What Ought We To Do About Wannabes?
 Original Article
The author builds a long, convoluted argument in favour of providing surgery for transabled individuals.
He seems to want to dazzle us with his knowledge and his ability to build his argument. Further, he uses arguments that show a lack of understanding of conditions such as GID. Yet, he arrives at a conclusion that should make anyone with BIID happy.
He explores concepts of GID, as well as moral and philosophical theories to arrive at his conclusion.
"The only other group of people who desite to make such radical changes in their bodies through surgery are the peopel who wish to change sex"
It depends on one's view of what "radical" is, doesn't it? It is only relatively recently that such a surgery as breast augmentation has become somewhat benign, but it is relatively "radical".
"People seeking transsexual surgery commonly justify their desire by asserting that they feel inside that they belong to the sex they seek to emulate. The fact that the notion is commonly expressed should not necessarily lead one to infer that it truly reflects what the aspirant transsexual feels"
This implies that both transabled and transsexual individuals don't know what they want.
It also introduces the concept of being an "aspirant", as in "we aspire to become". This concept shows a misunderstanding of transsexuality. One doesn't aspire to be transgendered. One is, or one isn't.
"One thing that is certain is that surgery will not achieve the ostensible goal of making the gender of the identity and the sex of one body coincide. All that surgery can do is to convert the exterior of the person to a simulacrum of the body of someone belonging to the opposite sex."
Yet, isn't it better to be that much closer? It allows someone to identify more closely to their "true" gender.
"So knowing that the desired transformation cannot be achieved, they must know that the reason offerd for seeking the surgery must be just a pretext [...] You don't release the gender inside by modifying your outside to make it easier to impersonate a member of th other sex."
The author clearly doesn't "get" GID. And this is one of those things that is difficult to explain, you either get it, or you don't.
"I suggest that it is not to change sex at all, but to become the beloved, to incorporate the beloved into oneself, that the desire is not to become a member of the other sex, but to become the angrogyne, self and beloved, fused and inseparable."
This might be an interesting statement, if there was any supporting evidence for this claim. It doesn't appear to be in line with the currently accepted theories about GID.
"Also the aspects of feminity apparently most valued by transsexual females are not those associated with maternity or domesticy, and this suggests that aspirant transsexuals do not want, really, to become members of the opposite sex, they want to acquire only a sub-set of the attributes of the sex, the glamourous ones, the sexually provocative ones."
This illustrates, again, how little the author understands GID. But it also shows a prejudice towards fixed gender roles that are not particularly appropriate in this day and age.
"How could you feel yourself to be an amputee inside when you aren't in fact an amputee?"
We feel we should be disabled, not that we are. This may be perceived as semantics, but it is an important distinction.
"I believe that the core of these desires is the desire literally to incorporate, to embody, the beloved"
This is a simplistic, unsupported statement.
"I suppose that there might be a parallel in feelings of attraction, not only to the state of being an amputee, but towards the accessories that the state makes necessary, so just as a transsexual woman might get pleasure from wearing feminine clothes, so the aspirant amputee could justify fetishes for crutches or prosthetics, by seeking a state in which such objects become necessary adjuncts to his daily living."
People who have BIID aren't, generally, turned on at the idea of using the "hardware". In fact, it seems somewhat odd to think that someone might need to lose a limb in order to be able to use a prosthetic because they are are turned on by it. Apotemnophiles may exhibit some of that, but one would think it is a rather extreme way to give in to a sexual attraction to crutches, braces, wheelchairs or prosthetics.
"Perhaps another parallel reason is that by becoming an amputee he would be joining the class of disabled people of whom society expects less performance than it does of the able bodied."
Society does not necessarily expect less of people with disabilities. In fact, disabled individual are often expected to show courage, perseverance, etc. They have to become the "supercrip" in order to function. Not only do you have to put up with the world at large, but on top of that, you must be an inspiration to others.
"I suspect that the feelings are those involved with normal sexual behaviour: appetite, action taken to satisfy it, and detachment, intensified by the fact that the behaviour that satisfies the appetite, being taboo, is resisted until the hunger becomes unendurable, the desired activity is undertaken, satiation follows, and with it self-disgust [...] I conjecture that such an emotional patter would be likely to follow the satisfaction fo the desire of the aspirant amputee."
