The Science of Transgender Medicine and Surgery

To be a Catholic Physician is to be Canceled

This afternoon session is clear, so let’s—let’s pray to St. Michael.

In the name of the Father, and the Son, and the Holy Spirit, amen.
St. Michael the Archangel…

Heart of Jesus. Have mercy on us.
Immaculate Heart of Mary. Pray for us.

Thanks. So that’s the last thing you’re going to hear about Catholicism, because to be a Catholic physician today is to be completely canceled.
And you’re not allowed to say anything.
And you’re going to get fired.
And that’s the reality.
It’s not an exaggeration.

So, I’m a plastic surgeon who is specialized in microsurgery. And that is connecting small blood vessels and nerves with an operating microscope, with suture material finer than your hair, using needles that are 75 microns big.

So what do you need that for? Well, if someone were to amputate a hand or a finger, you can reattach that. And then we can also take tissue from one side of the body and transfer it somewhere else. These techniques I learned at UCSF here in San Francisco and at the Bunky Clinic.

So, in those days, we would transplant a toe to the thumb to make the hand work. We’d transplant part of the fibula to make a jaw. We can take the tummy tissue and transplant it to the chest for women with breast cancer. That’s what we did.

Transgender Surgery

Today, those same centers I trained at—their claim to fame now is transgender surgery. So I’ve done a lot of these procedures, but I have only taken care of transgender patients who had complications.

I’ve been a longstanding board member of the Catholic Medical Association. And again, we’re one of the few organizations that are actually standing up against transgender medicine.

I would not be welcome to give this lecture at the medical school that I have clinical appointments to. But more important, I’m not welcome to give this lecture at the Catholic healthcare system where I work. So that tells you something.

All right, so this could possibly be one of the greatest scandals in medical history. And you say, “Wow, you’re really overstating it.” But those aren’t my words.

They belong to Christopher Gillberg, who’s a neuropsychologist in Sweden. And he’s the one that coined this as being perhaps the greatest scandal.

And you say, “Well, wait a minute.” You know for sure that at the University of Washington they published a paper just the other—the other year, about two years ago—and it went viral. It was all over Channel 5 News in Seattle. And then the Associated Press carried it.

And they showed that if you block children’s puberty and give them cross-sex hormone, you’re going to improve their mental health. You’re going to have a 73% lower odds of suicide.

And in fact, at their gender clinic, they created this message: “Researchers found gender-affirming care made a big difference in reducing depression levels for transgender youth.”

“Gender-Affirming Care Is Life-Saving”: The Mainstream Claim

“Who is involved in the clinical care of transgender people, transgender youth, and does participate in this research, has very consistently found these similar results: ‘Gender-affirming care is life-saving care. Gender-affirming care really helps somebody live a full and complete life that most of us need to take for granted.'”

So, Arin is a man who transitioned to be a woman. She’s the second author—he/she is the second author of the paper. “Gender-affirming care,” she says, “is life-saving care.” And anybody involved in the research knows that that’s true.

That’s the point. And then just last year, there was an article in The Wall Street Journal that said: Gender Transition Is Pushed Without Evidence.

And the president of the Endocrine Society, Dr. Hayes, responded. Now, endocrinologists are specialists who give hormones, right? That’s what they do. Now, they are some of the smartest people in medicine. Endocrinology is a subsection of internal medicine. These are very, very, very bright people.
They—they have my respect. And so Dr. Hayes says, “Wait a minute. There’s 2,000 studies since 1975 that show a clear picture: gender-affirming care improves well-being.”

Pushback, Retractions, and Reversals

Then this article came out a couple of years ago from the Karolinska Institute in Sweden and Yale University, published in the American Journal of Psychiatry, a very reputable journal.

And they looked at mental health studies, retrospective analyses, and they found an average of 8% reduction in mental health [issues].

And this article went viral as well. And Abramson from the Karolinska Institute said, “Now we have strong support for providing gender-affirming care.” Dr. Pan is from Yale. He had an op-ed in The New York Times and he went on and on: “No longer can we say that we lack high-quality evidence of the benefits of providing gender-affirming surgeries.”

This is the Karolinska Institute. This is Yale University, right? Well, guess what—within that year, Yale University had to file a retraction. Karolinska had to file a retraction. And the American Journal of Psychiatry had to file a retraction. You don’t have to be a statistician to see: these are the people that had surgery in the dark. And actually, their outcomes were worse. Their outcomes were actually worse.

