Horrendous case transgender surgery

[BovaryX]

The Telegraph reports a disturbing case involving a female to male patient. This patient had agreed to a hysterectomy, but repeatedly stated that they wished their vagina to remain intact. Not only did the surgeon remove the patient's vagina, but his colleague falsely amended the surgical form to make it appear the patient had consented. The patient describes the devastating impact upon their life and the surgeon has been fined and suspended. This case highlights the myriad problems with surgical interventions. In this case, the surgeon deliberately falsified records after performing an operation the patient had specifically refused. But what if the patient regrets the surgery even after giving consent? What if surgery is not a solution, but creates further, intractable problems? Why isn't therapy promoted first? I think there will come a point in the future when these draconian surgical interventions will be looked at with astonishment.

^Two Harley Street doctors have been suspended after mistakenly removing the vagina of a transgender patient without his consent.In what is believed to be the first case of its kind its kind inBritain the man - who was transitioning from a woman - was left “distraught” after the irreversible gender reassignment procedure was carried out.
A disciplinary tribunal heard that Giulio Garaffa, a gender reassignment consultant, mistakenly carried out the procedure and that his colleague Dr Marco Capece, in what was described as “a moment of panic”, “dishonestly” altered a form to say that consent had in fact been given^

I can’t really get over the existence of medical facilities to remove healthy organs and body parts at the request of patients.

I'm also very concerned that radical operations like this, which are at the furthest end of the scale, minimises surgery such as double mastectomies, and risks making this seem more acceptable.

This is confusing. So this person wanted to have both a penis and a vagina? I didn't think that was possible, even with surgery.

These surgeries can't give people the bodies they want, or think they want, all they can do is provide a very poor cosmetic imitation of the real thing at the cost of massively reduced functionality, a great deal of pain, and ultimately disappointment. Why would any society encourage young people down that path?

Absolutely agree Kitten It is really shocking. And as any woman who has had to have gynaecological surgery for a medical condition knows, contemporary best practice focuses on keyhole surgery, minimal intervention and reducing the risk of surgical complications. In other words, the opposite of this.

Why would any society encourage young people down that path?

Money. Always money. Hence the desperation to remove psychological.assessment and grab them.in kindergarten. Blockers, hormones , binders, packets, operations and it's never just one is it. Often there are repairs or multiple stages. Any priveleged white man dr is set for life with these surgeries.

Money corrupts..

It feels like despite all the lip service given to respecting trans people society doesn't really care if the surgeries they're having have terrible results. I saw a video of a vaginoplasty last week (that included film of the actual surgery) and it's just so brutal and horrifying, and that's the less brutal and less prone to long term complications of the two procedures compared to phalloplasty. All I could think was, do the parents patting themselves on the back for validating their trans children and jumping fully onboard with medical transition realize that in the long term this is what they're signing their child up for?

This was Harley street. Anyone can set up a Clinic there and have the whiff of respectability. They were planning on surgery which isn’t a full ‘sex realignment’ - they agreed that because the patient wanted it, and would pay, they would do it, whether made sense or not.

Why would the patient not want the full removal? What did they want to achieve? Were they given counselling or advice?

5 months and 12 months?
Is that all?

I agree with you hokolo. I read a recent account from a detransitioner who had come to see their mastectomy as an extreme extension of the self harm that had been a part of their life since childhood.

As for the urethra, I believe the standard procedure is to lengthen the urethra and then divert it through the enlarged clitoris (neophallus).

I don't know if this has been talked about in the past but I've never understood why these surgeries are treated differently from other patients who want a healthy body part removed.

Here's an extract from a case a few years ago and look and how differently it reads from these cases of "gender reassignment" surgeries:

"Andrew Smith believed his left foot was not part of his body and, since the age of eight, had experienced a pathological desire to lose his left leg. This intensified over time and, as far as he was concerned, by the time he was an adult, amputation above the knee was the only option.

When Mr Smith sought professional help, he was prescribed electroconvulsive therapy (ECT) and a selective serotonin reuptake inhibitor, but neither improved the problem. After years of psychological evaluation, he was diagnosed with body dysmorphic disorder (BDD); this psychological condition, also known as dysmorphophobia, causes individuals to become preoccupied with an imagined or minor defect in their appearance to the extent that their social, occupational or other areas of functioning are impaired.

After years of searching, Mr Smith found a sympathetic surgeon with a particular interest in amputation surgery. Mr Jenkins was willing to amputate the healthy leg, believing the diagnosis of BDD to be incorrect. He felt people seeking amputation of healthy limbs may have one of four different conditions - self-mutilation, dependency, sexual gratification, or a desire to lose a limb that has become an all-consuming part of life. Mr Jenkins believed the last condition applied to Mr Smith; importantly, he would not consider surgery for people in the other groups.
...
After 18 months’ careful consideration, Mr Jenkins approached a private hospital where he hoped to carry out the amputation. Although the hospital’s medical advisory committee supported the surgeon, the managers did not, so he approached the medical director of an NHS trust who consented to the surgery taking place.

Mr Smith had his left leg amputated; he paid for the surgery and a five-day stay in hospital; Mr Jenkins waived his fee. The surgeon went on to carry out another “healthy limb” amputation at the same hospital, but when a third man requested such a procedure the trust’s new chief executive and chairman put a ban on the surgery and ordered an internal ethical inquiry."

It’s awful, but I’m not sure it says anything specifically about the ethics of doctors working in gender reassignment though, as a one off scenario

Let’s see, we have the case in the OP. Then we have Christopher Salgado who posted photos of his patients’ genitals on Instagram:

www.google.com.au/amp/s/www.nytimes.com/2019/03/14/us/transgender-surgeon-patient-photos.amp.html

Then we have Marci Bowers who removed Jazz Jennings’ testes despite Jazz saying, on camera, that Jazz had never experienced any form of libido. Bowers knew that taking that final step of surgery would make that permanent.

