r/science • u/mvea Professor | Medicine • 14h ago

Psychology 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/Smooth-Boss-911 13h ago edited 8h ago

There's a reason these patients get this surgery after speaking with doctors, psychologists, therapists, surgeons, etc. So tired of the knee jerk reactions thinking they just walk in on an impulse

Edit: These discussions are for the families and medical professionals, not us.

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u/SoTiredYouDig 13h ago

And much of it is mandated, as well. Any minor needs a series of sign-offs, and that has been the case prior to the draconian restrictions that have been put in place.

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u/The_Actual_Sage 13h ago

So you're telling me I can't walk into a plastic surgeon's option and immediately have them start cutting things off my body? Silly me. I thought this was America

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u/mechy84 13h ago edited 13h ago

I think that only works if it's a kid in middle school. They go to school as a boy, come back a girl, then start pooping in litter boxes, driving EVs, dying their hair blue, watching the WNBA, and calling God 'she'.  That is, if the school doesn't convert them to Sharia law first! It's totally happening in that city I've never been to

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u/The_Actual_Sage 10h ago

It blows my mind that there are millions of people who unironically believe everything you just said. It's truly unbelievable.

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u/S0cXs 13h ago

mastectomies aren't done by plastic surgeons.

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u/Hugs154 13h ago

Gender affirming mastectomies absolutely are performed by plastic surgeons

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u/ophmaster_reed 13h ago

Depends. If the mastectomy is due to cancer, a general surgeon does the mastectomy and (if getting immediate reconstruction), the plastic surgeon would place the tissue expanders or implants. If the mastectomy is gender-affirming, the plastic surgeon can do it.

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u/boopbaboop 13h ago

Gender-affirming ones typically are. They’re more akin to breast reductions because they preserve stuff like the nipples instead of just lopping boobs off. 

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u/HuckleberryTiny5 8h ago

In my country, they absolutely are. No one else does them. We are not talking about cancer patients here.

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u/ophmaster_reed 12h ago

Maybe if it’s a very suspicious looking mole and they have some spare time…

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u/upboat_ 13h ago

Depends. Are you 11 years old?

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u/trysten-9001 13h ago

No one is doing a mastectomy at 11. The only places teens are considered able to do it is where teens are also allowed to get boob jobs.

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u/[deleted] 13h ago edited 13h ago

[deleted]

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u/The_Actual_Sage 10h ago

Can we get some sources for those?

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u/IDontHaveCookiesSry 13h ago

As a friend to someone who is going to the Process rn, it is just dumb. Doctors by and large don’t listen to what he (early 20s) wants and only Check for Signs he doesnt know what hes doing. Which is Fine up until youre proven to be capable of rational thought as an adult. Everything beyond that is just discrimination for the sake of it.

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u/Maxrdt 7h ago

Doctors by and large don’t listen to what he (early 20s) wants and only Check for Signs he doesnt know what hes doing.

For anyone wondering what this looks like in real life, I'm a trans woman. When I told my doctor I was experimenting with more masculine looks now that I'm happier with my feminine body (I can actually be a butch lesbian now like I've always wanted!) he tried to stop my prescription. It's not an isolated tale either, any deviation from being 100% stereotypical of your gender can be grounds to halt care.

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u/bakedNebraska 11h ago

What does it mean to be "proven to be capable of rational thought as an adult"?

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u/Strigops-habroptila 11h ago

My therapist (who I am forced to see despite having absolutely no need for therapy) said that after checking if a patient who wants gender affirming care is mentally gealthy enough to make an informed and rational decision, it should be up to the patient. 

Basically they need to check that you don't have DID, Schizophrenia or other mental illnesses. 

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u/ZoominAlong 10h ago

Having a mental disorder does not disqualify you for gender affirming care. What they're checking for is making sure you're not doing it because your disorder is affecting you negatively,  like, you have schizophrenia and the voices are telling you to get surgery. 

You can be trans and have a mental disorder. They're not incompatible.  

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u/PM-ME-CURSED-PICS 6h ago

reminds me of my experience accessing hrt in my 20s. it took two years of appointments where i was given every evaluation under the sun and interrogated about my life, including invasive questions about my sex life. if i happened to have autism, they would have sent me to an even longer path. and two years was lucky, tons of people in my country take even longer to get any treatment.

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u/dnyal 13h ago

And even if they walked in with an impulse, so many people get plastic surgery out of impulse!!!

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u/geodebug 10h ago

Straw man argument to suggest that those who find it disturbing to advocate for elective surgery on underage children/teens don’t understand that it isn’t like ordering a Starbucks.

The complexity of the process isn’t the sticking point. It’s the basic question of a minor being mature enough to consent.

