Surgery Requirement Held to be Unconstitutional


A Japanese family court has ruled that the country’s requirement that transgender people be surgically sterilized to change their legal gender is unconstitutional. The ruling is the first of its kind in Japan, and comes as the Supreme Court considers a separate case about the same issue.

In 2021, Gen Suzuki, a transgender man, filed a court request to have his legal gender recognized as male without undergoing sterilization surgery as prescribed by national law. This week the Shizuoka Family Court ruled in his favor, with the judge writing: “Surgery to remove the gonads has the serious and irreversible result of loss of reproductive function. I cannot help but question whether being forced to undergo such treatment lacks necessity or rationality, considering the level of social chaos it may cause and from a medical perspective.”

In Japan, transgender people who want to legally change their gender must appeal to a family court. Under the Gender Identity Disorder (GID) Special Cases Act, applicants must undergo a psychiatric evaluation and be surgically sterilized. They also must be single and without children younger than 18.

Momentum is growing in Japan to change the law, as legal, medical, and academic professionals are speaking out against it. United Nations experts and the World Professional Association for Transgender Health have both urged Japan to eliminate the law’s discriminatory elements and to treat trans people, as well as their families, the same as other citizens.

In 2019, Japan’s Supreme Court upheld a lower court ruling that stated the law did not violate Japan’s constitution. However, two of the justices recognized the need for reform. “The suffering that [transgender people] face in terms of gender is also of concern to society that is supposed to embrace diversity in gender identity,” they wrote. Earlier this year, the Supreme Court ruled in favor of a trans government employee using the restrooms in accordance with her gender identity. Her employer had barred her from using the women’s restrooms on her office floor because she had not undergone the surgical procedures and therefore had not changed her legal gender.

The current case before the grand chamber of the Supreme Court asks the justices to eliminate the outdated and abusive sterilization requirement.

link: https://www.hrw.org/news/2023/10/16/japan-court-rules-against-mandatory-transgender-sterilization

archive link: https://archive.ph/4IRKj

  • Nobody@lemmy.world
    link
    fedilink
    English
    arrow-up
    146
    arrow-down
    7
    ·
    8 months ago

    Rationality wins out in the end. People are who they are. The less the government is involved, the better. What right does the state have to tell you who you are or who you should love?

    Consenting adults should be allowed to live out their lives. Why is this even an issue? How does it hurt anyone to have someone live as the person they truly are so they can be happy?

        • Adi2121@lemmy.ml
          link
          fedilink
          English
          arrow-up
          8
          ·
          8 months ago

          The subscribers list shows only subscribers from your instance I believe. Like for me, the lemmy.world meta community has less than a thousand subscribers, but that’s only because I’m on lemmy.ml. Can’t imagine those nutjobs have too many subscribers anyway, though.

  • Badland9085@lemm.ee
    link
    fedilink
    English
    arrow-up
    77
    arrow-down
    9
    ·
    8 months ago

    Wow, wtf is wrong with this comment section? People don’t realize how laws made in the past just stay around until someone steps up to change it? Or y’all don’t have the capacity to look at the world through a different mindset, even if you disagree with the mindset? As much as we all hope that people around the world are accepting, it doesn’t just happen, and you can’t just hope people who don’t understand your PoV will just realize something’s wrong waking up one day.

    Either those, or y’all have either grown too cynical or are trying to be cynical just for the sake of it.

    Can’t y’all just celebrate the fact that this is happening in Japan, an infamous nation that usually tries fervently to preserve their tradition and status quo?

    • GiddyGap@lemm.ee
      link
      fedilink
      English
      arrow-up
      12
      arrow-down
      1
      ·
      edit-2
      8 months ago

      Wow, wtf is wrong with this comment section? People don’t realize how laws made in the past just stay around until someone steps up to change it?

      Exactly.

      One example is a 2006 constitutional amendment in Colorado that enshrined marriage as between one man and one woman. Colorado has since then become vastly more progressive, but the law is still there and same-sex marriage would become illegal in Colorado if SCOTUS overturns Obergefell one day.

    • dangblingus@lemmy.world
      cake
      link
      fedilink
      English
      arrow-up
      9
      arrow-down
      37
      ·
      8 months ago

      Why do you care so much? People are reacting to a wrong being righted.

      Or y’all don’t have the capacity to look at the world through a different mindset, even if you disagree with the mindset?

