Dr. Richard Bosshardt criticizes the practice of cutting off teenage girls’ breasts, which is part of so-called “gender-affirming care”:
I am a plastic surgeon. Over the past 35 years, I’ve seen many of my colleagues abandon the most basic premise in human biology: that there are two, immutable sexes. Their capitulation to “queer theory” has resulted in children receiving needless, dangerous, and life-altering surgeries—all based on the lie that people can change their sex.
Each of these “gender-affirming” procedures is grotesque. I want to focus on just one—“top surgery,” a breast procedure that I, as a plastic surgeon, understand well. Top surgery is a euphemism that refers to cutting off a woman’s natural breasts to masculinize her chest. Because most of today’s trans-identifying adolescents are girls, top surgery is the most common gender-related operation, and is performed on girls as young as 13 years old.
Surgeons refer to this procedure as a bilateral mastectomy—typically performed as a treatment for breast cancer. As a “gender-affirming” intervention, the operation involves removing as much breast tissue as possible while preserving the skin and nipple-areola complex.
Mastectomies carry several risks and consequences. One is the potential loss of one or both nipples due to compromised circulation. Another is the creation of an uneven or otherwise abnormally shaped chest. Like other surgeries, it also carries risks of infection, bleeding, blood clots, and other complications.
Top surgery has lasting consequences. The procedure results in permanent nerve damage and surgical scars. Since the surgery removes all duct tissue, it renders patients permanently unable to breastfeed.
Advocates of “gender-affirming” care often insist that this damage is reversible. Asked about girls who later regret their decision to have their breasts removed, Joanna Olson-Kennedy, a pediatrician and prominent advocate of transgender medicine stated, “If you want breasts at a later point in your life, you can go and get them!”
Her comments are unacceptable and dangerously naive. If she is telling patients that they can easily “go and get” breasts after a mastectomy—that breast reconstruction is a low-risk procedure—she is misleading them. Breast reconstruction is a major surgery. It requires inserting implants and/or shifting skin, fat, and, sometimes, muscle, from one area of the body to the chest. Some procedures leave two distinct surgical sites, both with potential complications. In the worst case, reconstruction can have catastrophic consequences, such as failed reconstruction or even death. Even if the procedure avoids these harms, the patient’s reconstructed breasts will never look or feel normal.
Neither top surgery for a person with gender dysphoria, nor breast reconstruction for a “detransitioner” who regrets her initial procedure, results in a natural, functional chest. In both cases, minors are left with permanently disfigured bodies, and potentially lifelong medical complications.
We will one day view “gender-affirming care” in minors with the same revulsion that we now view frontal lobotomies. Until then, many children will continue to suffer tragic—and irreversible—consequences.
The number of “top surgeries” conducted on minors rose by 389% from 2016 to 2019. Between 2018 and 2023, states spent tens of million of dollars on “gender transition services” for kids — including puberty blockers, hormones, and sex-change surgeries.
At least 225 hospitals have provided irreversible transgender procedures to kids, and at least 6,000 kids have had transgender surgeries, according to insurance-claims data unearthed by the medical non-profit Do No Harm.
A gender transition can result in a lifetime of pain, discomfort, and medications, such as hormone therapy. As Britain’s National Health Service explains, hormones “need to be taken for the rest of your life, even if you have gender surgery.” The FDA notes that puberty blockers can cause brain swelling and vision loss, and an FDA official who supported giving minors puberty blockers conceded that they actually increase suicidality. Indeed, the “FDA knew ‘gender affirming’ puberty blockers increase ‘suicidality’ in 2017,” reported Just the News.
95% of young transgender people on testosterone develop pelvic floor dysfunction; most have bowel issues and sexual dysfunction. As the Telegraph reported, “Around 87 per cent…had urinary symptoms such as incontinence, frequent toilet visits and bed-wetting, while 74 per cent had bowel issues including constipation or being unable to hold stools or wind in. Some 53 per cent suffered from sexual dysfunction…Almost half had an ‘orgasm disorder’, while a quarter suffered from pain during sexual intercourse.”
To overcome parents’ natural reluctance to subject their kids to this suffering, doctors who do sex changes often tell parents that they need to gender transition their kid to keep them from committing suicide, even though this isn’t true. One of America’s most prominent gender doctors, “Dr. Olson-Kennedy disclosed to how she speaks with parents of gender dysphoric patients: ‘We often ask parents, “Would you rather have a dead son than a live daughter?”‘”
One study found that sex changes massively increase suicide risks, rather than reducing them. “Gender-affirming surgery is significantly associated with elevated suicide attempt risks,” according to that study in the Cureus Journal of Medical Science.
The lawyer challenging Tennessee’s ban on certain transgender treatments for minors, Chase Strangio, conceded to the Supreme Court that “completed suicide is thankfully and admittedly rare” among transgender youth, even those not given gender-affirming treatment, and that “there is no evidence…that this treatment reduces completed suicide.”
