Gender-Affirming Surgeries

Gender-Affirming Surgeries
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Gender-Affirming Surgeries
LGBTQ+ have historically faced a situation where their acceptance in society has been contentious. This situation has called for more efforts to integrate and accept them into society. However, authorities should expand these efforts to include government support, specifically through funding, of gender-affirming surgeries for transgender people. A transgender person is one whose gender expression fails to align with their assigned sex at birth: this disparity and a constant fight between their internal and outward selves. The argument for supporting transgender surgeries emanates from a philosophical claim by such individuals as Simone de Beauvoir, who express that one is not born as a woman but becomes a woman (Butler, 1988). Therefore, an individual trapped in a gender they were assigned and wishes to transform into the gender that one identifies with should not face social, political, or economic hurdles.
Due to their condition, transgender individuals face mental and psychological problems as they struggle to gain self and social acceptance. The feelings of anxiety likewise lead to elevated mental disorders, which have recently reached scary heights. A study by Austin et al. (2022) unearthed that 82% of transgender persons have deliberated taking their own lives, and 40% have tried suicide, with suicidality high ranking amongst transgender youth. The highly politicized nature of these issues means that even when transgender people accomplish gender-affirming surgeries, they still face abjection and physical and mental health issues. This paper argues that government should fund or help fund gender-affirming surgeries. However, this position may raise ethical challenges, which the paper will also assess. The paper will offer an overview of biopolitics and abjection as the lens through which the issue of gender-affirmation surgery is viewed. The paper will explore the physical and mental health issues associated with gender-affirmation surgery, followed by an argument for government-funded surgeries and their ethical implications.
Biopolitics and Abjection in Gender
Biopolitics is a term whose origins are difficult to establish. However, the early works of such scholars as Michael Foucault offered the earliest clue of what entails biopolitics: that 'life' and 'living being' have become the center stage for new political battles and economic strategies (Lazzarato, 2002). In this case, biopolitics becomes the political administration and regulation of species' life and localities' population. According to Stryker (2014), biopolitics "describes the calculus of costs and benefits through which the biological capacities of a population are optimally managed for state-like ends" (p. 38). Gender issues have often dominated research and commentaries on biopolitics. Gender stereotyping, forms of erotic expression, and bodily normativization comprise most of the gendering activities. Gender subjectivizes individuals through socially constructed categorization that often becomes accepted as innate and ontologically given. However, the transgender phenomena call attention to the issues of gender normativity. Transgender people have become vulnerable to repression and oppression in society and politics. In many cases, transgender issues pass over for social investment instead of being cultivated as politics' valuable bodies.
Transgender people also face abjection, which can be described as extreme societal rejection. Abjection may also refer to a vague sense of horror that invades the boundary between the self and the other (Phillips, 2014). In other words, abjection entails the exclusion by identity regimes of subjects that such regimes consider beyond classification or unintelligible. Transgender people do not fall under the normalized male versus female classifications. As a result, they often face abjection from the rest of society by failing to comply with other classifications. As a social construction, abjection may occur even when transgender people undergo gender-affirming surgery, often the start of mental and psychological health problems.
Physical and Emotional Health Benefits of Gender Affirmation Surgeries
The physical and emotional health benefits of gender-affirmation surgery can be explained by considering the challenges faced by individuals still trapped in their transgender bodies. The central position held in this regard is that the emotional health of individuals depends on their mental state. Therefore, mental problems associated with transgender people affect their emotional health, and resolving mental illnesses improves emotional health. In many cases, transgender people suffer from identity crises and mental illnesses associated with them (Sumerau & Mathers, 2019). In this case, identifying as one or the other gender could help alleviate such mental illnesses. Some scholars argue that the need to change gender is not a mental health issue but a self-determination one (Davy, 2015). However, the same scholars argue that one way of removing the trauma associated with transgender is by removing the problem, which should make transitioning a human right within a health framework. If being transgender is traumatizing, then undergoing gender-affirming surgery should alleviate these mental health issues associated with the condition. In other words, it can be expected that transgender people with mental health problems can be expected to get better once they accomplish gender-affirming surgery.
