Paxton is Investigating Dell Children's Medical Center Over "Gender Transitioning Procedures" for Minors

[Al Bundy's Napoleon Hand 13584]

19 minutes ago, naija said:

Then you get responses to a point I never made, as if stating a fact is the same as condemnation.

Because implication has been such the dependable plausible deniability tactic formerly fig leaf fascists have used for DECADES that they grew lazy enough with a sense of impunity to allow themselves to get bitch-slapped with a 788 mil settlement.

Who the fuck are you? NOW is the time you have "political" opinions and wanna start CR posting? The fascist insurrection that attempted and failed to prevent the peaceful transfer of power for the first time in this nation's history wasn't enough capture your interest?

Authoritarianism wasn't worth your while to wander over to the shit hole CR?

BUT an infinitesimal sliver of the population using their freedom of choice to make a personal medical decision you have no goddamn fucking vote in, and the ludicrous drama queen compelling public interest ramifications if the Harper Valley PTA DIDN'T get involved....

...that was a line too far?

 

[safe sex 11717]

1 hour ago, naija said:

Someone upfield made a statement that no such surgeries were being performed on minors. Somehow pointing out that this is not true, means I harbor some prejudice against the practice. I didn't comment on how often or the volume, just that it happens. Then you get responses to a point I never made, as if stating a fact is the same as condemnation. Incredible and yet, not surprising. 

Minors can have mastectomies for non-gender-related reasons too. Should we ban those?

When people talk about gender surgery on minors, they are referring to vaginoplasties. Ask any MAGA piece of shit what they're talking about with gender surgery and they'll mention chopping dicks off (not what happens). That is what I was referring to, again, for the reason that mastectomies happen for many reasons.

Your faux concern about besides-the-point semantic accuracy is noted, though.

Edited May 8, 2023 by safe sex

[troph 24787]

21 hours ago, naija said:

I took a look at that first link in this post. I noticed really quickly that in at least two of articles listed in the first 4 or 5, the authors conclusions do not quite match up with what that gentleman has summarized. Take the Finnish article for example. 

This is what the Finnish authors put in their abstract

This is what he wrote in his summation of the article

It is really easy to read what he wrote and come to conclusion that that particular study was part of the positive ledger for gender-affirmation, when the authors don't even think it was.

I did not go through all the articles cited, but when someone is willing to play games like that, and seemingly is depending on the likelihood that the majority of people will not track each article down and pore through the original data themselves, it puts a dent in the credibility. 

Wait? Now I can’t transition because I’m trans and I have low grade anxiety and depression and transition will only solve for gender dysphoria and won’t solve for my other issues? Goalposts.

we trans people talk, to each other, a lot. We have therapists, doctors, endocrinologists, and more and you know what? We all know that the only thing transition will help with is gender dysphoria. The rest will follow you, because it’s a different issue.  Now, will gender dysphoria induced symptoms subside? Yes. Absolutely. 100% unequivocally, absolutely.  But part of getting treatment includes understanding all of this. 

Edited May 8, 2023 by troph

[troph 24787]

I have zero issues with top surgery for 16-18 year olds who have been consistent in their gender identity and their expression of it for at least 3-5 years. Puberty can hit at 11 or 12 and frankly it can be the cause of gender dysphoria for many, it was for me. I think doctors should be able to make the call even younger for kids who have been consistent since earlier years. At some point it’s rock solid known to a certainty the kid is trans. at the 1 year mark in teens, maybe there is a risk, but at 3-5 years of consistent presentation and identification you can bet the house that kid is trans. At that point nothing should be off limits.

I’ve wondered if detransitioning would make my life easier - it might - but I don’t because the congruence I feel is sticky, there really isn’t anything anyone can do to cause me to change my mind. 

and to that I make two more points, the fact that a very small handful of people will regret it should not be the basis for blocking treatment to all others - this actually is the embodiment of valuing cisgender lives over trans lives by a factor of 100 to 1. It’s gross.  Second, the people clamoring to stop trans care for minors aren’t listening to the families and the kids or the trans adults. 
 

yeah, if I had puberty blockers at 12 and surgery at 17-18 I would have been thrilled.  The fact that many trans kids are wanting that is not shocking to me at all. 
 

denying treatment and legislating discrimination against us in dozens of states with multiple forms of new laws aimed at making our lives harder, criminal or impossible is Nazi level eugenics. 

Many of y’all can’t fathom how normal being queer and trans is to us, it’s not a big deal, it’s human and we aren’t that different compared to everyone else. You get to have medical autonomy let us have it too. Leave all of us alone, let doctors and families make their decisions. 

Edited May 8, 2023 by troph

[naija 2854]

4 hours ago, Neonmoon said:

Boo Fucking Hoo

You don’t get to make choices for other people, including 17 year olds that have been emancipated. 
 

 

I can only assume you didn't actually read what the bold part refers to. It is the idea that the only prerequisite for surgery should be a desire or want of it. Maybe you need to read that again. Forget gender affirming surgery for a second. Surgery should not be practiced that way. Across all surgical subspecialties. Have you ever sat through an Indications Conference? The reason that you operate on someone can't simply be, they wanted it. 

[naija 2854]

3 hours ago, Al Bundy's Napoleon Hand said:

Because implication has been such the dependable plausible deniability tactic formerly fig leaf fascists have used for DECADES that they grew lazy enough with a sense of impunity to allow themselves to get bitch-slapped with a 788 mil settlement.

Who the fuck are you? NOW is the time you have "political" opinions and wanna start CR posting? The fascist insurrection that attempted and failed to prevent the peaceful transfer of power for the first time in this nation's history wasn't enough capture your interest?

Authoritarianism wasn't worth your while to wander over to the shit hole CR?

