Trans Health Isn't the Scandal You Think It Is

In the midst of a teenage mental health crisis it's important to put transgender healthcare in context

“When you break the nose to thin the nose, quite often you get black eyes like this,” says Dr. Anthony Youn in a TikTok video commenting about a young woman’s rhinoplasty aka a nose job. The video reveals a disturbing image of her with wide, puffy red swelling around her eyes and on her eyelids, with bandages over the nose.

Another surgeon, Dr. Kim Patrick Murray, uses TikTok to market plastic surgery to teens. He performs rhinoplasties on girls as young as 14.

Influencers often get free surgeries in exchange for marketing a plastic surgeon on the app which is predominantly used by young teens. Insider set up a fake profile of a 14 yr-old on TikTok and within 8 minutes was targeted with ads by plastic surgeons, despite those ads being banned.

When a celebrity named Zoe was in middle school a boy told her she had a big nose and it “unlocked a new insecurity,” she claims. She needed treatment for a deviated septum and “floated” the idea to her surgeon about cosmetically fixing her nose:

Without skipping a beat, her doctor agreed with the idea; Zoë’s nose could use a little work. The plastic surgeon she met up with shortly afterward agreed, too. He even pointed out characteristics of her nose she had never noticed before…

Soon, Zoë was going under the knife in pursuit of a new and improved, itty-bitty nose.

The end product left a lot to be desired: The recovery process alone took two years, and even after that, her nose healed incorrectly and remained a little crooked. Zoë’s nose was different, but her insecurities stayed the same…

“I regret having it done. I was too young to make that decision. My brain and worldview were not developed. If I had waited until I was older, I definitely would have changed my mind.”

Zoe was in middle school at the time.

In 2019 there were 3,300 teens 17 and younger who got breast implants and 2,000 who had breast reduction surgery in the U.S.. 2,600 had cosmetic ear surgeries, 1,700 had nose jobs and 3,500 had liposuction. 4,500 teens 17 and under received botox injections and 15,000 got laser and cosmetic hair removal.

If you include 18-19 yr-olds the number of cosmetic surgeries jumps to over 200,000.

“It's legal to perform plastic surgery on anyone under 18 – as long a parent or legal guardian consents,” says Dr. Steven Pearlman.

“Social media pressure has encouraged teens as young as 13 to get bigger lips, smaller noses, lifted breasts and other procedures,” a report from the Today show said. They called it “Snapchat dysmorphia” and produced a program called #FillerNation: Beauty in the age of social media.

There are hundreds of plastic surgery games targeted to kids as young as 8 in the app stores. “These apps make choosing a new nose look as innocent and harmless as choosing a new outfit rather than the major surgery that it is,” says psychologist Sarah McMahon.

“There was actually a girl on our campus, she went on Snapchat and she filmed herself getting a live liposuction,” a young college student told NBC.

The TikTok hashtag #nosejobcheck has over 3 billion views and #plasticsurgery has 17 billion views. It’s mostly young women sharing videos of their cosmetic surgeries.

In comparison to the tens of thousands of plastic surgeries that non-trans teens get every year, transgender youth get around 200-500. Most commonly they receive top surgery. The New York Times surveyed eleven gender clinics and Reuters calculated insurance statistics.

Trans critics say teens cannot consent to gender surgeries. But somehow they can consent to rhinoplasties? Breast implants? Breast reductions? In several states teens can get abortions without parental notification. Children and teens get chemotherapy, radiation, and dangerous surgeries. Teens drive which has risk of serious injury and death. Their logic doesn’t hold.

Jordan Peterson called surgeons who operate on trans youth “butchers and liars” and “psychopathic.” His outrage is selective, however, just like the politicians who ban trans surgeries but not young girls getting rhinoplasties.

Where are all the moral crusaders who spoke at the anti-trans Rally to End Child Mutilation? One of the signs read “Knives OFF Teens!”

“We also know a lot of these surgeons use predatory techniques when promoting their work on social media,” says Dr Antonis Kousoulis, director at the Mental Health Foundation. He’s referring to plastic surgeons like Dr. Murray who use TikTok to find patients as young as 14. “They weaponise mental health, and say the operations will solve your problems and make you feel better.” 

Teens and young women share photos of their rhinoplasy surgeries on TikTok

If transgender teens got rhinoplasties you’d see widespread news coverage, and vitriol. Photos would go viral online like photos of top surgeries shared by trans critics.

The same plastic surgeons operate on trans and non-trans youth. For them, surgically reducing a teenagers breasts is not that different than removing them. It has nothing to do with gender. There are undoubtedly more surgeons willing to break the noses of 14-yr-olds or put in breast implants than there are doing gender surgeries.

There’s more plastic surgeons per capital in Mormom-heavy Salt Lake City than in Los Angeles. Despite the state being ultra-conservative and 57% mormon, it has the second highest rate of plastic surgery. One surgeon estimates 40% of his patients are Mormon.

