alt Hacker NewsDoctors are allowed to make judgement calls within whatever rules the insurance providers and laws give. The status quo before all this was that gender-affirming care was never covered, which changed to always covered in discrete steps across the 2000s and 2010s. Doctors didn't get to decide that on their own. Before that even, medical schools instill rules and values that come mostly from the outside, while the medical knowledge and experience is from the inside.
Another controversy is physician-assisted s–... euthanasia. Some doctors would consider it medically necessary, but they can't legally perform or even recommend it, as it's considered murder. They can in Canada. Abortion of a viable fetus not threatening the mother is illegal in all 50 US states, but legal in many states in earlier stages, again based on what the states consider murder (but the doctor judges what is viable or a threat to the mother).
Anyway if gender-affirming care is just medically desired but not medically necessary, the sterilization is accepted but not necessary. I agree with the spirit of the wording, even though it's imprecise, because it highlights that children are taking on an irreversible side effect. It's a short quote and not a whole essay where he gets to clarify.
I’m curious, do you personally know anybody who’s gone through gender-affirming-care?
For me it was a really confusing issue until I became close friends with someone whose childhood best friend is trans.
If he was born a decade earlier, he probably would have killed himself (this was the path he was on, which is incredibly tragic and all too common); the gender dysphoria invoked depression was unbearable.
Instead, he was able to work through therapy and medical care to understand his gender dysphoria and receive gender affirming care in his late teens.
Now (over a decade post treatment) he’s among the most cheerful people I’ve ever met. He inspires joy as a band teacher, is inspiringly happily married, and is raising a beautiful baby girl.
I often think about him when people talk about the issue in the abstract. The hundreds of children whose lives he’s impacted for the better, let alone the lives of his friends and family. Removing gender affirming care is implicitly saying you don’t want any of that to happen, because the logical conclusion of removing is people like him in a pit of depression and despair that often ends in suicide, all over an affliction that they did not choose.
This is where the “medically necessary” part of gender affirming care comes from.
I didn’t understand it before I knew him and his story so I don’t begrudge people who are in shows I used to walk in. But I’d encourage people to try to understand and lead with empathy and meet people where they are.