Do phalloplasties actually work?

Yes, I remember that now. It was really disappointing because a well run study such as that would be useful

Look what happened to James Caspian, an academic who wanted to conduct proper researchers into trans regret following a conversation with a leading surgeon who performs these operations.

The surgeon had told him that a number of patients had come to him wanting to reverse the surgery and Caspian thought this deserved proper scrutiny, because more knowledge, more understanding helps everyone, no!?

Apparently not, his university shut the whole thing down, and he couldn't raise the funding he needed.

Shameful.

It is a horrific discussion. And I known of several personal friends who are parents of teens who have discussed their fears for their children regarding these types of medical treatments with me because I asked how they were going. This is sadly not rare.

What an awful discussion. It's relevant that this is being done to young people as their relationship experiences may be limited - often with little or no sexual experience - let alone the concept of becoming a parent.
So informed consent to having their sexual organs butchered, sexual feelings and potential fertility removed seems unlikely.

“Sounds very cult like”

It has been said before. Strangely, anytime it used to be said on MN up to about a few months ago, it was deleted. In fact, I expect it would be deleted sometimes now too.

You then have to add it to the question list.

What type of group monitors and enforces language of others, while denying they are acting in an authoritarian and totalitarian manner?

Add it to this one

What type of group uses such poor quality academic papers and studies to support their demands and shape policy based on a philosophical belief about someone’s identity that doesn’t reflect material reality?

Sounds very cult like. Harmful.

Awful isn't it. Very sad.

We have heard from detransitioners or from people still transitioned but who tend to be campaigning for better quality of care that those in the support groups or social groups don’t want to talk about any negativity.

They shut down people who are trying to talk about their complications. whether it is surgical, or side effects from hormones or just doubts about what it all means. I think there are many people out there who feel rejected by the group (the ones who pride themselves on how inclusive they are!) and those people are the ones who are very vulnerable. I remember reading posts once from a male transitioner in Canada who felt failed because of reaching the end of the treatment options only to discover that none of it made him feel better.

He was still male and would never really be the female person all the messaging from groups and allies said. That it all relied on existing in a bubble where everyone acted in support but it never was true. And I believe he applied for assisted death because of the complications and the severe mental health.

There are plenty of personal accounts though of the lack of support in the groups for discussing negative health impacts. It seems like the groups are there to celebrate themselves and their medical outcomes, and to become ‘chosen families’ after encouraging people to go no-contact.

I think there's phenomenal pressure on those who've had surgery to tell the world it's wonderful. Otherwise they look like fools.

They must also desperately need to convince themselves that they have done the rights thing.

Most of you probably knew this but, before reading the studies I linked above, I'd never been clear on what they do with the clitoris. One would hope they could somehow stick it at or near the end of the 'penis' but I couldn't imagine how that might work.

Answer: they don't. They loosen and move it a bit, then wrap the flesh roll around it. A large nerve is re-routed from (usually) the thigh, popped inside the sausage, and attached (hopefully) to one of the clitoral nerve bundles. Ideally the re-sited nerve will 'learn' it's now part of the clitoris and transport sensations through the length of the phallus. If this ever does happen it will take years. Until then, the best sexual sensation a patient can get is by stimulating the base of the sausage, where the clitoris is buried.

I tried looking at how the clitoris is loosened, and how much of it makes it to the new position. But I got too squeamish.

I used to follow Exulsanic on Twitter. She's a detransitioner and she often links to transmen talking about being surprised by the reality of their surgery. She's also, over the years, covered the tragic downhill of several transmen who post on Insta and TikTok. I can recall at least three deaths. At least one of them involved a young women whose never-ending urinary infections and slow loss of kidney function led to deep depression and, it was surmised, sepsis.

Just as everyone, when asked how often they have sex by someone doing a survey, says two or three times a week (because who wants to admit they go weeks at a time without, or have it twice a day?) I think there's phenomenal pressure on those who've had surgery to tell the world it's wonderful. Otherwise they look like fools. I see quite a few quotes lifted from Reddit forums where, when they think the world isn't watching, they talk more realistically about the downside and the surgical failures. Infections seem to be rife.

Sensory outcomes are complex ... we conclude that outcomes often do not match expectations, which causes dissatisfaction in a proportion of participants ... discuss the considerable probability of having to face shortcomings with regard to the esthetic and/or functional outcomes as well as a reduced sensibility and long recovery time

pmc.ncbi.nlm.nih.gov/articles/PMC8498953/

The objectified sensitivity of the neophallus, measured by the SWM test, was significantly reduced compared to that of the donor-site, with the proximal part being more sensitive than the distal part. While we found evidence that sensation improves over time, it remains unknown, when sensory recovery stabilizes and at what level. Several previous studies showed that sensory recovery of the neophallus after nerve coaptation is possible for various flap techniques, but the overall tactile sensation recovery remains suboptimal in all presented techniques.

