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Zagarna's avatar

Out of curiosity, do you routinely describe plastic surgery as "mutilation"? If not, why not?

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Thorby Baslim's avatar

No, I don't. This isn't routine plastic surgery. Do you think it is?

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TessK's avatar

Right?

What word besides mutilation works for this?

These are surgeries that destroy sexual function, reproductive capacity and have a range of other risk factors. Just once I would like to see an activist/ally type explain how the the removal of healthy, developing and functioning breasts and genitals of children and very young adults is something BESIDES mutilation.

Dr. Marci Bowers, a transwoman, and VERY experienced surgeon, has acknowledged that biologically male children blocked in tanner stage 2 and who then have genital surgery to construct an approximation of a vagina arenтАЩt able to achieve orgasm as young adults. Tanner stage two is pre-teen age wise. I am dumbfounded that anyone would be able to think that a 12 year old could give meaningful consent to never being able to experience sexual climax or have children. This isnтАЩt routine plastic surgery.

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That TERF Owl's avatar

"What word besides mutilation works for this?"

Sometimes I use the word "maim," because it puts the onus on the physicians doing these barbaric treatments when they took an oath to "first do no harm."

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Zagarna's avatar

12-year-olds aren't consenting to genital surgery, because it is not performed on 12-year-olds.

As for removal of healthy, developing and functioning tissue, have you let, say, Simona Halep know of your concerns that she has "mutilated" herself, or does this particular bit of hectoring only apply to trans youth?

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TessK's avatar

ThereтАЩs a pathway here. Blockers >>> hormones>>>surgery as older teen or very young adult.

For natal males, blocking in tanner stage two and continuing to estrogen is proving to be essentially irreversible- they can have surgery without enough tissue for the surgeon to work with or they can live with a non-functioning, under developed penis. Most go on to have surgery and the surgical outcomes arenтАЩt great. ItтАЩs such a lie to say that 12 year olds arenтАЩt consenting to anything irreversible. ItтАЩs a comfortable lie but itтАЩs a lie nonetheless.

This is an issue that I have lived in a much more personal way than you can probably comprehend- paying for and providing post-operative caregiving for my FTM sibling after his double mastectomy in 2002 to mothering a now desisted son to loving and taking care of several additional trans-identified children.

I used to make similar pro-trans arguments. I used to play on your team or at least an adjacent one.

As a mom of children who arenтАЩt transgender but who got caught up in identifying as such for complex reasons, I had no choice but to reevaluate and deeply question my тАЬgood liberalтАЭ biases and beliefs. Once I did that, insisting puberty blockers are just тАЬa harmless pause buttonтАЭ and that no irreversible surgeries are done in young people without extensive therapeutic safeguards in place was no longer an option. IтАЩve spoken to doctors, therapists, endocrinologists, parents, happily trans adults, desisted and detransitioned teens and adults. We are living through a medical malpractice scandal, one that hurts transgender people as much as those who ultimately end up desisting or detransitioning.

What you call тАЬhectoringтАЭ I would call тАЬsaving my child (who has long expressed a desire to be a father someday) from sterilizing himselfтАЭ and тАЬreminding my niece that liking girls doesnтАЩt mean sheтАЩs a boy- itтАЩs really ok to be a lesbianтАЭ.

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Thorby Baslim's avatar

Many good points here. Thank you also for letting us know your personal experiences.

In particular I appreciate you bringing up the dubious nature of the consent involved in surgeries if the child (and parents) have already been on this path for years and (understandably) feel committed to it.

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TessK's avatar

Also, comparing an elective double mastectomy to breast reduction is such a silly argument. A double mastectomy completely eliminates the primary functions of the breasts- a reduction can often be done in such a way that most function is maintained. Have you listened to any detransitioned women speak about their experiences or is your opinion rooted in your own unchallenged political beliefs?

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Zagarna's avatar

A clever transposition of the word "routine" there, but unfortunately, that's not what I said. I asked if you routinely used that descriptor, not if you used that descriptor about routine things.

There are a plethora of widely-practiced plastic surgeries, among them the insertion of silicone implants and liposuction just to name a couple, that I would pretty readily describe as "not routine" (to say nothing of the infamous Brazilian butt lift or weight-loss surgery). So: mutilation, or nah?

