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Paxton is Investigating Dell Children's Medical Center Over "Gender Transitioning Procedures" for Minors


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7 minutes ago, TwiceHorn said:

I think it's pretty clear that the loudmouths are on the right.  They give not a single fuck about gender dysphoria patients, they're just trying to pass peformative laws that stick it to the icky queers.  Any notions of patient safety are a smokescreen for sticking it to the icky queers.

The thing is, the loudmouths on the right don't even try to hide that this is about trying to fuck over some group of people they don't like.  When they tell you who they are, everybody should be listening.  This has been ramping up in Texas ever since Dannie Goeb became obsessed with who was using what bathroom, even though most of us had never encountered this issue that Dannie was losing his shit over.

Dell Children's happens to be in Austin, which is a win-win for Paxton, because the only kids using it would be libtard kids, right?  Well, except for all of the kids from 46 outlying/rural counties that get flown or transported in, but still, it's a win-win for Paxton, especially since it's associated with the University of Texas.

Would be nice if Michael Dell got involved - he's spent a lot of money on Republicans over the years, I'm sure he can't be too happy that Paxton is trying to fuck with a project that's very near-and-dear to him, the Dell Medical School, and to UT.

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5 minutes ago, naija said:

Yes, medicine proceeds afoot without definitive evidence all the time. But it becomes more of an issue when the consequences of said treatment can be very dire. Gender-affirming surgery, if incorrectly assigned to an individual, certainly falls under that rubric.

It is impossible to claim that politics doesn't play a part here. It certainly does. You'd be blind as a clinician to not think it does. The WPATH guidelines reflect this. Removing the need for a mental health examination reflects this. There was no solid reason, other than the offense it gave to some, to remove that guideline. Again, when the effects of a treatment can be dire, you should err on the side of caution. The demands on well-meaning gender-affirming surgeons are only going to grow.

As with many other things in this country, the loudest voices are now being deployed by people at the extremes of the position, even in medicine. People who lay somewhere in the middle, and just want to get good data on the topic are quietly leaving the stage. You certainly aren't going to see many people get up at a national meeting, and start questioning the de facto position, that gender-affirming surgery is a good thing. 

Gender affirming surgery, to my knowledge, is only undertaken by adults after informed consent. No one other than the patient and their surgeon should have a say in the matter, no more so than anyone should be able to prevent an adult from having rhinoplasty, breast augmentation, liposuction, or any other cosmetic procedure. Unless you want to require a mental health evaluation for all cosmetic surgery, I don’t know how you can mandate it for gender dysphoria. Hormone blockers for pre pubertal and pubertal kids is a whole different ball of wax 

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5 minutes ago, TwiceHorn said:

Well, in these other countries, the debate seems to be mostly confined to the medical community, outside the public view.

 

Yes. I agree.  It is particularly in this country where we have gone off the rails. Its hard to totally unpack in soundbites, but it is a pretty good ironic contrast of the approach from the liberal socialist medicine countries and our profit driven one. What a world. 

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2 hours ago, Anastasis said:

This is misinformation. 

No, it isn’t.

 

Quote

The truth is that data from more than a dozen studies of more than 30,000 transgender and gender-diverse young people consistently show that access to gender-affirming care is associated with better mental health outcomes—and that lack of access to such care is associated with higher rates of suicidality, depression and self-harming behavior. (Gender diversity refers to the extent to which a person’s gendered behaviors, appearance and identities are culturally incongruent with the sex they were assigned at birth. Gender-diverse people can identify along the transgender spectrum, but not all do.) Major medical organizations, including the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, the American Medical Association, the American Psychological Association and the American Psychiatric Association, have published policy statements and guidelines on how to provide age-appropriate gender-affirming care. All of those medical societies find such care to be evidence-based and medically necessary.

