Australian girls as young as 13 are allegedly having their breasts surgically removed to make them look and feel more masculine as they undergo gender transition.
One 15-year-old who has gender dysphoria documented having a double mastectomy at an Australian plastic surgery clinic in a Reddit post.
Describing the experience as ’10/10′, the teen encouraged other adolescents who did not identify with the sex they were assigned at birth to undergo the same operation.
The teen wrote that an initial appointment with a surgeon in January lasted no more than 20 minutes and a follow up to take measurements took a similar length of time.
The teen then called a psychiatrist requesting a referral for ‘chest masculinisation’ – sometimes called top surgery – and was told he was unavailable for the next 11 months.
A teenager who recently underwent a double mastectomy was pictured smiling in a Facebook post. The 17-year’s mother wrote: ‘My baby’s top surgery was today it went well… ‘
But when the teen told the psychiatrist they already had a surgery date booked he offered an appointment a couple of months later.
After just one consultation with the psychiatrist in May the psychiatrist allegedly wished the teen luck and wrote a referral for a double mastectomy.
The teen had spent two years saving up for the surgery, which took place on June 18, and their parents covered the rest of the $14,873 bill.
Another teenager who recently underwent a double mastectomy was pictured smiling in a Facebook post with his mother.
The 17-year’s mum wrote: ‘My baby’s top surgery was today it went well… he was so excited. Still in recovery but surgeon said it all went well.’
Another mother replied that she had planned taking her 17-year-old to Thailand for the same procedure when he turned 18 but surgeons there would not perform the operation on anyone under 20.
Senior child and adolescent psychiatrist Dr Jillian Spencer said there were Australian psychiatrists and surgeons who were recommending and performing such operations.
Dr Spencer said young people requested approval letters from a psychiatrist and if they did not get what they wanted would post negative reviews on social media and go elsewhere.
‘It is very concerning that there are a very small number of child psychiatrists in Australia whose clinical practice deviates markedly from that of their colleagues,’ Dr Spencer said.
Girls as young as 13 are allegedly having their breasts surgically removed to make their chests more masculine as part of a teenage gender transition process. Stock image
‘These child psychiatrists are providing approval letters to allow adolescents to undergo chest masculinising mastectomies after as little as only one appointment.
‘The names and contact details of these child psychiatrists are shared by adolescents on social media to allow other adolescents to follow the same pathway to easily obtain the surgery.’
Dr Spencer said psychiatrists who wanted to undertake ongoing assessment of adolescents with gender dysphoria risked being publicly labelled transphobic.
She said automatically affirming children’s beliefs about their gender identity and giving them referrals for life-changing surgery without thorough examination was a ‘radical approach’.
‘Adolescents often have unrealistic fantasies about the cosmetic outcome of surgery,’ Dr Spencer said of children presenting with gender dysphoria.
‘When a 15-year-old adolescent sits in front of them, no child psychiatrist has any way of determining if that adolescent’s gender dysphoria will desist or persist over coming years.
‘They struggle to understand the serious risks of surgery such as haemorrhage, infection and anaphylaxis to anaesthetic. They think these things could never happen to them.
‘They also struggle to understand how debilitating persistent chest numbness, scarring and phantom nipple pain could be.’
Dr Spencer said adolescence was a time of development and many young people believed the way they felt now was how they would feel for the rest of their lives.
‘Fifteen is too young to be making a decision that can have such profound long-term consequences,’ she said.
‘At 15, a young person has likely not experienced the full course of physical puberty and is unlikely to have completed all of these developmental tasks of adolescence which can assist in healing gender dysphoria.’
After seeing the 15-year-old girl’s Reddit post women’s rights advocate Leah Whiston made two phone calls to the clinic to confirm it was true.
Psychiatrist Dr Jillian Spencer (above) said there were psychiatrists and surgeons who were well known for recommending and performing mastectomies on teens with gender dysphoria
Both times she was told the clinic would perform top surgery on girls as young as 13 if they had a referral letter from a psychiatrist written in the past three months.
‘I felt sick to my stomach,’ Ms Whiston said. ‘It is just evil. They must know it’s wrong. They must be psychopaths to do this to young girls.’
Dr Spencer said there was overwhelming pressure on doctors to support childhood medical transition at the risk of professional sanction.
‘I assure you this is not part of a culture war,’ she told a women’s rights forum in Sydney last week. ‘This is a really serious child protection issue.’
Adjunct Associate Professor Karleen Gribble from Western Sydney University School of Midwifery was a researcher on the first study of a transman who shared his pain at not being able to breastfeed his baby.
Professor Gribble said she had spoken to women who did not understand the complexity of breast structure when they had chest masculinisation mastectomies.
It had not been made clear to them that surgery would mean they would not be able to breastfeed.
‘I have seen discussions amongst young people online suggesting that they believe these surgeries can be reversed and even in some cases that breast tissue will regrow if the come off testosterone,’ Professor Gribble said.
Professor Karleen Gribble (above) said she had spoken to women who did not understand the complexity of breast structure when they had chest masculinisation mastectomies
‘An 18-year-old detransitioner asked me if there is any way that she could breastfeed, even with the use of a breastfeeding supplementer.
‘It was heart-rending to need to explain to her that given the type of surgery she had and what she described about her nipple grafts, that it was very unlikely.
‘All I could offer her was empathy for her grief.’
Anna Kerr, a lawyer from Feminist Legal Clinic, was involved in the first case against a psychiatrist who approved the removal of a 19-year-old’s breasts after just one appointment.
Jay Langsidonis later regretted the procedure and is suing the psychiatrist for professional negligence.
Ms Kerr said protections for vulnerable young people from such medical treatments were inadequate and varied from state to state.
In a 2020 case known as Re: Imogen, the Family Court clarified medical practitioners cannot proceed with gender affirming treatment for a minor without the consent the consent of both parents.
‘Unfortunately, obtaining consent from vulnerable young people and their concerned parents is only too easy for those ostensibly wielding medical authority,’ Ms Kerr said.
Lawyer Anna Kerr (above) was involved in the first detransitioner case against a psychiatrist who approved the removal of a 19-year-old’s breasts after just one appointment
‘Indeed, the recent introduction of gay conversion therapy bans, which have been inappropriately extended to cover ‘gender identity’, effectively mandate gender affirming treatments.
‘However, any health practitioner acting in good conscience should be guided by their duty of care to patients and the foreseeable harm of life altering surgeries hastily undertaken in youth.’
Professor Gribble said the Australian Professional Association for Trans Health did not require adolescents to be given information about the prevention of future breastfeeding after top surgery.
‘I have written to AusPATH asking them to include this in their guidelines,’ she said.
Both Professor Gribble and Dr Spencer said there was no evidence of any long or even medium-term benefit of chest masculinisation surgery on minors.
Dr Spencer also noted there were no published guidelines on how to counsel and obtain consent for a double mastectomy in a 15-year-old for the purpose of chest masculinisation to relieve gender dysphoria.
She said previous versions of the World Professional Association for Transgender Health guidelines recommended such surgery not occur until the age of 16.
WPATH’s latest standards of care document published in September 2022 removed all lower age limits for gender affirming interventions.
AusPATH and WPATH guidelines do not state the consent process for minors considering chest masculinising mastectomy should include a discussion of the impact of the surgery on breastfeeding.
AusPATH states on their website that it is well established that most trans people do not regret affirming their gender.
Access to medical gender affirmation can be life saving and improve quality of life for those who seek it, it said.
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