At 4thWaveNow we are serious about fact-checking and providing sources so that our readers can verify information for themselves.

It is well known that Susie Green of Mermaids took her child to Thailand to undergo SRS, which was carried out on the child’s sixteenth birthday. As 4thWaveNow contributor Artemisia pointed out in a post last year, this operation would not be legal in Thailand nowadays. Under the Thai laws currently in force, it is illegal to perform SRS on anyone below the age of 18, while patients aged 18 to 20 require parental consent.

It has come to our attention that there is a rumor on social media that the law was changed because the people of Thailand were shocked and revolted by Mrs Green’s action. This is completely untrue. We do not know where that story originated; we’ve attempted to correct it several times on Twitter, yet the rumor persists.

 For the benefit of those who want to know more about the real reasons for the legal changes, Artemisia has provided us with the following detailed account.

For further information on UK charity Mermaids, see this 2017 article by Artemisia, “Should Mermaids be permitted to influence UK public policy on trans kids?”

by Artemisia

Susie Green is the Chief Executive Officer of Mermaids, a UK charity noted for its advocacy for the off-label use of  gonadotropin-releasing hormone (GnRH) agonists to disrupt the normal progress of puberty in children labelled ‘trans’. Mrs Green has also indicated her support for removing age-related restrictions on surgical procedures intended to make the bodies of trans-identified people conform better, superficially, to the sex to which they wish that they belonged. At present under the National Health Service irreversible gender-related surgery is only available to patients eighteen and older. This is in accordance with international standards of care.

Recently Mrs Green tweeted her approval of a statement by a US specialist in genital surgery who argues that ‘surgery should be allowed based on competency’ — that is, ability to give informed consent to treatment — rather than ‘age of majority’.

She has already shown a strong personal commitment to this position. In 2009 she took her child, Jackie, to Thailand for a vaginoplasty: the creation by plastic surgery of an artificial vagina. Susie and Jackie have told this story a number of times in interviews with the media and also in a television documentary.

Why did Mrs Green take Jackie to Thailand? During the course of the last forty years, Thailand has built up a reputation as a place where male persons seeking feminisation surgery can have various procedures, including vaginoplasty, performed by competent surgeons for far less money than it would cost them in Europe or the United States. The development of this highly specialised trade certainly owes something to the presence of a strong indigenous tradition of males who present as female: the kathoey, often referred to as ‘ladyboys’. It is reported that many of them undergo feminisation surgeries, including vaginoplasties.

Until 2008 there were few or no legal controls over such operations. In April that year the Thai government imposed a ban on the castration of males below the age of eighteen.  According to a report in the Telegraph (a reputable London newspaper) the new law was a response to pressure from the Medical Council of Thailand, which had issued a warning about the health risks of teenage castration: damage to ‘hormone growth and physical development’. Boys as young as 11 or 12 were undergoing castration in the belief that it would help them present a more feminine appearance as they grew older. It was a preliminary to later feminisation surgeries. In that respect, its use was similar in purpose to the current use of GnRH agonists as ‘puberty blockers’.

The move to make it illegal was strongly supported by the Gay Political Group of Thailand, whose leader, Natee Teerarojjanapongs, told The Bangkok Post, “These youngsters should wait until they are mature enough to thoroughly consider the pros and cons of such an operation.” In another, later interview he said, “I got so many calls where they said they are so sorry that they did a sex change … They make a big mistake and they want to come back and be the same. But they cannot!”

The Medical Council of Thailand is a professional body that has statutory authority. In April 2009, a year after the ban on castrating under-age boys, the Council issued a new regulation: in future, ‘sex change surgery’ would be permitted only if the patient was over 18. Furthermore, patients of 18 and over who had not yet reached the age of 20 must have the permission of ‘an authorized guardian’. (In Thailand 20 is the age of majority.) This regulation was to come into force 180 days after publication in the Government Gazette. It was during this period of grace that Susie Green took Jackie to Thailand for an operation to create an artificial vagina.

