Plastic surgeons like Dr. Curtis Crane see new bonanza in youthful transgender operations

In modern Western history, there is no prior precedent for adults publicly advocating for minors under the age of 18 to undergo major, elective surgeries on healthy tissue. Surgeons don’t tout breast augmentation or reduction for minor girls.  Even adult women have a difficult time finding surgeons who will perform elective hysterectomies, since most doctors are reluctant to permanently deny future fertility to healthy women of reproductive age. After all, these women might change their minds later. (It never seems to enter anyone’s mind that a 20-year-old FTM might also change their mind but…never mind.)

In an earlier post, I wrote about the successful lobbying by TransActive of Portland, Oregon, along with their enablers and allies, to lower the age at which parental consent is required for these permanent procedures in the state of Oregon. The Oregon Health Plan, Oregon’s taxpayer-funded Medicaid equivalent, now also covers transition services, thanks to lobbyists like Jenn Burleton. TransActive transition-promoters were also overjoyed that there is now no longer a LOWER age limit for “gender confirmation surgery” WITH parental consent.

The demand for early access to surgery is growing, and there are surgeons happy to profit from this trend.

One surgeon whose name I’ve seen mentioned over and over again on FTM sites is Dr. Curtis Crane in San Francisco.  He does advertise the fact that he has performed plenty of mastectomies on minors.

crane under 18s

Generally speaking, Dr. Crane appears to have an “anything goes” approach to surgery, if discussions between gender specialists on the WPATH public Facebook page are any indication. According to one satisfied patient, Crane is happy to provide his clients with any potpourri of surgeries they desire, regardless of “identity”:

Dr. Crane WPATH page

Dr. Crane practices in California, so he can’t yet offer these surgeries to 15-year-old California residents over the objections of “unsupportive” parents like doctors can in Oregon.  For Oregon teens, I’ve seen many recommendations lauding Dr. Juliana Hansen and Dr. Jennifer Murphy, both of whom offer mastectomies for “gender reassignment” at the Oregon Health Sciences University plastic surgery clinic in Portland.  Hansen and Murphy, both with training in breast reconstruction, have undoubtedly parlayed their prior clinical experience with treating breast cancer patients, who had to have breasts removed due to an actual medical emergency.

But of course, in several states, lobbyists have managed to convince lawmakers that these surgeries are medically necessary, and that insurers must include them in their policies. Given that the AMA, the American Psychiatric Association, and WPATH (World Professional Association for Transgender Health) have all jumped on board with the idea that transition procedures are a matter of medical necessity, insurers can’t be far behind. In fact, just a few days ago, this article reported that over 400 US companies include gender reassignment in their company insurance policies, up from only 49 in 2009. For policies in the state of Oregon, these companies would presumably have to offer SRS to 15-year-old patients, whether their parents approved or not.

Are there any providers who see a problem with permanent surgical interventions for young people? At least two, Dr. Charles Garramone, who heads a clinic in Florida, and Dr. Kathy Rumer in Philadelphia, talked good sense in an interview in the New Yorker magazine in 2013.

Charles Garramone, a plastic surgeon in the Fort Lauderdale area, will not perform sex-reassignment operations on minors, because, he says,  “patients need to have a mature outlook in terms of being able to really understand the irreversibility of this surgery.” In addition, Garramone thinks that the skeletal structure underlying the chest of a sixteen-year-old may change enough over time so that a second surgery will be required.

Kathy Rumer, a plastic surgeon outside of Philadelphia who has a large transgender practice, also declines to perform reassignment surgery on minors. “I have had parents plead with me,” she says. “And I can feel for them. But I don’t want someone coming back to me when they are twenty-five saying, ‘I didn’t really want this. It was my parents.’ Adolescents are really in flux. I wouldn’t want to make a permanent change  based on that stage of life, which can be difficult, no matter what you’re going through.”

It’s hard to understand how any parent of a teen could “plead” with a surgeon to irrevocably alter the body of their child, but as we have seen recently, there seem to be an awful lot of parents who want to hop on the transition bandwagon with their offspring as quickly as they possibly can.

And when it comes to top surgery, with online role models like this, an eager teen might just see any resulting scars as a super cool body modification to show off to friends. Hey, scars are sexy.

“I have lots of scars, all over my body, but my top surgery scars are my favorite. They’re this warm, gentle reminder of how hard I’ve worked to be me. They represent so much fucking work. They’re my ultimate love note.”

top surgery scars

65 thoughts on “Plastic surgeons like Dr. Curtis Crane see new bonanza in youthful transgender operations

  1. You say that ‘In modern history, there is no prior precedent for adults publicly advocating for minors under the age of 18 to undergo major, elective surgeries on healthy tissue.’ But there is a precedent – female genital mutilation is offered in some cultural traditions on the basis that it will increase a girl’s chance of a successful marriage and that it offers lifelong freedom from troubling sexual feelings. Such a practice is, of course, illegal in the UK (and the US?) on the basis that it causes loss of sexual feeling and birth problems. It’s ironic, then, that surgery which produces infertility and lifelong mutilation is accepted in the US for minors.

  2. 😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱😱

    The Facebook post by a doctor asking about how to make someone a pornoid shemale fake hermaphrodite?!!!!! 😱😱😱😱😱😱😱😱😱 He or she said patient, I assume a medical doctor. But whatever they are they should lose their license. WTF is this crap?

