Transgender flag
© Getty Images / Drew Angerer
For trans people, the quest to create the body that matches their perceptions is a life devoted to drugs and doctors. For Big Pharma, the challenge is to serve the interests of this group without being blinded by big profit.

Western society is currently witnessing something of a medical revolution, which many have denounced as a dangerous experiment, whereby individuals, acting as their own medical experts, readily self-diagnose themselves as 'transgender.' What often follows is a regimen of powerful drugs and radical surgical techniques in order to 'fix the gender' they were mistakenly 'assigned' at birth.

Has mankind finally outsmarted Mother Nature?

While it is still too early to answer that question, one thing remains clear: members of the growing transgender demographic who opt to undergo 'gender confirmation surgery' inherit a lifetime relationship with the medical industrial complex. And, as is the case with most medical treatment in the United States, those services do not come cheap.

A new frontier in medicine - and profit

For the uninitiated, the medical techniques now available to transgender men, women and increasingly children will probably sound absolutely shocking, and more so when it is realized how little research is available on the subject.

RT reached out to the Kelsey Coalition, a non-partisan group that works to "protect young people from medical and psychological harms," to better understand the many unseen chutes and ladders a transgender person must pass before acquiring their dream body. The following is a brief primer into this brave new world of gender makeovers, which pushes the boundaries of science to the extremities.

"Usually, the process starts with puberty blockers (if the young person's puberty has not been completed); once the young person confirms their decision to transition, they receive cross-sex hormones (and, for males, also a blockade of testosterone produced by the testes), and they may opt for subsequent surgeries (biological males have their testes removed, their penis is inverted and a neo-vagina is constructed, and they could also get breast implants; for biological females, breasts are amputated, the ovaries and uterus removed, while a neo-penis and testes are constructed, often from tissues taken from their forearm or leg).

In the case of older teens, the process starts with cross-sex hormones and proceeds as described (they don't get puberty blockers if their puberty is fully completed). The procedures all have formal medical names (e.g., hysterectomy; mastectomy, oophorectomy, etc.)..."

And these procedures are not risk-free. According to a report by the American Heart Association, "people receiving hormone therapy during gender transition had an elevated risk for cardiovascular events, such as strokes, blood clots and heart attacks."

With the available data, Kelsey estimates that the total medical bill for gender surgery per year in the United States comes to just over $1.3 billion. That figure, however, is "most likely conservative," they say, as it is based on 10,000 known cases; the actual number of cases could be many times higher (This link to a US-based transgender surgery clinic provides some idea of the costs involved).

Dr. Curtis Crane, a plastic surgeon who performs transgender surgery in Austin, Texas, discussed with RT the cost of gender confirmation procedures. He revealed that a biological female undergoing an operation to 'become male' can cost between $150,000 to $200,000, while the cost for a male-to-female operation is between $80,000 and $100,000. However, these are just the prices of the initial operations.

After surgery, patients face a lifetime of purchasing estrogen or testosterone hormones, with all of the inherent risks mentioned above, while routine medical checkups are also a priority. These additional expenses can quickly add up to several hundred dollars per month, depending on each individual case.

When asked if the pharmaceutical industry stands to profit from the upsurge of interest in the transgender movement, Dr. Crane responded: "Yes, I believe so."

"Gender dysphoria has been a much more common diagnosis in the last few years compared to previously," he noted. "I think with that we'll see a demand for cross-sex hormones - estrogen for a male-to-female patient, testosterone for a female-to-male patient."

Michael Laidlaw, MD, a physician board certified in Endocrinology, wrote that the medical industry stands to gain a "windfall" from patients seeking out treatment for 'gender dysphoria,' the medical term for the condition.

"Big pharma, big hospital systems, surgical centers and doctors seek to gain huge profits. Lupron [a puberty blocker prescribed to children] monthly is $775 alone. That's a $27,000 'pause button' at 5 years [of age]," Laidlaw wrote. "Multiply this together with the huge rise in cases documented or observed in Western nations and a major windfall is to be had."

Incidentally, Laidlaw and his colleagues discovered that in 2017 the Children's Hospital Los Angeles had lowered the minimum age for cross-sex hormones from 13 to eight years.

"Imagine giving eight-year-old girls testosterone," Laidlaw remarked during a panel discussion organized by The Heritage Foundation. "They are in third or fourth grade. This is unbelievable. But this is going on."

