Friday 9 October 2009

Size matters

Should a transsexual be entitled to breast enlargement on the NHS, just because it makes her feel better about herself? Couldn't you say the same of a £5000 dress or a facelift?

A transsexual known only as "C" has had her request for the operation turned down by West Berkshire Primary Care Trust and is now suing them in the High Court.

Among other things she is claiming her rights under the Sex Discrimination Act and the Human Rights Convention.

She says that as a transsexual, her flat-chestedness causes her psychiatric distress because she doesn't feel sufficiently like a woman. The operation would relieve this distress.

But surely natural women come in all shapes and sizes and bust dimensions and if you think flat-chestedness makes you less of a woman that's purely a subjective opinion. So why should the NHS cater for personal opinions?

If she feels so strongly about it, she should find the money and get the operation done privately - as thousands of women do every year. It isn't a medical need by any stretch of the imagination.

Of course transsexuals are coping with a unique psychological dilemma which is different from those of other men and women. I understand that. But there's nothing unique about wanting bigger breasts. If you want them, go out and buy them.

15 comments:

  1. You know what's funny, I've actually given this some thought before! Wondering if sex reassignment surgery and all its ancillaries should be covered by health insurance--and no, although I don't have any problem with people expressing their identities however they must, I don't support coverage for this.

    And when you're dealing in the "extras," well, you raise the most compelling point of all--women by birth come in all shapes and sizes, and breast implants are not covered for cases that are just about aesthetic!

    Interesting post. I wonder if anyone will disagree with you?

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  2. Leah - A lot of the related medical treatment is often supplied by the NHS where agreed by a psychiatrist - hormone treatment, genital surgery, mastectomy etc. But breast enlargement? How is that a necessary part of the process?

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  3. Okay, maybe I overstated it in the comment I just erased. I am surprised that sex reassignment surgery is covered by health insurance--but I looked it up, and some insurances in the US cover it too. Who knew?

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  4. if a guy truly wants to become a woman then a certain amount of navel gazing regarding body shape is part of the deal. some women get things changed to suit their ideal but most of us still dont so we all go through a process of learning to love or live with what we've got.
    actually, if this person is so breast-centric with regard to what constitutes femininity then i could go so far as to say he is still a man :)

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  5. Certainly they should be covered by health insurance but perhaps at an extra premium as is the case here for cosmetic surgery. The exception being breast reconstruction after a mastectomy or gender reassignment after psychological profiling. This sort of thing though, shouldn't be subsidised by the NHS. . .bottom line, it's not essential and it is 'cosmetic' not plastic. Also, she could take hormonal treatments which will enlarge her breasts without the dangers of surgery.

    Next thing you'll have body builders wanting their prosthetic pectoral and glutimus maximus implants on the NGS . . .

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  6. Leah - The justification is medical need in the sense that the person is psychiatrically distressed by their unmet desire to be the opposite sex. Some latent transsexuals are seriously disturbed and even suicidal.

    Kylie - I guess for a transsexual it's not a question of living with what you've got as they didn't have it to begin with! But yes, being so mammocentric does make you wonder a little about her true identity!

    Baino - Apparently she IS taking hormones but presumably not with the desired effect! Psychological profiling is always a precondition for NHS surgery, but how can it seriously claim an overwhelming need for big breasts?

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  7. well, i changed from girl to woman without any control of how it all turned out and i know it's a bit different for a transexual but how different? the whole issue of what we hope for and what we get is common to all women.
    i dont know how it goes for the fellas, i'm just thinking that it is probably a bit less variable

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  8. Kylie - Oh, new pic there! True enough that what we hope for and what we get is something all women have to deal with. And men too. I'm sure there are plenty of blokes out there who would like to have huge muscles or chiselled features or more hair. Or of course a bigger doodad.

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  9. I am against any thing that messes with nature. There are any number of examples to show that it is a no win situation in the long run, to mess with nature. I would also imagine that this particular case is not as much about breast implants as about drawing attention to oneself!

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  10. Indeed, or use copious amounts of tissue like the rest of us!!

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  11. Ramana - Not messing with nature seems sensible to me too, though the majority of transsexuals claim they are very happy with their new gender identity and how can I argue with that? But I do think there's an element of attention-seeking, particularly those who let the TV cameras follow the whole process.

    Suburbia - Quite so! And the effect can be extremely convincing to us innocent blokes if the right filling material is used!

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  12. Having lived with a pastry board chest for many many years, I don't agree with these enlargements be they provided by NHS or otherwise. I totally agree with the wise person that said 'More than a handful was waste'!

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  13. Grannymar - More than a handful is waste, I like that. I'm sure those women who have to cope with enormous breasts and the resulting backache and male leering would agree too!

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  14. One of the blogs I visit recently posted some "vintage" Playboy shots. I'm not terribly excited by that sort of thing, but I must admit it was refreshing, to see some REAL breasts!

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  15. Megan - Indeed, that's what's so weird nowadays, you really have no idea if a woman's breasts are real or not. Perhaps the genuine women should wear a lapel badge "100% natural - absolutely no additives"?

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