    A brief OT aside on parents: Not all the parents who are going along with this for their kids are necessarily like Jazz Jennings parents. Some parents may simply believe that when a psychiatrist says their kid has this weird female in male body or vice a versa thing that it’s real. The same way kidney disease is real. Would they have to be really stupid to think that? Possibly. Or cowed by medical authority. Lots of the parents on here have commented about their kids and ones they’ve read about having all kinds of other mental health issues. Your kid has anxiety or depression and you can take them to the psychiatrist and the psychiatrist says oh all of that is happening because of this transgender thing which will be cured by treatment XYZ. A lot of people will just believe that. The kind of people who believe car financing ads. Gullibility is all around us. But it’s not the same thing as the Honey Boo-Boo Mom Parents who turn their kids into a media cash cow/freak show. We’re losing track of the fact that trusting people are being taken advantage of. And with the aid and connivance of the American Psychiatric Association, what a shocker. Just because all you guys saw through this crap and are protecting your kids from that, which is so so important, doesn’t mean everybody else who didn’t see through it is evil. Compassion is a good thing, it doesn’t have to preclude criticism. Some gender critical people like to throw around the term ‘Munchhausen’s by Proxy’. But Munchhausen’s by Proxy was a bogus psychiatric diagnosis (I’ve read the original paper, guess how many cases were in it?) That was used to JAIL the mothers of SIDS babies. The doctor who invented it, Roy Meadow, lied on the stand in order to convict women, and was vocal in claiming that SIDS doesn’t even exist, and is always really maternal murder. Back in the 90s this was recognized as a big feminist issue. Munchhausen’s by Proxy, like Gender Dysphoria, is a bogus psychiatric diagnostic category. Which is not to say that parents like Jazz Jennings’s, and the family of Corey are not abusive. They are. But the things that they’re doing do not even fit the diagnostic criteria that the promoters of Munchhausen’s by Proxy laid out.

    • Yes I actually can understand how some of these parents feel they are doing the right thing and end up going down this road. I could have been one of them. In fact, those of us who are bucking the trend are also bucking the medical establishment. That said, the parents who go on to parade their kids in the media, beg the public for money for “medical expenses” through GoFundMes…that’s taking things in a direction beyond taking care of their kids and into attention-seeking behavior.

      • Exactly. There is something very wrong with them. And someone should be studying it. Not to mention rescuing the kids. 😲

      • They’re convinced they are crusading for justice, you know? By becoming advocates for the movement, they’re hoping to build a better world for their kids. Or at least, some of them are. Which is why they would likely dismiss other parents’ opposing views as outdated, bigoted, and dangerous.

        They’re convinced the benefits are going to outweigh any potential risk/harm. And in a lot of cases I’m sure they are desperate to believe that transition will alleviate their kids’ existing mental health issues — which for a lot of these kids have been evident for a long time. The trans narrative would assure them that the kids only have mental health issues due to societal pressure regarding their sex-role nonconformity, and that the societal pressure will be reduced as the kid transitions and successfully passes. I am sure that many of them are scared to death already and beyond frustrated in dealing with the behaviors/ideation. You slap a suicide threat on that and … hey, it does not surprise me that people sign on. You know? No one is offering any other responsible course of action. As if there is none.

        For some people, for some amount of time, alleviating societal pressure by appearing as the desired gender does appear to work. But I can’t just think of how my kid is going to be short term. I have to think about how my kid is going to be at 30, at 40, at 50, at 60, dealing with the long-term effects of T and … still grappling with the mental health issues that were already evident when my kid was LITTLE and was in no way identifying as anything but the natal sex. Way before any supposed societal disapproval around gender presentation, for sure. I’m not going to be around to help, at some point. And I want to make damned sure that whatever the consequences are, the kid could not say, to my face or over my grave, “Dammit, mom, why did you not talk me out of this? why did you not protect me from this?” I want to make sure that whatever goes down, the responsibility is the kid’s. The choice has to be hers. Not a choice I will have made for her.

    • I do not believe that all parents are behaving as if they wanted to get attention for themselves. (That’s what I think of as Munchausen-by-proxy — parents who are doing things because of gaining acceptance and approval.) I think SOME parents — like the one who made a youtube video of giving her kid hormones fits that bill.

      But I think a lot of parents are quietly going along with “experts” because they think they should and because they assume that those people wouldn’t steer them wrong. And, frankly, I don’t think the professionals are all necessarily evil, but I don’t think most of them are as smart as they want us to think they are.

      It is usually a common standard of care to do the least to get the most benefit. Or to try several therapies or strategies, from least invasive to most, if the lesser treatments don’t pan out. But that’s not what’s happening. We’ve moved to a place where every professional I’ve spoken to refuses to do the least invasive treatment and see if that works. No, straight to hormones and surgery. And, my kid’s “identity” has changed in the past two years, even after she said she was trans. So, she hasn’t been consistent. And psychology/psychiatry talks a good game about how different things work for different people and no one is exactly the same. And yet that gets tossed out the instant a kid cries trans.

      • Munchhausen’s by Proxy is poisoning your kid, in some magical way that would require medical expertise and a university level bio lab in your basement, so that they’ll be sick with some actual disease in order to get the doctor not the public to pay attention to you. It has never had anything to do with seeking public attention. And the this thing, definitely does NOT exist.

