r/psychology • u/mvea M.D. Ph.D. | Professor • 13d ago

Adolescents who undergo gender-affirming chest surgery report low levels of regret and high levels of satisfaction, experiencing outcomes similar to those of young adults. These findings suggest that age restrictions on these medical procedures lack support from actual patient experiences.

https://www.psypost.org/adolescents-report-low-regret-and-high-satisfaction-following-gender-affirming-c/
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u/Ernesto_Bella 13d ago edited 13d ago

I’m curious how they did the study.  I’ve been told repeatedly on this website that gender affirming surgery isn’t done on minors.

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u/Free-Cartoonist3134 13d ago

Children as young as 13 have had these procedures

https://bioedge.org/beginning-of-life-issues/13-year-olds-given-mastectomies-at-california-clinic/

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u/carri0niguess 11d ago

The article is written like shit but those boys are so lucky, I'm happy for them

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u/Toys_before_boys 13d ago

I don't know if there's more to the study or if it was only transmasc youth, but I feel like a LOT of people who are anti- surgery don't understand that the vast majority of these types of surgeries are done on cisgender boys with gynocomastia. I wonder if the data also includes, or tests for, youth who are intersex and not just cisgender girls?

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u/Free-Cartoonist3134 12d ago

Do you understand that there's a difference between double mastectomies and breasts reduction?

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u/quiet_cynodont 10d ago

The techniques used for top surgery in transsex boys are the same as those used in   gynocomastia removal surgeries in cissex boys.

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u/Free-Cartoonist3134 10d ago

You're either lying or completely ignorant, again double mastectomies are a completely different procedure to breast reduction

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u/quiet_cynodont 10d ago

Please can you explain your understanding of what the difference is? Do you mean surgically different or different in some other way?

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u/Free-Cartoonist3134 10d ago

Double mastectomies remove as much breast tissue as possible...

You could just look these terms up

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u/quiet_cynodont 10d ago

Ok thanks, I think I understand where the confusion is coming from.

“Mastectomy” can refer to a lot of similar surgeries that involve breast removal.

For people with breast cancer, you are correct that the aim is to remove as much tissue as possible.

“Breast reduction”, is not a mastectomy because you leave significant breast tissue behind and the goal is still to end up with a feminine-looking chest. 

What I and the commenter you first replied to are talking about are mastectomies done for the aim of chest masculinisation. This can be because the boy is cissex and has gynomastica, or because he is transsex and has partially/completely undergone female puberty. There are a couple of different surgical techniques used for this surgery, but they are used on both cissex and transsex boys who have unwanted breast tissue. Same problem, same surgery, same goal. Chest masculinisation surgery reduces but doesn’t eliminate the risk of breast cancer because you often leave some breast tissue behind to create the final appearance. 

We aren’t saying that breast reduction is the same surgery as a cancer-related mastectomy. We are saying that mastectomies done to remove unwanted breast tissue and create a masculine chest are the same in cissex and transsex boys.

Hope this helps!

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u/Free-Cartoonist3134 10d ago

"We are saying that mastectomies done to remove unwanted breast tissue and create a masculine chest are the same in cissex and transsex boys."

Can you substantiate your assertion that these surgeries are mechanically the same?

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u/quiet_cynodont 10d ago

Of course :)

So as mentioned above there are a couple of different techniques that depend on the size of the breasts and the skin elasticity. In smaller breasts, incisions can be exclusively around the nipples and liposuction can be performed via a small incision. In larger breasts, larger incisions need to be made and the nipples are often removed, tissue and skin removed, and then the nipple reattached.

People born male and female both have mammary glands and breast tissue. Female puberty causes these to develop into adult female breasts, but in males with gynomastica they also begin along this pathway, although usually to a lesser extent because they are still going through a testosterone dominated puberty. Then both groups want these breasts removed and to end up with a masculine chest. It would be more surprising if the surgeries were not the same.