While the quest for profit is not an inherently negative thing, the spectacle of powerful medical and pharmaceutical companies cashing in on the transgender phenomenon naturally arouses suspicion, especially when so little research data is available into the long-term and even short-term effects of these radical new procedures, which are now available to very young children.

And here is where the medical community finds itself at war with itself.

'No need to be a teen to know your sexual identity'

Advocates of medical transitioning believe that the associated risks involved in the process do not compare to the risk of living a life trapped inside a body that does not conform to a person's sexual identity. At the same time, age does not seem to play a factor in the decision-making process.

In schools across the country, children as young as five and six years-old - almost too young to lace up their own shoestrings - are being told stories about individuals who have been 'born in the wrong body'. But the issue goes beyond mere books. Although Big Pharma is not directly responsible for what is being taught in the US school system, of course, such early instruction prepares the soil, as it were, for these children to not only accept such ideas as natural, but to pursue 'gender reassignment' later in life. And, as it turns out, 'later in life' is sooner than one might imagine.

When 'transgender' children are just eight and nine years-old, they are being placed on puberty suppressors. In the state of Oregon, meanwhile, girls as young as 15 years old can have a mastectomy or a hysterectomy without parental approval. Even earlier, with parental consent. After the age of 18, these patients may wish to have so-called "bottom surgeries," which involve the removal of the penis in born men, and the creation of an artificial penis in born females.

When asked if there are inherent risks associated with placing children on the fast track for hormone treatment and sex-change operations, Dr. Crane responded that it is possible for extremely young children to know their true 'gender identity.'

"They aren't even teens, but a person knows their gender identity at a very young age," he claimed. "At two and three years old you start seeing differences in males and females, and so it's not necessarily true that you have to wait until someone's a teen for them to know whether they are truly male or female."

Unsurprisingly, there is some extremely outspoken criticism of such opinions, especially with regard to children.

'Psychiatric counseling is impermissible'

The opponents of "gender manipulation" argue that the medical community is - much like in the days when frontal lobotomies were considered an acceptable way of treating mental disorders - attempting to treat a psychological condition with non-irreversible surgical techniques.

Paul McHugh, a psychiatrist from Johns Hopkins University, believes that the increase in gender confusion is mostly caused by the "psychological and psychosocial problems these people have," he said, in an interview with The College Fix.

One reason why so many people who opt for gender surgery remain unhappy following the procedure, McHugh hypothesizes, is that they discover too late that "they did not address the primary problem," which was some unaddressed mental health issue.

Other medical analyses point to similar conclusions. A recent study in the American Journal of Preventive Medicine, for example, proved that some 80 percent of US college students who are transgender suffer from some sort of previous mental disorder.

Meanwhile, in a letter (Dec. 2018) to The Lancet, a prestigious medical journal, the entire notion that sex is an arbitrary notion 'assigned' - sometimes incorrectly - by doctors at birth, while only the individual knows with certainty his or her 'true' gender - was dismissed as essentially bad science.

"Sex has a biological basis, whereas gender is fundamentally a social expression,"wrote Dr. Richard Byng and other members of the Community and Primary Research Care Group. "Thus, sex is not assigned - chromosomal sex is determined at conception and immutable."

"Distress about gender identity must be taken seriously...but the impacts of powerful, innovative interventions should be rigorously assessed," the doctors argued. "The evidence of medium-term benefit from hormonal treatment and puberty blockers is based on weak follow-up studies."

Perhaps the most astonishing thing about children who believe they were somehow born in the wrong bodies, however, is that they will not be provided with any psychiatric counseling to address their youthful beliefs. Why not? Because current medical protocol demands it.

The child's self-diagnosis that he or she is the opposite sex must be accepted at face value by the medical practitioner, who is strongly advised by leading medical and psychological organizations that "transgender identities and diverse gender expressions do not constitute a mental disorder."

This non-interventionist approach, known as the 'gender-affirmative care model' (GACM), is arguably the primary cause for so many children entering into a lifetime of expensive treatment.

Here is what one mother, 'Elaine', whose daughter is in the process of transitioning into a male, had to say about the process, during a panel discussion organized by The Heritage Foundation.