        If we want to talk about seeking public attention through sensationalizing something about your child we need a different term for that. Munchhausen by Proxy is already taken. And means this other thing.

      • Munchausen just means to knowingly fake an illness. By proxy means to knowingly fake someone else’s illness. Some parents have faked their children having cancer to get public attention and money before.

    • I think part of it is that some people don’t question medical and psychiatric professionals. They figure these people know what they are doing and that their goal is to do no harm.

      Long story short, I question all of these people because I personally had some very bad experiences. My mother was not the type to question doctors. To the point she didn’t recognize the fact a pediatrician was touching me inappropriately for years while she was sitting in the examination room.

      I am definitely on the extreme end of distrust because of that, but it has served me well. These professionals are also human. So they make mistakes and they get things wrong sometimes. Most probably have good intentions, but to me they are not above being questioned.

      I don’t know if I totally buy into the Münchhausen by Proxy explanation, but who knows. I do find it a bit odd that someone would parade their child around who has these issues because man I think it’s pretty darn personal. Then again, I am not particularly eager in general to air my private business to the world. I suppose a reasonable argument for these parents doing that is that they believe in what they are doing. Maybe they think that putting themselves out there like that will help other people. I would like to put myself out there with my views on this to help people, but I can’t get past the thought of the negative attention I’d probably get by doing so. And this would be a serious invasion of my kid’s privacy. So for those reasons, this forum is about as good as it is going to get for now.

      And regarding the article. Ugh. I hate to make mean comments about people, but really I would not be happy to know that my child’s idol and role model was a mutilated prostitute. He/she is still a person and free to do what they want to their own body, but I am not thrilled with the sensationalizing of this. Something I tell my kids constantly is that stuff you see on TV and a lot of what you read/see on the Internet is often not entirely accurate. Do not believe everything you see, read, hear about, etc. Think things through for yourself. A lot of this stuff is entertainment and they want to get a reaction or sell you on something. And some people love attention. How they really feel and what their life is really like underneath that all is probably a lot different.

    • Regarding Munchausen Syndrome by Proxy, that term is just one of many medical terms to describe a law enforcement issue otherwise known as Medical Child Abuse.

      It is absolutely true that parents have been wrongly accused of this. The Boston Children’s Hospital case involving Justina Pelletier comes to mind (which is doubly disturbing to me given that BCH is also such a huge proponent of pediatric gender transition; that hospital can’t be sued enough for my taste).

      However, it’s also unfortunately the case that some people really do abuse children, the elderly, and the mentally disabled in a way that allows them to portray themselves as virtuous. This link will take you to a large review study of the literature pertaining to 796 case studies: https://www.ncbi.nlm.nih.gov/pubmed/28750264

      And, while I agree that in the current pediatric gender controversy, most parents are sincere and well-meaning, with the unethical behavior coming from professionals they’ve wrongly placed their trust in; I must confess that have encountered parents in discussion threads whose level of pro-transition self-righteousness crossed a line that made me think of Munchausen by Proxy. I wish it weren’t true, but my gut says otherwise.

  3. I feel like Alice through the Looking Glass…there are men who want their penis and a vagina. How in the hell can any rational, educated human being think this is normal? And health insurance, which I can’t even get for my routine health needs, will pay for this insanity? There aren’t enough words in the English language to describe how appalled I am. The backlash against this militant fad is already being hurled at at the gay community…and will only worsen as more of these stories hit mainstream media. Dark times ahead….for all of us.

    • Insurance (which means you, folks, via your premiums) now basically paying for the fulfillment of adult fetishism. O, brave new world.

    • I agree, not really normal. Maybe not abnormal enough to be harmful. After all, it’s not like they get excited over the idea of molesting children. So they get excited over the idea of having female body parts. So the answer is to have cosmetic surgery to get the parts. On what universe is this some sort of “treatment”?!

      But there is one reasonable consideration for allowing this. The fact of the matter is that historically some of these people went to extreme lengths to get these surgeries. Including going to shoddy quacks in foreign countries who would dump their body into a dumpster if they ran out of money. So there must be with some of these people an extremely strong and disconcerting feeling. So I don’t think we can dismiss the feeling as not causing problems for some. So what do we do? I just think why can’t we come up with and try some alternatives? And how has this turned into an option that will be so easy to get that anyone who just shows up at the office of a gender specialist will be sent through the body modification factory all in the name of allowing them to “be who they want to be”?

      Some people are honest about their feelings until the gender explanation BS gets planted into their heads. I spent some time in various chat rooms with these people learning about the stuff they talk about (yes I’m thorough..LOL). All the time you get some who come in there who say stuff like, “I’m having these really strange thoughts. I get so excited imagining myself with breasts. I am not turned on by my girlfriend, I am turned on at the thought of me having her body. What is this?” So then swoop in the gender fairies with, “Oh that’s totally normal. You are suffering from gender dysphoria. You have a feminine brain. You need to get to a therapist so you can get on hormones and go for the SRS. You have to do this otherwise you’ll never be right in the head.” Even if the person insists they don’t actually want to become a female, they are encouraged that they do. Talk about confusing and this is the kinda crap I don’t want my kid to encounter. But damn there is pretty much no way I can deal unless I lock him in a closet. Which of course I will not do.