BUT an infinitesimal sliver of the population using their freedom of choice to make a personal medical decision you have no goddamn fucking vote in, and the ludicrous drama queen compelling public interest ramifications if the Harper Valley PTA DIDN'T get involved....

...that was a line too far?

 

well, if you think I've never posted in the Cloak Room, or in any of its previous iterations, or been involved in any of the other hot-button topics across this board and the others, you are wrong, and fucking stupid.

 

[naija 2854]

3 hours ago, safe sex said:

Minors can have mastectomies for non-gender-related reasons too. Should we ban those?

When people talk about gender surgery on minors, they are referring to vaginoplasties. Ask any MAGA piece of shit what they're talking about with gender surgery and they'll mention chopping dicks off (not what happens). That is what I was referring to, again, for the reason that mastectomies happen for many reasons.

Your faux concern about besides-the-point semantic accuracy is noted, though.

How do you know its faux concern? Is it even possible for you to swallow the invective and use a slice of reason? Know why it's not just semantics? Because this particular scenario played out in a children's hospital when an administrator was responding to questions about the hospital performing gender affirming surgery with emphatic "no's" (being either unaware that top surgery was being performed at all, or that it was considered gender affirming surgery), and during the clarification/walk-back process, made the surgeons at that hospital look like they were hiding something and increased the threats they were getting.

It's not semantics. Say, yes, gender-affirming surgery is performed on adolescents. And here are the reasons why. This is the multidisciplinary team we employ to ensure we run a good clinical practice. 

[naija 2854]

By the way, boys and men with gynecomastia don't just walk into an office and get mastectomies without questioning either. First, most don't even get mastectomies, they get reduction mammaplasty (sorry if you think that's semantics). Second, since, it is usually covered by insurance, there are several things that must be documented before it will get approved. Same with girls/women with macromastia. Want isn't the only prerequisite required for surgery.

Medicine and medical doctors should mostly be left at it alone, but I can't think of a single industry where some outside participation, if not oversight, is not a good thing. The medical profession is no exception. A society should have interest in what its doctors are doing. Beauchamp's and Childress' 4 principles of biomedical ethics, respect for autonomy, nonmaleficence, beneficence and justice mostly evolved from concerns over what doctors were doing, unmonitored. If I said, police departments should have civilian monitoring or oversight, that's probably an opinion that would elicit positive reactions on this board. The two are not the same, but they aren't entirely dissimilar either. 

[naija 2854]

3 hours ago, troph said:

Wait? Now I can’t transition because I’m trans and I have low grade anxiety and depression and transition will only solve for gender dysphoria and won’t solve for my other issues? Goalposts.

we trans people talk, to each other, a lot. We have therapists, doctors, endocrinologists, and more and you know what? We all know that the only thing transition will help with is gender dysphoria. The rest will follow you, because it’s a different issue.  Now, will gender dysphoria induced symptoms subside? Yes. Absolutely. 100% unequivocally, absolutely.  But part of getting treatment includes understanding all of this. 

Except, the paper doesn't say that.

[naija 2854]

3 hours ago, troph said:

I have zero issues with top surgery for 16-18 year olds who have been consistent in their gender identity and their expression of it for at least 3-5 years. Puberty can hit at 11 or 12 and frankly it can be the cause of gender dysphoria for many, it was for me. I think doctors should be able to make the call even younger for kids who have been consistent since earlier years. At some point it’s rock solid known to a certainty the kid is trans. at the 1 year mark in teens, maybe there is a risk, but at 3-5 years of consistent presentation and identification you can bet the house that kid is trans. At that point nothing should be off limits.

I’ve wondered if detransitioning would make my life easier - it might - but I don’t because the congruence I feel is sticky, there really isn’t anything anyone can do to cause me to change my mind. 

and to that I make two more points, the fact that a very small handful of people will regret it should not be the basis for blocking treatment to all others - this actually is the embodiment of valuing cisgender lives over trans lives by a factor of 100 to 1. It’s gross.  Second, the people clamoring to stop trans care for minors aren’t listening to the families and the kids or the trans adults. 
 

yeah, if I had puberty blockers at 12 and surgery at 17-18 I would have been thrilled.  The fact that many trans kids are wanting that is not shocking to me at all. 
 

denying treatment and legislating discrimination against us in dozens of states with multiple forms of new laws aimed at making our lives harder, criminal or impossible is Nazi level eugenics. 

Many of y’all can’t fathom how normal being queer and trans is to us, it’s not a big deal, it’s human and we aren’t that different compared to everyone else. You get to have medical autonomy let us have it too. Leave all of us alone, let doctors and families make their decisions. 

troph, not everyone who questions something about transitioning is against transitioning. I'm not. I will in fact wager, that I'm probably one of the few posting on this thread  who has participated in gender affirming surgeries. And it wasn't because a shotgun was held to my temple. If you weren't posting, I would not volunteer that information.

now, to some of what you've written above.

why 3 to 5 years. How is that not an arbitrary mark? You might posit it as a gut feeling, but really what is your 3 to 5 years based on? Why should a kid suffer for 5 years to satisfy this criteria?

Nothing should be off limits? Does that include bottom surgery? And if you say it doesn't, then again, why not?