AAP and Endocrine Society guidelines call for developmentally appropriate care, and that means no puberty blockers or hormones until young people are already undergoing puberty for their sex assigned at birth. For one thing, “there are no hormonal differences among prepubertal children,” says Joshua Safer, executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York City and co-author of the Endocrine Society’s guidelines. Those guidelines provide the option of gonadotropin-releasing hormone analogues (GnRHas), which block the release of sex hormones, once young people are already into the second of five puberty stages—marked by breast budding and pubic hair. These are offered only if a teen is not ready to make decisions about puberty. Access to gender-affirming hormones and potential access to gender-affirming surgery is available at age 16—and then, in the case of transmasculine youth, only mastectomy, also known as top surgery. The Endocrine Society does not recommend genital surgery for minors.

Scientific American republished the article, in March 2023,  to counter actual misinformation which is cited when legislators push anti-trans bills.

 

https://www.scientificamerican.com/article/what-the-science-on-gender-affirming-care-for-transgender-kids-really-shows/

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3 minutes ago, Sawbonz said:

Gender affirming surgery, to my knowledge, is only undertaken by adults after informed consent. No one other than the patient and their surgeon should have a say in the matter, no more so than anyone should be able to prevent an adult from having rhinoplasty, breast augmentation, liposuction, or any other cosmetic procedure. Unless you want to require a mental health evaluation for all cosmetic surgery, I don’t know how you can mandate it for gender dysphoria. Hormone blockers for pre pubertal and pubertal kids is a whole different ball of wax 

Top surgery happens in adolescents. 

This is not a cosmetic procedure. The push for this to be covered by insurance points to that. Second, if you were to relate what they are undergoing to a cosmetic procedure, you will find that transgender patients would have very strong views about that. Ethical guidelines by the Aesthetic societies do ask that the practitioner not discount the number of patients one might encounter who are best served with a psychological assessment. 

As for the patients and surgeons having a say, I would reference a portion of an Op-Ed written in the NYTimes about 4.5 years ago by someone who transitioned and when I read it at the time, didn't sit right with me.

Quote

The medical maxim "First, do no harm" assumes that health care providers possess both the means and the authority to decide what counts as harm. When doctors and patients disagree, the exercise of this prerogative can, itself, be harmful. Nonmaleficence is a principle violated in its very observation. Its true purpose is not to shield patients from injury but to install the medical professional as a little king of someone else's body.

Let me be clear: I believe that surgeries of all kinds can and do make an enormous difference in the lives of trans people.

But I also believe that surgery's only prerequisite should be a simple demonstration of want. Beyond this, no amount of pain, anticipated or continuing, justifies its withholding.

I just fundamentally have a problem with that mindset, and I think anyone who wields a scalpel should. 

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20 minutes ago, Willfully Horn said:

No, it isn’t.

 

Scientific American republished the article, in March 2023,  to counter actual misinformation which is cited when legislators push anti-trans bills.

 

https://www.scientificamerican.com/article/what-the-science-on-gender-affirming-care-for-transgender-kids-really-shows/

I took a look at that first link in this post. I noticed really quickly that in at least two of articles listed in the first 4 or 5, the authors conclusions do not quite match up with what that gentleman has summarized. Take the Finnish article for example. 

This is what the Finnish authors put in their abstract

Quote

Results: Those who did well in terms of psychiatric symptoms and functioning before cross-sex hormones mainly did well during real-life. Those who had psychiatric treatment needs or problems in school, peer relationships and managing everyday matters outside of home continued to have problems during real-life.

Conclusion: Medical gender reassignment is not enough to improve functioning and relieve psychiatric comorbidities among adolescents with gender dysphoria. Appropriate interventions are warranted for psychiatric comorbidities and problems in adolescent development.

This is what he wrote in his summation of the article

Quote

This study is from Finland. Researchers conducted a retrospective chart review of 52 adolescents who received gender-affirming hormones (estrogen or testosterone) and found statistically significant decreases in need for specialist level psychiatric treatment for depression (decreased from 54% to 15%), anxiety (decreased from 48% to 15%), and suicidality or self-harm (decreased from 35% to 4%) following treatment. However, the authors note that gender reassignment is "not enough to improve functioning and relieve psychiatric comorbidities among adolescents with gender dysphoria."

It is really easy to read what he wrote and come to conclusion that that particular study was part of the positive ledger for gender-affirmation, when the authors don't even think it was.