(It was noted that the trans men thought the sensitivity was better than it really was. The researchers put this down to improved self-image.)

pmc.ncbi.nlm.nih.gov/articles/PMC8498953

Provided that patients have experienced clitoral orgasm before surgery, clitoral transposition does not result in a subsequent loss of ability to achieve orgasm with direct stimulation of the clitoris site.

In our experience, many patient’s report lack of familiarity with their genitals (e.g., use for sex, exploratory touching). Such lack of familiarity may predict for poorer sexual function post-op: two of the three patients that had never experienced orgasm before surgery reported an inability to achieve orgasm after their surgery.

pmc.ncbi.nlm.nih.gov/articles/PMC4708164/

Lowest scores in satisfaction were observed for the sexual functioning of the neophallus, with 34% satisfied to very satisfied participants.

https://www.sciencedirect.com/science/article/pii/S1743609521003027

Most reports give very high levels of satisfaction, including sexual satisfaction (80% - 95%). Reading many different sources, though, it seems that only satisfied patients opt in to the follow-up studies. Most of the studies only covered 10 or 20 participants - the one showing 34% sexual satisfaction had 102.

As Scott Newgent explains, these surgeries are brutal, very experimental and come with no guarantees.

There's not much evidence as there's not much follow up, there are some studies here:

https://statsforgender.org/category/medical-transition/

sexual dysfunction after phalloplasty 54% . (Dominoni et al)

Only a single case2 of a female-to-male transitioner treated with puberty blockers followed by cross-sex hormones and surgeries has feen followed long-term.
The individual, who was in his thirties during the follow up, reported an inability to have a satisfying sexual life due to “shame about his genital appearance and his feelings of inadequacy in sexual matters”. The researchers concluded, that despite the gender reassignment, “in the area of intimate relationships, it may remain difficult to find a suitable partner”. (Cohen-Kettenis et al)

Figures on female-to-male transitioners are less clear. However, a clinical follow-up study2 of 38 transmen – 29 of whom had received phalloplasty, and 9 metoidioplasty – found that reported loss of orgasmic capacity was more marginally common than reported gain of orgasmic capacity. (Manrique et al)

The idea that detached arm or leg skin and muscle will become erogenous is clearly fantastic, plus tissue which has been removed, reshaped and sewn on somewhere else is not likely to be very happy to say the least. I've seen lots of transmen blithely posting about 'nerve hook up' and 'nerve regrowth'. If you've ever had any nerve damage you will know that it results in numbness, tingling,or pain, sometimes for years. It's not like plugging a lamp into an extension lead. And nerve pain can be horrific. Maybe numbness is the best outcome to be hoped for, but it's certainly not what most people would want of their genitals.

Edited, posted too soon

IF they can orgasm at all … does anyone track that? Or is sex life and pleasure just not a metric for this population?

You're proud of 'your side' over depth of research and credibility etc - you're assuming that nobody outside of your views is educated and well read on the subject.

We don’t have to assume anything, because we can read what they write, which exposes their poorly informed and incoherent reasoning.

You're proud of 'your side' over depth of research and credibility etc - you're assuming that nobody outside of your views is educated and well read on the subject.

Good research is not about sides. We don’t assume people with alternative views are not educated; we assume they are hence we ask for the evidence they are relying on. But experience shows the studies they turn to are weak, biased, or simply misrepresented time and time again.

You're proud of 'your side' over depth of research and credibility etc - you're assuming that nobody outside of your views is educated and well read on the subject.

Whilst I come across trans people and cisgender men and women who I know definitely haven't studied the papers and journals, so very many of us have, so very many of us have first hand experience or have friends or family who have. Mostly good experiences with the odd hiccup depending on a variety of things which can happen during or after any surgery.

You think we are uneducated but the majority of us are, and many of those have read the studies. And don't just rely on hearsay or people's privately run Web blogs. I also think reddit is a terrible place to go for help or support or education, noone knows who is posting, we all know people will pose as someone fictional to drive a narrative, I won't touch reddit with a bargepole because my visits there have been full of very obvious shitposters and unreasonable people to have any discussion with.

Given that many site pre approve comments and won't publish those that point out the emperor is in the nuddy or are moderated with a heavy hand so remove such references it's a pretty pointless exercise.
If the 'gender' of the poster can be 'determined' from posts then they must need to be made with a name that is presumably checked in some way or Dave could post as Mary and no-one would be able to tell if Chris is Christopher or Christine. We know women are very, very reluctant to put comment publicly so either the sex of the poster has been confirmed which means they are identifiable and ergo unlikely to speak up or the survey has gasp assumed the gender of the commentators which is literal violence!

