Admiral Rachel Levine, in effect Joe Biden’s Cabinet Minister for Trans Affairs, proclaimed last October that “accredited medical professional groups agree that gender-affirming care is medically necessary, safe, and effective for trans and non-binary youth.” Last March, Levine ramped up the claim.
“President Biden supports you. I as the Assistant Secretary for Health will support you and I talk about this topic, everywhere I go, to get the word out,” said Levine, a Harvard grad and medical doctor. “I am positive and optimistic and hopeful that the wheel will turn after that and that this issue won’t be as politically and socially such a minefield.”
“Gender affirming care” commonly includes cross-sex hormones, puberty blockers, and gender reassignment surgeries.” Those contemplating these procedures should know what they entail.
Dr. Maddie Deutsch, Associate Professor of Clinical Family & Community Medicine at the University of California – San Francisco (UCSF), and Medical Director for UCSF Transgender Care, reviews the “choices, risks, and unknowns associated with feminizing hormone therapy.” Taking higher doses of hormones, “will not necessarily bring about faster changes, but it could endanger your health.”
As Dr. Deutsch explains, “your skin will become a bit drier and thinner. Your pores will become smaller and there will be less oil production. You may become more prone to bruising or cuts and in the first few weeks you’ll notice that the odors of your sweat and urine will change.”
In these conditions, “you can also expect your muscle mass and strength to decrease” and “your testicles will shrink to less than half their original size, and most experts agree that the amount of scrotal skin available for future genital surgery won’t be affected.”
According to Dr. Deutsch of UCSF, “many of the effects of hormone therapy are reversible, if you stop taking them. The degree to which they can be reversed depends on how long you have been taking them. Some breast growth, and possibly reduced or absent fertility are not reversible.” (emphasis added)
Puberty blockers, according to the Mayo Clinic, are hormone (GnRH) analogues that “can be used to delay the changes of puberty in transgender and gender-diverse youth who have started puberty.” Delaying puberty “might improve mental well-being, ease depression and anxiety, improve social interactions with others,” and so forth. On the other hand, puberty blockers alone “might not be enough to ease gender dysphoria.”
Possible side effects of GnRH analogue treatment include: “swelling at the site of shot, weight gain, hot flashes, headaches,” and “mood changes.” GnRH analogues might have long-term effects on “growth spurts, bone growth, bone density” and “fertility, depending on when the medicine is started.”
As the Mayo Clinic warns, “some of the changes triggered by gender-affirming hormone therapy cannot be reversed. Others may require surgery to reverse.” (emphasis added) And “gender confirmation surgery” (GCS) is necessary to complete reassignment from the original design.
For the male-to-female (MTF) patient, surgical procedures may include: mammoplasty, orchiectomy, penectomy, vaginoplasty, clitoroplasty, vulvoplasty, labiaplasty, urethroplasty, and prostatectomy. Facial reconstruction, voice surgery and liposuction may also be required.
For the female-to-male (FTM) patient, surgical procedures may include, subcutaneous mastectomy, nipple grafts, chest reconstruction, salpingo-oophorectomy, metoidioplasty, phalloplasty, vaginectomy, vulvectomy, scrotoplasty, and implantation of erectile and/or testicular prostheses. Some of these procedures have variations.
A total vaginectomy “involves complete removal of all the tissue of the vagina and is considered risky.” It does not remove the uterus or ovaries, which are removed by salpingo-ooporectomy and hysterectomy. A muscosal vaginectomy removes some of the lining of the vagina and then closes up the entrance. The inside of the vagina then collapses in on itself. The effects of vaginectomy “are permanent and cannot be reversed.”
A penectomy, “completely destroys the penis,” leaving no skin for a vaginoplasty. For new genitals, the patient needs labiaplasty, clitoroplasty, and vaginoplasty by other means. According to Oregon Health and Science University, the risks to vaginoplasty include vaginal stenosis, narrowing of the vaginal canal, and “a second surgery is often required to fix it.”
There is also a chance of injury to the rectum, and the possibility of fistula, a rare connection between body parts such as the vagina and rectum.
“If you see fecal matter (poop) coming from the vagina,” OHSU explains, “you may have a fistula and should tell us right away.” A fistula of this type may recall Dr. Ergon Spengler (Harold Ramis) warning fellow ghostbusters that “crossing the streams” is bad. This problem requires “another major surgery.” No word of the costs, like all these procedures, probably on the high side.
According to the Cleveland Clinic, the two reasons for having a penectomy are cancer and “gender affirmation.” In a total penectomy “the entire penis, including the root that goes into the pelvis, is removed.” In this case, the urethra, the tube that allows urine to leave the body, is rerouted to a spot in the perineum, the area between the scrotum and anus. In a perineal urethrostromy, “you’ll need to sit when you urinate.”
According to the Cleveland Clinic a scrotoplasty for gender affirmation “typically includes creating a penis” from existing genital tissue or skin from another part of the body, as in a phalloplasty. To construct a scrotum “the surgeon cuts and shapes the lower part of your labia majora into a scrotum-like sac.” After the scrotum heals, the patient may choose to get testicular prostheses, silicone gel or saltwater implants that “create the look and feel of testicles.”
According to GCS specialist Dr. Christopher Salgado, scrotoplasty and glansplasty require an operation of 8 to 12 hours and a two-week stay in hospital. “Some transgender men will have their neo-penis tattooed to give the area natural coloring and depth.”
Complications of scrotoplasty include: abnormal connection between your skin and urethra, breakthrough and exposure of the testicular implants, and rejection of tissue transplanted to create a penis. Remember, in penectomy and vaginectomy, the original equipment is destroyed and the procedures are irreversible. MTF or FTM, the patient is basically SOL.
Dr. Levine thinks it’s all “medically necessary, safe and effective” and “President Biden supports you.” Remember, it’s okay to have your own opinions, except when they differ from those of the Admiral Levine and President Biden. Then you become a domestic terrorist and violent extremist.
What procedures Biden’s Assistant Secretary for Health has endured is not exactly clear, but the results are not convincing. Levine may recall the transvestite Dr. Robert “Bobby” Elliot (Michael Caine), who carves up women in Dressed to Kill. The Admiral’s side effects appear to include hardening of the attitude toward the First Amendment rights of the people.