Where Is the Line? When Medicine Alters a Healthy Body

Doctors Alter Healthy Bodies All the Time

0:06 Attention. Here is today's Trader Warning. If you require a warning before hearing an opinion, consider yourself now warned. Because somewhere in the next hour, someone may ask what you believe, what you believe it, and whether you had anything resembling evidence. Those easily offended by facts, follow -up questions, or complete sentences may wish to leave right now. Those remaining can meet the cast and suggest subjects that deserve our attention by visiting us at .gandthediscussance .com You're listening to .gandthediscussance on sabbatical.

0:53 The doctor is in. Welcome to the Wednesday edition of Doc G and the Discussance. As promised in the Monday show, we're going to continue our conversation about transgender surgery. I think we're going to talk about that further. Yeah, isn't it? Doesn't that excite you? We had a little conversation off the air about some informal. transgender surgery that had been done and widely noted by what that surgeon's name Bobbitt I believe is what it was. Yeah she had an interesting way of getting rid of her medical waste that probably wouldn't be sanctioned by the MA.

1:49 So now I'm sorry I did it I really am. Last time we taught we asked what a physician owes a child when evidence is uncertain and treatment may permanently alter the body. But there's an obvious problem with saying doctors should never alter healthy tissue. They do it every day. Cosmetic surgery can change a healthy nose, breast, face, or abdomen for reasons that are not necessary to physical health at all. I thought we'd start with Dr. Iris Slavisky again with his no harm message. We're talking about children, the most vulnerable population of them all and as physicians we take an oath to do no harm and we failed them and I think that we also take pride on providing medicine based on evidence and if you're gonna provide irreversible surgeries, life altering on minors, you better damn well have overwhelming evidence to support this and this just wasn't the case.

2:56 Many of these surgeries are irreversible and how can we do that to children? You know, we absolutely need to be sure that we're doing the right thing and they're just... is insufficient evidence. I was trying to find a statistic what percentage of minors that had the surgeries regretted it later in life and I asked you during the commercial do you know what that number is? I couldn't find it and what did you say? It will be very hard to find that data because these institutions are most likely going to brush it under the rug and Also, these patients may be very embarrassed to go back to the provider that had provided these surgeries, so they'll likely go somewhere else.

3:36 There is no national database that's tracking this, which I think when you're getting federally funded, I think we need to take careful analysis and records of these surgeries. Just admitted that they are not taking count of how many of these things are going back the other way. And it's suggested that is for purpose of advocacy for these programs. Last time we asked what a physician owes a child when evidence is uncertain and treatment may permanently alter the body. But there is an obvious problem with saying doctors should never alter healthy tissue because they do it every day and cosmetic surgery can change a healthy nose, breast or face.

4:24 As we said earlier, here's the AMA or the American Society of Plastic Surgeons with Bill Mollusian and Dr. Siegel from Fox News. They're not really down with the AMA on their position now, and I think it'd be interesting to maybe think about why. Welcome back. The American Society of Plastic Surgeons has become the very first major medical group to oppose so -called gender -affirming surgeries for minors. Joining us now to talk about this is the author of The Miracles Among Us, Fox News' senior medical analyst, Dr. Mark Siegel.

4:58 Doctor, thanks for your time today. Good to see you, Bill. Likewise, so the American Society of Plastic Surgeons, what they say carries a lot of weight. They're made up of 11 ,000 plastic surgeries, which includes about 90 % of the plastic surgeons in both the United States and Canada. Here's the statement they're putting out on this quote. ASPS concludes there is insufficient evidence demonstrating a favorable risk benefit ratio for the pathway of gender related endocrine and surgical interventions in children and adolescents.

5:30 ASPS recommends that surgeons delay gender related breast slash chest genital and facial surgery until a patient is at least 19 years old. That puts them in line now with the United Kingdom and most of Europe. And it's very important because as you said, plastic surgeons tend to. follow this, and the American public is way on the side of this. Only 37 percent of the American public believes that any kind of gender -affirming care, whether it's medical or surgical, should be considered in minors under the age of 19.