      And I get the desire to make this a little more palatable for people. Problem is, what are we really doing to address the problem? Oh you get excited by boobs, alright lets mutilate your body, have you pop some pills, and we’ll throw a dress on you. Anyone who says you aren’t a real woman is just an insensitive bigoted jerk. But really I think the insensitive bigoted jerks are those who push someone like that in this direction. Does it help some? Maybe. But we really don’t know. There is very little follow up. And after going through all that, how many people would admit to that mistake? Best you can do is learn to live with it and carry on.

      My well meaning friends tell me that surely I can find some alternative treatment. Well, no I can’t. There is nothing else. It is either stay clear away from these people, or go along with them. That’s it.

      • Excellent comment. With regard to the chat room people you described with that ‘you better transition’ said to the person who just has the sexual fetish, tell your son they’re like the shitty friend who wants you to go shoplifting with them because they’re scared to do it on their own.

    • This so sad, especially that a psychologist enabled this. Not only did she lose her sight, but her mother and sister stopped talking to her.

      At the end of the article she is quoted:
      “When there’s nobody around you who feels the same way, you start to think that you’re crazy. But I don’t think I’m crazy, I just have a disorder.”

      It makes me wonder. If she thought she was crazy, maybe she wouldn’t have blinded herself. It sounds like since she “just” has a disorder, that she is using this as her reason to feel justified in doing this to herself.

      • WTF is going on in our world?!?! This better have a cabal of disability fetishist or serial mutilator shrinks behind it. Cuz if normal medical people are embracing this …

  4. So this guy will do transracial surgeries too, I assume? He is one patient away from being shunned for making the movement look bad.

    • I’ve been looking into what a lot of WPATH members are saying in public forums. Basically, the trend is now moving toward giving the patient exactly what they want. The next version of the ICD diagnosis codes (ICD-11) will jettison “gender dysphoria” because activists have lobbied for there to be NO disorder or illness attached to being “trans.” The new term will be “gender incongruity,” which will be seen as a normal variation in human experience. They also don’t want “distress” to have to be part of diagnosing someone. But they also want insurance to cover it. A sticky wicket. In essence, the providers are totally enabling people labeling themselves as “trans,” “genderqueer,” “nonbinary,” as WELL as changing identities as often as they want (i.e. “gender fluid”) but they should be able to receive surgeries and hormones on demand. I’m serious. This is exactly where this is all going. If they manage to get insurance coverage for basically what amounts to a lifestyle choice, it will be quite the coup.

      • I think insurers are going to push back. If there is no distress to treat it’s cosmetic. Insurers are in the business of denying as many claims as possible. You could in theory get any procedure if you “identify” with it. Narcissistic people, who happen to be opportunistic and vain, will scam the insurers into oblivion.

      • They’ve managed to walk the line so far. Even with “gender dysphoria” the current diagnosis, they are insisting that it’s not a “disorder.” They say it’s a biological issue–in other words, they are relying on the “born in the wrong body” explanation, so that altering the body is a simple matter of correcting some sort of mistake. But yeah, this would take it several steps beyond that to what DOES seems like cosmetic surgery. I know that many trans activists are now saying you shouldn’t have to experience “dysphoria” to get transition-related health care; that if you say you’re trans, you just are, dysphoric or not. I frankly don’t know how they’re going to keep diluting the diagnosis and still get insurance coverage, but they are apparently going to try. See here:
        https://www.facebook.com/groups/WPATH/permalink/1071555382888887/

        //4thwavenow.com/wp-content/uploads/2015/10/wpath-gender-incongruence.jpg

        People don’t realize how much the gender specialists are kow-towing to what the activists want–which is basically “give me hormones and surgery cuz I said so.” To the point that anyone should get hormones just because “it’s time for a change.” Further down in the same thread:
        //4thwavenow.com/wp-content/uploads/2015/10/wpath-joyful-life.jpg

      • I don’t think I slept a full hour last night because I could not stop thinking about this. I’m hung up on the fact I don’t know if this “treatment” helps or works. I can remain open minded enough to entertain the idea that it might be a viable treatment, but nobody can tell me that.

        I think my kid is smart and if he can help it, he won’t do this. Problem is, if they make it that easy, I worry.

      • If it’s a well-functioning ADULT who wants to transition, that’s a totally different ballgame than a child or a teen. But then again, why would a non-dysphoric individual want to transition?

        I just finished reading two of Jenny Boylan’s books. Unlike the trans kids I’ve been reading about here, Jenny had to complete a number of requirements that took a couple of years before the docs would perform sex reassignment surgery. A doctor who evaluated her at the beginning of the process said that Jenny (then Jim) was one of the healthiest, highest functioning patients he’d seen. This doctor felt Jenny was a good candidate for transition was precisely because she didn’t have other mental health problems. But she had been struggling with gender dysphoria since childhood and couldn’t cope with it anymore.

        Jenny transitioned in the late 1990s and early 2000s, which was quite awhile ago but not exactly ancient history. But the careful process she described in her books is so radically different from what the doctors are doing now. What bothers me is that this rush to transition is happening to KIDS. Jenny Boylan was in her forties when she transitioned, not a kid or a teen or even a young adult.

