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^

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?

Some of us struggle with the idea that a person who apparently has gender dysphoria elects to keep those body parts that are most symbolic of the rejected sex, whether vagina or penis and testicles. It’s like they don’t have a problem with their body and the sex it reflects, more a problem with how they are viewed by everyone else. So the bits that can be hidden they’ll keep but they’ll change the external bits. It’s like role play, and it troubles me.

It’s like they don’t have a problem with their body and the sex it reflects, more a problem with how they are viewed by everyone else. So the bits that can be hidden they’ll keep but they’ll change the external bits. It’s like role play, and it troubles me.
I find this pretty perceptive, and tallies with the constant demands for ‘validation’, and accusations of ‘literal violence’/phobia/hatred etc against other people do not believe the exact same about the nature of sex & gender and have the temerity to express an alternate opinion.
I think it is reasonable to suppose that self-hatred/lack of self-acceptance and dysphoria/dysmorphia focused on secondary sex characteristics could develop from an intense desire to ‘be seen’ as the opposite sex.
Disclaimer - not all trans etc.

The St Peter’s Andrology team (operating out of Highgate Hospital) are the only surgical team who do FTM ‘bottom surgery’ (phalloplasty, metoidioplasty, stage 2 and 3 follow up surgeries (hooking up the new urethral length and adding silicone implants to look like testicles etc).

NHS patients see the exact same staff in the exact same locations.
I don’t know anything about how the NHS commissions private providers but these surgeons should certainly be capable of following NHS protocols and procedures and the thought that they would be less rigorous with patients paying out of pocket (presumably those who feel unable to cope with the NHS waiting list) is pretty terrifying too.

It's awful. I don't know if you can draw sweeping conclusions about reasignment surgery based on one (atrocious) incident though.

I find the falsifying more disturbing in some ways. That was not a mistake, they did it deliberately to gaslight the patient. I can't believe they are just suspended.

“Some of us struggle with the idea that a person who apparently has gender dysphoria elects to keep those body parts that are most symbolic of the rejected sex, whether vagina or penis and testicles”

I agree, but our understanding or lack of doesn’t make another person’s choices or feelings less valid, does it?

The vagina, vulva and clitoris are not visible to the outside world, and it may well suit a person’s choice of sex partner and source of sexual pleasure.

The public responsibility is to look at the ethics around consent, access to counselling, support for emotional and psychological health (for everyone) and adherence to professional and legal practice within medicine.

There has been a movement for people with achondroplasia (dwarfism/ short limbs) to undergo bone lengthening. Bone lengthening is a brutal and lengthy procedure involving cutting though healthy bones and months in a fixator frame forcing the bones apart. People advocate and undergo this to look ‘normal’. It is a choice we enable people to take. If people feel strongly, with the right support, that they want their sexual parts to feel ‘normal’ that is right for them, then who are we to judge?

Disclaimer: I am not talking about Mermaids style self electing for irreversible treatment for U18s without counselling beyond the ‘affirmation model’.

Poor thing.
The whole concept that they have performed an operation against consent and falsified the consent afterwards is disgraceful, regardless of what they were doing and why.

Simila- ish thing happened to my mum back in the day. But she was just a woman so told that 'doctor knows best'. I wonder if she would the same response today (but being a woman I couldn't actually say for sure).

It could also be that there are downsides to removal of the vagina that this person wanted to avoid.

Not to downplay the error in the surgery, but it is the case that even with good procedures, errors happen sometimes. I don't think it's that weird that there was such an error, that is the whole reason for the development of protocols, because it's not that difficult for a surgeon to make an error when a patient is wheeled into the OR. But like any kind of procedure, sometimes there will be mistakes. Just like when we make food in a factory we know that sometimes systems will fail, there could be an error.

Anyone who has any cosmetic procedure needs to consider this.

that they want their sexual parts to feel ‘normal’

How can it be normal to purposefully elect to have a facsimile of both male and female genitals created via surgery? I understand wanting a less invasive and easier to recover from option, but it doesn’t bring normalcy.

(People born with ambiguous genitalia are a completely separate category - but worth noting that no intersex condition results in both male and female genitalia)

But she was just a woman so told that 'doctor knows best'.

Your poor ma. Your phrasing reminds me of the awfulness of the ‘husband stitch’.

www.healthline.com/health-news/husband-stitch-is-not-just-myth#1

DON'T READ THAT LINK IF YOU ARE EATING YOUR LUNCH! My toes are all tingly now...

