Clearly wanting something isn’t enough to justify it, for many reasons.
I think the thing that needs more examination is how we tell the difference between the kind of mind that wants to saw its own arm off for no apparent direct gain from the kind of mind that knows it was born into the wrong body. These are clearly both deviations from the norm, but as a bisexual man, I also realize that a large portion of the population still believes I’m mentally ill, even if wanting other body parts isn’t part of my “illness”, and so I can’t reduce the plight of a pre-op trans person to just a simple matter of wants.
Continuing on the future tech thought experiment, I also wonder how opinions would change if a test were developed that could reliably predict if someone would be happier after an operation. Something that detects/indicates compatibility.
It seems that most opposition to these operations fall into two buckets:
1. The religious one, where this is an abomination and no amount of progress will change the nature of the opposition. I have little interest in arguing against this, since the premise is inherently illogical.
2. The logical one, built on the legitimate concern that an operation can’t be undone, and therefore could potentially cause more harm than benefit in the long run if the patient later realizes that they were mistaken.
Difficult for sure.
For example, I have met utilitarians that have little regard for life that has no economic value, but they are upfront regarding the value of life in economic terms, versus inherent value which a decision one has to make that is inherently illogical.
My point is that I have little interest in arguing against the claims in a book or books, written by men, claiming to be the infallible word of whichever god or gods in a discussion about an individual’s bodily autonomy and pursuit of personal well-being. I think it is as irrelevant as invoking any other random work of fiction.
Someone else can have that argument and I’ll eat popcorn, but as a child and survivor of a dogmatic and traumatic religious upbringing that taught me to hate my own sexuality, I have no interest in wasting more energy on it.
Part of the confusion around this topic might come from the many different perspectives on what it means to help someone in need.
Any parent knows that a child could (and have been known to) kill itself given the option to only eat what they want (candy, cookies, etc.) There are documented cases of near-death experiences of children due to parents who gave in and only fed the child favorite sugar rich-cereal for every meal.
It may seem unfair to the child that their parents are disrespecting their deeply held beliefs about their diet, but they aren’t mentally developed enough to understand what’s best for them.
Another analogous phenomenon is transeablism: “The desire to acquire a disability through choice rather than happenstance”
People suffering from this have been known to band-saw off their arms, or throw themselves into machinery to acquire disabilities to help their body match their internal mental identity/state.
One could imagine a nice doctor helping someone band-saw off their arm to achieve their mind/body peace if the technological cost on everyone was zero in some future, just as today we see well-meaning doctors chemically band-saw off people’s healthy body functions through chemical castration.
Definitely a difficult topic.