The Gender Identity Disorder Treatment Therapy Medical Malpractice Case

Graduate Student, Ritsumeikan University
【The article below is the same as the article that appears in the eighth issue of the CGS Newsletter.】

In late March I filed a law suit against Osaka Medical College (OMC) after a failed surgical breast excision operation that was part of my treatment for GID (Gender Identity Disorder). I wish to express my thoughts and feelings regarding the trial, and to shed light upon issues pertaining to GID medical care. I must stress beforehand that I do not presume to represent or speak on behalf of all GID sufferers.

Discussions of GID often refer to the patients’ suffering, as well as the inescapable feelings of dislocation and disharmony they feel with their bodies. However, will the pain and suffering of the patients be relieved if they are simply treated as being of “the opposite sex to their natural-born sex”? The obstacles faced by many GID sufferers include not only a sense of disharmony with their physical body, but also the rigid categorization of male and female in our society. How valid is this “gender binary” in the context of GID?

After my initial consultation, I waited three years for an operation, during which time I thought carefully about what I wanted from it. My aim was not to get rid of my breasts at any cost, no matter how messy the end result may be. Nor did I wish for a perfectly “male” body for I was aware of the limitations of modern medicine. What was important for me, was that I, as an individual, would be able to embrace my own body, and that the operation would improve my quality of life. I passionately explained to the surgeons beforehand that I wanted to be treated, like other patients, as an individual case and not a “GID patient” according to some preconceived category in a universal medical manual.

In response to my persistent questions regarding the risks, I had always been told that it would be an “easy” operation. The results seemed to belie the doctors’ platitudes. The stitch suppurated and the suture thread began to come loose. Without showing any signs of recovery, the affected site became necrotic and I suffered spasms of extreme pain. As one misfortune followed another, what bothered me was the fact that the hospital and doctors had not taken my wishes before the operation seriously. One doctor told me that “there is no need for concern since we can just perform a skin transplant on the necrotized area.” The unspoken assumption behind those words was that no matter what happens during the treatment, the GID patient will be happy in the end as long as his/her body is transformed into something approximate to the “opposite sex” should this kind of medical treatment be supported, regardless of its quality or content, if that is its only aim? The diverse needs of GID patients are being neglected, and their importance diminished, by this mind-set of doctors that is obviously based on gender binary.

Currently in Japan, there is a shortage of hospitals and doctors involved in legitimate medicine. This often leads to conflict situations amongst GID sufferers themselves. In fact some have even said that “this law suit will make hospitals atrophic and set back GID treatment therapy.” However, how can there be true progress when hospitals stubbornly claim that the cause of the necrosis is “unknown,” and continue to high-wire by conveniently recouping a patient’s needs on their own accord? As hospitals offering legitimate medical treatment, they must question their attitudes, as well as their skills, or these problems will continue to recur. OMC’s response to my questions was that there had been no error in the operation. What has been hidden can only be brought to light in the courtroom. Only then can GID treatment begin to make progress again. I have faith in the consciences of the doctors involved.

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