‘Gender Hybrid’ Children?

Fresh off publishing an unsubstantial attack on the Cass Review that recommended against puberty blockers for gender dysphoric youth, the New England Journal of Medicine offers an advocacy piece demanding that prisoners claiming to be transgender be given free “transition surgeries.” From “Gender-Affirming Surgical Care in Carceral Settings“:

Several U.S. courts have held that access to gender-affirming care during incarceration is a trans person’s right. This conclusion is reflected in the Federal Bureau of Prisons (BOP) clinical guidance, which governs clinical care provision within federal carceral facilities, which house an estimated 1200 trans people. The BOP, whose guidance often sets the standard for health care delivery in state and local carceral facilities, recommends provision of gender-affirming care during incarceration, including consideration of surgical procedures.

Prisoners should receive proper medical care, of course. But transgender identity is a subjective emotional issue, not a disease such as cancer or a medical emergency like a heart attack. Indeed, these days people “change” their genders with a mere assertion of identity — and society is supposed to provide and pay for every accommodation that transgender advocates conjure.

But Wesley! Prisons should follow medical guidelines in treating prisoners.

True. Except in this case, the guidelines the authors want followed are those pushed by the discredited transgender-ideological medical organization WPATH:

Carceral facilities should follow international standards of care laid out by the World Professional Association for Transgender Health (WPATH), the most recent of which move away from the historical (and stigmatizing) gate-keeping approach that accepted the outdated classification of trans identities as mental health conditions, making psychiatrists the primary arbiters of the provision of gender-affirming care. Gender-affirming care in carceral settings should be supervised by trained medical providers utilizing the informed-consent approach broadly used for patient-centered clinical decision making, allowing trans persons to develop plans involving medical therapy, surgical therapy, or both. The evaluation process for surgical affirmation should follow WPATH’s guidance, including aligning surgical and medical gender-affirming care planning as well as the person’s reproductive goals.

I guess that means we should also freeze the eggs of women who identify as trans men before their hysterectomies.

And check out the resources — financial, time, and personnel — that would be required to accommodate the desires of trans prisoners:

To meet these standards, carceral facilities may need to identify, and potentially train, appropriate professionals to complete the mental health assessments recommended as part of presurgical evaluations. Carceral systems can establish relationships with gender-affirming surgeons as they do with other surgical care clinicians who deliver care in carceral settings, with surgical plans developed using the same patient-centered approach used in community settings. These plans include postoperative management, which often requires tailored wound, nursing, and medical care that would have to be supervised and delivered by carceral-facility staff if the person is incarcerated during the postsurgical period.

Not only that, but even prisoners to be incarcerated for short periods should have access to surgeries:

With increasing uptake of surgical affirmation in general, trans people are likely to be incarcerated at various stages of the process. Carceral systems should therefore anticipate gender-affirming surgical needs even when the period of incarceration is brief.

And Medicaid should pay! Good grief. Talk about the tail wagging the dog.

There is a far larger issue at stake here than whether trans prisoners should be entitled to have their gonads or secondary sex characteristics surgically altered on the taxpayers’ credit card — which for me is a hard no. The New England Journal of Medicine used to be a national treasure. But it is growing more ideologically outrageous with almost every edition it publishes.

Indeed, it is ruining — has ruined? — its reputation for sober and trustworthy scientific discourse because of its editors’ continual descent into woke advocacy. That’s very bad for medicine and the society the Journal is supposed to serve.