Is this mutilation or liberation?

Sex change surgery (Transsexed). pic.twitter.com/W5jQk5dMqO

— Learn Something (@EarnKnowledge) August 14, 2019

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The federal 9th Circuit Court of Appeals said that the State of Idaho must provide this surgery for a gender-dysphoric male sex criminal imprisoned for sexually abusing a 15 year old boy. Now the Idaho taxpayer is going to have to provide this man with the surgery, then transfer him to a women’s prison. Beautiful. The court, and NPR, in its report, call this man “she.” Because all a trans person has to do is claim to be the opposite sex, and voilà… .

What if a man said that having his legs surgically removed was necessary to his well being. So that he could be his True Self? This is an issue the medical community is facing. Excerpts:

In the late 1990s, the Scottish surgeon Robert Smith performed elective, above-the-knee amputations on two people. (The hospital he was affiliated with eventually compelled him to stop.) Smith’s patients are just two examples of people who have body integrity identity dysphoria, also known as being transabled: They feel they are disabled people trapped in abled bodies. Some people feel that they are meant to be amputees and will even injure themselves in order to create the desired amputation or make it medically necessary for a surgeon to perform it. Other people feel that they were meant to be blind or deaf.

Anthropology scholar Jenny L. Davis writes about how transabled people construct their identities. Not all transabled people express what Davis refers to as “impairment needs” in the same way. She writes:

The term wannabe refers to those who want/need to have a physical impairment. Pretenders act out their impairment-needs by, for example, folding an appendage, inserting ear plugs, wearing opaque contacts, walking on crutches, wheeling themselves in a chair, or wearing neck/leg/back braces. Devotees experience fetishistic attractions toward the physically impaired bodies of others…

More:

Philosophers Tim Bayne (Monash University, in Melbourne, Australia) and Neil Levy (University of Oxford, in England, and Macquarie University, in Sydney, Australia) make the case that transabled people who seek amputations should be allowed to get them from reputable surgeons. They write:

Given that many patients will go ahead with amputations in any case and risk extensive injury or death in doing so, it might be argued that surgeons should accede 
to the requests, at least of those patients who they (or a competent authority) judge
 are likely to take matters into their own hands.

They also cite the issue of autonomy. If people can choose to reject life-saving treatments, the authors ask, why shouldn’t they be allowed to elect a surgery that will leave them disabled? If a person can elect to have plastic surgery, which is often used to make the body conform better to social ideals, why shouldn’t people also be allowed to change it in ways that society is less comfortable with? Lastly, they argue that according to the limited data available, people who seek and achieve their desired amputations feel relief from their suffering, a relief that they are unable to get by other means.

If transgender surgeries are not only permitted, but under certain conditions can be ordered as medically necessary (as in the Idaho inmate case), on what grounds do we refuse to allow the “transabled” to have the surgeries they want? Because it’s weird? That won’t fly.

So why then? Because such surgery takes a healthy, functioning part of the body and renders it non-functional (or non-existent)? What do you call what that video above demonstrates sex-change surgery does to the penis and testicles?

If individual autonomy trumps all other considerations, and “health” (an objective state) is defined as “well being” (a subjective state), then why would you tell a “transabled” person that they can’t lop their legs off it they want it badly enough?

Why is one liberation, but the other mutilation?

UPDATE: A reader writes, snarkily:

If we don’t allow the surgeries, people will just travel to unsafe countries for the procedures, or they’ll go to back-alley amputationists.