Shrinking to survive: A former trans man reports on life inside queer youth culture

Max Robinson is a 20-year-old lesbian who recently detransitioned after 4 years of hormone replacement therapy. She underwent a double mastectomy at age 17, performed by plastic surgeon Curtis Crane in San Francisco. Max reports that her gender therapist wrote letters verifying the immediate medical necessity of these treatments.

Max currently works to provide direct support to developmentally disabled adults living in group homes; she detransitioned on the job in December 2015. Her novel Laika, which tells the story of the little stray dog who was sent outside Earth’s atmosphere in a Soviet satellite, is available digitally or in print here. In addition, Max and her partner collaborate on many graphic art and creative writing projects.

 Max, like many young lesbians of her generation, was led down the path to FTM “transition” as a teen, effectively short circuiting her chance to fully integrate her orientation as a same-sex attracted female.  As detailed in her account, the difficulties many young trans men face in queer communities are not widely known; and the less-than- rosy experiences of FTM teens are certainly not discussed in the many mainstream media stories which unquestioningly celebrate testosterone and surgery as welcome treatments for dysphoric girls—many of whom are same-sex attracted.

Max’s story will also appear in an upcoming anthology to be published within the year.

In the meantime, Max is available to respond to your questions and discussion in the comments section below this post.

All of us at 4thWaveNow are very grateful to Max for her courage in writing this post.


by Max Robinson

When I was 5, I led a girl rebellion. We put on capes and chased some boys in capes around. Whatever they said we couldn’t do, we did. It was mostly push-ups or holding bugs. I could hold any bug. My dad still has a picture in his office of me at a science fair, hands full of hissing cockroaches.

I hated to be told there was something I couldn’t do. In first grade, I’d go home from school all in a huff because the girls’ bathroom pass had pictures of bows on it, while the boys’ had soccer balls. My teacher wouldn’t let me choose which pass I wanted. I played soccer!

When I was in third grade, I drafted letters to the author of a children’s book series. I was bothered by the constant underlying sexism in her books about a family rescuing animals. The mom and the daughter were always secondary, sweeping or cooking in the background, while the father and son saw all the action. What troubled me most of all was that these books were written by a woman. I didn’t understand why she couldn’t create a single interesting female character.

Around the same time, my mom finally let me buy a pair of boys’ shoes. They were red and black, and I didn’t have to tie them. I wore them all the time, so often that the plastic frame of them tore through the fabric. It cut into my feet, but I didn’t tell my parents. I thought I wouldn’t get another pair. They didn’t find out until they saw the back of my ankles, torn and bleeding. When I told them why I hadn’t said anything, they got me another pair. This is my first memory of hurting myself on purpose so that I would feel better about my appearance. Later, there was tweezing, high heels, waxing, shaving, running, and trying to starve myself. In all of those, at one time or another, I was encouraged, but they really weren’t for me. I wanted to choose to hurt myself in my own way.

When I was 16, I talked my older sister into ordering me a binder, and I wore it as often I could. It hurt like hell. I insisted it didn’t. The pain made it easier to think less, which was nice, especially at school. Class was boring and I couldn’t focus, so I would always spend the whole day winding myself up with some thought obsession or another to keep busy. I would ask the teacher for bathroom breaks, and then used them to cut myself, just because I was under-stimulated and unhappy.

After school, I read Autostraddle articles and dozens of pages into the archive of FTM blogs. I was glad to see some women who looked kind of like me, saying that they had futures now. I wanted what they had, and I hated what I had. I think I was 15 or just barely 16 when I started checking this stuff out.

The longer I thought about it, the more sure I was that it was true. At first, I thought I might be genderqueer. Then, I wanted to go on testosterone for a while, but keep my breasts. Next I was sure that I wanted them gone. I would confess these changing thoughts anxiously to other trans-identifying friends online. They would reassure me that this happened to a lot of people, and that the dominant transgender narrative was oppressive.  Then I began reassuring others of this, too. We all agreed that being trans was very special and difficult.  Before, I had never felt special or that my pain mattered.

Some part of me knew I was talking myself into it. I ignored that part.

