Vermont opens door for gender-affirming surgery for transgender youth

This is what so many of us have been so concerned would happen (and is happening):
Ve rmont opens door for gender-affirming surgery for transgender youth

Vermont health insurance regulators are planning to tweak Medicaid rules so transgender youth no longer have to wait until age 21 to seek gender-affirming surgery.

Note: This is not an effort to lower the minimum age requirement; the intention is to eliminate a minimum age requirement altogether.:

The new rule, proposed at the end of May, eliminates an age minimum and allows youths under 18 to get surgeries with informed consent from a parent or guardian.

No age would be too young for sexual reconstruction surgery under the new requirements; and, of course, puberty blockers could be given to even younger children:

"Having young people have to wait until they were 21 just didn't really make any sense," Inker said.

That statement chills me to the bone. I keep thinking, "First, do no harm," and she sees no sense in not fixing what isn't broken.

The choice to have surgery is a personal one that should be explored in every age group, Inker said, although people who are young enough can be given puberty-blocking treatments to inhibit development of secondary sex characteristics like breasts or facial hair.

And, of course, cross-sex hormones. (Note: Cross-sex hormone treatment is often called HRT for Hormone Replacement Therapy, but this is incorrect, because HRT replaces the hormones naturally produced by the body... Cross-sex hormone treatment introduces opposite sex hormones to the body.)

The new rules would drop the minimum hormone therapy requirement for genital surgeries from two years to one year. Hormone therapy would no longer be a requirement for breast-removal surgery.

This is horrifying. Teenage girls will be allowed -- encouraged??? -- to have their breasts cut off before they're even old enough to know themselves... during what is arguably the most emotionally turbulent time in their life... before they have the experience or the judgment to understand and weigh the lifelong consequences of what could very well turn out to be a temporary feeling. And, in fact, if left alone to grow and mature, most likely would be temporary. And if they've been taking puberty blockers, then their mental and cognitive function have been retarded to one extent or another, perhaps by as much as 10 IQ points.

The rules also reduce some of the requirements to get surgery covered, like the need to have letters of support from two psychiatrists. The new rules ask for a mental health provider and a medical provider to evaluate the procedures as medically necessary.

Informed consent is basically another way of saying "self-ID." No medical or psychiatric diagnosis for gender dysphoria; only as "medically necessary." No months or years of psychiatric counseling or therapy necessary (as we are so often told). No need to "live as" the preferred gender first.
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ETA: As pointed out by Phage, the above is incorrect:

Eligibility for Care Vermont Medicaid beneficiaries who are diagnosed with and receiving treatment for gender dysphoria, who satisfy all conditions set forth in this rule, and for whom the service(s) for which prior authorization is sought is both medically necessary and developmentally appropriate are eligible for coverage of the services governed by this rule.

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Folks in Vermont have about a month to let their critters know what you think about this:

The Medicaid Policy Unit is accepting public comment about the proposed changes through July 17. Comments can be emailed to [email protected].

For those of us not in Vermont, this is a heads up because it probably won't be long until similar bills and regulation changes are made in our own states and municipalities.

I can't help but think that most of these kids on Medicaid are probably in the foster care system... they've already been let down by the adults in their lives in the worst ways... our "woke" critters aren't going to protect them. If not us, then who? And if not now, then it's too late.

Complete mind-boggling insanity.

originally posted by: schuyler
Complete mind-boggling insanity.

Yes, it is... and cruel to boot.

I don't blame the kids at all in any way. It's the so-called adults that are failing them.

More from Breitbart:

Vermont to Allow Taxpayer-Funded Transgender Sex Reassignment Surgeries for Children

And a little about ROGD and girls:

A study published in August by Dr. Lisa Littman, an assistant professor of behavioral and social sciences at Brown University, found 87 percent of teens were reported by their parents to have “come out” as transgender after increased time spent on social media and the Internet and after “cluster outbreaks” of gender dysphoria among their groups of friends.

Most of the teens who claimed to be transgender had also already been identified with at least one mental health disorder.

The study drew the ire of LGBTQ activists.

And this is heartbreaking:

Dr. Quentin Van Meter, an Atlanta pediatric endocrinologist who trained at Johns Hopkins University when “transsexualism” was first studied, told Breitbart News in September that, since gender ideology has been forced on the American people, “every single transgender patient who has come to me has come from a totally dysfunctional family.”

