The new taboo: More people regret sex change and want to ‘detransition’, surgeon says
Dr. Miroslav Djordjevic says more people, particularly transgender women over 30, are asking for reversal surgery, yet their regrets remain taboo
Five years ago, Professor Miroslav Djordjevic, the world-leading genital reconstructive surgeon, received a patient at his Belgrade clinic . It was a transgender patient who had surgery at a different clinic to remove male genitalia – and had since changed their mind.
That was the first time Djordjevic had ever been contacted to perform a so-called “reversal” surgery. Over the next six months, another six people also approached him, similarly wanting to reverse their procedures. They came from countries all over the Western world, Britain included, united by an acute sense of regret. At present, Djordjevic has a further six prospective people in discussions with his clinic about reversals and two currently undergoing the process itself; reattaching the male genitalia is a complex procedure and takes several operations over the course of a year to fully complete, at a cost of some euros 18,000 (pounds 16,000).
Those wishing the reversal, Djordjevic says, have spoken to him about crippling levels of depression following their transition and in some cases even contemplated suicide. “It can be a real disaster to hear these stories,” says the 52-year-old. And yet, in the main part, they are not being heard.
Last week, it was alleged that Bath Spa University has turned down an application for research on gender reassignment reversal because it was a subject deemed “potentially politically incorrect”.
James Caspian, a psychotherapist who specializes in working with transgender people, suggested the research after a conversation with Djordjevic in 2014 at a London restaurant where the Serbian told him about the number of reversals he was seeing, and the lack of academic rigour on the subject.
According to Caspian, the university initially approved his proposal to research “detransitioning”. He then amassed some preliminary findings that suggested a growing number of young people – particularly young women – were transitioning their gender and then regretting it.
But after submitting the more detailed proposal to Bath Spa, he discovered he had been referred to the university ethics committee, which rejected it over fears of criticism that might be directed towards the university. Not least on social media from the powerful transgender lobby.
Speaking this week, Caspian described himself as “astonished” at the decision, while Bath Spa University has launched an internal inquiry into why the research was turned down and is at present refusing to comment further.
Until the investigation is complete, Djordjevic, who performs around 100 surgeries a year both at his Belgrade clinic and New York’s Mount Sinai Hospital, is unwilling to give his exact opinion on the apparent rejection, but admits he is baffled as there is a desperate need for greater understanding in reversals.
“Definitely reversal surgery and regret in transgender persons is one of the very hot topics,” he says. “Generally, we have to support all research in this field.”
Djordjevic, who has 22 years’ experience of genital reconstructive surgery, operates under strict guidelines. Before any surgery, patients must undergo psychiatric evaluation for a minimum of between one and two years, followed by a hormonal evaluation and therapy. He also requests two professional letters of recommendation for each person and attempts to remain in contact for as long as possible following the surgery. Currently, he still speaks with 80 per cent of his former patients.
Following conversations with those upon whom he has helped perform reversals, Djordjevic says he has real concerns about the level of psychiatric evaluation and counselling that people receive elsewhere before gender reassignment first takes place.
Djordjevic fears money is at the root of the problem, and says his reversal patients have told him about making initial inquiries to surgeries and simply being asked to send a cheque in return.
“I have heard stories of people visiting surgeries who only checked if they had the money to pay,” he says. “We have to stop this. As a community, we have to make very strong rules: nobody who wants to make this type of surgery or just make money can be allowed to do so.”
To date, all of his reversals have been transgender women aged over 30 wanting to restore their male genitalia. Over the last two decades, the average age of his patients has more than halved, from 45 to 21. While the World Professional Association for Transgender Health guidelines currently state nobody under the age of 18 should undergo surgery, Prof Djordjevic fears this age limit could soon be reduced to include minors. Were that to happen, he says, he would refuse to abide by the rules. “I’m afraid what will happen five to 10 years later with this person,” he says. “It is more than about surgery; it’s an issue of human rights. I could not accept them as a patient as I’d be afraid what would happen to their mind.”
Referrals to adult and child gender identity clinics in the UK have increased dramatically over the past 10 years. In April, the Tavistock and Portman NHS Foundation Trust, the only clinic for adolescents in England, reported 2,016 referrals to its gender identity development service, a 42 per cent rise compared to the previous year, which in itself marked a 104 per cent increase on the year before that.
