Surgeon's account of gender affirming care

[BettyBooper]

A surgeon has been writing to various bodies for the last two years to raise serious concerns about surgeries and hormones. Noone is willing to take responsibility.

Horrific that this can continue.

His account and the responses he has received here

https://www.scotpag.com/post/gender-reassignment-surgery-a-medical-deception

‘Many of them have underlying mental illnesses such as: depression, anxiety, autism, obsessive compulsive disorders etc. Many of these youth, in my opinion, are encouraged to believe through social media indoctrination, that they are born in the wrong body. There is no scientific basis for such an ideology.’

How have the medical profession colluded with this insidious ideology? How have they done this to vulnerable young people? Why the hell has nobody stopped them?

To my dismay, I have been unable to identify any professional body that explicitly endorses these surgeries or is prepared to assume full responsibility for them. Yet, these procedures continue to be performed with apparent impunity.

So no one is taking any responsibility, at all. They're 'not having a stated opinion at this time', or batting him backwards and forwards from pillar to post. With one person suggesting it's up to the surgeon?

Bloody hell. No one's recommending this, or endorsing it, or taking responsibility for it, but nonetheless, it's going ahead.

How can that be happening??

I hope a parent sues the fucking arse off one of these surgeons, and wakes them all up

How have the medical profession colluded with this insidious ideology? How have they done this to vulnerable young people? Why the hell has nobody stopped them?

This is something that really baffles me about the current situation. How did so many seemingly rational people get taken in by such an obviously insane ideology? What convinced surgeons, who normally perform operations to save people's lives or improve their lives, to remove healthy body parts from mentally unwell patients?

I know, it really is quite baffling. It's one thing to have a contradictory and rather daft opinion online.

But a professional surgeon starting to cut completely healthy body parts off teenagers??

And the fucking government all sitting there on their arses.

Shocking doesn’t even cover it, does it?

Presumably when/if it all unravels they've all got plausible deniability and can shift responsibility on to the gender clinics for authorising the surgery and the patients to consenting to it.

I have to say, I do think I kind of understand why the surgeons/gender clinics are doing it. They're presented with patients (if we can call them patients when there's nothing physically wrong) who are super keen to have the operations, tell them they understand exactly what the consequences are and are seemingly delighted with the results, at least in the short term. They're told that only a tiny percentage regret their decisions and mostly because of external pressure. Who wouldn't be reassured to go ahead under those circumstances? They're told that this is the accepted and only treatment and that it's well established.

From their point of view there's no need to actively seek out patients years later to find out if they're still happy. There would be if it was a study or experiment, but as far as they're concerned, once the operation's done then their involvement is over. Interestingly, whenever patient satisfaction is quoted it's always compared with knee, hip or eye operations. These are all things we have 2 of. If you've had one hip operation you're more likely to need the other one doing at some point so you're likely to come back into contact with a surgeon and therefore be able to report on whether you were happy (or not) with the first.

Anybody who doesn't 100% want to go ahead has presumably dropped out at puberty blocker/hormone stage. There's no follow up for these patients because they're no longer patients so just don't exist as far as the gender medicine services are concerned.

Maybe I'm completely wrong and they are all being followed up and actively surveyed for patient satisfaction?

It seems to me that in the end the buck stops with the psychologists and those doctors who have claimed that "gender affirming care" is "life saving" necessary for these patients.

I can completely understand why a surgeon would not feel like he or she had the expertise to make a determination about that.

And then I suppose their presumption is that the people referring kids for this care understand what it can and can't do, what the state of the surgery and hormonal interventions is. Similarly the college of anaesthetists must typically rely on surgeons to make decisions about surgery, and see themselves as in a supporting role for that.

I'll be honest, I increasingly don't think psychaiatry is real medicine. I don't think I'm speaking from a place of total ignorance on it, as a layperson - my father was under psychiatric care for many years and has been an in-patient on several occasions in a mental hospital, and my dh is currently under care. But particularly with my father I can see how much of it was frankly cowboy medicine and "life saving" use of heavy drugs has destroyed his kidneys and impaired cognitive function based on what were I think trendy diagnoses at the time. And I think a very high proportion of the care I see for children is probably damaging and again, based on fad diagnoses that have them on drugs with unknown effects long term.

There are exceptions, I've seen psychiatrists who seem to have a larger perspective on the nature of their practice and are careful about evidence base and what it does, and can, really show. But it seems rare.

All of which is to say I don't think these people should be in charge of whether my dogs get's his balls chopped off, much less vulerable people.

I don't want to let surgeons off the hook either, I think the whole sector of for profit cosmetic procedures needs to be completely divorced from medicine. If there wasn't this idea that whatever the patients want to reshape themselves as is ok, maybe they'd have thought twice about this stuff. Whatever that is, it's not medicine.

Wasn't it Helen Joyce who talked about everyone in the line of 'gender affirming care' presumed someone else had done the necessary due diligence? I think this article very much confirms this to be the case.

It's absolutely scandalous. Where is the BBC reporting of this national outrage? 🤔

I remember, many many years ago, watching a documentary about a woman with body dismorphia; she was desperate to convince the medical professionals to surgically remove her leg. None would do it, they referred her for psychiatric help. Would she be able to have her leg removed now?

We've become weak and submissive as a society. We over analyse, need "research papers" to back up logical opinions all the time. Even on here! It starts with "no". "No you can't be a girl , David. It's impossible." Kids need boundaries to push them back to knowing where the line is. We're failing young people by our inability to say "no"

Agree. The way people have parented for millennia, protecting their chidren and providing boundaries, is far from entirely wrong.