I did not go through all the articles cited, but when someone is willing to play games like that, and seemingly is depending on the likelihood that the majority of people will not track each article down and pore through the original data themselves, it puts a dent in the credibility. 

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48 minutes ago, naija said:

More Trans Teens Are Choosing ‘Top Surgery’

There is also an article, if you are able to find it on PubMed, called Top Surgery and Chest Dysphoria Among Transmasculine and Nonbinary Adolescents and Young Adults. The age range of population was 13 to 24.

I could only see the abstract on the study. I would not agree w surgery under 17 yo presuming puberty blockers are available.
 

The NYT article quotes a 17 yo. I have no problem with a 17 yo who is emancipated or whose parents consent to the procedure undergoing it. I would also not have an issue with a 17 yo cis male with gynecomastia undergoing the procedure

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6 hours ago, naija said:

The push for this to be covered by insurance points to that.

Congrats, you just touched on why Annie hates this! It'll cut into his profit margin and he may not be able to send his kids to the nicest private school anymore 

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I’m not an MD, and not directly affected by this, but I’ll offer an anecdote regarding spinal surgery.  Buddy Tipton, who is a damn good orthopedic and spinal doctor, told me twenty plus years ago that he would strongly prefer not to operate on my spine and discs.  He said clinical outcomes for the first five years favored surgery, but after that alternative methods including physical therapy and cortisone shots outperformed surgery in otherwise healthy patients.  
 

I finally did the surgery, twice, once neurological issues started to manifest in the sciatic nerves.  But the point is he was not pushing surgery, he was providing the best possible information using his knowledge and the available clinical data.  
 

I have always believed that’s the kind of medical system we want.  Cost aside, I think it’s what we have.  It should be up to the doctor and patient (and family).  I see a lot of other interests trying to get involved here.

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I still don’t get why anyone outside of the affected and the medical community give a fuck about any of this. Oh, I forgot, they’re horrible shitbags that want to control other people. 
I'm with you, just weird
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14 hours ago, Sawbonz said:

 

Define woke

Type in any professional organization and equity or diversity and you’ll find some stupid initiative or committee. While the idea sounds good, prioritizing diversity ends up producing less competent and capable physicians and leaders imo.
 

It’s filtering all the way through to med school admissions as I’m sure you’re aware. 
 

C27-AB703-C318-4-B94-BC0-F-950-EB79-FE1-

 

dumb policy

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3 hours ago, Hefeweizen said:

 I see a lot of other interests trying to get involved here.

Well, it’s low-hanging fruit to stigmatize a small portion o the population that most people don’t know or understand in order to score some votes, and to distract people away from things that should actually concern them far more.

The louder Paxton, Patrick, Abbott, etc, screech about trans kids or whatever, the greater the likelihood that there is something that has them worried and they are trying to conceal it from the public.

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19 minutes ago, Mullet Free said:

Type in any professional organization and equity or diversity and you’ll find some stupid initiative or committee. While the idea sounds good, prioritizing diversity ends up producing less competent and capable physicians and leaders imo.
 

It’s filtering all the way through to med school admissions as I’m sure you’re aware. 
 

C27-AB703-C318-4-B94-BC0-F-950-EB79-FE1-

 

dumb policy

Maybe if the whites invest in Bitcoin, they will get ahead 

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On 5/5/2023 at 4:16 PM, troph said:

40:20 to the end is so good. Alok, non-binary literary poet, just nails it. Just nails it. This trans battle is about allowing every single person to be who they are and to be free from external prohibitions that enslave us - even cisgender men who are told they can’t be this way or that way. The chronic loneliness many cisgender people, especially men feel. When I came out the instant community I gained was so powerful, and amazing that part truly got me through.
 

What really resonates with me is Alok’s reaction to trauma was “to be exceptional which is is an elaborate form of begging, goddammit see my humanity and then to know it will never be enough because of what I look like.” I’ll admit being the most open here compared to anywhere else in my life has led me to try and show my exceptionalism openly - sometimes in “look at me” fashion as well and I readily admit I chase accolades and trophies and awards for this very reason feeling like I’m unlovable.  It’s hard I wasn’t like that before, no I was just alone. So amazing the way Alok talks about it.

they are trying to legislate sex and gender and say it’s fixed. Nothing in this world is fixed. 