      No u

      • Badland9085@lemm.ee
        link
        fedilink
        English
        arrow-up
        7
        arrow-down
        1
        ·
        8 months ago

        I’m probably replying to a troll, but I will do so anyways for the sake of those who need to read this.

        If we aren’t in any way bothered to see such narrow-minded reactions to a wrong being righted, then humankind is definitely headed for a few horrible decades ahead, filled with unnecessary strife and conflict out of pure indifference to each other’s backgrounds and current understanding of the world. And I’d even imagine it’d be worse than what we’re already seeing this decade. I suggest you go back and rethink what really matters as humans, instead of focusing on just some narrow definition of what a win is.

  • Flying Squid@lemmy.worldM
    link
    fedilink
    English
    arrow-up
    32
    arrow-down
    1
    ·
    8 months ago

    I have a transwoman friend who I’ve been friends with long before she transitioned (we were friends in high school in the 90s). She has two kids with her wife and those kids couldn’t be more loved or well-cared for.

    • HardlightCereal@lemmy.world
      cake
      link
      fedilink
      English
      arrow-up
      2
      arrow-down
      3
      ·
      8 months ago

      FYI, trans woman and woman are the same noun. Transwoman isn’t a word, and the reason people don’t want it to be a word is that making “trans woman” a different noun from “woman” implies they’re not the same thing. Trans women are women, and that’s why the noun is the same. Trans is an adjective.

      • Flying Squid@lemmy.worldM
        link
        fedilink
        English
        arrow-up
        4
        ·
        edit-2
        8 months ago

        I realize that, but sometimes you need to specify. Also, I think I’ll go with how she identifies herself and not how you tell me she should be identified.

        • HardlightCereal@lemmy.world
          cake
          link
          fedilink
          English
          arrow-up
          1
          arrow-down
          2
          ·
          8 months ago

          Yes, you specify that someone is a trans woman by saying “trans woman”. You don’t say “transwoman”, because it’s not a word.

          • Flying Squid@lemmy.worldM
            link
            fedilink
            English
            arrow-up
            3
            ·
            8 months ago

            Again, I think I’ll go with how they identify themselves rather than how you say they should be identified.

  • scarabic@lemmy.world
    link
    fedilink
    English
    arrow-up
    15
    ·
    8 months ago

    Well fuck me that’s good news but still somehow feels like bad news that this was even a question.

  • Pixlbabble@lemmy.world
    link
    fedilink
    English
    arrow-up
    14
    arrow-down
    2
    ·
    8 months ago

    They have ton of old people and not enough young people. They need babies, it makes sense to not have sterilizations from that point of view.

    • Lucidlethargy@sh.itjust.works
      link
      fedilink
      English
      arrow-up
      13
      arrow-down
      3
      ·
      edit-2
      8 months ago

      Where in America are you referring to? Central America? I’m curious if this horrific concept is real somewhere.

      Ediy: I read the comments… It’s not America, it’s Europe. Fuck… I’m pretty disappointed now in humanity. People can be such fucking pieces of shit. Leave people alone, shitbags of the world. Let them live the way they want to live.

      https://www.economist.com/the-economist-explains/2017/09/01/why-transgender-people-are-being-sterilised-in-some-european-countries

      • laylawashere44@lemmy.blahaj.zone
        link
        fedilink
        English
        arrow-up
        8
        ·
        edit-2
        8 months ago

        Good news, in the Islamic Republic of Pakistan, being transgender is a protected class, you can change your gender legally by just going to the government identity office (nadra) and sex reassignment surgery is perfectly legal and practiced. This was put into law by the Transgender Person (Protection of Rights) Act 2018 but that was really just a codifying of a 2010 supreme court case. And even the Islamist opponents of the bill didn’t want it struck down but to add a medical board to disallow self-determination. Its one of the most liberal trans rights laws in the world, and by far the most I’m a Muslim country. It’s not all sunshine and roses though, there aren’t any criminal penalties in the law for example, so the enforcement relied on prosecutors filing civil cases or injured parties filing cases. The social acceptance is far behind the progressiveness of the law too. However, trans people are pretty decently represented in the media too, though there is definitely an exploitation film aspect to it.

  • ebenixo@sh.itjust.works
    link
    fedilink
    English
    arrow-up
    1
    arrow-down
    1
    ·
    8 months ago

    surgeries should be like a mc donalds drive through. mix and match whatever procedures you want and pull up to the window.

