Horrific case report after genital surgery *TW distress*

[Faffertea]

This link has been shared by @FOJN on the Marci Bowers thread but I feel the person involved deserves to be remembered and for the horrific injuries inflicted on them in the name of so called medical care to be known more widely so that when this house of cards finally falls these doctors are held to account.

If you read the journal article be warned there are graphic medical images at the end.

For those who cannot, this is a case report of the death of an 18 year old from complications after genital surgery. They died from overwhelming infection originating from their own bowel which was used to create a facsimile of a vagina after puberty blockers and cross sex hormones meant they didn’t have enough penile tissue to use.

Necrotising fasciitis is one of the worst post operative complications I have ever seen and this young person, just legally an adult had 60% of the body area of their skin and subcutaneous tissue removed to try and treat it.

The article lists serious surgical complications as 0.6% or roughly 1 in 200 patients. That’s about the same as the failure rate of a vasectomy and 5x higher than the most serious complication (perforation of the womb) when fitting contraceptive coils.

I am here in tears having read this case, knowing the suffering this young person will have been through. They deserve to be remembered.

I believe that in Hannah Barnes' book she talks about how the fact that puberty blocked boys don't have enough penile tissue to do a penile inversion was discussed at GIDS but that how even once this was known the information wasn't disseminated amongst all staff effectively.

If the parents / child did not know this (the more risky procedure required for puberty blocked boys) right at the start then I don't think it can be informed consent (to the puberty blockers) can it? And the problem is, once the child has had puberty blockers and cross sex hormones I think they feel there is pressure to have surgery (even though most adult trans identified males don't have surgery). It's become a conveyer belt. Why on earth aren't these young people shown the many, many, many (95%?) adult transwomen with penises and told there is an alternative to experimental surgery with a not very great success rate?

Even if you're the biggest ever TRA forcing kids down this route and not having much, much stronger research and data doesn't make sense. So I suppose it must be all about the money.

Ritchie Herron expressed reservations about his genital surgery many times but in the end he had the surgery because he was fearful the therapy he was receiving would be withdrawn if he didn't go ahead with it. https://www.dailymail.co.uk/news/article-10953157/Man-suing-NHS-trans-surgery-regrets-bravely-waived-anonymity-share-ordeal.html

Although one could argue the therapy wasn’t that great if it was guiding him towards surgery …

From a bit of a read up, bowel vaginoplasty used to be a fairly rare method compared to the more prevalent penile inversion.

Presumably with a wave of younger patients who've been on puberty blockers it may become more common.

The RH case is more nuanced though "The first question you get asked there is, “Do you want genital surgery?” ’ he says. ‘I wasn’t sure. But I’d heard you could get therapy if you were on the waiting list for surgery, so I said yes.’"

so he said yes in order to get therapy. Then, in his own words, he became determined to do it. He was fully adult, suffering from MH conditions that I also have, but I wouldn't want my bodily autonomy questioned. The more that he says, the more puzzled I am. It went from "I wasn't told anything" to the version we have now.

which brings me to personal responsibility.

hence why I'd really like to know how much individuals are asked. Sad as it is, did the patient sign a consent form saying they were happy for bowel tissue to be used? Were they told the worst possible outcomes? Maybe 18 is too young and certainly the medical treatment of teens isn't rughtl - but RH case is very different.

when I was young, as a family we knew two people who had full surgery. It was known to be absolutely brutal. I remember my parents being very scared for them, and my dad in particular saying how strongly someone must feel in order to go through that.

What I'm wondering now is if doctors are being as clear and honest as they apparently were in the past. You hear so many stories of (women in particular) unpleasant procedures being made to sound like no big deal, can do without sedation etc etc, are we in a time where surgeons aren't clear with their patients?

Cross post
yes, seems that way.

I wish I believed in hell because the doctors performing these types of surgeries and the adults cheering them on belong there.

RIP to the young person who passed.

Does anyone have a link that works please?

The link @thenightsky posted does work. Here you go again:

No link added.

It must be because I'm not in the UK.

Omg that poor child. Those doctors deserve to be struck off

I managed to read it via VPN. Absolutely horrific. So young. It does seem like an extremely rare case but I'm not minimising it by saying that, but again how many such cases happen with out our knowledge? .

To read the full article follow that latest link. It brings you to the 1st page. On the left of the vertical line is a box called “save” and you can download it from there. HTH.

Thank you. I had to turn my VPN on and it worked.

I have lost all faith and respect for 'doctors'.

Sadly, I suspect nothing will come of this...Doctors are virtually untouchable!

This is horrific. Eighteen year olds are not equipped to understand this level of complication.

Bowel vaginoplasty appears to have been used for some time to treat women, primarily those with Mayer Rokitansky Syndrome (MRKH) which is a DSD. This paper from 2006 suggests the results for those women are reasonable. It is not the only method for treating MRKH.

https://www.auajournals.org/doi/abs/10.1016/S0022-5347%2806%2900337-5

Reading the original paper it looks like anastomotic leakage (leakage from where the bowel was joined together again after a portion was removed) was part of the problem but the paper also says that a side to side anastomosis was used rather than an end to end; are there any surgeons here who are able to explain why that choice was made. I've worked in health care and seen plenty of bowel resections but I have never seen a side to side anastomosis used to join bowel together again, I've only seen the end to end technique used.

Trans Day of Remembrance….

don’t forget those trans kids who lost their lives in the pursuit of a mis-sold dream.

That poor kid. You get the impression from that report that the medical team responsible would shrug and say even a tooth extraction can go wrong for a tiny percentage of people.

I did blink on the 'has been found to reduce behavioural problems' line explaining why this massively invasive surgery is justifiable.

I couldn't bear to read the article but it sounds like this is the key point re the puberty blockers. How can any p re pubescent child make an informed decision about this?

Perhaps your post ought to be shown to those idiotic teachers in our schools telling our children that puberty is optional along with some graphic images of this poor unfortunate to demonstrate why that is not, has not been and will never be the case.

The abstract summary says: the genital surgery had a positive impact on the patients quality of life.

What??

Yes I read that and was like wtf!!!

The only way this surgery could be in any way justified is if the outcome of not operating was far worse.

Selling the propaganda that this is “life-saving” healthcare and the alternative is death has done a number on patients and even some doctors - although I have no doubt there are one or two of the latter whose desire to make a name for themselves in an experimental area makes them first cousins to Mengele. But there is no wave of trans suicides from those who have to wait for surgery. On the contrary, the only long-term study to date suggests suicidal ideation increases after genital surgery, and 85-90% of adult transwomen certainly seem pretty damned happy to keep their penis.

This young man was sold a lie and his death was a needless waste. I’m so angry about this.

Back in the 1980s/90s I was working in cardiology. I don't want to out the person so I will be vague.

We had a patient who had had what is now called 'top surgery' but then the Drs found a heart condition and they decided the 'bottom 'surgery' was too risky.

This was an adult of sound mind and I am not sure whether they should have been allowed the op as they understood the risks.