Taxpayers should pay £40 million for trans men to have penises fitted abroad to bypass NHS waiting lists

Not surprising when we have people like transactivist doctor Johanna Olson-Kennedy saying that if girls who have had mastectomies want breasts later they can just go and get them.

Presumably they're being told the same lies about all the other transgender surgical procedures.

There's no long term studies. The closest we have is the real life case study of Buck Angel, who after 25 years of exogenous testosterone had her womb atrophy and begin rotting down inside her, she got sepsis and nearly died.

As a PP mentioned, on 🥝 farms there is a thread on SRS or GRS with pictures. ⚠️ You will need a very strong stomach. Many of the pictures are of surgeries that have gone wrong, but even the others are … something.

The conflation and misuse of language to deliberately hide or misrepresent or confuse reality is a feature of transgender activism.

It is a removal of power and agency to make it harder to verbalise, vocalise and recognise harms.

This is what happens with authoritarianism.

If you can't describe what is happening, you can't stop it.

Also, language. If society could stop using incorrect terminology for the results of these procedures!
In this case 'penises surgically attached ' ... who is donating these penises?

Also, language. If society could stop using incorrect terminology for the results of these procedures!

I agree. It's telling lies with deliberately misleading terminology. Then people get confused, e.g. if a person has a surgically-constructed neo-cervix then does that mean they need a cervical smear?

Short answer: NO.

Long answer: No, because a neo-cervix made of surgically-reconstructed colon is "like" an actual cervix only in the sense that a neo-liver made out of surgically-reconstructed armpit-hair is "like" an actual liver.

You have a point. They are typically not kids or adults of any age who have ever done enough sport to discover the frustration of a sporting injury that took 30 seconds to sustain and six months to heal. That kind of experience endows you with unwanted knowledge concerning the sheer delicacy of the human body, and you stop taking its healing abilities for granted.

Also, language. If society could stop using incorrect terminology for the results of these procedures! No trans-identifying man has a vagina, or clitoris, or cervix (excepting his avtual spine), no matter how many operations he's been through, and use of these words misleads everyone.

It's like speculating that we can remove an unwanted appendix and transform it into a functioning heart.

Phalloplasty has a >50% complication rate, especially urinary / kidney issues because the female urethra is so much shorter than the male's and it's hard to stretch it.

Also I bet there's no evidence in relation to long term complications of these procedures. Once these women have been without oestrogen for 30+ years, their risk of urinary tract complications must go through the roof.

That does seem to be how they think, and it's scary that anyone could pretend this level of lack of understanding could ever amount to "informed consent."

Truly scary - that poor misguided teenager that Purgatory quoted is in for a shock if/when reality bites.

Again, I honestly do think this way of regarding the human body is heavily influenced by the fact that kids these days are increasingly disembodied as they live through their phones rather than in the real world.

So true!!!

These kids seem to think human beings are like sims or lego men.

and

The kids think human bodyparts are easier to fix and replace than a roll of gingham cotton!

That does seem to be how they think, and it's scary that anyone could pretend this level of lack of understanding could ever amount to "informed consent."

If I cut up a ruffled dress, it wouldn't be reversible. There is a saying "measure twice, cut once" for fabric, which alludes to the impossibility of putting your fabric swatch back together after you've cut too much off.

The kids think human bodyparts are easier to fix and replace than a roll of gingham cotton!

Lol it's deiniftely not reverisble because they flay the penis, remove the inside and use it to construct the labia, whilst stitching the penile skin to the inside of the incision they make to create the vagina. And they re-route the urethra and also remove the tip of the penis to create a faux clitoris, plus they remove the scrotal sac and testicles, so....

Could you theoretically unscramble it all to create a surgically created penis? Only in the sense that you can recreate a whole egg out of some smashed bits of shell. These kids seem to think human beings are like sims or lego men.

Text of Abstract
Introduction: Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS.

Aims: To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere.

Methods: From November 2010 through November 2014, seven men 33 to 53 years old with previous male-to-female SRS underwent reversal phalloplasty. Preoperatively, they were examined by three independent psychiatrists. Surgery included three steps: removal of female genitalia with scrotoplasty and urethral lengthening, total phalloplasty with microvascular transfer of a musculocutaneous latissimus dorsi flap, and neophallus urethroplasty with penile prosthesis implantation.

Main outcome measures: Self-reported esthetic and psychosexual status after reversion surgery and International Index of Erectile Function scores for sexual health after phalloplasty and penile prosthesis implantation.

Results: Follow-up was 13 to 61 months (mean = 31 months). Good postoperative results were achieved in all patients. In four patients, all surgical steps were completed; two patients are currently waiting for penile implants; and one patient decided against the penile prosthesis. Complications were related to urethral lengthening: two fistulas and one stricture were observed. All complications were repaired by minor revision. According to patients' self-reports, all patients were pleased with the esthetic appearance of their genitalia and with their significantly improved psychological status.

Conclusion: Reversal surgery in regretful male-to-female transsexuals after SRS represents a complex, multistage procedure with satisfactory outcomes. Further insight into the characteristics of persons who regret their decision postoperatively would facilitate better future selection of applicants eligible for SRS.

Keywords: Male-to-Female Transsexuals; Outcomes; Phalloplasty; Regret; Sex Reassignment Surgery.

Link to Abstract

As I'm sure you will appreciate, this is not restoration of a penis. It is a description of a similar procedure to a phalloplasty procedure that is used on trans-identifying females who wish to live as men, but using flesh from the back instead of the arm or thigh. It even links to an abstract on exactly that: Total Phalloplasty With Latissimus Dorsi Musculocutaneous Flap in Female-to-male Transgender Surgery

Agree with all this.