Some might want to use the point about detransitioning as their argument for blocking all forms of treatment, but can you consider that isn't the only reason to seek better data on detransitioning or regret? And I say better, because the studies that have even bothered to broach this are mostly not doing so with great statistics. For one thing, they tend to forego the intention to treat model and simply discount patients who fall out of the study or chose not to respond as null respondents, when in actuality some are probably one of the two. So why else should there be interest in that data? Because it simply helps the physician/team/surgeon have a fuller, more informed conversation about what the risks are with the patient. This is not a small thing. Part of why surgeons choose which operations they will perform, sometimes has less to do with technical ability and more to do with one's tolerance for complications. If this goes wrong, what can or can't I live with. This is why Pediatric Neurosurgeons and Cardiothoracic Surgeons are a cut above. And please, let's not go with the argument that it is the patient who alone bears the burden. I have personally known two uber-talented, altruistic people walk out of medicine because of surgical misadventures. The full title of the specialty that most often deals with transgender surgery is after-all Plastic & Reconstructive Surgery and that second word isn't just for show. People don't go into this because they like extirpative procedures, and transgender surgery involves two of the most irreversible, yet-not-fatal, procedures you can perform. You won't know it, because the resident and fellowship applicant pool is brimming with people who are excited about developing gender-affirming practices, but there are also a number who started and have pulled back or are hesitant to start at all because there is that feeling that they can't turn the same questioning stance on aspects of this as they can with other procedures. It is likely impossible to have all the data on any procedure, but you don't want to be left feeling like your ability to critique and refine is hampered. When you couple that with the removal of what were held as some safeguards, i.e, mandatory mental health evaluation (which needs to be taken into account when people quote detransitioning  or regret percentages), and the increase in the prevalence of LGBTQIA kids, there is a concern that more people are going to get operations they shouldn't have. And for some surgeons, an n of 1, is a complication they aren't willing to deal with. Anyone is free to think those people are cowards.

So that's one reason, if not THE reason, for the interest. It really is to be better at this.

[Neonmoon 38129]

2 hours ago, naija said:

I can only assume you didn't actually read what the bold part refers to. It is the idea that the only prerequisite for surgery should be a desire or want of it. Maybe you need to read that again. Forget gender affirming surgery for a second. Surgery should not be practiced that way. Across all surgical subspecialties. Have you ever sat through an Indications Conference? The reason that you operate on someone can't simply be, they wanted it. 

Of course any person who desires said surgeries should go through all the same consultations as any other person that receives these surgeries. If they are 18, or emancipated 17 year old. Any person desiring gender affirming surgery, whether a trans or a cis. Everyone should be treated the same. 

[troph 24787]

4 hours ago, naija said:

Except, the paper doesn't say that.

It’s the proposition you quoted it for - or at least the proposition opponents quote it for. I’m not arguing with you, I’m arguing against those who will use any thing to argue trans care should be blocked. I’ve spent the last 8 years arguing on these boards against the idea that gender dysphoria is really just acute depression.   And those people are in power and those people are on this thread. You may be very genuine but there is a 80 year history of cis people controlling trans care as gatekeeper who are doing harm by blocking care.  And I’m not a simple informed consent proponent. I think care should be measured and should be conducted in steps with the least intrusion first. 

Edited May 8, 2023 by troph

[wildcat09 29353]

The key thing to understand in these discussions is that the person playing the role of Anastasis, pretending not to be a bigot but just insisting the scientific evidence isn’t there yet, is doing the same thing the “oh your fetus has a fatal birth defect and you will die without an abortion but you’re not in septic shock yet so come back when you are and maybe you can have an abortion then” guy is doing.

[YGIFS 19450]

To keep children safe, Imagine if we put the kind of scientific analysis we do into trans surgeries into something like keeping them from being slaughtered by AR-15s 

i know, I know…the data just isn’t there yet on being shot as causing death.  
 

I am nowhere close to any of you on knowledge of the trans science or the trans experience.  But this is Texas.  If you’re 17, you can’t take a hormone blocker but you can sure as shit take a bullet.  

[Willfully Horn 8014]

9 minutes ago, wildcat09 said:

The key thing to understand in these discussions is that the person playing the role of Anastasis, pretending not to be a bigot but just insisting the scientific evidence isn’t there yet, is doing the same thing the “oh your fetus has a fatal birth defect and you will die without an abortion but you’re not in septic shock yet so come back when you are and maybe you can have an abortion then” guy is doing.

Anonymous message board dude is so much more reliable than the NEJM, the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, the American Medical Association, the American Psychological Association and the American Psychiatric Association. These are the groups that have the ideological worms, not the hate engines on the right. Not to mention those researchers whose names are on their studies. All those folks are suspect. Unlike el-anonarcissist.

 

[troph 24787]

3 hours ago, naija said:

troph, not everyone who questions something about transitioning is against transitioning. I'm not. I will in fact wager, that I'm probably one of the few posting on this thread  who has participated in gender affirming surgeries. And it wasn't because a shotgun was held to my temple. If you weren't posting, I would not volunteer that information.

thank you for the background. Understand you don’t sound supportive and you must understand the context we are living in, our lives are significantly threatened. Not hyperbole, and nearly every juncture of life that matters being trans is dangerous even for me, white, educated, I blend in, I make good money and I have a settled family. Heck I was at a high school sporting event and my ex walked up and I was nervous the person I was talking about would start wondering and then what that would mean. Daily life is full of Paxton, Patrick, Abbott, Cruz, Trump related stress. So when you post “what about this, what about that” understand that’s how our enemies post too (you don’t even have to leave this message board to find them). 

now, to some of what you've written above.

why 3 to 5 years. How is that not an arbitrary mark? You might posit it as a gut feeling, but really what is your 3 to 5 years based on? Why should a kid suffer for 5 years to satisfy this criteria?

I believe most medical care - certainly this kind - should be measured and graduated until the problem is alleviated and that’s especially true with psychological concerns. You may have participated in these surgeries but the physical care is last and the certainty should be there. I say 3-5 years only to highlight that care for minors is not a brightline - none before 18 and at 18 anything goes. I transitioned over 4 year period. I wasn’t fully settled for 6-7 because I was an adult. As slow as that was it was right. Some kids play around with pronouns and sexuality now because they can, I think establishing permanence is important. I think magically being 18 is irrelevant. The severity and permanence of gender dysphoria is what matters. I think legislating any of this is eugenics. I think professionals and professional associations should be allowed to create their protocols and should be left alone. But again in this dialogue I speak to 3-5 years to explain the importance of permanence and severity not age.

