TransActive doubles down on fast-track transition policy with clueless reblog of ex-client who decries their lack of gatekeeping

UPDATE June 12, 2016: Jenn Burleton, Director of TransActive Gender Center, has responded. See this post for details.


Regular readers will recall ”In praise of gatekeepers,” the 4thWaveNow interview with Cari, a former teen client of TransActive Gender Center in Portland, OR. In her interview, Cari, now 22, told us that TransActive “counselors” made it far too easy for her to  be referred for medical transition at age 16; she started testosterone at 17 and moved on to “top surgery” (double mastectomy) soon thereafter. In retrospect, Cari wishes there had been a lot more gatekeeping at TransActive—especially because her counselor never suggested investigating whether Cari’s history of trauma and comorbid mental health issues might have played a part in her desire to transition.

A few days ago, Cari wrote a post pointedly criticizing TransActive’s gatekeeper-free teen transition policies.

Kari on TA

Kari on TA addendum

Whoever manages TransActive’s official Tumblr blog reblogged Cari’s post, but instead of addressing her concerns, they simply doubled down on their propaganda:

Kari on TA 2


Either this TransActive employee has trouble with reading comprehension, or they just figured that spamming Cari’s Tumblr followers with their superRAD!-no-mean-cis-gatekeeping policy would somehow drown out her silly concerns. But either way, as Cari told 4thWaveNow, “This should give people some insight into how TransActive treats detransitioned ex-clients. Whoever runs their social media accounts has so little empathy, they reblogged a post by a woman who was irreparably harmed by their org and acted like I was praising their services.

Additionally, Cari told 4thWaveNow that she had previously written to TransActive to ask what services they could provide to someone who was unhappy with transition and wanted some support for  detransitioning. TransActive’s response was to send Cari a list of therapists—all of whom were trained by TransActive, and one of which is an employee of the LLC, BraveSpace, a newly established trans youth counseling org which has replaced TransActive’s in-house therapy program.  “This concerns me,” Cari told us. “While I’m speculating here, I know many detransitioned women I’ve spoken with have issues with therapists who think they are simply experiencing “internalized transphobia” or social pressure and therefore try to convince them to retransition.”

Given TransActive’s track record of spurring kids and teens on to hormones and surgeries—as well as the complete absence of any acknowledgement that regretters or detransitioners exist (let alone listing any resources for detransitioners on their very professional looking website), it’s unlikely an unhappy ex-client like Cari would find a sympathetic ear from any of the “counselors” affiliated with TransActive.

A couple of days ago, Cari tagged TransActive (i.e., she invited them to respond) in a followup post with a very clear message about the failings of her former TransActive “counselor” Sheryl:

Kari on TA 4.jpg

As of this writing, TransActive hasn’t reblogged nor replied to Cari’s latest post. Maybe they’ll be better at taking a hint with pictures than with words? Stay tuned.

Kari on TA 3

Mom forces insurance company to cover double mastectomy for her 15-year-old, with support of WPATH & Dan Karasic, MD

A 15-year-old cannot vote, sign a contract, drink, or get a tattoo. You can’t rent a car until you’re 25 years old. And in the US, the FDA has just proposed regulations to prevent minors from even using tanning beds.

Why all the restrictions? Well, last I checked, developmental psychologists, cognitive scientists, and informed members of the general public were aware that adolescents don’t have the cognitive wherewithal—the judgment, foresight, or awareness of future consequences–to make major, life-changing decisions, let alone suffer a bad sunburn. There has been so much replicated behavioral and neuroscientific research done on the subject of executive function in young people that it’s now considered settled science.

So the changes that happen between 18 and 25 are a continuation of the process that starts around puberty, and 18 year olds are about halfway through that process. Their prefrontal cortex is not yet fully developed. That’s the part of the brain that helps you to inhibit impulses and to plan and organize your behavior to reach a goal.

And the other part of the brain that is different in adolescence is that the brain’s reward system becomes highly active right around the time of puberty and then gradually goes back to an adult level, which it reaches around age 25 and that makes adolescents and young adults more interested in entering uncertain situations to seek out and try to find whether there might be a possibility of gaining something from those situations…one of the side effects of these changes in the reward system is that adolescents and young adults become much more sensitive to peer pressure than they they were earlier or will be as adults.