Excellent points!

Considering we know exactly how heavily moderated comments sections are, as per own experiences or just watching comments be deleted in media.

There is little to recommend this review as being anywhere near as strong to make the conclusion that was drawn.

I believe the author of the review was highly motivated to find their conclusions. I don't think that is a far stretch conclusion from looking at their work and the photos that I found.

"In this section, we describe how we collect comments from online news articles pertaining to the safety and privacy of patrons in female bathrooms, dividing them according to (a) the gender of the user who made the comment, (b) whether or not the comment is a negative comment, and (c) in the case of a negative comment, whether the comment describes a causal or incidental link between transgender females and safety and privacy in female bathrooms (or neither)."

What steps were taken to ensure the news articles used allowed the publication of "transphobic" comments e.g. women complaining about about trans women i.e. men in women's toilets? Was it assessed if comments could be made anonymously/ pseudonymously so women were less afraid of commenting? How was 'gender' of the user commenting discerned? Self id, guess work?
What a terrible way to decide men in women's toilets is 'harmless'.

Still catching up, but wanted to share my (admittedly derisive) hilarity at your efforts to support your points with data. You've linked to a study basing itself - in all apparent seriousness - on two weeks' worth of Google comments in 2015, when few people knew anything about transgenderism, and one I can't read without a subscription. Now you're telling us about an FOI that revealed no assault reports.

Let's consider women's reports of assaults by female-impersonating men.

Two UK women that I know of were raped in female hospital wards, then told by the hospitals that they couldn't have been raped as no men were present. One of the victims had the strength to persist and to share her experience. Hospital management doubled down on its insistence that she was 'mistaken'. The police, after talking to hospital staff, judged there was no crime. It took the woman a year of continued effort, through which she had to keep revisiting the crime against her, to achieve recognition of the truth and the apology she deserved.

Multiple groups of female NHS staff have been ordered by management to undress in front of male staff in the female changing rooms. Their unions supported the management.

Female athletes at every level have been told to welcome creepy and overbearing men in their changing facilities or lose their place on the team.

Too many women to count have lost their jobs for complaining about men in the women's toilets. Women have been ejected from pubs and clubs for the same. On social media, any woman daring to query the rights of female-impersonating men to invade their spaces and their bodies is bullied and cancelled, often having their accounts deleted by the media owners.

For years and years, mainstream media barely touched the issue due to the costs of litigation by transactivists. Vexatious litigation has been quite an effective tool in maintaining silence over any concerns about women's loss of rights to cosplaying men and their mouthpieces.

You're right that there is a dearth of data on the harms inflicted by transgenderism. That doesn't show there is no harm: it's evidence of intimidation. When victims are afraid to speak, authorities afraid to investigate and media afraid to report, there is no data; only silence.

This is something transactivism has done incredibly well - public opinion management by terror. The Stasi would be proud. Congratulations.

Actually, that was when the data was collected. I was in error.

The articles were from about a six month period and seem to be from around the world.

"Of the articles inspected, 190 contained suitable comments, from which the author collected 1035 comments. All articles were dated between 1 December 2014 and 10 May 2015 (inclusive)."

However, it was up to 2015 and the situation has moved on considerably since then.

Yes. We have been told that by posters in the past. We have been told this by supposed academics on MN in the past. They never seem to be able to post links that show what they claim.

Obviously, some of us hold academics and those giving vulnerable people support to a much higher standard than they do themselves. I am currently despairing at the lack of intellectual curiosity in some of the posts that I see on MN about this topic as they don't seem to be able to interrogate the logic or the information that they post.

There is this plea to their authority that because they claim to have qualifications or to be employed in this area, that they have superior access to knowledge that we don't have. It does usually end up not working for them on threads because they have overstated the merit of the information and they then get insulted. What I don't ever see happening is that they then think, oh fuck, have I got it wrong then?

Whereas, I and I think many others, read the information and think, ok, how does this work, how has this conclusion been supported and does it have merit to be included in my bank of information? I am perfectly happy to take on information if it is robustly supported, even logically, and that doesn't fail under scrutiny, or require a belief not supported by established science, to make it strong.

Wait.... so "April 29 and May 16, 2015" So for a total of 18 days? That is their sole evidence pool? 18 days? And that is the "peer reviewed research" that @MyOliveHelper said they had and preferred? 18 days?!??

But Helleofabore if we were only to know who they are and which organisation they worked for we would all be overcome with awe by their presence and defer to their obviously greater wisdom….