Nonbinary patient sues Utah MD who removed both ovaries

The story was published this morning in the Salt Lake Tribune. Leslie Shaw has filed a malpractice suit against  OB-GYN Rixt Luikenaar for removing both ovaries (instead of  only one as had been agreed, Shaw alleges), rendering Shaw irreversibly infertile.

Dr. Luikenaar has been mentioned in a former 4thWaveNow post, “Shriveled Raisins: The bitter harvest of affirmative care,” which covered the impact of transgender hormones and surgeries on future fertility.

Luikenaar’s surgical plan was to include a hysterectomy, the removal of both fallopian tubes and the excision of one ovary, court papers say. Shaw wanted the second ovary retained so natural hormones would still be produced and so Shaw might have a biological child one day.

salt lake trib story

“I absolutely thought we were all on the same page,” Shaw said in an interview. “I said to [Luikenaar], ‘I’m only at peace having this surgery as long as one ovary is retained.’ ”

Luikenaar’s response: “We’ll leave the pretty one,” court papers say.

Instead, Shaw awoke after surgery to learn Luikenaar had removed both, the lawsuit states. Post-operative notes say both ovaries were removed because Shaw was suffering from endometriosis, but subsequent testing of the tissues found no sign of the disease, the lawsuit contends.

Surgeries and hormones for nonbinary, genderqueer, and gender fluid individuals have become more frequent in the last few years, with top US gender doctors publicly supporting such interventions. (An upcoming post on 4thWaveNow will document one such MD praising hormones and surgeries even for “gender fluid” people under the age of 18 who may change their identities in the future).

Shaw was born female and no longer identifies as a woman, but as a “transgender, nonbinary or agender individual.” Shaw came out as trans in 2013 and prefers to use the pronouns “they” or “them” instead of she…

…The surgery has left Shaw in a permanent state of menopause, according to the lawsuit…

…Court papers also say that Luikenaar has used Facebook to try to pressure a mental health care provider to give her Shaw’s records. The records were not released, court papers say.

“I genuinely worry,” Shaw said, “that other folks are not receiving good care but are afraid to come forward.”

In April of last year, Luikenaar took to her professional Facebook page to announce she would no longer be seeing trans patients due to the lawsuit.  She shared her post on the public WPATH Facebook page.
FACOG announcementLuikenaar’s announcement did not sit well, however, with many WPATH members, who objected to the idea that the doctor could choose not to see trans patients. Luikenaar subsequently deleted her post, but her situation–and the ethics of an MD terminating care for trans patients–continued in a new posting,  with many comments, that is still available on the WPATH Facebook page.

Luikenaar discussion

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34 thoughts on “Nonbinary patient sues Utah MD who removed both ovaries

  1. I foresee many many more lawsuits. Did signals just get crossed? Did someone change their mind about what would be the correct surgery at that time? How is a doctor to do surgery to make the body of a “transgender, non-binary, or agender” individual match their mind? I don’t know how they will sort out in court, but I expect that decisions will be all over the map.

    Liked by 8 people

  2. Wait so she was voluntarily having a hysterectomy and removing one ovary but is concerned about fertility? Having surgery to remove reproductive organs is at odds with aiming to retain reproductive function. It’s literally putting all your eggs in one basket. There could be problems extracting eggs, with the one ovary itself vs the other one, implanting embryos in someone else, a partner who is infertile, lack of funds for surrogacy, etc. All problems that are more healthily solved by not having elective surgery. An ethical surgeon would have explained how having one ovary only reduces your fertility greatly to begin with. I’m not trying to diminish what she went through here but emphasize that the surgeon seems to have made more than one lapse in ethics. The facebook messaging is disturbing if true.

    Liked by 7 people

    • The article states ‘Shaw, 37, was suffering from menstruation problems, including painful periods that lasted several weeks’, but that’s too vague to say whether or not a hysterectomy was in fact necessary. The fact that she was still menstruating also says she wasn’t taking testosterone.

      I do think this lawsuit isn’t frivolous, but it’s also not like she went in to have endometrial adhesions removed and they took out everything. If you want a biological child, getting most of your reproductive organs removed is clearly antithetical to that.

      Frankly, it does in fact seem like a bad idea for a doctor to perform hysterectomies/oophorectomies/etc. on any trans person who has not been on testosterone for several years (since that already renders a person sterile) or has a true medical necessity such as cancer. Such a potential for lawsuits.

      Liked by 3 people

      • Actually, testosterone doesn’t necessarily end menstruation. I had a problem with my pituitary some years ago that put my T level at zero (women produce some T, men produce some estrogen). I was given testosterone, and my periods did not stop. Also, didn’t feel like a man, and I was angry rather than happy. (I was lucky that the source of the problem was found in a short time)

        Also, testosterone had no impact on my menstrual problems that came from endometriosis and fibroids. I eventually had a hysterectomy (kept my ovaries & cervix), which made for much greater comfort.

        Liked by 2 people

  3. When I read this my thoughts were that this made no sense from any standpoint. There are no “non binary” mammals. Any ethical surgeon should not take orders from the patient. Even if the survey had been done to the patient’s specifications, I fail to see where it made sense from either a medical or psychological standpoint. Gender ideology has hijacked all disciplines and rationale.