  • randon31415@lemmy.world
    link
    fedilink
    English
    arrow-up
    7
    arrow-down
    9
    ·
    8 months ago

    “Transgender man” … “Surgery to remove the gonads”… surely if they have gonads and are transgender, they are a transgender woman, right?

      • randon31415@lemmy.world
        link
        fedilink
        English
        arrow-up
        4
        ·
        8 months ago

        Wait, ovaries can be gonads? Ok, I thought they meant “nuts” and were misgendering the person.

    • Drivebyhaiku@lemmy.world
      link
      fedilink
      English
      arrow-up
      12
      arrow-down
      1
      ·
      edit-2
      8 months ago

      Nope, everybody has gonads. Removing overies can have some nasty life shortening effects, not doing so also keeps the option of temporary detransition to have kids later so trans men often elect to keep them.

      • MooseBoys@lemmy.world
        link
        fedilink
        English
        arrow-up
        8
        ·
        8 months ago

        temporary detransition

        That’s a very strange way to phrase it. I wish we could just recognize that sex and gender can be orthogonal properties of an organism.

        • Drivebyhaiku@lemmy.world
          link
          fedilink
          English
          arrow-up
          3
          ·
          8 months ago

          It’s the technical term at present but the whole thing is compounded by the whole medical transition and social transition are two separate things. Medical temporary detransition often just means suspending the use of horomone medications to achieve a temporary aim like pregnancy. It doesn’t really take into consideration that in social matters the person in these circumstances does not socially detransition.

    • stolid_agnostic@lemmy.ml
      link
      fedilink
      English
      arrow-up
      1
      arrow-down
      8
      ·
      8 months ago

      Surely sounds like unnecessary surgery is needed for reasons haha because you’re so right haha because reasons haha

      Seriously, learn to be less hateful.

  • Tb0n3@sh.itjust.works
    link
    fedilink
    English
    arrow-up
    11
    arrow-down
    55
    ·
    8 months ago

    Isn’t that kind of the end goal? You’re usually sterilized if you remove your penis and testicles or womb and ovaries to replace with a vagina or penis.

    • anarchotoothbrushist@lemmy.ml
      link
      fedilink
      English
      arrow-up
      53
      arrow-down
      3
      ·
      8 months ago

      Surgery is not the end goal for all trans people, and even if it were, requiring that it be completed before they can have their gender identity legally recognised is unnecessary and unhelpful.

    • Dentzy@sh.itjust.works
      link
      fedilink
      English
      arrow-up
      30
      arrow-down
      2
      ·
      8 months ago

      First, even if you were right about the medical part, “getting sterilized” is not the end goal of anyone transitioning, the end goal is feeling more comfortable on their own bodies, some of them might accept losing reproductive capabilities as a trade of, but not necessarily all.

      Second, “trans” is applied to anyone that is not comfortable with their assigned gender at birth -not only to people that have gone through the full transition-, transgender people can fell comfortable enough at any point of the transition and many stop before the reassignment surgery (if you ever see a video of how it works, you might understand why). That means that many transgender people have full reproductive capabilities, and many want to have them, as reproducing is part of their goals/desires/dreams; same a many cisgender people, you see?

      Last but not least, it is their fucking body, the government should not in any way be allowed to decide that one group of people should not reproduce, and force them to undergo medical treatment just due to pure bigotry, period.

      • Tb0n3@sh.itjust.works
        link
        fedilink
        English
        arrow-up
        5
        arrow-down
        39
        ·
        edit-2
        8 months ago

        Wouldn’t somebody suffering from dysphoria not want to bring somebody into the world who is more genetically predisposed to suffering the same fate? There’s apparently data suggesting it’s genetic.

        And as far as the government telling you what you can and can’t do with your body I kind of prefer that people like that girl with a genetic abnormality who had a child with the same condition despite warnings against it had been stopped.

        This one.

        • Dremor@lemmy.world
          link
          fedilink
          English
          arrow-up
          12
          arrow-down
          1
          ·
          8 months ago

          There is no proof that dysphoria is genetic.

          And even if it was, there are a lot of tools to treat it, be it through simple therapy, or transitioning.

          The condition itself isn’t a handicap, the problem is acceptance. If being black was seen as badly as transidentity, the result would be the same. Should black people refrain from having children in such a scenario?