6:04 What HHS Secretary Kennedy says is the word irreversible. That's what bothers him, and that's what bothers me, because I could make a case for some of the medication being used having long -term effects. but it's clear that surgery is very difficult to reverse, whether you're talking about, you know, breast surgery or genital surgery or even facial surgery. These are all on the... Yeah, that is very interesting to me because... If we look at elective cosmetic surgery, it's the clearest challenge to the simple healthy tissue must not be touched rule.

6:43 A competent adult may accept surgical risk for an aesthetic or psychosocial benefit, even when the body part being altered is functioning normally. Why does that matter? The ethical issue is therefore not simply healthy versus diseased tissue. Medicine weighs autonomy, expected benefit, risk alternatives, realistic expectations, and the patient's ability to consent. And here's where it gets more sticky. Cosmetic surgery in adolescence is treated much more cautiously, at least in some areas. Physical growth, emotional maturity, expectations, the patient's own motivation, and parental involvement.

7:29 All matter. So, discussions, why is the nose job ethically acceptable? And I guess we could split that into two questions. Ethically acceptable for adults, but maybe not so much for somebody who's a minor. Is the psychological benefit enough? And does adult autonomy settle the question? What changes when a patient is 15 rather than 35? Let's throw it out there. Sarah, what do you think? Any reaction to this? As far as cosmetic surgery? Right, yes. Well, I mean, we have people addicted to cosmetic surgeries, kind of runs along the same line as these transgender things, and doing no harm.

8:24 per se, but you know, are they necessary? No. Do they have body dysphoric? Just I can't say it. Can you say that? Dysmorphia? Yeah, dysmorphia. Um, those people probably have that same thing that the kids supposedly have. So, I mean, do I think it's good on either regards? No. Yeah. Well, we've noted The cat women? Yeah, cat women or lion face. So it seems like certain of us, women of a certain age now, all sort of turn into cat women. They have lion -like features, cat -like features, their eyes are swept back, their lips are way too plump, their cheeks have implants, and they all end up looking suspiciously like one another.

9:15 Real housewives. Oh, you're arousing me. So is that good? I mean we've we've looked at that and so I'm not so sure no harm is done in that situation. I'm always curious when these women have children how early do they have their children get plastic surgery because they don't look like their mom. Yeah that's been something that you've brought up but we also kind of know the answer to that question. We've seen plenty of breast augmentation. And pretty young girls. And pretty young girls in some of these reality shows.

9:52 No, surgeries are really prevalent. Yeah, exactly. You know, lion women, Tom, you seem to be, you know, all for it. You seem to be on board with that. Yeah, come on. Tell us all about it. And look, he has a tattoo. And I cut all my hair off. You know, I had a former girlfriend who said she'd get a boob job, except that she was afraid there might be detrimental side effects to that surgery. Also, I think I've known maybe a couple of guys that have had nose jobs, just because, you know, if I go through life with a nose that you're not digging or into, I can see that.

10:38 I don't know. Where do you draw the line? I guess when it's... Well, we say underage. We were talking about tattoos on little kids. Maybe that hasn't happened yet. That probably has happened with a few biker gangs. Yeah. In the young teens, for sure, I'm pretty sure underage kids have had it done. But what about the girl that wanted to look like Barbie? I mean, how do they keep getting those things done? How? I don't understand how they can just keep getting that stuff done. Is anyone aware? I know we have watched Botched on TV.

11:18 Have you watched Botched, Professor? It is about a pair of plastic surgeons in Hollywood who repair damage from previous plastic surgeons, many of the surgeries being performed in Brazil. And so you've got a variety of crazy things that have been done to people. And they'll come and ask this pair in Hollywood to either fix it or make it even better. I mean, these people look otherworldly. And it seems like once they have one surgery, then the others follow in fairly short order. certainly not in America, but they inserted something that irritates the tissue in some way that the tissue produces moisture, water, or something.

12:20 The body produces a fluid. And so, therefore, the boobs are always growing, always, always growing. And if she wants them no bigger than a certain point, she has to have a position, drain some fluid off. If he does nothing, they continue to grow. So I thought I'd throw that one out. Again, it sounds like maybe you've aroused yourself yet one more time. I had nothing to do with that one, but it sounds like a wonderful way to go through life, doesn't it? Well, first break on the way. Let's now change just one thing.

