Billboard Chris latest post Trigger warning injury detail

[User76543]

This post features a very disturbing imagine of a non verbal young person with no top on who has had a mastectomy

I thought I was past the point of being 'peaked' but here we are again. How can anyone think this is ok? Not just the mutilation of a healthy body but also the exploitation for social media and now a "go fund me" - who is caring for this young person? How can this be happening?

https://x.com/BillboardChris/status/1879701706608705734
https://x.com/SarahisCensored/status/1879773878156681621

Fucking hell. What bastards did that ?

I watched that video last night when Genevieve Gluck posted about it - it made me so upset and tearful to see what had been done to that poor girl. Adults are completely abrogating their duty to safeguard the vulnerable.

@UtopiaPlanitia I am not easily upset but this did me in this morning.

Seeing this video being shared widely has made me uncomfortable. I don't think the young woman in the video has an intellectual disability, does she? I think this type of surgery is unethical for all the young people it is carried out on. I don't think it is any different for this young woman. I'm not sure her disability is relevant.

I read that she had had a stroke as a medical complication having had a deep brain stimulator implanted. So Cerebal Palsy (which can cause learning difficulties 50% of the time) plus a stroke.

Kiwifarms (SRS thread, page 1606) has found a lot of information, for example, the go fund me below.

https://www.gofundme.com/f/operation-maras-independence

https://www.nhs.uk/conditions/cerebral-palsy/symptoms/

She’s starting at a disadvantage compared to adolescents with healthy bodies. Surgery like this will make her already challenging life and health situation even harder. Her carers and medics have an even stronger moral duty not to facilitate making her health worse.

My husband mentioned this earlier.

I agree that it is disturbing but if she has mental capacity to consent (we don't know what, if any, mental disability she has) then I don't believe this is any worse than any other young woman being provided with an elective mastectomy for cosmetic reasons (which I think is abhorrent and revolting).

She shouldn't be infantilised because of her physical disability.

If it turns out she did not have capacity to give informed consent, then it would be a fucking disgraceful abuse of power by those who are supposed to be caring for her.

Agree. A speech impediment doesn't make someone 'non verbal'. And her palsy doesn't necessarily make her more or less vulnerable than other non disabled people.

"I agree that it is disturbing but if she has mental capacity to consent (we don't know what, if any, mental disability she has) then I don't believe this is any worse than any other young woman being provided with an elective mastectomy for cosmetic reasons (which I think is abhorrent and revolting)."

100%

If someone has mental capacity, they have the right to make decisions- whether they are good or bad ones.

I’m not trying to infantilise her, rather I’m saying that her physical health is already compromised by her disability and that doctors and carers should not undertake anything that will make her health worse or will cause potential for complications in the future. For example, she wears a harness around her chest to help her sit in her wheelchair, the harness sits in the area where the mastectomy scars are - this has a great possibility of causing ongoing physical complications following the surgery.

I just want surgeons to think practically and long term rather than think, ‘My job is the surgery and what comes after is nothing to do with me’. I want doctors to realise that sometimes surgery is not appropriate for somebody simply because they want surgery and it can be done.

I think it is different. Even if she's perfectly mentally capable, she is still highly vulnerable. I'm absolutely appalled at the doctors who did this, though at this stage nothing surprises me.

I know what you mean, but I think vulnerability is difficult to quantify. The situation is uncomfortable for sure, but it bears examining why that is.

Currently in law we have the concept of mental capacity regarding consent for medical procedures which I don't believe takes into account additional vulnerabilities. I don't really see how it could.

We have different age cut offs for some activities, and the law doesn't take account of additional vulnerabilities that may exist eg you have to be 18 to buy cigarettes, and whether or not you're asthmatic doesn't come into it. You have to be 18 to buy alcohol and whether or not you have existing mental health problems isn't a consideration under the licensing laws. Of course, the people in those scenarios are more at risk but the law doesn't take account of that - as a competent adult they are considered to be able to weigh the risks for themselves.

I do think there is an element of infantilisation of disabled people by society, which is why we are so shocked and horrified at something like this. Amputation of healthy breasts is shocking. I'm not sure it's any worse if it's a disabled person doing it - I think that pov could be seen to be quite ableist upon analysis.

I'm not saying she isn't vulnerable. I'm saying we have rules around capacity and consent and this scenario seems to sit within those rules rather than break them, and I don't see how you could change them without drastically restricting individuals personal freedom.

She's also on testosterone.

So we have a young woman with a physical condition (that can also cause learning difficulties in 50% of cases) that means that she needs care for basic needs (including intimate care), that looks like she has a feeding tube in some pictures showing her abdomen. She has also had brain surgery which resulted in a stroke.

On top of this, she has had a big operation that is known to cause issues with moving your arms in some patients (and she did not start with the full range of arm movement before the operation). This is an anaesthetic that she did not need (there are risks for this alone) for an operation that was not required for medical reasons, it was ideological.

Then you add in the testosterone. I'm sure that people will remember the transman with 'locked-in' syndrome and the transmen who have had other health issues with large doses of testosterone (compared to what a female should have). If we just think of the medical issues that the female East German athletes had, we know that this is a risk.

