Facing painful facts
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- 4 days ago
- 8 min read
Updated: 3 days ago
Part 2 of ScotPAG interview with whistle-blowing surgeon
In this part of our interview with Dr Chrysostom, he presents some of the most devastating facts about the nature and effects of medical and surgical ‘treatments' for the nebulous diagnosis of 'gender dysphoria’. His research confronts us with the reality of unethical interventions based on an unscientific belief that humans can change sex. He provides ample evidence that this ideology permeates the NHS, professional bodies, regulatory bodies, and the political establishment, and that, when challenged, all claim no responsibility for their actions, and for the unfolding disaster affecting the lives of so many children, young people, vulnerable others, and society as a whole.
The interview was conducted by Carolyn Brown, Convenor of ScotPAG
Q: What are the harms that are caused by cross sex hormones for children, young women, and young men?
A: Puberty blockers and cross-sex hormones are not licensed for the treatment of children and young adults with “gender dysphoria”. Administering these hormones to individuals of the opposite biological sex may lead to unpredictable and as-yet-unknown metabolic consequences, posing a significant risk to their long-term health and life expectancy.
A recent case report has documented the occurrence of breast cancer in a male patient undergoing exogenous so-called "gender-affirming" oestrogen therapy (Radiology Case Reports, Volume 18, Issue 7, 2023, ScienceDirect, Elsevier). Additionally, there is a reported case of acute ischaemic stroke in a 23-year-old previously healthy female, who had been treated with testosterone for one year under the false assurance that it would enable her to become male. Tragically, this patient has developed quadriplegia and a locked-in syndrome — a devastating and catastrophic condition (Journal of the American Academy of Neurology, April 2023). The journal concluded:
"Acute ischemic stroke may be an under-recognised complication of testosterone therapy in transgender males, independent of the degree of erythrocytosis. Further research is needed to establish a safety profile of testosterone therapy in this understudied population”.
Already established risks for both females and males include:
Sterility
Venous thromboembolism
Pulmonary embolism
Myocardial infarction
Stroke
Liver toxicity
Osteoporosis
Cognitive impairment
Breast cancer in males.
The administration of androgenic hormones to female adolescents leads to virilization, characterised by:
the development of facial hair
male-pattern baldness
deepening of the voice
The female reproductive system is significantly impacted due to atrophic changes.
Only time will let us know if these androgens will predispose these women to malignancy.
Conversely, the use of oestrogenic hormones in males, coupled with testosterone suppression, through surgical and chemical castration, can predispose individuals to:
premature heart attacks and strokes in middle age due to an increased risk of atherosclerosis.
Emerging evidence also highlights a heightened vulnerability to heart failure associated with androgen deprivation in a male body.
Furthermore, physical feminisation — including breast development, reduction of facial hair, and redistribution of body fat — can cause significant distress for individuals who later choose to de-transition, as well as emotional distress for their families and loved ones.
Q: What are the harms caused by surgery, including phalloplasty, for young women?
A: These vulnerable young adolescents and adults are being misled. They are consenting to surgery under the false belief that they will be provided with a functional penis. The very name of the procedure, "phalloplasty," (link) seems designed to perpetuate this illusion.
The structure that these plastic surgeons create is a “skin and fat flap mound” that is translocated from the forearm to the pubic region. This structure has no anatomical and histological resemblance to a normal penis as it lacks the structures integral to the penis like erectile cylindrical bodies and the specialised innervation from the autonomic nervous system.
The parasympathetic innervation of the male penis has the unique ability to secrete large amounts of nitric oxide which plays the major role in erection. The skin and fat flap mound does not have such intricate physiology as it is a chunk of fat from the forearm. This skin and fat structure that is fitted over the pubis has no anatomical or physiological similarity to a penis.
The claim that phalloplasty enables penetrative sex is misleading. True penetrative sex requires a functional erection in the penis, followed by the natural phases of emission and ejaculation. Without these physiological processes, authentic penetrative intercourse cannot be achieved.
If the primary aim is simply to urinate while standing, this can be accomplished using a urethral catheter connected to a uro-bag or a similar device, which can be discreetly concealed and emptied while standing. This provides the desired outcome of "standing urination" without resorting to such a drastic, high-risk procedure that leads to permanent mutilation and disfigurement.
Phalloplasty enables urination through a rolled-up skin and fat mound, but this artificial extension of the urinary tract relies on the successful integration of the flap and proper healing at the anastomosis points where it connects to the natural female urethra. Complications such as strictures, fistulas, or failures at these sites can lead to a narrowed urine stream or abnormal leakage, with the risk of serious issues like sepsis in an otherwise healthy young woman. Further complications include failure of vascular anastomosis in the groin leading to flap necrosis.
The operation irreversibly destroys the individual's natural female anatomy, leaving no possibility of restoration in case of regret, which is not uncommon among patients undergoing these types of procedures.
Many individuals undergo mastectomies but later choose to have children and become mothers. However, their decision to undergo these irreversible surgeries prevents them from breastfeeding, depriving their infants of a basic human right. The World Health Organization (WHO) recommends breastfeeding for the first six months of life, citing numerous benefits for both mother and child. These surgeries, in my view, cause both physical and emotional harm. I have reviewed the internationally recognised surgical textbooks:
Bailey and Love’s Short Practice of Surgery, 27th Edition
Sabiston Textbook of Surgery, 21st Edition
Oxford Handbook of Clinical Surgery, 4th Edition
Lecture Notes in General Surgery by Ellis, Calne, and Watson, 13th Edition
Schwartz’s Principles of Surgery, 11th Edition
Essential Surgical Practice for Higher Surgical Training edited by Prof Sir Alfred Cushieri (University of Dundee) and Professor George B Hanna, Imperial college London.
