[auung]

> The number of those kinds of surgeries people claim to be "oh so concerned" about is in the low double digits--generally low single digits--normally zero in a year.

In the US it's hundreds of such surgeries each year, and rising, per https://www.reuters.com/investigates/special-report/usa-tran...

This is a lower bound as not all of these young girls get their breasts removed through health insurance, some will be paid for privately.

[bsder]

All right, fine. Let's use your definitions. Here is a report from the US in 2022: https://pmc.ncbi.nlm.nih.gov/articles/PMC9555285/

From 2013-2020 in Northern California we have:

> Among the 209 adolescents who underwent gender-affirming mastectomy, only two expressed regret.

> In our cohort, two patients (0.95%) expressed regret; one inquired about reversal surgery, but neither had undergone reversal surgery within follow-up periods of 3.7 years and 6.5 years.

Note the followups are into post-teenage years and most are very satisfied.

> Gender-affirming mastectomy, also known as “top surgery,” is the most prevalent surgery requested when considering all transgender adolescents, whereas “bottom surgery,” which affects genitalia and fertility, is relatively more complex and mostly performed after age 18.

As far as I can see, this is a medical system that is being very conservative (especially involving irreversible effects on fertility), involving parents/guardians at all stages, and prefers therapy first, hormones second, and surgery only as a very final choice. And note this level of conservatism in a system in Northern California--which is likely to be the most accepting of such medical actions.

So, if you are advocating that this should not be the case, understand that you are directly attempting to legislate the complex relationship between parent and teenager as well as both of them communicating with a medical professional for something which evidentially is a neutral to positive outcome for 98+% of the patients involved.

What right do YOU think you have to enter into that conversation at all?

[auung]

Did you read this section of the paper?

> Our study has several limitations. First, its retrospective design meant we were unable to measure patient satisfaction and quality-of-life outcomes. Complications and any mention of regret were obtained from provider notes, which may be variable, and thus both may be under-reported. In addition, although an integrated health care system allows for continuity of care, some members may have transferred care or changed their insurance status and thus, subsequent complications, or reversal operations, would not have been captured. Next, our study was conducted at KPNC in an insured cohort of individuals with access to gender-affirming medical and surgical care. Therefore, our outcomes may not be representative of the general population, many of whom lack similar access to care. Finally, the time to develop postoperative regret and/or dissatisfaction remains unknown and may be difficult to discern.

You state that "the followups are into post-teenage years and most are very satisfied", but the authors were very explicit about not being able to determine this due to the study design.

The authors also report that:

> The median age at the time of referral was 16 years (IQR=2) and ranged from 12-17 years. Patients had a median post-operative follow-up length of 2.1 years (IQR 1.69).

Which implies that for many patients, the follow-up would have been within their teenage years.

[Dig1t]

Not only that, but the number of kids on hormone blockers is in the thousands (and increasing a lot every year). It's claimed that their effects are reversible but that is false, they lead to sterilization if the timing is wrong.

https://www.nhs.uk/conditions/gender-dysphoria/treatment/

>Long-term gender-affirming hormone treatment may cause temporary or even permanent infertility.

And the worst part of all:

>56 genital surgeries among patients ages 13 to 17

That's 56 kids who were permanently sterilized before their brain was even finished developing.

I have nothing against trans people, but many people draw the line when it comes to kids.

[irisgrunn]

According to this way more recent study they are totally reversible: https://www.sciencedirect.com/science/article/pii/S0929693X2...

And this one says the same: https://academic.oup.com/jsm/article/20/3/398/7005631

And then there's article from Yale that actually disproves the cass report where the NHS guidelines are based on: https://law.yale.edu/sites/default/files/documents/integrity...

> I have nothing against trans people, but many people draw the line when it comes to kids.

Except when those children happen to be trans, that case they're not allowed to exist or be mutilated for life, even though it's easily preventable

[jimbokun]

I appreciate the study links, but it makes it really hard to take you seriously when you claim trans kids are not allowed to “exist”. That’s extreme hyperbole, as if they’re still alive they obviously exist.

[irisgrunn]

If you don't allow for proper treatment like social transitioning and puberty blockers, they can't be themselves and therefore they can't exist.

Next to this there's also risk of those kids committing suicide because they can't get proper treatment, which is only getting worse with all the anti-trans laws. See https://www.nature.com/articles/s41562-024-01979-5.epdf

[zahlman]

>According to this way more recent study they are totally reversible: And this one says the same:

I see nothing in your links that supports those conclusions. The second one at least asserts that recipients overwhelmingly don't want to reverse the effects, but this too is a complex topic (see e.g. https://slatestarcodex.com/2018/09/08/acc-entry-should-trans... ).

Also, the link you're responding to isn't a "study", but rather a position document from the NHS (UK national healthcare).

[irisgrunn]

> I see nothing in your links that supports those conclusions.

I'd start with chapter 5.2.1.7 go from there.

> but this too is a complex topic (see e.g. https://slatestarcodex.com/2018/09/08/acc-entry-should-trans... ).

You can either force a trans kid to develop the wrong kind of secondary sex characteristics. With all trauma and painful corrective procedures that will follow later in life, or you can let them take a pill a day which will halt it until they're old enough to make that decision. That really doesn't seem difficult to me.

> Also, the link you're responding to isn't a "study", but rather a position document from the NHS

I know but it's still based on the cass report, which claims to be a study.

[zahlman]

>I'd start with chapter 5.2.1.7 go from there.

As far as I can tell, you linked to abstracts for a paywalled academic papers.

>You can either

The point is about the objective fact of what the kids want. Your moral judgement of what should be done as a result, is irrelevant to that.

[irisgrunn]

> As far as I can tell, you linked to abstracts for a paywalled academic papers.

Just scroll down, no paywall.

> The point is about the objective fact of what the kids want. Your moral judgement of what should be done as a result, is irrelevant to that.

This has nothing to do with my moral judgment. If a kid gets diagnosed with gender-dysphoria, they should get proper treatment. Social transition in combination with puberty blockers are the known effective treatment.

Not sure about the US, but here gender-dysphoria in children has to be diagnosed by a team of professionals that aren't allowed to steer them in any way.