          • Tb0n3@sh.itjust.works
            link
            fedilink
            English
            arrow-up
            3
            arrow-down
            13
            ·
            8 months ago

            Studies have shown it’s likely. All I’m saying is, if you had the choice of being normal or trans I think most people would choose to be normal. Aside from the social issues it causes there’s lots of work that needs to be done in life to just feel normal. The suicide rate for trans individuals is really high.

            Not sure why you brought race into it, but I’m sure I’ve heard many people who’ve had a hard time in life claiming not to want to bring a child into the world to suffer like they have. Even climate activists claiming they won’t because of the coming uncertainty in the climate.

            • Aceticon@lemmy.world
              cake
              link
              fedilink
              English
              arrow-up
              10
              arrow-down
              2
              ·
              edit-2
              8 months ago

              Just dig deeper into all those definitions you’re using there without having even wondered about them.

              For example, what is “normality” in a person? If your think it through, it’s really just being close to the norm which is, guess what, the central point in a Normal distribution of behaviours, i.e. what most people do.

              So saying “most people will want to do what is normal” is circular logic: it quite literally translates to “most people will want to do what most people do” (yeah, well, duh!)

              Maybe trying to force ALL people to behave the same as MOST people isn’t exactly wise, certainly it’s not at all respecting of each person’s individuality and freedom to do what they want with what is theirs (namelly, with their own body).

              (And I’m quite certainly it would even affect you: there are A LOT of different elements in human behaviour and pretty much everybody in some of those acts in ways which are unlike most people. Why should be gender be treated any different than, say, liking a different sport than most people around were you live? Woukd being outside the norm really justify mandatory psychological support and sterilization for people who like Golf rather than Footaball?)

              And this is before we even go into how “normal” is not fixed but actually at many levels a societal construct: for example men sodomizing other men was “normal” in Ancient Greece but in present day Greece is not “normal” but rather it’s unusual.

              Consider the possibility that your thinking is bound by walls you don’t even know are there.

              • Tb0n3@sh.itjust.works
                link
                fedilink
                English
                arrow-up
                4
                arrow-down
                9
                ·
                8 months ago

                Normal being the ability to exist comfortably without the need to put large amounts of effort into feeling good about yourself.

                • Aceticon@lemmy.world
                  cake
                  link
                  fedilink
                  English
                  arrow-up
                  5
                  arrow-down
                  1
                  ·
                  edit-2
                  8 months ago

                  I suggest you go check a dictionary for the actual definition of the word, which is most definitelly not that.

                  Further your definition of “normal” would make almost every human being out there not be normal: the number of people who have the self-confidence and strength of character to feel good about themselves in all ways “without the need to put large amounts of effort into feeling good about yourself” is ridiculously small: most people out there put lots of effort into fitting into the social environment they’re in, and trying to adjust to what one thinks others expect from you is quite the opposite of “feeling good about yourself”.

                  Mind you, it actually makes sense that people who are submissive to what they think the society around them expects them to be, will actually explain to themselves their submission as actually no such thing (as “submissiveness” is generally considered a negative personality trait) but rather as a “normal” (and hence good) thing. Probably explains why some are so extraordinarilly threatenned by people who don’t just comply as they do in domains generally deemed more important, such as gender identity, when logically the gender identity of others is not really important for oneself outside specific domains such as sex.

                  Normality is quite the big box of surprises if one really starts thinking about it.

            • Burn_The_Right@lemmy.world
              link
              fedilink
              English
              arrow-up
              2
              arrow-down
              2
              ·
              8 months ago

              Even climate activists claiming they won’t because of the coming uncertainty in the climate.

              So… You would support legally-required sterilizations for climate activists? What is the point of this statement?

              • Tb0n3@sh.itjust.works
                link
                fedilink
                English
                arrow-up
                2
                arrow-down
                1
                ·
                8 months ago

                I made a deliberately extreme point about genetic disorders that we treat by abortion. All that was meant to do was show that sometimes we do treat things that will make people suffer if they are born in such a way that they are not born. That’s it. I’m surprised there’s so many people that don’t understand that. People that seem to be on the same side as the conservatives on the abortion issue. The initial point was that if transgenderism is in fact genetic and somebody who is transgender understands the difficulties they have gone through in life due to it, would they choose to put somebody else through the same pain? It’s not directly comparable because one is an extreme example for a reason. Merely a thought experiment.