An investigative reporter looked at the data from Washington—or the University of Washington—and he wrote this article: “Hormones Didn’t Improve Trans Kids’ Mental Health.” That’s what the data showed. It didn’t improve it. Yet they published an article that said it did—that published the opposite.

So what did the University of Washington—number one–rated school by U.S. News and World Report in Primary Care—do? How did they respond?

Well, they took down the video. That’s all they did. They just took down the video.

And when you look at the data—and statisticians have looked at it—the control group of patients who were not treated versus those that were… aren’t standardized. There’s a huge amount of attrition in that.

And statisticians looked at that and said, “You can’t make any conclusions regarding this data.” So you might not be able to see this—I’ll read it to you.
This is a leaked internal email from the University of Washington Department of Epidemiology:

“As there is an overwhelming amount of positive coverage of the study’s findings, I don’t believe there’s a need for proactive response beyond continuing to monitor.”

And the response to that email says:

“Yeah, I read this exceedingly long article with criticism, which claims that the research was flawed—or worse, made up.
But given the extremely positive pickup by the mainstream media—and there was—I would agree to just let this be.”

Wow.
Wow.
Wow.
Wow.

I just—I just can’t believe that. A university—number one rated—oh, we just let this slide?

And then the letter that Dr. Hayes had—said 21 clinicians from nine countries responded. The systematic review doesn’t show any evidence of mental health benefit. No systematic review shows that. By contrast, there are significant risks—including lifelong dependency on medication, the anguish of regret, sterility. And Dr. Hayes claims that gender transitioning reduces suicides—contradicted by the review in their own journal.

And the article written in his own journal says:

“We could not draw any conclusion about death by suicide.
No reliable evidence suggests that hormone transition is an effective suicide prevention.”

I told you this is one of the most intelligent group of doctors in the world, so how could he not know the published data in its own journal? Is it willful ignorance? Is it—what is it? Is it outright, uh, being disingenuous? Is it outright lying? What is it?

And the National Board of Health in Sweden said it best: For adolescents and with gender incongruence, the national board deems the risk of puberty suppression with pubertal blockers and gender-affirming hormone currently outweighs the possible risks. So, uh, they banned it—except in exceptional cases.

And that’s why we have all the European countries and some of the Pacific countries putting a halt—including England, Sweden, Finland, France, Denmark, Norway, Australia, New Zealand, Scotland. Recently, they’re completely banning transitioning minors. Italy and Belgium are on their way to look at the same thing.

The Kyra Bell Case in the UK

And this came to a head in 2020 with Kyra Bell. Kyra Bell is a young woman who became a whistleblower in the National Health System in England, and she was actually able to sue the National Health System—and very difficult to do in England—but she did it and she won. And the high court—one of the judges in the high court—wrote in the decision:

“There is no age-appropriate way to explain to many of these children what losing their fertility or full sexual function may mean to them in later years.”

And not only are they made infertile—they’ll not have any normal sexual function. Right? And so she was the whistleblower that got the Tavistock clinic in London closed, which was—um, there’s some seats there, I think—which was the largest gender-affirming care clinic in England at the time.

And Kyra, reflecting on her past, says:

“What was really going on is I was a girl insecure in my body, with parental abandonment. Her mother was a crack addict. She never left the apartment.”

She then went to live with her father, who had a live-in girlfriend who convinced Kyra that all of these problems are probably due to your—that you’re probably the opposite sex. And she took her to the clinic—the Tav—and they transitioned her.

But she says:

“What was really going on—I was suffering from anxiety and depression and struggled with my sexual orientation. As I mature, I recognize that gender dysphoria was a symptom of my overall misery, not its cause.”

Very insightful. And that’s exactly the point. And that’s what Gillberg in Sweden is trying to say—these are children who have a lot of psychological wounds.

Broken Promises and Psychological Vulnerability

And right away we’re said—we’re lying to them. They’re doing this one thing—will change their lives for the better. And so the National Health System—just now, March of 2024—came out with the Hilary Cass Review.

And so this started—it just came out now—but it started in 2020. And all of the data from the Tavistock clinic were compiled by York University independently. They looked at the data, and what Dr. Cass said—what she found—was sexless adults, depleted bone density, hampering of cognitive development, and reduced emotional—and produced—and what it did is produced emotional problems.

