DAB No. 2576 - NCD 140 3 Transsexual Surgery

DAB No. 2576 - NCD 140 3 Transsexual Surgery by EvanMcSan

A follow-up to a previous post on the issue.

Reading between the lines, there are some very damning comments about how the original decision was arrived at - such as the dismissal of studies with follow-up over many years as "not long-term" without defining what "long-term" meant; or the citing of treatment as "controversial", not in a scientific sense, but a political one.

We note that in addition to stating that transsexual surgery was experimental, the NCD and the 1981 report stated that transsexual surgery was "controversial." NCD Record at 18(1981 report stating that "[ o ]ver and above the medical and scientific issues, it would also appear that transsexual surgery is controversial in our society"). The AP and the new evidence dispute the relevance of this statement. The AP objected that this point relies on two "polemics" that are "are either completely unscientific or fall far outside the scientific mainstream," and Dr. Ettner stated that the views expressed therein "fall far outside the mainstream psychological, psychiatric, and medical professional consensus and call into question the objective reasonableness of the NCD. AP Statement at 15-16; Ettner Supp. Decl. at,;,; 17-18. CMS has not asserted that the Board's decision may be based on factors over and above the medical and scientific issues involved. Considerations of social acceptability (or nonacceptability) of medical procedures appear on their face to be antithetical to Medicare's medical necessity inquiry, which is based in science, and such considerations do not enter into our decision that the NCD is not valid.

One of those appears in this post, 50,000 deaths. I'll try to find the source of the other one, a religious tract. Though the first one is a religious tract too, or at least, ideological.
Neither Religion nor Ideology have any place in medicine, or indeed, science generally.

Tony Abbott - Trust Me

It's not just the fact that the budget is deliberately and maliciously targeted at the poor. It's the completely blatant lies, no attempt to cover them up, and no end to them, they keep on coming.

Trust

No Government Should Get to Decide This

Why Does Kindness Get You? This.

At Last The 1948 Show - Episode 1

Do Not Adjust Your Set - Episode 1

The Social Construction of Sex

The Social Construction of Sex - Pacific Standard: The Science of Society - Alice Dreger

This, then, brings us to the issue of gender identity. Gender identity can be described as the internal feeling of being a boy, girl, man, woman, or something else. Is gender identity socially constructed—that is, are people taught to feel like one or the other?

When I started doing intersex work,I thought so. I thought we were taught to feel, act, and behave like girls and boys. But I don’t think that anymore. That is to say, sure we’re taught these things, but many of us probably get our core gender identities as much from our biological origins as we do from our gender educations. I’ve met too many people who, in spite of careful gender educations—sometimes even intensive gender educations—just clearly felt the gender assigned to them was the wrong one. I’ve also seen a lot of evidence from intersex that prenatal hormone levels correlate with gender-type behaviors, gender identities, and even sexual orientation. (Correlate, not cause! But correlations can be useful clues to causal factors.)

...

On this note, let me just say this: People who think gender identities, gender roles, and sexual orientations are all socially constructed are the most naive biological determinists I’ve ever seen. They think all human brains are completely without structure when it comes to these things; we all have empty slates in our skulls at birth. No, we don’t! Really!
In fact, I think we can’t know that much about any individual person’s biology without a huge amount of study on that person—and even then, it’s hard to know much. (I think the same is true about an individual person’s social history.) In this sense, I’m much less of a strict biological determinist than the social constructivists people incorrectly lump me with. I happen to think that, for any given child, we can’t predict with certainty what gender identity or sexual orientation she or he will grow up to have, even if the child is raised in a very sex-role-strict culture. Some will go against our best guesses and educational attempts—we know that again from cross-cultural studies, where transgender, lesbian, bi, and gay children and adults show up again and again.

Yup. That sums it up pretty well.

US MilitaryTransgender ban

From the AP

An independent commission led by a former U.S. surgeon general has
concluded there "is no compelling medical reason" for the U.S. armed
forces to prohibit transgender Americans from serving and that President
Barack Obama could lift the decades-old ban without approval from
Congress, according to a report being released Thursday.

"We determined not only that there is no compelling medical reason for
the ban, but also that the ban itself is an expensive, damaging and
unfair barrier to health care access for the approximately 15,450
transgender personnel who serve currently in the active, Guard and
reserve components," said the commission led by Dr. Joycelyn Elders, who
served as surgeon general during Bill Clinton's first term as
president, and Rear Adm. Alan Steinman, a former chief health and safety
director for the Coast Guard.

At least a dozen nations, including Australia, Canada, England and
Israel, allow military service by transgender individuals. Transgender
rights advocates have been lobbying the Pentagon to revisit the blanket
ban in the U.S. since Congress in 2010 repealed the law that barred gay,
lesbian and bisexual individuals from openly serving in the military.