I have to say, I do think I kind of understand why the surgeons/gender clinics are doing it. They're presented with patients (if we can call them patients when there's nothing physically wrong) who are super keen to have the operations, tell them they understand exactly what the consequences are and are seemingly delighted with the results, at least in the short term. They're told that only a tiny percentage regret their decisions and mostly because of external pressure. Who wouldn't be reassured to go ahead under those circumstances? They're told that this is the accepted and only treatment and that it's well established.

But all that also applies to people who want to have healthy limbs removed, and yet surgeons aren't doing that, and in fact one surgeon who carried out a few amputations for this reason was eventually prevented from carrying out more operations even though his patients were happy with the results.

A New Way to Be Mad - The Atlantic

One of the big threads of the Victoria Climbie inquiry 2003: how did this disaster happen?

By everyone leaving the difficult decisions to someone else because they were afraid of being stuck with it.

No sharing of information centrally to everyone involved.

No one with responsibility and accountability.

Safeguarding 101 for almost 25 years now.

Fucking hell, the way various NHS bodies just kept redirecting him, finally to the Parliamentary Health Service Ombudsman, to whom he has written three times and not had a reply 🤬

And I just want to highlight this bit:

“These are mostly patients who are in the adolescent age group who have not completed their adolescence. (Adolescence is defined as between 10 and 24 by Oxford Handbook of Pediatrics, 3rd Ed.)”

I recently needed to re-read Balint’s chapter on “collusion of anonymity”. The phrase captures the phenomenon where patients may bounce from one specialist to another with nobody accepting or acknowledging overall responsibility for the patient as a person.

Somehow, this diffusion of responsibility feels (understandably) risk averse rather than patient centred (which is the usual rhetoric of care).

Meghan Murphy and Mia Hughes discuss the apparently high success rate of "gender affirming surgeries" in this video.

Its interesting - Mia says that the very very low rate of reported dissatisfaction is evidence that these people are in a cult - they see what happens to detransitioners, and they know if they report unhappiness with their surgery they will be ostracised etc

What is the comparison with plastic surgery? Where people get healthy bits of their body chopped around?
Is there not a discretionary surgery you are allowed? I appreciate we could say it’s not funded by the NHS because it’s not necessary, but can you not have anything you like done post 18?
I don’t see the philosophical difference between a full face lift, an arbitrary leg amputation, and an elective mastectomy.

A lot of psychiatric "care" is just a stab in the dark and it is usually Psychiatrists who are sanctioning "gender affirming care" as they like to call it. Psychiatry is not a respected field of medicine and psychiatrists are not well respected by other doctors some even question if it is a field of medicine at all. I am not saying there aren't any good Psychiatrists out their doing good work but most of them are literal headshrinkers and their is a growing body of research and descent on the field of psychiatry as a whole.

I think perhaps in time the roll of psychiatrists in the whole perpetuation of gender care will be a big part in its undoing, as for the doctors removing healthy breasts and sex organs, they are nothing more than butchers.

As a midwife, medical litigation is often a PITA, as you have to spend a lot of time writing about everything you've done in triplicate rather than actually doing things that help the patient.

However, this is one area where it is going to be extremely helpful. Various health practitioners will become really, really cautious about signing off on anything to do with this.

10-15 years, if not sooner, there's probably going to be a lot of ads, 'if you've been affected by gender medicine ...', like PIP and now car finance.

It really surprises me how many medical practitioners go along with this, as healthcare affecting reproduction is a very litigious area. E.g, when we do a caesarean (except in some emergencies where you have minutes), in maternity care the patient needs to sign the consent form which lists hysterectomy as a risk for them to be able to do it, even if you'd be completely insane to not have one in that circumstance. Otherwise they could have an argument to sue - could argue they wouldn't have given consent if they knew it was a risk.

IIRC that's pretty much what happened at the Tavistock. The kids were being examined by psychologists, not psychiatrists, so the psychologists couldn't write a prescription. Then they'd be passed on to the endocrinologist who would look at a note from the psychologist diagnosing gender dysphoria, say "seems legit" and work out the dosage of blockers or hormones.

And no one person with overall responsibility for any patient. So this Catch-22 situation where nobody is responsible because everyone thinks someone else is responsible.

I’m not sure it’s even that, it is not necessarily they think someone else is responsible, more they don’t want the responsibility themselves.

Modern life is complex and within large organisations there is a lot of passing things around to get sign off to share out responsibility, unless you have an individual prepared to say “we’re doing this unless anyone writes to disagree” - then no-one wants the responsibility of saying “no”, so it happens.

Add to this mix that the “no” sayers in this instance would see vengeful harpies descending to try to break their career and will be categorised as bigots/nasty prejudiced people. No one wants that, so almost everybody shucks responsibility and passes the buck (as with the good doctor’s letter being referred on and on).

Oh yes absolutely! Thank you for this reminder. It is absolutely the same. Safeguarding has gone out of the window indeed.

Completely agree. Having worked with some very high up Camhs psychiatrists (and psychologists) who have massively pushed this stuff, I've very much witnessed the 'stab in the dark' approach.

@BettyBooper Absolutely, I would not like to be a psychiatrist, or surgeon who had been involved in GIC or any kind of Gender Care 5 or 10 years down the line, chickens coming home to roost soon.