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The number of gender reassignment surgeries being carried out on American children has risen 13-fold in the last decade, a study suggests.
Researchers looked at the number of mastectomies — sometimes called ‘top surgery’ — performed on girls under 18 at a major health system in California since 2013.
The operation involves surgically removing breast tissue and flattening the chest of biological girls who are trans, so they can feel aligned with their gender identity.
Results showed children as young as 12 were offered irreversible operations between 2013 and 2020. The overall incidence of mastectomies among minors rose from 3.7 per 100,000 persons-years to 47.7 per 100,000 in that time.
As gender-affirming care becomes more popular among children, an increasing number of patients who regret having the irreversible procedure have come forward and claimed they were not challenged enough as children.
The rate of children undergoing the procedure rose 13-fold since 2013 (pictured left). Some patients were as young as 12 (show top right). The vast majority had no regrets about the surgery, with only two children saying they wished they had not gone through with it
The researchers studied mastectomies performed on girls aged 12 to 17 at the Kaiser Permanente Northern California health system between January 2013 and July 2020, covering 56 regions.
The hospital is home to two specialist gender clinics, but patients can access gender care across its services.
The researchers calculated the rate of mastectomies by dividing the number of patients who had the operation by the number of children assigned female at birth who were registered with the health system at the start of each year.
Of the 209 patients who had the surgery between 2013 and 2020, 10 were aged 12 or 13. The median age of referral was 16 years.
The majority had a history of mental illness — around 60 percent had anxiety and/or depression, and 11 percent had history of an eating disorder.
The most common procedure was a double incision, where a horizontal cut is made on each side of the chest to remove breast tissue. Nipples are also removed and resized.
Only two patients reported regret after the surgery, but neither underwent reversal surgery.
However, the median post-op follow was only two years, and an increasing number of patients are coming forward expressing regret in adulthood after having the surgery as a child.
Out of the 137 patients who were followed up more than a year after surgery, seven percent had at least one complication, including bad bruising, infection, and scars requiring steroid injections.
All were biological girls, 87 percent of who identified as male. Some 10 percent identified as nonbinary, and three percent identified as ‘other’.
One of the hospitals in Oakland carried out 70 top surgeries in 2019 on children aged 13 to 18 — compared to just five in 2013, according to the New York Times.
This map shows the proportion of children aged between 13 and 17 years old that identified as transgender by state. The darker colors indicate a higher proportion of youngsters. In New York and New Mexico, it is as high as three per cent
A Massachusetts-based detransitioner who goes by the name Shape Shifter transitioned from male to female, but encountered appalling medical issues. He has since detransitioned, identifying as a gay man with a feminine look. He has faced intimidation and harassment after publically criticizing transgender ideology. He was branded a lackey of Florida Gov. Ron DeSantis for testifying at the Florida hearing, and is now considering whether to buy a gun for self-defense
Sinead Watson, from Glasgow, Scotland, lived as man from the age of 23 and had a double mastectomy, but realized at age 27 that she had made a terrible mistake, and detransitioned at 28. She spoke out on social media this week about widespread harassment from the transgender community she was leaving: ‘I was sent rape and death threats,’ posted Watson, pictured earlier this year. ‘I was called a hideous freak show.’
To live as a man, Watson took the male hormone testosterone for years, which has left her with a gruff voice and facial hair she removes every two days
The study was published in the journal Annals of Plastic Surgery.
While it only applies to California, a Vanderbilt University study last month found the number of chest reconstruction surgeries performed on trans youth had surged five-fold in recent years across the US.
There is currently no national or federal data.
As of September this year, transgender children from other states can safely travel to California to receive gender-affirming care.
Democrat Gov. Gavin Newsom signed a bill allowing legal protection for transgender youths and their parents fleeing states where access to thing such as puberty blockers is limited.
Four states — Alabama, Arkansas, Texas, and Arizona — implemented policies restricting children’s access to gender-affirming care in the summer.
This year, 15 states are looking at implementing similar laws.
In October, the Florida Board of Medicine voted to ban gender-affirming care for trans teenagers.
The move will block access to puberty blockers and hormone therapies for minors under 18 who have gender dysphoria.
Board members said the decision was made based on the irreversibility of the drugs and the growing number of people choosing to ‘de-transition’.
Florida’s Republican Governor Ron DeSantis has long been critical of the use of medical treatments in trans children, previously saying doctors who operate on children ‘need to get sued’.
Several Republican states are imposing age limits or tightening access to puberty blockers or surgery as the procedures become increasingly common and a growing number of ‘de-transitioners’ say they regret the irreversible operations.
Roughly 300,000 teenagers identify as transgender in the United States, according to the Williams Institute, a research center within the UCLA School of Law specializing in LGBQT issues.
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