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.

As a 6 year old boy in the 1970s I started feeling like I wanted to be a girl. That is the beginning, the middle, and end of it. I knew it was something I could never, ever tell anyone else.

What did you think 'being a girl' meant when you were 6? Surely that could only be based on stereotypes (wanting to wear a dress or play with dolls, for example) or wanting to play with girls rather than boys.

I am happy to believe that people who consider themselves trans exist.

That's not a reason for performing double mastectomies on teenagers.

It is a reason for giving young people psychological support and space to acknowledge their feelings whilst they mature into adults.

Performing unnecessary multilating surgery on teenagers is not healthcare.

Thanks for the update MadBadDaddy

However, I have looked back through this thread and it does not seem that your posts are actually clear on what you think about 'affirming only' treatment, particularly in light of the concerns that have been raised by me and others on this thread about such treatment for girls under 18.

I am sure that you are well aware of just how high the risks are for female to male transitioners in that they are having their breasts removed which will effect their chance of breastfeeding should they decide to have children at a later date. More of the effects of the increase of testosterone on a female body are irreversible compared to the effects of males taking cross sex hormones.

Do you understand why we have expressed such deep concerns for this teen and the thousands like her around the world at the moment?

I'm sorry to keep coming back to it, but I did look back and I must be still missing your comment about sharing your concern specifically that these girls may well be being let down by a system that seems to not be addressing the specific issues that girls have. For instance, particularly the increase in awareness of ASD and social contagion. Or do you honestly believe that the system is serving these girls the best they can if it allows teenaged girls to remove breasts?

thank you for sharing that Madbad - it is always interesting to have personal input from someone with direct experience. Apart from working with a transgender person many years ago and some people who live locally to me (although I would never presume to start asking them personal questions about their lifestyle, they say hello and I say hello and everyone's happy), I have little direct testimony to work on.

I'm sorry that you had such emotional challenges in your childhood.

Could I ask, was it an emotional sort of feeling of wanting to be a girl, or more of a physical manifestation, or both? Without prying too much, were there any childhood difficulties, sibling loss, parental difficulties etc etc that you have subsequently found to be a trigger for your feelings? or did they just grow?

You mentioned that at age 6 you didn't have the words to articulate how you felt - at what point did you find those words?

I must admit I am slightly intrigued at your rather low opinion of us on FWR, is that from personal observations of the interactions on the boards, or did you have preconceived ideas before coming here? There do seem to be fairly strong feelings out there that we are all awful - we are not komodo dragons wanting to eat you up.

I hope, from spending some time on this board you will understand that we are not all against transgender people, in fact you on many threads you will have seen quite a degree of sympathy for people in such distress but our main focus, and I hope you can see that, is that we want to protect the children (and ourselves) from marauding males (we have been programmed for this for millenia).

From what you say it would seem that you have not had major surgery relating to this? I hope you can understand that the impact on young girls (and boys) of having major, life changing surgery and hormone treatment is huge and should be treated with extreme caution (personally I believe that no one should be able to consider it until after age 25 when the frontal lobes develop fully and people can assess risk and consequences fully) and as there seems to be such a high risk of the clinicians getting it wrong and misdiagnosing (or the young people self diagnosing - this happens in no other clinical situation), that we must take this very seriously and err on the side of extreme caution.

Anyway, thank you for your time on this.

If I ever saw a cool girl at school or on TV or wherever, I never knew if I wanted to be with her, or be her.

But don't you understand that this is just buying into marketing??

There is no such thing as a 'cool girl'. Most teen girls are wracked with indecision and frequently a lot of anxiety.

Can't you see how utterly dangerous and unfair it is to propagate the idea that teenage girls are all so cool, because of the stereo typing promoted by filmmakers to sell movies?

Teenage girls are human beings, you know. Not some gilded, pampered, sassy, kewl ideal.

You're utterly buying into the advertising here.

No wonder the government has said general identity must not be based on stereotypes.

Because that's all it bloody well is.

I think Renata said it was all about girls being the embodiment of passivity and submission.

Women are just fucking cardboard cut outs, aren't they?

But what is really unforgivable is in order to protect this ideal to which you aspire, you must buy into the fact that some teenage girls have to have their breasts cut off.