And there was no statistically significant difference in gender dysphoria, mental health, body image, and psychological functioning in children and adolescents treated with blockers. So there was no data that any of what happened in the Tavistock clinic helped anybody. In fact, it probably made things worse.

U.S. Whistleblower Jamie Reed at Washington University

And closer to home, at Washington University in St. Louis, Jamie Reed now made national headlines. And she’s a whistleblower there now. Jamie is very, um—let’s say accommodating to gender ideology. She—she says she’s a queer woman married to a transgender man. And you can think about what that means in the brain. Anyway, what she says—what’s happening with children—is morally and medically appalling.

And that’s what’s happening in the United States—morally and medically appalling. So the only secular point to make is that transitioning—the only reason to transition—is to improve gender disorder. This angst—that you’re actually in—not—can’t identify with your biologic sex. That’s the only reason to transition. And as we go through more data, that’s the thing to keep in mind: is it—is it helping somebody improve in their sense of disorder?

Now—so what’s the incidence of transgenderism in the United States? Well, the best data comes from the School of Law, UCLA. And this is the data that the CDC compiles. So we’re talking about 300,000 youths and 1.3 million adults.

Mental Health Challenges Among Transgender Adults

Now again, these are adults that have a lot of psychological baggage. Think about—48% tried to kill themselves. This is why—because they have a lot of psychological issues with—and depression. And 23% actually did try to kill themselves. And that’s a basis of psychological pathology. And 26% were addicted to drugs in an attempt to self-medicate themselves.

So when we look at the graph from the CDC, what I want to show you is: This was the historical incidence of transgender. It was little boys—prepubescent boys. And then now we see this music rise—and this is adolescent girls.

Now it’s a big shift. Sixty-nine percent are now confessing girls. Why? Because going through puberty as a girl is tough. We raised four daughters. I can tell you—they all have a—And if you were to tell them, “Well, this is because, you know, you’re really not a girl. Of course your periods are awful. Would you like us to stop that?”

So there’s a huge coercion going on in this. And now activists say, “Well, the rise is because we’re—we’re accepting now gender ideology. So more and more children are coming out and saying you’re gender dysphoric.” Well, that’s not the case. And I can prove it with data.

Because in Finland, they noted the same thing. They’ve always been accepting.
But they noticed the same adolescent skyrocketing incidence. And when they looked at their data, they found that natal girls—girls who were born girls—are overrepresented. And that there’s severe psychopathology that preceded the gender dysphoria. And a lot of these youths are on the autism spectrum.

And so they concluded that you have to consider gender dysphoria in minors in the context of the severe psychopathology and developmental difficulties. And this is what we are completely ignoring in the United States. We’re—we’re not listening to what people have already said, that already done.

“Born This Way”? The Claim of Inborn Dysphoria

And so the other claim is that gender dysphoria is innate. The claim: “I was born this way. You know, you have to accept me because I was born this way.”
And, well, that’s all disputed. And uh—uh—doesn’t—doesn’t hold muster when we look at Dr. Milton Diamond’s study.

Published—and it was a study of monozygotic twins. So we all understand—monozygotic twins are—are identical twins, right? So if things are due to genetics, then it happens in both twins. Hair color—99%, eye color, height and weight. In monozygotic twins—identical twins—they’re the same.

But when we look at the homosexuality, by the way, or—uh—transsexualism,
the concordance rate is only 28%, which is very low. So gender dysphoria is not innate. Well, what does it do to a whole host of issues? But they’re postnatal, right? They’re not shared—postnatal experiences and social reinforcement. And I think parental psychopathology—what goes on in families—is key.

And these children become wounded somewhere in their early lives, right? And it doesn’t have to be sexual abuse. But they undergo some wounding—something’s missing in their life, right?

And of course now we have the social contagion. That’s why I think we have that big—because kids are told on TikTok and on YouTube that, “Well maybe you’re not that sex anyway.” And that’s what’s going on. So social contagion has a lot to do with it. And all of these things play a role in gender dysphoria.

The Rise of Detransitioning

Well, do gender dysphoric kids—do they stay that way? There’s a seat right here. Do trans—do trans kids stay that way?

And—well, look at the desistance studies. And what are those? Well, those are studies—and Dr. K*** reviewed 11 of them. These are studies that follow kids if you counsel them and leave them alone. Basically, what happens to them as they get through adolescence?