Plastic surgeons and hospitals care as much about trans youth as they do Mormons. They will operate on anyone and everyone. It makes no difference to them.

But the few surgeries, hormones and setbacks in gender medicine have led to doomsday-like warnings from critics. Jonathan Chait warns the flaws within trans healthcare may, “take its place among the gravest medical scandals in modern American history.”

Medicated Minors

When 16 year-old Amiee Folan went to her medical clinic in Scotland seeking help they prescribed medication quickly. "I went there to ask for help, counselling or something with a therapist, but they prescribed antidepressants and sent me on my way after a 10-minute appointment,” she told the BBC.

Less than a week later she attempted suicide after hearing voices and hallucinating, symptoms she had never had before. Folan described her experience as “quite traumatic.”

"I thought it was quite scary that I could just walk in and say 'I'm depressed' and basically they just handed them to me,” she said.

If a story came out about a transgender teen getting hormones in 10-minutes it’d be news headlines and aggressively amplified online.

Folan isn’t alone.

In the U.K. 1 out of 3 teens report being on antidepressants.

Family doctors in the U.K. said “a lack of access to effective psychological therapies on the NHS has led to them going against official guidelines and over-prescribing medication” to teens. A teenager said, “I was diagnosed with depression over the phone where they prescribed me with antidepressants. This is wrong, and everyone should be able to access counselling.”

“Some of the skilled treatments like therapy that we know work are super expensive,” says Matt Richtel, whose writing explores adolescent mental health. “They’re labor intensive, expensive to reimburse for insurance, and their expensive to train and we don’t have enough of these people.”

Richtel contrasts therapy with giving meds to teens. “Giving a pill is easier, it’s less expensive, and insurer’s are more prone to do it.”

Family doctors are “breaching medical guidelines by prescribing antidepressants for children as young as 11 who cannot get other help for their mental health problems,” The Guardian reports.

Doctors are irresponsibly prescribing them to children because of long waiting lists, or them being refused access to care. But antidepressants should only be prescribed “after an assessment and diagnosis by a child and adolescent psychiatrist.”

It’s not just psych meds. Over prescribing is a huge problem. “Many patients are being prescribed unnecessary and even harmful treatments,” writes the BBC about a report chronicling over prescriptions in the U.K. The government appointed a tzar to try and remedy the systemic issues.

In the U.S. the rate of adults taking five or more medications doubled between 2000 and 2102. “Too often more prescriptions simply mean more serious harm from side effects…10 million people experienced an adverse drug event in 2018. More than one-quarter of a million were hospitalized because of a reaction to medication.” They refer to it as an “epidemic of medication overload.”

It’s clear issues about improperly medicating patients, lacking staff and resources are not unique to trans health. Practitioners in every field are trying to cope with a population that’s becoming sicker, more overweight, and struggling with mental illness. The CDC recently highlighted a teenage mental health crisis which TIME magazine called an epidemic.

Trans health clinics like Tavistock and St. Louis Children’s Hospital have been met with similar allegations of too easily prescribing puberty blockers and hormones without therapy. Critics blame gender ideology for the failings but it’s clear the problems are systemic.

There’s 4 to 6 million children on powerful psychiatric medications. Rates have been steadily increasing.

Antidepressant usage in teens has increased 40% in the U.K. in recent years. There’s now over 1 million prescriptions for antidepressants written for teens every year in England. The number of US youths treated with two or more psych meds has risen from 100,000 to 300,000 in recent years.

Even more disturbing is that many are completely ineffective.

The Lancet published a study in 2016 that concluded anti-depressants don’t work in children and teens. “Zoloft, Paxil, Celexa, and Cymbalta — showed no benefit over placebo for this age group.”

In an article called Teenage antidepressants 'doing more harm than good', the BBC reported that professor David Healy told a global health conference that “in 29 paediatric clinical trials of antidepressants - every single one failed to produce an obvious benefit.” He continued: "At the same time, in every single one of these trials it has produced more harms than benefits in the sense that it has made children become suicidal who wouldn't have become suicidal if they hadn't been put on these drugs." He concluded with a startling recommendation: "We have a situation where if you are following the evidence no-one should be using these drugs.”

The New York Times published an article called This Teen Was Prescribed 10 Psychiatric Drugs. She’s Not Alone. They quote clinical psychologist Lisa Cosgrove at the University of Massachusetts, Boston: “You can very cogently argue that we don’t have evidence about what it means to be on multiple psychotropic medications. This is a generation of guinea pigs.”

These drugs “generally intended for short-term use, are sometimes prescribed for years,” with severe side effects NYT reports. “Many psychiatric drugs commonly prescribed to adolescents are not approved for people under 18” and are being “prescribed in combinations that have not been studied for safety or for their long-term impact on the developing brain.”