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Thorby Baslim's avatar

I'll go back to my original comment and clarify my language. The word "mutilation" is a strong one, and it's rare that I use such strong language. I would not use the word to describe either minor surgery (say, a nose job) or a major procedure that was medically necessary and justified by careful research. Serious procedures such as liposuction that are elective provide interesting food for thought here, but as others have already noted, these don't destroy function, they are backed by careful research (and if not, they should be paused!), and they are performed on consenting adults.

For example, a serious condition (e.g. major trauma, gangrene) in my leg might require its amputation, and I would not call that "mutilation". However if a doctor amputated my leg when it was not medically necessary, I would think the word "mutilation" is a fair one. (And I would sue for malpractice.)

In the case of youth gender surgery, we're talking about irreversible procedures that remove healthy tissue and destroy function, and that drastically change the person's way of living. My read on the evidence base is that it provides very weak support, at best, for such procedures on minors. I find very little commonality here between these surgeries and cosmetic surgery done on adults--which is what I was trying to get at in my previous, rather terse, reply.

One concern here might be that if one uses the word "mutilation" in the youth gender surgery context, one would also use it to describe the same surgeries for consenting adults. (I would not describe the more serious of these surgeries as "plastic" or "cosmetic", so this is going away a bit from your original question.) I think it's important not to downplay the seriousness of those surgeries, but the fact that a consenting adult is signing off on them is the crucial difference. Hence I would not want to use the term "mutilation" there.

Overall, in the youth gender surgery context, I find a rather harsh term such as "mutilation" to be more accurate than not. But I understand someone who would want to use more guarded language.

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Zagarna's avatar

The evidence on liposuction is that it is not just ineffectual, but actively harmful:

https://en.wikipedia.org/wiki/Liposuction

In other words, scientists have carefully researched the procedure, they have overwhelmingly concluded that it's shit, and people continue to demand it and have it performed anyway, with no apparent objection from politicians or Very Serious Opponents of Mutilation. Caveat emptor, etc. Aside from parental consent, which is more or less mandatory for all surgeries on under-18s, there are no restrictions on minors getting it.

So I ask again: mutilation, or nah?

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TessK's avatar

You are uninformed if you think that parental consent is required for youth transition in all states. Check out the laws on the west coast and similar laws in other very liberal states. I volunteered to get both the state AG and Governor elected and yet the laws they have pushed to enact on this issue have left me completely without anyone to vote for for Governor in 2024 (the AG is seeking the Governorship, the party is captured in this issue).

The law in my state for a long time now makes it so kids 13 and up have decision authority in reproductive and behavioral health. Yes, they are interpreting that law to include any and all things related to gender.

I have to get my 14 year old to sign a release for me to see his records related to those things, even the insurance billing records we are responsible for are redacted.

Maddeningly, I still have to sign a form for him to get so much as an aspirin from the school nurse so the gap in the law is weird. If he were to go to the emergency room for a physical health matter, if the care needed wasnтАЩt deemed truly urgent they would hold off on anything until then could get a parentтАЩs consent.

Further non-affirming parents are being conflated with child abusers and yes, I know parents who have had this be an issue in maintaining their custody of their children. My state isnтАЩt alone, there are other states with similar laws and DCFS type policies and still more states wanting to pass and implement them.

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Zagarna's avatar

Surely you do not seriously expect me to undertake an extensive, unpaid legal research project into the various and ever-changing laws relating to parental consent to medical procedures in the several states because you made some vague assertions about one, unnamed, state. If you want to cite a specific law with a specific criticism, be my guest. This sort of vague handwaving? Not a chance.

At any rate, none of this has even the remotest of relationships to the question at hand, which is whether it's correct or reasonable to describe a desired surgical procedure as "mutilation" just because you, a random outside observer, think the person in question shouldn't have it. I take it that you have no actual justification for that position and hence are trying to flee in a cloud of squid ink.

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TessK's avatar

тАЬAt any rate, none of this has even the remotest of relationships to the question at hand, which is whether it's correct or reasonable to describe a desired surgical procedure as "mutilation"

So it would seem that to you the crux of the issue is one of semantics. Is it or is it not correct or reasonable to use the word тАЬmutilationтАЭ to describe interventions that destroy sexual and reproductive function? Oddly enough, as the parent of a desisted son and caregiver to several additional trans identified children, this isnтАЩt a semantics question for me. You can call it тАЬloss of sexual and reproductive functionтАЭ if that makes you feel better but I will call a spade a spade and I donтАЩt care if you like it or not.