“There’s nothing normal about the environment where these children are brought up,” Van Meter explained. “There are emotional traumas left and right. It is so obvious that what we’re doing is painting over the trauma.”

These kids need help, desperately, but this gender reassignment surgery isn't it.

Isn't the risk of post surgery complications(reopening wounds/infection/etc) really high for gender reassignment surgery(I thought it was like 40 or 50%).

originally posted by: MisterSpock
Isn't the risk of post surgery complications(reopening wounds/infection/etc) really high for gender reassignment surgery(I thought it was like 40 or 50%).

Yes, it is. Infections are always a risk with any invasive medical procedure, and especially with sex reassignment surgery.

I cannot find statistics right now, but I recall reading once that the chance of infection is highest in female-to-male surgeries immediately after surgery, but that the risk for males-to-females is higher over the course of their life. Apparently because unlike the female-to-male surgery which ultimately heals, the male-to-female surgery is essentially an open wound that must be manually stretched and manipulated to prevent healing (closing).

Sorry if that's too much information.

Sadly enough, I read that Medicaid will NOT provide reverse surgery if the patient is not happy with the results. They'll put them in that position, but won't get them out again.

a reply to: Boadicea

No months or years of psychiatric counseling or therapy necessary (as we are so often told). No need to "live as" the preferred gender first.

Incorrect

(C)A written clinical evaluation by a qualified mental health professional will include at a minimum:
(i) A diagnosis of persistent gender dysphoria, with demonstrated:
(1)Participation in a treatment plan in consolidating gender identity, and
(2)Participation in addressing interpersonal issues as part of a treatment plan,
(ii)Diagnosis and treatment of any co-morbid conditions,
(iii)Counseling of treatment options and implications,
(iv)Pyschotherapy, if indicated,
(v)Formal recommendation of readiness for surgical treatment, documented in a letter that includes:
(1)Documentation of all diagnoses,
(2)Duration of professional relationship and type of therapy,
(3)Rationale for surgery, and
(4)follow-up treatment plan.
(2)Documentation of medical necessity from a medical provider working in conjunction with the qualified mental health professional(s).
(3)Completion of at least 12 months of living in a gender role that is congruent with their gender identity, across a range of life experiences and events that may occur throughout the year.
(4)Documentation of hormonal therapy, as appropriate to the beneficiary’s gender goals, unless such therapy is medically contraindicated. Specific hormonal therapy pre-requisites are as follows:
(A)At least 12 consecutive months for all genital surgeries,
(B)At least 24 consecutive months for breast augmentation mammoplasty, and
(C)There is no hormonal therapy pre-requisite for coverage of mastectomy.
(5)Documented informed consent, including knowledge of risks, hospitalizations, post-surgical rehabilitation, and compliance of treatment. For minors under 18 years of age, documented informed consent of a parent(s), legal custodian, or guardian is also required unless the minor is emancipated by court order.

a reply to: Phage

Incorrect

Thank you -- I do believe you are right about that. I did not see the link to the scrib doc until after I posted, and I'm trying to read it now.

I am hanging my head in shame.

Let me get back to it...

a reply to: Boadicea

Most who go through this as a child grow out of it. This is insanity.

My apologies all. Phage seems to be right and me very wrong:

Eligibility for Care

Vermont Medicaid beneficiaries who are diagnosed with and receiving treatment for gender dysphoria, who satisfy all conditions set forth in this rule, and for whom the service(s) for which prior authorization is sought is both medically necessary and developmentally appropriate are eligible for coverage of the services governed by this rule.

So, yes, a diagnosis and ongoing treatment is still required for surgery. So, hopefully, no decisions will be made on a whim.

But that only buys a little time before the worst can happen. Puberty blockers are still very risky, as are cross-hormones.

Source

originally posted by: OccamsRazor04
a reply to: Boadicea

Most who go through this as a child grow out of it. This is insanity.

Yes, they do -- if given that opportunity! But it seems that if given puberty blockers, they don't grow and mature, so they don't get the opportunity to grow out of it.

And we cannot ignore the damage that puberty blockers alone cause.

I hope you saw that I was wrong about the need for a diagnosis and treatment being eliminated as well as the minimum age requirement. If not, now you do know!

a reply to: Boadicea

It's a seriously sick world when a premium is placed on aligning with gender dysphoria, when extra research and medical care could be applied to real diseases.