The only ethical surgeon when it comes to doing these operations is the one who refuses.

It’s like experimentation. If you have the money you will be able to find a surgeon who will do anything.

It’s like experimentation. If you have the money you will be able to find a surgeon who will do anything

And some things just have an invisibility cloak. Remember the case of the 14 year old who had such an extreme case of period pain/pmt she was suicidal every month. Her mum had the same thing and the only thing that cured it was a hysterectomy. But drs refused on the child because of her age . Even though there was nothing else they could really do to enable this child to have a normal life.

But she was a girl. Born a girl. No additions that would take it from a hysterectomy to affirmative care .

Add the T into the mix and all of a sudden you can take your pick of drs and theres some fa cup sanitised name for the procedures .

You can he prosecuted for fgm and breast binding but that's cos it's not white people doing it. If you are white and place your child on medicatical paths that remove function, and fertility at 12 it's all good.

I just think of the mega boob jobs, the extreme plastic surgery, the man who wants to look like a parrot and had his ears cut off, people who have horns inserted under their skin or tongues split, or tattoed eyeballs. Even women in their 60s having babies with medical intervention.

Yes, the surgeons and doctors can do this - but should they?

OT but I find chin implants really disturbing, especially when combined with drastic narrowing of the jaw. It just hits all the uncanny valley buttons.

The comments in the Mail so many people asking WHY someone would want to keep their vagina. Surely the answer is that it's part of their body, has nerve endings, links to the clitoris, is involved in sexual sensation and orgasm unlike a fake arm-skin penis?

It's not all a question of cosmetic appearance.

The misleading language around this is so frustrating.

The patient had agreed to have a hysterectomy and a metoidioplasty, which would have given him a penis

Look up metoidioplasty if you don't know what it is. It does not give the recipient a penis.

I can’t really get over the existence of medical facilities to remove healthy organs and body parts at the request of patients

This. Thanks for the case about the man who wanted his leg amputated definitely - I think anyone who wants sex change surgery should be required to consider such cases. They should also be required to a) view operations and b) read accounts of people who have had such operations (many of whom have long term health problems as a result). Only if all of this has been done plus extensive counselling can it even be considered, ethically. But of course they just seem to be jumping on in there. Healthy body parts should not be removed just because someone wants them to be. Frankly, any doctor who would do this surgery already has dubious ethics as far as I'm concerned.

Interesting how in the end the medical management decided that leg amputations weren't ok - there is no objective difference between that and removal of sex organs. The only difference is political wokery.

Removing body parts without consent and then forging documents to try and get off must surely be a criminal matter??

I’d say so.

This is confusing. So this person wanted to have both a penis and a vagina? I didn't think that was possible, even with surgery.

It’s becoming increasingly common for both FTM and MTF to keep some of their original parts and have additions. I question the ethics of this but it’s the upshot of politicians saying stuff like ‘nonbinary people are valid’

Actually, I increasingly question the ethics of all cosmetic surgery and cosmetic injectables.

I am really pleased this case is getting media coverage. This case is absolutely shocking and it raises many serious questions about the ethics of the doctors involved. Best practice in contemporary gynaecological surgery such as the removal of ovarian cysts or the treatment of fibroids is focused on keyhole surgery and minimising the potential for damage whilst achieving the medical aims. This surgery was elective and draconian. It is irreversible. The two surgeons involved will be wielding scalpels again in 12 months. There are profound ethical issues here. Public scrutiny and transparency is imperative.

I thought the surgeons would have many direct discussions with the patient before agreeing to do the surgery. If that had happened then they would have known without a doubt what the patient wanted and why. It smacks of there being an unquestioning production line. The surgeon and theatre team rocked up and did their standard job on the latest faceless young woman on the table only later twigging that this one wanted something a bit different.

It alarms me from that point of view alone, leaving aside the huge ethical problem of surgery that takes healthy functioning body parts and makes them damaged non-functional body parts requiring lifelong medical support. All with the aim of improving a suicidal patient's long term mental health.

At the start of every operation a WHO checklist has to be read, which includes checking the identity of the patient, the people in the room, the consent and the procedure planned.
Other people knew...
I made this point above - I’m not sure a private hospital is obliged to use a checklist - was one used?

Look up metoidioplasty if you don't know what it is. It does not give the recipient a penis.
I posted this earlier too but it was hidden in my waffle www.healthline.com/health/transgender/metoidioplasty - it creates a ‘neophallus’ 3-8cm long (an enlarged, released clitoris). But I guess the mainstream media are as likely to print the word ‘neophallus’ as they are ‘clitoris’!

We are told the surgery is needed to avoid suicide.

If I were a surgeon being asked to do harmful surgery to help my suicidal patient's mental health I'd spend hours talking to the patient before I'd pick up a scalpel.

How on earth do any of these surgeons get insurance? The insurers are going to be paying out millions over the next few years.

The surgeon and theatre team rocked up and did their standard job on the latest faceless young woman on the table only later twigging that this one wanted something a bit different. It alarms me from that point of view alone, leaving aside the huge ethical problem of surgery that takes healthy functioning body parts and makes them damaged non-functional body parts requiring lifelong medical support. All with the aim of improving a suicidal patient's long term mental health

Great post. Your observation about the production line has a grim ring of truth. It is quite incredible that while modern gynaecological surgery for medical reasons is focused on minimal intervention, this draconian, irreversible, elective removal of all gynaecological organs is taking place in the 21st century advanced West. What are its long term physical and mental consequences? What does it say about the ethics of those involved in this specialist surgery that one surgeon is prepared to deliberately falsify the patient's consent form post surgery?