You insisted that parental consent is always required. It is not.

What is happening here is clear:

You either canтАЩt or donтАЩt want to argue in good faith on the merits of the issue so you resort to discounting things that donтАЩt confirm your biases or that contradict your beliefs. ItтАЩs easier for you to feebly attempt to insult me and mischaracterize my positions or claim the information is irrelevant to the semantics than it is for you to wrap your brain around the idea that someone like me who is so not a right wing conservative could still disagree with the left party line on pediatric gender medicine.

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Zagarna's avatar

I've invited you to have a discussion in good faith on the merits of whatever specific laws you are criticizing; you have elected not to do so. So be it. As I said, I am not your Westlaw research mule.

And your repeated invocations of a personal history that, for all I know, may be a pure Internet fabrication do not alter my point of view, so you can stop trying to harangue me with special pleading. It doesn't impress me.

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TessK's avatar

You got me, I subscribed to this podcast in April (May? Sometime in the spring) of 2020 on Patreon and started sharing about my personal experiences with and shifting views on this issue all so I could have an intricately fabricated backstory to fight with you, today. I can see the future and I have nothing better to do than *lie about my children* on the internet. Imagine: impressing you ainтАЩt on my list of shit to do.

You made a false statement, one that can be disproved with the simplest of internet searches. You have offered no shred of evidence that disproves my direct knowledge of the issue in the PNW.

People like you are why an increasing number of dyed in the wool Democrats (I used to be on the board of the local Democratic Party) are done with the mindlessly affirming left wing on this issue. You suck both at proving your assertions and winning people to your side of the argument. You think you sound smart- in reality you just sound heartless and unable to process information you just donтАЩt like.

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TessK's avatar

For those reading this who might actually benefit from this information (since this dude isnтАЩt capable of that), hereтАЩs a link.

Parental notification on Oregon is only for kids under 15. So 14 and under, parental consent with the requisite caveats for custody disputes and the reality that not all parental consent is given without the тАЬlive daughter or dead sonтАЭ emotional blackmail.

https://www.statesmanjournal.com/story/news/politics/2023/08/15/oregon-tina-kotek-gender-affirming-care-abortion-house-bill-2002/70592245007/

The laws in WA are are little more complex in that the existing laws that allow for children to consent to reproductive and mental health services from 13 and up are being redefined by some providers. ThereтАЩs also the issue of SB 5599 which adds another layer of nuance to the discussion. IтАЩve described some of these nuances various posts here and IтАЩm not regurgitating them here as I am presently stir-frying chicken and broccoli and and donтАЩt wanna overdo it on the chili sauce. This batch has an extra kick. Cold noodles on the side. Dinner in 10 people!

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Thorby Baslim's avatar

I'd have to look more deeply into the question of liposuction to have a definite opinion on it. If there is currently a large uptick in poorly-justified liposuction performed on minors, I would find that interesting and concerning. My instinct would probably not be to use the term "mutilation" in that case though, since we're just talking about removing fat cells.

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Zagarna's avatar

Well, I don't know-- are those fat cells healthy tissue? Are they functioning as fat cells? Yes to both, if I'm not mistaken. Sure seems like by your own stated definition of "mutilation," liposuction qualifies.

Now, I realize that your stated definition is not your actual operational definition-- which is that "mutilation" is something that you personally don't like and want to morally condemn, and "cosmetic surgery" is something you don't give a shit about-- but it's still interesting to uncover the ways in which these sorts of arguments are pretextual.

As a side meta-note, I cannot help but be incredibly amused by the positions being taken by the majority of likes on this thread, which are that a. there is too much demonization and polarization in politics and everyone needs to turn down the rhetoric, and also b. anyone who disagrees with me to any degree about youth gender medicine wants to mutilate children. Absolutely chef's-kiss hypocrisy.

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Allie Cat's avatar

IтАЩm probably going to regret wading in here but I think you might be fixating too much on a word.

The original commenter wrote, тАЬThe bigger question about whether these kids should be on hormones or mutilating their bodies gets a little lost sometimes.тАЭ He or she was making a point about the article. There is no reason to fixate on when the commenter does or doesnтАЩt use the word тАЬmutilateтАЭ because itтАЩs not the point.

