American genital surgeon admits they’re learning as they go

[NotBadConsidering]

And talks about how the medical team touching the patient’s genitals before and after surgery is often the first time anyone has, including the patients themselves.

The original video was a year ago but I don’t think we noticed it here.

How this is allowed to continue and be championed will be the subject of many a scathing book in years to come😡

https://twitter.com/Real_EdDiehl/status/1662258674734346240?cxt=HHwWgMDRhaXdw5EuAAAA

I know it's a hot topic, but surely this is not the only area of medicine and surgery that can be "experimental", where the doctors are "learning as they go". I don't agree with "trans healthcare", but I don't think it's fair to levy these particular accusations against it.

surely this is not the only area of medicine and surgery that can be "experimental"

The point is that with medicine, it's always a balancing act to make sure that the good outweighs the harm. Ie balancing the outcome if you don't do the treatment vs the risks and side-effects of the treatment.

Minor condition + well understood treatment with few side effects = OK

Serious illness which will inevitably kill the patient within months + dangerous experimental treatment with potentially serious life-changing side effects = Acceptable if there's a reasonable chance of success and the patient wants it

Mental health condition which has an 80% chance of resolving by adulthood + dangerous experimental treatment with potentially serious life-changing side effects = Why on earth would anyone think this is acceptable?

Describing it as "experimental", which adds a veneer of rigour to the "learning as they go" I suggest may not be warranted, if the similar talk discussion about puberty blockers is anything to go by...

But I suspect there probably is more "research" into this area than puberty blockers. There is a real technical field here, and apparently that was a focus at that EPATH conference. But the the thing being learnt isn't "does this resolve the condition we're purporting to treat". I imagine it's mainly "what's the cosmetic result?" and "how many complications does this cause?". Hopefully sufficient of the latter.

Although it's not clear how much they care about the latter. Corinna Cohn was speaking in an interview with Benjamin Boyce recently about being involved in a state bill in the US that would compel insurers who cover "transgender" surgery to also cover follow-up care. That was blocked by Democrats.

It should be conducted as part of research, with ethics approval, so it can be stopped when the ethical boundary is crossed. Because that isn’t the case, “we are traumatising patients by touching their surgically altered genitals” exists only as a YouTube clip, not evidence in front of a disciplinary board.

In addition, the clip is incontrovertible evidence that children are not being consented properly. He clearly says it. Yet they haven’t stopped. And no one is stopping them.

Yes there are other areas of medicine and surgery where clinicians “learn as they go” but it’s usually small adjustments; a dose might be optimised, a procedure tweaked, a different dressing is used.

But name something as radically life altering that is done in this fashion?

And the point about this being the first time that anyone has touched the patients genitals - even the patient themselves - is about informed consent.

For dangerous experimental treatment with potentially serious life-changing side effects, it's imperative to make sure that the patient understands and consents to the risks (unless it is immediately life-saving treatment, such as after a car crash. Which this is not.)

An inevitable side effect of removing/surgically altering a patient's gentals is that they will no longer be able to use them. A likely side effect is that it will severely reduce their ability to experience sexual pleasure.

How can a patient possibly give informed consent to that when they've never experienced their own sexuality? The patient could possibly be helped to feel better over time - and learn to love and enjoy their own body - with sensitive counselling and their own maturity. They can't imagine it. But we know how important sexuality is to humans - so we know that this is not informed consent.

Although it's not clear how much they care about the latter. Corinna Cohn was speaking in an interview with Benjamin Boyce recently about being involved in a state bill in the US that would compel insurers who cover "transgender" surgery to also cover follow-up care. That was blocked by Democrats.

So much for TRA's calling us transphobic. It sometimes seems that we're the only people who actually care about these kids.

How can a patient possibly give informed consent to that when they've never experienced their own sexuality? The patient could possibly be helped to feel better over time - and learn to love and enjoy their own body - with sensitive counselling and their own maturity. They can't imagine it. But we know how important sexuality is to humans - so we know that this is not informed consent.