13:03 The patient does not want a healthier looking body and the patient wants a perfectly healthy leg removed. We'll explore that type of surgery and disorder when we come back. We'll give the Discussence a moment to regroup. In the meantime, visit docgandthediscussence .com. Episodes, the shop, ways to support the show, and of course, Doc's Bright Box. Do make proper use of it. Doc G and the Discussence on sabbatical. We'll be right back. Some of our best ideas come from the people listening. If you have a question, a comment, a show idea or maybe someone you'd like us to interview, we'd love to hear from you.

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17:22 Welcome back to the discussants, Dr. G and the discussants

“Doctor, This Leg Does Not Belong to Me”

17:38 in our freak farm. As we take a deep dive into the back alleys of cosmetic surgery. Integrity dysmorphia is what's going to lead this section off as we continue our show. The title of this segment, by the way, a working title. Doctor, this leg does not belong to me. Isn't that nice? So BID is recognized as a legitimate psychological condition. A person can experience an intense and persistent desire to become physically disabled. often through amputation and profound discomfort with a currently non -disabled body or body part.

18:36 So if we imagine a competent adult who has wanted one healthy leg removed for years, understands that amputation is permanent, understands disability and the surgical risks involved, and says life with the limb is just intolerable is causing this person intolerable distress. What then? There is no universal medical rule simply authorizing amputation on request. BID remains an active clinical and ethical controversy. Published cases and scholarship include both elective amputations and arguments against them.

19:22 So discussants. I'm just gonna walk out and punt this one, I think. Should the surgeon amputate? If no, why not? If bodily autonomy and relief of psychological suffering justify cosmetic surgery, why do those principles stop there? If yes, if your answer is yes to that, what limits this principle? You know, I didn't even schedule any actualities for this break. I knew you all loved this so much that you could just... you know, enjoy this to its maximum degree. I think each to his own is the key thing here.

20:00 Each to his own. And if a client comes in and wants a leg removed, I mean, that's nothing I would want to do, of course, personally, but each to his own. And the doctor, if he wants to pull in some more dollars, and what doctor does not, I'll then... I think there just needs to be some kind of ironclad affidavit, one that can't be broken up later by attorneys. The client has to sign away the leg beyond a reasonable doubt, beyond reproach. It can't be people always say, well, a prenup can be shredded by a good attorney.

20:39 Well, this better be an affidavit that cannot be shredded. Because the doctor could be in trouble if the affidavit is shreddable. So each to his own. The guy wants a leg taken off, the doctor wants money, money, money, money, money. That's why he's an M .D. He wants money. And so, okay, everybody have at it and get the paperwork signed and make sure it's beyond reproach. So you're saying because this person is an adult and the doctor says okay, and it's an ironclad clause that it's okay. Is that what you're saying?

21:14 Yeah. OK. So I'm eight. I want to be a boy. How the doctor says, OK. OK. I thought we were moving a leg. Well, we are. Yeah, we are. I'm just asking that question. If it's OK to remove a leg just because that's what I want. If I wanted to be a boy. Why is that not okay? That's kind of where That's exactly why I have presented this to the discussants for discussion because I don't agree with either one Okay They are they are diagnosed mental illness body dysphoria BID, both in the psychological books as a mental deficiency.

22:13 But, so let's say it's, I don't know, somebody like Marcus Allen dating myself, a fantastic running back, who shows up at the doctor's office and says, Doc, can't stand this leg, even though it's maybe one of the fastest legs in the entire world. want you to hack that thing off. And it seems that the professor has decided as long as the paperwork is in order, fire up that black and decker and get up on the table because that's just fine. Go ahead and assuage your illness, assuage that little illness.

22:59 I have a feeling that if a person was that mentally incapable of dealing with this, that if they can't find a doctor that's going to do it, one, they're going to find a way to get it done. That has happened. And that's one of the arguments for allowing this sort of procedure is that there are on the books people who have looked for... you know, help from the medical community to do that. And it was refused. And so they took matters into their own hands one way or another because their mental dysphoria so profound that they were willing to do something like that.

23:46 And so from some quarters of the medical community, that's one of the arguments for going ahead with this sort of thing. They might actually do themselves more harm than if they would have just had the surgery, right? Let me throw this in. This is reminding me of that, the fly, not the one, not the second movie, but the original fly movie where the guy did not want to have that fly head, so he puts his head in a big hydraulic press and crushes it. Yeah, I can see that. I mean, you know, oh, I don't want my arm anymore.