There has been a movement for people with achondroplasia (dwarfism/ short limbs) to undergo bone lengthening

Your analogy is flawed. The patient in this case does not have a condition like dwarfism. The patient is healthy and electively chose a hysterectomy. There is no suggestion whatsoever that the patient had a medical condition which necessitated a hysterectomy. Modern surgical approaches to gynaecological surgery are predicated upon minimizing surgical trauma. Ethical gynaecologists view hysterectomy as a last resort. This patient has undergone a draconian surgical removal of their gynaecological organs. Do patients have the right to demand the removal of healthy organs? What are the physical and mental consequences of such surgery? What does this case say about the ethics of the specialised surgeons involved in this surgery? One of these surgeons deliberately altered the consent form post surgery. He will be wielding a scalpel again in 12 months. What protection do vulnerable natal female patients have against draconian surgical interventions?

^The tribunal heard his specialist skills are such that he is one of only two doctors in the world capable of performing specific procedures.
He was criticised by the panel for failing to check that the patient had consented to the vaginectomy^

It is important to note that these specialists are in a tiny pool. Ergo their ethical behaviour, or lack thereof has a direct impact upon the entire gender reassignment paradigm.

Shrieking
I agree, but our understanding or lack of doesn’t make another person’s choices or feelings less valid, does it?

I actually don’t really care what procedures a competent adult chooses to have or not have, if they are funding them privately. When they are being treated by the NHS there is unarguably a public interest in the reasons for procedures. The NHS does sometimes pay private bodies to provide surgery (so the NHS may have been paying here despite the Harley Street location) and dealing with complications may well fall to the NHS.

These are not simple, cheap procedures. The money spent on them needs to be justified, and I’m not sure wanting a different life from the one you’ve actually got is a good justification.

I think the comparison to surgeries for bone lengthening is valid as far as it goes. It is a fairly horrendous surgery that is done largely for perceived aesthetic reasons. We accept a lot when we think it is necessary, even if it's more about psychological QOL. For all that we talk about accepting diversity, and want to be unique, as a species we also have a very strong desire to fit in.

I think the comparison to surgeries for bone lengthening is valid as far as it goes. It is a fairly horrendous surgery that is done largely for perceived aesthetic reasons

I think the comparison is flawed. I think elective plastic surgery when the patient is suffering dysphoria is a much more valid comparison.

I actually don’t really care what procedures a competent adult chooses to have or not have, if they are funding them privately

Really? So if a privately funded adult asked a doctor to remove their arm, or leg or head, you reckon a surgeon who performs such an operation should still have a license to practice medicine?

I've just remembered the father of one of the girls I knew growing up did what we called "sex change" surgeries. At the time we all thought it was this slightly mad niche thing.

I've just looked him up and it turns out he's now one of the most prolific gender reassignment surgeons in the UK. He is working for a private hospital and apparently his waiting list is over a year long. He must be absolutely raking it in.

I just found an interview with him and he says "I was in the right place at the right time". He refers to his fellow surgeon who is only 34 saying "There are not many younger surgeons going into gender reassignment. Tina is our secret weapon. She is down with the kids".

Grim.

Tina? Is that him?

No Tina is his female colleague. His name is James Bellringer.

Dreadful website. I see he only does m2f 'gender' ops.

For all that we talk about accepting diversity, and want to be unique, as a species we also have a very strong desire to fit in

But Goose - no one will ever 'fit in' to the opposite sex from which they were born.

If trans people were to be given every help possible to come to terms with and accept this fact of biology, then hopefully the numbers risking their lives and health would greatly reduce.

Do you think they mean vulvectomy as well? Ie all external genitalia removed (barring clitoris) or just vagina, leaving appearance of female anatomy externally plus a neophallus. I’m confused about the terminology used and know that the media generally doesn’t like to talk about vulvas.
It’s a horrendous case regardless and it’s heartbreaking for the patient. Hopefully they will be financially compensated and be able to afford some very good counselling to help them cope with this

The tribunal heard his specialist skills are such that he is one of only two doctors in the world capable of performing specific procedures.

So despite being an unethical liar, he can't be struck off because he's niche.

So despite being an unethical liar, he can't be struck off because he's niche

It is absolutely dire, isn't it?