          • Tb0n3@sh.itjust.works
            link
            fedilink
            English
            arrow-up
            4
            arrow-down
            11
            ·
            8 months ago

            And? Eugenics isn’t just something the Nazis did. It can also be beneficial to the human race and anyone born so that they don’t have to suffer with severe mental retardation and disabilities that will majorly impact their enjoyment of life or cut their life short very quickly. Did you check the link I posted? Do you think that child should have been born? A toddler requiring a tracheotomy.

              • Tb0n3@sh.itjust.works
                link
                fedilink
                English
                arrow-up
                3
                arrow-down
                2
                ·
                8 months ago

                Having a viewpoint that is different to you is massively different to having to suffer excruciating mental or physical pain until you die because of a choice your parents made.

            • archiotterpup@lemmy.world
              link
              fedilink
              English
              arrow-up
              3
              ·
              8 months ago

              Not really. If it was that important we’d still be leaving babies in the woods to be eaten by wolves. We’re not neolithic barbarians anymore.

              • Tb0n3@sh.itjust.works
                link
                fedilink
                English
                arrow-up
                2
                ·
                8 months ago

                We have safe abortions now. If you think about it, it’s basically the same thing but without the suffering of the infant.

            • blue_zephyr@lemmy.world
              link
              fedilink
              English
              arrow-up
              4
              arrow-down
              2
              ·
              8 months ago

              And? Eugenics isn’t just something the Nazis did.

              How the fuck does anyone write this and post it on a forum without realizing they’re reaching comedic levels of evil?

        • blue_zephyr@lemmy.world
          link
          fedilink
          English
          arrow-up
          4
          arrow-down
          1
          ·
          edit-2
          8 months ago

          Being trangender is not a huge problem from a medical perspective. You can simply transition. The struggle that trans people have to deal with is bigoted shitheads that suggest evil garbage like legislation that would force them to be sterilized. If anyone should be sterilized, it’s them.

        • saltesc@lemmy.world
          link
          fedilink
          English
          arrow-up
          2
          ·
          edit-2
          8 months ago

          I think they’d prevent that from happening by preventing that from happening.

          Unless you know of someone so addicted to procreation, they can’t help themselves in anyway, and want government intervention to save them, thus making it not a eugenics thing…

          Whew! Gymnastics is exhausting.

        • Dentzy@sh.itjust.works
          link
          fedilink
          English
          arrow-up
          1
          ·
          8 months ago

          Then what? Do we sterilize autistic people? Blind people?little people? Asmathics? People with ADHD? Alergies? Other races? Less than average IQ?

          I am not even discussing the outraging comment you made, even if you accept that, where do you stop then? Where you think it is acceptable enough? “Wait a second! Not people with allergies, I have allergies!”

          We don’t have to prevent people with dysphoria from being born, we need to create a society in which people born with dysphoria can feel comfortable at every moment (not just when they “don’t look like trans”) and can have easy and free access to anything they need (therapy , hormones, surgery…).

      • Tb0n3@sh.itjust.works
        link
        fedilink
        English
        arrow-up
        8
        arrow-down
        12
        ·
        8 months ago

        Wouldn’t it be pretty triggering of dysphoria to have the wrong genitals staring at you all the time?

          • Tb0n3@sh.itjust.works
            link
            fedilink
            English
            arrow-up
            6
            arrow-down
            23
            ·
            8 months ago

            Literally being transgender means you feel like you’re actually the opposite gender. If you don’t feel that you’re something else.

            • Chud@lemmy.world
              link
              fedilink
              English
              arrow-up
              17
              arrow-down
              1
              ·
              8 months ago

              I don’t think it’s that black and white… Not every transgender person feels the same way (the same as everyone on earth has different feelings). I think the end goal is more for them to feel comfortable in their own skin. To whatever degree of transitioning that is.

            • webadict@lemmy.world
              link
              fedilink
              English
              arrow-up
              7
              arrow-down
              2
              ·
              8 months ago

              That’s not correct. It just means you’re not the gender assigned to you at birth. You’re not the “opposite gender” because there are ranges in gender identity and expression. Non-binary, for example, is trans and that is identifying as neither male nor female.

              But, surpising to no one, everyone is different. Some want surgical reassignment. Some don’t.