Well, this study by Cantor—60 to 90% of trans kids turn out no longer to be trans by adulthood. And if we look at another study from Toronto, in Dr. Singh’s study—88% had desisted. In other words, they get through puberty, somehow they figure it out, and they’re not—they don’t have the dysphoria anymore.

And from Amsterdam, a study by Steensma had 63%. So the key is: if you left these kids alone and you counsel them, they would actually do fine. All right?

Claims About Coercion and Suicide Risk

Most of them—or some of them—would become homosexual or bisexual, but they would have this angst that, uh, that they’re in the wrong body.

Now let’s look a little bit at suicide rates. You know, we heard during this meeting that Elon Musk was forced into giving, uh, giving puberty blockers to his son because they told him this: “It’s better to have a live daughter than a dead son.”

And what whistleblowers are saying—this is exactly how parents are being coerced in gender identity clinics. And it’s absolutely a false claim because we know that 90% of all suicide victims have a diagnosed mental disorder. People who kill themselves have a psychological problem. Normal people don’t kill themselves. And children are no different.

So we have to focus on prevention. And again, from Amsterdam, Dr. Stena—she showed that 75–90% of pre-alleged gender dysphoric children resolved by adulthood if they’re neither affirmed nor medicated.

So that’s the data. And now the final nail in the coffin on this issue of suicide comes from Finland—was published this year. They studied 2,083 gender-confused children, compared them to 16,600 matched controls—matched for anxiety, matched for depression, matched for autism. And when you match apples to apples, they found that medical gender reassignment does not have an impact on suicides.

So I hope that’s finally going to be laid to rest. But I think it’ll continue to be said as science when it’s not.

And so, I’m sorry to say this is what we’ve seen—the death of science. People publishing data and giving false conclusions, ignoring data that’s published. And that’s where we are.

Before 2007: Traditional Understanding and Treatment

So, you know, a lot of us ask ourselves: how did we get here? How in the world did we come to this day?

Well, I want to take you back to what the treatment was before 2007. And you’ll see in a moment why 2007 is an important date for this movement.

Now, before 2007, if the child didn’t align with his biological sex, we considered that a sign of confusion and mental illness. And in fact, gender dysphoria in the old diagnostic manual was called “gender identity disorder,” right? Then, with the changes in the culture, it was downgraded to a dysphoria.

So the child was encouraged to identify with the biologic sex—say, “No Billy, you really are a boy.” And some families chose “watchful waiting,” others chose therapy. And 75 to 90% of them would actually get through—accepted their biologic sex from puberty.

Again, this was published in the American Psychiatric Association handbook. It had been published previously—this was known data.

So what happened in 2007? Well, the culture accepted this idea that you can be trapped in the wrong body. And first, it started with the adults.

And Dr. Bailey from Northwestern University—he wrote, and he had done a lot of study on monozygotic twins—but he wrote then, and it’s true today, that the predominant cultural belief that all male-to-female transsexuals are essentially women trapped in men’s bodies has little scientific basis and is inconsistent with clinical observation.

And it’s true today.

Experimentation Becomes Norm: The Dutch Protocol

Now, at this time, entered the Dutch protocol. This is what happened in the Netherlands.

So the Dutch physicians were transitioning people for a long time, and they understood that when they transitioned them in adulthood, they did not resolve their mental health issues. The surgery did not resolve their mental health issues—nor would you expect that it would. If it’s a psychological problem, why would you think it would be cured?

So by the late 1980s and 1990s, what they ended up thinking was, “Well, let’s take a small group of boys and transition them early. The results might be better,” right?

And that’s what they did. And they produced what was known as this “innovative practice model,” right? So it was an experiment.

They never did any more data. They never created reliable, reproducible research. But what they did create was “runaway diffusion.”

And what is that? That’s where the medical community mistakes a small innovative experiment as proven practice, right? And this rapidly spreads in general clinical study, and it’s accepted as clinical practice.

And this is really well documented by Al SE. Last year, he wrote this wonderful article: The Myth of Reliable Research in Pediatric Gender Medicine: Critical Evaluation of the Dutch Studies, and basically said they should have never done it. There was nothing to support it.

But at the same time—now 2007 again—a physician at the Boston Clinic, Norman Spack, goes to the Netherlands and thinks, “Wow, this is the best thing I’ve ever heard of,” and comes back to Boston and creates the first gender identity clinic.