Cool.

Escapeplanning

What are the protocols followed by a cosmetic surgeon for surgery to remove healthy breasts from a 17 year old? I will be interested to see if this makes the press.

A really important question Escape!

My high school aged niece has just come out as lesbian to her family in Canada. All fine and we are happy for her (that she was comfortable to tell her family, and knew she would be accepted).

I am concerned about her friend group...that she may start to feel that being L isn't cool enough, she must take a step further. Jumping on the trans boat because lesbian is just so last decade.

I know I know... But these girls DID NOT feel they were trans since they were six. They just didn't. This is a friend group/school /social media thing very different from what was happening to a six year old in the seventies. Somebody jumping onto a craze should not be affirmed as trans yet I am sure it is happening.

@PurpleHoodie

Escapeplanning

What are the protocols followed by a cosmetic surgeon for surgery to remove healthy breasts from a 17 year old? I will be interested to see if this makes the press.

A really important question Escape!

This is hugely important. Essentially, a surgeon would have to say to a judge:

“Your Honour, a recent paper published in the American Journal of Psychiatry showed, on correction, that surgery procures no benefit to the mental health of trans people, but I would like to ignore that because...”

How are they going to finish that sentence and remain ethical and compliant with the standards of their relevant supervising medical board?

I just don't really get how they can justify it - there is nothing like strong enough research to justify it. I have a long-time family friend who transitioned in the late 70s/early 80's, as a man entering middle age, and seemed to find it helpful - even in that instance though, the research is unclear as to how much good it does. But at least you are talking in that case about someone who has a mature brain, has had adult relationships, knows what it means to live in the world and the potential implications.

There is just none of that with a teen, or even someone in their 20s.

Anyone insisting that the reasonable requirements of parents to understand that there are proper protocols in place, and properly followed are toxic is the one speaking inhumanely here.

And regarding my lack of positive statements about what "trans" is, I fail to see the need for me to say anything like that, unless I fancied making a rod for my own back. All the information is freely available, anyone is free to take it or leave it.

Yes, the DSM V diagnostic criteria have been posted on this thread. The NHS used to say something very similar, but they have now removed that and replaced it with some waffle about gender dysphoria being very rare in children.

You said: "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."

I'll compare this to the DSM criteria.

1. A strong desire to be of the other gender or an insistence that one is the other gender
2. A strong preference for wearing clothes typical of the opposite gender
3. A strong preference for cross-gender roles in make-believe play or fantasy play
4. A strong preference for the toys, games or activities stereotypically used or engaged in by the other gender
5. A strong preference for playmates of the other gender
6. A strong rejection of toys, games and activities typical of one’s assigned gender
7. A strong dislike of one’s sexual anatomy
8. A strong desire for the physical sex characteristics that match one’s experienced gender

"It is not dysmorphia" contradicts 7 and 8.
"it is not being GNC" contradicts 2,4 and 6 and possibly 3 and 5.
"It is not 'being trapped in the wrong body'" contradicts 1,7 and 8.
"It is not an escape from social constraints" contradicts 2-6.

@MadBadDaddy, your list of what 'trans' is not means that none of the criteria for a diagnosis of gender dysphoria/transgenderism in children are valid according to you. It's all very well saying that the information is freely available, but when transgender people insist that it's none of the things that the medical profession say it is, we're a bit stuck.

A slightly more detailed report here.

www.thetimes.co.uk/article/canadian-court-blocks-trans-teenager-from-getting-surgery-w5g9q2ksm

"In a statement issued through her lawyer to the Canadian Broadcasting Corporation, the mother said that her child was “caught up in a fad” and blamed British Columbia’s education ministry for distributing materials designed to foster inclusivity and prevent bullying around gender identity and sexual orientation.
The mother said that the materials pushed “depressed and anxiety-ridden girls to gender-change clinics when what they need is psychiatric care”.

Whilst I am generally concerned about under 18's making irreversible decisions which are elective (as gender reassignment is) this case is not straight forward, why doesn't the young person live with their parents?

