The child sex-change industry is about to boom in states where treatments for minors are not restricted or banned by law, a Boston Children’s Hospital doctor has predicted.
Ganor serves as co-director of the Center for Gender Surgery at Boston Children’s Hospital.
As some states “work to criminalize” child sex-change treatments, greater numbers of patients will be “traveling to seek care in states with more open legislation,” Ganor wrote in his piece entitled “Streamlining Interstate Access to Gender-Affirming Surgeries.”
But there may not be enough resources to handle all the requests for treatment.
“Although the legal landscape may be more favorable in these states, the capacity to treat these patients does not match the demand.”
Also, facilities, he wrote, should “consider the safety of clinicians providing these services, as well as patients.”
Hospitals should prepare “protocols to swiftly address threats as they arise, with the involvement of law enforcement,” so that medical personnel can “care for transgender patients without fear of harm,” Ganor wrote.
Selling Sex-Change Surgery
“To qualify for gender affirmation at Boston Children’s Hospital, you must be at least 18 years old for phalloplasty or metoidioplasty [surgeries to create male genitalia] and at least 17 years old for vaginoplasty,” an archived version of the Boston Children’s Hospital website reads.An archived version of the website also offered breast removal or creation for children as young as 15.
For these surgeries, the hospital required a letter from a doctor or nurse documenting “persistent, well documented, gender dysphoria.” It also required a letter from a mental health provider stating that the surgery patient has the “capacity to consent” and that any “significant mental health issues” are being addressed.
After media reports about the website’s content, it was updated and that information was removed.
The hospital’s current website states it won’t perform genital surgery on transgender patients younger than 18.
“Our skilled team includes specialists in plastic surgery, urology, endocrinology, nursing, gender management, and social work, who collaborate to provide a full suite of surgical options for transgender teens and young adults,” the hospital’s current website reads.
The website also includes a statement opposing bans on child sex-change procedures and restrictions that would keep transgender youth from participating in sports against athletes of the opposite sex.
“The proposed bans on medical care, sports participation and other legislation aiming to restrict the rights of transgender and gender diverse youth are in direct opposition to our commitment to equity, diversity and inclusivity, as well as the standard of care that we live by,” the Boston Children’s Hospital website reads.
So far, Boston Children’s Hospital has treated more than 1,000 families of children who want so-called gender-affirmative procedures, according to the website.
Differing State Laws
In 12 states, child sex-change bans outlaw the prescription of cross-sex hormones to children. But many of these states don’t prohibit the continued use of cross-sex hormones by children already taking them by the date the ban goes into effect.In his piece, Ganor wrote that the federal government should act to “ensure harmonized health care regulations.”
“If a physician provides care to a patient in a state with anti-transgender legislation, for example, what would the consequences be for the patient and the physician?” Ganor asked in the JAMA article.
“Or if a patient receives a procedure in a transgender-friendly state, but returns home to a state with unfavorable policies, what does that mean for the patient’s follow-up care?”
In the meantime, Ganor wrote, sex-change clinics in liberal-leaning states should prepare for an influx of young patients and “improve capacity.”
Ganor’s predictions of a surge in transgender patients seeking out-of-state care align with conclusions by Grand View Research, a market analysis firm.
“Maybe 20, 25, 30 years back, nobody was actually talking about the surgeries overall as part of the LGBTQ+ community,” the firm’s research manager Pranita Bhor told The Epoch Times. “But now the movement has been much stronger than it was 30 years ago.”
By 2030, the transgender-surgery industry will be worth $4.9 billion annually, Bhor predicted. From 2015 to 2016 alone, sex-change surgery numbers increased by 20 percent, she said.
The number of people identifying as transgender has increased due to increased access to online information on sex-change procedures, increased gender dysphoria, and increased social acceptance, Bhor said.
X and Y Chromosomes, and Gen Z
About one-in-five young adults now identifies as non-heterosexual, according to recently released Gallup research. About 9 percent of LGBT adults identify as transgender, the research notes.Among members of Generation Z—born between 1997 and 2004—about 10 percent of LGBT adults identify as transgender.
And with so many younger adults “seeing themselves as something other than heterosexual, the LGBT share of the entire U.S. adult population can be expected to grow in future years,” Gallup’s researchers concluded.
For sex-change providers, that could bring about a bonanza.
A genital sex-change surgery can cost as much as $100,000. Costs vary widely for other sex-change surgeries, such as facial feminization or masculinization, breast amputation, breast addition, body sculpturing, fat removal or addition, and more.
The most common transgender surgeries involve breast creation and removal, Bhor said. These cost between $10,000 and $20,000, she said.
But sex-change surgery has gotten far less expensive over the past decade, she said.
And if enough people sign up for sex-change surgeries, the cost is likely to drop further, or the government may pay for them, she said.
For now, sex-change surgery is expensive and highly risky, Bhor said. But that will change, she predicted.
“If there are specialty centers, and more and more people opt for it, more and more health care professionals are trained for that, then obviously, these risks are going to go down,” Bhor said.
Cost also will decrease as the supply of doctors willing to perform them increases.
And as technology advances, sex-change surgery options have broadened, she said.
Insurance Foots The Bill
Grand View Research figures the sex-change surgery industry currently is worth $1.9 billion annually. But that’s only a small part of transgenderism’s overall economic effects, Bhor said.The company’s research hasn’t factored in the money made by selling puberty blockers, cross-sex hormones, breast binders, prosthetic male genitalia for women, fake breasts for men, and other transgender items.
And every surgery patient likely has undergone years of use of cross-sex hormones, puberty blockers, and other sex change-related services, Bhor said.
“The surgery population is only a part of the entire community,” she said. “Many people actually stop at the hormonal stage of this particular transition.”
In Europe and Asia, insurance doesn’t cover transgender surgeries, Bhor said. But in America, many private insurance companies cover or partially cover “very expensive” sex-change surgery, she said.
Despite the boom in transgender surgery, most medical curricula don’t teach doctors how to do sex changes, she added.
Transgender people have no visible physical injury, she noted.
“Generally, all the medical procedures, they are done as treatments and to treat something which is visible to you, which is not working,” Bhor said, drawing on extensive experience analyzing the medical industry.
The biggest threat to the sex-change surgery industry is child sex-change bans, said Bhor. If children don’t start their sex changes early, they won’t be ready for sex-change surgery as adults, she said.
“If it is banned or criminalized this year, the market is obviously going to plummet within the coming five, six years,” she said.
It’s “a little difficult to say” whether these laws will just delay sex-change surgeries, or cause children to grow out of gender dysphoria, Bhor said.
However, children who feel uncomfortable in their bodies might be able to travel to other states for sex-change hormones, she said, referring to that option as “medical tourism.”
Opponents of sex-change surgery for minors worry about long-term effects, such as mutilation, permanent wounds, infertility, and hormonal problems.
But all surgeries have risks, Bhor said.
“All of these risks are equal in most other surgeries the moment the template [on how to perform the surgery] is out,” she said.
Once sex-change surgeries are commonplace, they won’t be as risky and experimental, Bhor said. And people undergoing sex-change surgery receive extensive psychological aid, she said.
But some detransitioners—former transgender patients who regret and try to reverse their sex-change treatments—say they were never offered psychological treatment.
