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Portland's OHSU Hospital Covers Up Sex-Change Abuses
Nine transgender patients accuse Dr. Daniel Dugi of disfiguring and "experimenting" on them. One patient accuses Dr. Dugi of coercing him into sex-reassignment surgery.
ALEX MARKEL NEVER WANTED sex-reassignment surgery. Dr. Daniel Dugi of Portland’s Oregon Health & Science University (OHSU) hospital talked him into it, he claims. Alex (alias name) told me he had only wanted an orchiectomy (removal of the testicles) but Dr. Dugi refused and instead pressured him into getting sex-reassignment surgery. Being only 22 years old and feeling vulnerable he went along with it.
Alex told me that he had never expressed any interest in getting sex-reassignment surgery prior to meeting with Dr. Dugi one-on-one. I asked if he had told his therapist, doctor, or any OHSU team member that he wanted the surgery. He said he hadn’t. Alex said he felt like he “was very much pushed into transition” because of ongoing “mental health problems” that his therapist failed to properly diagnose.
What about the two letters attesting readiness required from a therapist before getting surgery? Alex never provided them with his own accord. Dr. Dugi personally sought them out Alex told me. He reached out to Alex’s therapist and got what he needed.
Dr. Dugi, who was new to the procedure at the time, left Alex severely disfigured in his attempt to create a vagina. “It looks like a mutilated penis and scrotum,” Alex told me during an interview. A full one-inch of the penis and all of the scrotal tissue remain. Alex told me the corrective surgery team analyzing him said his result is the most intact genitals post-surgery they’ve ever seen.
After being disfigured, Alex claims the hospital then tossed him out. No one explained what went wrong with his surgery or offered a remedy. He wasn’t given any support or follow-up care either.
Alex told me he believed his surgery was “rubber-stamped.” He said Dr. Dugi used “a bunch of trans people to experiment on and gain experience without being properly trained.” Alex went along with it after Dr. Dugi repeatedly refused his request for an orchiectomy. He said he felt confused and gave in under the pressure of an authority figure like Dr. Dugi.
Alex has since de-transitioned and uses male pronouns.
An Experiment Gone Wrong
ON JULY 23RD, 2018 NINE transgender patients, including Alex, banded together and sent a letter to OHSU complaining of being disfigured and mistreated by Dr. Dugi. They described how they were left with serious complications such as terrible aesthetic outcomes, pain, strange sensations and improperly functioning anatomy. One patient complained that when they urinate they orgasm. Another has a thumb-sized hole where the urethra should be.
I first heard of this patient uprising at OHSU when I visited the Friday night Portland transgender meet up group in October 2018. I had a chance to speak with a few of Dr. Dugi’s patients in person. I asked one woman how she’d rate her surgery result on a scale of 1-10. She told me one. I asked if she had any tissue covering her clitoris. “No” she replied. I then asked how Dr. Dugi rated the surgery. “Ten,” she said.
Amy Penkin, LCSW, is the program supervisor of the OHSU transgender program. She is one of the OHSU officials whom the letter was addressed.
In the letter, the patients described how they were mistreated and coldly shut out by the hospital. They even cited the historical record of minorities being used as test subjects.
Confused and distraught, the patients were sent to the “risk management” department by the transgender program. They were told their only option was to file a lawsuit. One patient explained. “I used Oregon Patient Safety Commission’s Early Discussion and Resolution process, but OHSU had no interest, and never contacted me. It took almost two months to receive my medical records.”
“Association can be made with historic narratives involving certain minority populations being used as test subjects by doctors.”
At the end of the letter, the patients state that most poor/low-income Medicaid patients in Oregon are “funneled” to OHSU hospital. Thus, those disfigured and injured by the program were more likely to be more oppressed. “Too many people have come out of the program harmed without the financial or social means to do anything about it,” they write. “Association can be made with historic narratives involving certain minority populations being used as test subjects by doctors.”
Below are brief excerpts from the patients’ personal accounts of being disfigured and abused by Dr. Daniel Dugi (emphasis added).
“The most significant issue being what appears to be an unfinished urethroplasty, leaving a hole where my urethra should be, large enough to place a thumb into…I subsequently have internal hair growth. My clitoris is exceptionally large, and I have substantial holes on either side that never healed shut. My general aesthetic is not anatomical.”
“Ninety percent of the time that I urinate, I have an orgasm…My clitoris looks like a poor after thought. And what labial lip-works I have, look like they’re attached to my legs on the ventral side and flapping in the wind on the dorsal side.
Within days of my surgery, I developed an abscess behind the area of my upper pubic bone and clitoris…As part of the GCS crafting process, I was left with a lump of flesh interposed directly below my clitoris, and directly above the location of my urethra...urine streams spray all over the underside of my legs, buttocks, and the interior…”
“Both sides of my labia have a strange skin tag, almost as if both come to a small triangular point, which I can only assume is some sort of stitching anomaly…I’ve had extreme difficulty achieving orgasm to the extent that I no longer bother masturbating.”
