- Horrified viewers likened the 'evil' procedures to Nazi-era experiments.
- Advocates say they're rare but vital for those with serious body dysphoria.
- Read about OHSU's 'Dr Death' helping out-of-staters end their lives in Oregon.
A surgeon dubbed Dr Frankenstein has candidly revealed the downsides of performing genital re-shaping surgeries on transgender children and adults, in a video which has since been deleted.
In the video, Dr Blair Peters, a self-described 'queer surgeon' with 'he/they' pronouns, pink hair and a 'passion' for genital surgeries, says patients face fertility, sexual pleasure and other lifelong post-op complications.
Perhaps more concerning is how Dr Peters — who works at one of America's most progressive hospitals — presents his procedures, some of which involve robotics, as experimental.
He says he's 'figuring out what works' and that his team will know more in the next 'five-to-10 years.'
Surgically altering male and female genitals to match those of the opposite sex, or simply removing patients' privates altogether, are widely understood to be tough and problematic procedures.
Advocates of gender-affirming care, as it is known, say they're rare but vital for some trans people. Critics say they should be banned, especially for kids, and that patients need counselling, not cutting.
Dr Peters, a highly-rated plastic surgeon at Oregon Health and Science University (OHSU), made the admissions in a 37-minute interview with Dr Brianna Durand, of Empower Physiotherapy in Seattle.
The original video post from last year appears to have been deleted, but then retrieved from an archive and shared recently on social media. Viewers called the procedures 'evil' and compared them to Nazi-era experiments.
The conservative scholar Christopher Rufo likened Dr Peters to another clinician, the fictional experimenter who builds a monster from body parts in Mary Shelley's 1818 novel, Frankenstein.
OHSU, Dr Peters, and Dr Durand did not answer our requests for comment. OHSU's gender clinic is well regarded among trans patients; wait times for some procedures stretch to as long as two years.
In the video, Dr Peters describes advances being made in phalloplasties and vaginoplasties, including by using a robot controlled by a second surgeon to build a 'neo-vagina' from penis and scrotum tissue.
He also describes wholesale genital removals for non-binary patients, an increasingly popular procedure known as 'nullification.'
Controversially, he addresses the 'handful of puberty-suppressed adolescents' undergoing genital surgeries at OHSU — referring to minors who have taken puberty blockers to delay their growth spurt.
With those boy-to-girl transitioners, he said, surgeons 'don't have enough tissue' to build the neo-vagina and must graft skin from elsewhere.
'We're kind of learning and figuring out what works,' said Dr Peters.
Patients frequently have problems after surgery, added the doctor.
They can suffer 'rectal injury and urinary incompetence,' he said. Others struggle to achieve 'sexual satisfaction' from altered body parts and have worse chances of 'future childbearing.'
Some have a 'really demanding post-operative care process,' he added.
Pretty much every male-to-female genital surgery recipient sees their neo-vagina canal shorten over time, he said.
'We've seen patients coming back even 20-plus years out from a vaginoplasty that have something happened in their life, that they just don't dilate, and aren't having sex for a year, and they will lose a lot of a lot of depth,' said Dr Peters.
Dr Peters said his techniques and success rates were improving as ever more Americans — both young and old — opted for genital surgery, but that there was still much to learn on this new frontier of medicine.
'We're going to learn a lot more about it in the next five to 10 years as we're doing just increasing numbers of these cases,' he said.
Dr Peters and other advocates of trans medicine present the surgeries as a trade-off, acknowledging the substantial drawbacks, but saying they're vital for those with serious discomfort with their own body.
Even so, they are rare within the transgender community.
Of the estimated 1.6 million trans and non-binary Americans aged 13 and above, only 31 percent take cross-sex hormones and 16 percent opt for surgery, according to research by the Washington Post and KFF, a health charity.
Most surgeries are breast removals for female-to-male transitioners.
Genital surgery on children is very rare and massively controversial.
Even the World Professional Association for Transgender Health, which advocates for gender-affirming care globally, says procedures should not be attempted on children.
In the US, Republicans have sought to ban puberty blockers, hormones, or surgeries for minors in about 20 states this year. Sweden, Finland, the UK, and other European countries have restricted or halted trans care for kids.
Dr Peters and OHSU have faced criticism for their progressive approach in the past.
Last year, Dr Peters faced a backlash for a since-deleted tweet remarking on having performed breast-removal surgeries on three young adults and adolescents in a single day.
Another OHSU clinician, Dr Nicholas Gideonse, controversially became the first US professional to help terminally ill Americans travel from out-of-state to get their hands on a deadly cocktail of drugs in Oregon to end their lives.
