Do phalloplasties actually work?

notoriously gender critical

As opposed to embracing of regressive, arbitrary stereotypes?

Since gender is the mechanism by which patriarchy is enacted being critical of it is something to be proud of. That is the substance of radical feminism, aka second wave or gender critical feminism. If the stereotypes of masculinity and femininity didn’t exist perhaps people wouldn’t feel the need to take such extreme steps to distance themselves from the ones socially imposed on their sex. Gender critical = critical of sex stereotypes.

'Ah, and sorry about "sex reassignment surgery". I used it out of habit. Is "gender-affirming surgery" better'

'surgicical body alteration' might be more appropriate, or 'genital alteration'?

If we are honest with the often vulnerable people seeking these massive procedures we should call it what it is. You can affirm your believed gender by dressing and acting how you perceive to be the 'correct gender'. There is absolutely no need to endure extensive, mutilating operations as it doesn't affirm anything.

That's a very thought provoking post, thanks

All these things you quote are different in themselves, with different risks and variations in satisfactory outcomes, and genital surgery is different again, so this is not a helpful observation.

Thank you for for bringing this up.

I think she's the other side of the same fucked up society and social imagary that creates transgender identification. One lot are making themselves into a chariacture of the sex they are, the other into a chariacture of the sex they are not. I don't think we should be normalising either of them. Both groups are reacting to some inner beliefs about what men and women are "supposed" to be and finding themselves not matching up. And I'm horrified if under-18s are getting extreme dental treatments or cosmetic surgery.

One thing to consider is that society is tending to frame the same-sex-chariacture people as doing this as a cosmetic choice while the opposite-sex-chariacture people as seen as requiring this as a treatment. I do think that implies opposite-sex body modifications are somehow more necessary, more above criticism, and from the oppostiet perspective more problematic which may not in reality be justified.

I'm not in the UK, and I don't want a phalloplasty, so I wouldn't know if it's available on the NHS.

Whether it should be... I would tend to say no, for at least three reasons.

1. It's extremely expensive. There's no justification for spending so much money on a non-life-threatening condition, when it's my understanding that there isn't enough money to treat actually life-threatening conditions.

2. "Do no harm." Private doctors can put their limit where they want, but a national health service should be very strict about that.

3. Lack of experience. Surgeons need practice to get good results. The trickier the surgery, the more practice is needed. A surgeon who performs only a handful of phallophasties a year is not going to get the results of one who performs dozens. So unless NHS surgeons are thoroughly trained by experts, they shouldn't be performing phalloplasties at all.

Ah, and sorry about "sex reassignment surgery". I used it out of habit. Is "gender-affirming surgery" better?

Yes, I do protest against those, but being narcissistic and obsessed with how you look is not the same as being a vulnerable, ND, young person, who necessarily has a reduced capacity to consent, especially given that the outcome they desire after this barbaric, unproven surgery can never happen because you cannot change sex. They are left on a medical pathway for life, most with horrendous wounds that will never heal. It’s experimentation on people with MH issues and it is quite simply morally and ethically inhumane.

It is different.

The surgeries are more extreme - breast removal is different than breast enlargement. Phalloplasty has enormous complication rates and potential ill effects.

And it's posited as having an entirely different purpose. It's suggested as a solution to 'dysphoria', it's presented as a way to solve a mental health issue.

People also claim that having these surgeries mean someone has 'changed sex'. Which is of course impossible.

We've just had this discussion if you read the thread, no one is supporting having these procedures either. This one is about phalloplasty
Also, no one believes that having a nose job means they change sex.

This is grossly disingenuous.

It interferes with healthy and functioning bladder function with potentially life changing consequences.

It disrupts sexual function, with complications around pain, inability to organism.

And ultimately it doesn't deliver on the goal, which is to pass as the other sex. Because it can never achieve that.

Yes, actually many of us are concerned for people having those too, especially when they are botched or there is lack of informed consent as to the risks - especially as, by and large, many people are not happy afterwards and go on to have further elective cosmetic surgeries. For many therapy would be a wiser route. However, if a person choses to have those surgeries, they are a) self funded and b) usually reversible. So, Not. The. Same. Thing.

