United States: Pediatric Malnutrition
Surgical operations are useless and may cause lifelong suffering
(Chicago) - Doctors in the United States continue to perform unnecessary medical operations, which can permanently hurt children, Human Rights Watch and Interact said in a report released today.
Despite decades of controversy over procedures, doctors continue to perform gonadal surgery, internal sex organs and child genitalia at a young age who are not allowed to participate in the decision, although surgery can be safely delayed.
The 160-page report, "I Want to Be as Nature was created by me: Nature of unnecessary surgery for gays in the United States , " examines the physical and psychological damage to medically unnecessary surgery for bisexuals born with chromosomes, glands, and genitalia that are different from those seen As usual for boys and girls. The report deals with the controversy surrounding operations within the medical community and pressure on the parents to choose the surgical procedure .
Dual-sex is not considered a presence but is widely misunderstood. They were called "female genital mutants" (a term that is now considered disdainful and obsolete). Doctors perform surgery for bisexual children - often in infancy - for what they consider to facilitate their "natural" growth, based on a medical theory common in the 1960s. The results are often catastrophic, the supposed benefits are largely uncertain, and there are seldom urgent health considerations that require urgent and irreversible intervention .
"Unnecessary surgery on a bisexual baby always has serious physical and psychological consequences," said Kimberly Ziselman, a dual-sex woman and executive director of Interact, although medical advocates have alerted the medical community about the damage caused by these procedures for decades. Doctors continue to offer these surgeries to parents as good options. "
Up to 1.7 percent of children are different from what is usually called a boy or girl. The chromosomes, gonads, and internal or external sexual organs of these children differ from social expectations. Some traits - such as non-typical external genitalia - appear at birth. Some others - such as gonads or chromosomes that do not match certain sex expectations - may appear later in life, and in some cases at puberty. The child can be raised as belonging to any sex without surgery. On the other hand, genital surgery or gynecomastia in young children early on the identification of their sexual identities the seriousness of the appointment of a wrong sex surgically .
Surgery for gonadectomy can lead to infertility without the consent of the patient, and therefore require lifelong hormone replacement therapy. The size or appearance of the child's genitals carries the risk of urinary incontinence, scarring, numbness and trauma. The irreversible procedures, the nerves that are cut can not grow, can limit scarring to the tissues of the options for future surgery .
Medical rules have evolved - especially with the increasing use of multidisciplinary teams working on "differences in sexual growth". Most doctors now agree that parents may prefer to leave their children's bodies intact. "We listen to adult patients who tell us they feel abused and mutilated, and that's very impressive," one of the teams told Human Rights Watch.
However, the field is still fraught with unequal, inadequate and fragmented standards of care - and wide differences among practitioners on how best to respect and protect the rights of their bisexual reviewers. Although some surgical interventions on bisexual children are not medically necessary without controversy, some surgeons in the United States are performing medically unnecessary exercises for bisexual children before they often begin to speak .
"The medical community has made progress in gender-specific care in recent decades, but unnecessary surgical operations on children and infants are still common, " said Kyle Knight , a researcher at Human Rights Watch who co-authored the report: "There is real pressure to adapt to life normally, But there is no evidence that the surgery is enough to facilitate this, and there is considerable evidence that it could cause irreversible damage for life. "
United Nations human rights bodies have increasingly condemned States around the world in recent years for not prohibiting unnecessary medical surgery for bisexual children. Said the Special Rapporteur of the United Nations on torture in the released 2013 report: "Children conveyers exposed to the characteristics of the sexes to determine their gender irreversibly, and to sterilize involuntary, and surgery is voluntary for the normalization of sexual organs ... with leaving them in the absence of a permanent and non - fertility Treatable, and inflict severe mental suffering. "
In July 2017, three former American surgeons wrote that they believed there was "insufficient evidence that growth with atypical sexual characteristics could lead to psychological damage". "Although there is some evidence that infant cosmetic surgery is necessary to reduce psychological damage, But the evidence shows that the surgery itself can cause severe physical damage irreversible and emotionally damaging. "
The report is based on in-depth interviews conducted by researcher Kyle Knight and Dr. Sugih Tamar-Matisse, a research physician and research consultant at Human Rights Watch, with 30 adults and 2 dual children, 17 parents of dual-sex children and 21 health care practitioners, including gynecologists , Endocrine, urinary tract, psychologists, and other mental health providers who work with bisexuals. The report also includes extensive academic review and provides available surgical data.
Many doctors told Human Rights Watch that while they are increasingly uncomfortable advising parents to choose these surgeries, operations are still taking place in their clinics. Parents said they still felt pressure from doctors to adopt these surgeries.
"The pediatricians are in a position of strength, if the issue is parents' fear, it is the problem that needs to be solved," said a doctor with endocrinology and a professor of Human Rights Watch who told Human Rights Watch that "it is not really a meaningless operation, and nothing is solved." "When we try to force people to only cultural norms and gender culture, there is a high probability that we will make some big mistakes and harm people irreparably," said a gynecologist in a team working on "differences in sexual growth."
"The doctors told us that it was important to have the surgery done immediately because our baby's growth would be traumatic," said the parents of an 8-year-old boy born with atypical genital organs: "What is the biggest shock, this kind of operation or growing slightly different?"
These and other parents told Human Rights Watch that the most useful resource for raising their children was to meet other parents and two adults in support groups.
The experience of those undergoing surgery and the principles of medical ethics suggest that specific surgical procedures should not be used for infants and young children unless there is evidence that the medical benefits of these procedures outweigh the potential harm, Human Rights Watch and Interact said. There are no simple evidence at present, despite decades of such operations.
The US government and medical agencies must end all surgical procedures that seek to alter the gonads, genitals or internal organs of children with atypical sexual characteristics and are too young to participate in the decision when such actions involve serious risks, Human Rights Watch and Interact said. , And can be safely postponed.
"Parents of children are often scared and confused about how best to protect their children from stigma," Kimberly Zislman said.
Region / Country United States of America