What is shocking is that he has noticed this, yet continued with surgery. He’s saying this needs to be addressed for future surgeries, but it didn’t stop him operating on the ones he did.

It was the same with Jazz Jennings and Marci Bowers. Jazz tells Bowers about never experiencing orgasm. Instead of stopping, and help Jazz experience libido and orgasm, there was just a collective shrug and they carried on.

Because they know the only way for that to happen pre-surgery is for patients like this to either a) go through some semblance of male puberty or b) be given some testosterone.

To do either would be to acknowledge the entire flaw in blocking male puberty: males need testosterone for things to work properly. So they don’t. Instead they just carry on.

All the counselling in the world for puberty-blocked males to encourage them to touch their own genitals before they lose them isn’t going to make a difference, because without testosterone, nothing will happen.

This is the point of madness we have reached: a cohort of teenage boys need to be told to touch their own genitals for the first time in human history.

So much for TRA's calling ustransphobic. It sometimes seems that we're the only people who actuallycareabout these kids.

Here's a of the tail of the discussion... The point is that seems to be that there's universal agreement that "gender" care is medically necessary and vital - ie the initial "affirming" treatment that also "affirms" the "making trans people is good" bit.

But the further you go into it, and the less "yay! trans!" the patient is the less automatic acceptance there is that this is "medically necessary". There's an ideological component to the acceptance.

CC: Insurance companies can voluntarily offer reconstructive procedures for detransitioners. And so it might be that you're if you're lucky enough your insurer might cover it. A lot of them do not.

BB: Do we have numbers on that?

CC: In Texas we don't have clear numbers because this is very fuzzy. We know that some people have been denied their claims, and they gave up after being denied once or twice. Some people are tenacious and they try three or four or five times to get their their claims covered and sometimes the insurance companies will do it on a case-by-case basis. So it's hard to say by numbers what the different companies are doing because it really depends more on an individual basis. But instead of requiring individuals to doggedly pursue their claims, some of which or many of which would be denied anyway, what this does is say if you provide the on- ramp into this condition you also have to provide all of the maintenance care and also the off-ramp.

BB: So it seems like they have an idea that this is a bad thing. I don't see how it's a bad thing.

CC: I believe I can represent it. I'm going to give it the best steel-man argument that I can, and then I'm going to tell you what I think is actually happening, because I think these are two different things.

So the strongest steel-man argument is, if you require for example that an insurance company that covers a phalloplasty, which is the the highest rate of complications for any of these "gender-affirming" surgeries, that if you say that this procedure which might require two or three or four or five follow-up surgeries due to complications also have to be covered by insurance, that the insurance company will say that's too expensive for us to cover and therefore we're not even going to cover the initial phalloplasty.

So what could happen in some cases is that the insurers would choose to reduce the amount of coverage that they offer for some procedures; and I'll be honest with you - that is something that we are not opposed to happening if some of these procedures are so dangerous and unreliable that they end up causing a massive harm to the patient. And let's say phalloplasty is without a doubt the the most extreme example of that. So they say, well if this passes there'll be fewer phalloplasties.

Now I think what's actually happening is that because there are there's other legislation that's happening in the Texas House right now one of the things being SB14 which curtails paediatric gender transition medication I believe what's actually happening is that the Democrats are resigned to the fact that SB14 is going to pass despite all their delaying tactics and this is just a thumb in the eye of the Republican sponsors of this legislation for also supporting SB14. This is just revenge.

God - what a crazily irresponsible take on life changing surgery.

Sorry pal we've learnt that this is impossible. No refunds as per the contract. But still , you are helping us to make history. 🤮

They are operating on HEALTHY bodies. Able bodies.
Absolutely-nothing-wrong-with-them bodies. Underage bodies.

That’s the awful bit.

Adults may do what they want, and regret it. But unnecessary, damaging experimental surgery on young, healthy bodies is veering far into Mengele territory as far as I’m concerned.

Although it's not clear how much they care about the latter. Corinna Cohn was speaking in an interview with Benjamin Boyce recently about being involved in a state bill in the US that would compel insurers who cover "transgender" surgery to also cover follow-up care. That was blocked by Democrats.

