medically necessary

On Bruce Jenner and Gender

In between books, so I have a minute to comment on issues of the day.

Let’s start with Bruce Jenner and his public pronouncement that he thinks of himself and plans to live as a woman. This is instructive partly because of various reactions: some feminists resent a privileged white man muscling in on their desire to be both utterly equal and specially protected. One spokeswoman for that point of view demanded he get a vagina and suffer pay discrimination before being allowed to call himself a woman.

Others were all for his announcement and supportive of the blow he was striking in public for coming out as who you feel you really are, until he also mentioned she sees herself as a Christian, conservative Republican. Fuses blew and some partisans disowned him — not “the right sort” to be striking a blow for anyone’s freedom.

I’ve known transgender people both pre- and post-op, as well as other diverse sorts. The feeling that your body does not go along with the gender role you feel comfortable as is real and efforts to do something about it are understandable. But it’s interesting that what activists say they work toward — complete equality of the sexes — if achieved, would reduce the expectations of stereotyped behaviors from either sex and make this discordance less uncomfortable. There are people who aren’t bothered by the equipment they have and just bravely act the way they wish to, disregarding social convention, and there always have been. The idea of a physical sex change operation is recent and still somewhat impractical; we can imagine the day when medical science allows a real genetic and physical modification that makes one sex the other, and vice-versa. Science fiction has it covered, with some highly-advanced societies of people with very long lives who choose to change sexes occasionally for variety.

But why? I support everyone’s effort to achieve the self they want. But counselling very young people to start considering a sex change operation — instead of supporting them in being who they want to be in the body they have — seems like a mistake. The numbers of people who go through the operations and come out the other side regretting it are larger than activists prefer to acknowledge. It’s like going along with peer pressure to get lots of heavy metal tattoos and realizing later you didn’t need that permanent change to be a rebel, or to be who you are. Making it Conventional Wisdom that any gender confusion should be solved by hormones and surgery is making it harder for people with that problem to make the wisest decisions for themselves.

The worst political issue related to this now is the sneaky subversion of the law of medical necessity, which has been quietly changed to include sex change operations as “medically necessary.” Most people assume that means you must have a treatment or you will die or be incapacitated; being unhappy because your body doesn’t match your feelings does not really qualify. But by slipping this in to regulations, then requiring insurance and state health care to cover all “medically necessary” treatment, you get bizarre and undemocratic outcomes like a $300K sex change for a state prisoner, when law-abiding citizens go without care outside the prison. This incites a horrible and unnecessary conflict between traditionalists who rightly feel they were snookered, and people sympathetic to the transgender, for whom good results for victims trump any consideration of who pays and whether such payments are just.

Death by HR: How Affirmative Action Cripples OrganizationsDeath by HR: How Affirmative Action Cripples Organizations

[From Death by HR: How Affirmative Action Cripples Organizations,  available now in Kindle and trade paperback.]

The first review is in: by Elmer T. Jones, author of The Employment Game. Here’s the condensed version; view the entire review here.

Corporate HR Scrambles to Halt Publication of “Death by HR”

Nobody gets a job through HR. The purpose of HR is to protect their parent organization against lawsuits for running afoul of the government’s diversity extortion bureaus. HR kills companies by blanketing industry with onerous gender and race labor compliance rules and forcing companies to hire useless HR staff to process the associated paperwork… a tour de force… carefully explains to CEOs how HR poisons their companies and what steps they may take to marginalize this threat… It is time to turn the tide against this madness, and Death by HR is an important research tool… All CEOs should read this book. If you are a mere worker drone but care about your company, you should forward an anonymous copy to him.