Nothing should be off limits? Does that include bottom surgery? And if you say it doesn't, then again, why not?

nothing should be off limits when talking about legislation. Standards of care, treatment protocols and decisions should remain with patient and doctors/other professionals and family where minor care is involved.

Some might want to use the point about detransitioning as their argument for blocking all forms of treatment, but can you consider that isn't the only reason to seek better data on detransitioning or regret?

if that’s the case then you and they didn’t read for comprehension or understand what I said. It’s also the case you are sounding like our enemies.  being trans is sometimes awful. There is not a day that goes by that my life isn’t negatively impacted by it and I live a beautiful life. Most of it is paranoia or anxiety or back up plan mental energy against the backdrop of the politics of our age but it’s real. Every day I look in the mirror before going out and ask if I look cis enough because of the ramifications of what being outed means. If that doesn’t once and again make you question your decision then you’re not being genuine. YET the answer is a HARD NO. Why? Because my gender is immutable. I give you that anecdote to explain how sticky this is, and I knew since I was 12 and saw a friend post-pubescent male crotch in the football locker room and went home and cried for hours because I did not want that. When children know they know and the only factor is making sure the professionals and family understand the child knows and isn’t just at the doorstep of discovery. 

And I say better, because the studies that have even bothered to broach this are mostly not doing so with great statistics. For one thing, they tend to forego the intention to treat model and simply discount patients who fall out of the study or chose not to respond as null respondents, when in actuality some are probably one of the two. So why else should there be interest in that data? Because it simply helps the physician/team/surgeon have a fuller, more informed conversation about what the risks are with the patient. This is not a small thing. Part of why surgeons choose which operations they will perform, sometimes has less to do with technical ability and more to do with one's tolerance for complications. If this goes wrong, what can or can't I live with. This is why Pediatric Neurosurgeons and Cardiothoracic Surgeons are a cut above. And please, let's not go with the argument that it is the patient who alone bears the burden. I have personally known two uber-talented, altruistic people walk out of medicine because of surgical misadventures. The full title of the specialty that most often deals with transgender surgery is after-all Plastic & Reconstructive Surgery and that second word isn't just for show. People don't go into this because they like extirpative procedures, and transgender surgery involves two of the most irreversible, yet-not-fatal, procedures you can perform. You won't know it, because the resident and fellowship applicant pool is brimming with people who are excited about developing gender-affirming practices, but there are also a number who started and have pulled back or are hesitant to start at all because there is that feeling that they can't turn the same questioning stance on aspects of this as they can with other procedures. It is likely impossible to have all the data on any procedure, but you don't want to be left feeling like your ability to critique and refine is hampered. When you couple that with the removal of what were held as some safeguards, i.e, mandatory mental health evaluation (which needs to be taken into account when people quote detransitioning  or regret percentages), and the increase in the prevalence of LGBTQIA kids, there is a concern that more people are going to get operations they shouldn't have. And for some surgeons, an n of 1, is a complication they aren't willing to deal with. Anyone is free to think those people are cowards.

On my phone this is challenging … answers are actually in the quote in bold.  Probably fucked it up but whatever my answers are up there.
 

additional answers to the questioning part of your post. If you are supportive you need to understand the politics of trans care are perpetuated by cis people who for 80 years have blocked trans care. I think questioning and improvements need to be allowed for and they have occurred care is so much better now than when my identity was emergent. Jesus our estrogen used to come from horse urine now it’s bio identical. Some of the most prestigious medical schools in the world wouldn’t touch our care now there are departments. This is good but politics needs to be out of our care. I am NOT a fan of informed consent.  I had one letter after 18 months of therapy and gender presentation exploration before I started hormones, and the rest of my care is no one’s business but informed consent wasn’t the model. 
 

as for detransitioning again - that happens and will happen more with more access. But trans care should not be upended because a low percentage want to detransition. There’s no other medical procedure where treatment is denied because a few change their mind. 

3 hours ago, naija said:

So that's one reason, if not THE reason, for the interest. It really is to be better at this.

Great thanks, understand you’re  keeping company with bigots and legislators who use political power to ask and answer similar questions with laws aimed at eradication and systemic discrimination. So you should be very clear about your motives, your practice and your personal views if you want to be heard as a caring, supportive doctor who wants to make things better and you should be patient with those that don’t believe you because the rhetoric on the otherside is awful. 
 

fundamentally, families, patients and their doctors and professionals should be left the fuck alone. And the professionals should be allowed to do what they do - practice medicine and that means making it better through their process of research and review. 

Edited May 8, 2023 by troph

[troph 24787]

35 minutes ago, wildcat09 said:

The key thing to understand in these discussions is that the person playing the role of Anastasis, pretending not to be a bigot but just insisting the scientific evidence isn’t there yet, is doing the same thing the “oh your fetus has a fatal birth defect and you will die without an abortion but you’re not in septic shock yet so come back when you are and maybe you can have an abortion then” guy is doing.

Pretty much yes.

[troph 24787]

5 hours ago, naija said:

I can only assume you didn't actually read what the bold part refers to. It is the idea that the only prerequisite for surgery should be a desire or want of it. Maybe you need to read that again. Forget gender affirming surgery for a second. Surgery should not be practiced that way. Across all surgical subspecialties. Have you ever sat through an Indications Conference? The reason that you operate on someone can't simply be, they wanted it. 

This is why your posts seem more like Anastasis and Poe than like a medical doctor that cares about trans patients and their true well being.  While I don’t doubt there are some trans activists that want no protocols they are not the parents and trans patients I’ve ever known. The goal here is to get the legislative nonsense out of the practice of medicine. We FINALLY have the medial community’s attention and concern - in a GREAT WAY - students want to help us this is AMAZING. And now like clockwork, here come the legislators.

as a physician, the only message you need to harp on is to let doctors and other professionals do their job and tell law makers to stay the fuck away. You say that, we know you are an ally. You don’t say simply that, you’re suspect. It’s really that simple.