Cases of successful amputations show that it is not the case. In the literature, both Falkirk amputees report being completely happy about their amputations. Others also say they are happier as an amputee than before.
"I conjecture that such an emotional pattern would be likely to follow the satisfaction of the desire of the aspirant amputee."
This conjecture is incongruant with the statement of people who became amputee post surgery, or self-injured.
"There are different conceptions of ethics and these conceptions depend on different axioms and consequently the desire fo the aspirant amputee may be legitimate and acceptable in one system of ethics but unacceptable in another."
Ethics do vary from place to place and from time to time. What was acceptable 100 years ago is now common place. Plastic surgery, for instance, wasn't even thought of 100 years ago, yet is now so common place that teenage girls are able to receive breast augmentation surgery without even the blink of an eye.
"From a strictly utilitarian viewpoint it should be clear that, in principle, society should not satisfy this desire."
Why? Does it? We're not convinced. Is the unspoken argument here that if someone becomes an amputee, they aren't "useful" in society anymore? If so, the basis of that argument is ill-founded. People with relatively minimal disabilities such as amputations, paraplegia, blindness or deafness can be successful and a participating member of society. Most often, when they aren't able to, it is society's fault to begin with, by its unwillingness to adapt.
"...the desire to become an amputee, is, in effect, a neutral one, wrong in principle..."
Why is it wrong in principle? This is suggested as a self-evident truth, which is not evident at all.
"...there is nothing to be said about the desire, except that it is rare, and that even if it were satisfied for all who possessed it, the numbers of people involved would be very small."
This is an interesting argument. Basically the author is saying it's wrong, but there are so few people affected that the impact on society would be negligible.
"...there is no conflict between the right of the individual aspirant to pursue happiness and the right of society at large to do so, no reason for society at large to deny the aspirant the satisfaction of his desire even though the satisfaction will entail some costs."
That is an interesting take.
"There are other much commoner desires that lead to self-destructive behaviour and significant social costs to society. Smoking for example leads in very many cases to irreversible physical impairment requiring treatment for acute conditions and for long term care"
This is an excellent point, and one that a paternalistic society might use to stop funding treatment for smoking related illnesses for smokers, as seen in some countries. It unfortunately does not, a priori, necessarily support a "right" to surgery, rather it forces a re-examination of these other self-destructive behaviours.
"Suppose the aspirant works physically to support his family: the amputation of one or more limbs is likely to reduce the aspirant's ability to work and therefore the income of the family."
On the other hand, chronic depression, stress, and emotional trauma do reduce the ability to remain in one's job, and after surgery, with these "effects" lifted, it is much more likely that the individual would be able to remain in a job.
"Central to the practice of medicine and surgery is the axiom: Do no harm. Nobody could deny that the amputation of a sound limb would be harmful to the patient"
From a viewpoint that health is merely physical, that statement is true. But looking at health from a more holistic point of view, the removal of a limb, or the aquisition of paralysis is a relatively minor harm, compared to the huge emotional and mental benefits. In many ways, BIID is like a cancer. And while removing a cancerous leg is harming the body, the greater benefit justifies it.
"The aspirant ought to be make himself aware of the physical consequences to be expected as a result of the amputation, for example phantom limb effects and the possibility of chronic pain, in order that the choice may be made with as much information as is available."
One might glibly say "D'oh!". There's one self-evident truth. It would be irresonsible for anyone to embark on the path of surgery without being in full possession of as much understanding as is possible. The majority of individuals we are in contact with know as much about their required impairment as anyone who doesn't have said impairment could possibly know. For instance, it is not unusual for paraplegic wannabes to know more about spinal cord injury than medical doctors that don't specialise in the field of SCI.
Although we have witnessed many individual having a shallow understanding of the condition they think they seek. This is where the importance of therapy before surgery would come into play, acting as a filter of sorts to separate those who have done their "homework" and those who haven't.
"Since indulging the desires of the wannabes costs us all so little, while at the same time satisfying an yearning that can be comletely disabling in its intensity, I conclude that we ought to accept their desires and help them to achieve the bodily modification they desire."
We like the conclusion, but aren't sure that the way it was arrived at is sound. We are also unsure as to what the early comparison to GID has to do with the rest of the article.