Again, no data to support any of this. It was an experiment. But he comes back to the United States, and he says, “That’s what we’re going to do.” And that’s the first gender identity clinic in Boston. And now we’re up to 100.

Affirmation, Puberty Suppression, WPATH, the Role of Activism, and Unrealistic Expectations

And the idea is to affirm a child’s desired sex and gender—not the biologic sex like we did before 2007. Having left socially as the opposite sex, put them on pubertal suppression at Tanner Stage 2—when a child is 10 or 11 years old.

Little boys— their scrotum is just starting to increase a little bit, their testicles are just starting to get larger. Little girls might get a little breast bud, just started. So that’s Tanner Stage 2.

And these are small kids—they’re 10 or 11 years old. Then, cross-sex hormones, and then mastectomies when they’re 16. This was a protocol—had no evidence anywhere. We were just kind of making it up.

Enter at the same time is WPATH—the World Professional Association of Transgender Health, formerly known as the Harry Benjamin International Gender Disorder Association. And they changed the name to WPATH, and they started creating these guidelines.

Now these are all gender activists themselves. These are all people that transitioned in one way or another, so they’re activists. But they’re going to create these guidelines.

And these guidelines took hold and basically coerced all of the medical society. And they created these guidelines.

And then in 2022 created the last set of guidelines. And this is the guidelines for pubertal blockers.

And I want to just show you—so to give pubertal blockers, the patient, a 10- or 11-year-old, has to demonstrate the emotional and cognitive maturity.

Do you have 10-year-olds in your life?

And then mental health concerns, if any, have to be cleared up—which didn’t happen. And then they have to be informed of the reproductive effects, including the loss of fertility.

Now if you’ve ever had a discussion about sexuality with a 10-year-old—it’s not on their radar. They don’t care if they never have kids. It’s only going to be important to them later, when they become adults.

So these are the guidelines that are basically nonsensical. They can’t be applied to a 10-year-old or 11-year-old.

And in addition, now these guidelines double down that we can only affirm. Only affirmation. Can’t discuss with a child why we’re feeling this dysphoria—that’s conversion therapy.

If they say they have this dysphoria, they have it. You have to go along with it. And radical of time—pubertal blockers, transition—and that’s it. Like on a conveyor belt.

This is it. We’re just on a conveyor belt.

Removal of Age Requirements and Introduction of New Identities

And now they removed all the lower age requirements, so you can do this to any child at any—at any age now.

I—I know it from a good source that, um, the age requirements were removed by Admiral Rachel LaVine. She was really pushing for it. And he, uh, he was born in as Richard LaVine—a pediatrician and the current Assistant Secretary of Health for the Department of HHS.

So don’t look for the Clinton administr—uh, for the Biden Administration to—to come to near.

They also created a new unique gender identity for young men who want to be castrated, and that now they can have their own identity. And they removed the chapter on ethics.

Well, I know—does anybody know the WPATH files? Anybody familiar with that?

See what our media is doing? Reporting nothing.

Well, this shocked the transgender world. The WPATH files were released on March 4th, 2014. They were leaked, and this investigative reporter Mia Hughes—he gave us, um, an insight into what really happened in that organization with bulletin boards for discussions.

And, uh, they revealed medical malpractice on children and vulnerable adults. There are, uh, documented, uh, discussions that actually—transitioning homeless people. How can they—how can they take care of themselves as homeless? They’re having a hard time just staying alive.

But so this is the radical type of things that WPATH has promoted.

And, uh, and I read all 177 pages, uh, and listened to their videos.

And in this video, uh, the physician down here—he’s a pediatric endocrinologist—and he’s bemoaning the fact that he can’t really discuss, um, infertility with young 10- and 11-year-olds because they haven’t even had high school biology. So they have no idea what the reproductive system is.

And then they’re trying to—to, I think, cover their—their backs in “informed consent,” discussing these things with kids that cannot possibly understand.

The Collapse of WPATH

And that’s why you have prominent leaders in WPATH like Stephen LaVine—who actually authored the Standards of Care Five—and Erica Anderson himself, a transgender female, saying the mental health establishment was failing trans kids and have left.