Edited May 8, 2023 by troph

[TwiceHorn 31457]

4 hours ago, naija said:

troph, not everyone who questions something about transitioning is against transitioning. I'm not. I will in fact wager, that I'm probably one of the few posting on this thread  who has participated in gender affirming surgeries. And it wasn't because a shotgun was held to my temple. If you weren't posting, I would not volunteer that information.

now, to some of what you've written above.

why 3 to 5 years. How is that not an arbitrary mark? You might posit it as a gut feeling, but really what is your 3 to 5 years based on? Why should a kid suffer for 5 years to satisfy this criteria?

Nothing should be off limits? Does that include bottom surgery? And if you say it doesn't, then again, why not?

Some might want to use the point about detransitioning as their argument for blocking all forms of treatment, but can you consider that isn't the only reason to seek better data on detransitioning or regret? And I say better, because the studies that have even bothered to broach this are mostly not doing so with great statistics. For one thing, they tend to forego the intention to treat model and simply discount patients who fall out of the study or chose not to respond as null respondents, when in actuality some are probably one of the two. So why else should there be interest in that data? Because it simply helps the physician/team/surgeon have a fuller, more informed conversation about what the risks are with the patient. This is not a small thing. Part of why surgeons choose which operations they will perform, sometimes has less to do with technical ability and more to do with one's tolerance for complications. If this goes wrong, what can or can't I live with. This is why Pediatric Neurosurgeons and Cardiothoracic Surgeons are a cut above. And please, let's not go with the argument that it is the patient who alone bears the burden. I have personally known two uber-talented, altruistic people walk out of medicine because of surgical misadventures. The full title of the specialty that most often deals with transgender surgery is after-all Plastic & Reconstructive Surgery and that second word isn't just for show. People don't go into this because they like extirpative procedures, and transgender surgery involves two of the most irreversible, yet-not-fatal, procedures you can perform. You won't know it, because the resident and fellowship applicant pool is brimming with people who are excited about developing gender-affirming practices, but there are also a number who started and have pulled back or are hesitant to start at all because there is that feeling that they can't turn the same questioning stance on aspects of this as they can with other procedures. It is likely impossible to have all the data on any procedure, but you don't want to be left feeling like your ability to critique and refine is hampered. When you couple that with the removal of what were held as some safeguards, i.e, mandatory mental health evaluation (which needs to be taken into account when people quote detransitioning  or regret percentages), and the increase in the prevalence of LGBTQIA kids, there is a concern that more people are going to get operations they shouldn't have. And for some surgeons, an n of 1, is a complication they aren't willing to deal with. Anyone is free to think those people are cowards.

So that's one reason, if not THE reason, for the interest. It really is to be better at this.

People should read this, it's insightful and offers a perspective not generally presented here.

[troph 24787]

5 minutes ago, TwiceHorn said:

People should read this, it's insightful and offers a perspective not generally presented here.

And they should read my in-line responses as it’s insightful and offers a perspective not generally presented here. Twice to be really fair his response was mostly questions of me. To quote only him and not the conversation is inadvertently (you’re a good fella and I don’t question your motives) a problem. 

Edited May 8, 2023 by troph

[troph 24787]

Just a reminder on the Ken Paxton is investigating doctors and hospitals thread that our lives and care have been politicized - from the LGBTQ thread - just ONE example of what’s going on… 

the Florida kidnapping bill.  Parents can have their kids taken away from them over gender affirming care and procedures. 

https://newrepublic.com/post/172444/florida-passes-bill-allowing-trans-kids-taken-families

No one here should have any standing other than those intimately involved. doctors, other professionals, professional associations, genuine researchers and patients and families need to be left the fuck alone. That’s the ONLY bright line here. You’re on the right side or the wrong side of this “debate” there is no middle ground when it comes to healthcare. 

[atomheartbevo 89656]

5 minutes ago, troph said:

Just a reminder on the Ken Paxton is investigating doctors and hospitals thread that our lives and care have been politicized

With the Allen mass shooting, I expect that Paxton will be announcing more hospitals that need to be investigated.

[YGIFS 19450]

Well statistically speaking some of these mass shooting events did probably have their dicks and breasts removed without parental consent.   

So I'm sure Paxton will want to get to the bottom of this post-haste!  

[Longhornfan1024 1707]

Is there any actual news in this thread?  Or is it just the original story and then four pages of @Anastasis sodomizing himself while staring deeply into @Sawbonz's eyes?

[YGIFS 19450]

Nothing newsworthy.  Just a reminder that centuries from now, digital archivists will comb through the history of Texas and see consistently massive theme bubbles like settlement/urbanization, energy, booms and busts, guns, water, crime, civil rights, agriculture and ranching, football, space travel, tourism, music, etc. for 200 years. 

And then one guy will be like, "That all makes sense, those were the broader societal issues of their time."  And the other guy will ask, "What are these tiny little bubbles here from 2015-2025"?  First guy, "Apparently for 2% of their existence, they were freaked the fuck about 9 kids questioning their gender during puberty.  And something called CRT, and men dressing as ladies to sing for fun, and women having to call a local politician to get reproductive counseling.  I dunno, buncha weird shit in that little slice.  Never showed up before or after.  Odd.  We could probably piece together the mystery with the old printed materials but they burned all their libraries that year." 

[High Plains Drifter 11046]

On 5/6/2023 at 3:37 PM, Sawbonz said:

There is no such thing as an irreversible hormone

 

Thank you, that's what I thought, but not being in the medical field, I was unsure.

