Canada - Judge delays double mastectomy

[Dimpsey]

Saw this on twitter and thought I would share: vancouversun.com/news/b-c-supreme-court-judge-orders-surgeon-to-deny-trans-teens-mastectomy-wish?utm_term=Autofeed&utm_medium=Social&utm_source=Twitter#Echobox=1604974077

Mother of the child asking the surgeons to provide evidence of the protocol they have followed to demonstrate that the operation is in the child's best interests.

@MadBadDaddy
4. Before i showed up, this thread was nothing but attacks on everyone involved except the absent mother.

I posted hours before you. I said:
Tbh it sounds like a sad case. The teen doesn't live with their parents. And I expect most teens would only be made more determined by court intervention! Wonder what the details will show up.

The fact that you consider that to be an attack on someone (and made a point that you then went on to make yourself, whilst also claiming that no-one had questioned it) absolutely baffles me and suggests you and I interpret language so differently that coherent discussion between the two of us is sadly impossible. You also ignored my genuine question, presumably for the same 'I'm not telling you yet I expect you to change your opinion' reasons you didn't answer the other ones.

Anyway, wrenching this back to the topic at hand, I was curious as to how the mother of the 17 year old could come to be able to challenge this decision.

I am assuming that the minor is still covered under the parents health plan or something similar? I have a hazy understanding of Canadian Medicare, but it’s at least partly delivered through insurance, isn’t it?

So I am surmising that the 17 year old is still on the parents health plan, and the legitimacy of the claim rests on the mother asking the doctors to provide the treatment protocols they have followed in a claim that will be made on her insurance, on her child’s behal (otherwise how could she have done this?)

I personally think she should get to do that. It’s a very pertinent question: are you providing the most optimal healthcare for my child?

If the answer is “yes, here are the treatment protocols we have followed, here is how it will benefit your child, here is the analysis of the risks and issues in proceeding or, not proceeding”, then it’s all very easily resolved isn’t it?

Seems to me the difficulty only arises if none of this is available, and if in fact there is no coherence to the diagnosis, there is no good understanding of the risk (generally or specifically to this 17 year old), or if alternatives have not actually been explored.

Or should we not ask questions of doctors?

1. If you'd read the thread, you'd know how reticent I was to make this AAM.

I'll put my hands up to that one - sorry - I rather optimistically thought that MB might expand on their initial points. MB seemed to be trying to add to the conversation but was not really explaining fully what they meant so I was one of the pps who made a specific request for them to answer our questions.

It is always interesting and helpful to get a range of views and I erroneously thought that MB might be prepared to give another perspective and help advance our collective understanding - My bad.

I am intrigued by the twitter screenshot that MB posted earlier - thank you for further helping to publicise the sex based abuse of girls from around the world but MBs comment and from reading the rest of the twitter posts it seemed that the activists may think that FGM, child marriage etc is fake news - I hope I am reading that wrong MB?

Sophocles, I don't think so. Canadian healthcare plans tend to cover things like dental care, vision care, prescription drugs and allied therapists like physio, etc. If you want a cosmetic procedure such as a breast augmentation your extended healthcare plan wouldn't pay for it, it's entirely out of pocket. In which case, this teen just wouldn't be able to do it without a parent paying for it. My guess is this is covered by our public system as part of "gender dysphoria" treatment.

Thanks teezle, I was hoping there would be Canadians around so we could explore this.

I would like to understand the basis that she’s able to challenge it on. I’m glad someone is holding the surgeons feet to the fire on this, but would like to get a grip on the mechanics, as to be honest, much as I think it’s right that a 17 year old should not be undergoing this operation, we do have to balance autonomy of a teen somewhat here.

Whether it’s the mum, the insurers or the state who are paying, Medicine should be evidence based and do no harm at a minimum, and doctors must a,ways be able to articulate what they are doing and why.

teez

So would a portfolio/photos and info about the procedure be part of the package, id this is one that would have to he paid for?

Surely that's a very basic requirement of the drs in question? Strange the parent would have to go to court to see info usually presented as a selling point?

Or is it not like that ?

I personally think she should get to do that. It’s a very pertinent question: are you providing the most optimal healthcare for my child?
If the answer is “yes, here are the treatment protocols we have followed, here is how it will benefit your child, here is the analysis of the risks and issues in proceeding or, not proceeding”, then it’s all very easily resolved isn’t it?

absolutely this - I find it astonishing that doctors are prepared to perform this surgery with such a minimal clinical evidence base.

We go back to the question of what is the diagnostic procedure for the gender dysphoria that leads to mastectomy? Is it rigorous enough to ensure that the clinician makes the decision to approve surgery with limited influence from the patient (otherwise, that is closer to self diagnosis)?

If the patient is allowed to have the major influence in the decision making, why is that and is that typical of medical care in Canada?

If this is the case, do they hold similar standards for any other type of major surgery? I wonder how the Canadians view women's request for standard sterilisation procedures. Obviously in this country, it is strongly discouraged until after the age of 30(?).

I find it concerning that in America, the approach seems to be to approve medical transition costs in children but the 15 yr old who now wants to detransition (following a double mastectomy) can't get their treatment approved by the insurance company. I don't know if that is a blanket approach across all insurers.

I do find it concerning that in this country there are certainly private doctors who carry out this type of surgery on young people - surely they have to work to some guidelines/standards to ensure correct diagnosis (again, what are the criteria) and presumably cover themselves from malpractice suits.

My NB acquaintance is getting closer to raising the funds for their surgery and, while still very young, is over 18 - I have such clear memories of being that age - I was absolutely in no position to make life changing decisions and I fear they are not either. I have so much sympathy for the distress in their body and I know it is none of my business but I feel a bit like I'm standing by and watching an accident unfold, unable to shout a warning.