It’s no different to breast enlargements or nose jobs or labioplasty or any number of surgeries people have because they dislike how their body looks. Do you protest against those?

Thank you so much for saying this, young women like your daughter so often get forgotten in this awful situation. As the mother of a 27 year old autistic son, I am so grateful that he missed this when he was going through puberty, I dread to think what rabbit holes he could have gone down. And you’re absolutely correct in that they are typically young for their chronological age, my son was roughly 18 months to two years behind, which makes a huge difference in the teenage years.

I wish you and your daughter all the very best, you’re clearly a great mum to her, and she will thank you for your ‘fierce gatekeeping’ and keeping her safe.

Who’s wagging a finger? I wasn’t even talking to you lot. Just expressing my opinion on the change in Mumsnet.

It's ironic that a poster is suggesting a board of women with endless experience and knowledge of women's bodies may not be a good place to discuss the mutilation of female bodies in pursuit of allaying a mental health issue.

Even more so given that this ideology is driven by men claiming they know what it is to be a woman.

I understand it has already happened with many TMs already using walking sticks and wheelchairs by the time they are 30. I thought it was just the intersection of disabled and trans activists at the demos until it was pointed out that, no, these were long-term T users now damaged as a result of enforced premature menopause. I was horrified.

Agree, but also, given at least 70% of those referred to the tavistock were autistic, it’s also necessary for these surgeons to understand that autistics are pretty shit a truly appreciating risk. They are emotionally and neurologically less mature than their NT peers and really cannot make risk assessments on the same basis. It is a heinous dereliction of clinical duty that an 18 or 19yo autistic person is ‘trusted’ to make decisions that impact the rest of their lives when they really are not capable of seeing much beyond the ‘now’. It’s only because my DD is now 20 (and after I fiercely gate-keeped who she spoke to and which services she had access to) that she is old enough to appreciate that mastectomies and testosterone would be deeply harmful to her. Mentally and physically.

Just having the opportunity to trial 5 different ADHD meds and even more mood stabilising meds over the period between 14-20, discovering how severe the side-effects can be, has made her very very wary of ever taking hormones. I think she’d still love to magic herself into a male body, ideally one about 5ft 11 by contrast to her 5ft 4 self, but she’s come to understand that drugs and surgeries won’t actually ‘fix’ her. Occasionally she thanks me for ‘getting in her way’ as she now appreciates that even at 20, she is young compared to her peers.

I've often wondered this, we know osteoporosis can be a problem in menopausal women. These women identifying as men who have had ovaries removed and are testosteroned up with beards will we see wards full of them with broken bones in years to come? I hope not.

@SilverTapz this is a fairly comprehensive and balanced summary of transition interventions for men and women ( again we have to be mindful that it’s a highly complicated research field https://link.springer.com/article/10.1007/s13669-024-00390-1….. you did ask about concern about people regretting their surgery later and I thought this statement is apt “In one study, 17% of 69 Trans masculine people who de-transitioned cited medical complications as the main reason [30].”
Also important :
“Pain
Trans men who had undergone phalloplasty were four times more likely to experience pain during sexual intercourse compared to those who underwent metoidioplasty [9]. A recent publication also documented complications of penile and testicular prosthesis following gender-affirming phalloplasty. Three of 45 patients experienced pelvic or pubic pain with prosthesis [29]. Individuals undergoing penile prosthetic implantation may experience acute or chronic post-operative pain. This could be due to prosthesis malpositioning, alterations in proprioceptive nerves particularly with ilioinguinal nerve coaptation, excessive pressure from the prosthesis on the skin of the free flap, or irritation of the pubic bone at the fixation point [30].”
and also this:
“One study including 211 trans men prior to medical or surgical intervention showed a 42.9% rate of difficulty with orgasm that affected their daily life [9]”.
”In a survey study of 170 trans men prior to medical or surgical intervention, 42.9% experienced low sexual desire and 28.6% experienced sexual aversion [9]. Distress surrounding sexual activity or one’s own sexual health, which may or may not include individual anatomy, may impact general sexual satisfaction [17, 18]. Thus, those experiencing high levels of gender dysphoria may have lower levels of sexual satisfaction. Dissatisfaction with one’s body, or body dysmorphia can heavily contribute to sexual dysfunction and plays a large role in gender dysphoria [3]. Specifically, one study of 141 trans men demonstrated a connection between body dysmorphia and difficulty with sexual arousal in 91% of participants [18].”
….it may well be that medical input is seen as important to help trans people with their sexual function but perhaps it’s about researching what other options ( including sexual and psychological therapies) work best to help those individuals rather than proceeding to invasive surgeries that may cause more harm than good.

