Reality: The NCHCT commissioned Raymond’s paper to both support and inform only 1 of 3 conclusions found in the OHTA Report. The three conclusions were: Raymond’s NCHCT report and Raymond’s own citation are used to make the “ethical” case that trans medical care should be excluded from public insurance policies because it’s “controversial.” Thomas Szasz’s review of Raymond’s 1979 book (in which she calls for trans care to be morally mandated out of existence) is also cited after Raymond drew attention to it in her NCHCT report. Recall that OHTA said the NCHCT “was directed to consider broadly the implications of new and existing medical technologies, including their legal, ethical and social aspects.” The OHTA report explicitly claims that Raymond’s NCHCT report functioned to support this purpose. One-third of the 773 respondents reported that waiting for a gender clinic appointment had contributed to suicidal behaviour. One wrote: “If I hadn’t started self-medicating out of desperation, I’d have hanged myself by the end of 2018.” I cannot help but feel that every word wasted on manufactured debates could have been spent talking about the fact that trans people are being driven to a choice between self-medication and suicide. The conclusion of the report was that transsexual surgery is ‘controversial’ and ‘must be considered experimental.’”

Raymond's views on transgender people have been criticized by LGBT and feminist writers as transphobic, and constituting hate speech against transgender people. [11] [12] [13] [14] In conclusion, my 1980 paper on the social and ethical aspects of transsexual surgery did not feature influentially in the NCHCT’s report concluding that transsexual surgery was controversial and experimental. Nor did the NCHCT report “eliminate” federal and state funding for transsexual surgery because funding was not approved for this purpose long before my paper was written. 3) Fiction: Note that these reports were intended to be primarily used by groups such as federal health programs, third-party payers, policy-makers, and legislators. Indeed, NCHCT reports are cited by third-party payers as being a metric they’ve used [3 ] to determine coverage and, specific to OHTA reports, the NCHCT said that “[t]hird party reimbursers, providers, hospital administrators, health policy-makers and analysts, and government officials have reported using the assessments as well.”

5) Fiction:

The government never funded any trans medical care, therefore her contribution didn’t actually change funding of trans care. Carol Riddell argued in 2006 that The Transsexual Empire "did not invent anti-transsexual prejudice, but it did more to justify and perpetuate it than perhaps any other book ever written." [19] The castration business is booming. According to Peters, the gender clinic at OHSU has “the highest volume on the West Coast”—and with the help of the robot, his team can perform multiple vaginoplasties per day. The phalloplasty program has a 12-to-18-month waiting list for consultations and an additional three-to-six-month waiting list for surgical appointments. Over and above the medical and scientific issues, it would also appear that transsexual surgery is controversial in our society. For example, Thomas Szasz has asked whether an old person who desires to be young suffers from the “disease” of being a “transchronological” or does the poor person who wants to be rich suffer from the “disease” of being a “transeconomical?” (Szasz 1979). Some have held that it would be preferable to modify society’s sex role expectations of men and women than to modify either the body or the mind of individuals to fit those expectations. (Raymond 1980).”

FM I am constantly frustrated by the idea that women’s rights and trans rights are in opposition. These are not two separate categories. Some trans people are women, and therefore the struggle for women’s rights is also theirs, even if they do not experience all of the same issues as cisgender women. Some trans people who are not women are affected by issues that have historically been part of the women’s rights movement; for example, some transgender men and non-binary people also need access to reproductive healthcare. Trans people of all genders are affected by issues like domestic and sexual violence. To be the parent of a trans person now, in Britain, is also to witness a regular assault of distortions and half-truths. We hear that trans people can access medical treatment with dangerous ease, when they in fact face monstrous waiting times, or that there is a powerful trans lobby trampling on the rights of others when anti-trans groups are significantly better resourced. Hostility to trans rights runs across the political spectrum, from the Arkansas Republicans who have just banned treatment for young trans people, to George Soros-haters, to radical feminists and liberal opinion formers. Heyes, Cressida J. (June 2003). "Feminist Solidarity after Queer Theory: The Case of Transgender". Signs: Journal of Women in Culture and Society. 28 (4): 1093–1120. doi: 10.1086/343132. S2CID 144107471. The Transsexual Empire has become the archetypal articulation of radical feminist hostility to transsexuality and has had a persistent influence on feminist perceptions of transgender.

4) Fiction:

A meta-analysis published in 2010 by Murad, et al., of patients who received currently excluded treatments demonstrated that there was a significant decrease in suicidality post-treatment. The average reduction was from 30 percent pretreatment to 8 percent post-treatment.