"At this time there are no plans to change the department's policy
and regulations which do not allow transgender individuals to serve in
the U.S. military," said Navy Lt. Cmdr. Nate Christensen, a defense
department spokesman.

Scientists Discover Children’s Cells Living in Mothers’ Brains - Scientific American

Scientists Discover Children’s Cells Living in Mothers’ Brains - Scientific American

Women may have microchimeric cells both from their mother as well as from their own pregnancies, and there is even evidence for competition between cells from grandmother and infant within the mother.

It's more complicated than most people think. Our bodies are not static, they are performance art. We are not defined completely by our DNA.

A Re-run of Munich. If we're lucky...

See also Munich Agreement

The Munich Agreement was a settlement permitting Nazi Germany's annexation of portions of Czechoslovakia along the country's borders mainly inhabited by German speakers, for which a new territorial designation "Sudetenland" was coined. The agreement was negotiated at a conference held in Munich, Germany, among the major powers of Europe, without the presence of Czechoslovakia. Today, it is widely regarded as a failed act of appeasement toward Germany. The agreement was signed in the early hours of 30 September 1938 (but dated 29 September).

If the EU gets its act together, then stationing a few special weapons under Ukrainian control might defuse the situation. They gave up their own in return for a guarantee. We must make good on that promise, or return the capability to them. And let Putin know that those are the two options - which would he prefer?

UPDATE : Ukraine calls on NATO to make good on guarantee.

1997 Charter on a Distinctive Partnership between the North Atlantic Treaty Organization and Ukraine:

14. NATO Allies will continue to support Ukrainian sovereignty and independence, territorial integrity, democratic development, economic prosperity and its status as a non-nuclear weapon state, and the principle of inviolability of frontiers, as key factors of stability and security in Central and Eastern Europe and in the continent as a whole.
15. NATO and Ukraine will develop a crisis consultative mechanism to consult together whenever Ukraine perceives a direct threat to its territorial integrity, political independence, or security.
16. NATO welcomes and supports the fact that Ukraine received security assurances from all five nuclear-weapon states parties to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT) as a non-nuclear weapon state party to the NPT, and recalls the commitments undertaken by the United States and the United Kingdom, together with Russia, and by France unilaterally, which took the historic decision in Budapest in 1994 to provide Ukraine with security assurances as a non-nuclear weapon state party to the NPT. 

1956 GOP Policy

Post by Alan Grayson.

Methodological Questions in Childhood Gender Identity ‘Desistence’ Research

Methodological Questions in Childhood Gender Identity ‘Desistence’ Research from Kelley Winters

An Oopsie in Arizona.

HB2153 was supposed only to target GLBT people. But the way it's been drafted means it goes rather further than that.

Sec. 2.  Section 41-1493.01, Arizona Revised Statutes, is amended to read:

41-1493.01.  Free exercise of religion protected; definition

A.  Free exercise of religion is a fundamental right that applies in this state even if laws, rules or other government actions are facially neutral.

B.  Except as provided in subsection C, government of this section, state action shall not substantially burden a person's exercise of religion even if the burden results from a rule of general applicability.

C.  Government State action may substantially burden a person's exercise of religion only if it the opposing party demonstrates that application of the burden to the person person's exercise of religion in this particular instance is both:

1.  In furtherance of a compelling governmental interest.

2.  The least restrictive means of furthering that compelling governmental interest.

D.  A person whose religious exercise is burdened in violation of this section may assert that violation as a claim or defense in a judicial proceeding, and obtain appropriate relief against a government regardless of whether the government is a party to the proceeding.  The person asserting such a claim or defense may obtain appropriate relief.  A party who prevails in any action to enforce this article against a government shall recover attorney fees and costs.

E.  In For the purposes of this section, the term substantially burden is intended solely to ensure that this article is not triggered by trivial, technical or de minimis infractions.

F.  For the purposes of this section, "state action" means any action by the government or the implementation or application of any law, including state and local laws, ordinances, rules, regulations and policies, whether statutory or otherwise, and whether the implementation or application is made or attempted to be made by the government or nongovernmental persons.

While the government has a compelling interest in preventing murder in general, it's arguable that there is no compelling interest in preventing the murder of gays, just as there is no compelling interest in preventing them from being arbitrarily fired. The state often sanctions killing, by police in the course of their duties, or execution. There are thus obvious exceptions to the general rule.

Similarly, while the the state has a compelling interest in preventing the murder of children in general, does it have a compelling interest in preventing the sacrifice of a particular child by the child's parent?

This bill is so broad in its exemptions that such cases are at least arguable, and I think, the defendant would succeed on the wording if not the intent.