The clinic stresses the majority of its young referrals do not end up receiving physical treatment through the service. While NHS guidelines state young people should not be given cross-sex hormone treatment until 16, concerns have been raised about the lack of regulation, particularly in the private sector.
Earlier this month, it was revealed a Monmouthshire MP, Dr Helen Webberley, was being investigated by the General Medical Council (GMC), following complaints from two GPs that she had treated children as young as 12 with hormones at her private clinic, which specialises in gender issues.
Webberley insists she has done nothing wrong, and there were no “decisions or judgments” made on the claims against her. “There are many children under 16 who are desperate to start what they would consider their natural puberty earlier than that,” she said this month.
Djordjevic feels differently, and admits he has deep reservations about treating children with hormonal drugs before they reach puberty – not least as by blocking certain hormones before they have sufficiently developed means they may find it difficult to undergo reassignment surgery in the future.
“Ethically, we have to help any person over the world starting from three to four years of age, but in the best possible way,” he says. “If you change general health with any drug, I’m not a supporter of that theory.”
These are profoundly life-changing matters around which he – like many in his industry – feels far better debate is required to promote new understanding. But at the moment, it seems, that debate is simply being shut down.
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I guess when sexual orientation and gender identity aren't biologically determined-- but they think they are anyway, at least for awhile, it's a real surprise and disappointment to find out they weren't.
I'm not sure what you meant by that baseless comment.
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Again, it's not clear what you're referring to. Given that Serbia is generally quite hostile to LGBT folks it wouldn't be a surprise to learn that this doctor's GRS practice is comprised of transgender folks who didn't get puberty blockers and who have been traumatized by a hostile society and a lack of access to adequate healthcare prior to GRS. So it wouldn't be a shock to learn that the outcomes aren't as good as those in other countries or with other groups of GRS patients.
It's also not clear what your concern is. Are you suggesting that these particular patients not get GRS despite the fact that it's often done to reduce a risk of suicide?
The statement becomes the basis for operations when it turns out it was a mistake to have them. When you have to get puberty blockers to promote the transformation, the operation itself seems to be motivated more by belief and desire than sexual orientation and gender identity being biologically determined.
I've listened to parents who already know what gender their child is as early as 5 and younger, although it is contrary to the child's outward appearance.
Oh yes, I believe some males are really females and vice versa and it can be either or both their physiological makeup and/or mental makeup. This is a major decision and it is not wise to determine the sex long before it has been studied both by the physicians, psychologists and patients extensively, since it has everlasting effects on the patients life.
You obviously have no idea what you're talking about. Puberty blockers aren't used to "to promote the transformation", they're merely used to delay the physical changes of puberty so a transgender child can attain the age where they can decide for themselves whether to use hormone therapy.
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???? What does "outward appearance" have to do with the issue of gender identity? For most people their gender identity is stable by the age of 5 so if your kid is consistently and insistently stating that you're misgendering them, you might want to pay attention before you cause a problem which results in a dead kid.
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A truly ironic and clueless statement. Fortunately good parents are now recognizing the issue at an early age and seeking the professional advice their kid will need. Even better that fewer and fewer parents are being swayed by the rants of bigoted bible-babblers.
Let me tell you how I see it Skrekk. When you don't allow a young person to develop as nature intended by using blockers to prevent it from happening, you're promoting the transformation in my opinion. You've already convinced the child that thing hanging between his legs was a mistake and he maybe he should have it whacked off, literally. He is prevented from having natural tendencies as other children experiencing the onset of puberty because his parents and the so-called professionals, who probably need to see a psychiatrist themselves, have prevented the child from doing what all his/her classmates are doing, becoming adults.
No offense, but there are a lot of crazy people raising children and most of them aren't Bible Thumpers.
That's just silly. The use of puberty blockers merely delays the onset of puberty so that the child can be a bit older when they decide whether and how to treat the issue. When puberty blockers are stopped a completely normal puberty resumes, or if a decision is made by the transgender kid and their parents and doctors that HRT is appropriate then cross-sex hormone treatment is started. For a transgender kid a puberty which doesn't conform to their gender identity is both very traumatic and dramatically increases the risk of suicide, but it also makes any long-term HRT or GRS much more complex and much less effective.
Note that by the time puberty blockers are started the doctors involved are pretty sure that the kid is transgender.