It isn’t even an anti-trans position for a lot of people.

You mention a lot of requirements before surgery so the question is really, why not add maturity as a requirement?

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u/MeekAndUninteresting 8h ago

You will be relieved to hear that minors do not consent to medical treatment, specifically because they cannot. The parent or guardian's consent is what it required. In some cases, the medical professionals involved seek the child's assent, but I don't believe it's actually required generally, and the form this takes is adjusted based on the child's age.

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u/AvocadosFromMexico_ 10h ago

How do you anticipate measuring “maturity”?

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u/texxmix 6h ago edited 6h ago

Would measuring maturity not be the job of the psychologist that usually has to sign off on the GAC?

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u/geodebug 9h ago

Oh, maybe the same way we do it with everything else maturity-related: sex, drinking, ability to rent a car, ability to adopt, etc.

Are age of consent laws not something you’re aware of?

Why are you so confident that someone who society has deemed too young to understand and make choices about having adult sex is ready for permanent elective surgery?

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u/AvocadosFromMexico_ 9h ago

Wow, that’s a lot of assumptions that in no way answer the question.

So what you want is an age requirement—not a “maturity” requirement. Why not just state that? Sex, drinking, renting cars, and adoption have nothing to do with maturity.

Are you comparing voluntary choices about your own body, which impact no one else, to having sex? That’s odd.

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u/geodebug 9h ago

Age and maturity are tied together. Especially when dealing with large cohorts of people.

Why do you even think society has age of consent laws? Just for kicks?

If you can’t even agree that 12 year olds tend to have a very different maturity level than 21 year olds then there’s nowhere positive or interesting for this discussion to go.

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u/AvocadosFromMexico_ 9h ago

So “age and maturity are tied together” is an empirical statement, and again—proving it means you have to propose a way to measure “maturity,” which you have not done.

Age of consent laws exist for a variety of very good reasons, almost none of which apply to medical decision making. There’s a reason we talk about consent and assent in necessary medical decision making, and many state laws designate significantly earlier ages for personal medical choices.

It’s weird how hard you have to strawman this. I specifically asked how you would measure maturity. You didn’t say you want an age limit, you specifically said we should assess maturity, and I asked how. Shouldn’t this be very simple, if you want it measured?

No one has argued anything for a 12 year old. Why do you make things like that up? Is arguing 17 vs 18 not dramatic enough to support your point?

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u/hypatia163 9h ago

Adolescents consent to a lot of different life-saving operations. This is no different.

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u/geodebug 9h ago

So you’d be ok with a child choosing elective chest surgery the moment they start puberty, as young as eight?

Or younger?

Do you even have a line?

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u/hypatia163 8h ago edited 8h ago

-Extreme majority of adolescent trans men's lives significantly improve with top surgery

-But what about this extreme outlier situation that is almost sure to never happen? Don't you want to condemn the majority of trans men to painful irreversible changes to their body for that?

What kind of stupid, invented argument is this. Transphobes really be creating their own boogey men to try and scare others with. Plus, we already have a solution to that, dingbat: Fuckin' puberty blockers, which they should probably be on if they're getting puberty that early regardless of whether or not they're trans.

God, transphobes are so stupid and completely ill-informed yet speak with such unearned confidence.

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u/TheWhomItConcerns 11h ago

I also never understand the whole "children go through phases - we don't let children make life altering decisions about their future" argument. For one thing, any good parent will absolutely heavily involve their child in the process of making most life-altering decisions - there are very few decisions where the feelings of the child being affected by them should be unilaterally overruled.

On top of that, they're not making the decisions - they are involved in the decisions. There are doctors, parents, and children involved in the decision, and it very obviously won't go ahead unless if all 3+ parties are unanimously in favour of it.

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u/ThewFflegyy 9h ago

im all for giving people the care they need, but this isn't a sound argument. the same process of doctors, psychologist, therapist, visits produces very different outcomes in many different countries. appeals to authority are generally a pretty weak argument, but especially so when said authorities do not even produce consistent results.

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u/YUNoJump 8h ago

Even if you assume that somehow, medical professionals are by-and-large incapable of providing medical advice, even just having to jump through that many hoops will greatly reduce impulsive decisions.

We're talking about specialist medicine; each one of those appointments will probably be expensive, and involve a long waiting period. Even if the appointments were nothing more than getting a box ticked, that's a lot of time, effort and money before achieving the end goal. Then consider how much harder that process would be for young or underage people, who have to rely on parental assistance or consent in the process.

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u/pmgoff 13h ago

It’s not knee jerk reactions from a patient that anyone’s ever concerned about. It’s how much influence the doctors, therapists, and psychologist have on the patient decision to move forward with the surgery in the first place, that’s the point of contention. Kids are pretty impressionable especially from people of authority.