24:22 And so I want to remove, nobody will do it. So I do damage to myself so that my arm has to be, has to be removed. Okay. But that's a different situation. We're talking about a completely healthy limb here that someone has decided they don't want anymore. Right. Okay. So now let me add this thing wrinkle. Okay. So I guess the discussions have decided fine. Uh, let's get rid of that limb. Even if you don't, I, I find that I don't know. I have a different idea. getting more attention. That does that does show up in the literature as a reason why they want this thing done or as part of the BID diagnosis is that they actually aspire to be someone with a disability.

25:28 And so it's sort of a combination of I hate this limb. It's, you know, more than I want to live with, but it sort of then stems from what the professor just suggested, that they are, you know, they admire that condition, which for me is... Yeah, yeah. Maybe I like this limb, but I think it'll be pavement for a life I will like better once it's gone. That is exactly part of the thing. Yes, it is. That is in the literature. to answer the question. But I am a little surprised that the discussions are so, you know, okay, let's just do this.

26:11 And that's okay. I kind of think about it maybe just a little bit differently. I would want to make sure this person, and the professor covered this ground, he said this needs to be ironclad legally and I would assume that would also include making sure everybody's psychologically fit to make this decision. Now it gets tougher. Let's say it's a child. Now it's Billy wants his leg amputated and Billy is, let's say, Let's say Billy's 16. He's almost of age to make these sorts of decisions. Now, Disgustance, what are we going to do?

26:53 Billy, if you want that leg cut off, you're damn well going to wait till you turn 18 and you make the decision on your own. I'm not going to stand for it. Okay, well that was exactly how a parent might deal with it. It would be sort of my approach, only... I would never encourage them to do it in any way, shape, or form. I mean, I see that as a way to go. Sarah, what do you think? I agree. I wouldn't let him do it either. But now give him two years, and then what? Two years, he becomes of age. I can't stop him in two years.

27:34 I can't stop him as a parent. I don't have any control over that. Right. I'm going to tell him what I think, and I'm not saying that I agreed they should have it done. I didn't agree with that. If he arrives at that point, then perhaps he really hasn't been parented correctly. Well, it's a mental issue, right? Well, that's that's the premise we're working from is that this is an actual condition that somebody has and they I don't know how you ever pass a lot of psychological Evaluation and it be okay because if it's a mental issue a mental issue issue You can't pass the psychological test for it to be approved And so that also goes for an adult is what we're saying as well So if you're completely of sound mind and body for a little while anyway, before the saw bones gets a hold of you.

28:37 We're saying, go ahead. Is it really a mental issue? Or is it some kind of proximity that's been engendered over many years of shit parroting? Well, I'd say that, you know, it's again, as the setup. It is in the actual psychological, psychiatry literature as a disorder. And so, yeah, of course. Like Munchausen's. Yeah. And that's sort of where I want to pick it up when we get back is what good is psychology anyway? I mean, what good is it? We'll be right back. We all have mental health issues. You're listening to Doc G in the discussions.

29:21 The discussion continues in just a moment. While we take a break, go to docgandthediscussants .com. Meet the Discussants, catch another episode, support the show, visit the shop, or tell your favorite cast member exactly what's on your mind. Doc G and the Discussants, on sabbatical, back after this. Looking for the official Doc G and the Discussants merchandise, you'll find it on our website, DGND .com. Browse our sabbatical collection for premium tees, hoodies, signature women's v -necks, whiskey rocks glasses, distressed ball caps, coffee mugs, and more.

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33:30 We're talking

Autonomy, Distress and the Limits of Medicine

33:32 about What was your idea about emotional support animals Yeah, we do we have ours here no, I forgot to trash this promo and I mean I think we need to change it to You know, we provide those as you walk into the studio to everybody who shows up, an emotional support animal of one sort of another. And feel free to say at the end of the day, circle back, what else? We won't be unpacking anything here on the show. You know, that kind of crap. My bird was talking loud earlier, but he's sleeping right now.

34:11 Orville asleep. He's normally, you know, right here for the show. Yeah, he was here during an earlier show. Put him to sleep like we did Sarah last week. Bo's not, Bo is not on the ground. He's in the house. Oh yeah, yeah, not on that. Yeah, that's the other thing that drives me nuts. It's kinetic action for war or here on the ground. What is a post in the air and you know, kinetic action. I mean, they hear something and they just kill it, repeating it to death. We were talking about children. and their gender -affirming surgeries, I will not say care.

