Thread by @Bernard_Lane

It's the Oz election campaign & there's confusion among politicians & journos about trans-identifying minors & their access to surgery. Short answer: biological girls under 18 *do* get trans mastectomy in Australia. To say it doesn't happen is wrong. #AusPol #AusVotes #Health

In Australia, 15 is the youngest known age for "top surgery", as it's often called online. See this news report & screenshot.
theaustralian.com.au/nation/ignore-…

Family Court has been the only info source on under-18 trans surgery. Until the 2018 case re Matthew, the court had to give the green light, even if docs & parents agreed. This was said to be "discriminatory". Now, judges only hear under-18 surgery cases if there's a dispute.

In the Dutch protocol for medicalised gender change, puberty blockers is stage 1, opposite-sex hormones stage 2, and stage 3 is surgery, including mastectomy. Family Court had sped up underage access to treatment.

About the re Matthew case hrlc.org.au/human-rights-c…

There is no publicly available national data about Dutch protocol treatment of minors. I've asked federal Health Department, Australian Institute of Health & Welfare, & Family Court. Our kids' hospitals, so far, do not do trans surgery, leaving it to private surgeons.

Following coverage in The Oz, federal Health Minister Greg Hunt insisted the states in charge of kids hospitals had to come up with a national framework for data collection & tracking treatment outcomes. There's no sign of progress & still little transparency in gender medicine.

A striking fact: the trans activists & their media allies in Australia & the US who insist that medicalised gender change is "lifesaving" often deny that any minors get surgery. Surely they would approve of lifesaving medicine being extended to minors?

The "trans kids" narrative is all about easier & younger access to treatment supposed to reduce suicide (the evidence for this is low quality). Australia's biggest youth gender clinic, at the Royal Children's Hospital Melbourne, has campaigned for in-hospital trans mastectomy.

The RCH "Australian Standards of Care" treatment guideline, used by other kids' hospitals, says "chest reconstructive surgery" (mastectomy) is "regularly performed across the world" in countries where the age of majority is 16. RCH takes kids up to 17.
rch.org.au/uploadedFiles/…

At Victoria's 2019 royal commission into mental health, the RCH clinic director Dr Telfer gave evidence that "many" of the "post-pubertal trans males" (biological females) in her clinic's 2018 intake "were requesting ... chest reconstructive surgery [mastectomy]".

She said there were "no private surgical services" for trans boys under 18 in Victoria, "leaving them with no option but to seek chest reconstructive surgery interstate or overseas should they be unable to manage their distress until they turn 18".
…hs.archive.royalcommission.vic.gov.au/AProf_Michelle…

Dr Telfer cited international evidence that trans mastectomy improves mental health, including a US study with 33 biological females -- "with a gender identity along the masculine spectrum" -- under the age of 18. Two were 13 years old. Their "chest dysphoria" reportedly eased.

The 2019 program model for the RCH gender clinic includes a line saying "Assessment for surgery (Chest reconstructive surgery: TBC)". That year, Dr Telfer told the Vic royal commission that "chest reconstructive surgery is an integral part of the transition for trans males".

In 2021, RCH told me it had "no plans to introduce 'top surgery’." I've asked for an update & will post if one comes. In 2019, RCH said its gender clinic worked with "the best available medical evidence" & applied "strict clinical governance standards".
blogs.rch.org.au/news/files/201…

Last year I reported a journal article by a senior Australian psychiatrist arguing that trans mastectomy with teenage girls is "experimental", being supported only by a handful of low-quality, short-term studies claiming mental health benefits.
link.springer.com/article/10.100…

In March 2022, the US Court of Appeals for the 9th Circuit handed down a judgment in a case about trans mastectomy for minors & insurance coverage. The teenage plaintiffs argued surgery was so vital that the court should grant an urgent injunction ordering insurance coverage.

The plaintiffs had heavy-duty lawyers & experts on hand -- including the World Professional Association for Transgender Health -- for a potential class action. This was a chance to show the evidence that trans mastectomy is lifesaving.
cdn.ca9.uscourts.gov/datastore/opin…

The teenagers' case was that they “urgently need" trans mastectomy to ease gender dysphoria & that there is “broad consensus within the medical community that the surgery is a safe, effective, & medically necessary treatment" bringing "enormous psychological relief".

The court also heard from The Society for Evidence based Gender Medicine Segm.org about an international shift to more caution in the face of a worrying surge in teenagers, chiefly female, seeking irreversible interventions.
More info here genderclinicnews.substack.com

SEGM told the court: "After reviewing the available evidence, SEGM concluded that gender-reassignment surgeries, including masculinizing mastectomies, cannot be considered safe, effective, and medically necessary for minors."

The upshot? The court denied the teens' preliminary injunction request, which requires a high standard of proof, noted expert challenge to the claims made for trans mastectomy & raised "concerns" about the teen who was still a minor when proceedings began.

"This gave rise to twin concerns: was his gender dysphoria permanent & did he sufficiently appreciate the consequences of irreversible surgery?" The court also cited evidence "that some individuals who present as trans during adolescence revert to their natal gender later on."

"These concerns are reinforced by the apparent fact that [this teen] had serious psychiatric issues distinct from or related to his gender dysphoria." There was evidence "gender dysphoria might mask other psychiatric issues & top surgery might not address those other issues".

The court noted the litigation by a young English woman, Keira Bell, who argued she was a troubled girl unable to give informed consent at 16 when the UK Tavistock gender clinic gave her puberty blockers. Identifying as male, she had a mastectomy at 20.
persuasion.community/p/keira-bell-m…

For the London-based Pink News, mastectomy is "pure trans joy". Not everyone sees it that way.
thecritic.co.uk/issues/may-202…

Sinead Watson, a Scottish "detransitioner" who re-embraced her birth sex after taking testosterone & undergoing a double mastectomy, explains here the unexamined & untreated issues that can be masked by the label "gender dysphoria".

More on detransitioners here genspect.org/detransitioner…

You can read the unrolled version of this thread here: typefully.com/Bernard_Lane/8…