• southsamurai@sh.itjust.works
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      2 months ago

      I agree.

      I also see why it isn’t the default. It should be, but there are other procedures where that’s the case, depending on where you are in the world.

      Post mastectomy reconstruction surgeries aren’t always covered by everything. Should be, but aren’t.

      I say anything that treats the patient should be covered, period, including any and all reconstructive procedures like FFS. It’s just a matter of getting people to realize it’s medical care, not elective cosmetic surgery.

      Doesn’t seem to matter whether it’s a form of socialized health care, or capitalist, allocation of funds/resources is rarely decided by people that actually understand what’s going on, it’s decided by accountants, lawyers, and legislators.

      It sucks. There are goodly amount of surgeries and other care that get labeled as cosmetic or elective that are fundamentally part of treating the patient. It’s absurd.

    • rbesfe@lemmy.ca
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      2 months ago

      Considering that the province won’t even pay for dental or eye care, I’d say this was the right call. Debates about what kind of cosmetic surgeries count as healthcare can’t begin until we fix those holes first

      • Ada@lemmy.blahaj.zone
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        2 months ago

        Trans surgeries are not “cosmetic”.

        Speaking as a trans person, access to trans healthcare is far more important to me than dental healthcare.

        • Cypher@lemmy.world
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          2 months ago

          It is obviously cosmetic as it relates to appearance. That can still be a serious issue but then you go on to dismiss dental care.

          Someone with damaged teeth would disagree with you because of appearance, health, social and mental impact of living with and having to hide damaged teeth.

          Arguing trans healthcare should always come first because you prefer it in your situation is a shit argument.

          You’re saying the majority of people to put trans healthcare at the bottom of the list of priorities because it doesn’t affect them.

          Besides this isn’t an ‘us’ vs ‘them’ issue. There was zero reason to make that argument.

          Edit: I even fact checked myself on my ‘obviously cosmetic’ claim. Mayo clinic: https://www.webmd.com/a-to-z-guides/what-is-tracheal-shave

          Also, as the procedure is generally considered cosmetic

          • marcie (she/her)@lemmy.mlM
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            2 months ago

            its not cosmetic, its reconstructive. i dont give a fuck what some fascistic cis people think is ‘cosmetic’ or not, the term is mostly just used by insurance companies and governments to weasel out of paying out to medically necessary interventions.

            why the fuck are you in this comm? leave.

            • Cypher@lemmy.world
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              2 months ago

              I am happy to be corrected about whether specific surgeries are considered cosmetic or not but I do not, as a rule, take the comments of random people on the internet as gospel.

              what some fascistic cis people

              Do you have something against the Mayo clinic?

              Not that I need to explain to you but I commented because I saw a misguided comment and was hoping to have an open discussion about how healthcare should always be available to those who need it.

              I’ll be here all week. :)

            • Sethayy@sh.itjust.works
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              2 months ago

              I’m a trans commie and think dysphoria is generally cosmetic, and think its fucked both teeth and ffs aren’t covered.

              But I guess I just don’t like punching down

              • Diva (she/her)@lemmy.mlM
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                2 months ago

                It is fucked that both teeth and ffs are arbitrarily gate kept in order to balance the books in a deeply disfunctuonal healthcare system. It should obviously all be free at the point of care. And the only reason it isn’t is to deny care to poor people.

                What’s obnoxious are the cises showing up (in other comments) to be like " um actually if you look up the medical authorities in the fascist country America people say it’s cosmetic". 🤓

                • Sethayy@sh.itjust.works
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                  2 months ago

                  Yeah I agree with that, and people need their argument dopamine hit so things are gonna by defualt get unruly pretty quick.

                  I think the only thing I disagree with is making it too much of an us vs them situation, as hard as that is when it feels like they’re doing the same, but hey maybe I was just born out of hippie times and am feeling the pain lmao - they had some shit going on when they disagreed with labels being overly general in my opinion

          • Ada@lemmy.blahaj.zone
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            2 months ago

            Cosmetic surgery relates to appearance. Transition related surgeries relate to dysphoria

            Someone with damaged teeth would disagree with you because of appearance, health, social and mental impact of living with and having to hide damaged teeth.