34:54 I'm not going to do it. As body... Yes, sir? Please say care. Body integrity dysmorphia. Let's talk about that. It exposes... The reason I put it out there for discussion is it exposes a collision among several medical values. respect for patient autonomy, relief of suffering, preservation of bodily function, and the obligation not to impose unjustified harm. But the complication here is, some people with BID have injured themselves, as we noted earlier, attempting to force an amputation. There are public cases, public cases, my word, I might need surgery on a tongue.

35:42 Should I have my tongue?

35:47 Published cases report patients satisfied after amputation. So they're not only do they have it done, but then they're satisfied afterwards. That does not establish amputation as a standard treatment, but it makes the ethical problem harder than simply calling the request irrational. And the discussions. They had no problem with the irrationality of the decision. They basically said, hey, they are adult. They're autonomous. They should be able to make these calls for themselves, which I thought was going to cause more of a problem in here than it did.

36:24 I'm disappointed that it didn't. What I said was that if they don't get it done, a lot of them would cause it to happen. And that's in the literature. And then the professor pointed out. that some of these folks have admiration for those that are disabled. And that's a motivation for that. That is also in the literature. So this didn't trip the discussants up whatsoever. And I'm... Not surprised, but I don't know, maybe a little gratified that... You sound surprised. He does, doesn't he? I guess I am a little surprised because that's a rough one.

37:03 So let me put it out there a little bit differently then. So we're absolutely then, I guess, fine with transgender surgery for adults.

37:19 I can't. I don't know. Uh huh. Yeah. I don't know why Bruce did it. Yeah, I don't understand that one either. See, that just... Okay. It just makes me sick. Just honestly. It grosses me out. There we go. Finally. There it is. Just grosses me out. What? Just gonna say it. The whole thing. The whole thing. The whole thing. Body dysmorphia? I love it. All of it. Or transgenderism. Both. Okay. Yeah. You know, I wanted to, also when I was thinking about this, I thought of a specific question for the professor.

37:51 Do you remember Renee Richards? Tennis player. Tennis player. Yeah, I remember that vaguely. It's been a long time ago. Long time ago. Now we're talking about early 70s, if I recall correctly. It, him, She, yeah, decided that they were going to, it, she, what, I don't know, were going to play professional tennis on the women's tour. And that was early 70s, was it not, Tom? That's what I'm thinking. And it caused an uproar at the time. But. Okay.

38:44 Thanks for that sprinkling. It was like, you know, just like a crop dusting of, you know, just ran by and threw that up. So, you know, I mean, we've been dealing with this for a while, but when that came around, it was immediately. Yeah, it was discarded very quickly and there was you know, it was seen as it probably should be seen today as an Yes, there was yes, yes and but these they weren't they did compete I Think in some exhibition matches, I'm not sure they ever made it to actual turnip play.

39:32 So were they full -on transgender? Yes Or at least as close as we can tell I mean we were told so both genders. I mean, it was very now for back then. It was a good time, but I just was a real bitch. You're listening to MS Now. Doc G and the folks that just stepped in off the street, we're talking about the good old days when switching roles was a lot of fun for the professor and his... The good time was head read by... Thanks for tuning in. Let's see. So where were we at? Now I've had a little too much fun.

40:40 Yeah. Okay. So we were talking about kids and so it exposed that collision, which the discussants sort of just brushed off. But when I say, so transgender surgery. No, but you'll let somebody cut a leg off. I am going to say if they can't. it, being able to be done for them, they will find a way to get it done. Okay, and that relates... Okay, so they're gonna get their leg amputated in Brazil, they're gonna get their transgender surgery in Brazil, and all these things... Well, you know, so I guess, you know, we've basically accepted this premise as well.

41:33 No, I don't accept it. I'm saying they will find a way. If they think it has to be done and it needs to be done, they will find a way. Not the question at hand. The question at hand is we decided that BID and an amputation are okay if an adult does this. And I'm asking why you're not okay with transgender surgery, because what's the difference? I mean, there's a loaded difference. What I'm talking about, we're talking about getting rid of, in some cases, healthy body parts. And in one case, we're saying no problem.

