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I’m looking for examples for something I’m writing. Trans people are diagnosed as trans based on not much more than their say-so. There are no lab tests, MRIs, CT or X-rays to diagnose it. I don’t think there’s any other medical field in which they cut off your testicles, uterus or any other organ because of the patient’s decision alone.

You can rule out cosmetic surgeries as an example, because trans surgeries aren’t just cosmetics - a double mastectomy isn’t just a breast reduction, for example.

My understanding is that psychiatric surgeries have gone mostly out of style, and while might be performed in some countries still, they’re a very rare edge case.

Thanks.

I’m looking for examples for something I’m writing. Trans people are diagnosed as trans based on not much more than their say-so. There are no lab tests, MRIs, CT or X-rays to diagnose it. I don’t think there’s any other medical field in which they cut off your testicles, uterus or any other organ because of the patient’s decision alone. You can rule out cosmetic surgeries as an example, because trans surgeries aren’t just cosmetics - a double mastectomy isn’t just a breast reduction, for example. My understanding is that psychiatric surgeries have gone mostly out of style, and while might be performed in some countries still, they’re a very rare edge case. Thanks.

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I know that there is a treatment for extremely debilitating OCD which involves brain surgery and an electrical implant which stimulates the brain. I don't think there's anything other than the accounting of the sufferer to diagnose these patients. However, in the specifics of the one case I know about, the patient was debilitated because he felt he had to always concentrate on his breathing and was constantly anxious over whether he was going to be unable to breathe. His distress was so extreme that he was going to surgeons and asking them to give him a tracheotomy.

I believe it's still a very experimental deal and hasn't been done often. The case I saw on a TV show talked about the struggle of this man to get insurance to cover the cost of the surgery and implant and extensive follow-up.

They can use implants like that on severe tourettes too.

[–] ProxyMusic 5 points Edited

But conditions like severe OCD and Tourettes are not self-diagnosed conditions that are purely psychological and internal like "gender dysphoria" or "transness" are. Being "gender dysphoric" and/or "trans" boils down to one, some or all of the following: 1) being obsessed with sex stereotypes, either because they cause distress or intense pleasure (or both); 2) desiring a different body type and set of physical sex characteristics to your own; 3) preferring and adopting a mode of dress, hair style, hobbies/interests/toys, affect and behaviors more associated with the opposite sex - or with neither sex - in your particular culture & era; and/or 4) issuing public pronouncements on social media and IRL about yourself and "your" pronouns to let others know that you are NLOG/W or NLOB/M and there will be hell to pay if anyone fails to see you as a part of a special breed of people who are apart and above the rest of us the way you see yourself.

By contrast, OCD and Tourette's are long-established, clearly-defined conditions, one neuropsychiatric and one neurological. Both conditions are subject to external diagnosis because they result in a set of observable, unmistakable symptoms that others (and machines) can see and measure. And the diagnosis can be verified by repeating the testing and analysis and getting additional opinions.

OP asked about conditions in which people get surgeries based solely on the patients' say-so. Nobody gets a diagnosis of OCD or Tourette's, much less invasive interventions like surgeries and devices implanted into the brain for those conditions, simply by telling a physician or therapist that they "feel like" or "identify as" having OCD or Tourette's or by claiming they have them. Sure, the symptoms of OCD and Tourette's can be mimicked and faked, but to give a diagnosis and recommend interventions, psychiatrists and neurologists will want to see evidence observed over time and will conduct a through investigation that will involve things like brain scans and testing of brain activity.