        No, the docs aren’t doing surgeries on minors (yet), but blockers and hormones cause permanent physical changes. Even Jazz Jennings has said she wants biologically-related children. I saw where people came down hard on her for that remark she made about her sister serving as a surrogate mom. But that’s the kind of “solution” any magically thinking teen would come up with. The real issue is that a fourteen-year-old shouldn’t have to make these kinds of decisions about his/her fertility, or lack of it.

      • 4thwave I read through that stuff that you linked from Facebook. The person I saw is in that forum. She pretty much admits that she gives the diagnosis even if the person does not exhibit any stress related to their gender identity. She back handedly says that she just calls it how she sees it, who is she to judge. In other words, I guess it is good enough for them to show up in her office wanting a sex change operation for whatever damn reason.

        I guess since I was there it was presumed I wanted to alter my kid. Hell no I don’t. I wanted information and to know what this was about. Had I any idea she wouldn’t even bother to listen to me, I would never have stepped foot in her office.

      • Wow. So you actually saw the “gender specialist” you visited talking on that Facebook page? I would recommend screenshots of her comments, vs. making any comments of your own there. It is mind-boggling, isn’t it? I sent you a private email just now.

      • … In the uk a diagnosis of gender dysphoria and the act of transitioning can qualify trans individuals for lifelong disability benefits as well as free NHS therapy, treatment and surgery. This psychiatric diagnosis some of them seem so keen to dispute, absolves the transitioner of any requirement to seek work, entitles them to demand housing, transport, welfare and social support from the state .. they have the luxury of no responsibility and all the time in the world to disappear up their own arses…even if theyre a middle aged man who has just walked away from a wife and kids ..so erm.. talk about shooting yourself in the foot..Even as it stands, where a psychiatric opinion is all that separates a serious diagnosis from a load of old twaddle and codswallop, the justifications for such extreme and destructive treatments are nothing but logical fallacies – none of the arguments hold any weight.. because there arent really any arguments except ‘i want’..and ‘if you dont let me have it i’ll kill myself or be miserable for ever and EVER AND THEN YOU’LL ALL BE SORRY YOU BASTARDS!!!’ .. . there arent any other mental illnesses im aware of these days routinely treated with a lifetime of untested drug regimens, dangerous surgeries and the destruction of healthy organs. So let them keep digging themselves into a hole. Without an illness there is nothing to treat, just scribble out any mention of it in dsm5 with a biro and youre cured!. marvellous! carry on.

  5. (Sorry, this has turned out to be a long and maybe tedious comment, so please feel free to edit or not post, but use the info if you like. I just thought it was important to illustrate how devious organisations like WPATH and their allies are.)

    I don’t know if it helps to be clear on what the current situation is?
    When the current DSM V was published Gender Identity Disorder was replaced by Gender Dysphoria in order to remove the stigma of the word ”disorder”. Gender Dysphoria was also given it’s own chapter separate from Sexual Dysfunctions and Paraphilic Disorders.

    This is what APA said about the need to have a diagnostic label……
    ”To get insurance coverage for the medical treatments, individuals need a diagnosis. The Sexual
    and Gender Identity Disorders Work Group was concerned that removing the condition as a psychiatric diagnosis—as some had suggested—would jeopardize access to care.”
    This is taken from a very clearly worded statement issued by APA in 2013 prior to the publishing of the DSM V . Link here http://www.dsm5.org/documents/gender%20dysphoria%20fact%20sheet.pdf

    This statement also makes it quite clear that Gender Non-Conformity is not a mental disorder. ”For a person to be diagnosed with Gender Dysphoria, there must be a marked difference between the individual’s expressed/experienced gender and the gender others would assign him or her, and it must continue for at least six months. In children, the desire to be of the other gender must be present and verbalized. This condition causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

    WPATH had considerable input, for example the name Gender Incongruence” was initially proposed by the DSM V work group and Gender Dysphoria that preferred by WPATH.

    This is taken from WPATH’s reaction to the initial recommendations made by APA on the rewriting of Gender Identity Disorder’ diagnosis found in DSM IV…..

    ”Given….WPATH’s recommendation for diagnoses based on distress instead of identity, it should come as no surprise that we favor changing the name of the diagnoses from Gender Identity Disorders to Gender Dysphoria. While we think the proposed new name of Gender Incongruence is an improvement, we prefer the term Gender Dysphoria to reflect that a diagnosis is only needed for those transgender individuals who at some point in their lives experience clinically significant distress associated with their gender variance. Moreover, the term incongruence implies that congruence is the norm and that incongruence is per definition problematic, which is not necessarily the case. A person can be comfortable with variance among the various components of one’s sexual identity .”

    The above citation comes from this WPATH published document….http://www.wpath.org/uploaded_files/140/files/WPATH%20Reaction%20to%20the%20proposed%20DSM%20-%20Final.pdf

    So,4th Wave, you are saying that WPATH now want to rename Gender Dysphoria as Gender Incongruence, a name that they quite clearly rejected for the DSM V and they also, more subtley, want to remove ”distress” from the diagnosis. My head has been spinning trying to get around this backtracking, or maybe we just missed where they were going all along. I hope APA stands up to this.