'One thing that cannot be emphasised enough is that there's extremely little actual safeguarding possible regarding sex reassignment surgeries. What I mean is, trans men are extremely good at sharing tips and advice on how to get what they want.'

It's the same with everything, to get what you want you do need to research and know what to say. Is this available on the nhs and do you agree it shouldn't be?

I'm interested in the term sex reassignment surgery as sex can't be reassigned. They should rename it body modification/alteration surgery.

It's ironic that a poster is suggesting a board of women with endless experience and knowledge of women's bodies may not be a good place to discuss the mutilation of female bodies in pursuit of allaying a mental health issue.

Also worth pointing out that trans lobby groups have been all over schools, children's homes, online - see Hannah Barnes book Time to Think for details of the inappropriate influence Gendered Intelligence and Mermaids had on GIDS, influencing "child healthcare" for their own political ends. Despite their lack of knowledge of child psychology, development, parenting and education.

We're in this mess because people, especially women, have been routinely bullied and intimidated into keeping quiet.

No more #nodebate. We must talk and expose what's being done to children and young people in the name of queer theory / trans ideology.

@MyOliveHelper just seen the discussion about teeth and cosmetic dentistry - if you read the personal accounts of Scott Nugent and Buck Angel you will actually see, ironically, that as a result of enforced early menopause and subsequent osteoarthritis, they lost many of their teeth (Scott mentioned in one interview that most of them cracked and had to be removed) so that cosmetic dentistry was something that became necessitated by trans affirming surgery.

I wonder if people are dismissive of the risks because they are primarily young.

Taking risks is part and parcel of young adulthood - it is programmed into brain development, probably as part of the evolutionary need to break away from the original family unit.

I'd like to see the charities and advocacy groups who have pushed the, "if you don't hurt yourself then other people will hurt you" message onto vulnerable young people in the dock for child abuse. The media is complicit too.

How the hell does a sane, mature adult think this is the best way to support already distressed teenagers. It makes me so angry.

Two things from a trans man.

1. I do think MN is a great place to ask such questions, because here you can find both educated women and TRAs. The educated women will point to the studies, the articles, the statistics, and so on. The TRAs will give pro-trans views. The result is extensive information mixed with lived experience, which is ideal I would say.

Would it be better to go on trans men forums? No, I don't think so, quite simply because there, the harsh realities of the studies and statistics would not be welcome by some participants, so they would either not be mentioned, or they would risk deeply upsetting some members who would not react well and the conversation would quickly become unpleasant for everyone involved.

2. One thing that cannot be emphasised enough is that there's extremely little actual safeguarding possible regarding sex reassignment surgeries. What I mean is, trans men are extremely good at sharing tips and advice on how to get what they want. "Go see Dr X", "Say this and never admit to that," are commonplace advice among trans men. So even if doctors wanted to ensure that the person in front of them is properly aware of the risks and truly consenting to them, they couldn't be sure, because the person would say all the right things, without necessarily having thought through any of them.

I was once friend with a trans man who couldn't consider transitioning socially - but still had top surgery and then had his documents changed. He ended up being officially Mr X, with his breasts gone, but still presenting as Mrs Y, even while refusing to understand why his family was making lesbophobic comments towards him and his girlfriend. It was a complete mess, and it took him years and years to set things straight in his head. Now imagine if it hadn't been about a marker on official documents, but about a massive surgery...