 

[hayden_horn 11362]

13 hours ago, troph said:

Many of y’all can’t fathom how normal being queer and trans is to us, it’s not a big deal, it’s human and we aren’t that different compared to everyone else. You get to have medical autonomy let us have it too. Leave all of us alone, let doctors and families make their decisions. 

that's what abbott just wants - for all yall trans folks to just leave him alone and start asking for things like human treatment. you'll settle for less than mexican, and like it, by god!

seriously, what's so hard about this?

it does not affect anyone, except to free up people to live their own lives as fellow human beings. god forfuckingbid.

[nbmishoid 949]

15 hours ago, naija said:

and you know I don't care about outcomes from spinal surgery how (which is a rather broad catchall term and involves more procedures than are available for gender transition)? I didn't care when I had two procedures? care to guess my thoughts on cranial vascular bypass surgery as well? To point out and discuss some of the practice complexities of gender affirming surgery does not equate to being against gender affirming procedures. It's this sort of binary thinking that rather proves the point about the minefield it can be to just even talk about it. 

Someone upfield made a statement that no such surgeries were being performed on minors. Somehow pointing out that this is not true, means I harbor some prejudice against the practice. I didn't comment on how often or the volume, just that it happens. Then you get responses to a point I never made, as if stating a fact is the same as condemnation. Incredible and yet, not surprising. 

I surely misinterpreted your meaning.  Not the only one.  Thanks for your clarity.

Yet my point was that concern about regrets, on a population basis, directed at gender affirming surgeries is like swatting a fly on the charging elephants.  Misplaced priorities.  I don’t now attribute that view to you.  I hope your back is better.

[Goredho 17400]

Wait, the government is responsible for protecting me from regret?  If so, I'd like to expand the conversation to talk about reparations for watching some of Mack Brown's teams play Oklahoma.

[nbmishoid 949]

Those games fucked with your tone, right?  

[hpslugga 4058]

On 5/6/2023 at 12:13 AM, atomheartbevo said:

Paxton

 

[Sawbonz 27548]

Naija is a good dude. I feel bad that my ignorant (as in lack of knowledge) post about top surgery brought him into this thread. He probably knows more about the technical side of physical transition than all of us put together. I read his posts as being concerned about how a treating physician would go about synthesizing data and counseling patients and coming up with a plan based on pros and cons and, within that context, where the shortcomings, are rather than a negative critique of the process. And Troph’s replies were great.
 

I totally get that anxiety and depression are independent issues but intimately part of dealing with gender dysphoria. I know analogies can be misconstrued, but I see a lot of chronic pain patients and long ago figured out they were almost all depressed and anxious. Well, hurting all the time is fucking depressing, and not being able to do what you want and need to do is anxiety inducing! In many but not all cases fixing the underlying cause of the chronic pain fixes the rest, but one cannot assume it will and the whole picture has to be addressed. 
 

 

[TwiceHorn 31457]

6 minutes ago, Sawbonz said:

Naija is a good dude. I feel bad that my ignorant (as in lack of knowledge) post about top surgery brought him into this thread. He probably knows more about the technical side of physical transition than all of us put together. I read his posts as being concerned about how a treating physician would go about synthesizing data and counseling patients and coming up with a plan based on pros and cons and, within that context, where the shortcomings, are rather than a negative critique of the process. And Troph’s replies were great.
 

I totally get that anxiety and depression are independent issues but intimately part of dealing with gender dysphoria. I know analogies can be misconstrued, but I see a lot of chronic pain patients and long ago figured out they were almost all depressed and anxious. Well, hurting all the time is fucking depressing, and not being able to do what you want and need to do is anxiety inducing! In many but not all cases fixing the underlying cause of the chronic pain fixes the rest, but one cannot assume it will and the whole picture has to be addressed. 
 

 

Yes, that's what I thought was insightful.  At least I found it interesting.

And it doesn't change my mind about the politics of this.  I can respect any informed opinion on this, just about.  I can't respect those that come from the politics first and medicine and patient welfare second.

[TwiceHorn 31457]

9 hours ago, troph said:

And they should read my in-line responses as it’s insightful and offers a perspective not generally presented here. Twice to be really fair his response was mostly questions of me. To quote only him and not the conversation is inadvertently (you’re a good fella and I don’t question your motives) a problem. 

See my above. I kind of elided the part responsive to you and dug in on the actual surgeon's view and it raised some things, not particular to gender issues, that I hadn't really considered.

[naija 2854]

22 minutes ago, Sawbonz said:

Naija is a good dude. I feel bad that my ignorant (as in lack of knowledge) post about top surgery brought him into this thread. He probably knows more about the technical side of physical transition than all of us put together. I read his posts as being concerned about how a treating physician would go about synthesizing data and counseling patients and coming up with a plan based on pros and cons and, within that context, where the shortcomings, are rather than a negative critique of the process. And Troph’s replies were great.
 

I totally get that anxiety and depression are independent issues but intimately part of dealing with gender dysphoria. I know analogies can be misconstrued, but I see a lot of chronic pain patients and long ago figured out they were almost all depressed and anxious. Well, hurting all the time is fucking depressing, and not being able to do what you want and need to do is anxiety inducing! In many but not all cases fixing the underlying cause of the chronic pain fixes the rest, but one cannot assume it will and the whole picture has to be addressed. 
 

 

Thanks.

[troph 24787]

14 hours ago, Sawbonz said:

Naija is a good dude. I feel bad that my ignorant (as in lack of knowledge) post about top surgery brought him into this thread. He probably knows more about the technical side of physical transition than all of us put together. I read his posts as being concerned about how a treating physician would go about synthesizing data and counseling patients and coming up with a plan based on pros and cons and, within that context, where the shortcomings, are rather than a negative critique of the process. And Troph’s replies were great.
 