In my experience the trans teens I know (and I know quite a few) all have experienced significant trauma in their lives including early loss of a parent, domestic violence, parental abandonment and in one case extreme religious indoctrination. I definitely think there's a lot more we need to research, and I'm not denying there are people who genuinely feel trapped in the wrong body, it's the increased prevalence and that in my personal sample (all friends and acquaintances of my dc) none come from what you may describe as "normal" homes, sets alarm bells ringing and this Canadian case seems to have a complex family set up issue too

No one has ever been able to explain what “feeling like a girl/boy” actually is, without recourse at some level to gender stereotypes (or a refusal to engage with the question, presumably because the only way to answer it is by reference to gender stereotypes).

I was a girl. I am now a woman. I never wanted to be a boy. But I could not tell you what “feeling like a girl” is, because I only know how it feels to be me. I am not “cis”, because I reject many of the gender stereotypes associated with being a woman. I am not “non-binary”, because I am absolutely clear that I am a woman, not least because I inhabit a female-sexed body. But how do I know that my experience of “feeling” like a girl/woman has anything in common with that of any of the other women on this thread, or in my workplace, or who I went to school with? I cannot ever define what “feeling like a girl” is so narrowly, because the experience is as diverse as the female population of the world. The only thing we absolutely have in common is our biological sex. And the same must be true of “feeling like a boy”.

Yet we are allowing clinicians to remove healthy breast tissue from under-18 girls who claim to “feel like a boy” without any clear criteria on what this nebulous feeling is beyond an over-reliance on cultural stereotypes that society hangs on the words “boy” and “girl”, and without any robust exploration into the comorbidities which could be, and often are, leading young girls in particular to feel uncomfortable in their sexed bodies.

Not fucking good enough.

No one has ever been able to explain what “feeling like a girl/boy” actually is, without recourse at some level to gender stereotypes (or a refusal to engage with the question, presumably because the only way to answer it is by reference to gender stereotypes).

Transgender people who tell us about their childhood often say that they had at least one parent (usually their father) who insisted on very traditional gendered behaviour. I wonder if they don't see this as being about stereotypes because it's so firmly ingrained in their experience.

I would like to hear more from transmen who have had no issues with their identity until becoming a teen. Particularly what their thoughts are about allowing girls under 18 to remove their breasts.

Our regular posters who give us their insights are all mtf. I am not sure just how much they are aware of the differences of the girls now and their backgrounds of being bullied for being non conforming males. There seems to be little care about how great the impact of these hormones and mastectomies are on the female body if these teen wish to detransition.

Here on this thread, MadBadDaddy immediately discounted Buck Angel’s perspective as being not worthy and denigrated Buck’s experience. well..... Buck is probably one of the first to medically transition and was the patient that alerted clinicians to the atrophy of internal organs a female experiences with testosterone. Why would any person discount Buck’s experience? Unless it was inconvenient to you that Buck now advocates that under 18s are not medicalised. And let’s face it, being marginalised is something Buck has experienced from birth.

Another inconvenient truth may be that perhaps a degree of male socialisation still exists in discounting the experience of teenaged females.

It certainly comes across with two posters (who are not active on this thread) in particular who has told us they were misogynists in the past (and to be honest, still shame and remonstrate women as though they still very much are).

It would be very interesting to see a transman regular discuss this from their perspective.

@OldCrone

And regarding my lack of positive statements about what "trans" is, I fail to see the need for me to say anything like that, unless I fancied making a rod for my own back. All the information is freely available, anyone is free to take it or leave it.

Yes, the DSM V diagnostic criteria have been posted on this thread. The NHS used to say something very similar, but they have now removed that and replaced it with some waffle about gender dysphoria being very rare in children.

You said: "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."

I'll compare this to the DSM criteria.

1. A strong desire to be of the other gender or an insistence that one is the other gender
2. A strong preference for wearing clothes typical of the opposite gender
3. A strong preference for cross-gender roles in make-believe play or fantasy play
4. A strong preference for the toys, games or activities stereotypically used or engaged in by the other gender
5. A strong preference for playmates of the other gender
6. A strong rejection of toys, games and activities typical of one’s assigned gender
7. A strong dislike of one’s sexual anatomy
8. A strong desire for the physical sex characteristics that match one’s experienced gender

"It is not dysmorphia" contradicts 7 and 8.
"it is not being GNC" contradicts 2,4 and 6 and possibly 3 and 5.
"It is not 'being trapped in the wrong body'" contradicts 1,7 and 8.
"It is not an escape from social constraints" contradicts 2-6.