For the first time, I had a community that paid attention to me, at least online. We talked about our feelings and we listened to each other. This was my first real experience with Internet culture. I loved having friends. It wasn’t like school, where I was irritable and weird, floating between tables at lunch. People actually liked me on Tumblr. Almost all my friends were female and trans-identifying.

max jpg

I didn’t know anything. It was just so comforting to think that I was born wrong. If my body was the problem, it could be solved. Transition had clearly defined steps. Everybody chose from a set list, and when it was over, they were properly assembled.

When I renounced my connection to womanhood and what I shared with my sisters, I sealed away important parts of myself. I thought I was turning away from the hurt that came from being seen as a woman by men, but it was too late for that. That hurt has been inside my bones for years. After transition, I kept quieter than ever before. Always afraid, always afraid. Brought back into line.

Transition was supposed to fix things. That’s what I believed and that’s what doctors told my parents. I was 16 when I started hormone blockers, then testosterone. I was 17 when I had a double mastectomy.

If I didn’t look like a dyke and act like a crazy teenage girl, there would have been nothing to fix.

To fund my surgery, I started a blog where I posted print-to-order clothing and gifts, pandering to the interests of the people I saw on there. It worked pretty well. I got a bunch of money, but not quite enough. My parents used some of theirs, and my grandma helped, too. After all, this was a medically validated condition. I had been to appointments with professional after professional, all of whom agreed this was the way to go.

But it turned out to be cold comfort, removing hated body parts. Breasts marked me as a woman dressed funny. I wasn’t afraid to be anesthetized or cut open. The day of my surgery, after the doctor drew the lines of the incisions on my skin in Sharpie, I asked him where the tissue would go. He told me it would be incinerated as medical waste. I cackled. When they led me back to the operating room, I was confused. I thought there would be a silver table that I had to lie down on. I told my doctor this. He told me it wasn’t an autopsy, and laughed.

My first post-op memories don’t start until a day or two later. The pain wasn’t bad, and emptying my drains reminded me of using a menstrual cup, just with a lot more yellow stuff. It felt better than trying to live as a man with breasts. I couldn’t lift my arms to wash my own hair for a couple weeks, but seeing a flat chest was a breath of fresh air. It felt like it made sense after I had been watching my old face disappear, cheeks narrowing, beard coming in, because of testosterone. I didn’t want to be seen as a woman–as a lesbian–and I didn’t want to ask why.

Or maybe I just didn’t know who to ask. I did try. Before I started medical transition, I asked my gender therapist, a trans man, about internalized misogyny. The question was dismissed. I didn’t even really know what internalized misogyny was, but  I wanted to understand. Instead, I was assured that it probably wasn’t that. I got a letter for hormone replacement therapy, and later, for the top surgery. I was grateful.

It took years of testosterone for me to finally realize it was okay to live in my own body without it, that making this peace with myself was possible, and that I deserved that chance. I didn’t know it was okay to be a dysphoric lesbian, that I could survive this way. I was almost 20 when I stopped hormones. I had been 20 for a little while when I stopped understanding myself as a trans man.

Things changed. My mind changed.

There’s a species of rotifer (microscopic zooplankton) called Bdelloidea. A male bdelloid has never been observed. They’re all female, reproducing exclusively through parthenogenesis for millions of years. How did they survive quickly evolving parasites and rapidly changing environments without the adaptability afforded by sexual reproduction? Bdelloids shrivel up under stress. In anhydrobiosis, they’re easily carried away by the wind. For up to nine years, they’ll stay alive like this–barely living, but alive. Shrinking yourself to survive is a legitimate strategy, and sometimes it works.

After I detransitioned, I started a new job where I was known as a butch lesbian. At first, people treated me worse than when I was “passing” as male. Nobody trained me. They tried not to look at me at all. They didn’t relax until I started talking, talking like I had in high school. I made jokes and people laughed. I told them about my childhood when they told me about theirs. I did more than listen, finally. People actually liked me here, the same people who looked at me funny when I first started the job.

It had been so long since I had said anything outside my home without worrying about whether I “sounded male.” I hadn’t realized how much I had been holding back since I decided to transition. I hadn’t made new friends, except online, in years. In a couple weeks at this job, I got rides home and wedding invitations. I thought I was incapable of connecting to anyone in person, but I was just incapable of connecting to anyone as a man — because I’m not a man. I can’t pretend to be one without hiding an essential part of my nature.