Current studies seem to agree on the inverse relationship between gender-affirming surgeries and mental health. According to Hughto et al. (2020), gender identity disclosure and engagement with medical procedures are inversely related to anxiety and depressive symptoms. Gender-affirming surgery allows individuals to reveal their true gender identity finally. The relief obtained from such an opportunity had been found to reverse suicidal attempts, ideation, and other non-suicidal self-injuries. These findings support the assumption that gender-affirming surgery and other medications, including hormone use, protect against mental health problems faced by transgender individuals. As explained earlier, the mental problems caused by the transgender status are the ones that can be resolved by affirming one’s gender. Hughto et al. (2020) explain that suicide risk and mental health issues observed among transgender emanate from identity-based embarrassment, violence, discrimination, and various forms of stigma. Such arguments can be supported by empirical evidence, including the observation that 63% of transgender people report experiences with discrimination. Transgender people get discriminated against in employment, are refused healthcare, and face verbal and physical abuse and intimate partner violence (Hughto et al., 2020). All these cause stigma and negative mental health outcomes.
Further empirical studies illustrate that mental health issues improve post-surgery compared to pre-surgery. For example, a study by Almazan and Keuroghlian (2021) examined 27715 transgender people and found that 95% of the respondents expressed low psychological distress in the past month, suicidal ideation in the past year, and smoking in the past year. However, the study also revealed that most people who underwent surgical procedures were older, more educated, employed, had health insurance, reported higher household income, and endorsed family rejection. While this finding may be used as proof that if transgender people had the means, they would seek gender-affirming surgery, it also illustrates a firm belief among this population that surgery and other medical procedures would resolve all mental health issues they experience as transgender.
The empirical studies can be described as reflecting the lived experiences of transgender people and their perceived or actual benefits after undergoing gender-affirming surgery. For example, a recent Harvard Chan School of Public Health study using 2015 data showed that gender-affirming surgery reduced psychological distress by 42% and suicidal ideation by 44%. Substance abuse, specifically tobacco smoking, dropped by 35% after the surgeries (Harvard Chan School of Public Health, 2021). These are significant statistics with massive implications for public health policy.
The issue of gender dysphoria may be contentious, but it helps explain most of the mental health issues facing transgender people. Previously referred to as gender identity disorder, the Diagnostic and Statistical Manual of Mental Disorders defines gender dysphoria as “a marked incongruence between their experienced or expressed gender and the one they were assigned” (Garg et al., 2022, para. 1). Individuals experiencing gender dysphoria cannot correlate their gender expressions when they identify themselves within the assigned gender roles, which is a significant cause of stigma. Stigma further causes relationship difficulties with peers, family, and friends, which causes interpersonal conflict, social rejection, various disorders (substance use, anxiety, and depression), adverse well-being outcomes, poor self-esteem, and a heightened risk of suicidality and self-harm (Garg et al., 2022). These health issues are often treated through psychiatric support, hormonal therapy, and surgical therapy. Therefore, it can be observed that a medical approach to the issue of gender can resolve mental health problems, especially since it helps overcome societal abjection. This approach includes gender-affirming surgery, which allows individuals to correlate their gender expression with the gender they identify with as opposed to that which they have been assigned.
Unlike mental health, physical health benefits of gender-affirming surgery have not received adequate attention. However, it is possible to make inferences from emotional health and other mental health issues, including psychological and social well-being. Physical health involves normal body functioning, for instance, sleeping and eating well, getting enough relaxation, and being physically active. Body composition, muscular strength and endurance, flexibility, and cardiovascular endurance also comprise physical health. Mental health, including emotional, psychological, and social well-being, can affect physical health. The Mental Health Foundation (2022) believes that bodies and minds are not separate, which explains why mental illnesses affect bodies. For instance, depression can cause fatigue, anxiety, headaches, and digestive systems. Anxiety can upset the stomach or result in other symptoms, such as difficulty with concentration, insomnia, and restlessness. This relationship between mental health and physical health leads to the conclusion that if gender-affirming surgeries reduce mental illnesses, positive physical health responses can also be observed.
The emotional health of transgende...