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.

Yes, Thanks. It's one reason why pro-ana sites and open amphetamine sales were banned.

Mad. No.

they deserve appropriate support and healthcare

Which is exactly what this parent is doing by insisting to see how the decision has been reached. The parent now has one month (ie. Not long at all) to establish whether having a 17 year old breasts removed is the right treatment.

It has been said the teen has other mental health issues and the mother is attempting to make sure that the underlying issues are also being treated before a significant cosmetic surgery is done.

You mention Keira Bell. There are many more than Keira in the world. Plus there are clinicians continually pointing out that without proper treatment of mental health issues before permanent and irreversible changes are made, mental health does not necessarily improve after transition either.

So for the sake of making sure that this teen has received in-depth mental health care, it is well worth investigating.

There are many reasons why this teen is not living with either parent. It does not mean that the teen is not still being supported or in close contact with either.

Another poster has expressed doubt about a parent interfering with the medical treatment of a under 18 minor. A double mastectomy and hormones are very different from abortion and contraception as had been discussed on these boards many times.

To use that as a comparator is not useful. Removing a limb because they feel that that limb is an imposter is perhaps a better comparator. Or to put this case as reported in this particular article into perspective, the mother now has one month to ascertain that a correct diagnosis (and that the best mental health treatment) has been made for her teenaged child before that teen has a perfectly healthy body part removed.

I regret some significant and life changing decisions I made at 17 having lived completely independently from my parents already since early 16. I am just pleased they were not completely irreversible.

Another poster has expressed doubt about a parent interfering with the medical treatment of a under 18 minor. A double mastectomy and hormones are very different from abortion and contraception as had been discussed on these boards many times

They are "very different" because you (general you) want them to be different. I stick to my opinion the parents of a 16 year old should not be allowed to prohibit a 16 year old instructing treatment.

Of course you (general you) are going to say decisions about abortion and contraception should be up to the 16 year old. I'm sure there are plenty of parents who will disagree with that.

It’s not about treatment and decision making generally though. It’s about specifics. Evidence and research shows that contraception and, if required, abortion for a 16 year old is in their best interests. Evidence and research, published in Pediatrics and the American Journal of Psychiatry shows that puberty blockers and surgery for trans people and children with gender issues are not beneficial. Therefore a child wishing to undertake abortion and contraception can legally argue they are right. A child wishing to undertake mastectomy needs to argue why they will benefit despite the evidence showing the contrary. The parents in this particular case have medical evidence behind them.

Gillick competence is case, child, disease specific. It’s not generic.

And it’s completely contradictory for people to want the best healthcare for these children and think that involves them doing whatever they want to themselves when the evidence clearly shows it doesn’t help. If we want the best healthcare for these children the evidence is NO puberty blockers, NO cross sex hormones and NO surgery.

@winesalot

Thank you, yours is the first post to even consider the possibility that the child may be receiving suitable treatment. I know Canada has a certain reputation for affirmative care, but even so the stereotyped view of a 'conveyor belt' of coerced transition is a fearmongering myth.

Keira Bell may not be alone in her regrets, but she is most certainly in a minority of transitioning children, who do not deserve to have an already difficult journey needlessly complicated by those that do not even credit 'transgender' as a legitimate status, as evidenced in this thread

I made it clear that the answers may not be simple or obvious, and i wouldn't ordinarily stick my oar in, but the rush to judgement on this thread was turning my stomach.

They are "very different" because you (general you) want them to be different.

They are very different because they are.

One difference is that one is preventative of having a child. The other is surgery treatment that is still effectively experimental in whether it reliably treats gender dysphoria felt at that age when the very presence of detransitioners is proof that it is not necessarily the best in all cases.

Of course distress, anxiety and depression in children and young people is real. Of course it’s very common for anyone of any age to be gender non conforming. Nobody is denying that. That’s not the same as saying there are ‘trans children’ though. That would be an entirely adult label, like describing them as ‘Labour children’, ‘Conservative children’, or ‘ children’. These are cultural labels, evidence of family background or children absorbing social cues, not evidence as a basis for medical diagnosis and Invasive permanent treatment.

All children and young adults with emotional distress should be offered abundant high quality professional psychotherapy. Plus other support and interventions to help the child/young person and family as needed, if there are also other underlying medical or family or social issues affecting the child.

I am glad in this case that a parent is seeking to preserve the child’s right to an open future. I don’t think anyone under the age of mid-twenties (apparently the age of typical full brain maturation after normal un’blocked’ puberty) should have permanent physical surgeries aimed at helping their distress at their body image and the social meaning out on to that. It’s not proven to help them.

Where is the proof that surgery actually resolves the emotional distress long term and could not even potentially make it worse for the patient? Why aren’t service providers, judges, parents, wider society listening more closely to detransitioned people who have been through these surgeries and not been helped? Women and men who have detransitioned have changed their minds about the identity they felt very convinced about perhaps only a few years previously. They feel that having had permanent surgery and drugs with major permanent side effects hasn’t ‘confirmed’ their gender feelings or helped them with their feelings in any positive way.