            Both my partner and myself both have damaged teeth. It’s nothing like that

            Arguing trans healthcare should always come first because you prefer it in your situation is a shit argument.

            I don’t need it. I was fortunate enough to be able to self fund my own surgeries. But doing so has had long lasting effects on my financial security.

            Notably, I didn’t spend that money on teeth or any other cosmetic issues, because it’s not even remotely the same. Spending my future to make my teeth look better would be a poor choice.

            Spending my future to deal with my dysphoria was what I had to do to ensure that I had a future.

            • Cypher@lemmy.world
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              2 months ago

              You’re not getting it.

              In a discussion about healthcare and insurance coverage this should not be one or the other.

              • Ada@lemmy.blahaj.zone
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                2 months ago

                Yeah, the trans person, talking about first hand experiences navigating this exact topic is the one who doesn’t get it…

                • Cypher@lemmy.world
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                  2 months ago

                  A type 1 diabetic with ruined teeth would likely disagree with you on priorities. Having a mouth full of rotting teeth is painful, unattractive and can cause severe distress and social isolation, even depression.

                  It can also contribute to other severe medical problems such as a massively increased risk of heart attack.

                  You are putting your own struggles first and foremost while dismissing the pain and sufferring of others. I am saying neither people with dental problems or trans people should be denied healthcare, you are saying

                  my problems are more important so only my problems should be dealt with

                  I am disagreeing with your argument because it dismisses a genuine and serious form of medical care that should be afforded to all who need it.

                  Trans surgeries are not “cosmetic”.

                  The Mayo clinic, which is a respected source, disagrees with you on at least one of the surgeries being sought.

                  Speaking as a trans person,

                  Your experience is valid.

                  access to trans healthcare is far more important to me than dental healthcare.

                  And you shouldn’t dismiss the experiences and needs of others.

                • Sethayy@sh.itjust.works
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                  2 months ago

                  No offence but comments like this are only harmful to our community, and I know saying this might not change your mind on anything, but I’d feel wrong if I didn’t ask.

                  Don’t try to speak for all of us, I know many of us have been treated horribly for years simply because who we are, and as fucked as that is it doesn’t make it ok to put your trauma above others, in a way that may be affected by your personal bias.

                  The queer community has always been about outsiders, arguably even more so than simply about sex or gender, and in that vein I couldnt go to bed comfortably if I could gaurentee ffs to some of our sisters while leaving millions in constant physical pain, just like I feel looking in the mirror every day.

                  This is class warfare, not bum fights in an alleyway - cause we all know the upper class has rock solid solidarity, and we don’t stand a chance until we do as well.

  • jsomae@lemmy.ml
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    2 months ago

    I don’t mean any ill but I’d just like to understand better; I apologise sincerely if this is offensive and I beg your patience with me. Supposing a transgender person already “passes,” is there a meaningful difference between FFS and cosmetic surgery? There are cis people with very severe body image issues including with, say, how their nose or brow looks – even suicidally so.

    • marcie (she/her)@lemmy.mlM
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      2 months ago

      Its medically necessary, and many states and organizations state it as such. Being against it is transphobia.

      This community is not about cisgender people. Body dysmorphia in cisgender people is a different illness from gender dysphoria altogether, and has a different treatment regimen.

      • jsomae@lemmy.ml
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        2 months ago

        I’m not against it, I want to understand the issue better. I do not understand why being against it is transphobia, but I would like to understand this better.

        No provinces in Canada nor any medical boards consider it necessary, though they do consider other more expensive transgender surgeries medically necessary. (That is not to say I agree with them on account of their authority – but I am curious what analogous organisations in the US differ here.) I imagine the vast majority of trans people agree that gender-affirming surgeries like top & bottom are necessary, or at least should be covered, but I’d be interested to see if most trans people agree that FFS is medically necessary.

