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So if someone with body integrity cuts off their leg, is that harm? Or treatment?
Of course it's harm. However, it very well may be viewed as harm caused by the person's attempt to treat, rather than harm from the underlying disorder.
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Serious question, because I think it's definitely harm, definitely caused by the disorder, and no different than surgical gender reassignment.
Well, the obvious difference is that gender reassignment surgery is an endorsed medical procedure, conducted (in general) by licensed physicians, and accepted practice in the medical community. Whereas lopping off your own leg is, you know,...not. Whether you and I think it should be an acceptable practice or not is a separate question.
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There is harm, and there is distress. They aren't necessarily the same.
They're not necessarily the same, but in this case, the distress (frequently extreme) caused by the disconnect between physical and perceived gender IS the harm that is deemed to be caused by gender dysphoria. If that distress didn't exist, or if it wasn't harmful, there would be no need to seek treatment.
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What you're saying is that someone with gender dysphoria experiences distress, and the "treatment" reduces that distress. It might, it might not- but I'm saying either way, the treatment itself is harm.
I can't speak to the efficacy of the treatment. I don't know if it relieves the distress or not. As I mentioned, with any treatment, the question is whether or not any harm caused by the underlying disorder outweighs any harm that comes with the potential treatment. For example, chemotherapy for cancer is basically poison to the body. They harm the body enormously. But that harm is acceptable because it treats the greater harm of the cancer itself.
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Whether or not someone is happy to believe their gender is different from their actual gender makes no difference insofar as that is concerned- it represents an incorrect perception of reality and of self, and is therefore disordered.
I think the medical community generally tries to stay away from calling harmless delusions "disorders." If they didn't, there'd be a lot of medical professionals trying to label the religious as "disordered" due to their incorrect perception of reality. Therefore, they only worry about something as a disorder if it causes harm.
I agree that, whether it causes harm or distress or not, believing yourself to be one physical thing when you are demonstrably another is a sign of something psychological or physiological not working correctly. I simply think the specific term "disorder" is use more narrowly for medical purposes.
Slowguy
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