The private surgeon advertises the procedure on Insta with 'cool merch' etc - surely there are laws around this???

@gardenbird48
Please take a closer look at the screenshot

[quote MadBadDaddy]@gardenbird48
Please take a closer look at the screenshot[/quote]
I have - I'm not really getting your meaning - without knowing who these people are I'm not getting the reference - someone is saying that 'these people are obsessed' apparently in reference to an image of the abuse suffered by children and someone else is saying 'I'll book the honeymoon', possibly in reference to the child marriage??

Can you spell it out for me - are you posting that tweet in criticism of what seem to be trans activists mocking an image of abuse in children?

@gardenbird48
A trans woman had posted announcing their honeymoon, someone else had responded to that with the collage. While we're all here casually discussing the validity of lifestyles like mine, transphobic abuse continues.

(The children in the picture were just some random flower girls at a wedding BTW, not child brides)

But child brides exist . One made the news recently who died after the wedding night due to injuries.

In some states in America parents can sign off on child married

I'm still more concerned about 17 year old girls wanting to have their breasts cut off. I think it's far too young to make such a decision. Her health isn't at risk by keeping her breasts, and if it's affecting her mental health then psychological support is needed, not surgery.

If she decided at a mature age to go ahead with the surgery then that's different, but under 18s definitely do not fully understand what it is to be an adult.

(The children in the picture were just some random flower girls at a wedding BTW, not child brides)

What about the other pictures? I don't understand what point you were trying to make by posting that screenshot.

But that happened on Twitter

People are arseholes on Twitter. Huge surprise.

Any chance you’ll engage in an actual discussion on medical ethics and evidence based medicine as they apply to paediatric/teenage transition, of female bodied people, that being the topic of this thread, on this board?

I don't understand either gardenbird, nothing about the screenshot or the intended messages are clear - however this is a person who thinks 'this is a sad case' is an attack on a child, and a comment on a trans lifestyle, so my assumption is they interpret words, intent and context differently from you and I.

"While we're all here casually discussing the validity of lifestyles like mine, transphobic abuse continues."

Theres nothing casual about a conversation about a 17yo girl having her healthy breasts surgically removed.
The discussion has nothing to do with you personally or your lifestyle whatever that actually means.
Its not about you.
Cutting bits off children and making them sterile is abuse. Child abuse.
Anyone defending sterilising and mutilating children needs their head checking.
Wrong. And sick.

Fully expect that post to be removed.
Honest words not allowed where this is concerned.
We have to use twee euphemisms that hide the reality of what is actually happening to vulnerable children.

So, for those of us interested in the topic of this thread. What can we do to support girls and young women to prevent them accessing such damaging treatment?

Fully expect that post to be removed.
Honest words not allowed where this is concerned.

Yes. Hence my endless and boundless style. An attempt to not cross guidelines and get deleted. This is such an important topic!

"What can we do to support girls and young women to prevent them accessing such damaging treatment?" I thought this was interesting-- not how to support, but possibly information about how people get drawn in:
twitter.com/CultExpert/status/1279890717507227648?s=20

"A couple of years ago I was approached by @LisaMarchiano, a therapist who wanted to know my opinion on the phenomenon of young people being drawn into a cult-like situation where, all of a sudden, they thought they were the opposite sex."

This is turning into transphobia bingo, and i'm not inclined to continue playing.

Well, obviously, no one is forced to do anything. But, personally, I think you should keep posting.

[quote MadBadDaddy]@gardenbird48
A trans woman had posted announcing their honeymoon, someone else had responded to that with the collage. While we're all here casually discussing the validity of lifestyles like mine, transphobic abuse continues.

(The children in the picture were just some random flower girls at a wedding BTW, not child brides)[/quote]
I see now - that does seem like a strange response to that honeymoon tweet. It was made last year and the account has been deleted but I can see that those people obviously had some antagonism between them, there are various discussions re. transwomen are biological women and that twitterer is arguing that.

I don't accept your claim re. the child brides picture - do you have proof of that, other than what those people were saying on twitter as they dismissed the images? You do know that it happens in many countries with girls as young as that?

Anyway, sorry for the derail - back to the thread.

I feel so bad for the mother trying to protect her daughter against these people who would carry out this surgery so easily. The trouble is, I remember how determined young people can be to push away from their parents and go against what they are saying.

What can we do to support girls and young women to prevent them accessing such damaging treatment?

• blanket ban on gender related hormonal and surgical intervention for under 18s
• throw resources at MH services
• tell girls young that they can safely disregard gender. Pursue whatever interests you like and appear as you wish.
• far more emphasis on critical thinking and scientific understanding in schools.
• an attempt to provide perspective. Butleresque pomo genderism is geographically and culturally specific. It is entirely irrelevant in the culture and lives of billions of people alive right now. Teenage girls can choose to waste not one single second of their precious lives trying to change themselves to meet the expectations of others. I am so angry that this is yet another thing which girls must contend with. I feel bad for the girl's mother too. I hope she takes comfort in knowing that her DD will one day understand.

Tbh, I wish men and transwomen would butt out of female experience. Being dysphoric about your breasts and wanting them removed is a female experience. Males cannot understand it and have no experience of it.

This is women's and transmen's business.

Women

This was recently posted on Twitter. It's regarding Finland's PALKO, whose twitter bio (in translation) says 'PALKO is an institution appointed by the Government, whose task is to make recommendations on which services belong to the range of health care services', and their recent recommendations about the clinical treatment of trans and NB people, and compares it to the situation in Canada. genderreport.ca/finland-strict-guidelines-for-treating-gender-dysphoria/