I thought “woman” was wrong for me, because of how I dressed, how I related to my body, how I resented the expectations society had for me as a woman. I didn’t realize that my horror at my body could be caused by the horror of living in a world that wants to control all women.

If “being a woman” really was nothing but an identity, if I had been raised in a world where it really did just mean calling myself a woman, I never would have transitioned.  I would never have attempted to surgically and hormonally erase my femaleness. My drive to be anything but a woman was rooted in the material reality of being a woman, a material reality that cannot be identified out of. Trying to live in a fantasy where everything women have suffered for being female is null and void, even as misogyny continues to shape our lives, was valuable only in that I finally learned how incredibly valuable it was to name myself as a woman.

There is power in naming. It’s how we find each other, how we connect to our histories, how we connect to our futures. Driving us apart from each other is the easiest way to keep us from learning to recognize attempts to redefine our realities.

I didn’t know this then. I subscribed to an incredibly misogynistic set of beliefs for years. “DFAB privilege” was a common phrase in our community – “designated female at birth privilege.” It was accepted fact that being born female gave you a lifelong advantage over a male who transitioned. This included men who used transition only to mean using different pronouns on Tumblr and having an anime girl as their avatar. We believed that, as “dfabs,” we needed to shut up about our petty problems. We could never have it as hard as any “dmab women or non-binary people.” Everyone in the trans community agreed that it was our responsibility to uplift “dmab voices.” None of this seemed outrageous or strange to me; it felt pretty intuitive. Growing up under male domination is a grooming process that leaves many girls and women extremely vulnerable to manipulation.

The first experience that did make me start to feel suspicious of male transition was when I was 18 and a genderqueer-identifying man who had never pursued any kind of transition raped my best friend, a woman unacquainted with insular trans community politics. I had indirectly introduced her to this guy via mutual friends. After the rape, she told me what he did; I had been in the next room the whole night, awake, talking to someone I didn’t even like. I had no idea it was happening. When she let our mutual friends know, we both assumed they would have her back; after all, they referred to their apartment as a safe space for rape survivors. But instead, her rapist changed his pronouns on Tumblr, claimed to have schizophrenia, and then said that he couldn’t possibly have raped her, because of the power dynamics between a “cis” woman and a transwoman. He moved back to LA a few months later, without ever taking any steps towards transition. When he got there, he told his old friends he wasn’t schizophrenic or trans anymore.

Years before that, two different transwomen I knew had pressured me into sending nude photos of my breasts to them. I messaged them first, as a 16 year old, after seeing them repeatedly posting about being horny and suicidal, and how only nudes would make them feel any better. They didn’t even know who I was. To one of them, I submitted the nudes anonymously. I didn’t want to talk, I just wanted him to feel better. I thought it was my responsibility. It might still be posted somewhere, I have no idea.  Both of the transwomen who sexted with me identified as lesbians at the time and knew I was a transman. They didn’t care, as long as we were talking one-on-one.

I didn’t fully see the value in differentiating male from female until a traumatized and disabled lesbian I knew well, K, finally admitted to me that her transwoman partner M was beating her regularly.

For three years, she lived with steadily escalating physical & sexual violence, the details of which were originally included in this article but have now been removed for privacy reasons. Suffice it to say – it was an intimate portrait of what radical feminists understand as male violence.

It’s been two years since she moved in with me, away from him, and she’s still recovering from what he did to her. She had two decades of trauma before that, but nothing ever broke her like this did. Calling that relationship “lesbianism” left her stranded from the framework she desperately needed in order to contextualize her experiences as a survivor of captivity. It destroyed her ability to call herself a lesbian or a woman for a long time: if lesbians like to sleep with transwomen and were repulsed by the supposed maleness of transmen, how could she be a lesbian herself? If women are what her ex-partner M was, then she, K, must be something else entirely. The language of transition lends itself readily to abusive gaslighting that disguises and distorts women’s ability to name what is happening. What was done to her was extreme cruelty of a distinctly male variety, cruelty she was especially vulnerable to because of her lifelong history of trauma at men’s hands.

