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I mostly agree with the labeling of your specific examples, but I'm still not satisfied with motive as the determining factor. Consider a doctor who was deluded into thinking that sodomizing with a broom would cure cancer, so they regularly did this to child cancer patients with no ulterior sexual motives. I think most people would call it sexual abuse. It's hard for me to figure out which components of this are causing that: the action itself being generally sexual in nature, the nature of the harm to the child, or the doubt that the doctor's motives are really so pure. It might just be that such a belief would be so egregiously negligent that no one could possibly believe it except by biased reasoning motivated by subconscious pedophilic motives, but I still think even given a guarantee of the pure motives it would still count as abuse. In the realm of physical abuse, we might consider
A: a man falls and his fist strikes his wife by mistake
B: a man believes striking his wife will save her from demons possessing her so he beats her on purpose for her own good
C: a man is angry so he strikes his wife.
A is almost certainly not abuse, C is definitely abuse. B is probably abuse, the closest of the scenarios to actual medical transitions: an action, taken deliberately, with the same effect as regular abuse taken for purportedly good but dubiously intelligent reasons. Now, maybe if we made an example with more science and reasoning behind it we could make an even closer approximation that paints the man in a better light. Maybe leading scientific journals publish papers suggesting that reinforcement learning therapy is good: so if you beat your wife only as punishment for mistakes (and reward obedience) she'll become a better happier human being, and the man reads these and trusts the science behind them. But I still think the deliberate performing of the action with mistaken beliefs would count as abuse in a way that the mistaken action in scenario A does not.
Terms don't have to, and often don't, have perfectly sensible meanings outside their value as use. A doctor sodomizing with a broom would be considered 'sexual abuse' either because 'broom in ass' is a fundamentally sexual act (is it? say a primitive tribesman falls on a wooden pole in the ground and it goes up his ass and it hurts. Do he or his tribebuds consider that sexual? I'd lean towards 'they'd notice it and joke about it, but not take it seriously', but I'm not sure.) or because 'broom in ass' is close enough to a sexual act we'd consider it sexual abuse.
What this points to is that the 'very bad'ness of sexual abuse is borne out of specific characteristics of the claimed harm that, in a way mostly related to their sexual nature, interact with the future of the person harmed in a negative way. So being raped as a child would be sexual abuse because it'd cause, so it's claimed, trust issues, fear about having sex in the future, maybe seeking to imitate that sexual abuse in the future with other abusers, et cetera. Whereas having your balls or penis cut off by a doctor accidentally probably wouldn't do that. The reason we find sexual abuse to be that bad is in part wanting to protect kids from that. But it's also mixed in with a lot of disproportionate, bizzare overreaction tbh. Children getting raped is bad, but it isn't really worse than murder or accidental death - but people, culturally, act like it is.
And that's why calling it 'sexual abuse' is materially wrong and not useful - having gender transition surgery doesn't cause any of the bad things sexual abuse causes, or have any of the malicious motives most sexual abuse has. Sure, it has different bad effects and bad motives. But they aren't the same. But because it's quite adjacent to 'children' and 'sex', and for whatever reason 'protect the children from pedophiles' resonates so much with people, we get this.
I'm not convinced. It causes severe sexual disfunction, usually prevents the achieving of orgasm, will significantly interfere with the ability to have meaningful sexual relationships in the future, can cause long term body image issues and dysmorphia. While these are not a perfect overlap with the harms of more central examples of sexual abuse, and the mechanism it causes these through is more physical and less psychological (though still some), I still think that broadly they are in the same class as those of sexual abuse. It's (probably) not going to prevent them from living their daily life, or driving a car, or performing your job, or having ordinary friendships, but it is going to permanently cripple their ability to have sex and sexual relationships. The harm is primarily of a sexual nature, even if the action itself is medicalized and professional in bearing.
SRS doesn't "usually prevent achieving orgasm". It definitely sometimes causes that, but in >75% of cases i'm pretty sure it doesn't (and it's probably higher). example reddit posts, iirc studies from surgery clinics found >75% could orgasm. I don't think it causes "severe sexual disfunction" in most cases either.
Yeah, but in an entirely different way from sexual abuse. From a purely outcome-based perspective, the way it prevents that is much closer to 'cancer surgery gone wrong' than 'sexual abuse'.
Why does that make it bad in the same way? None of the things that are supposed to make sexual abuse 'VERY BAD' - e.g. "there are a bunch of opportunists who will take advantage of children if they're given the opportunity" - apply to it.
Why call it sexual abuse, i guess? SRS doesn't have that much in common with the features that makes sexual abuse specifically bad. Accidentally injuring a penis during sex is also 'harm of a sexual nature', but it's not sexual abuse. Same for getting STDs.
There are here too. Maybe it would be more appropriate to refer to the entire grooming scenario as sexual abuse rather than just the surgery itself in isolation. That is, you have some sort of "therapist" who thinks that being trans is wonderful and good and better than being cis, which is a bias and agenda motivating their reasoning. Even if not strictly sexual in desire, they have ulterior motives of pushing the trans agenda. They then convince kids with mental illnesses or other social problems that the cause of their problem is being in the wrong body, push them down the trans chain, which ends in surgery. I would argue that this entire process is sexual abuse more than the surgery alone at the end of the line. And this is opportunists taking advantage of children given the opportunity, even if their motive is money and/or personal fulfillment and pride.
None of this is accidental. Nobody is accidentally chopping off genitals. I agree that we can't take a purely consequentialist perspective completely devoid of intent, but the intent is to cause harm "for the greater good" rather than the harm being accidental. Purposely injuring a penis during sex is sexual abuse. I would argue that deliberately giving someone an STD, not just negligent sex while infected but deliberately acting with the intention to maximize the chance of giving it to them, is also a form of sexual abuse. Even if it doesn't meet some strict set of criteria that you might use to define the term, it's something comparably bad such that mislabeling it sexual abuse isn't carrying any false connotations.
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