              • Tb0n3@sh.itjust.works
                link
                fedilink
                English
                arrow-up
                4
                arrow-down
                16
                ·
                8 months ago

                Nonbinary is another new fad that doesn’t mean anything. There is only Male and Female. Anything else is just made up to be different. Theres probably more transtrenders than actually trans people these days seeing how rare it actually is.

                • webadict@lemmy.world
                  link
                  fedilink
                  English
                  arrow-up
                  6
                  arrow-down
                  1
                  ·
                  8 months ago

                  The problem with your statement is that it is incorrect in every possible way: Historically, culturally, psychologically, biologically, just to name the easy ones.

                  Let’s do a thought experiment: Are left-handed people a fad because there was a period of time (up to, and including, now) where parents, teachers, guardians, priests, etc. would force children to use their right hand instead of their left hand when they picked things up? Left-handed people increased in large numbers when we stopped discriminating against them (as much), and let them use the hand that they wanted to use. What possibly caused that dramatic increase???

            • AngrilyEatingMuffins@kbin.social
              link
              fedilink
              arrow-up
              1
              ·
              edit-2
              8 months ago

              No. They feel like the gender that they are, and express it.

              Feel free to keep trying to add proscriptions to things you don’t really understand, though. But it’s probably a waste of time.

              • Tb0n3@sh.itjust.works
                link
                fedilink
                English
                arrow-up
                0
                ·
                8 months ago

                To be more accurate then, the sex they were born with does not align with the sex they feel they are.

                Man, I really should stop using the word Gender since it’s all made up bullshit anyway.

                • osarusan@kbin.social
                  link
                  fedilink
                  arrow-up
                  1
                  ·
                  8 months ago

                  In other words, you don’t understand the concept of gender, a basic and well-established sociological principle, and you’d rather just make ignorant and hurtful statements instead of learn about something unfamiliar and try to grow as a person.

              • dragonflyteaparty@lemmy.world
                link
                fedilink
                English
                arrow-up
                10
                ·
                8 months ago

                No, they’re not just asking questions. They’re also making statements and seemingly implying that only people who fully transition are transgender and every trans person must also identify as male or female because non-binary is a “fad” that people made up and doesn’t really exist.

              • osarusan@kbin.social
                link
                fedilink
                arrow-up
                6
                ·
                edit-2
                8 months ago

                He’s not “just asking questions.” He’s regurgitating anti-trans rhetoric and making dishonest arguments. Someone who was “just asking questions” would accept the answers given to them, and make an honest effort to learn, instead of arguing against them by slinging right-wing propaganda.

        • Starkstruck@lemmy.world
          link
          fedilink
          English
          arrow-up
          13
          ·
          8 months ago

          Some trans people don’t feel the need for bottom surgery, some do. Dysphoria is different for everyone.

        • atzanteol@sh.itjust.works
          link
          fedilink
          English
          arrow-up
          12
          arrow-down
          1
          ·
          8 months ago

          Maybe. That’s up to the individual. Surgery is also a pretty big deal and comes with risks.

    • Drivebyhaiku@lemmy.world
      link
      fedilink
      English
      arrow-up
      4
      arrow-down
      1
      ·
      8 months ago

      The trouble here assumes that the goal is the same for everyone which isn’t the case. People look at the risks of every single given surgery independently. Top surgery is pretty common because it’s low risk and goes a long way to changing the way one looks through their clothes everyday. Bottom surgery can be scary. It requires one to take months off work to heal and it has a higher chance of not working out and some people keep their pre-existing kit for other reasons. You could be discouraged by the choices of surgery available, you might have a partner you value more who quite frankly didn’t sign on when you got together for that big a change or it might just seem unnecessary to your individual needs.

      Sterilization by removal of gonads is more often an elective by trans women because it cuts down on required daily medications to block testosterone production and less so on the docket for trans men because removal of both ovaries tends to have life shortening effects. Between the two horomones estrogen is the most nessisary for systainable long term health so if you aren’t already planning on taking estrogen medication it’s a bad idea to remove the organs that produce that horomone.

      Also temporary detransition to have kids is a thing for trans men. Some folk don’t want to give up the option of having their own kids even if the pregnancy might be mental hell.

      The important thing to realize is that transition is often an incredibly logical process where one’s individual values come into play and get weighed against the neurological programming beyond one’s control that effect one’s wellbeing. People generally don’t take medicine with side effects unless the problem to be solved is worse than the medicine.