    Liked by 9 people

    • I’ve seen Natalie reed (and others…)advocating for srs that would have both a neovagina and natal penis because dysphoria can make people distressed unless they have a configuration that isn’t actually found in nature. Surgeons dont do this (yet?) and its called discriminatory. Males that call themselves “bigender” are often wanting these fantasy surgeries.

      Liked by 1 person

  4. The thing about this story that strikes me is that it’s really not that unusual for a doctor to make a mistake –it’s why they all carry malpractice insurance. (A part of me wonders if this would even have been a news story at all if the same thing would have happened to someone who didn’t “identify” as some gender or the other.)

    The significance to me is that all surgeries carry risks whether from error or other unforeseen consequences such as infection or adverse reactions to anesthesia, etc., and whether the proven benefits (inconclusive, according to an exhaustive meta-study of research on “trans” outcomes performed by the govt. office of medicare & medicaid services) outweigh the risks involved. Are any of these surgeries –given such risk –ethical?

    Should someone who “feels” that sex-based stereotypes don’t reflect their “authentic selves” be able to *compel* ANY doctor, as Karasic claims, into performing surgery on healthy tissue or face charges of discrimination & loss of medicaid/medicare funding?

    The ob/gyn here, regardless dubious motivation, had expressed the intent not to perform such procedures & was basically informed that under the ACA rulings, she would HAVE NO CHOICE if she wanted to continue her practice as is on patients with biological (rather than metaphysical) need for her services.

    This is not o.k. Not by a long shot.

    https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=282&bc=AAAAAAAAAAQAAA%3d%3d&

    Liked by 4 people

    • Seriously? There’s some entity that stands over doctors and tells them they HAVE to do some particular thing? Because we can’t even get them to do their jobs properly. Including because there’s no enforcement mechanism. Doctors throw people overboard and screwup uncomplicated diagnoses all the time. And deploy the “it’s all in your head” bomb. I guess the difference here is some other doctor invented these weird modes of surgery such that the patient can come in and demand them. 🙄

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  5. It is sad and it is a mental illness, often a transient mental illness. If I wanted to change the way I look (as in look like a younger person) it would be coded as elective surgery and I would have to pay for it.

    Liked by 2 people

      • Exactly, and if I threatened to kill myself unless I received surgery to make my boobs round and perky and my tummy flat, my insurance program certainly would not be willing to pay anything toward those surgeries, although they probably would pay for some mental health treatment, which would be appropriate for someone who feels suicidal.

        Liked by 3 people

  6. A glance at Luikenaar’s Facebook page shows a couple of things. First, it is replete with glowing testimonials, many showing a very high degree of emotional commitment to and involvement with this doctor. Words like “amazing,” “super-hero,” and “authentic” and statements like “I owe her so much of my happiness,” and “thank you for helping me become the person I am.” In my view, engaging with a medical professional, or any professional really, on this level, is a bit of a fraught situation. I think it’s wise for both parties to maintain more of a critical distance; at the end of the day the doctor is not there to validate a person or their choices, but to perform professional duties to the best of his or her abilities. Investing any professional with this kind of power is bound to end badly for at least some people. This type of emotional entanglement may also help explain why so many transgender individuals and parents, seem to become so credulous and trusting in circumstances that actually demand a high level of skepticism. Perhaps it is the case that for some people, consulting a “gender specialist” feels like a very affirming experience, one that is hard to come by in everyday life, and this leads them to invest the relationship with qualities that don’t lead to good decision-making.

    The second observation is kind of sad. Luikenaar claims to have delivered “over 3000 babies,” and to have had several of her own: there are some sweet pictures of herself with what are presumably her own young children. It is poignant that, as personally aware as she appears to be of the joys of motherhood, she is apparently less concerned about preserving that option for others.

    Liked by 5 people

  7. By definition i think surgeons willing to remove perfectly healthy organs to validate an obvious delusion or even just a mutable identity are dangerous and totally open to malpractice lawsuits.. and i hope there are many, for this is insanity. The relationship between these trans affirmative surgeon, endo’s and shrinks is more akin to a Folie à deux than the more normal professional relationship between a doctor and a patient im familiar with. i strongly suspect litigiousness is going to increase and they are going to have to have a massive rethink about this.. the problem being of course that its very hard to turn a yes into a no, unlike the other way around..this is going to be hard and expensive and bewilderingly complicated to step back from.

    Liked by 2 people

  8. A large percentage of the income of plastic surgeons is from “elective” surgery. Hard to stay unbiased and question your patients” decisions when this is the case. Hence we get Michael Jackson, a man who wants to look like a Ken Doll, and numerous transgender mutilations. But even someone getting a more minor procedure like a nose job shouldn’t be encouraged to think it will radically transform their life and solve most of their problems.