The more I started to understand that M could not have been female, the more I understood why I was. One’s actual sex matters. Running from its significance prevents you from doing anything but continuing its cycles of destruction. As soon as a transwoman said, “No, I’M not a man,” we instantly lost our ability to protect ourselves from him. Women who never transitioned in these trans circles believed their “cis privilege” rendered them man-like in their power. For those of us females (mainly lesbians) who did seek transition, we were often told that, as transmen, we were exactly as bad as any other men.

Loading the language was an incredibly powerful tool. I was a lesbian trying to save my friend from domestic violence at the hands of a man she had partnered with out of intense desperation, facing immediate homelessness as a severely mentally ill woman with limited mobility. Understanding this could have connected us to our foremothers who struggled through similar battles to protect each other from abusive men. Instead, we felt completely adrift. Other women dealing with abuse perpetrated by transwomen have described a similar sense of being in entirely uncharted territory, terrified to speak first, unable to find anyone else sharing experiences; they’re all too scared of being labeled an untouchable “trans-misogynist.”

In the 21st century, intelligent and capable adult women are having to relearn what “man” means, with fear at their backs every step of the way. We were among them, exploring radical and lesbian feminist ideology online and marveling at how decades-old works precisely described circumstances we had thought of as occurring only recently. Janice Raymond’s discussion of transexually-constructed lesbian feminists in The Transsexual Empire was startlingly relevant. She saw this coming. As lesbians, we have a rich history of theory that had been completely denied to women who came of age when K and I did. All either of us knew about Janice Raymond, until last year, was that she was evil to the core; a horrible transphobe. We believed this because we didn’t know any better.

Deprogramming took almost a year. Both of us were terrified just to read dissenting opinions. K, me, and another lesbian exited from the radical queer scene began moderating an online support group for anyone dysphoric and born female, including many who still identified as trans. When that group started, I was still one of the transmen. All of us were so incredibly relieved not to be alone. We disagreed on a lot of stuff, but we were all tired of what we saw happening to females.

When our remaining friends from the transgender community found out that we considered transwomen capable of male violence, and that we were concerned about transition’s effect on young adults, almost all of them deserted us immediately. Female trans-identifying friends who knew K’s history of homelessness and our currently rocky financial situation started talking publicly to each other about how we literally deserved to starve to death.

Losing these friends hurt enough on its own. Being cut off from them just when we had begun to see the severity of the situation within these groups was so much worse. I have a list of 20 intercommunity predators, mainly transwomen who prey on females — women or transmen. Eleven of them are one or two degrees of separation from us. So many women in our community had themselves been pressured to share nude photos, coerced into unwanted sex, or outright violently assaulted by males describing themselves as transwomen, but they still didn’t feel able to challenge the narrative they were being fed. These women, our friends, had been there with us. They saw transwoman predator after transwoman predator being named by their terrified female victims. The “call-outs” (a word used for anything from hurting someone’s feelings slightly to brutal rape) usually only happened once several victims of the same predator found each other and made sure they had friends on their side. When victims couldn’t be sure they would be supported, they didn’t come forward. The political climate made it doubly difficult to “call out” a transwoman. We were constantly being reminded that transwomen are harmed by the horrible stereotype that they’re all rapists or perverts, and we were taught that we needed to be constantly policing ourselves to avoid perpetuating this idea.

The silent victims of transwomen had good reason to keep quiet. We all saw transwomen using the language of “cissexism” and “transmisogyny” against anyone who named their behavior as harmful. Even transwomen dating other transwomen experienced abuse at their hands. In the resulting fallout, it was never clear who the true aggressor was; both of them would immediately begin using identity politics and “privilege dynamics” (i.e., someone poor can never hurt someone rich, under any circumstances, etc.) in a way that was very effective at obfuscating the truth. Our friends had been right beside us for all of this, and they still damned us for beginning to name what had enabled this wide-scale intercommunity violence.