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No one is "convincing the child" of anything. And such surgeries aren't performed on children. The transgender person decides as an adult whether to do GRS, and most trans folks don't do bottom surgery anyway. Besides which it's their decision not yours.
What you seem to be whining about is that some parents don't stigmatize or abuse their transgender kids like the bible-babblers and other conservatives do, and instead they seek current medical advice. Such parents deserve a lot of credit because their kids are far more likely to survive and lead a happy and productive life. But it's your choice.....feel free to stigmatize and abuse your transgender kid in order to drive them to suicide. Heck, do what other conservatives do and take your trans kid to your local cult to exorcise their trans demons, and if that doesn't work just beat them or kick them out of home. In the unlikely event that your kid survives their childhood they can be guaranteed to have a far higher rate of homelessness and unemployment.
I read a story about someone in Brittan I think it was. Anyhow it was a country in which Their laws cover sex changes with government money. Someone had a sex change that was paid for and now wants to change back and have the taxpayers pick up the tab...AGAIN. Gotta love it.
LMAO! You think I made that up?
All right - who cares? That was in London. Not here. So fucking what?
Evidently YOU cared enough to ask for a link. Or you thought you did?
Did you think transgenders are never confused about gender?
That doesn't make any sense. No wonder you're laughing at it.
I didn't think it was difficult to understand or needed clarification, but apparently I was mistaken. Thank you for explaining the obvious.
It's quite ironic to me that some people decry that we would even consider equality for such a small percentage of our population and conversely are obsessed by that small percentage and pretend that they care deeply about their well being.
The cognitive dissonance required for this posit is galactic.
You appear confused. I didn't say anything about caring for anyone, although I may. I just put an article up that showed the lack of care for those who have discovered they may have made a mistake in doing what they did. The same people who profess to care about them don't seem to be interested in them unless they go along with the program. If you're referring to me, I'm not even a part of this scenario. This is your bag, not mine.
i agree, its quite amazing
It's quite ironic to me that some people decry that we would even consider equality for such a small percentage of our population
I have no problem with it at all. The problem I have is when that small percentage of the population insists that, 98% of the population needs to make, and adhere to, new controversial laws in order for them to achieve their vision of equality.
What laws are you whining about? It seems that those who are used to privilege often find that equality is oppressive.
Specifically laws that make it OK for biological men to use the women's room and vise-versa regardless of what kind of reproductive parts they still have.
In general there are no such laws one way or the other, historically it's purely been social custom where people with a female gender expression use the women's restroom and people with a male gender expression use the men's restroom. In other words that's the way it's worked for both transgender and cisgender folks ever since gender-segregated public restrooms became common about 100 years ago. But note that in the confederate states that gender-segregation was usually only for the whites-only restrooms......"coloured" folks just used the same restroom regardless of gender. And apparently the racist bible-babblers had no problem with that arrangement.
The funny part is that folks like you apparently want to force burly transgender men like Buck Angel to use the women's restroom. Why you want to force such folks to use a restroom which conflicts with their gender identity and gender expression is beyond me, but at least there are a number of legal precedents which will prevent the laws you want to pass from ever going into effect.
Doctors who perform these mutilations are in violation of the Hippocratic oath.
No kidding and the Liberals love em and love the people who have these operations done to them unless they discover that it was a mistake. Then they don't want to hear from them.
They love blacks, too, unless they want to leave the plantation.
Really? Are you suggesting that these particular patients not get GRS despite the fact that it's often done to reduce the risk of suicide?
"...that it's often done to reduce the risk of suicide?"
Not true.
As I've noted elsewhere you literally have no clue what you're talking about on this topic. It's a good thing that transgender folks don't seek your advice or the advice of other bigots.
This recent study shows that transgender folks who are treated with puberty blockers prior to any hormone treatment or gender confirmation surgery (the "Dutch Protocol") and who are raised in a supporting family have the same suicide rate as the general population:
??? You have no clue what you're talking about. A reduction in stress related to gender dysphoria is one of the main reasons a psychiatrist will advise HRT or GRS as an appropriate treatment.
Again, the data demonstrate you are wrong.
What data are you referring to? Psychiatrists who work in this area have clearly stated why they support GRS for this subset of transgender folks, so your statement is quite clearly erroneous.
Doctors who perform these mutilations are in violation of the Hippocratic oath.
