In Canada, I was quite shocked to learn transsexual men can have hysterectomies after a certain amount of time on testosterone: this leads to premature menopause which is an indicator for hysterectomy–without the need of going through the DSM or the Standards of Care, AT ALL.
The pathologization of transsexual men in Canada, at least for hysterectomy surgery has never been; ‘top’ surgery, depending on the doctor, can be similarly finessed.
I had to obtain a diagnosis for GID and follow the Standards of Care. I would argue there is a fundamental sexism involved here–one I have never heard discussed.
Julia Serano has argued the entire sexist reaction of society to transsexual men–less–and transsexual women–more–is not because of the women and men we were, respectively; it is because of the men and women we are now, respectively.
As I read one of the depathologization manifestos there was a call for surgery to be covered by national health insurance plans. Without some medical diagnosis, coverage, such as the San Francisco municipal plan would lose its medical base and would probably not cover any more.
I recognize the extreme libertarian culture in America is often profoundly against single-payer, such as we have in Canada, that provides coverage for SRS, without which many, many transsexual women–the men in many cases already covered under OTHER categories–will, as they are now, be excluded.
There must be a way to square this circle–depathologize but retain medical coverage to the extent that it will be paid for. Unless libertarian ideology replaces transgender ideology governing the lives of transsexual women without regard to their lives and needs–what’s new!
I appreciate the de-psychopathologize intermediate position, of requiring national insurance coverage, but, as I’ve pointed out in Canada, we are just talking about transsexual women, transsexual men have long escaped the psychopathologization the women have always been subject to.
And in libertarian countries, such as the United States the entire idea of single-payer, or ANY health care system run by the government, smacks of “repellent socialism.”
I also appreciate this is a very class-structured thing, which is precisely why I advocate for single-payer.
For the reason of sexism/gender the men simply go through the system without any stigma; the women must.
Until the Depathologization Movement actually, formally, explicitly recognizes this sexism at the heart of the treatment of transsexuality–including its–it will be little more than an interesting side issue.