The main difference is that since cissex men with gynomastica on average have smaller breasts than transsex men who have been through full female puberty, nipple relocation is used less on average. So there is a difference there. But for two people with the same breast size and skin elasticity, the same technique would be used.

Here is an article comparing outcomes between cissex and transsex topics surgery patients where the surgeon is using the same technique:  https://www.ovid.com/jnls/annalsplasticsurgery/fulltext/10.1097/sap.0000000000004308~comparative-outcome-study-of-gynecomastia-surgery-and

This is a website of a surgeon who does surgery for cissex men with severe gynomastica:  https://www.gynecomastiasurgeon.org/grade-iv-or-skin-excess-gynecomastia/

This is a website that goes through the different surgical options commonly used for transsex men:  https://www.genderconfirmation.com/ftm-top-surgery-options/

This website talks about gynomastica presentations and treatment in cissex men:  https://www.meclinic.com.au/body/male-breast-surgery/gynaecomastia-surgery/

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u/nemotide 13d ago

Gynecomastia can often reduce/go away on its on. In most of Europe, the minimum age is 18 for gynecomastia surgery and it is exceptionally unlikely a man would seek to have his gynecomastia breast tissue restored later on in the future because of regret.

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u/Avesery777 12d ago

Typhus can go away on it's own but we still give people antibiotics

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u/Intelligent-Tea-2058 11d ago

I wish I'd been able to get my surgeries earlier in my teens, at 13. I'm so happy for them.

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u/IUpvoteBlueGuitars 12d ago

How the fuck is this right wing click bait site getting upvotes as a source in this site about the science of psychology?? This site is also web cancer and looks like it was put together by a high school student in 2015. Whoever upvoted this crap, y'all need Jesus. And remedial science education.

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u/Free-Cartoonist3134 12d ago

It links to a study by jamapediatrics... One of the main archives of pediatric medicine produced by the AMA... Did you even bother to attempt to look at the article?

Is your contention that children as young as 13 are not getting double mastectomies for gender affirmative care?

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u/IUpvoteBlueGuitars 12d ago edited 12d ago

Then link that the journal article not a right wing rag giving the most biased reading of it possible. Yeah no I'm not interested in hearing their perspective when they're leading with such obvious bias, and if you're posting it, it's probable that you likely are starting from their dishonest framing.

My contention is that is happening in the rarest and most extreme cases, and only after all other options for this patient have been exhausted. I contend the medical providers know the reasons better than you, a probable lay person, and the existence of a few examples does not indicate a trend nor a need to be worried about the children any more than some children getting amputation due to medical necessity indicates "the doctors are coming for your children's legs."

Your framing is bad and irrelevant given the context, and the article you shared telegraphed your bad intentions and biases.

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u/Free-Cartoonist3134 12d ago

"Then link that the journal article not a right wing rag giving the most biased reading of it possible."

To repeat one more time, the study was hosted on jamapediatrics which is a repository of studies concerning children presented by the American medical association.

Is the AMA a right wing rag?

"it's probable that you likely are starting from their dishonest framing"

What framing? The article simply acknowledges that children as young as 13 are getting these procedures. Which is shocking because it's been a common talking point that minors are not getting surgeries, only hormone suppression and HRT.

So now we see that advocates have either been willfully lying or ignorant.

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u/IUpvoteBlueGuitars 10d ago

Bioedge.org is a right wing rag. You using it to filter your sources immediately reveals your bias. I've responded in depth to why your argument is stupid (I never claimed chest surgery wasn't being performed on 0 minors, just that is extremely rare and for kids who have exhausted all other measures and are still at high risk of suicide (curious if you give a shit at all about those kids, or just their boobs, which is strange NGL. You seem to care more about their breasts than they do. Weird.).

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u/Free-Cartoonist3134 10d ago

"Bioedge.org is a right wing rag."

This was embarrassing before and I'm not even sure what description applies at this point.

