Pardon, are you saying that people with Asperger's and Bipolar Disorder have a lower chance of survival?
'Cause I don't think they do.
You can harp on about "political correctness" all you want, but it's about anti-discrimination. Would you support it if a black person was put behind white people because "black people are more likely to be murdered"?
Zachski, I'm going to put it in the most basic terms. There has been one fact critical to this debate that has been ignored, organs are limited, people will die.
I repeat. No matter what decisions you make, I make, doctors make, or society makes, people will die. This is the unpleasant fact here. This is not My Little Ponies. Princess Celestia will not come out of the clouds at the last minute and create a secondary organ. If A lives, B dies; if B lives, A dies.
So, how do answer this question? How do we determine which lives are worthy of living relative to those who unfortunately are not worthy? As Nick said, "doctors are not going to flip coins or throw dice over such an important decision." The answer, we literally put a value on life. We look at this in the most Un-PC manner. It's not fair, but neither is life nor the situation. We factor in certain conditions, come up with a value of that person's life, and we come to the conclusion on who lives and who dies. Unfortunately, we've gotten on a bit of a tangent. The OP discussed Coffin-Siris syndrome and Down's Syndrome; two conditions which (again, un-PC) objectively create a lower value and quality of life. They are less likely to be the heads of households, less likely to be important or contributing people in society (in purely economical terms), and less likely to enjoy the same quality of life as most society. Call this ableist all you want, but such is the unpleasant reality of triage.
Then, you got off on the tangent of transsexuality (largely I feel as a political point, a "gotcha Queen"). But you know, I will say it, in this instance, we have to look at the issue on paper. Again, it's not fair, but neither is life, nor the situation. If life were fair, I'd have a vagina. If factors stemming from my transsexuality (lack of dependents, weaker organs via HRT, etc) determines I should die, so be it. Like I said, people will die and this isn't pretty. Now, of course I would understand someone being a hypocrite and fighting tooth and nail when it's them, I would. But on paper, some people have to die and I could very well be that person.
And the whole reason is, as Sylvana said, triage. The purpose is to determine who has the best chance of living a productive live (productive in both personal and societal senses). Like, pretend we have two patients. Both need livers, we have one liver. Patient A is 25, has a host of health problems, in and out of the hospital, and with the liver, likely wouldn't live past 40. Patient A has no job, no children, and no body who depends on her. She lives largely off of medicaid and low income assistance. Patient B is 40, a widower with three children who depend on him. He makes enough of an income to give them a good life. If we ignore these health factors (or if we include them, ergo a de facto discrimination) and go with patient A, we have condemned 3 kids to a life of poverty and in a few years will have 2 dead people instead of 1.* To choose B solely because of A's condition would be ableism, but it would also be the best decision to make for society. Ultimately, the goal of all institutions should be utilitarian.
And this is the whole cause of the debate, the intentional misrepresentation of triage. It's not a list of qualifiers and disqualifiers, but a hierarchy of who is most deserving all the way down to the least deserving. Unfortunately, we perpetually have a lower amount of organs than patients who need them. Thus, the criteria which put one at the bottom of the list is a de facto disqualifier (down's syndrome for example, they go to the bottom of the list, we have limited organs, they don't get one, they die). If science were to develop advanced 3-D organ printing tomorrow or find a cache of well-preserved organs, those with coffin siris or down's syndrome would not be disqualified from transplants, they would get them. Therefore, the issue is not "you have down's syndrome no organs" but "we have limited organs, you have this condition, we're sorry." So, what we are arguing is not "qualifiers and disqualifiers," but the hierarchy of needs the medical profession uses. It just appears as a list of qualifiers and disqualifiers because perennially we have fewer organs than patients.
*while we can't know for certain, hey, patient B may be hit by a bus tomorrow, again, we look at this on paper.