Another very readable (and amusing) article, “Dude, where’s my frontal cortex?,” sums it up thusly:

The frontal cortex is the most recently evolved part of the human brain. It’s where the sensible mature stuff happens: long-term planning, executive function, impulse control, and emotional regulation. It’s what makes you do the right thing when it’s the harder thing to do. But its neurons are not fully wired up until your mid-20s.

But the gender specialists at the helm of the World Professional Association for Transgender Health (WPATH) apparently never received the decades-old bulletin on adolescent brain development (or lack thereof), or so it seems. In the Brave New World of transgender “health care,” a 15-year-old can ask for and receive a double mastectomy, with mom’s blessing and collaboration. (In Oregon, a kid can decide to have her breasts removed whether mom approves or not, thanks to trans activists like Jenn Burleton and TransActive).

Last July, a mom posted to the WPATH public Facebook page, looking for advice on how to get “chest reconstruction” for her 15-year-old (i.e.,  double mastectomy. Why can’t these people use actual medical terminology, even amongst themselves? Do the providers and parents also get “triggered” by seeing a reference to female anatomy?)

[Note: For privacy reasons, I have chosen not to directly link to the (nevertheless) publicly viewable thread on the WPATH Facebook page.]

Seems mom’s insurance company balked at  covering elective removal of breast tissue in people under 18.

WPATH mom of 15 yr old

Psychiatrist Dan Karasic, one of the key contributors to the WPATH Standards of Care (SOC), and provider at the San Francisco Center for Excellence in Transgender Health, is happy to help, citing the SOC chapter and verse (page 21 to be exact) that WPATH fully supports “chest surgery” for minors, although it’s apparently still “too limiting” for his taste:

WPATH mom 2

Mom has already picked out the surgeon for her child, and another commenter, former Transgender Law Center employee Jason Tescher, recommends she try to “force” her insurance company to cover the cost (per the doctor’s website, $8500):

tescher

The WPATH thread went dark until today (more on that in a minute). But who is Dr. Mangubat?

mangubat

In addition to being a popular presenter at Gender Odyssey, the yearly shindig for all things transgender, Dr. Mangubat is apparently well known as a surgeon who’s an easy touch for those looking for double mastectomies. As recently as six days ago,  underage top surgery seekers on Reddit were recommending him:

Also, the surgeon I went to (Dr. Mangubat) did not require any kind of letter and I don’t think he requires patients to be on T either, but I could be wrong on that. It was as easy as emailing his office to set up a consultation and then I was immediately able to schedule the surgery.

As to the mom’s efforts to get insurance to cover the removal of her child’s breasts,  an update appeared moments ago on the WPATH thread. Mom shares her good news: the insurance company has agreed to reimburse her for the double mastectomy that they “couldn’t wait for” and had done in August.

insurance appeal

Dr. Karasic couldn’t be happier.

karasic happy

It’s likely only a matter of time before insurance coverage for teen surgery will be the norm. The Obama administration recently proposed new rules that will require all insurance companies to pay for “transition” services. One wonders just how many “identities” the transgender umbrella will cover when it comes to federally mandated health care services?

The entire Reddit thread that references Dr. Mangubat  (as well as two other surgeons I’ve previously written about–Dr. Curtis Crane in San Francisco, and Dr. McLean in Ontario) is worth reading in this regard, because it’s primarily about “nonbinary” people who don’t identify as FTM getting access to “top surgery” on demand–exactly what providers like Dan Karasic promote and what is already happening, apparently, in San Francisco at taxpayer expense, as I detailed in a recent post.

As I also discussed in that post, Karasic is a major WPATH player pushing for the elimination of “gender dysphoria” as a requirement for “transition” services; he wants to  replace GD with a new diagnostic code, “gender incongruence,” which would do away with the need for any distress, dysphoria, or disorder but still allow for billing for what amounts to a lifestyle choice–for anyone who claims “gender incongruence,” on demand.

So we know Karasic and WPATH are OK with 15-year-olds who ID as FTM undergoing irreversible surgeries. Does he also believe, as he does for adult patients, that a 15-year-old (or 13-year old?) who identifies as genderqueer, gender fluid, or non-binary should ALSO get insurance-funded double mastectomies?