“I have had complications after surgery, including granulation tissue, suture break, and extreme inflammation of the area. My labia were made much larger than what is normal…I continue to deal with the significant aesthetic issues and internal hair growth.”
“Today, my vagina looks different than most cisgender women’s vaginas. My clitoris looks different, and is significantly too large. The urethra still looks odd, and has maintained a swollen appearance while still causing urine flow issues. I have had an issue with either a cyst, or a hematoma at the vaginal entrance, and was seen for a gynecological exam recently…My urethra lacks external structure to guide urine flow.
“I had phalloplasty surgery with Drs. Dugi and Berli almost two years ago, had numerous complications, including lingering bad side effects from anesthesia and surgical trauma. Both surgeons misrepresented their expertise, experience, and readiness. My first, of three surgeries was incomplete, and took 17 hours, more than twice as long as it should. My penis is half as long as it’s supposed to be due to poor surgical technique, and cutting the flap shorter than agreed…. My urethra was destroyed due to poor surgical technique, improper catheter and stent placement and/or type, negligence, and Dr. Berli trying to make my penis too small.”
There are more first-hand accounts in the group letter which can be read here.
OHSU Says Program is “Thriving”
GIVEN THE SERIOUSNESS OF THE disfigurements and complications, one would hope that OHSU would have provided support and compensation for the injuries. They didn’t.
I emailed the OHSU transgender department and received a reply from staff member Jess Guerriero. They told me the “surgical program is thriving” and that “Dr. Dugi will be continuing to operate.” I pressed them further on Alex’s terrible disfigurement and the pain and suffering clearly documented in the letter of the nine patients who came forward. I asked about Alex’s claim that he was coerced into getting sex-reassignment surgery. I then received a generic response from OHSU’s strategic communication director Tamara Hargens-Bradley stating they deeply care about their patient’s wellbeing and safety. Dr. Dugi told Jezebel in their reporting that “occasionally there are complications.”
“Ninety percent of the time that I urinate, I have an orgasm.”—Dr. Dugi patient
Many of the transgender patients disfigured by Dr. Dugi at OHSU will face life-long physical and psychological impacts. Without the financial compensation or logistical support from the hospital, it’s uncertain what, if any, resources they’ll find to help cope.
If Dr. Dugi had inappropriately touched a patient’s genitals even one time he’d be fired. In the trans healthcare field, permanently disfiguring patients’ genitals is permissible, however. One is a crime, the other is not.
200 Trans Patients Decry Abuses
NEARLY 200 POST-OPERATIVE TRANSGENDER patients signed onto an open letter in 2018 to the WPATH transgender health organization complaining about serious abuses in the sex-reassignment industry. They listed several complaints:
“Offering free or low-cost surgeries to under-resourced patients in order to gain operating experience in procedures for which they have incomplete professional training.”
“Engaging in pre-operative counseling, academic publishing, and public presentations using complication rates that are [false].”
“Providing insufficient aftercare.”
“Providing patients with inaccurate medical information both within and outside their practice.”
“Offering experimental procedures without counseling patients as to the experimental nature of the procedures.”
They also noted in the letter that those patients who were part of “medically underserved populations” were “disproportionately affected by these negligent and exploitative practices.”
The report quoted a sex-reassignment surgeon who said they’ve seen “horrific unethical practices by surgeons” who lie and leave patients with terrible results.
“I have seen horrific unethical practices by surgeons who lie about their experience and horrific results surgically as a result of that. We are using transgender people as guinea pigs and the medical profession allows this to happen.”—Sex Reassignment Surgeon
Trans healthcare is not free from the same human error or abuses that are found in the wider healthcare system. Every year 12 million Americans are misdiagnosed when seeking treatment for a medical condition. Add in malpractice, fraud, corporate greed, and other abuses and there are real concerns. Large corporations often do not have the best interests in mind for vulnerable and marginalized transgender patients.
Sex-reassignment surgeries are highly lucrative operations and hospitals stand to make millions of dollars off of them. It’s not unthinkable as the example of OHSU suggests that there are bad actors within the trans healthcare field seeking to capitalize on the growing interest in these surgeries. There is a risk of inexperienced, poorly trained surgeons being hastily brought in and used to achieve this goal.
And there is no regulatory body overseeing sex-reassignment surgeons so people like Dr. Dugi can freely disfigure patients with no recourse whatsoever. Neither is there any required standard for training to become a sex-reassignment surgeon.
The decisions and challenges surrounding transition are difficult and complex enough. Now families have to imagine that their loved ones could be coerced, disfigured, and then coldly shut out by sex-reassignment surgeons and hospitals.
See Jezebel’s story on Dr. Dugi & Dr. Rumer: When Surgeons Fail Their Trans Patients
Contact: bescofieldwriter @ gmail.com / Donate here
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