None of the textbooks I mentioned list gender dysphoria as an indication for mastectomy. The only accepted indication for mastectomy is breast cancer or prevention of cancer in high-risk patients. None of the standard surgical textbooks mention gender dysphoria as an illness needing any form of surgical treatment.
Q: What are the potential harms caused by surgery for young men?
A: The technical details of these operations being done on young men is in the following textbook. Surgical Management of the Transgender Patient (Schechter, Loren S; Publisher Elsevier)
The surgery that these surgeons are offering as “Bottom Surgery/penile inversion surgery” is in my opinion a misnomer. The term penile inversion is certainly misleading because at the end of the operation most of the penis is amputated. The name and description of the operation is misleading the adolescents and youth who are unlikely to have the cognitive maturity to fully understand what is involved with this surgery. This is because it gives them the wrong impression that the normal penis is inverted to form a vagina (and it can probably be reversed). Those advocating for ‘affirmative surgery’ downplay what this surgery really entails.
The operation involves the disassembly of the erectile tissue of the penis, amputation, and removal of most (>90%) of shaft of penis except the very tip, as well as bilateral orchidectomy. Only the skin of the penis is left and a tiny bit of tip of glans penis for reconstruction.
To achieve this plastic surgery, surgeons do extensive dissection of the entire perineum and deep within pelvis between the bladder and rectum where there is very limited space in a normal male anatomy. Surgeons will try to create an artificial space within the pelvis where there is no space. In the process, they may even cut the levator ani muscle to create some space. This can lead to pelvic floor instability. In my opinion, this is a treacherous dissection and excision of erectile tissues on a person with no physical illness.
Due to this lack of present space in a male, there will be immense post-op discomfort due to the pressure of the newly created structure to the bladder and the ano-rectum. This potential space tends to close off over the new so called “vagina” as a stricture, needing very painful dilatations requiring time and suffering all through the person’s remaining life. Some of them develop granulations leading to persistent bleeding and pain during dilatations.
The following are the complications that can arise with a Vaginoplasty/Vulvoplasty:
Post-op infections and sepsis
Necrotising fasciitis
Pulmonary embolism
Inadvertent bowel and bladder injury
Urethral and Recto-neovaginal fistulae (This complication can leave the individual with uncontrolled leakage of faeces and/or urine between the legs all the time)
Urinary strictures
Neovaginal stricture requiring often painful dilatations life-long.
Numbness in perineum
Fungal and pyogenic infections in neovagina
Failure of Reproduction/ sterility (the young individual is very likely to regret later)
Unpredictable effects on the prostatic tissue
Urethral and Recto-neovaginal fistulae (This complication can leave the individual with uncontrolled leakage of faeces and/or urine between the legs all the time which can lead to untimely death due to gram negative endotoxic shock).
To rescue such a patient if surviving sepsis, surgery will include a colostomy to divert faeces to the abdominal wall prior to another major plastic surgery in the form of Gracilis muscle interposition. This procedure will need liaison with the colorectal team and intensivists. Such a rescue operation by a colo-rectal surgeon is technically very demanding to do in a perineum with abnormal inflamed, scarred skin of a “neovagina”, apart from generalised scarring and blurred planes of dissection. This rescue operation is fraught with further complications and unacceptably high peri-operative mortality. Instead, a surgeon may opt for the safer option of Hartmann type of permanent colostomy (life long).
Q: You have written, ‘These procedures are inherently deceptive and should be banned in the UK’. Can you explain why you think this?
A: The key deceptions include:
"We will feminise" – implying it is possible to create a woman from a man.
"We will masculinise" – implying it is possible to create a man from a woman.
These claims are biologically impossible without altering the genome of approximately 30 trillion human cells. No such transformation can be achieved through surgery or hormones.
Additional deceptive claims include:
That a vagina can be provided for a man.
That a penis can be provided for a woman.
That masculinising a chest is achieved simply by removing breast tissue, when in fact, even after bilateral mastectomy, the individual remains biologically female.
None of the medical professional bodies including the Royal Colleges whom I contacted, have been able to adequately respond to, or refute, the serious concerns about deception that I continue to raise.
Q: What is your opinion on the claim that they are doing these surgeries based on “informed” consent?
A: In my opinion is that the consent involved in these operations are “mis-informed consents”. This is because these interventions are being carried out on the basis of a false promise: that one’s sex can be changed and reproductive anatomy with its physiology recreated. Any consent obtained under these misleading premises must be considered invalid, as it fails to meet the standards of informed consent required by medical ethics and law.
Given the irreversible harm these procedures cause and the ethical and legal implications of proceeding without valid consent (a consent obtained through false information is invalid), I have respectfully urged the Parliamentary and Health Service Ombudsman and the UK government to investigate this matter urgently.
Part 3 of our interview with Dr Chrysostom will appear in our next blog and features a discussion on ethics, responsibility, and collusion in the NHS and beyond
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