Good news for Brazilians seeking a sex-change: your national health care system has you covered. The Brazilian government is, in fact, opposed, claiming that it doesn’t have enough money to pay for the operations (the Ministry of Health estimated that about 1 in 10, 000 Brazilians would sign up for the surgery, which costs about $1000 US dollars), but a court ruling is the thing, asserting that a safe (the chief judge said that the ruling would prevent transsexuals from self-mutilation in attempting to perform the surgery themselves) and publicly-subsidized surgery is a constitutional right.
Of course, in order to receive the subsidized surgery patients will have to be approved by a panel of doctors after extensive medical and physical examinations have taken place. Still, this raises all sorts of interesting questions. Is feeling like a woman trapped in a man’s body, or vice-versa, a physical condition (“I am a woman”) or a mental condition (“I feel like a woman”)? Does one type of condition take primacy over the other? Is it unfair that, as it stands in the US and elsewhere, sex-changes (like psychoanalysis) are generally a luxury? Should—can—the government protect you from yourself?
By using public health care to fund sex changes, people—patients?—would be implicitly defining their pre-operation states as an illness*, which I’m pretty sure many of them would be uncomfortable with, if only because it damns those that don’t have the operation. In less ambiguous, more insidious, matters, Brazilians have shown a purely ugly and physical approach to sexuality—trends which have indeed affected American culture. If the US ever achieves national health care, will we cover sex-changes? What about cosmetic surgery? Therapy? Who gets to decide? The experts (often influenced by factors other than their expertise) or the people-patients?
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