    Otherwise, I too shall be standing under the trans umbrella as someone who is sure as hell affected by trans-issues. I could say that I have ”clinically significant distress or impairment in social, occupational or other important areas of functioning” because it hurts and, yes it causes me shame and distress to have to spill the beans on what I consider private and personal information when I have to do business with my ex in public. My children and I have actively avoided social situations which may bring us into contact with him. Yes, at the very least I should be able to claim for my own and my children’s therapy costs while my ex has everything provided, therapy, hormones and, when he eventually gets round to it, surgery.

    APA is quite clear that to get insurance coverage for medical treatment a diagnosis is required. Otherwise why bother with psychiatrists in the first place? Let’s all just choose whatever medical treatment we want, whenever we want. I don’t think so.

    • I do hope that the APA will stand up to this, but I am not holding my breath. These are the guidelines the APA released back in August:
      http://www.apa.org/practice/guidelines/transgender.pdf

      Some disturbing quotes (by the way TGNC=Transgender and Gender Nonconforming according to the APA, they treated as the same):

      “When working with adolescents, psychologists are encouraged to recognize that some TGNC adolescents will not have a strong history of childhood gender role nonconformity or gender dysphoria either by self‐report or family observation (Edwards‐Leeper & Spack, 2012). Some of these adolescents may have withheld their feelings of gender non‐conformity out of a fear of rejection, confusion, conflating gender identity and sexual orientation, or a lack of awareness of the option to identify as TGNC. Parents of these adolescents may need additional assistance in understanding and supporting their youth, given that late onset gender dysphoria and TGNC identification may come as a significant surprise.”

      “Mental health problems experienced by a TGNC person may or may not be related to that person’s gender identity and/or may complicate assessment and intervention of gender related concerns. In some cases, there may not be a relationship between a person’s gender identity and a co‐occurring condition (e.g., depression, PTSD, substance abuse). In other cases, having a TGNC identity may lead or contribute to a co‐occurring mental health condition, either directly by way of gender dysphoria, or indirectly by way of minority stress and oppression (Hendricks & Testa, 2012; Meyer, I., 1995, 2003). In extremely rare cases, a co‐occurring condition can mimic gender dysphoria (i.e., a psychotic process that distorts the perception of one’s gender; Baltieri & De Andrade, 2007; Hepp, Kraemer, Schnyder, Miller, & Delsignore, 2004).”

      “Psychologists are strongly encouraged to be cautious before determining that gender nonconformity or dysphoria is due to an underlying psychotic process, as this type of causal relationship is rare.”

      • OMG! It’s like they anticipated all the completely legitimate and good objections and decided to say ‘well you know if you think it’s a psychosis then you just suck’. If you’re not already familiar with how skevey the DSM is you’re in for a disgusting treat. I found this very brief post by Paula J Caplan, but for the full feast you want to check out her book They Say You’re Crazy, How The Worlds Most Powerful Psychiatrists Decide Who’s Normal. The process for producing the DSM is beyond slack.

        https://www.psychologytoday.com/blog/science-isnt-golden/201111/challenging-dsm-5-growing-fast

      • Thank you, overwhelmed, for linking to that. I can’t say that I’ve read all 55 pages yet, but a few things jumped out.

        Yes, it’s concerning how they (APA) have lumped together Trans and Gender Non Conconforming together for the entirety of these ”Guidelines” and come up with TGNC. To me it is not the case that these are the same thing, nor does one automatically lead to the other. Gender Non Conformity can be a lot of different things to a lot of different people. GNC people can be heterosexual, homosexual, any of the other labels such as gender queer, or trans. Gender conformity is something societal. It becomes a problem when people put labels onto GNC people ; for example the boy who likes to wear pink and play with barbie dolls is labelled as trans. Who’s to say that it is not a phase, or that that child may be a perfectly healthy and well adjusted gay man in later life? Putting T together with GNC is wrong, in my opinion.

      • So … the APA has summarily decided that butch isn’t a thing anymore, then? That all GNC natal females are trans by default, and if they have not self-identified like that, then they’re probably simply repressed?

        Ai yai yai.

        I love how the late-onset ‘transness’ is also simply dismissed as repression or ignorance of the option to identify as trans. The idea that it might be the result of a TREND is beyond the conception of these people. Again … I think they are so influenced by the notion that ‘no one would choose this’ that all they know about the way teenagers passionately latch onto trends that seem to give them a feeling of affiliation goes right out the window. I KNOW they know these patterns. I know they have seen these patterns before. But trans is the third rail, professionally speaking. Here there be dragons. So they forget what they know. Except for a few (like Lane) who have the guts to speak up. Sometimes at the cost of their jobs.

      • I’m having trouble figuring out where to put my ‘replies’. The “not tedious” one was addressed to transwidow.

        And this one is addressed to puzzled. Ai yi yi, indeed! Yes the gender therapists and the APA have no conception of all kinds of things that the average second-year soc major is perfectly well aware of. Whatever the reason they should be held responsible for their incredible stupidity.

        The APA are a bunch of psychopaths, there I said it. They have long shown themselves to be willing to accommodate whatever sector of the emotion illness industries comes calling. It would only be surprising if the APA did not rolled over for the trans industry.

    • This cultural phenomenon is unlike anything before in modern history. The entire societal power structure is telling you you’re wrong when you feel you’re right. And all you want to do is protect your kid, like all good parents. Vent away.