        I can understand the argument that it’s simply a different illness than cisgender dysmorphia. But, why do we not consider cisgender dysmorphia something which warrants medically necessary surgery? It can cause equal amounts of suffering. Perhaps we should fund both.

        • Elise@beehaw.org
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          2 months ago

          Hey jsomae, thanks for your curiosity.

          Of course everyone can understand that having something like severe underbite is terrible. However, it is still a different thing.

          I am trans and living in the nl. When I am outside for an afternoon I am insulted at least once. On average three times.

          I’m the sweetest person you’ll ever meet, and I’m basically a quaker when it comes to pacifiism. Yet I know how to hurt people really badly and carry a knife.

          Any more questions? ❤️

          • jsomae@lemmy.ml
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            2 months ago

            Thanks for your reply. I didn’t realize the Netherlands had it so bad: I assumed they were open minded about lgbt stuff. My condolences, and I hope your conditions improve.

            • Elise@beehaw.org
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              2 months ago

              Yeah, it’s not as bad here as in many other places. Healthcare covers at least a few things, but it takes years before someone can even take a look at you and there’s still discrimination there too. I pay 250 a month for healthcare plus ‘own risk’ every year, yet I pay my own medicine and have private healthcare from the uk in addition. I use home compounded medicine, otherwise I can’t function. I am close to homelessness and receive 0 support from the state.

        • marcie (she/her)@lemmy.mlM
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          2 months ago

          Its my understanding that body dysmorphia is best treated with anti-depressants in most patients. Anti-depressants have no effect on gender dysphoria. If anti depressants aren’t working, maybe some other kind of intervention is warranted for those patients.

          I do not understand why being against it is transphobia, but I would like to understand this better.

          FFS is a reconstructive surgery. It is hard to compare to anything, but the purpose is to revert disfiguration by having the improper hormones. If cis people had this issue with hormones, then of course they should be covered.

          • jsomae@lemmy.ml
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            2 months ago

            OK, the argument that it’s caused by improper hormones is very compelling. The state could save money by helping ensure the hormones are corrected as early as possible.

            I do not know if antidepressants help cis dysmorphia, I’m somewhat skeptical about that. Antidepressants aren’t a miracle drug when it comes to this kind of thing, from what I’ve seen.

            • marcie (she/her)@lemmy.mlM
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              2 months ago

              I’m not sure about it either, I just know that it seems to be the most clinically significant treatment. Most people with body dysmorphia regret their surgeries, rates for trans regret are extremely low. Usually in the range of .5%-2% depending on surgery. For reference, somewhere around 30-40% regret knee surgery depending on the study. Regret rate science is a pretty well established thing.

              • jsomae@lemmy.ml
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                2 months ago

                Yeah that makes sense, I don’t doubt the regret numbers. I didn’t realize cosmetic surgery regret was that high. Well damn, consider me educated.

                I’ve seen that knee surgery figure before but I don’t think it’s a good comparison at all, and it’s easily attacked. Knee surgery has immense potential for chronic pain afterward, and poor mobility. Dysmorphia regret rates are much more compelling.

  • Auzy@beehaw.org
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    2 months ago

    I have at least one trans friend and many gay friends (mainly from climbing).

    I know it’s not a popular opinion but I agree taxpayers shouldn’t cover it, as it’s referring to physical characteristics. One could otherwise make the argument that breast enhancement surgery, hair transplants for beards or penis enlargement surgery should be covered too.

    I’d even argue that allowing this would even cause more division in the community honestly (so it’s not even a good thing for the lgbtiq community possibly)

    Honestly, I’m not the most handsome guy either, but I wouldn’t expect free plastic surgery either.

    I think this is fair… I wish her the best though

    • Ada@lemmy.blahaj.zone
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      2 months ago

      “I think this is the fair, and I wish her a lifetime of endless discrimination from people who are transphobic to identifiable trans people”

      • Auzy@beehaw.org
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        2 months ago

        I’m not a big guy and I got bullied in high school.

        I’ve been made fun of for a patchy beard too.