Rooke, Alison (April 2008). "Review of The Transgender Studies Reader". Culture, Health & Sexuality. 10 (3): 307–308. ISSN 1369-1058. JSTOR 20461007. a b Shrage, Laurie J., ed. (2009). You've Changed: Sex Reassignment and Personal Identity. Oxford University Press. pp.47, 98. ISBN 978-0-19-974502-9 . Retrieved 29 August 2020. Clements-Nolle, et al., studied the predictors of suicide among over 500 transgender men and women in a sample from San Francisco and found a prevalence of suicide attempts of 32 percent. In this study, the strongest predictor associated with the risk of suicide was gender-based discrimination which included “problems getting health or medical services due to their gender identity or presentation.” According to Gorton, “Notably, this gender-based discrimination was a more reliable predictor of suicide than depression, history of alcohol/drug abuse treatment, physical victimization, or sexual assault.” Throughout the essay, Stone examines several representations of male-to-female "transsexuals", [1] including autobiographies, biographies, and medical literature. She begins with a passage from Jan Morris's Conundrum (1974), and goes on to discuss Niels Hoyer’s account of Lili Elbe in Man Into Woman (1933), Hedy Jo Star's autobiography I Changed My Sex! (1963), and Canary Conn's Canary (1977). These accounts are all discussed critically for their portrayal of transsexualism as a simple switch from male to female with no ambiguity or middle period, and for their tendency to reinforce "a binary, oppositional mode of gender identification." [11] :6

2) Fiction:

The NCD record also includes three letters that the Transsexual Rights Committee of the American Civil Liberties Union (ACLU) of Southern California sent to HCFA in April 1982 disagreeing with HCFA’s non-coverage policy. The ACLU letters enclose letters and affidavits from physicians and therapists supporting the medical necessity of transsexual surgery and taking issue with the non-coverage determination. On May 11, 1982, a HCFA Physicians Panel, which had referred the issue of coverage to the NCHCT in September 1980, recommended against referring the ACLU’s submissions to PHS, “on the basis that it does not contain information about new clinical studies or other medical and scientific evidence sufficiently substantive to justify reopening the previous PHS assessment.” The NCHCT’s May 6, 1981 memorandum, the 1981 NCHCT report, and the notes of the HCFA Physicians Panel meeting on May 11, 1982, are the materials in the NCD record containing analysis by HCFA or PHS of the issue of Medicare coverage of transsexual surgery. Although the NCD was not issued until 1989, it is clear that the NCD was based on the NCHCT report and memorandum from 1981. The National Institute of Mental Health of the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) performed a literature review and provided an opinion on the efficacy of sex change surgery for transsexualism. The information database on transsexual surgery prepared under contract for HCFA by Health Information Designs, Inc., and a National Center for Health Care Technology commissioned paper on the social and ethical aspects of transexual surgery by Janice G. Raymond, Ph.D., of Hampshire College, University of Massachusetts, were used in this assessment. In the essay, Stone critiques medical research and theory that deem transgender individuals too illogical or damaged to represent themselves, as well as the institution of passing and its role in the reproduction of binary gender and sexist social norm. Stone argues that these social phenomena have precluded transgender individuals from participating in their own discourse, and bear negative psychic, social, and political consequences. In response, she proposes the formation of a counter-discourse that disrupts binary understandings of gender, thereby allowing transgender individuals to speak as transgender subjects.

But focusing on the “why” of this link is missing the point. To those asking this question, I would ask: Why do you want to know? What would you do with the answer? I am suspicious of this line of questioning for the same reason I am suspicious of attempts to identify a so-called “gay gene”. The next logical step, after the search for a cause, is the search for a cure. It’s possible, even likely, that the increases in people identifying as transgender, especially female-to-male, are due to the greater visibility of trans people in general and trans men in particular. The internet and social media will have played a part in this heightened awareness. But why jump to the conclusion that this is indoctrination? Information, you could call it, or support, or solidarity. And why be so much more perturbed that people assigned female at birth should make choices about their own bodies? Being trans and being autistic Institute of Medicine’s A Consortium for Assessing Medical Technology: Planning Study Report, 11/1983, p 3Others have expanded Stone's concepts or incorporated them into their own frameworks, such as Talia Mae Bettcher, whose concept of first-person authority (FPA) is inspired by Stone’s appeal to "trans-authored narratives". [2] a b Culter, Connie (July 12, 1980). "The Transsexual Empire: The Making of the She-Male". Gay Community News. Boston: The Bromfield Street Educational Foundation. 7 (50): 11. ProQuest 199398282. This chance of regret is treated as a problem unique to gender-affirming treatment, but it is inherent to many forms of medical care. Regret is a consequence of living. We still have the right to make decisions on our own behalf. Is there a ‘social contagion’?