So essentially, the risks keep adding up and this poor young woman doesn't need much interms of deteriation in her condition to make a huge negative impact on her life.

That's not even taking into account the statistics of sexual abuse in the disabled population and the statistics regarding sexual abuse and trans identification (as per the Tavistock, see 'Time to Think by Hannah Barnes). I am not saying that this has happened in this particular case, but it is something that shouldn't be ignored when discussing people with disabilites and trans identity.

Where is 'first do no harm'?

I don't want to sound dismissive, but I'm pretty sure that the person who has had the top surgery done has to have 'capacity to consent' in order for top surgery to occur. So this would include not having an intellectual disability. Facial tics/physical disability don't necessarily indicate an intellectual disability. Even if we don't necessarily agree with the choice being made by someone who is able to consent, this is clearly a different context from someone who doesn't have capacity to consent.

The risks keep adding up...

Absolutely, this is very true.

It sounds like the surgery was an all round terrible idea.

And, as the PP said, she would have had to give consent and for that she would have to have mental capacity.

Either - that did not happen as it should - which would be an horrendous travesty and need investigating

Or

She did have capacity and gave her consent, therefore it is not for us to judge that she should not have had the surgery.

The rules are clear.

If we were to change them, the question is, how would you judge? Who would judge? What would be the criteria?

Disclaimer: I'm saying this as someone who thinks elective cosmetic mastectomy is a terrible idea for anyone!

There are enough detransitioners who have said that they did not fully understand what they were consenting to, plus the revelations in the WPATH files ('The dog isn't doing it for you anymore, huh?'), that I am convinced that 'informed consent' is an illusion in many cases.

We have to ask ourselves, are there some things that cannot be consented to?

I used to think if someone was 18 or over, that it was up to them. However, I think that I was wrong. The current situation is outside the norm in so many ways. The most similar is people wanting a limb amputated for no medical reason (we don't let that happen). Or the 'Eunuch maker' who is now in prison.

I completely agree that this elective, cosmetic surgery is something that shouldn't be offered to anyone, therefore no one should be able to consent to.

(However, given that is IS currently available, the rules should not be different for someone because of a disability they have).

For clarity, I have a disability related to my central nervous system. I have had multiple operations.

Ignoring the disability aspect. I am constantly appalled by how this area of medicine (gender affirming care) has much lower standards. This is not acceptable. Even the most ardent supporter should want a high standard of care for trans people. I can tell you plainly that what we have now is not even close.

Regarding taking physical disability into account (and assuming that there are no cognitive issues that would impact the ability to consent). If you just look at the risks that are taken with elective surgery (when your quality of life could be so negatively impacted) this is a factor that should be considered very seriously. Is this really possible when the whole field (including therapists) is so ideologically driven?

My worry would be that her weighing up of risks, is less likely to be I understand and on balance accept those risks, but blah, blah, blah those risks don't apply to me. Which isn't informed consent.

I agree. Decades ago I wrote a biomedical ethics paper on ‘informed’ consent.

The patients that I interviewed for my paper unanimously agreed that they had no real idea what the surgery entailed or what the potential consequences and risks entailed but all agreed that they ‘trusted their doctor’.

The flip side was also listening to doctors explain the surgery and the vast majority took v little time, used medical jargon and minimised risks. It didn’t matter if it was required or elective, the surgeons were similar. Absolutely rubbish at explaining the surgery.

It would not come as any shock if the same pattern occurred with these young men and women agreeing to so-called SR surgery. Alas, they trusted the doctor to their detriment.

To throw another factor into the mix - I would very much like to see proper research done into the occurrence of both Munchausens and Munchausens by proxy in the field of gender identity and 'gender affirming care'.

All the logician pick-mes are out in force to tell us how this teenager is possibly the same mental capacity as other teenagers.

If this were their daughter, they'd be the first in line, fighting tooth and nail to get the extra 20mins at exam time because "she needs more support".

Hypocrites.

The rule isn't being applied differently because she's possibly disabled. Her ability to consent is measured differently. But common sense is being thrown out the window and we treat someone with brain stimulation as if they have a slight lisp.

i wonder why it is that it is illegal to electively amputate a limb, yet legal to electively amputate breasts (or a penis?)?

Is that a dig at me?

Your post makes no sense.

Is logic now a bad thing?

My posts have not been hypocritical, nor pick me (I don't think that means what you think it means).

If that's what you take from reading them, I suggest you go back and read them again, because you have spectacularly missed all the points.

The flip side was also listening to doctors explain the surgery and the vast majority took v little time, used medical jargon and minimised risks.

I should think most surgeons find themselves time-pressured as you describe, and defaulting to jargon and it's wretched that this hasn't improved over time.

Years ago, I read a piece by a neurosurgeon about informed consent for highly specialised brain surgery. His perspective was that if patients and their family weren't sobbing with fear by the time he'd finished going through the potential risks, then he hadn't explained them adequately. He'd give them time to settle and then start again. The cycle would continue until such time as he felt that they truly understood the risks.