@MadBadDaddy, your list of what 'trans' is not means that none of the criteria for a diagnosis of gender dysphoria/transgenderism in children are valid according to you. It's all very well saying that the information is freely available, but when transgender people insist that it's none of the things that the medical profession say it is, we're a bit stuck.

@OldCrone

"It is not dysmorphia" contradicts 7 and 8.
"it is not being GNC" contradicts 2,4 and 6 and possibly 3 and 5.
"It is not 'being trapped in the wrong body'" contradicts 1,7 and 8.
"It is not an escape from social constraints" contradicts 2-6.

I'm really not best placed to give you more robust answers than I have. All I can confidently say is that I can recognise that I am trans, and I can recognise it in others, but I don't use a series of bullet-points to do so. (I also want to make it clear that I'm making no comment here on the "trans" status of the Canadian 17-yo in question.)

I would say that individually, the points you raise about contradiction sound reasonable, but collectively they still add up to something else, which is what the DSM requires ("6 or more").

The case in Canada is sad, and doesn't sound straightforward. If the young woman (not "very young child" as they were referred to on this thread) is not trans, and yet undergoes transition, then they will in effect be giving themselves Gender Dysphoria, and no trans person would wish to see that happen. My reason for jumping into this thread, which was "smearing"(qv) everyone except the mother, was to suggest that we reserve judgement, and allow for the possibility that everyone involved has their eyes wide open and that the doctors' are acting in their patient's best interest, which is what the courts will be deciding on.

(BTW I've very much appreciated the interesting and constructive responses to my posts. The others....less so. If I wasn't so old and ugly, and didn't turn a blind eye to a lot of the provocative, even sneering language here then I would have flounced off ages ago. As I said earlier, unless the denial ceases, and everyone can accept that Trans Is A Thing, the debates will sadly remain toxic.)

All I can confidently say is that I can recognise that I am trans, and I can recognise it in others, but I don't use a series of bullet-points to do so.

But doctors do before they decide to give kids puberty blockers. So are they wrong? Can you tell doctors how they should recognise trans in children, if not by these criteria? A child needs 6. That means if you don’t believe in stereotypes a child will never be diagnosed because that eliminates 4 and leaves only 4. So what would you tell doctors to do instead?

It’s important because it’s being used to make children infertile and asexual for the rest of their lives.

@Winesalot
Regardless of their experiences and backgrounds, the opinions and personas of Buck, Debbie & others are not held in very high regard by a lot of trans people. (Go to Buck's Twitter feed if want to see how and why.) Please don't shoot the messenger here, but they are seen as privileged & unrepresentative at best, and 'bootlickers' at worst.

Are they MadBadDaddy? How very interesting. I certainly don’t agree with some of Buck’s or Debbie’s views.

Whose boots are they licking? Or are they just trans people who don’t follow the seemingly rigid views considered allowable?

I certainly don’t agree with every opinion of prominent feminists but I would never discount their opinions because they might be not the right type. And I would not consider them unrepresentative if they present a view from a female perspective. I might not understand it and seek to see the motivation.

Yet, we hear this unrepresentative term from transpeople. And importantly, from prominent transwomen who tell women that they also represent women and are better at womaning.

At the risk of being repetitive. Buck has a unique point of view being one of the first females to medically transition with testosterone. They had severe complications and endured much.

Why are they considered privileged Exactly? What makes them privileged? Being a porn star? Being female?

Who are the others that you consider privileged and unrepresentative please?

And tell us, in your opinion, who would you and other transpeople take notice of with the message that there seems to be a problem with affirmative only treatment, and that young females seem to be at risk of not getting the best medical treatment for their particular needs which are completely different in many ways to those of male transitioners?

Who will be listened to?

Sorry.

from transpeople. And importantly, from prominent transwomen should be

from some transpeople. And importantly, from some prominent transwomen. Just to be clear.