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>is he really just being happy about officially having a dick again ?

Yes that's probably exactly it. It's very easy for people who don't experience these things to say "well logically it's not that bad so why are you so unhappy?", but these kind of issues can cause constant psychological stress, and even purely cosmetic changes can make a huge difference to people's quality of life.

>how do we prevent people who are fantasizing about a sex change from deciding something they will come to regret

You can't absolutely prevent it, but it's vanishingly rare in practice, and these kind of overblown concerns end up causing far more harm by making it difficult for trans people to get surgery than they do by saving hypothetical confused cis people.

Also, for trans people who do opt for sex change surgery, it's usually driven by persistent discomfort caused by the body they currently have, not just "fantasizing" about the body they want.

There are several Internet communities where transgenders can talk pseudonimously.

Indeed, I think part of the problem is that the only interactions a lot of people have with trans people is with political advocacy, where people are too busy trying to deal with rampant misinformation to ever get into nuance. And people then assume this is the only form of discourse that trans people ever engage in.

Much as people like to deride "safe spaces" as echo chambers, actual safe space trans communities are far more open to discussing conflicting feelings, doubts, regrets etc. because they know people won't use those admissions to judge or invalidate them. Which is of course, exactly the point of a safe space.

(PS: The preferred term is "transgender people" or more commonly just "trans people".)

I think part of the problem is that the only interactions a lot of people have with trans people is with political advocacy,

I've personally been attacked a few times on HN as transphobic for trying to talk about women's issues and my personal problems as a woman in a man's world. My experience suggests the trans community frequently takes approaches that are openly and unnecessarily hostile.

I also spent 9 months being very supportive of a MTF trans youth met through HN whose life was in serious crisis at the time. Several other members of HN are well aware of the support I provided her. None of them ever stepped forward in my defense during the time when I was being repeatedly randomly attacked as supposedly transphobic.

The MTF individual in question was incredibly ugly to me during the months that I was supportive. Every single personal problem I had as a divorced single mom, problems very typical of divorced single moms, was dismissed as me being incompetent, not wanting success badly enough, etc.

I got badly burned for being sympathetic and supportive. I have reason to believe this individual still has the ear of powerful people and there is evidence they are still telling lies about me and dragging my name through the mud.

If my experience is at all representative, then your description of the problem space doesn't begin to capture the issue.

>If my experience is at all representative

I don't really see any reason to think that your interactions with one trans woman would be representative?

You are glossing over large parts of my comment. This is hardly limited to interactions with one individual.

The part of the comment about trans people is an off-topic derail. Sex reassignment surgery is not free for the asking. There is substantial prep work preceding it, including psychological exams. You have to convince a bunch of people this is merited and appropriate in order to get such surgery.

None of this would apply if it was e.g. a hand transplant, would it?

both my complaints would still apply:

I still want a provable control mechanism to measure the influence of organ donor status (donating or not, rich or poor, etc) on donor death rate (if this is happening this would typically not be just for one organ, but for multiple; and the value of the organs would have to exceed the costs from the perpetrator perspective: value from acceptors, from research on tissues, from educational value of the body parts, saved future costs of the donor on the health care system, ...).

Think of it this way: if there was a mathematically provable mechanism in play to prevent this in an open, reproducible and public fashion, there would be more people open to donating their organs after death.

Just as for the genital case, if a person had a hand transplant and exclaimed the finality of his joy without first assessing the result (do I still have the same dexterity? if my sensation is measured with an ABX test, do I provably feel as finely details in texture of objects? do I have full motor control?) then yes I would make the exact same complaint.

I don't think your concerns are invalid.

I can't source it and it is not a study/statistics, but I did see a piece once on a Black American with a brain injury in a coma who was declared dead and then their organs were promptly harvested. The article suggested the patient could have recovered from their brain injury with proper care and that a well off white person with the same injury would have gotten the care they needed to recover instead of being declared dead and then essentially parted out.

It's a pretty macabre scenario. It's a question most people don't want to ask. Organ transplants get hyped a lot as miraculous and entirely positive events.

I used to belong to a number of cystic fibrosis lists. CF accounts for about a third of adult lung transplants and about half of all pediatric lung transplants in the US. I have seen plenty of discussions by family members, recipients or other concerned parties about things like being listed and waiting for a donor, as well as stories of people dying slowly from rejection.

So I have thought long and hard about this and I have my misgivings about "heroic medicine," such as insanely expensive drugs (one new-ish CF drug costs about $250k-$300k annually) and organ transplants.

The patient who received a new penis may not have gone through this, but one of the things that horrifies me about transplants is that, once you are listed, you essentially sit around hoping that a young, healthy person who is a tissue match dies tragically in the prime of their life in an accident so that you get a second shot at life. If your condition is deadly, you have been listed because you are basically dying. So you sit there hoping someone dies fairly soon. I can't imagine what that does to someone psychologically.

However, my father and my ex were both career army. The military has a very long association with experimental medicine and this relationship is more responsible for medical advances than people realize. I'm extremely sympathetic to this story in part because he's a veteran.

Returning to the question of studies, I do recall a blurb about Puerto Rico being a major source of organs for transplant. The article went into some of the reasons for that, though I don't recall any of the details. You could try looking for info on that angle and see where it leads you.

> ... one of the things that horrifies me about transplants is that, once you are listed, you essentially sit around hoping that a young, healthy person who is a tissue match dies tragically in the prime of their life in an accident so that you get a second shot at life.

I've thought about this some, because I carry a donor card.

I have read an account of someone who had been waiting for transplant (kidney, if I recall correctly). The call comes, she and her husband are driving two hours to where the operation will be, they're all happy... and then it hits her: Someone had to die for her to get that kidney.

But from my (abstract) perspective as a (potential) donor, I'm dead anyway. You might as well take my parts, because I don't need them any more. Whoever I am, I'm already gone, and I'm not coming back. So take my parts with my blessing, and don't feel guilty about it. Use them in good health and long life.

I have seriously thought about writing a letter to organ recipients, stating all this, but I don't know if my family would be allowed to give it to them...

Without getting this too far afield into religion, philosophy and psychology, some people believe that prayer et al can influence outcomes and many people feel incredibly guilt ridden about hoping for certain kinds of outcomes, no matter how irrational you may feel that is.

Thank you for being a donor. I am not against organ transplants. I just wish there was more emphasis placed on more prosaic, less "heroic" solutions to certain problems.

Edit: Please look into whether or not they would be willing to give such a letter to a recipient and, if so, how that could be arranged.