And recently, uh, there’s a WPATH declaration that over 2,000 physicians signed. And the declaration states: WPATH has discredited itself with these standards of care and can no longer be viewed as a trustworthy source of clinical guidance in the field of gender medicine.

And when we look at the membership of WPATH—look what happened in one year. In one year, they plummeted to 1,590.

And, uh, if you look: 1, 2, 3, 4 are from the United States. This is an American organization, right?

And so what I ask you is: how do 1,200 physicians persuade—with 1 million physicians in the United States, right? There’s 100,000 Catholic physicians—where are you?

Why is everybody going along? There’s only 1,200 of these guys—and they’re making it up.

So that’s very disheartening.

Affirmation as the Standard of Care

So with these standards in the United States right now, this is the standard of care: you affirm a child’s confusion, chemically block—give them pubertal blockers and lifelong cross-sex hormones.

And we know this arrests bone and decreases bone density, and prevents adolescent brain maturation.

So the adult prefrontal cortex—the executive functioning of your brain—in men does not mature until age 25, right? That’s why insurance rates are so high for adolescent boys, right?

That’s why—’cause they—they can’t assess risk. That’s what the frontal brain does.

Now, in order for that brain to mature, you need same-sex hormones. Boys need testosterone for that to happen. It’s been known for a long time.

And yet, we’re preventing brain maturation by giving them blockers.

And this is an article that shows that one year of pubertal block decreases their IQ by seven.

And, of course, they’re going to become infertile—and this is not reversible.

IQ and Irreversible Fertility Loss, Brain Development and Hormonal Suppression

So this is going to be complicated. I want to show you why it’s complicated.

But basically, the hypothalamus gives messages to the pituitary, and the pituitary goes to the gonads. They produce hormones. They go back via negative feedback mechanism to equilibrate how—how much hormones there are.

So pubertal blockers mimic this hormone and override the pituitary so that there’s no more production, eventually, in the gonads of estrogen or progesterone.

So this is the same drug we give to men with prostate cancer—to stop production of testosterone.

This is the same drug we give to women with breast cancer—to stop production. That’s estrogen.

This is the same drug we’ve given to, uh, sexual criminals—to castrate them medically.

And this is the same drug we’re giving to 10- and 11-year-old girls.

So what happens if you give testosterone to a girl?

Well, you lower their high-density lipoproteins—the good cholesterol—increase their triglycerides. You increase homocysteine, which is a protein that causes inflammation in the arteries.

You can cause liver failure. Polycythemia is overproduction of red cells—that makes their blood sluggish. Sleep apnea. Insulin resistance—that leads to diabetes.

And we don’t know exactly what’s going to happen to their breast or their endometrial tissue.

And then, of course, there’s the risks of a double mastectomy. But we’re doing all of this as if this is somehow good for these kids.

And for natal boys, you give them estrogen—immediately the risk of thrombosis goes up fivefold. Not 5%—fivefold.

They get cardiovascular disease, weight gain, high triglycerides, high blood pressure, decreased glucose tolerance—or diabetes—gallbladder disease, prolactinomas—or tumors in the pituitary that secrete milk. And then they get breast cancer.

Is there any data for the breast cancer? Yes, there is. From Amsterdam.

They followed 2,260 trans women—men who want to become women—who were on estrogen for 18 years.

Forty-six–fold higher risk of breast cancer.

Breast cancer is almost unknown in men. But if you take estrogen for a period of time, your chances will go up 46 times.

Ethical Concerns and Physician Responsibilities

And so this goes against the very nature of physicians, who take an oath to do no harm.

Because children and adolescents are cognitively and experientially immature. We know that. Anyone who has a kid knows that.

And so allowing them to assent—allowing them to make these decisions for permanent, life-altering and toxic procedures—is a gross violation. It’s a gross violation.

Good News in the Fight against Gender Ideology

So there is some good news.

The ACP—the American College of Pediatricians—along with other organizations (these were in your seats there), uh, created a—a document now that’s been signed by 75,000 physicians. And it’s a dissenting view, saying that the treatment is malpractice.

And this is a significant dissenting view of the science and the standards of care. Because in the past, they would say, “Well, we’re just following what WPATH says. WPATH says, you know, this is the standard of care. We’re just doing what they say.”

Now we have a document. Seventy-five thousand physicians from 58 countries are saying no—that is not the standard of care. And it is, in fact, malpractice.