    Liked by 2 people

    • Agree completely with one addition. They already think it will magically transform their life, they should be dissuaded from thinking that. And of course the cosmetic surgeons don’t want to be bothered to do that. 😕

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      • Our local weekly paper just published an article about an initiative to get the school district to adopt new LGBTQ policies. One of the chief activists is the mother of a transgirl who graduated from my daughter’s HS. This transgirl also happens to be the grandchild of a prominent retired general who held a key position in the Obama Administration at the helm of a US Intel Agency. There was no name dropping in the article and I have no idea what his feelings are on identity politics but I am irritated that she is behind a movement that wants special accommodations for every confused high school teen, including all the non binary kids who are allegedly terrified to “come out”.

        Sometimes I feel that until everyone reaches Peak Trans kids like my daughter have no hope in learning to cope with reality because they will feel entitled to special treatment. They aren’t even given the space to work through their feelings with adults on standby ready to affirm and force others to do the same.

        Liked by 1 person

  9. There seems to be an inconsistency in the story. The story says the patient wanted both Fallopian tubes removed but wanted to retain one ovary.

    I did a bunch of Googling, and I’ve yet to find anything that supports keeping an ovary without its accompanying Fallopian tube. Looking at images of the female reproductive system, the ovary is attached by ligaments on one end to the uterine wall, on the other end to the Fallopian tube. There is also a membrane that further attaches the ovary to the tube which contains blood vessels.

    The only thing I’ve come across is a “Salpingectomy and Delayed Oophorectomy”
    which is done for certain ovarian cancers which originate in the tubes, and the ovaries are retained to keep a young woman from going through premature menopause. However, the ovaries are eventually removed (delayed oophorectomy) and I wonder if such an ovary would even produce viable eggs, as “part of the ovarian blood supply is coming from the uterus and is compromised when the uterus is removed, resulting in reduced ovarian activity.”

    Liked by 1 person

    • Yeah, the whole thing doesn’t make any sense to me. I wonder if this woman had a consultation with an actual specialist about how to address her painful periods, or if she just decided on this bizarre surgery after talking to her trans community. I feel sorry that she is now infertile and reliant on exogenous hormones, when clearly she thought her plan would avoid that, but wonder who approved this surgery to begin with.

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  10. I missed this in the first article:

    “A hearing was held in April 2016, with the DOPL’s [Division of Occupational and Professional Licensing] panel concluding that Luikenaar had breached the standard of care. The panel said the removal of the second ovary was not medically necessary, agency records show.”

    So the State licensing agency has already determined that Luikenaar was negligent. Interesting.

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  11. Would it not be easier – and ethically superior – to change a patient’s mind, rather than embark on a series of changes to the body that do not provide what is promised (a “sex change”) but merely a simulation that may or not be even aesthetically successful?

    When I was growing up, not only was the legal drinking age 18, but parents could provide alcohol to younger kids, the logic being that it was better for the kid to learn about alcohol from loving and experienced adults. I remember enjoying the feeling of being one of the “grown ups” at the table when served a glass of wine in a restaurant. I also learned that my mind could engage in more than one state, that mind was kind of a fluid thing.

    I think that treating feelings as immutable while treating the body as something that can be cut-and-pasted into a shape to suit feelings might have something to do with an insufficient understanding of the fact that all of us are an amalgamation of multiple roles – child/sibling within the family, student at school, employee, friend, boy/girl scout member, etc., and that the collection of roles changes over time – the child becomes a parent, the student a teacher, the subordinate the supervisor, etc.

    Not only does the trans view of the person seem to be one-dimensional and rigid, but that seems to me to somehow fit the way that trans activists use certain collections of traits/behaviors to signify the “trans” status of individuals, but also accuse society of putting trans individuals into “boxes” unfairly (I see this formulation in a lot of their discussions & videos, even though our society is remarkably accepting of people who don’t sit in M/F boxes, like the male nurses & female sewer, workers that I personally know). I think it’s not our society, but trans activists, who are exhibiting the rigid behavior of trying to put people into boxes, and define the entire individual by traits that most of us would view as a small part of the individual’s activities, attitudes and relationships.

    Liked by 1 person

      • Thanks, JBro!

        I would add that trans activists are not only demanding the right to change their physical bodies in pursuit of an “opposite sex” body that is biologically impossible to achieve, but also demand that the rest of us change our language (usage and words that did not develop organically from our linguistic heritage), our legal system (punishing disapproved grammar variants) and our infrastructure (having built one house and remodeled another with my husband, I can attest a 50% increase in plumbing is a huge and expensive change).

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      • Indeed. If you say you “feel black” and that makes you black, you will be accused of cultural appropriation or worse. (viz – Rachel Dolezal case)

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  12. I don’t understand how she (the patient) expected to have a biological child with just one ovary and no uterus. I guess I shouldn’t be surprised that another gender special snowflake fails at biology. It may be possible to extract some eggs from her one ovary (if she still had it) but that sounds like it would be very difficult. Is she rolling in the dough with money for a surrogate?

    It doesn’t make sense to get the majority of your reproductive system removed if you want to have biological children (and factors like cancer aren’t a consideration.)

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    • Yes, but I feel bad for this person because her doctors should have informed her that this plan wouldn’t preserve fertility. These people aren’t medical professionals; they are butchers.

      Like

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