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[caveat : I'm not especially concerned about hormones for 16+, and I don't really get the object to 17+ mastectomies. These processes do have risks and side effects, but they're relatively well-bounded and understood, and combined with the drastically reduced incidence of desistance by those age ranges, the harm calculations just aren't looking that severe. I could be persuaded on these things -- I have been persuaded that use of puberty blockers were not just a minimally-harmful experiment but instead ranged from ill-advised to active malpractice, and the prominence and tolerance of bad actors from that sequence does leave me more cautious about the evidence and documentation for hormone therapy for the 16-18 range -- but I've had too many serious medical interventions before I was 18 for the 'mutilate' or 'consent' frameworks alone to really hit. Younger hormone therapy seems to have serious impact on bone health, and the long-term effects of orochidectomy and hysterectomy are much more serious and much harder for teenagers to understand.]
There are definitely clinics without surgical capabilities (or in jurisdictions that prohibit surgical intervention for minors), so psychological support and pharmaceutical interventions and such clearly can suffice for some businesses, and naively I'd expect that while the individual compensations are higher for surgical intervention, the bread-and-butter by definition is a lot more likely to come from recurring stuff. Dunno if there are any public figures, though.
Eh, I get this is playful overstatement, but the extent minor insurance tomfoolery is tolerated is pretty important to recognize. Unless you're Haim, the feds really don't get involved in Medi* stuff unless it's hilariously overt or big amounts of cash are floating around, and sometimes not even then. Just fucking up ICD codes is wrist-slap stuff at best. Which is why it's a big concern... but it also means that it's a lot less of a big overt scandal if it's proven.
Some discussion here
I'm not quite so optimistic; there was a mess of legal interplay here that would have gotten less favored political actors disbarred, and while requests for emergency relief have been denied so far, the jurisdiction charlie foxtrot is enough a mess it's possible the summary statistics will only be released if O'Connor defies procedure.
To be clear, eyepopping was more a reference to the 5k surgery interventions, but yes, the discrepancy between TRUE's claimed patient count and that available to other observers is concerning. Similarly, SEGM estimates a maximum of 1k masectomies on under-18s per year, and I'd consider them gender-critical in a way that would give higher-end estimates whenever possible. If they're vastly underestimating things, that's a concern regardless of the merits or demerits of the procedures simply because we can't possibly measure the outcomes on things that we don't know are happening.
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