And that’s why England, Sweden, Finland, France, Denmark, Norway, Australia, New Zealand, Scotland have pulled back on transitioning children and are re-evaluating that.

Closer to home—these are the states that have put some moratorium, some restriction, on transitioning children.

And of course, trans activists are saying these are the states that are preventing, uh, care to children.

And—and the answer is: we’re preventing bad care to children.

These—these children need good care. They need psychiatric evaluations. They need to be cared for. They need to be loved.

They need—they need a Catholic-authentic, uh, care. That’s what they really need.

They don’t need to be, uh, to be given drugs that change their lives forever.

Conclusion on the Medical Aspects of Gender Dysphoria

So in conclusion for the medical part—and I’m unscheduled, by the way—gender dysphoria is not an age. Psychological factors are important.
The key here: 75 to 90% of these kids would just resolve their gender dysphoria if we just took care of them, we just loved them, we just reaffirmed who they really are.
And notice I’m not using any—uh—I’m giving you secular arguments, because that’s what’s important in medical circles. You have to give them secular arguments.

If you suppress them, they’re going to be infertile. And then they’re going to be on toxic prescription hormones for the rest of their life. So this is not harmless, as we hear over and over in the media. It’s not reversible.

And tell me what we’re going to do with the 54,000 detransitioners who are on Reddit. Reddit is a platform I’m on—they won’t let me post anything, but I can still read what’s going on. 54,000 of kids and adolescents—and their stories are harrowing.

Abandoning Detransitioners

And who’s taking care of them? The, uh, the gender identity clinics don’t want them. They all say that. “We can’t get back. Nobody’s taking care of us.”

So now what do you do with the 19-year-old who’s been on estrogen for 12 years? Some of them have had surgeries that really didn’t go that well. And well, how do you transition them back? How much hormones do you give them back? How do you do that?

Nobody knows. Nobody knows. And nobody’s trying to find out.

So this is a real, real problem. Let me get to the U.S. sex reassignment surgery. Again, we’re told it’s safe and effective. And it is not.

It’s difficult to find out how much of this surgery is going on. But this study from Columbia University—13,000 surgeries in 2019. It’s come down a little bit in 2020.

And when you look at it, most of it is breast and chest. And then these are the younger patients. Older patients have genital surgery, and then facial surgery to make them look more feminine.

What I thought was impressive is that almost 8% are minors.

That again—can’t possibly consent to having their breasts removed or having their genitals changed.

In terms of payment: 30% with some government agency, 60% are private, and about 6% are private—wait, that doesn’t add up, but that’s what was said—

Transgender Surgery

So how do we go from being a man to a female? Now I didn’t bring my usual lecture. If you want to see my usual lecture, come to our annual meeting and I’ll show all the gory pictures. I didn’t want anybody to vomit today, so I didn’t bring those pictures.

But I’ll describe what’s going on: To go from male to female, there’s complimentary hormone therapy, then breast augmentation. These are men who are getting breast implants after they receive hormones. The chest tissue softens a bit. Then they have genital surgery and then something to do with their forehead, their trachea, or whatever.

Now in order to do the genital surgery, the first thing is an orchiectomy—which is castration. You remove the testicles. Then you have to disassemble the penis.

Now the penis has three parts to it. So you leave the skin and you leave part of the corpus spongiosum that has a neurovascular bundle in it. Then you amputate the rest of the penis.

And you create a space that doesn’t exist—an alcove between the rectum and the bladder. In that space, you invert the penile skin.

Of course that space is going to try to contract and close. And that’s the big problem—because it’s a wound that’s trying to contract. Then you have to create the urethra.

So a man has a long urethra, women have a short urethra. So now you have to shorten that urethra. And then you can create the labia majora from the scrotum.

Now this study from the Department of Urology in Philadelphia by Dreher looked at the complication rate.
She reviewed 125 articles, but only 13 met the criteria for review.

That means—what does that mean? That means there’s 125 articles in there, but only 13 actually talk about the complication rate.
They documented them well.

So that’s still 1,684 patients.
The overall complication rate was 32%.

When there’s stenosis of the meatus of the urethra—what that means is, you need a catheter to urinate. Or a suprapubic tube. That’s a serious, life-altering event.

Stenosis of the neovagina is about 10%. So these are serious complications.

Then when you look at this paper that comes from San Francisco—this is an incredible paper—their complication rate was 26%.