42:16 In the other case, we're a little bit more screamish. Let's go Professor can you shed some light on why we're squeamish here and about one and not the other see I'm gonna say this I'm not I'm not even sure I support cosmetic surgery the inclusion of sexuality that's not present in the leg removal that is in the other. And we could explore what that inclusion mandates, so to speak, but I think even that's it. There's something sexual in one of them, not in the other. Well, now I suppose that would depend on the leg now, wasn't it?

43:12 Hey, come on now! I told you this is a family show! Well, and so I guess you know, I was ready to say the discussants handled this rather well now I'm not so sure because we're back to Maybe this is okay, huh? Yeah, it kind of seems that way I don't think we're back to square one, but but that that's the whole reason why I Reason I wanted to throw it out there is because you know, there's I as a doctor wouldn't do either I wouldn't do either. I would take my oath extremely seriously to do no harm.

43:51 I would consider no matter what somebody wanted. They could go down the street and get it from somebody else. They wouldn't be getting it from me in any case, because I would say, and this is how I would feel, that you are a very healthy person. You are extremely lucky to be healthy, have patients that would come in here and give anything to keep their leg. And I just can't do that for them. I will not, under any circumstances, remove a leg from you. You sound completely sane. Well, I just, that's how I feel about it, and that's how I believe, you know, do no harm should sort of be interpreted.

44:33 That's my interpretation of it, which means nothing, but that's my opinion. Yeah, and I don't think that, I see transgender surgery the same way, and I promise that we would maybe explore just what good is psychology anyway if they can't treat these diseases. are conditions that are supposed to be psychological conditions, instead we look to treat them physically. We'll be right back. When we do come back, the question that started all this, but add one fact that changes everything, the parents, and we are talking about children, yet again, you're listening to Doc G and the Discussants on sabbatical.

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48:36 Visit docgandthediscussants .com, comment on the show, suggest a subject, visit the shop, support the program, or leave something for Doc in the gripe box. Now come back to Doc G and the Discussants on sabbatical. Thanks so much Lizzie, we appreciate it.

So Where Is the Line?

48:54 You're back with Doc G and the Discussants where we have had a little tussle. with transgender surgery and body dysmorphia and what's okay and what isn't. And for the last couple of segments, because it slipped my mind the last segment, these are psychological disorders, but it does seem that they are approached and cured, in quotes, with physical approaches. Surgery. In some cases, hormones, puberty blockers, these seem completely unreasonable to me in any circumstance. If I were a medical doctor, there is no way I would do that for any child.

49:47 I don't care how much their parents ask for it. I don't care how much a kid wanted it. You'll have to go up the street. And it would appear that the American Society of Plastic Surgeons is starting to agree. And I think that that is. That's exactly where I was headed. I think they see the writing on the wall now because they are the ones probably most responsible for these kinds of surgeries and they see which way this thing is going. They changed their mind on this back in February. The AMA has so far not done that, even including this week, and the American Physicians Association also has not done it.

50:35 So we'll see how quick they followed suit. I sort of have a feeling they may wake up to some new realities because I think this is a no -brainer. Speaking of the brain, psychology. What good is it? We started to say just a minute ago that these things are psychological disorders. In fact, they're described in the psychological literature. But yet, psychology doesn't seem to be able to solve these problems. In fact, some things that were once described as disorders are now being described as completely healthy and normal.

51:15 For years, homosexuality was described as a disorder. BID is still described as a disorder. Body dysmorphia is still described as a disorder. So if these are mental disorders, why doesn't psychology take care of these things instead of hacking people to pieces to match their mind? And of course, we know that People change their minds all the time and we have heard statistics Earlier about how many people change their minds where this is concerned What does psychology do for people if? Then we have to change the body to match the disorder that's already been described Is this a fair question professor?

52:09 Bottom line, ultimately, psychology, in most cases, probably harms a person's life a little bit, makes it a little bit worse. It seems like psychology is another degree, another certification one could obtain from a school. And so, therefore, it, of course, provides more jobs, more career opportunities for so -called professors. And, of course, it gives the people that aspire to get that certificate, it gives them an income for as long as they want to work in that area. It seems like it boils down to what drugs they prescribed.

