Oh of course, massive respect to the actually good surgeons specializing in things like genital reconstruction and organ transplants, shit is seriously impressive work. That's on me for not clarifying I mean two types of
bad surgeons doing sex reassignment. Sex organs are a complicated and delicate part of the body--I guess that's why gynecologists and urologists were some of the first medical specialty fields. Probably also why there's such a massive chasm of skill between the good doctors, and the Nazi war criminal ones.
What's more- if they're American, you can't make them do it.
If there's nobody who
wants to take off legs, that's fine, that's just a gap in the market I suppose. But there are plenty of surgeons who I'm sure would be completely willing to do things like that, safely, through legitimate means and with good results. What I don't agree with is that even surgeons who
would be willing to do medically superfluous procedures,
won't. As you said, no doctor "would" take off your legs "just because you want it". That might do more harm than good. I'm not sure how well I'll get my point across here, but I'll try anyways.
First of all, there seem to be two particularly big reasons why surgeons won't do procedures without a medically necessary reason. The first is obviously, they'd get sued. However, I won't really put much weight on this, because I'm pretty confident that if someone had a bodypart removed while confirmably aware of both the potential and definite consequences of it, and then regretted it, they wouldn't have that much of a case. The main problem there is that informed consent isn't very legally robust; if there were a fleshed-out legal definition of what constitutes as "informed" for medical consent, there would be basically no legal risk. As it is, a civil case wouldn't turn out well for the surgeon, but I don't think just for the problem of consent.
The second reason, and it seems the much bigger risk, both legally and professionally, is medical ethics. I know enough about medical ethics to know that "do no harm" is a simplification, but also how important it is. The problem is that what constitutes as "no harm", more often than not, really just means medical necessity. If something isn't made totally necessary by a medical condition, then it's "doing harm". In a binary way, that's fine, since procedures almost always take something away. Of course cutting off someone's perfectly healthy leg will have negative consequences, so it's just reasonable to say it's doing more harm than good. Conversely, if someone's leg is necrotized, falling off, and gone septic, then amputating it is doing more good than harm.
But these concerns seem to bolser an environment where genuinely unethical doctors thrive in places like sex reassigment surgery. Since SRS is a medical procedure for a psychiatric condition, it seems a lot of people, and consequently a lot of doctors, consider it as an unnecessary procedure. Which means that some surgeons
willing to go into it
won't, because it's too legally or ethically unsafe. And the more surgeons ultimately decide against going into it because of those risks, the higher the percentile of self-interested and unscrupulous hacks in the field.
Doctors being unwilling or unable to do unnecessary procedures also, more certainly, creates an environment where people will fake and lie to therapists and doctors for a rubber stamp. If any autogynephilic troon could get SRS without a Gender Dysphoria diagnosis, they wouldn't even bother trying to find psychiatrists to con, and the state of research would be in a much better place than it is now with 90% of the patientbase being malingerers. That's a bit more universal of a point, though; if any Munchie could just pay to get their lung taken out and lie to people that it was because cancer, hospitals would waste less resources on their bullshit, too.
Unnecessary surgeries being readily available just seems like a win-win to me.
yes it's probably awful that trans people have to go through this big change that will remind them that their body is not what they want, but you need to do it because it also weens out the people who feel 'dysphoric' because they had a traumatic puberty and not because they have actual gender dysphoria
Dysphoria and dissociation are common symptoms of puberty. Common symptoms of depression and autism, too. I would say people widely "forgot" that dysphoria isn't only gender-related, but that would imply anyone knew what dysphoria was in the first place.