Now the authors call these “minor complications”:

• Granulation tissue: means that tissue hasn’t healed.

• Intravulval scar.

• Colp pain: 22%.

• Incontinence: now you’re living with a diaper, 15%.

• Retention: you need a catheter, 9%.

• Vaginal drainage: 133%. Wait—probably meant 13.3%.

• Fifty percent…

So those complications I would not call minor. Urinary incontinence, prolonged pain—I would call major complications.

What they considered major complications were:

• Necrosis, which is when all that tissue just dies because it’s outstripped of blood supply.

• Emergency operation.

• Complete stenosis.

Total complication rate: 70%.
Reoperation rate: 50%.
And 32% of the patients requested another surgery.

I can tell you—if I had a complication rate in my microsurgical cases of 70%, I wouldn’t be standing in front of you. My license would have been gone years and years ago.

Yet this is published in the American Journal of Plastic Surgery. This is a very reputable journal. There’s no higher standard in the United States.

And yet we’re accepting this like, “Oh yeah, this is just how it is.”

Female-to-Male Surgeries and Outcomes

Alright, I have a few minutes left. Female to male—very difficult surgery.

So these women undergo mastectomy—their breasts are removed. The vagina is removed. And then here’s the difficult part: again, women have a short urethra. Now we have to make a long urethra to make this new penis.

Metoidioplasty is making a penis out of the clitoris, which has undergone enlargement because they’ve been on testosterone. It doesn’t work. Most of these patients undergo phalloplasty.

So you take most of the forearm—on the radial artery and vein—and then you transplant it to the groin. That takes microsurgical skill.

These are skillful surgeons. These aren’t—you know—they’re skillful. The Scandinavian countries have been doing it for a long time. And yet the complication rate is very, very high.

This article comes from Amsterdam. A single institution. It was urology and plastic surgery—which is actually the best it’s ever going to be. When you can get a team of urologists and plastic surgeons from one institution working together all the time, you’re not going to do any better than they do.

And what are their results? You read the script:

• 63% of people need a catheter in order to urinate or use internal bladder fistula.

• 50% and 27% are living in diapers.

• Revisional surgery: 73%.

But they patted themselves on the back because eventually some of the patients—44 patients—were able to void from the tip of the phallus. And they congratulated themselves for these wonderful results.

Long-Term Psychological Outcomes

Now, certainly we’re doing all of this because it’s proving psychological benefit, right? And if you look at this study from Germany and Sweden—15 years after these patients had surgery—the quality of life was lower in the means of:

• General health

• Role limitations

• Physical limitation

• Personal limitation

This came from a questionnaire. And I think there’s even better data that comes from Sweden. This is a longitudinal population study. The wonderful thing about the Swedes is everything is in a national database.

They know exactly what the diagnoses are. The follow-up was 10 years.

In other words, these patients had surgery, then 10 years later they wanted to see how they were doing.

The completed suicide rate was 19 times their controls—not 19%—19 times.
And the patients that were female to male, it was 40 times.

Transitioners had higher heart disease and psychiatric hospitalization, as we know. And then male patients had a high rate of criminality.

A Medical and Moral Reckoning

So about the surgery—these patients present with psychiatric disorder. Few studies actually try to measure their psychological benefits. If there are early benefits within that first year, those go away. And longitudinal studies fail to show them.

But although we know there are hormone complications and significant surgical complications—when they’re reviewed, all the gender-affirming surgeries are of low quality.

And that’s why the national science reviews in these countries have changed course.

So I hope I’ve convinced you in some way that Dr. Professor Gillberg is right.
This could—and probably will—go down as the greatest scandal in medical history. Gender dysphoria is a psychological diagnosis. It’s about identity.

Psychologists are famous—popular one, Jordan Peterson, has made this point: it’s about identity. All psychological [issues are] about identity.

Who am I? What am I supposed to do? What am I doing on this Earth? And this is all that happens in adolescence. And it’s about identity. We’ve made it into gender identity. But it’s about identity. Transgender ideology, on the other hand, is a social-political movement. Disregards science. Doesn’t allow debate. And I believe it’s dangerous.

And I’m left with thinking about Dietrich Bonhoeffer—who’s a hero of mine from World War II. Lutheran pastor. And he said it best:

“Not to speak in the face of evil is an evil in itself. And God will not hold us guiltless.”

Alright. Thank you very much.