    • I wonder if family members of lobotomized patients felt like we do. All the psychiatrists were saying this treatment was going to fix EVERYTHING. And the spouses or parents or other loved ones were thinking…”I’m not so sure about this. Seems awfully extreme.”

      I’m going to see if I can find something on that.

      • I’ve had similar thoughts. But then I’ve also had thoughts that I wonder if we sound like the people objecting to not calling homosexuality an illness. It just does not feel the same to me at all though. I cannot see it as normal to chop off body parts. And then I start to wonder if all this time I’ve been a lot more closed minded than I thought I was. That thought stresses me out too. I have really thought hard about this though. I did not come to this conclusion easily or quickly.

        And then I worry, will my kid be in therapy years from now listening to the therapist talk about what a crazy closed minded bitch his mother was. That I was just feeding him BS information. Ugh…Am I a horrible person?

        I tried to find a therapist to freaking talk to me, but she kept saying stuff like maybe I can’t accept that my son is really a daughter. WTF?! That I’m disappointed. If I’m sad, it is because my kid somehow has some unusual problem that I’m told is treated by mutilating his body and having him take hormones that I myself won’t touch with a 10 foot pole because of all the issues they have caused various family members. But I never cared whether he was a girl or a boy. Or about what he wants to do in his life.

        And here I am wasting my life and time just being eaten alive by the stress and anxiety of these thoughts. Maybe I need a damn lobotomy.

      • Being gay or lesbian does not involve denying biological reality and becoming a life-long patient, pumped full of dangerous drugs and subjected to repeated plastic surgeries. Homosexuality exists in the animal world in many species (easy to google). I don’t think there is any evidence of animals trying to tear their genitals off or attempting to attach a stump as a fake penis. I’m sure “transgender” chimpanzees would easily be clever enough to try something like that, and they are our closest relatives, DNA-wise, along with bonobos.

        When I was first confronted with this, I was fed the line that it was the same as accepting a lesbian daughter. IT IS NOT. It is a very convenient cooptation the trans activists have accomplished. They have hoodwinked the whole damn world, INCLUDING many (most??) gay and lesbian people. If they would look at data from years past, they’d see that the vast majority of gnc kids grow up to be gay/lesbian!

        If you look at the screenshots I posted in my comment in this thread, showing WPATH clinicians discussing how essentially anything goes with this “diagnosis,” you’ll see how much it is the sanctification of a warped belief system. (The closest analogy I can find to all of this is a religious cult.) Stay strong. Love your lobotomy comment, BTW. Maybe we’d all be happier. Hey, let’s start a movement. Lobotomies for “Unsupportive” Parents of “Trans” Kids!

      • You know, what I wonder is what medical malpractice insurers think about this. While health insurance may readily pay for this stuff, it’s the medical malpractice insurers who will be on the hook when this all blows up and the lawsuits start flying. If anyone thinks that’s far-fetched, just remember the nicotine settlements involving tobacco companies and smokers.

        If this transition madness results in worse suffering for patients or new distress because of inability to detransition or side effects from long-term use of hormones, I don’t think the very very lax standards of “informed consent” are going to insulate these transition mills from liability.

        Considering medical malpractice insurers are all about risk management, you’d think they would be extremely concerned about the lack of safety data regarding off-label use of medications on very young patients.

      • Best account of the lobotomy craze I’ve ever read is in a fantastic book called Mad in America. It came out in the early zeros, like 03 maybe. Lobotomy is like one chapter.

      • “But then I’ve also had thoughts that I wonder if we sound like the people objecting to not calling homosexuality an illness.”

        During the 90s this particular homosexual got really damned sick and tired of the way the pro-sadomasochism crowd piggy-backed on the radicalized gay rights movement that sprang up in response to the AIDS crisis. And oddly enough, the trans movement started piggybacking on the gay rights movement right around the same time. It’s actually not that surprising, because both trans anythingism and sadomasochism are all about roles.

        I wish I had a nickel for every time I head something like this: “But, how can you say that’s a perversion when some people say homosexuality is a perversion, too!”

        And then I’d point out that you can call an apple an orange all day long, and it will still be an apple. However, that doesn’t mean that an orange isn’t an orange, or that you’re mistaken to call an orange an orange, simply because there are people out there who can’t tell the difference between oranges and apples.

    • unrestricted …. you really gotta take a break from this stuff sometimes. you really do. I don’t know how 4thwave manages it. there have been days when I have been quite sure when I’m thinking way more about these things than my kid is. And that’s just silly. And then you completely lose the ability to find good things in each day, because your brain and heart are so full of this trouble and fear and worry about what’s coming.

      Do stuff that reminds you who you are, outside your role as your child’s parent. This is basic self care and … you have to do it, as tough as it is. Or you’ll get sick. Physically, mentally, both. IMO.

      • unrestricted, you sound like a great mom! But, I totally agree with puzzled. It sounds like you may need to detox from all of this for a little while. Take a break. Realize that you are doing the best that you can. From what I have read, this may take a lot longer to get through than you think. It may be more like a marathon than a sprint. You will need to take care of yourself so that you can last.

        I know I personally need to pull away from this subject every once in a while. I am too adept at catastrophizing where my daughter may be in the future. Sometimes it feels like it literally drains the life out of me.

  6. Quick reading of information on lobotomy…horrifying and eerily similar.

    Yeah I do stay pretty busy usually. And usually I do ok, but then geesh sometimes I can’t stand the thought of any of it for one more second.

