Plastic surgeons are now questioning the wisdom of providing surgical intervention for teens experiencing gender dysphoria.

"From our first days in plastic surgery residency training, we were taught that there are no surgical solutions to psychological problems and that remains true today" one plastic surgeon says.

The Catholic Star Herald says the American Society of Plastic Surgeons (ASPS) told the Manhattan Institute's quarterly City Journal about their concerns in performing "chest and genital surgical interventions for the treatment of adolescents with gender dysphoria".

Author Leor Sapir quoted ASPS as saying "the existing evidence base (for the practice) is viewed as low quality/low certainty".

There is "considerable uncertainty as to the long-term efficacy" of such procedures.

Lawsuits

"Plastic surgeons are increasingly finding themselves in the hot seat of gender medicine lawsuits" Sapir reported.

Those seeking to reverse the interventions are filing lawsuits.

There are "at least seven" ASPS members named as defendants in almost "two dozen lawsuits" Sapir added.

One plaintiff was 13 when an ASPS member performed a double mastectomy on her.

The plaintiff had received less than two hours evaluation by the surgeon and a psychologist before the procedure, Sapir wrote.

This was despite the plaintiff demonstrating a long history of mental and emotional distress.

Sapir's article said ASPS comments marked the "first big fracture" in the apparent US medical consensus over gender intervention for teens.

The World Professional Association for Transgender Health (WPATH) and the Endocrine Society was strongly in favour of that consensus among US medical professionals.

New insights

In Europe, a trend to halt the use of puberty blockers, hormones and surgeries in adolescents with gender dysphoria is emerging.

The Cass Review - an independent analysis of the UK's National Health Service - discovered evidence supporting gender intervention for children and teens was both insufficient and fraught.

The Review also noted WPATH and the Endocrine Society had been citing each other's statements rather than "conducting a scientific appraisal of the evidence".

Psychology vs ideology

The WPATH, the Endocrine Society and the American Medical Association are making "the suffering of these patients worse, and are contrary to the treatments now adopted in New Zealand, Australia and many European countries".

"These countries have prioritised psychological care over medical gender-affirming interventions" the Catholic Medical Association says.

The Association explains gender dysphoria is a psychological diagnosis.

Gender ideology however "is a belief system based on a false human anthropology which undermines the intrinsic value and uniqueness of the human person".

The Catholic Medical Association says "gender ideology is blind to the abundant scientific data already published on the treatment of gender dysphoria".

Physicians promoting it ignore the harm this belief causes to thousands of confused young patients. Those patients deserve compassionate, excellent medical care the Association says. It says systematic studies show compassionate psychological care enables 85-90 percent of teens to resolve their dysphoria without "harmful and irreversible effects...".

Source

• Catholic Star Herald

The mandate does not provide exemptions for doctors from performing gender-transitioning procedures after a mental health professional's referral. It overrules their opposition to the procedures for medical or conscience reasons.

"Biological identity must remain the basis for treating patients," the association's president Dr. Michael Parker says. The "transgender mandate" interprets unlawful sex discrimination in health care to include discrimination on the basis of self-determined gender identity, he explains.

Parker is concerned that the mandate not only risks patient health and safety, but also mandates that health care providers give up their fundamental right to conscience. "This sets a dangerous precedent with incalculable implications for the ethical practice of medicine," he says.

The Catholic Medical Association is a national network of Catholic doctors and health care workers. Together with the American College of Pediatricians, a national network of pediatrician, representatives say they represent 3,000 doctors and health care workers.

"Forcing doctors to prescribe transition hormones for 13-year-olds or perform life altering surgeries on adolescents is unlawful, unethical, and dangerous," says a Bangert, senior counsel for the two groups.

The lawsuit says that under the mandate, "doctors now face an untenable choice: either act against their medical judgment and deeply held convictions by performing controversial and often medically dangerous gender-transition interventions, or succumb to huge financial penalties, lose participation in Medicaid and other federal funding, and, as a practical matter, lose the ability to practice medicine in virtually any setting."

In US law, sex discrimination in health care is illegal.

Timeline of changes to the mandate

2016: The Obama administration first issued the mandate when it interpreted the health care law's prohibition on sex discrimination to include discrimination against gender identity.

The administration required doctors to provide gender-transitioning procedures upon referral. There were no exemptions for doctors' religious or medical objections.

Catholic health care institutions and several states sued. They won an injunction from the mandate in federal court in 2016.

2020: The Trump administration allowed doctors to opt out of the mandate. It re-interpreted the Affordable Care Act's prohibition on sex discrimination.

Two federal courts halted parts of that rule from going into effect.

2021: The Biden administration issued its notice reinstating the mandate.

A federal district court judge granted permanent relief from the mandate for the Catholic hospital network Franciscan Alliance and the Christian Medical and Dental Associations.

The lawsuit seeks a permanent nationwide injunction from the mandate for other health care groups as well.

Source

• Catholic News Agency
• Image: YouTube

Last week the US House of Representatives passed the Palliative Care and Hospice Education and Training Act by voice vote.

The bill funds efforts to increase palliative care faculties at medical schools. It also funds palliative care and hospice training and education.

Palliative care involves pain management and physical, psychological and emotional care for those suffering from a serious illness.

This type of care can be provided alongside medical care.

Hospice care is when palliative care is given to patients with a terminal diagnosis, who do not wish to unnecessarily prolong their life through extraordinary means of medical care.

At the same time, these patients wish to remain as comfortable as possible.

The new bill requires federally-funded palliative care to be in accord with Assisted Suicide Funding Restriction Act of 1997.

This means the funding cannot promote "assisted suicide, euthanasia, or mercy killing."

However, changes in the bill's language has some Catholic groups, including the U.S. Bishops Conference, concerned.

This is because the bill currently before the House omits language contained in the Senate version of the legislation.

The Senate bill states:

"As used in this Act (or an amendment made by this Act) palliative care and hospice shall not be furnished for the purpose of causing, or the purpose of assisting in causing, a patient's death, for any reason."

This clarification is significant because it offers a definition of palliative and hospice care that specifically excludes any act that would hasten or bring about death.

It refers to certain controversial practices which some in the medical community recognize as a legitimate part of palliative care, but which may cause or assist in causing the death of the patient.

"We support the Senate version, and we made it clear to both the House and the Senate that we want the Senate version to prevail," Greg Schleppenbach, associate director to the Secretariat of Pro-Life Activities at the U.S. Conference of Catholic Bishops, says.

Schleppenbach says the language in the Senate bill is key to providing a sound definition of palliative care.

This is important, as some in the medical community are advocating practices that are contrary to the Church's teaching on palliative and end-of-life care.

Source

• Catholic News Agency
• Image: The Mirror