Rückgängigmachung von „Geschlechtsangleichenden Operationen“

Ein interessanter Beitrag zur Rückgängigmachung von „Geschlechtsangleichenden Operationen“ oder „Geschlechtsumwandlungen“:

Those wishing the reversal, Prof 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-yearold.

Wäre interessant die Hintergründe zu erfahren. Ist das Ergebnis nicht gut genug um wirklich überzeugend zu sein? Fühlt man sich doch nicht so wohl, wie man dachte? Oder liegt es daran, dass viele Transsexuelle unabhängig von der Behandlung einen hohen Grad an Depression etc aufweisen?

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 specialises in working with transgender people, suggested the research after a conversation with Prof 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 Mr 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.

Wahrscheinlich, weil es als Transfeindlich angesehen würde oder befürchtet wird, dass damit Leute von einer Operation abgehalten werden oder die Bedingungen dafür erschwert werden.

Dabei wäre eine Verklärung hier ja gerade für Junge Menschen, die nach einer Behandlung wenn ich es richtig verstanden habe, meist steril sind, besonders tragisch.

Not least on social media from the powerful transgender lobby. Speaking this week, Mr 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, Prof 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.” Prof Djordjevic, who has 22 years’ experience of genital reconstructive surgery, operates under strict guidelines.

Die genauen Gründe herauszufinden könnte eben helfen Leute zu diesen Operationen richtig zu beraten. Das scheint aber letztendlich nicht gewünscht zu sein, eben weil es ein schlechtes Licht auf die Szene an sich werfen könnte.

Before any surgery, ‘It is more than surgery; it’s an issue of rights’ 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, Prof Djordjevic says he has real concerns about the level of psychiatric evaluation and counselling that people receive elsewhere before gender reassignment first takes place. Prof 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.

Klar, die Rückkehr ins männliche Privileg vermutlich. Oder es liegt eben daran, dass es wahrscheinlich noch schwieriger ist aus einem Mann eine Frau zu machen und damit auch die Akzeptanz geringer ist.

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.”

Das ist in der Tat ein sehr schwieriger Thema. Einige sagen, dass man gerade dann, wenn Minderjährige es wünschen, sehr schnell eine Hormonbehandlung starten sollte, bevor die Pubertät und die damit einhergehenden Hormone die Lage noch verschlimmern und eine gute Geschlechtsangleichung erschweren.
Andere sagen eben, dass der Eingriff zu gewaltig ist als das man ihn für einen Minderjährigen entscheiden könnte, gerade weil wohl Studien auch festgestellt haben, dass einige, die sich als Kinder für trans halten schlicht später als Homosexuelle leben und damit zufrieden sind.

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. Dr 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. Prof 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 lifechanging 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.

Also ein schwierigeres Thema als gerade radikale Feministen meinen, weil es eben eine Entscheidung mit schweren Folgen ist, die man dann auch nur schwer wieder rückgängig machen kann.

Allerdings ist der Artikel auch kritisiert worden, weil er eben keine konkreten Zahlen nennt, wie viele wirklich ein „Reversal“ wollen. Dieser Text hier führt beispielsweise an:

Fortunately, more useful statistics are now available on the practice of surgical reversal of trans genital surgeries. This month, WBUR CommonHealth reported on findings from a still-unpublished study:

The most recent data on transgender patients who change their mind after surgery is a study led by Oregon Health and Science University, which has not been published but was presented at a conference earlier this month. In it, 46 surgeons from around the world reported reversing 36 transgender surgeries, including 16 phalloplasties, after treating somewhere between 18,000 and 27,000 patients.

36 surgical reversals out of 18,000-27,000 trans patients who’ve received surgery is a reversal rate of 0.13-0.2%. This is consistent with existing studies finding that rates of regret following genital surgery of about 2%, and indicates that only a small fraction of those who do experience regret will go on to seek reversal surgery. I’ve been in touch with the study’s authors, and while the study itself is not yet available, I look forward to continuing to cover this non-epidemic – denominator and all.

Dann wäre es eine verschwindend geringe Zahl. Allerdings würden 18.000-27.000 Operationen weltweit auch deutlich machen, dass es überhaupt eine sehr geringe Anzahl von Personen gibt, die eine solche Behandlung überhaupt wollen.

In der Wikipedia heißt es:

Formal studies of detransition have been few in number,^[6][7] of disputed quality,^[8][9][10] and politically difficult.^[11][12][13] Frequency estimates vary greatly from 0 to 95%, with notable differences in terminology and methodology.^{[4][14][15][3][2]} The number of detransitioners is unknown but growing.^{[15][16][3][5][17][18][19]}

A 2014 survey of transgender and gender-nonconforming persons found a rate of suicidal thinking and self-harm to be 41%, but it is unclear whether such suicidality occurred before or after transition (among those who chose transition).^[15] In 2016, clinical psychologist James Cantor, PhD, summarized the statistical findings from ten professionally published studies^{[20][21][22][23][24][25][26][27][28][29]} (and one conference paper)^[30] on persistence of transgender identity in children. He concluded that „roughly 60 to 90%“ of transgender youth were found eventually to detransition, with most becoming gay or lesbian adults instead.^[14][15][3] A 2018 survey of WPATH (World Professional Association for Transgender Health) surgeons found that approximately 0.3% of patients who underwent transition-related surgery later requested detransition-related surgical care.^[31] Demand for surgical reversal of the physical effects of medical transition has reportedly been on the rise.^[16][17][19]

Detransition is more common in the earlier stages of transition, particularly before surgeries.^[4][15] Among eventual detransitioners, the progression of transition has been found to magnify, rather than remedy, gender dysphoria. Sufferers may fixate on passing (being perceived as their preferred gender), leading them to pursue ever further steps in medical transition.^[15]

Motivation to transition among detransitioners has included trauma, isolation, dissociation, inadequate mental healthcare, and social presure to pursue transition.^[15] Motivation to detranstion has included financial barriers to transition, social rejection in transition, depression or suicidality due to transition, discomfort with sexual characteristics developed during transition, concern for lack of data on long-term effects of hormone replacement therapy, concern for loss of fertility, complications from surgery, and changes in gender identity.^{[16][32][4][31][3][33][34]}

Informed consent and affirmation of self-diagnosis (both newer but increasingly employed models for transgender healthcare) have been criticized for failing to meet the needs of those who eventually detransition.^[2][15][5]

Gerade die hohe Rate derjenigen, die sich erst als Trans und dann eher als schwul betrachten macht deutlich, dass eine zu schnelle Angleichung vielleicht keine so gute Idee ist. 2222