    Part of it too is that I grew up with mentally ill family members. I was the oddball in the family. This just has dragged out so many lousy memories. Although, really nothing bad has actually happened. I just don’t know how in heck I’m going to manage it if it does. But then why sit around worrying about that? I know I’m being ridiculous.

    But yeah I think I do need to distract myself more for awhile.

    • I have been in the place you are. Sometimes I fall back into it. This week was bad, for a variety of reasons.

      I suggested it before and I’ll do it again because I’ve found it very helpful. Meditation. Ten minutes a day is helpful and I’ve found 20 is even better. There are plenty of apps out there — I use Headspace. (I am not affiliated nor do I get ANY reimbursement for it.) It’s narrated (the founder teaches you techniques and talks you through them) by a former Buddhist monk. He’s British, his name is Andy, I find his voice extremely calming and restful. I meditate with all of my kids, too. There’s a series of 10 meditations which are free and then you pay per month or per year or a lifetime subscription. But, there are lots of options, if price is a concern, you can find tutorials on youtube for free. It is a great help to alleviate anxiety.

      Also exercise. Doesn’t have to be anything extreme, but doing something grounded in your body every day increases serotonin in your brain and makes you feel good. I practice a martial art and when things are too busy and I can’t get to class, I get much more anxious. (Aside: My art is a fighting art and we spar. Most of the other students are teenagers and it is VERY cathartic to punch a lot of teenagers and pretend that they’re MY teenagers. Heh.)

      And, it’s a very hard time right now. Not just because our kids are worrying, but because you feel unmoored when you seem to hold an outsider opinion. Also, the entire culture is obsessed with this. As I complained to a friend, “I can’t even watch an unrelated reality show which entertains me and relaxes me without seeing an ad for that God damned MFing Jazz show. Or freaking Jenner. Or listen to NPR without “Up next, a story of bravery and wholeness from a transgender correspondent.” It feels like being targeted, sometimes.

  7. This is in response to fourth waves comment where she talks about being told this is like having a daughter who is a lesbian. It got me thinking.

    If you compare trans and gay side-by-side, particularly think gay people in the 19th century, they both have subcultures. But the trans try to bring their subculture out and force us to participate in it. Whereas the 19th century gay subculture was secret. The real activity of being gay isn’t the fighting for rights it’s the just being yourself. And it really was your real self that you were expected to hide. Like in the Rudolph The Rednosed Reindeer cartoon when the guy puts mud on Rudolph’s nose. So we can’t see that it lights up. That could be a gay Rudolph. A trans Rudolph would be having the nose cut off and changed into something else. And then make the claim that he was now a different species. With trans there is the shoddy change into a different biological thing, then there’s the extreme in-publicness about it. Both the activism and that so much of being trans is about the clothes you dress up in out in public. The whole thing has this creepy autogynephile vibe. Who want other people looking at them as part of their fetish. The whole society is being conned into believing in a new sexual minority thing that is really a subculture based on that fetish. It’s super bizarre. And I would bet dollars to donuts that in order for this to happens there must be people in very large numbers who are pro-gay rights while at the same time think of homosexuals as freaks. Which is really not the same thing as not being prejudiced. So something that really is freakish and bizarre comes along and they absolutely cannot see the difference.

  8. For those who are looking for a lawsuit parallel, check this out:

    http://www.youhavealawyer.com/risperdal/

    Risperdal is an antipsychotic drug that can cause male children to develop breasts. But in these cases, the boys don’t want breasts and have to undergo a masectomy to get rid of them. Like the drugs given to trans kids, Risperdal was often prescribed for off-label uses.

    Anyhow, if any of the parents here come across a gender specialist who gives you the “blockers and hormones for kids are safe” argument, ask that doc what he/she thinks of the Risperdal lawsuits.

    • There was a time when my kid was in pretty grave danger of getting diagnosed with ‘child bipolar.’ She sure met all the supposed symptoms for diagnosis. But I was so leery of the potential side effects of the antipsychotics that I just backed away, kept looking for less extreme tactics. A few years later the whole business had been discredited. Despite a decade of being widely embraced in the psych world, and a lot of stories in the print, broadcast, and online media, it all ended up being rejected as a wrong hypothesis. Too bad some of the treated kids ended up with gynecomastia, diabetes, tardive dyskinesia, among other unwanted permanent side effects.

      Child bipolar also had its superstar adherents in the psych world, generally linked to pharma firms via research $$, as exposed in Congressional hearings. They got wrist slaps in the end and are still out there doing … what they do.

      Gary Greenberg’s “The Book of Woe,” about the history of the DSM, has lots of additional sobering info.

      • Holy macaroni! I only had the tiniest inkling about that child bipolar thing. Is there a book about that? Like a big juicy exposé?

      • Peter Breggin, M.D.has written at least a couple books about the way children, in particular, are being increasingly overdiagnosed with all kinds of severe mental illnesses and prescribed all kinds of heavy-duty psychiatric drugs. (In the last ten years, for example it’s even become fairly common to prescribe antipsychotics for TODDLERS.) Breggin’s a psychiatrist himself; he believes most psych meds cause long-term damage. He’s spent much of his career advocating for a return to empathy-based counseling as the primary form of mental health treatment, even for people with very severe symptoms.

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