I totally get that anxiety and depression are independent issues but intimately part of dealing with gender dysphoria. I know analogies can be misconstrued, but I see a lot of chronic pain patients and long ago figured out they were almost all depressed and anxious. Well, hurting all the time is fucking depressing, and not being able to do what you want and need to do is anxiety inducing! In many but not all cases fixing the underlying cause of the chronic pain fixes the rest, but one cannot assume it will and the whole picture has to be addressed. 
 

 

I believe @naija is alright as well but the thing you MDs need to understand about trans care is that everyone is interested in it and the two groups most focused on it are your patients and our enemies. And our enemies are masterful at twisting well meaning but unsuspecting criticisms of current treatment protocols which are intended to improve healthcare to advocate for shutting it down altogether. Cancer treatments get criticized all the time yet treatment continues and improvements continue to advance at the same time. Our enemies have no interest in improvements and twisting fair criticism is actually how they justify the politicalization of your very profession and practice. 

Edited May 9, 2023 by troph

[DDD Dad 14338]

On 5/7/2023 at 4:08 PM, TwiceHorn said:

While affirmative action certainly falls withing DEI and thus is "woke," it long predates the term.  And, a legitimate debate can be had over affirmative action.

On the other hand, not all DEI is any kind of affirmative action.  In fact, most of it is simple empathy:  try to walk a mile in the other wo/man's shoes and then behave accordingly. And that is "woke."

And, that actually requires some understanding of the things that the dominant race has done to the other races, and that, while factual, is also DEI and also woke.

And by lumping it all together and calling it "woke,"  you have made simple good behavior and factual education necessary to good behavior a political canard on the level of debating affirmative action.

And that, friends and neighbors, is pure dee demagoguery.

Atticus Finch was woke

[fattyflattie 4639]

On 5/8/2023 at 8:29 AM, troph said:

Just a reminder on the Ken Paxton is investigating doctors and hospitals thread that our lives and care have been politicized - from the LGBTQ thread - just ONE example of what’s going on… 

the Florida kidnapping bill.  Parents can have their kids taken away from them over gender affirming care and procedures. 

https://newrepublic.com/post/172444/florida-passes-bill-allowing-trans-kids-taken-families

No one here should have any standing other than those intimately involved. doctors, other professionals, professional associations, genuine researchers and patients and families need to be left the fuck alone. That’s the ONLY bright line here. You’re on the right side or the wrong side of this “debate” there is no middle ground when it comes to healthcare. 

I reckon it's not a surprise to many here, but this belongs in the every accusation is a confession bucket.  From what I've been able to gather (I dont understand it) this is what the fringy right is deathly afraid of.  The govt assuming your child is trans (or them declaring themselves so), and removing them from you to be operated on/transitioned.  I don't dig in deep because I don't get it, but I know for a fact I've been sent more than one meme in that regard.  The accusation/confession thing is becoming pretty scary truthful.  

This may not be a surprise to you, as I'm sure you know what your enemies are spouting.  But I had to take a second read of your post because it's 180* of their "concerns", as I understand them. 

[troph 24787]

1 hour ago, fattyflattie said:

I reckon it's not a surprise to many here, but this belongs in the every accusation is a confession bucket.  From what I've been able to gather (I dont understand it) this is what the fringy right is deathly afraid of.  The govt assuming your child is trans (or them declaring themselves so), and removing them from you to be operated on/transitioned.  I don't dig in deep because I don't get it, but I know for a fact I've been sent more than one meme in that regard.  The accusation/confession thing is becoming pretty scary truthful.  

This may not be a surprise to you, as I'm sure you know what your enemies are spouting.  But I had to take a second read of your post because it's 180* of their "concerns", as I understand them. 

Quote

 Section 1. Subsection (1) of section 61.517, Florida
   73  Statutes, is amended to read:
   74         61.517 Temporary emergency jurisdiction.—
   75         (1) A court of this state has temporary emergency
   76  jurisdiction if the child is present in this state and:
   77         (a) The child has been abandoned; or
   78         (b) It is necessary in an emergency to protect the child
   79  because the child, or a sibling or parent of the child, is
   80  subjected to or threatened with mistreatment or abuse; or
   81         (c) It is necessary in an emergency to protect the child
   82  because the child has been subjected to or is threatened with
   83  being subjected to sex-reassignment prescriptions or procedures,

Quote

     61.534 Warrant to take physical custody of child.—
   88         (1) Upon the filing of a petition seeking enforcement of a
   89  child custody determination, the petitioner may file a verified
   90  application for the issuance of a warrant to take physical
   91  custody of the child if the child is likely to imminently suffer
   92  serious physical harm or removal from this state. Serious
   93  physical harm includes, but is not limited to, being subjected
   94  to sex-reassignment prescriptions or procedures as defined in s.
   95  456.001.

Quote

       (9)(a) “Sex-reassignment prescriptions or procedures”
  165  means:
  166         1. The prescription or administration of puberty blockers
  167  for the purpose of attempting to stop or delay normal puberty in
  168  order to affirm a person’s perception of his or her sex if that
  169  perception is inconsistent with the person’s sex as defined in
  170  subsection (8).
  171         2. The prescription or administration of hormones or
  172  hormone antagonists to affirm a person’s perception of his or
  173  her sex if that perception is inconsistent with the person’s sex
  174  as defined in subsection (8).
  175         3. Any medical procedure, including a surgical procedure,
  176  to affirm a person’s perception of his or her sex if that
  177  perception is inconsistent with the person’s sex as defined in
  178  subsection (8).

I think you are agreeing with me.

here is the actual law ... any medical treatment of any kind that is gender affirming (not just surgeries) is illegal and and even if only threatened the state of Florida can take custody of your child.