Cheers - Dave

What does it matter what age people are when they get these surgeries?

I understand that you might not approve of the surgeries all together... might think it's an abomination... might think it goes against your religion... might think it will cause these people physiological damage ... and ect ... and all of those things might be true; so how does age of the individual change any of those arguments for the worse?

The only thing I can think of that might mater would be the issues involved in performing surgery on a child in general. But to that argument; from your artical

The new rule, proposed at the end of May, eliminates an age minimum and allows youths under 18 to get surgeries with informed consent from a parent or guardian.

a reply to: Boadicea
The rule would allow medicaid coverage for minors (if the conditions are met). It would allow those who receive medicaid to have access to the same services as those who have other coverage.

originally posted by: bobs_uruncle
a reply to: Boadicea

It's a seriously sick world when a premium is placed on aligning with gender dysphoria, when extra research and medical care could be applied to real diseases.

Cheers - Dave

It is quite sad -- and wasteful of resources. The patients are guinea pigs for experimental drugs and practices. These drugs and surgeries create new conditions, which also then have to be researched and funded, thus reducing resources and funds for so many other diseases and conditions.

Informed parental consent? No, it's child abuse. In a recent case in our area a couple of lesbians stated that their child, a boy, really preferred to be a girl, so they started him on the hormonal therapy before he was even a teenager. But they insisted it wasn't from any pressure from them! Oh, no! He came to this conclusion on his own accord. They were simply facilitating what he wanted to do.

Riiiiight!

originally posted by: DanDanDat
What does it matter what age people are when they get these surgeries?

So many reasons. For one, these kids are not mentally or emotionally mature enough to make decisions that will have permanent consequences. And no one has the right to make such life-altering decisions for them. If left alone, the kids grow out of their dysphoria and into their sexuality just fine about 80% of the time. But with puberty blockers, the kids seem to be locked into their dysphoria and do not grow out of it.

The treatments all have known negative side effects and adverse outcomes, including impaired brain function, depression and anxiety (including suicidal ideation) and sterilization/infertility. These chemical treatments will have permanent effects even if stopped, the extent depending on the individual and the length of time taken. Surgical procedures likewise have lifelong complications, as all surgical procedures do. In this case, especially for males-to-females, there are lifelong potentials for infection and other complications due to the ongoing maintenance required. Most will become lifelong medical dependents for their survival. Many will not find relief from surgery, only more suffering, thus feeding the high rates of suicide post-surgery.

I understand that you might not approve of the surgeries all together... might think it's an abomination... might think it goes against your religion... might think it will cause these people physiological damage ... and ect ... and all of those things might be true; so how does age of the individual change any of those arguments for the worse?

I am a firm believer in free will and personal autonomy, including/especially in medical matters. Adults are free to make their own decisions and I would not try to stop an adult from choosing such surgery. If they asked my opinion, I would implore them not to for their own sakes, and if it ain't broke don't fix it cause you'll break it in the process, and I'd tell them they are perfectly imperfect just they way they are and don't have to change a damn thing. I'd tell them to embrace any gender norm they want and to blow off any gender norm they choose and to just be their own awesome self. But it's their decision, and I would respect their decision and their right to make that decision.

originally posted by: Phage
a reply to: Boadicea
The rule would allow medicaid coverage for minors (if the conditions are met). It would allow those who receive medicaid to have access to the same services as those who have other coverage.

Yes -- so I see now... Thanks for pointing it out.

I also edited the OP to show my mistake. I wish I knew how to "strike-through" text on ATS

a reply to: Boadicea

[strike] [/strike]

With square brackets. Not that I ever have need of it, of course.

originally posted by: schuyler
Informed parental consent? No, it's child abuse. In a recent case in our area a couple of lesbians stated that their child, a boy, really preferred to be a girl, so they started him on the hormonal therapy before he was even a teenager. But they insisted it wasn't from any pressure from them! Oh, no! He came to this conclusion on his own accord. They were simply facilitating what he wanted to do.

Riiiiight!

Beyond the oh-so-progressive parents who are too "woke" for their own good (not to mention their child's good), we have to consider Munchausen by proxy as well. This is ripe for abuse by those mothers so inclined -- and fathers, of course, but I believe mothers are the primary culprit in these cases.