The degree to which our health systems have followed a political agenda rather than careful medical practices based in actual scientific research and basic facts of biology has been apparent in the coercion and mandates for the use of experimental COVID shots, remdesivir, and ventilators during the COVID pandemic. 

Now the further depths to which at least one health system has sunk come to light in the tragic case of a young man coerced into permanent gender reassignment surgery from male to female, that has now prevented him from fulfilling his long-standing dream of being a father ⏤ and a better role model for his children than the abusive father he had. Richard decided courageously to speak out publicly about his horrible ordeal at the hands of Kaiser Health System to help prevent such tragic outcomes for other patients. 

Richard and his attorney and nurse go on the record on America Out Loud to share the painful truth of what his life has become since he was surgically castrated and now living with an artificially created “vagina” that has led to permanent medical complications and daily physical and emotional pain. This is also the story of a courageous attorney and military veteran who has taken on the challenge of this lawsuit to stop such monstrous abuse of other patients.

> Listen to the podcast on this story: The Emotional Pain and Tragedy of Gender Reassignment Surgery

The massive push for taxpayer funding of gender reassignment surgery in our military and for Medicare/Medicaid patients, passed in 2014, and the push for males-turned-females to compete in women’s sports is the ongoing tragedy of a political agenda that puts ideology ahead of proper medical-psychiatric care and treatment in the push to change men to women and women to men in violation of basic biological facts and in violation of medical ethics and standards of care. 

“Social equity” activists claim that sexual orientation is a preference, not genetic, and therefore can be changed based simply on one’s perception of being a different gender. That is the basis for the controversial legislation during the Obama administration that allowed self-selection of public bathrooms by transgender individuals—or anyone who even claims to be transgender. Assaults on women in public restrooms by men claiming to be women skyrocketed as a predictable result.

Nothing is more clearly genetic, however, than our biological sex. It is determined by our two “sex” chromosomes, one from each parent. Two X chromosomes determine a biological female, while one X and one Y chromosome determine a biological male. The Y chromosome can only come from the child’s father. That is basic biology.

But in the 21st century, “gender” has moved beyond biology, morphing into a new construct that is part socio-cultural, part ideological, and highly political: that gender is based on one’s self-perception of being male or female, and is changeable. 

Transgender activists believe that one’s feelings of gender cannot be questioned by the rest of society, and policies should be made according to the individual’s assumption of gender rather than biological sex. Such self-perceptions are rarely considered the criteria used for decision-making in other areas of medicine, psychiatry, or social policy. To do so across the board would result in chaos.

In medicine and psychiatry/psychology, we recognize that self-perception may be distorted and not consistent with observable phenomena. False self-perceptions or assumptions can have serious, and possibly lethal, consequences. Consider these common examples in medicine:

• An alcoholic has a self-perception that he/she is sober, then decides to drive while legally intoxicated, crashes into another car, and kills a whole family.
• A diabetic has a self-perception that blood sugars are normal, doesn’t check or treat them, and then falls into a coma from either hypo or hyperglycemia.
• A patient with high blood pressure has the self-perception that blood pressure is “normal,” doesn’t check or treat it, then has a stroke due to severe hypertension.
• A young woman with anorexia nervosa has the self-perception that she is grossly fat, yet has lost so much weight that she dies from malnutrition.
• A young man with body dysmorphic disorder has a fixed self-perception that he is “grossly ugly” and commits suicide, in spite of appearing to be a normal, good-looking young man.

I think most people who have common sense would agree that the individuals described above should be helped with treatment, not allowed to continue in their detrimental self-perception. As medical professionals, our job becomes to help that person’s self-perception match the medical reality so that proper therapeutic interventions may be offered, and lives spared.

Properly diagnosed transgender patients, who make up 0.3% of the U.S. population, have a similar disorder of assumption. One of the largest and longest studies, published in 2011 by the Karolinska Institute in Sweden, followed 324 individuals for up to 30 years after sex-reassignment surgery. 

Researchers found an alarming 20-fold increase in death by suicide among transgender individuals compared to a non-transgender population. Further, about 10 years after the sex-reassignment surgery, transgender individuals began developing higher rates of mental disorders such as depression. 

Johns Hopkins, the first American medical center to perform gender-reassignment surgery and to have a comprehensive team evaluation and treatment program, developed an outcomes study starting in the 1970s to evaluate post-surgical psycho-social adjustment. The Hopkins study found no better psychological outcomes for the group who had surgery vs. those who did not. Under the leadership of Psychiatrist-in-Chief Dr. Paul McHugh, the Hopkins team appropriately decided to stop performing high-risk sex-reassignment surgeries that had no long-term benefit. The benefits did not outweigh the risks, and the ethical practice of medicine could no longer justify such life-altering surgery that carried a 20-fold higher risk of later suicide.

My personal experience as a physician agrees with the studies. As a medical student, I scrubbed in on gender-reassignment surgery. It is lengthy, complex, risky—and expensive. Many separate surgical procedures are needed, and patients have long painful recoveries. I have since treated a number of patients who had it done. 

Even with surgery and lifelong hormone therapy to maintain a feminized body, transgender men are still biologically male even though they have assumed the social role and appearance of a woman. They still have the XY chromosome makeup, and still, need prostate monitoring for later cancer.

The reality is quite different from simply granting a patient’s preferences. Reality cannot be changed. Perception of reality can be. Our goal should be to “do no harm” in our treatment. Since long-term studies show that transgender patients who have sex-reassignment surgery may actually suffer more emotional distress over time, treatment should be focused on the underlying mental disorder of assumption that is not “fixed” by surgery.

Instead of seeking a sound therapeutic approach to help patients with their misperceptions, activists are ignoring the studies and demanding that society pays for wish-fulfilling but potentially harmful and risky surgeries.

The left’s politically correct social engineering is refusing to protect women and girls from sexual predators pretending to be transgender. This ideological agenda continues a war on women jeopardizing lives to satisfy a minuscule minority.

Bureaucrats, hospital administrators, physicians, and therapists endanger lives by pushing vulnerable patients into costly surgeries harmful to the troubled people it claims to help. Politicians are a danger to public safety and personal privacy when they replace reality and common sense with radical ideology and allow legislation to be enacted that incentivizes transgender surgeries and rations or curtails standard procedures for Medicare, Medicaid, and military service members.  

The medical damage and deaths due to political ideology are the antithesis of the physician’s Oath of Hippocrates. It is past time to stop this abuse of patients.

Listen to the podcast on this story: The Emotional Pain and Tragedy of Gender Reassignment Surgery