This is truly shocking and shows they don't really care about these children, and are happy to trade their health for political advantage.

Yes, sometimes experimental treatments are allowed but as PP have clearly stated it is where the benefits outweigh the risks - not true or even quantified in this case - a good example is of experimental cancer treatments on patients who will definitely die and for whom all other treatments have proved ineffective.

It's also for adults, the bar is generally higher for children especially where no risk to their lives.

And in addition, where experimental treatment is undertaken there is usually a very robust follow up - which doesn't seem to be happening AT ALL for gender reassignment surgery.

Basically, they've thrown all the normal protocols out of the window and this is for children and young adults. It's just utterly appalling.

unnecessary, damaging experimental surgery on young, healthy bodies is veering far into Mengele territory as far as I’m concerned.

Agree and I think we'll look back on this as a worse scandal than the use of lobotomies.

They are operating on HEALTHY bodies. Able bodies. Absolutely-nothing-wrong-with-them bodies. Underage bodies.

That’s the awful bit.

I was a bit sceptical about the whole "medical industrial complex" angle. But the point here is that if you have such a complex, the ideal patient is a healthy one!

You can use totally standardised treatment! No need to customise it for a particular condition. Profit margins are much higher than targetted treatment - all this stuff about custom gene therapy or whatever.

They're like the stereotypical American Wild West salesman wandering into town with a cart full of patented elixir. He's not going to tell you that his (only) product won't help you. And he's not going to hang around to deal with the side-effects of whatever he's put in the bottles.

And a lot of this "life-saving" stuff isn't just to sell it to customers, it's to deflect attention from attempts to get the providers to take responsibility. If it's really potentially "life-saving" then you can't really fault the failures so much, can you? Don't want to discourage the heroic emergency surgeon from the attempt to save a life...

Your third paragraph is spot on.

Absolutely crazy it has gotten this far. But it probably won’t reverse until the former trans children speak out en masse. Lawsuits and money and tell all books. But then I see minor trans celebrity Kim Petras pose sexily and sing about fucking, knowing that his surgical history is the same as poor Jazz, and it hits home just how much stakes on them repeating the lie.

The most life destroying youth fad ever, happily enabled by adults.

Spot on. I always think of Thalidomide. But that was a terrible mistake - albeit one they covered up for ages.

Lobotomy is a better comparison. They are deliberately destroying young people's bodies.

These are surgical procedures on healthy bodies which leaves them dependent on ongoing medical treatment. Supposedly under the guise of life saving and mental health purposes.

How is that not some of the worst ‘experimental’ health care around?

Not only that but have been confidently and consistently publicised as being the ‘consensus’ and scientificly sound. Whereas it is not. It is simply false to describe it as evidenced or as being supported by the majority of health professionals.

It certainly looks unethical to treat children iflet's imagineyou treat two children and one of them would have naturally recovered anyway.

I also don't see why we should give up on "conversion therapy" for children with gender dysphoria, as that's the healthiest outcome in theory.

It doesn't work? OK, well maybe we find more effective therapy strategies in the future?

And look, if you are willing to try puberty blockers, why not try psych medications to try to help people with their gender dysphoria? I'm not saying it's necessarily safe, but then puberty blockers aren't either. Why not experimental drugs to try to cure people?

I also don't see why we should give up on "conversion therapy" for children with gender dysphoria, as that's the healthiest outcome in theory.

of course. But when you talk to an adult transactivist it takes a few moments for that concept to even compute.

Try asking a transactivists whether they would support research into a cure for gender dysphoria, and watch what happens.

I wonder about informed consent for these procedures. Is the patient getting all of the info about the likely outcomes and ALL of the complications? If so, do they actually understand what they are consenting to?

DS had to have surgery as an infant. I’ll never forget the surgeon explaining all of the possible complications- including death. They also explained that they couldn’t give us complete reassurance, if even the surgery when well, about life span as the surgery had only been pioneered in the 1980s. Fortunately DS is doing great and the vast majority of people who had the surgery in the 1980s are alive and doing well.