Edited May 9, 2023 by troph

[fattyflattie 4639]

34 minutes ago, troph said:

I think you are agreeing with me.

here is the actual law ... any medical treatment of any kind that is gender affirming (not just surgeries) is illegal and and even if only threatened the state of Florida can take custody of your children.

I'm certainly not disagreeing.  What I was trying to convey is there are looney people that think the state will come take your child, and "force" on them the care they want, without parental consent.  Teachers, govt spooks, etc.  180* from parent trying to get their kid help, and then being punished for that.   Something like the short play below.  Fwiw, these are highly educated people sending me this shit.  

       FF 10 yo daughter: Teacher, I believe I am transexual, and would like to transition to meet my body's feelings. Typical other legitimate feelings I dont know of understand          inserted here.

      Teacher: Come with me, I'm turning you into the govt so they can force testosterone into you and other surgeries that are typical with this.  Your parents have no say in            this. 

      FF: Why didn't daughter come home from school this afternoon?!?!?!  Frantic shuffling.

      GMan: Rings doorbell.  Your son is now property of the US Govt, and his name is Bill. 

      FF: Daughter never even spoke with me about this.  Where is my daughter/son?

      GMan: Your son is now property of the US Govt.   Let's review your tax filings over the last 7 years. 

 

One of these dudes believes this issue is what will drive the country to a civil war.  I. Do. Not. Understand.

[troph 24787]

5 minutes ago, fattyflattie said:

I'm certainly not disagreeing.  What I was trying to convey is there are looney people that think the state will come take your child, and "force" on them the care they want, without parental consent.  Teachers, govt spooks, etc.  180* from parent trying to get their kid help, and then being punished for that.   Something like the short play below.  Fwiw, these are highly educated people sending me this shit.  

       FF 10 yo daughter: Teacher, I believe I am transexual, and would like to transition to meet my body's feelings. Typical other legitimate feelings I dont know of understand          inserted here.

      Teacher: Come with me, I'm turning you into the govt so they can force testosterone into you and other surgeries that are typical with this.  Your parents have no say in            this. 

      FF: Why didn't daughter come home from school this afternoon?!?!?!  Frantic shuffling.

      GMan: Rings doorbell.  Your son is now property of the US Govt, and his name is Bill. 

      FF: Daughter never even spoke with me about this.  Where is my daughter/son?

      GMan: Your son is now property of the US Govt.   Let's review your tax filings over the last 7 years. 

 

One of these dudes believes this issue is what will drive the country to a civil war.  I. Do. Not. Understand.

Yes every accusation (the email sent to you) is a confession (the law I quoted).  

[safe sex 11717]

We're having so many patients who have been waiting months to be seen to start their medical transition cancel on us.  Breaks my heart. 

Sigh. There is so much despair among our trans patients now. Increase in vocalized SI thoughts. Massive new amounts of anxiety.  Eating disorders flaring up. People detransitioning for their safety. Canceling their court appointments to change their name/gender marker.

This is working exactly as planned by the right. 

[fattyflattie 4639]

38 minutes ago, troph said:

Yes every accusation (the email sent to you) is a confession (the law I quoted).  

What’s most irritating (other than the obvious) about it to me is if I had the brains they needed to get thru school, or their exact lambskins, I’d be retired and lounging in a fighting chair right now.  I don’t understand how one can be so incredibly smart and so fucking stupid at the same time.  

[TwiceHorn 31457]

2 hours ago, fattyflattie said:

fringy right

It's not the fringey right though.  It's the majority of both houses of the legislatures in Texas, and in Florida, and a bunch of other states I can't enumerate right now.

While people were continuing to dismiss this kind of shit as fringey right and still voting R, this is what we got.

 

[fattyflattie 4639]

10 minutes ago, TwiceHorn said:

It's not the fringey right though.  It's the majority of both houses of the legislatures in Texas, and in Florida, and a bunch of other states I can't enumerate right now.

While people were continuing to dismiss this kind of shit as fringey right and still voting R, this is what we got.

 

I meant fringe right citizenry, not the govt officials.   I’ve known these guys for 20-25 years, in each other’s weddings and shit, and never heard a peep positive or negative about LGBTQ until 18 months ago.   Well educated, monied families, very center right/libertarian shit, 1 quasi religious, one absolutely not.  In 18 months it’s a complete reversal.  I bet I get 30 fucking memes a day in text, and I can’t even decipher what 25 are about.  The anger moves so rapidly. I just don’t get it. 

[troph 24787]

Tell them that’s not cool, you know a trans woman from the internet and she’s cool as fuck.

[fattyflattie 4639]

2 minutes ago, troph said:

Tell them that’s not cool, you know a trans woman from the internet and she’s cool as fuck.

Already done.  One was around the boards for old Tropheus.   I will admit, a recent trip to Disney by one made for some high comedy (to me). 

[Sawbonz 27548]

41 minutes ago, fattyflattie said:

I meant fringe right citizenry, not the govt officials.   I’ve known these guys for 20-25 years, in each other’s weddings and shit, and never heard a peep positive or negative about LGBTQ until 18 months ago.   Well educated, monied families, very center right/libertarian shit, 1 quasi religious, one absolutely not.  In 18 months it’s a complete reversal.  I bet I get 30 fucking memes a day in text, and I can’t even decipher what 25 are about.  The anger moves so rapidly. I just don’t get it. 

Were these same people sending you migrant caravan memes in 2015 and 2016?

[fattyflattie 4639]

32 minutes ago, Sawbonz said:

Were these same people sending you migrant caravan memes in 2015 and 2016?

Nah I don’t think so.  But maybe.  Ukraine and trans movement has broken some minds. 

[ChuckNorrisActionJeans 2663]

yes there was a poll recently saying that a majority of the population at large agrees with the R's anti-trans laws. Which contrasts with what the majority feels on pretty much every other R crusade. Propaganda regarding people most are unfamiliar with is extremely effective.