Should cometic surgery to 'affirm' someones gender be banned?

Mastectomies are the most common 'gender affirming' surgery by far. Not found a meta analysis of complications yet, will see if I can.

Meanwhile, here's one study of 100 odd patients:

https://pmc.ncbi.nlm.nih.gov/articles/PMC10917456/

'Among the 206 mastectomies, there were 5 wound infections (representing 5 patients out of 103, 4.8%) that were treated with oral antibiotics. There were 8 seromas (representing 7 patients out of 103, 6.8%) managed by needle puncture. There were 10 hematomas (representing 7 patients out of 103, 6.8%), 3 of which required surgical drainage, whereas the remaining 7 were managed by needle aspiration in the following weeks. There were 28 cases of NAC necrosis (partial or total; representing 21 patients out of 103, 20.4%), and 4 patients underwent surgical revision (3.8%), including the drainage of the 3 hematomas and 1 NAC excision. Any form of complication occurred in 33 patients, which represents 32% of the patients included in the study. '

I think your emphasis on the loss of reproductive capacity is concerning. If you were concerned about infection etc then I’d understand. But some people are quite happy to be infertile and it is not a requirement of anyone to have children. I know of a family friend who opted for a tubal litigation (after years of fighting for one) as she didn’t want kids and didn’t do well on contraception, do you take issue with her too?

MTF meta-analysis:

'A total of 3716 cases were analyzed. Overall incidence of complications included the following: 2% (1%-6%) fistula, 14% (10%-18%) stenosis and strictures, and 1% (0%-6%) tissue necrosis, and 4% (2%-10%) prolapse (upper and lower limits of the 95% confidence interval).

https://pubmed.ncbi.nlm.nih.gov/29489533/

https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/labiaplasty/

Quoted from the above page:

You cannot usually get a labiaplasty on the NHS
A labiaplasty is not usually available on the NHS. But it may be offered in some circumstances – for example, if the vaginal lips are abnormal, to repair tears after childbirth, or to remove cancerous tissue if a woman has vulval cancer

Differs markedly between the sexes.

Meta-study for FTM surgery:

'A total of 1731 patients underwent phalloplasty, with the most common type of reconstruction performed being the radial forearm free flap (75.1%). Overall complication rate was high at 76.5%, of which urethral complications were high in all reconstructive subgroups (urethral fistula rate of 34.1% and urethral stricture rate of 25.4%).'

https://www.sciencedirect.com/science/article/abs/pii/S2050052122000129

I mean, in the context of NHS treatment.

The only surgeon I've seen that operated in 'affirming' BIID surgery was forbidden from ever doing it again.

https://www.theguardian.com/uk/2000/aug/26/6

http://news.bbc.co.uk/1/hi/scotland/625680.stm

They are hardly medical necessities though are they?

Oh god didn't you get enough affirmation of your vitriolic views in the other thread?🙄

Do surgeons amputate in such situations? Or is BIID treated with talking therapies, anti-depressants, anti-psychotics etc?

If they are an adult, are self funding it and have proven to be mentally fit to make that decision then I think it’s fine.

People say a lot of things.

Did you read about Neil Hopper?

I am gender critical, however, trans people will say that the emotional pain of living with the ‘wrong sex’ genitals leads to depression and sometimes to suicide. I assume the surgeons performing the surgery take this into account when considering ‘do no harm’. I am also a doctor and would welcome a more open and public debate about what the NHS will and will not fund

We allow adults to get all sorts of cosmetic surgeries that are not necessary for physical health. Unless we ban all of those, we have no business evaluating the reason an adult wants to spend their own money modifying their body.

I would hope a reputable surgeon would consider just how many surgeries an individual can undergo safely. Beyond that, it is their choice.

Umm they absolutely do! If a consultant agrees to add them to a list it will be done and the majority of patients I see have this are young early 20 something's where the appearance is what they believe to be abnormal and it's getting them down despite being completely normal. Perhaps don't make such blanket comments if you're gonna be so incorrect.

The NHS doesn't do any cosmetic surgery, unless it's fixing something that has gone wrong in some way/is unhealthy. They certainly don't do cosmetic labiaplasty just because you want a different appearance! You would only qualify if your labia are considered abnormal and you have problems, such as painful sex.

This is an important point. The NHS ends up funding a lot of things around and after private care, so it's not possible to completely unfund something from the NHS. If they have a complication, infection or pre-op.flags something to be resolved before surgery that all falls on the NHS.

Anyone can make themselves look convincing in a photo, especially with filters etc but face to face walking down the street is a completely different matter.

It's impossible to disguise a male or female gait/musculoskeletal system because something will always look not quite right.

They are not cosmetic.

I don't understand how banning them would be justified when we allow the same cosmetic surgeries for others, and sometimes even on the NHS. Is a labiaplasty not in some way gender "affirming" (although I hate that word) as there's no clinical reason other than them feeling they don't conform to a notion of what a vulva should look like.

Really? You've never heard of a vasectomy or a tubal ligation???

Yes, but you could find gruesome pictures of surgery gone wrong of any surgical procedure. My question was do you have any evidence serious complications are always significantly more likely for gender affirming care than other cosmetic procedures? A few pictures proves nothing about actual statistics.

We're told to listen to trans people-well I am listening to people who regret terribly believing they were trans and being pushed into hormones & surgeries.

While ignoring the significantly larger majority who have not had serious complications and who don't have regrets. So no you are not listening to trans people, you're listening to people who confirm what you already want to believe.

There is simply no diagnostic tool to provide an evidence based diagnosis that someone is trans...

Yes. There literally is. The diagnostic criteria used by doctors is listed in the DSM-5-TR (for gender dysphoria) or the ICD-11 (for gender incongruence).

do you just want to stop trans people from being trans people?

I thought that neither surgical procedures nor medical interventions make someone trans or more trans than someone else and aren’t required to activate the gender reassignment protections of the EA2010 or to acquire a GRC under the GRA?

Do you have any actual evidence that gender affirming procedures have a higher rate of serious complication than every single other cosmetic or elective procedure? Or is it just something you reckon?

One way in which gender affirming procedures differ from many other procedures, especially when they are done on the NHS, is there is a lengthy (sometimes very lengthy) process of assessment and discussion and diagnosis before the procedure goes ahead, which reduces the risk of a hasty or uninformed decision. One perennial problem with banning stuff is it doesn't stop people accessing it, it just drives the process underground, making it unregulated and more dangerous so if your actual concern is with the risk of side effects and complications, banning it is probably only going to increase the risk of unsafe surgeries.

Is your real concern actually with safety though, or do you just want to stop trans people from being trans people?