Young lesbians in the “queer community” are known by many names: if you want to avoid scrutiny for not hooking up with transwomen, you’ve got to get creative. Some of us call ourselves queer, bisexual, or pansexual, because there’s no word for only being attracted to females, and you can’t be a lesbian if you date transmen or avoid dating transwomen. A lot of us, having been told that we can opt out of womanhood by choice, decided that we never want to be called “she” again. Young women who cling to the word “lesbian” find themselves increasingly pressured to sleep with transwomen, because—according to trans dogma–they are supposedly more vulnerable and oppressed than any “cis” lesbian.

Many transwomen seem to view dating a “cisbian” as a uniquely valuable source of gender validation. After all, lesbians only date women. There is no acknowledgement that, under some circumstances, some lesbians can be coerced into relationships that they are incapable of experiencing as anything except traumatic. I have never seen a transwoman from these circles ever express the possibility that this might be true. By all appearances, they have never considered it. Running from unpleasant truths is something that a lot of folks who transition (me included) tend to get very good at.

The insistence that lesbianism is not a strictly female experience runs so deep that transwomen, even those who only date other transwomen, often refer to themselves as “transdykes.” This includes those who are not transitioning–men who can literally only be differentiated from any other man when you ask his preferred pronouns. Many women believe that these “transdykes,” even those who have never been identifiable as anything but straight men to the outside world in any way, are more oppressed than any “cis” woman, specifically on the axis of gender. The level of gaslighting taking place here is difficult to overstate.

From the outside, now, I can finally see how ridiculous it is. Realizing this took months and months. It took us a year of exploring the feminist theory that had been forbidden to us before me or K could even call any transwoman a man without having a panic attack.

At first, when I started learning more about opposing viewpoints, I identified as a “gender-critical transman.” I knew that the transgender cause had been used in a lot of disgusting ways, but I still believed transition was the only way I could survive, and I was trying to reconcile seeing myself as transgender with believing that the vast majority of trans activism was harmful to women. During this time, I really looked up to gender-critical transwomen–transitioning males who were usually at least marginally more sympathetic and thoughtful than most men. I tried to reconcile our respective identities and our needs, as we understood them, with the needs of women as a class.

I failed. At the end of the day, I just don’t want anyone male in the bathroom with me. I don’t want them on a women’s volleyball team. I don’t want them at Curves. I don’t want them in a lesbian book club. The experience of being male is fundamentally different from the experience of being female — even if a man passes, even if a man has surgery to more closely resemble his idea of a woman. I don’t say this out of a hatred for transwomen. I say this out of love and respect for women. What we are cannot be conceived nor replicated in a man’s imagination, and it absolutely cannot be formed out of male tissue on an operating table.

The sympathy I feel for men harmed by gender, to the extent that it means I encourage male-to-female transsexualism, is in direct competition with the sympathy I feel for women harmed by gender. Everyone is entitled to make their own choices about their bodies. Everyone is also entitled to have opinions about the choices that others make about their bodies. I feel that transition is a treatment with far-reaching harmful side effects — not only for the individual receiving treatment, but for those around them.

Lesbians who see their sisters disappearing are more likely to try to erase themselves. Lesbians who are forced to welcome men into their spaces will never be able to see or understand the value of female-only space, having never actually experienced it. Transition does not cure the irreconcilability of our selves with our environments. Gendered identity crises are very real to the individuals experiencing them, myself included, but this energetic drive towards change is not best spent reforming ourselves into someone who can assimilate into the world men have built. We need to use this energy to work towards restoring balance to a sick world.

Many young lesbians (and some older lesbians caught up in a youth-oriented trans/queer culture) hold political views diametrically opposed to our collective interests. We genuinely believe some off-the-wall garbage, like that it’s wrong and evil not to be attracted to penises because of “internalized cissexism.” We have been successfully brainwashed to serve males at the expense of our own health and sanity.

I have so much empathy for other women who believed transition was their best choice. I lived that. The fact is, loving a woman does not automatically mean agreeing with her. I believe that all of us deserve better. We deserve to experience autonomous female space. We deserve the opportunity to experience our bodies as a part of nature worthy of celebration, not objects to be “reconstructed.” The energy we spend trying to run from our own bodies is better spent working to support each other.