Alok talks about how this is really eugenics. using the rhetoric of science to justify inequality. 

sexism and transphobia and homophobia are not science.

sex and gender are human constructs to categorize bodies.  There isn’t even a biological sex binary let alone a gender binary.

trans people aren’t being attacked we all are being attacked. They don’t want freedom they want monopoly and power, freedom is actually the opposite of power. And Alok’s superpower is community. cisgender men don’t have community, they have hyper isolation and hyper disassociation they mistake as personality. Letting go of power you can be vulnerable and be part of community. Men have to be all knowing all powerful and to be free from that very restriction IS the same fight trans people are fighting just more extreme. 

Alok’s talk on colonialism is so on point too. Alok’s culture celebrated trans people until colonialism changed values.

y’all gotta watch this person is so fucking smart and so good at communicating it.
 

Quoting troph here because anyone who doesn't read the LGBT thread should see it. And if you do read the queer thread but didn't watch the video, you owe it to yourself to do so. This affects you too. The right is working to define you in law, and they depend on the manipulated bigots like Anastasis, fatty, Sack, Incredulity, Chrispy, et al., or others who are disengaged (like those who might see a Project Veritas video and think it might have any sort of credibility or legitimacy, say) to muddy the waters and stir up fear about motivations, outcomes, and the poor outliers who took steps they only thought they needed. They do this, hoping that they can overcome the near unanimous voice of the medical associations and the transgender community at large. Of course there are disagreements on what gender affirming care should look like, but there is no disagreement that gender affirming care is what is needed. The right hopes that you will just be okay with a virtual genocide of trans people while "science figures it out." Once that happens, then people can be trans again. Except it will never happen. The reasons for why have been discussed ad nauseam in the other thread.  Science doesn't need to figure it out. Trans people have figured it out, and science is helping to guide.

Edited by safe sex
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So Aaron Reitz has resigned from Paxton's office to work as Chief of Staff for Ted Cruz.  He cites a growing negative work environment, some departures on legal approaches by the two of them (He was a very senior ADA), and a desire spend more time with his young family (this one I respect, but for the fact that his new gig will have in D.C. and campaigning far more than just being in Austin 90% of the time).  

Imagine looking at a piece of shit like Ted Cruz and thinking, "Well, he certainly seems to foster a more respectful work environment and political platform."  What the fuck does that say about Ken Paxton?  

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16 hours ago, aggie08 said:

Go jerk off to Project Veritas "reporting" man. Literally no one cares.

They recently lost even more credibility when they started stealing money from each other. They don't even trust each other. But it's cool. There are a lot dumb motherfuckers out there. 

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4 minutes ago, Chooky said:

They recently lost even more credibility when they started stealing money from each other. They don't even trust each other. But it's cool. There are a lot dumb motherfuckers out there. 


heavy emphasis on ‘dumb mother fuckers’ 

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6 hours ago, Hefeweizen said:

I’m not an MD, and not directly affected by this, but I’ll offer an anecdote regarding spinal surgery.  Buddy Tipton, who is a damn good orthopedic and spinal doctor, told me twenty plus years ago that he would strongly prefer not to operate on my spine and discs.  He said clinical outcomes for the first five years favored surgery, but after that alternative methods including physical therapy and cortisone shots outperformed surgery in otherwise healthy patients.  
 

I finally did the surgery, twice, once neurological issues started to manifest in the sciatic nerves.  But the point is he was not pushing surgery, he was providing the best possible information using his knowledge and the available clinical data.  
 

I have always believed that’s the kind of medical system we want.  Cost aside, I think it’s what we have.  It should be up to the doctor and patient (and family).  I see a lot of other interests trying to get involved here.

Absolutely, more patients regret back surgery than any other (according to my numerous docs and my personal experience).  Orders of magnitude greater than the numbers of total gender surgery.   Naija don’t care about this much larger population.   FO.