52:53 It seems like if one were inclined to be maybe, I'll call it religious, maybe a Christian, for example. It seems like I saw this years ago somewhere, and I don't know where, and it's been a long time, but any word... who spelling begins p s y c h is not the work of the lord it's the work of something else so that is a that is a quite an observation uh i wanted to play another uh cut from bill malusion and uh dr seagal sort of addressing that let's not lose our place though until you're age 21 just to have a beer, how does it make any sense for these minors to be able to have these surgeries that can change their bodies permanently before they're fully matured yet?

53:39 Sorry, God, I'll leave it there, but grateful for your time today, doctor. Thank you. And faith plays a role too. Faith plays a role too here, Bill, because Americans who believe in God believe God chooses gender, and that's about 80 % of those who are religious think that. so there you have it someone who maybe quite clearly sees that there was no mistake made when you were born that you know you were born as the Lord wanted you to be and if you're a person of faith it's a very simple question this doesn't have to get very deep We were talking about psychology.

54:22 The professor made the point that this is not a refuge that people of faith normally, I don't know, take advantage of. Is that a fair characterization? I think that might be an oversimplification of what you said, professor.

54:44 So you're not taking, I mean, I do think it's a little more nuanced, and I think what you said was a little more nuanced than that, but I still think that's sort of what it boils down to. So another couple of personal anecdotes. I have known people on mood -altering drugs at different stages in my life and in different professional settings and not so professional settings. And when they decided that they were going to start these, it was usually described as some sort of depression. And I could tell nearly instantly when they started with these sorts of drugs, because they were really sort of about three quarters there anymore.

55:32 Sort of artificially... I won't say happy, I won't say sad, a weird sort of state. I've noted that in several acquaintances that I've known over the years that took this route towards, I guess, being happier, not depressed. And so, it didn't seem. like a very good option and it also seemed to me like there was some things lacking in their life and one of the things was a spiritual connection. So we're only got about about a minute left in the program today and I don't think we've solved much except I think the administration is right about this.

56:18 I don't think doctors should be performing this surgery. I don't think I would go so far as to say outside of extreme circumstances where plastic surgery is concerned, I don't think that should be as common as it is. I'm a real old fuddy -duddy. I don't even particularly care much for altering your body in terms of a tattoo, so that's how far radical I am about harming healthy tissue. I think people need to be very happy that they were born healthy and happy. Tell me this, Dr. G, tell me this. Regarding tattoos, regarding ink, I've read that the body commences with trying to rid itself of that ink just the moment it enters under the skin.

57:06 That the body doesn't work then to get rid of it. That's what the redness is about. That's what the, you know, it doesn't care for it. You know, it will work to rid itself of a sliver the minute you get... I know that when Nikki Sixx was dating Kat Von D that she refreshed his tats for him. Well, I don't think anything says love quite as much as a refreshed tat. What are you talking about? Yeah, and especially if it... Hey, baby, would you refresh my tat?

57:42 Okay, so what have we learned through the episode today? Yeah, I don't think so. I meant for this to be a really serious exercise and we would get to the bottom of what's wrong here, but I think it really boils down to, and probably always was going to boil down to, what is people's personal sense of right and wrong? We've opened this whole show with Plato's allegory of the cave. What cave? But I think people have replaced the religion with ideology. The Green New Deal is one of those things, you know.

58:44 Right, right, right. I think that, you know, do no harm. I think that maybe I'll go this far. I think that maybe that doesn't really hold much sway anymore. I think that I might agree with the professor in that it's really the money. And that we can justify any one of these trade -offs by saying that it was of some good to someone. And that... Money, money, money, money, money. Money, money, money. I think that maybe that has a lot to do with it. Maybe everything to do with it. But I know I'm with the administration on this one wholeheartedly.

59:31 hang tight with us we will see you Friday for the Friday show when we'll be up to no good for certain it'll be trash TV Friday plus a Game of Thrones wrapped up and we'll talk about that and so we reach the end not the end of the argument obviously that would be terribly convenient there are still facts to examine conclusions to question and more than a few cliches awaiting retirement Before you disappear, visit docgandthediscussance .com, meet the cast, find the latest episodes, suggest a future subject, leave us a comment now, or if something has particularly annoyed you, place it directly into Doc's gripe box.

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