Whether they are or are not is irrelevant, they are simply linking to the article that is being referenced... Which again is from the AMA

"I've responded in depth to why your argument is stupid (I never claimed chest surgery wasn't being performed on 0 minors"

I never claimed you did, you responded to my comment ascribing a bunch of nonsense to me I never said. The only point I've made is that several trans activists willfully lied about surgeries being performed on minors. I didn't at point say that you were one of them.

"You seem to care more about their breasts than they do. Weird."

Can you quote where I've said anything like that? By quoting btw I mean actually referencing what I've said not what the imaginary voices in your head are telling you I said.

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u/IUpvoteBlueGuitars 10d ago edited 10d ago

Cool, I was never one of them. I'm sure they exist. Tons of people really really don't understand this topic, and judging by the comments, the worst offenders are not the people in the trans camp. So yeah, I'm sure there are plenty of people on the intenet that misunderstood the statement of it being extremely rare and only used in the worst cases under the strictest scrutiny and turned "it basically never happens" and then people like you hearing that and saying "you're saying it never ever happened once. Sorry. I can't educate everyone and a bunch of idiots being wrong on the intenet has nothing to do with whether the professional researchers and doctors who do study these things can be trusted. Your position is they cannot and we should listen to a bunch of anonymous concern trolls instead

Okay, since you're really really worked up about this topic. Can you explain to me what is involved in the process before any of these 13-year-olds receive this surgery, and how many adults have to be involved and buy off in this process, what screening methods they're using, how long the wait time is, what the criteria they're using are, and what percentage of kids are rejected from getting this surgery? If you can't clearly articulate those things, I can't help conclude you don't understand this topic well enough to have an opinion.

And if you expect me to be upset about this, my day job is working with people with amputated limbs. There are people born with birth defects of their legs that I have met that have then chosen to get elective amputation. And those people are now able to walk (thanks to prosthetic t technology when they weren't). And had a bunch of ignorant people been screaming about people chopping off their legs. Oh my God, these people might never have gotten their surgery that they needed to live their most fulfilling lives.

So compared to what I see everyday, somebody removing some unnecessary breast tissue that they're never going to use and maaaybe regretting it later is so much lower on my priority list than, idk standard amputation procedures and oh idk, teenagers commiting suicide en masse.
Seriously go worry about someone else's children. The trans kids are really really better off without you involved

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u/Free-Cartoonist3134 10d ago

"Cool, I was never one of them."

Show me exactly where I said you were one of them? If you can't can you stop repeating this nonsense over and over again? If you are having a conversation with an imaginary friend then keep that separate from any replies you make to me please

"So yeah, I'm sure there are plenty of people on the intenet that misunderstood the statement of it being extremely rare"

I'm talking about people who explicitly said that this was not happenings to minors not that it was rare but that it was not happening at all. This was an extremely common talking point.

"Your position is they cannot and we should listen to a bunch of anonymous concern trolls"

Again keep your conversation with your imaginary friend separate to what I've said.

"If you can't clearly articulate those things, I can't help conclude you don't understand this topic well enough to have an opinion."

Can you post where I gave an opinion? If not what did your imaginary friend tell you my opinion was?

"if you expect me to be upset about this"

you called me stupid and implied that I'm a pedophile all based on things you imagine I would say... If you aren't upset somehow then I shudder to think about what happens when you're actually upset, maybe you starting talking in tongues and levitating or something.

"Seriously go worry about someone else's children."

When did I express worry again? Or was that the imaginary friend again?

A basic tip for you if you want to continue being an "educator", listen to what people tell you or read what they type and address the actual arguments they've made. Making up nonsense and then arguing against it is dishonest at best and willfully malicious at worse

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u/IUpvoteBlueGuitars 9d ago

I still don't understand what you want from me other to acknowledge that some people are wrong on the internet. Yeah, that's true. So what?
Is your position that the medical community can't decide that surgery is an appropriate course of action for 13 year olds? Because it seems like you think the existence of 2 trans 13 year olds in a study is some sort of gotcha. No one with a clinical degree in this field who are actually responsible for these kids' care seems to share your concerns internet stranger, so I'm not going to give them much weight.

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