Does The Medical Profession Think That “Shoulder Width Reduction Surgery” Is The Ethical Practice Of Medicine?

Shoulder width reduction is an extreme form of surgery designed to allow men transitioning to glorious womanhood look the way they feel. The procedure involves a surgeon sawing sections of the patient’s clavicle off and  fusing the remaining pieces back together with a metal plate. The surgery generally costs  thousands of dollars;  you can see it being performed here. There is also the reverse procedure for women who have decided to be male, or who want to look like Joan Crawford.

Once upon a time, before the medical profession was completely perverted by fear of lawsuits and the love of money, surgery that served no functional purpose was regarded as unethical. The gold mine that is cosmetic surgery changed all that, along with greasing many slippery slopes. If a teenage girl’s parents felt she would be more popular and happy with a cute little turned up nose, then that was sufficient benefit to make the surgery ethical. Next it was just a few slips down the slope to similarly justify surgery to give some whacko pointy ears like an elf, or a split tongue like a lizard, or to make someone look like a doll…

Or a cat….

You see, if it makes the patient happy, that’s benefit enough. The slope even extends to amputating healthy limbs when a mentally-ill patient decides that an arm or a leg is malign. Surgical procedures require anesthesia, which inherently involves risk to the patient. That risk once meant that only surgery that was objectively necessary for the physical health of an individual would meet professional standards. No more, clearly. Shoulder reduction surgery is guaranteed to harm skeletal integrity and to make the recipient less physically able than before, but he-heading-to-she will look smashing in a bare-shoulders gown, as long as the scar…

…doesn’t show.

“gf just had shoulder reduction surgery, removed 3.2ish centimeters from both sides!” enthuses a fan on Twitter. “2.5 inches overall! any trans girl out there who hears she has to live with her shoulders should know that she doesn’t and the surgery exists and it’s safe. the difference is night and day…”

Where does the slippery slope go from here? Making aspiring females shorter would be my guess. Of course, that would involve taking pieces out of legs and arms, so the “improvement” doesn’t make the patient look like a gibbon.

I know what you’re thinking: “What about ‘first do no harm’? Well, 1) as we now know from the “your words make me feel unsafe so you must be punished” crowd, “harm” is highly subjective, and 2) ancient Greeks don’t perform surgery any more.

I perused the American Medical Association’s Ethics Code, and saw nothing in it that would encourage a surgeon to refuse to mutilate a healthy patient’s shoulders.

Do you?

AMA PRINCIPLES OF MEDICAL ETHICS

Preamble

The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The following Principles adopted by the American Medical Association are not laws, but standards of conduct that define the essentials of honorable behavior for the physician.

Principles of medical ethics

  1. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
  2. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
  3. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
  4. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
  5. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
  6. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care
  7. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
  8. A physician shall, while caring for a patient, regard responsibility to the patient as  paramount.
  9. A physician shall support access to medical care for all.

11 thoughts on “Does The Medical Profession Think That “Shoulder Width Reduction Surgery” Is The Ethical Practice Of Medicine?

  1. I’ve always had a issue with anything related to cosmetic surgery. Just because cosmetic surgery can do a lot of things under the knife doesn’t mean they should. I’m also not a big fan of makeup and hair coloring outside performing arts.

    It seems to me that ethics, as it’s related to what’s acceptable to do to the human body, has become rather quaint. For that matter, it seems to me that ethics in general is becoming quaint. It also seems to me that our culture is regressing to the lowest common denominator of stupid and that is now the dominating factor that all things are judged against; so if you’re not equally stupid, you’re wrong.

  2. 6. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care

    I would think that this would give adequate cause for a surgeon to say, “Sorry, I’m not doing this procedure”. Of course, then the patient will cry discrimination…

    • Gamereg,

      Number 9 covers it:

      “A physician shall support access to medical care for all.”

      Jack can probably correct me if I am wrong, but lawyers used to be obligated to represent anyone who came along (cab-rank rule). If doctors had a similar obligation, number 6 would free them from that obligation (except in cases of emergency).

      -Jut

  3. One more proof that medicine has become a business, not a scientific profession. It’s all about money. I don’t expect the AMA or any other certifying agency to take action on such abominations as shoulder reduction surgery, because they are the leaders of that business.

    And I don’t think the general patient population is ignorant of this. Why do you suppose patients are so eager for second and even third opinions these days? The kindly GP who made house calls was not the best system, but still it engendered care, compassion, and common sense. Now, if someone will pay to be mutilated, a willing and greedy doctor can be found to do it.

    I believe firmly that medical science has advanced light years in past decades, to the benefit of millions: our problem is the doctors who practice it.

  4. Since surgeons already perform mutilative surgery on people to resemble the opposite sex, why is shoulder width reduction surgery surprising? They obviously can never change genders, but why quibble with such such unpleasant biological facts when all that matters is the illusion. Or is it the delusion?

  5. … If a teenage girl’s parents felt she would be more popular and happy with a cute little turned up nose, then that was sufficient benefit to make the surgery ethical…

    It worked for Meghan Markle, didn’t it?

  6. I think we need to be careful not to conflate different cosmetic/plastic surgeries.
    1) Shoulder-width reduction is a pretty new thing and hardly a widely accepted medical practice.
    2) Amputation of healthy limbs (as for body integrity identity disorder/BIID) is vanishingly rare as the conditions leading to it are themselves exceedingly rare.
    I think there are rare/fringe cases where the above procedures are clearly justified; gender dysphoria and BIID exist, as all medical conditions do, along spectra, and there are people who are definitely debilitated by them, and of those people, there are certainly some for whom the benefits of surgery outweigh the risks.
    Can every doctor be trusted to go through all the necessary investigating, vetting and nonsurgical treatments before recommending these surgeries to patients? No. Can most doctors be trusted thusly? Debatable. I think the question asked by the headline oversimplifies the issue, though.
    I hope also that we can agree that some types of cosmetic surgery are medically and ethically defensible: corrective surgery after disfiguring injuries/burns, for example, or perhaps breast reconstruction after mastectomy.

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