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^

In a standard meto/phalloplasty scenario they use the labia skin in forming a ‘scrotum’ so yes, it includes a type of vulvectomy. This patient must’ve requested a non standard option and the press coverage doesn’t seem to be written from an informed viewpoint, so no way to know exactly what they requested nor what they ended up with. Those details are unimportant in concluding that the the surgeons were acting unethically though. All possibilities of what happens in the operating need to be discussed in advance and signed off by the patient (in the cases where plans change in theatre the patient should be warned of worst case scenarios ie, ‘if scenario x happens we will have to do y’).
Presumably this patient was catheterised and the surgical site was dressed after surgery, hence not knowing what had happened until a days later.

(My daughter had to have a very simple surgical procedure recently, the removal of a Hickman line, takes less than 10 minutes, the list of possible complications on the form I signed was enormously scary! Both the surgeon and the anaesthetist were there personally to talk us through the paperwork, which was on 3 page duplicate paper. The top paper, the one with the pen marks, is mine, presumably a system designed to prevent fraudulent alterations, as seen in this case)

I really hope this patient is receiving adequate follow up care, obviously nothing will make this OK, but counselling to help the patient move forward is vital.

As I mentioned on a thread the other day, a different patient of St Peter’s Andrology is currently engaged in a one person protest, camped outside the clinic. They’ve been there since September, so I suspect that adequate support after complications is seriously lacking. Of course, that patients complications aren’t necessarily due to error or negligence.

Photo of the protestor’s tent outside St Peter’s Andrology (not the patient in the case in the above story).

Close up of the above image.

This patient names three surgeons, one of whom is Mr Giulio Garaffa, responsible for Patient A’s non-consensual vaginectomy.

As I mentioned on a thread the other day, a different patient of St Peter’s Andrology is currently engaged in a one person protest, camped outside the clinic. They’ve been there since September, so I suspect that adequate support after complications is seriously lacking. Of course, that patients complications aren’t necessarily due to error or negligence

DuLang
Thank you for highlighting this. It is distressing to see those images of the patient protesting outside the clinic. What safeguarding procedures are in place to prevent emotionally conflicted patients from having unnecessary surgery? I think that the true cost of these radical surgeries will continue to become explicit in the next decade. It is imperative that the previously somnabulant media reports these cases.

That is shocking - that poor person.

They were probably made all sorts of promises about how their life will be all they dreamed of after these ops. All lies. And to be shouting about it only for no one to listen and to watch others be assaulted (its assault, right?)

Oh God, that's horrendous. That's everyone's huge fear in surgery - that something might go dramatically wrong. Knowing it went wrong due to the incompetence of the surgeon, and that their colleague tried to cover it up.... She's been so tremendously badly let down. My heart goes out to her.

It’s heartbreaking, not least because the people that actually seem to care about the well being of vulnerable people are demonised as transphobes.

Why isn’t Stonewall (or Mermaids) using some of their enormous wealth to actually help the people they claim to support? They are fannying about lobbying for paperwork changes and decreasing the minimum age for medical intervention when they could be demanding in-depth research, evidence based health care and holding unethical doctors to account.

Inside the trans community talking about stuff like this is largely taboo, because it’s seen as scaremongering or gatekeeping.

Never before have I seen a so-called liberation movement be it’s own worst enemy like this.

Oh shit, I forgot the pronouns. Fuck, this is not a case, in particular, where I'd ever want to do that.

Had major surgery myself a couple of years ago (including significant overlap with this person's - though mine was anything but elective, and I thankfully was lucky and all went swimmingly) so posted rather from the gut. Didn't stop to remember pronouns at all - the organs involved meant using those I did was automatic.

@DuLANGMondeFOREVER it's because this is a dream. They're selling vulnerable kids, especially girls, a dream that lifelong drugs, and extensive and dangerous surgery, can change the sex of human beings. And that you can ever really know what it is to be the opposite sex, rather than recognising that if you feel any gender whatsoever in your own sexed body, that's fine; you can be free to be you without needing to reject biology.

Questioning the whole thing in any way, to any extent, would puncture the fantasy. Hence the towering and instant levels of rage if anyone even hints at doing so.

Doesn't help that there's an awful lot of money to be made in this industry, too. Who's left to ask questions, other than mothers and feminists? And since when has anyone listened to women.

Why isn’t Stonewall (or Mermaids) using some of their enormous wealth to actually help the people they claim to support?

That's an excellent point. There are vulnerable people, most of whom are natal females, who are having drastic surgery. What safeguarding procedures are in place to protect them? There are huge ethical questions around this. Why are people who question this demonised? Why are so many trans activists determined to silence debate and shut down freedom of speech? Why are linguistic battles such a recurrent theme? Why the Year Zero determination to deconstruct language? Why the callous indifference to the experience of people like Keira Bell? Why is misogyny such a recurrent theme? Why is this activism so authoritarian? Those who use agents of the state to forcibly advance their agenda are not disadvantaged. They are the establishment The disingenuous attempt to claim oppression becomes increasingly tiresome.

Do patients have the right to demand the removal of healthy organs

Patients have the right to demand operations that remove healthy nose tissue or breast tissue to achieve the body they want.

‘Normal’ as in what they want to make an individual normal for them.

Of course anyone electing to have surgery needs to be aware of all risks including surgeon error. Surgeons falsifying documents and forging consent forms is a whole different matter.

"Struck off" is only a maximum of 5 years in the first instance, after which the doctor can apply to be re-instated to the Register.