The onus is always on anyone proposing to perform invasive medical treatment with permanent effects to show why doing that would be better for the patient than offering non- invasive, treatment like emotional/psychological care with ‘watchful waiting’. Has that work even been done here?

So I don’t think doing a prospective ‘voluntary’ mastectomy on a child should be a matter of parental consent either way. If the parent was strongly advocating for it, it would still be putting a child through unproven politically-based medicine with risk of very harmful lifelong effects and therefore should be wrong to provide, whatever the parent wanted.

MadBadDaddy

I think you have been posting on this board long enough to realize that most believe want the best treatment for GD as possible. If there was adequate long term and unbiased research to support affirmative only treatment, conversations here would be quite different I am sure.

The very fact that detransitioners are constantly minimized and the evidence of the fact that there is a great deal of pressure being applied through social media and peer groups to the current group of teenagers, leaves the effectiveness of affirmative only treatment unclear for this group of teenagers.

I am watching significant problems occurring in my own teen daughters friends. I think it is a mistake to apply the experience of an older transperson onto this cohort which I see done by some and probably too many. I am watching girl after girl in a group of 7 declare themselves to be trans. From what I can tell, each one’s mental health issues get worse despite affirmation at school, by parents and by friends. No, I disagree that these girls have the same motivations as the girls identifying as trans 10-15 years ago.

I truly do not think the significance of actually identifying and starting treatment on any comorbidities first can be overstated.

And treating comorbidities first should not be considered conversion therapy in my view.

most believe want the best
That is ‘most here want the best’

@MadBadDaddy

Transgender people, of all ages, deserve suitable healthcare. Gaslighting a trans child that they are not trans is every bit as evil as gaslighting a non-trans child that they are trans. It is conversion therapy, whatever way you cut it.

According to the article, the parents have been "separated" from this child for over 16 years, since the child was 6 MONTHS OLD. Why is no-one on this board questioning why that would be the case?

This board starts with the assumptions that "trans=bad" and that no child can be trans unless they are coerced, and willingly overlooks anything that might disrupt this forgone conclusion, even possible parental abuse.

I'm not suggesting that the correct course of action in this case is simple or even obvious, but anyone that thinks they are being fair-minded here needs to take a long hard look in the mirror.

Then how come so many "trans" children change their mind after they have gone through puberty? Surely that shows us that non reversible decisions shouldn't be made till puberty is well over with.

@winesalot

Ty, I wish I could believe what you say, and I know it is true for at least a few of you, but too many believe there is literally no such animal as GD, and i rarely see such viewpoints challenged. I don't really have the chromosomes or the energy to get stuck in on a regular basis.

I will concede that the landscape has changed over the last (ahem) few decades. I can't honestly imagine what any child's perceptions, trans or not, must be of the subject nowadays.
That said, if I knew from around the age of 6 that I was trans (despite having literally no words for any of it) and, by the time i left my teens, that it was never truly going to go away, then I also know that there will always be other children like me, and they shouldn't have to go through the blind torment and distress that i did.

But who am I to say with certainty that your DDs friends are like me or not? The truth is i cannot. But by the same token, neither can anyone else here.

The difference is that I know, with absolute certainty that there is a baby in that bathwater, wheras others, on this thread even, cannot or will not accept this as true.

I'm also inclined to trust the doctors, etc, who's job it is to help make the call one way or another on such a dramatic, disturbing decision. The topic above exists b/c of the mother's intervention, and the more general questions surrounding the child's capacity to advocate for themselves as well as the medical philosophy. There were no comments supporting the child's decisions prior to mine, and so i chose my battle.

Whatever debates are had around these matters, I'm as keen as anyone to see the best possible arguments thrashed out. TBH I don't really understand being trans at all, (much like no-one understands being left-handed). What hobbles these debates and makes them painful to even observe is any level of denial of the reality of our "gender incongruence" (current WHO term).

Being trans is not a choice. It is not dysmorphia, it is not being GNC, it is not an illness or a paraphilia. It is not 'being trapped in the wrong body'. It is not an escape from social constraints. We are born like this, and it never goes away. Ultimately, the best treatment is transition.

" Being trans is not a choice. It is not dysmorphia, it is not being GNC, it is not an illness or a paraphilia. It is not 'being trapped in the wrong body'. It is not an escape from social constraints. We are born like this, and it never goes away. Ultimately, the best treatment is transition."

This might be true for some but research validating this position are increasingly being found to be wanting in their methodology.

www.womenarehuman.com/sex-reassignment-treatment-does-not-improve-mental-health-journal-issues-correction/

How can it not be dysmorphia? A person who has a body they feel alienated from .., how is this not a disorder of perception? A male is free to enjoy stereotypically feminine things and vice versa, these are socially created gender roles, not concrete realities. So any feeling of being at odds with your body parts ... how is that not dysmorphia?

How does one define a trans child?
Remember, Mermaids were unable to explain or define this. And “born in the wrong body” isn’t real anymore, Mermaids said this too. How do you know if a child is trans?
What is trans?

but too many believe there is literally no such animal as GD

I don’t believe there is one thing that is GD in kids and as a result I don’t believe the one affirmative medical pathway can be applied to all kids.