        Lots of women I know felt insecure because of small breasts. Lots of them believe they’d be more attractive with a different butt

        I know Indian people here who had to put up with racism.

        The reality is, there are always assholes out there, but the best thing to do is to find people to accept you. Assholes will always be assholes and will always use people’s features to bully

        I know you think you’re helping, but I suspect this would create a massive backlash and incite hatred towards trans people. Trans people will still need to put up with assholes, but will also have to spend their lives proving that they’re not looking for special treatment and free handouts (ie. Something like this could hurt them more).

        The trans person I know is obviously trans too but actually has a huge amount of friends and is the nicest person I know. She also seems successful too. Something like this would actually work negatively against her.

        • Ada@lemmy.blahaj.zone
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          2 months ago

          Incase you’ve failed to notice, were in the midst of a global incitement of hatred towards trans people.

          I’m going to suggest to you that just maybe, if trans people wanting to escape that hatred makes people hate them more, then the problem isn’t the trans person

        • @Auzy If something causing immense distress to someone that requires a surgery to address the overall mental well-being, should be covered by medicare or the government. Trans or no trans this is to improve someone’s mental health and should not be count as beauty surgery, there is a big difference. Even at my home country IRAN part of the expenses are covered by government for trans people and this is just embarrassing for western countries.

          • Auzy@beehaw.org
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            2 months ago

            Absolutely. I agree with that and it’s a good point

            It would need to be applied in a generic way though. I feel based on the article it feels like they’re asking for special treatment.

            That being said not everything that causes distress actually matters. I used to care about things like even my hair cut. I used to be extremely self conscious.

            Growing up now, I realise it doesn’t actually matter and I’m actually fairly happy with myself (in fact, I just ended up shaving my head lol and don’t care that anyone finds it stupid anymore lol).

            Another point though would be whilst a very large amount of money might make a small number of people happy, the same money could also be spent to promote inclusion for all trans people and lead to better outcomes.

            But I’ve never asked my trans friend what she thinks (so I do accept my opinion could be plain wrong).

            • Ada@lemmy.blahaj.zone
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              2 months ago

              I used to care about things like even my hair cut. I used to be extremely self conscious.

              That is nothing like dysphoria, and your equating of the two experience indicates a very significant lack of understanding of the trans experience.

              I’m trans, and I used to be self conscious about my hair, but it didn’t cause me pain or dysphoria. Then I transitioned, and after surgeries and hormones, my body finally felt the way it should, no more pain or dysphoria. Guess what though, I’m still self conscious about my hair, because it’s entirely unrelated to my experience as a trans person…

              • Auzy@beehaw.org
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                2 months ago

                Why isn’t that an example of BDD? https://bdd.iocdf.org/professionals/signs-symptoms/

                You seem to be implying that BDD only affects Trans people… Just so you know, I was actually depressed for a lot of my life (and yes, there is lots of surgery, or medical assistance I could have done to improve that. I was actually voted the quietest person in my school). I didn’t get a date until I was 20 because of lack of confidence.

                Here in Australia though, not sure about US/Canada, but it’s worth noting most therapies are covered with the exception of some cosmetic: https://www.drmichaelkernohan.com.au/blogs/will-medicare-cover-gender-affirmation-surgery/ . Even HRT is covered. The difference appears to be that Adam Apple does seem covered in Australia… I feel that should be there too though.

                In the case of the article, there’s nothing that has stopped her getting HRT and everything else covered. There’s no laws stopping her getting cosmetic surgery. She simply doesn’t want to pay for that component (and a huge amount of the cosmetic component is already probably covered technically). I don’t feel there would be no fair way to provide facial cosmetic surgery without basically covering all cosmetic surgery for free. As I’m not sure how you’d even define what is covered by it

                What kind of cosmetic surgery specifically do you believe should be covered for free?

                • Gaywallet (they/it)@beehaw.org
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                  2 months ago

                  Hey dude, this is a trans space. You should not barge in and start fighting trans people. That’s not nice be(e)havior. If you want to engage with people you don’t understand, you need to do so by treating them with good faith and listen to them.