Those of us who make it out of communities like the ones I was in often only manage to do so because of strong female (in my experience, lesbian) support networks that help us relearn how to think for ourselves without getting angry when we make mistakes in the process. I hear political opponents of the transgender movement calling it extremely cult-like and in the same breath damning the women, usually lesbians, who fall into the trap. This reinforces the learned hatred of anyone who disagrees without creating any opportunity for victims of this ideology to ask questions and explore viewpoints that—while the victims have not yet extricated themselves–genuinely feel like some kind of blasphemy to them. The pace of progress needs to be determined by the individual. Frustration with the behavior of young people in the transgender community is very understandable, but even the most righteous anger is unlikely to change minds when it’s directed at someone who has been manipulated into believing that dissenting women are literally equivalent to murderers.

The beliefs they have internalized are harmful to all women. No one is obligated to subject herself to being triggered or re-traumatized by the virulent misogyny that trans activists tend to espouse, even in the name of reaching out to a sister in crisis. Taking care of yourself has to come first. I try to stay available for conversations with questioning trans-identifying females, but I can’t always be there. I need rest, too.

As I move away from viewing myself and my body as an object to improve, I’m realizing more and more how much of my energy has been devoted to appeasing men in some way. By and large, that was a waste of time. I’m working on using my emotional energy for the benefit of myself first, and then for the benefit of other women.

While I was transitioning, I was terrified of eventually regretting it. I sure as hell didn’t let on much about my doubts, for fear of losing access to medical treatment, but I was consumed all the time with obsessive thoughts about it. I didn’t understand how I could go on living as a woman with no breasts. What man would want to fuck me? Never mind that I didn’t want to be fucked by any man; that didn’t feel like a good enough answer.

I am so incredibly grateful that I learned that there was more to being a woman. Transition was absolutely not the easiest way to learn this, but it was how I learned it. It was how I learned that I could survive without men viewing me as a piece of meat. I never shaved my legs or armpits again. I stopped tittering at their stupid jokes. I dress practically. I’m grateful that I learned it was okay to exist as I am.

For me, transition was a processing of distancing my true self from my body and my environment. Detransition has been the opposite: learning to participate earnestly in the world again. For me, this isn’t about undoing my transition. I’m not seeking any further changes like electrolysis or breast reconstruction. I am a woman, even if my body is recognizable as the body of a woman who once thought transition was the best choice available to me. My body has known tragedies, but my body is not a tragedy. When I catch myself slipping into deeply misogynistic internal tirades about the aspects of my appearance that changed during transition, I practice thought replacement. I am not a waste of a woman.

I’m so grateful for all of the incredible women I’ve connected with who are on the other side of transgender identities now. Some of them are women I met years ago, when both of us were still pursuing transition. Transition doesn’t have to be forever. If transition makes you sick inside, you don’t have to live and die with that sickness. There is community. There is processing. There is genuine healing. More and more of us are waking up, each with her own story. We question and disagree, with our enemies and with each other. We learn. Together, we are moving forward.

Mom forces insurance company to cover double mastectomy for her 15-year-old, with support of WPATH & Dan Karasic, MD

A 15-year-old cannot vote, sign a contract, drink, or get a tattoo. You can’t rent a car until you’re 25 years old. And in the US, the FDA has just proposed regulations to prevent minors from even using tanning beds.

Why all the restrictions? Well, last I checked, developmental psychologists, cognitive scientists, and informed members of the general public were aware that adolescents don’t have the cognitive wherewithal—the judgment, foresight, or awareness of future consequences–to make major, life-changing decisions, let alone suffer a bad sunburn. There has been so much replicated behavioral and neuroscientific research done on the subject of executive function in young people that it’s now considered settled science.

So the changes that happen between 18 and 25 are a continuation of the process that starts around puberty, and 18 year olds are about halfway through that process. Their prefrontal cortex is not yet fully developed. That’s the part of the brain that helps you to inhibit impulses and to plan and organize your behavior to reach a goal.

And the other part of the brain that is different in adolescence is that the brain’s reward system becomes highly active right around the time of puberty and then gradually goes back to an adult level, which it reaches around age 25 and that makes adolescents and young adults more interested in entering uncertain situations to seek out and try to find whether there might be a possibility of gaining something from those situations…one of the side effects of these changes in the reward system is that adolescents and young adults become much more sensitive to peer pressure than they they were earlier or will be as adults.