And then you said the commenter was saying, тАЬтАжanyone who disagrees with me to any degree about youth gender medicine wants to mutilate children,тАЭ and that does not follow from what they said, which again, was a critique of the article and not attacking anyone.

No one has said that at all, in fact. Even if the commenter believes that youth transition тАЬmutilates childrenтАЭ, it does not follow they think that anyone who supports it to *any* degree тАЬwants to mutilate children.тАЭ The commenter may believe that those who support it genuinely believe they are helping children.

The fact that you ignored the original point on the comment and instead fixated on word usage makes people think you arenтАЩt interesting in having a conversation but want to pick fights. If you donтАЩt want to pick fights then you may want to change your approach so people feel you are arguing in good faith.

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Zagarna's avatar

Well, I already know that many people here think (wrongly) that I am not arguing in good faith, and the feeling is absolutely mutual, so I think that particular ship sailed a long time ago.

At any rate, as far as I'm concerned, the sole point of using deliberately-inflammatory rhetoric like "mutilation" is to pick fights. The reason to fixate on the language is that the language is designed to be fixated on. It's designed to promote murdering doctors who do these kinds of surgeries (after all, it follows apodictically that if they're mutilating children, then killing them is just the defense of others) and imposing total bans on the procedures in question (after all, what right-thinking person could be in favor of mutilation?). It's like calling a group of people cockroaches-- the rhetoric is murderous in intent and quite possibly in action. It is intended to incite attacks. Perhaps an even better example is the constant reference to reproductive health personnel as "baby-killers"-- that language is absolutely intended to inculcate in the listener a willingness to kill in "defense" of the "babies" in question.

I won't allow it to pass unremarked-upon, and if you think that it's just harmless wordplay, you can fuck all the way right off.

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Allie Cat's avatar

Wow I was really feeling respectful toward you and your opinions so IтАЩm taken aback by your harsh last paragraph.

Respectfully, I disagree that calling a procedure тАЬmutilatingтАЭ = promoting murdering doctors who perform it. For example, one can believe that abortion does kill a baby but also believe that in some cases it is the best choice. Some people believe tattoos тАЬmutilate the bodyтАЭ but they donтАЩt think tattoo artists should be murdered: they see it as a personal choice to mutilate oneтАЩs own body. So I disagree with you but I respect that you see things differently.

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Stephanie's avatar

Sure, mutilation. I think there should be more regulation of cosmetic surgery in general. Part of the issue is how the US health care system works.

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TLIVT's avatar

That youтАЩre willing to equate the removal of excess fatty tissue and/or the addition of silicone to the removal of functioning organs indicates youтАЩre not interested in arguing in good faith.

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A. Person's avatar

Bariatric surgery could absolutely be described as the тАЬremoval of functioning organsтАЭ

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TLIVT's avatar

IтАЩm fairly certain that the stomach isnтАЩt removed (certainly not in itтАЩs entirety).

ItтАЩs also not performed to directly remedy a mental health problem.

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Zagarna's avatar

It depends on the particular surgery in question. Full gastric bypass, yes, effectively eliminates the stomach from digestion by diverting the esophagus around it. Other surgeries leave a small pouch of residual stomach or narrow it to a sleeve. Still other surgeries leave the stomach in place but use bands to shrink its effective capacity-- those tend to be more reversible but less effective because they don't change metabolism the way that stomach removal does.

I'm not sure what the second sentence has to do with the price of tea-- what treatments should be prohibited if the objective is to treat what you have deemed a "mental health problem," and how do you square that with mental-health parity requirements?

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Zagarna's avatar

I take it, then, that you are vehemently, loudly and publicly opposed to vasectomy? It certainly disables the functioning of organs. Of course, that's literally the point of the surgery-- the people in question don't want the "functioning" that the organ is providing.

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Skull's avatar

As a treatment for a mental health disorder? Yeah that's probably a bad idea.

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Zagarna's avatar

So if someone came to the doctor and said "gee, doc, I really, really don't want to take the chance of having another child, in fact I'd get so depressed if I did that I might kill myself," no vasectomy? That just encourages people to be disingenuous with their surgeons.

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Midwest Molly's avatar

I do if it's of the the Lion Lady, Michael Jackson variety.

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