I wonder what the long term outcomes are for the various gender surgeries. The Eastern European women athletes that were dosed with testosterone didn’t fare very well.

Came here to say the same thing.

It's truly awful just how monetised it has as become. From being a last resort in a niche field of psychotherapy, where the aim of the intervention was to understand (through watchful waiting and talking therapy) if the young person could be at peace with their own body, hormones and surgery are now the front line response.

And the conveyor belt of children entering this experiment have all been suitably confused by a) the conflation of sex and sexual orientation (and sexist stereotypes) and b) gender identity being taught as fact not belief.

I don't have a gender identity but I accept that others do and for many, this is an important part of who they are (I feel the same about religion).

However, I don't accept it being taught as a fact that everyone has a gender identity. I don't identify as a woman, nor as [insert age], nor as blonde. I am factually all of those things (admittedly the blonde has been assisted), but I don't identify as any of them.

For some people "identity" is important but children are being encouraged, through RHSE and social media, to believe "identity" is the most important aspect of themselves. It's a subtle yet important twist on figuring out who you are as a person, which is a tricky time anyway as an adolescent.

I don't need anyone to affirm my right or what it means to be a woman, [insert age here] or blonde. I'm just going to get on being all of them. Although sadly the age one seems to move onwards and bring wrinkles with it, but I'll accept the reality of that (while admittedly wishing the wrinkles weren't there). I'll eventually (hopefully) be very old, but I won't ever identify as old (or young).

When I was an adolescent, my sense of self was totally different and I hated aspects of my body. In today's speak, I would have been distressed at my body not matching my identity - given the choice, I would have identified as a beautiful, confident girl who didn't feel awkward and gangly. I'm very glad that I didn't have the option of injections or surgery to change the things that distressed me about myself.

Gender dysphoria is undoubtedly real, but it's incredibly rare and it's been caught up in a whirl of commoditised identity-affirming body-perfecting. It's pulling in vulnerable children who have unexplored co-morbiditities because it provides a "simple" answer which has a booming industry attached to it.

It is chilling to hear the interviewer say “It will be fascinating to see how this plays out”.
I am sure Mengele was “fascinated”
to see how his experiments turned out, too.

Can that guy not see that removing the sexual function of someone who has not yet even experienced any sexual activities means that the patients will not be giving informed consent.

The more these people say the more they prove they don't give one single shiny shit about the kids. All they care about is making money/a name for themselves.

Arseholes.

Can that guy not see that removing the sexual function of someone who has not yet even experienced any sexual activities means that the patients will not be giving informed consent.

Yes he does see, because he says it raises questions about consent. So it’s worse: he sees, but carries on regardless. And not only do medical authorities ignore it, the applaud it.

I don’t think I will ever be able to fully express the contempt I have for the people who do this to young people and to those who enable it.

The thing is about the 'famous' transitioned children is that they and their families have made a huge amount of money from it and continue to do so. It's unlikely they'd be the ones bringing lawsuits.

The lawsuits will come from normal kids who have been turned into medical patients for life with chronic conditions they wouldn't have had and who have no sexual function and are sterilised and who've been dumped by the people who transitioned them when it comes to their ongoing disability. Because they have no benefit in keeping the charade up at that point. So many detransitioners talk about how the surgeons / GIDS / the adult GIDS (whose name I'm forgetting) basically didn't give a shit about complications once the 'transition' was complete and told them, in politer terms, to fuck off, especially if they had the realisation that they remained the sex they were born as and didn't keep up with the approved phrases and expressions of the cult.

And the thing is, you can sign something saying you consent but if you don't have capacity as is clearly the case for minors giving up sexual function who've never experienced it, I don't think any amount of signed documents will stand up in court.

Scott Newgent - who transitioned as an adult so not the same thing at all - was on TV recently talking about how she just pees in the middle of the street because she can't control it and has multiple infections. Walking around London, feeling like shit and pissing all over herself. And she had more capacity to consent than these children. We need more of these stories out there.