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MY MEDICAL MALPRACTIVE IS NOW YOUR “dynamic desire for gender-affirming medical interventions”

Opinion – Eliza Mondegreen

ELIZA MONDEGREEN – 28 July 2022 – gender:hacked

“Dynamic desires for gender-affirming medical interventions” sure is a ballsy way to refer to medical harm, regret, and detransition.

Gender clinicians really, really, really don’t want to talk about medical harm, regret, and detransition. Better to talk about “gender fluidity” or “gender journeys”— “journeys” that may include stunting normal development with unknown consequences or removing healthy organs. And, most importantly, “journeys” that could not and should not have been prevented by gender clinicians.

Instead, we get these odd disquisitions on “regret” (safely contained in air quotes). What does it mean if a patient “regrets” medically unnecessary and life-changing surgeries and hormone regimens? Annelou de Vries and Thomas Steensma want us to unpack our ideas about what “regret” means. It’s “too binary” to say a patient “regrets” or doesn’t regret surgery. (We just need to queer our concept of what a good medical outcome is!)

Olson-Kennedy, Turban, and Brady want to remind everybody that “regret is a complex and heterogenous concept.” (Now try that with ‘medical malpractice’!)

Asked about the possibility of regret and detransition, Olson-Kennedy wondered: “What does that actually mean? Does that mean that someone has additional breast tissue that they would not want at a later point? But they could get that breast tissue removed if they absolutely need to.” Or maybe you had your breasts removed but “if you want breasts at a later point in your life, you can go and get them.”

Or take Bernadette Wren, former associate director of the Gender Identity Development Service at the Tavistock, who writes these impenetrable monographs on autonomy and liberation and clinical responsibility as though it’s pure theory. “The body cannot be ‘known’ outside of, or apart from, the grids of intelligibility that exist in our culture, any more than the mind can,” Wren muses, as though she were a middling contributor to a freshman philosophy seminar. But the children under her care were real—flesh and blood—not social constructs, not points on abstract “grids of intelligibility.”

Gender clinicians are desperately trying to bury mounting evidence of medical harm, regret, and detransition, mostly by draining meaning from language and redefining mountains as rainbow-spangled molehills that it would be ever so edifying to visit, even if you ultimately decide you’d rather move on.

Their best bet for getting out of this with their reputations and business models intact is to destroy the possibility of speaking clearly and objectively about the situation: that a growing number of young people regret medical interventions they received under an affirmative-care model that did not take the possibility of medical harm, regret, and detransition into account. Gender clinicians want to make the conversation about how “regret” is “too binary” and “detransition” merely reflects “dynamic desires for gender-affirming interventions.” They want to make the conversation about the interiority of flighty patients, not the responsibility medical providers have to all patients…