Another reason why phalloplasties should not be offered is that it's really hard to know what specialism they flal into. In the US they seem mostly to be done by plastic surgeons, which is why in my view US patients end up with so many horrible complications.

For ACTUAL mean (e.g. injured soldiers) penile reconstruction is usually done by urologists and this would seem to be the more obvious specialism. But no decent urologist is going to want to sully their reputation with the losing game that is trans phalloplasty, which is why I think the spivvier plastics guys have gone into it instead.

I've just come across a worrying argument from November between a 14 year old trans-identifying child (who identifies as it) and some possible adult men/older teens on twitter. I am going to redact names, because there is no purpose in directing more traffic to harass a confused child. I share the conversation here, because the level of confusion over what surgery can and cannot achieve is very relevant to this thread, and this individual child's misapprehensions gives us further insights into what level of misinformation is flying around transgender support forums.

Trans-Identifying Teenager: no one cuts their dick off... it's meant to be 100% possible and facilitated to be able to detransition later in life if necessary.

Poster 2: Lmao.They are absolutely cutting d*cks and boobs off. Their is no coming back from cutting your dxck off. Once they mutilate their body it's never going to be the same again.

Trans-Identifying Teenager: the surgery turns your penis inside out, basically. remolds it into the shape of a vagina. 100% reversible. if you took the time to back your insolent arguments with evidence, you'd know that :)

Poster 3: You don’t even believe that. It’s not reversible.

After some more tedious back and forth, the teenager supplied this screenshot from an abstract, which the teen thought was proof penises could be restored.

I'll do a text version of that image in a moment.

The problem remains:

You have one theatre and one emergency team. Yet if you have a whole cohort of people who have surgery abroad who then have complications, you still only have one theatre and one team to deal with both the work load you've accounted for from domestic ops and this new work load you've got.

And this emergency team don't necessarily have specialist skills for this type of surgery repair.

So you run the risk of two patients needing the service provision that is inadequate for demand. That endangers lives and increases risk of further complications, not only of those going abroad for gender surgery but also regular surgery.

In order to facilitate extra surgeries abroad, you HAVE to expand emergency provision available domestically too. You can not just outsource all extra surgery abroad because it doesn't work like that.

If you can not increase emergency provision in line with the total number of ops regardless of the country they are carried out in (based on estimates of complications), you can not increase the number of ops without compromising patient safety.

You cannot just outsource provision because emergency provision can only be done in-house and that matters.

The complication rate being so high, means this is a non starter, because upping emergency provision simply isn't possible. It's the constraining factor not how many ops you can pay for abroad. It's how many emergency staff and facilities you have here.

And these staff need to be appropriately trained to deal with this type of complication. You can't magically increase this number over night.

Provision across the board has to be increased gradually. There are no short cuts.

And yes, if the failure rate and complication rate is that high, is it meeting the thresholds for effectiveness / cost for the NHS. Is the benefit significantly high enough to merit it - and crucially, where is the research to back this up.

If it does not exist, we absolutely should not outsourcing ops abroad in some kind of research project. (assuming here of course that they decide they need to do this research. If there's no research and no intent to do research then it's ethically a toilet of horrors).

Idiots are incapable of joining the dots on this though. They have no idea what good patient care is.

I don't think the NHS can reasonably say this because, if a patient is haemorrhaging or has another life threatening complication like a fistula, the NHS can't refuse to treat them. For example, the risk of haemorrhage after a hysto is quite high.

So I think it's an all or nothing choice, either the NHS offers the entire suite of surgeries and treatments in the UK at the NHS' cost, or they offer no transmasculine srgeries other than radical mastectomy which is at least somewhat more known.

I think that NO transgender surgeries should be offered on the NHS, and never to under 25s, whether NHS or private. But, if you're the type of person who wants to offer them, then it has to be all or nothing.

"First, do no harm*".

*except when there are multiple lucrative follow-up surgeries

This.

Let's offer all these procedures abroad. Great! Fab!

But we must warn you if you have an emergency complication, we can't guarantee we have got the resources to deal with that. Which might have massive implications for you, or another patient who needs emergency surgery when we don't have enough emergency operating hours.

What do you mean 'go abroad for the treatment for complications too'? You won't be well enough to travel and you won't be insured to travel. You certainly cannot fly...

Idiots.

Yep they need to make a BIG point about complication rate because no, surgery shouldn't be happening if the complication rate is that high. The surgery is clearly not ethical nor fit for purpose.

If this were a easy low risk operation you’d have private providers competing to offer it on price and location and cherrypicking it. Like they do with other straightforward treatments. The fact it has to be majority provided in a major hospital setting with a massive team tells you it must be known to very high risk in the profession and with expensive major hospital A&E emergency specialists needing to be on standby.

Phalloplasty has a >50% complication rate, especially urinary / kidney issues because the female urethra is so much shorter than the male's and it's hard to stretch it. Plus it's unheard of to do the whole procedure in one go, normally it's done in stages over 2 years. Especially if you're having RFFF where they deglove your arm of skin and muscle to the bone to harvest tissue for the phallus. Then you need a graft for the arm, plus later on there's the need for hysterectomy, oopherectomy...

My point being that I can't really see a scenario where these procedures could all be done overseas. The NHS would have to get involved at multiple points, either doing the surgeries at some stages or emergency treatment for the infections that are a very common complication of these procedures.

In fact with such a high complication / failure rate, these procedures should not really be offered at all.

Thanks for the link. It’s absolutely chilling what’s being proposed by the NHS. Built in medical failure ramping up on a mass scale. Where is the CQC on this? the GMC? NMC?

It should be in the Daily Mail soon if KJKs conversation with the first caller to TERF Talk Tuesday is anything to go by 😉

TERFtalktuesday #letwomenspeak