I will concede that the landscape has changed over the last (ahem) few decades.

That’s an understatement. We’ve gone from allowing kids time to go through puberty and letting them mature into their own decisions knowing many will desist, to deliberately preventing children from going through puberty abs causing irreparable iatrogenic harm for life.

I also know that there will always be other children like me, and they shouldn't have to go through the blind torment and distress that i did.

Then they should be fully supported mentally and socially with therapy, not medicalised for life. Adults who feel aggrieved by their treatment when they were young should not be pressuring healthcare workers to push children down a pathway of no evidence just because they aren’t happy. That’s no basis for good quality healthcare at all.

The difference is that I know, with absolute certainty that there is a baby in that bathwater, wheras others, on this thread even, cannot or will not accept this as true.

I think the opposite is true. All of the kids are being bathed in the same water regardless. They are all getting puberty blockers and affirmative medical and surgical treatment regardless of whether it’s right for them.

I'm also inclined to trust the doctors, etc, who's job it is to help make the call one way or another on such a dramatic, disturbing decision.

I don’t trust them at all. Doctors at gender clinics are either in thrall of activists or terrified of them, because they certainly aren’t following the evidence and are treating children purely based on an ideology.

Being trans is not a choice. It is not dysmorphia, it is not being GNC, it is not an illness or a paraphilia. It is not 'being trapped in the wrong body'. It is not an escape from social constraints. We are born like this, and it never goes away. Ultimately, the best treatment is transition.

But if it’s not any of these things, what IS it? Born like what? How do you know a child IS trans? How do you know which ones need medical transition and which ones don’t? The current diagnostic criteria is woeful. You’re asking us to accept that children need physical transition for a condition that has no objective assessment or test to confirm its presence. And children incontrovertibly suffer physical doctor-induced harm from these treatments. They are infertile. They do have no sexual function. They do have reduced bone density. They don’t have the brain maturity that comes with natural puberty. They do have a significantly increased risk of cardiovascular disease and cancer. They do need to see doctors for the rest of their lives.

And you’re saying the best treatment is transition, based on what? Your single experience. Because the evidence says that’s not true at all.

Apologies to the grammar gods but my " research" seems to have decided to be non binary . It should of course read " research is............it's....😳

Damn predictive text its not it's

Misery and distress isn't a permanent state of mind. It ebbs and flows and is a pretty common state for teenagers across generations, probably since the beginning of time.

A mastectomy is a permanent action which can not be undone. It is invasive and life changing and scarring. This procedure should not be given to children.

Gender is a social construct used by society to demarcate the two sexes. Biologically, male and female humans are different.

Nobody is born inherently 'transgender'. That doesn't mean that nobody experiences intense discomfort with their identity, clearly some do, but it isn't a given.

Many, many children have some discomfort with their 'gender'. I did. I went through a phase where I despaired of being female and the limitations society placed on me. It didn't mean I was trans. It just means that I recognised that because I am female, society placed certain restraints on me.

If an adult wants to change their body to match their preferred presentation, they have that choice. I don't think children should be allowed to make life changing decisions.

I'll believe in trans children when someone can actually tell me what one is.

So far even the "experts" cant eveb give us a straight answer. Its not born in the wrong body its not stereotypes and dysphoria isn't a requirement either.

Yet every single account from adults and children is based on one of these things.

Unbiased thorough psychological care should be standard. After all if there's nothing mentally wrong with them it won't change anything will it. And whats every one so afraid of when it's suggested they have it from a therapist who won't just affirm? Not to necessarily stop them long term but to just unpick why they feel the way they do.

I do not believe colluding is healthy. I think one day they will wake up and something will happen that will make then have ti face the very real fact that biology is real, and realise that everyone around them has not been truthful. I believe that would be incredibly harmful. To have no one you can trust around you.

Its nothing like abortion. Abortion is tried and tested and should not in the vast majority of cases stop them from having children in the future.

Access to birth control and abortion is also key in trying to help children who are being groomed and in trouble. Pregnancy would tie them to their abuser forever.

As i said, get back to us with a clear cut definition of what a trans child is. Or even an adult.

"They will tell you" is not an answer. Not if they cant tell us without all the other things they claim it isn't.

Keira Bell may not be alone in her regrets, but she is most certainly in a minority of transitioning children

Which studies support this statement? When it comes to surgical intervention, I want clinicians to follow scientific research. Rather than the strongly held beliefs of children. That is a responsible concern, not judgemental.

Girls should only have a double mastectomy for a real medical issue eg breast cancer.

Anything else being pushed by adults is child abuse.

Excellent post NotBadConsidering
Thank you for the link 334

I’m fairly sure that you cannot get a tattoo under the age of 18, or at least not without parental consent. But life changing surgery is apparently fine and dandy? And don’t pretend that there is any clear evidence of benefit here - quite the opposite, I thought.

@TomatoesAreFruit

Misery and distress isn't a permanent state of mind. It ebbs and flows and is a pretty common state for teenagers across generations, probably since the beginning of time.

A mastectomy is a permanent action which can not be undone. It is invasive and life changing and scarring. This procedure should not be given to children.

This!