There is a rumour that sometimes surfaces on Twitter that it was because of Susie Green that Thailand imposed the age limit – supposedly the authorities were so horrified at a mother bringing her sixteen-year-old for a vaginoplasty that they brought in a law to stop anyone else from doing this. There is absolutely no truth in this rumour. It is not clear who began it, and as stated above, 4thWaveNow has attempted to correct it on Twitter, with little success.

This is what actually happened: on 20^th April 2009 the Thai medical authorities announced a forthcoming ban on ‘sex change’ operations on any person under 18. The intention was to protect young people from undergoing irreversible surgeries that they might later come to regret. Jackie’s vaginoplasty was carried out on the child’s sixteenth birthday. This dates it to 16^th July: three months after the new regulation was announced and before it came into force on 29 November. In other words, the operation took place at a point when it was known that it would soon be illegal for such a drastic procedure to be performed on a patient so young.

Did Mrs Green and her advisers know that the law was about to change? It seems unlikely that Norman Spack of Boston Children’s Hospital, a well-known promoter of medical transition for teens, was unaware of the steps being taken in Thailand. Jackie was a patient of his at the time. Dr Spack has described at a TEDx event how, as an experiment (‘something a little bit innovative’), he prescribed Jackie ‘a blocking hormone’ (GnRH agonist) to block testosterone and later ‘added estrogen’ when Jackie was only 13. Following which, ‘on her 16th birthday, she went to Thailand, where they would do a genital plastic surgery.’ Helpfully, he added, ‘They will do it at 18 now.’

Two years after the operation Susie and Jackie gave an interview to the Sun newspaper, in which it was said that Jackie had become ‘one of the youngest transsexuals in the world’. A few weeks later, in a piece in The Yorkshire Evening Post, this had changed to ‘the youngest person in the world to have a sex change’, and over the course of the next two years this unverifiable claim was repeated as fact in The Daily Mirror, The Daily Mail and The Sunday Times.

It echoes a claim that was earlier made about a German teenager, Kim Petras. In February 2009, shortly before Jackie and Susie travelled to Thailand, the Telegraph reported: ‘German teenager Kim Petras has become the world’s youngest transsexual after undergoing an operation at the age of just 16.’ The story was also published in the Sun and the Daily Mail. Kim was reported as saying in an interview, “I had to wait until my 16th birthday but once that was past I was able legally to have the operation.” So when Susie Green arranged for her child’s surgery to take place on the day that Jackie turned sixteen, it meant that in future it would be Jackie who could make a plausible claim to that distinction.

In 2009 Kim Petras had begun on a modelling career and had also issued a CD. Nowadays Petras is a well-known singer-songwriter who has told the press, “I just hate the idea of using my [transgender] identity as a tool,” preferring to be known for the music. In 2011 the Sun reported that Jackie had plans to build a career ‘as an actress, model and singer’.

The following year Jackie competed in the Miss England beauty contest, reaching the final, and became the subject of a BBC documentary: Transsexual Teen, Beauty Queen. In a memorable section, Susie Green talks about her child’s operation. She reveals that because Jackie had not gone through a natural puberty (as a result of the hormone treatments prescribed by Dr Spack), the surgeon was unable to carry out a penile inversion procedure:

38:57: Susie Green (to camera). The majority of surgeons around the world do something called penile inversion where they basically use the skin from the penis to create the vagina. And she hadn’t developed through full puberty so to not put too fine a point on it there wasn’t much there to work with [starts to smile] –; sorry Jackie (she’ll hate that) [turns away from camera and convulses with laughter].

39.15: cuts to a still photo of 16-year-old Jackie on a hospital bed waiting to go into the operating theatre.

4thWaveNow postscript: As Artemisia has amply demonstrated in her article, it has never been in dispute—least of all by the Greens—that Jackie underwent SRS in Thailand at the age of 16. Interestingly, the UK Daily Mirror, in a story just last October, reported that Jackie’s surgery took place in the United States.

This is an error 4thWaveNow pointed out (as did a commenter on the article itself), but as of this writing nearly 6 months later, that error remains standing. Moreover, it seems safe to assume that the Greens are aware of the Mirror piece; apparently, neither Jackie nor Susie have required the newspaper to correct this significant error of fact.