A tribunal can:

- take no action
- accept undertakings offered by the doctor if agreed with the GMC
- place conditions on the doctor's registration
- suspend the doctor's registration
- erase the doctor’s name from the medical register, so they can no longer practise. "

Applications for restoration

"If a doctor's name is erased from the medical register, they can apply to restore their name after five years. A tribunal will decide if a doctor can return to unrestricted practice."

www.mpts-uk.org/hearings-and-decisions/hearing-types-and-how-they-work/medical-practitioners-tribunals

It would be interesting to know how many applications to reinstate are submitted and how many of those are approved.

Patients have the right to demand operations that remove healthy nose tissue or breast tissue to achieve the body they want.

Do they? I was under the impression that was a purchasable service, not a ‘right’.

I was going to post a link to the tent protestor too. It's the same Dr. Garaffa that person says destroyed their life and did procedures against consent. This "mistake" didn't come out of nowhere after a lifetime of expert care.

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

But they believe they will. Or at least that they will more than they do currently.

Do they? I was under the impression that was a purchasable service, not a ‘right’.

Right - no doctor has to agree to do it. But we allow people to have it done, and we allow doctors to do it, despite the risks and that it has no health benefits. It means we consider that something that people are free to choose, and that we think it's compatible with the practice of medicine.

There is likely a clearer division between the cosmetic and the medically indicated in the UK, Goose due to the former being self funded (unless extreme psychological distress can be evidenced) and the latter being covered by the NHS.

At the moment, elements of trans healthcare are funded by the NHS, but the push towards making legal sex marker change a Self ID thing, rather than a diagnostic thing and moving from ‘gender dysphoria’ to ‘gender identity’ might scupper that, especially if the few specialist psychs and surgeons keep getting struck off.

Anyway, having an arm flesh phallus added atop a vagina or a vagina fashioned from a scrotum with the penis still in situ is less like shaving down a nose or reducing very large breasts and more like adding a third breast, something even the most unethical cosmetic surgeons would surely baulk at?

SetYourselfOnFire

I was going to post a link to the tent protestor too. It's the same Dr. Garaffa that person says destroyed their life and did procedures against consent. This "mistake" didn't come out of nowhere after a lifetime of expert care.

Dear lord. I hope the media pick this up and this person's record is scrutinised. It's not good enough that their skill set is rare if they're a regular danger to their patients, ffs.

Scalpel happy, gung ho surgeons, treating vulnerable patients as no more than opportunities to revel in, appear to be quite common.

Setuourselfonfire if you have any more info about the tent protestor please do post it. All I know is the info on the signs on the outside of the tent.
I cannot imagine how awful a situation and how desperate a person must be to resort to camping outside the clinic, for months, through the winter.

from what I can gather on the internet... 'usual' sex reassignment surgery on FTM people involves... mastectomy, hysterectomy, sewing up the vaginal cavity, and then creating a sack for testes, inserting testicle implants and then making the patient a penis, usually using a forearm radial flap.

in this case, the patient requested they be left with their vagina intact, a non-standard procedure, which obviously didn't happen for them, and then the doctors forged the consent forms to pretend the patient had consented.

if you read the comments sections of the newspapers reporting on this story, most commentators find it bizarre that somebody going to such lengths would want to keep their vaginas anyway.

that statement doesn't seek to deny the doctor's malpractice, by the way. They forged the consent forms, after all. Allegedly, they panicked when they realised they'd messed up. However.... it seems strange to me that after all hatred of one's genitals a person would actively seek to keep their vagina intact. What for?

I know it's not the main point, but I'm really shocked people are dysphoric about internal organs they can't even see. If it is ruining your life, just knowing it's there, that is surely a much more serious mental health issue than those changing their outward physical appearance.

I find it really hard to understand the medical justification to remove a uterus but not a vagina. Surely if it's suicide risk from hating their body, only the vagina, or both, but the internal and not the external- I find that baffling. I can't imagine the risk benefit analysis allowing this at all?

Obviously, this is tragic and sad, but it's also really strange. I know plenty of people who have had internal organs removed, including me, and you don't give it a second thought, you can't see it. It's possible the uterus was damaged, but surely that would have been said?

I know plenty of people who have had internal organs removed, including me, and you don't give it a second thought, you can't see it

You certainly give it a second thought if it's major surgery. As I have already said, ethical gynaecological surgeons would never recommend a hysterectomy if there were other treatment options available. There is absolutely no suggestion this patient had a medical reason for a hysterectomy This surgery was elective. It is an indictment of the ethics of the surgeons involved in this that one performs a surgery without the patient's permission and the other deliberately falsified the consent form to conceal that fact

Don't let a surgeon mess about with the downstairs plumbing. My husband has had radiotherapy for Stage 2C prostate cancer. He had the 'least invasive' form of treatment and has the 'most benign' of complications according to his specialist NHS team.

Those benign complications are a tendency to explosive diarrhoea and constriction of the urethra. He watches his diet like a hawk and has to self-catheterise himself 3 times a week. Yes, stick a tube up his willy.

This poor person has had their vagina removed along with a lot of other cutting and pasting. There will be scar tissue everywhere. Trying to lengthen the urethra is risky procedure more often unsuccessful than not. This is signing up to enjoy the company of health care professionals for their entire lives.

I feel like spending time with a cancer survivor or someone who has had major surgery in their genital area should be a prerequisite.

Sorry to be explicit. That part of the body is a complicated compressed mass of nerves, blood vessels and specialist parts. So much to go wrong and so often does.