It's not just *an* interest, it's a *compelling* interest the government must have, in that particular case and those particular circumstances, not in general. And the law must not be over-broad, it has to be the minimum needed to satisfy the *compelling* interest. Exceptions are allowed.

So yes, they have just legalised human sacrifice, if it's done in the name of religion. In fact, all laws unless very narrowly drafted as the minimum to accomplish a goal that is of *compelling* interest no longer apply, if religious belief is invoked as a defence.

That apparently wasn't the intent, but judges have to interpret the law as written.

You probably missed this. A game changer.

It's a long video. You can't afford to miss it. The world has changed when we weren't looking.

If that's too long to watch, and too full of marketing hype, here's how it works.

Puff the Magic Dragon

This song always bothered me. This lovely song seemed just plain wrong, and far, far too sad. I always instinctively felt there was something missing.
And apparently, there was.

The original poem had a verse that did not make it into the song. In it, Puff found another child and played with him after returning. Neither Yarrow nor Lipton remember the verse in any detail, and the paper that was left in Yarrow's typewriter in 1958 has since been lost.

http://www.songfacts.com/detail.php?id=1276
Before I found this out, here's the verse I composed myself, a long time ago, as a child.

My song is nearly finished.
All good things have their ends.
But there are new beginnings,
And dragons find new friends.
Puff's new friend's Suzy Alice,
They laugh and have great fun.
For Suzy's great-grandfather
Was Jackie Paper's son.

Consider it released under the Creative Commons license for anyone else who wants to sing a more complete version.

A slightly variant form of this appeared in the comments at http://aebrain.blogspot.com.au/2009/12/some-girls-have-thing-for-horses.html

As far as I'm aware, the lyrics of the original verses, though not this one are (C) Leonard Lipton and Peter Yarrow and no challenge to the current copyright owners is intended.

Perspective

Earth, as seen from Mars

Restoring Natural Sensory Feedback in Real-Time Bidirectional Hand Prostheses

Restoring Natural Sensory Feedback in Real-Time Bidirectional Hand Prostheses Raspopovic et al Sci Transl Med 5 February 2014:

More please, and faster.

Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an object. Ideal bidirectional hand prostheses should involve both a reliable decoding of the user’s intentions and the delivery of nearly “natural” sensory feedback through remnant afferent pathways, simultaneously and in real time. However, current hand prostheses fail to achieve these requirements, particularly because they lack any sensory feedback. We show that by stimulating the median and ulnar nerve fascicles using transversal multichannel intrafascicular electrodes, according to the information provided by the artificial sensors from a hand prosthesis, physiologically appropriate (near-natural) sensory information can be provided to an amputee during the real-time decoding of different grasping tasks to control a dexterous
hand prosthesis.
This feedback enabled the participant to effectively modulate the grasping force of the prosthesis with no visual or auditory feedback. Three different force levels were distinguished and consistently used by the subject. The results also demonstrate that a high complexity of perception can be obtained, allowing the subject to identify the stiffness and shape of
three different objects by exploiting different characteristics of the elicited sensations. This approach could improve the efficacy and “life-like” quality of hand prostheses, resulting in a keystone strategy for the near-natural replacement of missing hands. 

Satisfaction with Genital Surgery and Sexual Life of Adults with XY Disorders of Sex Development:

Satisfaction with Genital Surgery and Sexual Life of Adults with XY Disorders of Sex Development

Koeler et al, Jnl Clin Endoc Metab Vol 97 Issue 2, February 1, 2012.

Results:

Dissatisfaction with function of the surgical result (47.1%) and clitoral arousal (47.4%) was high in XY,DSD partially androgenized females after feminization surgery. Dissatisfaction with overall sex life (37.5%) and sexual anxieties (44.2%) were substantial in all XY,DSD individuals. Problems with desire (70.6%), arousal (52.9%), and dyspareunia (56.3%) were significant in XY,DSD complete females. 46,XY partially androgenized females reported significantly more often partners of female (9.1%) or both sexes (18.2%) and dyspareunia (56.5%) compared with controls. Individuals with complete androgen insensitivity syndrome stated significant problems with desire (81.8%), arousal (63.6%), and dyspareunia (70%).

Conclusions:

Care should be improved in XY,DSD patients. Constructive genital surgery should be minimized and performed mainly in adolescence or adulthood with the patients' consent. Individuals with DSD and their families should be informed with sensibility about the condition. Multidisciplinary care with psychological and nonprofessional support (parents, peers, and patients' support groups) is mandatory from child to adulthood.

While I'm not real thrilled with the "XY, DSD" terminology, a nose by any other name would smell. The point is, don't surgically change Intersex kids unless it's immediately medically (not socially) necessary

New Medical Treatments for Transgender Adolescents: Norman Spack at TEDx...