Just look at the cocktail of powerful meds this teen was prescribed in high school, some of which were not even approved for treating adolescent depression:

Compared with the 4.4 million children and teens on psych drugs, there are 4,000-8,000 transgender teens on puberty blockers or hormones each year. Hundreds-of-thousands of preschoolers are on psych meds, in contrast.

The shortcomings of trans health routinely make news headlines, whereas the scope of dangerous and sloppy care elsewhere is much greater. A nefarious “gender ideology” is blamed, when the problems are systemic. Trans health is no worse than it’s related fields but it’s treated 100 times worse.

Anti-trans paranoia has grossly distorted perceptions and have led to several states banning trans healthcare for youth. Conservative commentator Matt Walsh wrongly told Joe Rogan there were “millions” of kids on hormones and puberty blockers. And Rogan himself thinks puberty blockers are given to babies.

Broken Systems

"It surprises me that it took this long for this to come to light," said a whistleblower named Ledesha Haynes. She worked as the Director of Human Resources at Lakeview Behavioral Health psych hospital. "I think from the second day I was there, I was concerned," she said.

Just a few months later in December 2019 over 50 police officers raided the center.

Haynes saw patients dragged down the hall, while others walked out unnoticed. One patient was found “in a freezer, crying” she said. “But his documentation said he was accounted for, which is not correct. It was covered up.” Haynes also said employees were caught sleeping on the clock but still worked there.

The 46 complaints alleged physical, emotional and sexual abuses, negligence and worse. An 11-year old was found with bruises all over his body. A child lost a toe. Another child didn’t get care for their physical disorder. Nurses failed to provide CPR for over 30 minutes to one patient and he died. A video revealed security guards beating a patient who didn’t take his medications. Three patients died by suicide within a few days of leaving because the hospital “failed to implement follow-up care.”

The problems were systemic and put patients at serious risk. “Some critical staff members didn’t even have the required credentials, inspectors found…Patients were not even given adequate psychiatric evaluations to justify their diagnoses or plans for treatment, reports show.”

You’ve never heard of Lakeview psych hospital but you would have if it was transgender related. It’d be front-page news.

This is the discrepancy with coverage of trans people.

Mental health systems are broken, under-funded, poorly staffed and driven by various incentives or “ideologies.” Pills are widely over prescribed in all medicine. No one is doing it well. Yet, trans healthcare gets extremely disproportionate and negative coverage.

Read the Atlanta Journal-Constitution’s shocking series on Georgia’s broken mental health system. They found kids being physically abused, raped and neglected by staff. There’s a massive shortage of space in treatment centers there and around the U.S.. It’s horrifying.

One family was told how to “break the cycle” for their son who couldn’t get help:

“When we knew this was really not a broken system, but a ‘gone’ system, is last year when we were finally told, ‘Look, his best help is for him to commit a felony,’” Tracey Jones said.

By threatening a police officer and getting charged with a crime, Justin got help through the criminal justice system at a state hospital where he stayed for months. “They would not let him go until they got him out of psychosis. And that was the very, very, very, very, very first time that happened,” she said.

Lakeview psych hospital is still open.

In contrast, it took just days for Missouri’s Attorney General to call for a moratorium against trans healthcare at a facility after a whistleblower came forward. The allegations haven’t been substantiated yet. He immediately launched a “multi-agency” investigation.

According to NBC, the transgender clinic whistleblower, Jamie Reed, “alleges the center was not doing its due diligence to thoroughly assess patients before moving ahead with treatment and would disregard the rights of parents. Reed also said the center was providing medication to children without making sure the patients understood the effects.”

Journalist Jonathan Chait said if Reed’s allegations were true it’d be “among the gravest medical scandals in modern American history.”

Really?

Worse than Georgia’s horrifying mental health system? The nationwide youth mental health crisis reported by the NYT? Over 200,000 preschoolers on psych meds? Worse than the 400,000 people who have died in the opioid scandal from the criminal actions of Big Pharma?

There’s literally a few thousand trans kids on hormones each year and a few hundred who get surgeries.

Chait, like so many others is caught up in a moral panic. It’s not unlike those who go down Qanon rabbit holes. They are in a parallel reality, where they obsessively share “evidence” of their conspiracies about trans healthcare.

Can you see the pattern? Far less serious complaints in trans healthcare routinely get national news coverage, moral outrage and inspire drastic legal reforms. And a nefarious LGBTQ agenda is blamed when it’s clear identical issues are widespread.

Meanwhile, every night hundreds of mentally unwell children are forced to sleep in Emergency Rooms because of a lack of beds in treatment centers. The NYT reports some of these kids are kept in makeshift sterile “psych” rooms for weeks in the ER.

“Often they were already on a fistful of pharmaceuticals,” whistleblower Jamie Reed wrote about the trans teens in the gender clinic. A fistful of pharmaceuticals that are so normalized she said nothing else about them.

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