislike the concept of adding a moral evaluation to people's illnesses. Lung cancer patients frequently get treated shabbily if they were smokers, and then when people find out they got it from another cause they're suddenly nicer about it. Because they don't "deserve" lung cancer as much as smokers do. Happens with other illnesses and ailments, too: HIV from a transfusion is morally worthier than from sex, which is morally worthier than from contaminated needles. Unless the needle was a hospital mistake and not recreational drugs. My father's cancer was caused by smoking but because it wasn't lung cancer people assumed it wasn't and were nice to him.

I'd rather have illnesses and ailments treated with no regard to morally evaluating the patient and deciding how much they deserved their suffering. Even if it costs the public money.

 

[Lplus]

The mentally ill don't deserve help?

You didn't include the mentally ill in your list. Still, in their case I think any money should be spent curing them in the short term rather than a long term commitment to the result of pandering to their crazy.

 

[Skeptic Ginger]

Okay, lets use transsexuals as a model. Evidenced by their HUGE suicide rate, they are not made happy by the changes. Corrinne wouldn't be either.

You lack a citation and evidence genital surgery is the only relevant variable.

 

[casebro]

You lack a citation and evidence genital surgery is the only relevant variable.

I bet even YOU could google <lgbt + suicide> (or any single letter) and find that their extremely high suicide rate is common knowledge.

They blame their high suicide rate on the way society treats them, nobody wants to blame their 'craziness' that is part of their syndrome.

Okay, I'll accept that it is not a choice. But it is a mental abberation at heart. Caused by genetics of brain chemistry. EVERYBODY wants mutual friction of mucous membranes. The choice of whose is mental. (emotional is a sub-set of mental)

 

[casebro]

They do still lock people away for "..being a danger to themselves or others."? Corrine, anybody?

You would slam-dunk her craziness if she was merely a 'cutter'.

 

[thines]

Voluntary amputation

This is an interesting thread. There is an excellent book on disorders of "the self" which includes a chapter on a fellow who wanted his leg amputated because he didn't like it, people who believe they are dead and other interesting such beliefs. It's Ananthaswamy's (2015) "The Man Who Wasn't There".

 

[arthwollipot]

In discussions like this it's important to remember that psychosis has a strict definition. It's an inability to distinguish between what is real and what is not, so things that are only imagined become real. This is not what is going on with body dysmorphia. Dysmorphia is this body is not mine and can lead to people self-harming to get rid of it. I know such a person.

 

[Skeptic Ginger]

I bet even YOU could google <lgbt + suicide> (or any single letter) and find that their extremely high suicide rate is common knowledge.

They blame their high suicide rate on the way society treats them, nobody wants to blame their 'craziness' that is part of their syndrome.

Okay, I'll accept that it is not a choice. But it is a mental abberation at heart. Caused by genetics of brain chemistry. EVERYBODY wants mutual friction of mucous membranes. The choice of whose is mental. (emotional is a sub-set of mental)

I think you missed my point. Of course there is a high rate of suicide among transgendered persons.

But where's the evidence gender reassignment surgery increases the suicide rate?

 

[Emily's Cat]

I'm not sure why the distinction is unclear?

The term disorder is often used to refer to a condition that causes distress or functional impairment or harm to others, and therefore may require diagnosis and treatment or accommodation. It is not synonymous with 'mental illness', and a large number of conditions classified as psychological disorders would not appropriately be described that way (e.g. autistic spectrum disorders). As we know from discussion elsewhere, the DSM defines numerous conditions that are only considered disorders if they cause distress/impairment/ or harm to others. Psychotic disorders are a subset of disorders that involve symptoms like hallucinations and delusions or disorganised thought, that could impair judgement.

There has been interest in the possibility that body integrity dysphoria involves some sort of inversion of the process involved in phantom limbs (where somebody is missing a limb and feels that it's still there). In the case of phantom limbs, the generally favoured (although still controversial) explanation is neurological - that each part of the body is 'mapped' onto a region of the sensory cortex, and the part of the brain devoted to mapping stimulation from the missing limb, receiving no sensory input, starts responding to stimulation in adjacent regions, which is misinterpreted as coming from the 'phantom'.

If the reverse is true, some parts of the body not being properly 'mapped' might lead to the sensation that a limb is not part of the body because the brain doesn't properly process sensory input from that part.

There seems to be some recent research along these lines, although the explanation is more complex and relates the issue to altered connectivity in larger scale networks.

Great post

There are so many complexities to the brain, and I don't know all of the terms. I know a few... but sometimes the boundaries seem fuzzy to me. For example, I have a neurological disorder - I'm epileptic. Sometimes my brain doesn't do the physical things it's supposed to do (or more appropriately, does too many physical things that it isn't supposed to do). My spouse, on the other hand, has a neurofunctional disorder - they're ADHD. Their brain does the physical things correctly, but doesn't respond or engage the elements it's supposed to. Even though there's nothing physically disordered in their brain, their executive function doesn't work correctly. My sister has a psychological disorder - they are bipolar. Everything physically functions correctly, and the responses from each brain area is appropriate, but the emotional regulation of those areas is out of whack.

It gets really confusing though. I don't really understand the distinctions between them, and I believe some conditions have changed categories over time.

 

[Emily's Cat]

"Reasonable people" also thought slavery and marital rape were perfectly sensible, and that interracial marriage and public education were not sensible.

Reasonable people can sometimes agree on things we now view as horrific... Therefore, let's toss the reasonable people out and listen to the unreasonable ones? Doesn't seem like a great approach to me.

Blind assumption that most people agree on what is reasonable, and that they are right, is not a secure basis for legal or regulatory standards. It's certainly not a good basis for ethical judgment.

But it *is* the basis for ethical judgement, and is a cornerstone of legal and regulatory standards. You might disagree with it, but in actuality, that's how it's done. A very large portion of law relies on either a "reasonable person" or a "prudent person" standard for situations where judgement is involved. The entire realm of negligence is based on "reasonable person" standards.

 

[Emily's Cat]

I've been asking that exact question for five years in the Trans thread.

Personally, I'd rather lose a leg than my boy bits, so if anything, genital removal is worse.

I can understand that your feelings fall that way, and it makes sense. But from a "third party" perspective... genital alterations of adults doesn't present a burden on anybody else.

Personally, I still end up thinking that vaginoplasty has too many risks that occur too often, and shouldn't be done at all. There are so many complications with infection and pain that it seems medically unsound to me. Phalloplasties also have risks of infection at the donor site, as well as scarring, and the whole lack of any sort of functionality... but those complications don't endanger the life of the person as much as vaginoplasty does. Mastectomy and breast implants have very little medical risk, my only hesitation on those is the age of the patient. But by and large, mastectomy and breast implants don't carry any higher medical risk than nose jobs or calf implants.