The one thing that is very new is genital surgery in someone who has underwent pubertal suppression. [It is] not so much an issue in someone with assigned female at birth anatomy that undergoes a bowelplasty because we're crating something new with a free tissue transfer -- a flap anyway, but a much bigger issue for a person undergoing a penile inversion vaginalplasty because we use all that tissue to create the vulva as well as lining the internal vaginal canal and as a specialty those of us who do a fairly high volume of genital gender-affirming surgery -- we've maybe done a couple, a handful, of fully purebertally suppressed adolescents as the field and no one's published on it yet, OHSU is still just putting our first series together as we're kind of learning and figuring out what works.

we see adults inflicting unspeakable harms on helpless children to affirm the adults' own worldview: that gender is somehow fluid, that sex can be surgically altered, that there are no lasting consequences of all this madness as the result of the sex-change procedures. What is even more alarming is that the central tenet of the trans-gender movement and its allies is to exclude parents as much as possible from making decisions about the health of their own children. Medical professionals and schools increasingly see parents as "trans-phobic bullies who must be prevented from standing in the way of a medical sexual transition of their own kids.