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1 hour ago, safe sex said:

  

Quoting troph here because anyone who doesn't read the LGBT thread should see it. And if you do read the queer thread but didn't watch the video, you owe it to yourself to do so. This affects you too. The right is working to define you in law, and they depend on the manipulated bigots like Anastasis, fatty, Sack, Incredulity, Chrispy, et al., or others who are disengaged (like those who might see a Project Veritas video and think it might have any sort of credibility or legitimacy, say) to muddy the waters and stir up fear about motivations, outcomes, and the poor outliers who took steps they only thought they needed. They do this, hoping that they can overcome the near unanimous voice of the medical associations and the transgender community at large. Of course there are disagreements on what gender affirming care should look like, but there is no disagreement that gender affirming care is what is needed. The right hopes that you will just be okay with a virtual genocide of trans people while "science figures it out." Once that happens, then people can be trans again. Except it will never happen. The reasons for why have been discussed ad nauseam in the other thread.  Science doesn't need to figure it out. Trans people have figured it out, and science is helping to guide.

Keep my name out of your filthy mouth, and go fuck yourself.  

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3 hours ago, Mullet Free said:

Type in any professional organization and equity or diversity and you’ll find some stupid initiative or committee. While the idea sounds good, prioritizing diversity ends up producing less competent and capable physicians and leaders imo.
 

It’s filtering all the way through to med school admissions as I’m sure you’re aware. 
 

C27-AB703-C318-4-B94-BC0-F-950-EB79-FE1-

 

dumb policy

Do you know what “define” means? I’m wondering how the fuck you got into and through med school 
 

 

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Mullet, caring about others, and being proactive in removing harmful cultural obstacles, does not detract from one’s personal professional skill package.  It enhances it, you fucking moron.   Additional knowledge helps.  Try it sometime. 

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7 minutes ago, Sawbonz said:

Do you know what “define” means? I’m wondering how the fuck you got into and through med school 
 

 

That might be their honest answer. 
 

“Woke” being defined as “anything diverse” seems to be their aim.
 

Why they won’t just say “woke = people thinking they should be equal,” I’m not sure. They’ve abandoned most of the other dog whistles for pure, uncut bigotry. Seems odd they’re holding onto this one so tightly. 

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5 minutes ago, Anastasis said:

This thread actually represents the state of the art in terms of the discussion in this country.  Which says as much as needs to be said on the topic. 

You mean like linking the economist and NYT in a discussion of health care best practices?

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Just now, Sawbonz said:

You mean like linking the economist and NYT in a discussion of health care best practices?

Go ahead and post the best practice documents.  Start in the US if you want, and then work your way through the rest of the western world.  We'll land somewhere in terms of consensus bonz, eventually.  There are lay people here that can benefit from lay press viewpoints. Let me know when you want to go deeper.  I am happy to oblige. 

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I’m pretty sure the AAP position statement has been linked in at least one of these threads. Here is the summary of their recommendations 

 

Quote

Recommendations

The AAP works toward all children and adolescents, regardless of gender identity or expression, receiving care to promote optimal physical, mental, and social well-being. Any discrimination based on gender identity or expression, real or perceived, is damaging to the socioemotional health of children, families, and society. In particular, the AAP recommends the following:

  1. that youth who identify as TGD have access to comprehensive, gender-affirming, and developmentally appropriate health care that is provided in a safe and inclusive clinical space;

  2. that family-based therapy and support be available to recognize and respond to the emotional and mental health needs of parents, caregivers, and siblings of youth who identify as TGD;

  3. that electronic health records, billing systems, patient-centered notification systems, and clinical research be designed to respect the asserted gender identity of each patient while maintaining confidentiality and avoiding duplicate charts;

  4. that insurance plans offer coverage for health care that is specific to the needs of youth who identify as TGD, including coverage for medical, psychological, and, when indicated, surgical gender-affirming interventions;

  5. that provider education, including medical school, residency, and continuing education, integrate core competencies on the emotional and physical health needs and best practices for the care of youth who identify as TGD and their families;