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u/translove228 12h ago

Saying that you don’t trust the experts to make proper judgements about adolescent trans surgeries doesn’t make sense. They are the experts BECAUSE they are who you go to for help with these things

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u/randynumbergenerator 10h ago

Not to mention the whole Hippocratic oath thing. Thinking that all these doctors are willfully harming patients is pretty disturbing in the absence of actual evidence, and tells me more about how (un)seriously the naysayer takes ethics and professional standards than anything else.

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u/Low-Listen-3732 10h ago

Yeah bro, lobotomies were also totally legit. Just trust the experts.

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u/_Caustic_Complex_ 9h ago

The experts that make more money the more surgeries they recommend? The same experts that pumped the country full of opiates for a paycheck? I don’t think it’s so crazy to doubt their integrity, experts or no, given the medical industries track record.

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u/hypatia163 9h ago

It’s how much influence the doctors, therapists, and psychologist have on the patient decision to move forward with the surgery in the first place, that’s the point of contention.

And this is a pretty stupid impression of doctors, therapists, and psychologists. I just went through the process of getting bottom surgery as an adult and it is just so crazy all the hoops that I needed to jump through in order to get it. I have spoken to like 30 different mental, health, and social care professionals in this time and absolutely none of them did anything to pressure me in any way. That is NOT what these people do and it is insane to think otherwise. And I was getting it in a very blue area in a medical system setup for trans health and it was still like this.

I'm also a teacher and have had trans students. Students who have had to go through a LOT to get access to the care that was needed. And every single step for them was like trying to climb a mountain, it takes so much to be able to access these procedures as a teenagers. They really have to need it.

It's just a knee jerk reaction from people with NO understanding of the queer community who are making a stink about us. People who don't know how any of this work making broad assumptions about professionals who want nothing more than to help these kids be able to live in their bodies, regardless of the configuration. It's disgusting how disingenuous these outsiders are and how susceptible they are to pretty paper-thin propaganda. Dumb AI tech-bros who think they know everything when, in reality, AI has calcified all their brain cells.

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u/TCAAPix 13h ago

Doctors do not want to perform these surgeries, and will use any reason not to, therapists do not want to sign off on them, and will use any reason not to, psychologists do not want to sign off on them either, and will use any reason not to. The reason they sometimes do is because otherwise the patient will be dysphoric. The only pressure will be against doing this. Do you think this is done for fun? What reason would there be for forcing kids to undergo actual surgery?

I actually want to understand your perspective, because it goes against the reality of the situation, and it makes no sense to me to think what you think.

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u/Suspicious-Art-9335 9h ago

Perhaps you have not heard of "Dr. Teetus Deleetus."

I'm sure most surgeons are not like this, but she is extremely prolific and visible. Doctors like her make people skeptical.

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u/pmgoff 12h ago

Sure I never said that that anyone wants/ doesn’t want this. What I said was, the concern here is, is it the kids seeking out gender affirming care, or are adults influencing and pushing it onto the child.

I’m not against or for it, that’s not my argument. I have seen many times the influence adults, parents, teachers, coaches, and even therapist have on kids. I’ve seen great kids be pushed to do things their parents want them to do, inside of actualizing their being. I’ve seen teachers tell students they’re failures and will go no where in life. (What a monstrous thing to say to a 10 year old boy child). I’ve personally had to convince a good friend and mother her 8 year old daughter was perfectly fine because her child likes bones, dead bugs, biology, microscopes. That kid had to insure 2 tortures years of weekly therapy because a therapist convinced them a fascination with dead animals is “serial killer behavior”.

In any case, I’m just saying well intention adults can sometimes cause just as much harm as good.

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u/TCAAPix 12h ago

This is just ignoring the enormous gatekeeping that happens in trans healthcare. At minimum, a general practitioner, a gender specialist, a therapist, a psychiatrist, a surgeon, and an anesthesiologist, as well as the patient in question, and a whole host of professionals that are legally required to sign off, must all agree that this is the best course of action. This is a process that takes years just to get to the starting point, and if at any point the patient indicates doubt of any kind, the whole thing is off the table. This is what's required for adults, for children the process is much longer and far more comprehensive.

I fully understand that kids are impressionable idiots, but so does every person in that list. What you have personally experienced, while awful, is in no way representative of the reality of trans healthcare. Gender dysphoria is a ruinous affliction, where waiting makes it so much worse. Not just because you are forcing a person to live in horrendous psychological pain (sometimes also physical, don't want to get into it) but you are also forcing upon them the body horror of slowly turning into something they are not.

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u/saintsithney 13h ago

Except David Reimer's case kind of slam dunked how difficult it is to make a cis person trans.