"If you take your child to a clinic to seek help, affirmative care means the therapist must follow the child's lead. Professionals must accept a child's gender identity. In fact, this is the law in many states. Under 'conversion therapy' bans, questioning a child's gender identity is now illegal." The comments in their entirety may be viewed here.

Without the appropriate psychological counseling to address a child's possibly confused belief, parents are left with little choice but to begin a highly traumatic and very expensive journey on the road to gender transitioning. And here is where the question of the corporate profit motive playing a role in this highly controversial approach must be revisited.

A conflict of corporate interest?

Even before Caitlyn Jenner, who has been called the most famous transgender woman in the world, graced the cover of the May 2015 issue of Variety magazine with the headline 'Call Me Caitlyn', there has been an explosion of interest in gender reassignment procedures. Aside from clinics specialized in the operations, regular hospitals are also getting in on the action.

According to the American Society of Plastic Surgeons, doctors performed 8,304 sex change operations in 2017; in 2018, that number had surged to 9,576. That upward trend is expected to translate into $968 million by 2024, according to Market Watch, citing the Global Sex Reassignment Surgery Market Forecast. That translates into a compound annual growth rate of 24.5 percent during the projection time period.

Thus, with many millions of dollars in profit on the line, do the medical community and pharmaceutical companies have an incentive to promote risky hormonal treatment, together with the radical surgical procedures, to the public?

Something similar is happening now in the United States with the deadly opioid epidemic. Big Pharma played no small part in getting these powerful painkillers to patients regardless of the safety hazards involved. According to The Kelsey Coalition, the situation with regards to hormone treatment is nearly identical.

By way of example, the for-profit advocacy group cited Endo Pharmaceuticals, a pill manufacturer, which lost millions of dollars in settling opioid lawsuits and was forced to abandon production of the pill. Instead, as the Kelsey Coalition told RT, the company is now "focusing on their testosterone line of products." That may not sound like such a terrible thing, until it is realized that "almost every vocal pro-medicalization 'gender expert' in the US has an association with Endo Pharmaceutical as an advisor," the group claimed.

The Kelsey Coalition specifically mentioned Dr. Joshua Safer, executive director of the Mount Sinai Center for Transgender Medicine and Surgery, New York, who speaks out on the purported benefits of puberty suppressors. Safer has reported that he'd received consulting fees from Endo Pharmaceuticals and that his wife is an employee of Parexel, the second largest clinical research organization in the world.

At the same time, the organization that's writing the treatment guidelines for transgender patients, The World Professional Association for Transgender Health (WPATH), is run by the for-profit company Veritas, which also appears to have serious conflicts of interest among its members.

Veritas sits on the advisory boards for a number of organizations, including Lipocrine Pharma, a company that produces hormones, with a particular focus on testosterone. This is significant, considering that, of the one million American youth who currently identify as transgender, many of them are adolescent girls with atypical, adolescent-onset gender dysphoria.

Testosterone is the 'treatment' that these young women who suddenly develop a transgender identity are prescribed in order to develop more male-like appearances. And, as mentioned earlier, these hormones place the user at risk of heart attacks, strokes, and cancer.

Veritas also sits on the Board of Intuitive Surgical, producers of robotic assisted surgical devices. This equipment has various medical usages, including the removal of the uterus, ovaries and vaginal canal, in preparation for the construction of the 'neo-penis' (artificial penis) for females transitioning to males. The study is available here.

So here we have WPATH, an organization that has an advisory role in determining what treatments are proven safe, being run by Veritas, a company that acquires large profits when pharmaceutical companies and surgeons implement expensive medicines and procedures provided by the very firms they represent. That certainly sounds like a conflict of interest.

Is this the reason WPATH states that psychological therapy is not effective for those who identify as transgender, and instead promotes the unproven belief that sex-reassignment is the only safe and effective way of treating gender dysphoria?

As the opponents of transgender reassignment unanimously argue, gender dysphoria remains poorly understood and has never been adequately studied. In other words, there is a very good chance that with the appropriate amount of psychological counseling, gender dysphoria would likely resolve over time with the right amount of psychological support. Yet, for reasons that continue to baffle much of the medical community and the public at large, supporters of gender reassignment have no desire for that approach to become the norm.

As such, it seems that people will continue to suspect that the real interests of the medical industrial complex are not the health and wellbeing of the transgender community, but rather their own enrichment. That skepticism does the transgender community no favors.