Another very readable (and amusing) article, “Dude, where’s my frontal cortex?,” sums it up thusly:

The frontal cortex is the most recently evolved part of the human brain. It’s where the sensible mature stuff happens: long-term planning, executive function, impulse control, and emotional regulation. It’s what makes you do the right thing when it’s the harder thing to do. But its neurons are not fully wired up until your mid-20s.

But the gender specialists at the helm of the World Professional Association for Transgender Health (WPATH) apparently never received the decades-old bulletin on adolescent brain development (or lack thereof), or so it seems. In the Brave New World of transgender “health care,” a 15-year-old can ask for and receive a double mastectomy, with mom’s blessing and collaboration. (In Oregon, a kid can decide to have her breasts removed whether mom approves or not, thanks to trans activists like Jenn Burleton and TransActive).

Last July, a mom posted to the WPATH public Facebook page, looking for advice on how to get “chest reconstruction” for her 15-year-old (i.e.,  double mastectomy. Why can’t these people use actual medical terminology, even amongst themselves? Do the providers and parents also get “triggered” by seeing a reference to female anatomy?)

[Note: For privacy reasons, I have chosen not to directly link to the (nevertheless) publicly viewable thread on the WPATH Facebook page.]

Seems mom’s insurance company balked at  covering elective removal of breast tissue in people under 18.

WPATH mom of 15 yr old

Psychiatrist Dan Karasic, one of the key contributors to the WPATH Standards of Care (SOC), and provider at the San Francisco Center for Excellence in Transgender Health, is happy to help, citing the SOC chapter and verse (page 21 to be exact) that WPATH fully supports “chest surgery” for minors, although it’s apparently still “too limiting” for his taste:

WPATH mom 2

Mom has already picked out the surgeon for her child, and another commenter, former Transgender Law Center employee Jason Tescher, recommends she try to “force” her insurance company to cover the cost (per the doctor’s website, $8500):

tescher

The WPATH thread went dark until today (more on that in a minute). But who is Dr. Mangubat?

mangubat

In addition to being a popular presenter at Gender Odyssey, the yearly shindig for all things transgender, Dr. Mangubat is apparently well known as a surgeon who’s an easy touch for those looking for double mastectomies. As recently as six days ago,  underage top surgery seekers on Reddit were recommending him:

Also, the surgeon I went to (Dr. Mangubat) did not require any kind of letter and I don’t think he requires patients to be on T either, but I could be wrong on that. It was as easy as emailing his office to set up a consultation and then I was immediately able to schedule the surgery.

As to the mom’s efforts to get insurance to cover the removal of her child’s breasts,  an update appeared moments ago on the WPATH thread. Mom shares her good news: the insurance company has agreed to reimburse her for the double mastectomy that they “couldn’t wait for” and had done in August.

insurance appeal

Dr. Karasic couldn’t be happier.

karasic happy

It’s likely only a matter of time before insurance coverage for teen surgery will be the norm. The Obama administration recently proposed new rules that will require all insurance companies to pay for “transition” services. One wonders just how many “identities” the transgender umbrella will cover when it comes to federally mandated health care services?

The entire Reddit thread that references Dr. Mangubat  (as well as two other surgeons I’ve previously written about–Dr. Curtis Crane in San Francisco, and Dr. McLean in Ontario) is worth reading in this regard, because it’s primarily about “nonbinary” people who don’t identify as FTM getting access to “top surgery” on demand–exactly what providers like Dan Karasic promote and what is already happening, apparently, in San Francisco at taxpayer expense, as I detailed in a recent post.

As I also discussed in that post, Karasic is a major WPATH player pushing for the elimination of “gender dysphoria” as a requirement for “transition” services; he wants to  replace GD with a new diagnostic code, “gender incongruence,” which would do away with the need for any distress, dysphoria, or disorder but still allow for billing for what amounts to a lifestyle choice–for anyone who claims “gender incongruence,” on demand.

So we know Karasic and WPATH are OK with 15-year-olds who ID as FTM undergoing irreversible surgeries. Does he also believe, as he does for adult patients, that a 15-year-old (or 13-year old?) who identifies as genderqueer, gender fluid, or non-binary should ALSO get insurance-funded double mastectomies?