Yeah, because it's so simple to convince a doctor to cut off your genitals. You have no idea what you are talking about.
You failed to refute my point.
I wonder if they support the amputation of healthy limbs too?
What 'point' would that be?
Do you think that you just walk into the surgeon's office and schedule an appointment to have your body disfigured? No. It takes years of counseling before any surgeon would agree to perform such a surgery, and the counseling it not designed to persuade the person to do it. If the end result is that the individual and the therapists are convinced that this is the thing that would make their life livable on their terms, then it moves forward.
I had an oral surgeon that had the 3 last fingers of his left hand amputated so he could more easily do oral surgery, and the last two fingers of his right hand amputated. It was creepy! Obviously someone did it to him, at his request. EEK!
I'd say the lesson here is, dont chop anything off till you're damn sure you never want to see or use it again.
OUCH !
Science still considers Gender dysphoria a mental illness. As we speak special interest groups are pushing the psychological community to ignore science and normalize.
Nonsense. Which source are you pulling that from?
I have often wondered what happened to a young man I read about a year or so ago who had the surgery to replace his penis with a vagina. His mother helped him transgender during high school. Prior to attending college he had the surgery. He was set up to live in a dormitory and his main concern was how he was going to care of the wound without anyone knowing. You see, it was an open wound and had to be properly cleaned and cared for.
This is just one story and I am sure there are many more.
What does that even mean? Open wound? Needs to be cared for?
This is just one story and I am sure there are many more.
I believe what magnolia is expressing is known as "concern trolling" on the intertubes.
I always suspected this is like the repressed memories nonsense of the nineties. The illustrious "educated" experts always stand by their voodoo science until society comes to its senses.
Unlike the pet rock or Beanie Babies, transgenderism is one fad you can't just give up once you start cutting.
It's not a fad.
It is not a fad.
That's one abstract from one study back in 2012. Hardly conclusive.
You're mischaracterizing that rather outdated study which is not about transgender kids per se but is about all children who express gender dysphoria before puberty. But that's why medical professionals rather than bigoted bible-babblers are helpful to advise parents on these issues.
It'll be a sad day for me if you lot ever actually read the stuff you link to, much less understand it not to mention the inability to do the arithmetic.
From your link:
Only rightwing math calls 43%, 70% I guess. All that really means is that, not surprisingly, kids who may not even be sexually mature are confused or expressing themselves of ideas of sexual dysphoria and without having it. They were never transgender or transsexual to begin with. (BTW, as I mentioned yesterday that's the reason for an entry in the DSM: to correctly ascertain whether someone does or doesn't truly have the opposite sexual identity not to label them with a "disease" or "disorder."
The only evidence from one study doesn't show it is a fad. You've proven nothing.
Then why the explosion of people who suddenly decided they're trans? Why are parents actually pushing their kids into thinking they are?
They didn't suddenly decide they were trans. Where did you get that?
What parents are 'pushing their kids into thinking they are'?
When someone asks something so stupid like that I just wonder if they really exist or it's some bot churning out imbecilic comments. First, anyone who thinks that since he's just now hearing about it must mean that it's just starting is pretty much the definition of egocentrism. (BTW, Trump does that all the time: he just learns about something that's been history for over a hundred years and thinks he's revealing something new). If it really is a real person I wonder if they've ever run across the word "taboo." People in this situation have not felt free to bring it out into the open until very recently. Caitlyn Jenner's story has made it easier for many people to now come out into the open and she waited until well past middle age to make it public and seek medical/surgical treatment. That tells us everything about how this condition would have been seen just 10 years ago.
Bruce Jenner did not have reconstructive surgery on his penis. He claims he still like women.....go figure. I think he likes to play dress up being surrounded by all those women for years.
And you know this how, exactly? As far as I know she hasn't discussed the specifics of her GRS.
By the way it's quite revealing that you misgender Jenner and use her old name. It reveals a deep psychological insecurity on your part.
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Sounds like you've confused gender identity with sexual orientation. Why would you expect the latter trait to change merely because a trans person has GRS?
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And you've confused being transgender with being a cross-dresser. Are all conservatives so profoundly ignorant?
Of course, it's easy to find some addled, bigoted quack whose puts his biases over both his education, such as it might be for a surgeon on this subject, and his oath. And then there's this howler:
According to whom (let me guess).