  6. that pediatricians have a role in advocating for, educating, and developing liaison relationships with school districts and other community organizations to promote acceptance and inclusion of all children without fear of harassment, exclusion, or bullying because of gender expression;

  7. that pediatricians have a role in advocating for policies and laws that protect youth who identify as TGD from discrimination and violence;

  8. that the health care workforce protects diversity by offering equal employment opportunities and workplace protections, regardless of gender identity or expression; and

  9. that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for youth who identify as TGD.AAP Policy statement

 

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3 hours ago, Mullet Free said:

Type in any professional organization and equity or diversity and you’ll find some stupid initiative or committee. While the idea sounds good, prioritizing diversity ends up producing less competent and capable physicians and leaders imo.
 

It’s filtering all the way through to med school admissions as I’m sure you’re aware. 
 

C27-AB703-C318-4-B94-BC0-F-950-EB79-FE1-

 

dumb policy

While affirmative action certainly falls withing DEI and thus is "woke," it long predates the term.  And, a legitimate debate can be had over affirmative action.

On the other hand, not all DEI is any kind of affirmative action.  In fact, most of it is simple empathy:  try to walk a mile in the other wo/man's shoes and then behave accordingly. And that is "woke."

And, that actually requires some understanding of the things that the dominant race has done to the other races, and that, while factual, is also DEI and also woke.

And by lumping it all together and calling it "woke,"  you have made simple good behavior and factual education necessary to good behavior a political canard on the level of debating affirmative action.

And that, friends and neighbors, is pure dee demagoguery.

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6 minutes ago, wildcat09 said:

Ah, now I see why Ana has stopped tap dancing on the dying women who can’t get abortions. He’s decided to focus his harassment on a possibly even more defenseless community.

Don't forget small, infinitesimally small. People act like adolescent wangs are getting chopped off left and right.  This should be a de minimis non curat lex thing.

https://www.reuters.com/investigates/special-report/usa-transyouth-data/

Over the last five years, there were at least 4,780 adolescents who started on puberty blockers and had a prior gender dysphoria diagnosis.

At least 14,726 minors started hormone treatment with a prior gender dysphoria diagnosis from 2017 through 2021, according to the Komodo analysis.

In the three years ending in 2021, at least 776 mastectomies were performed in the United States on patients ages 13 to 17 with a gender dysphoria diagnosis, according to Komodo’s data analysis of insurance claims. 

Out of 40 million insured aged 6-17.

Edited by TwiceHorn
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5 hours ago, nbmishoid said:

Absolutely, more patients regret back surgery than any other (according to my numerous docs and my personal experience).  Orders of magnitude greater than the numbers of total gender surgery.   Naija don’t care about this much larger population.   FO.

and you know I don't care about outcomes from spinal surgery how (which is a rather broad catchall term and involves more procedures than are available for gender transition)? I didn't care when I had two procedures? care to guess my thoughts on cranial vascular bypass surgery as well? To point out and discuss some of the practice complexities of gender affirming surgery does not equate to being against gender affirming procedures. It's this sort of binary thinking that rather proves the point about the minefield it can be to just even talk about it. 

Someone upfield made a statement that no such surgeries were being performed on minors. Somehow pointing out that this is not true, means I harbor some prejudice against the practice. I didn't comment on how often or the volume, just that it happens. Then you get responses to a point I never made, as if stating a fact is the same as condemnation. Incredible and yet, not surprising. 

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20 hours ago, naija said:

I just fundamentally have a problem with that mindset, and I think anyone who wields a scalpel should. 

Boo Fucking Hoo

You don’t get to make choices for other people, including 17 year olds that have been emancipated. 
 

 

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19 hours ago, Sawbonz said:

I could only see the abstract on the study. I would not agree w surgery under 17 yo presuming puberty blockers are available.
 

The NYT article quotes a 17 yo. I have no problem with a 17 yo who is emancipated or whose parents consent to the procedure undergoing it. I would also not have an issue with a 17 yo cis male with gynecomastia undergoing the procedure

I’ve known multiple people have this surgery under the age of 17. There were zero protests. 

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