The troubling trends in gender surgery - I’ve seen a change in my patients

[IwantToRetire]

I performed my first gender-affirming hysterectomy with pride. It was 2019, and I was delighted to be my local LGBT clinic’s official gynaecologist. There is, after all, no greater joy in medicine than providing great care to a vulnerable, under-served community in Iowa. This was, I felt, how the world should be.

Six years later, I’m not so sure. ...

But as the years went by, I couldn’t help but notice some troubling trends. The trans patients who came to me had more and more mental health complications. I also started seeing a fair percentage of them who were really quite feminine — not very different in their gender presentation from my biologically female patients.

Then came the see patients who truly stymied me. One who particularly struck me was just 21 years old, born a female but who now identified as nonbinary. They requested a hysterectomy to conform to what they saw as their gender identity, but otherwise did not desire transmasculine medicalisation such as testosterone or mastectomy, and had classically feminine mannerisms and dress.

I began to feel more uneasy that hysterectomy — surgery that carries numerous surgical risks, and results in irrevocable lifelong infertility — was necessarily the right thing for this new group of trans patients. But if they didn’t have any contraindications per se, I couldn’t really say no. After all, according to the American College of Obstetricians and Gynecologists, a hysterectomy is “medically necessary for patients with gender dysphoria who desire this procedure”. ...

I also discovered an emerging population of detransitioners, individuals who took steps to medically transition and who have now reverted to their natal gender identity. Although some do not regret the changes they made to their bodies, others are profoundly distressed by them and have serious and credible critiques of the gender medicine system as it stands.

I had just assumed the experts crafting guidelines were ensuring that there was a body of evidence supporting the incontrovertible long-term benefits for these extraordinary treatments that were being performed on young people: puberty blockers, cross-sex hormones, and double mastectomy. ...

Quite a long article at https://unherd.com/2025/06/the-troubling-trends-in-gender-surgery/

Also sounds like something that has already been posted but couldn't find anything. So if duplicate please add link to exising thread.

Or maybe it is because more and more people in medical provision are starting to be more questioning?

There’s a thread here:

www.mumsnet.com/talk/womens_rights/5348889-obgyn-in-the-us-questions-gender-affirming-surgeries

My friend couldn't get sterilised because her new partner didn't have his own biological children. But barely adults can get a hysterectomy just because they want it ? I don't understand.

It is very disconcerting that someone who has permission to perform life changing surgeries on people engages in such negligible philosophical or professional enquiry - and just accepts what they've been told; or who makes assumptions that have no grounding in reality.

This whole trans business has really revealed to me that no matter what your level of education, seniority or status....there will always be people who go along with the crowd and who do not engage in critical thinking. It has caused me to lose any 'faith' I had in the supposed wisdom of professional people, simply as a courtesy towards their status.

Activist organisations have been working behind the scenes for years to get certain protocols written into professional standards manuals. Nobody questioned any of it and ot was all just waived through.

There is a trans man on X who goes under the name The P*Ed Off Lawyer who has upset the trans community by saying they should be looking into the large number of young woman claiming to be trans and then detransitioning. And the pile on from the trans community has been intense.

Thanks. I did see that one and because the article title was not the same, I just assumed it was another one.

There really should be some sort of IT fix that would let MNHQ merge threads.

It took me 8 painful years of dealing with severe endometriosis before I was able to get the hysterectomy that I needed.

Several times I wondered if I could get rid of it quicker by deciding to identify as a man!

I have two children (one of each sex). I haemorrhaged with both births and was warned that future babies were risky. I have been with Dh since I was a teenager.

In my mid thirties I was discussing different options for birth control with my GP and I briefly wondered about sterilisation and was told that I was far too young to make such a permanent decision.