A new study in the Journal of the American Medical Association, Pediatrics suggests that adolescent girls and young women who experience discomfort and distress after developing breasts would benefit from undergoing a double mastectomy.
Breast-binding involves flattening one’s breast tissue by wearing tightly fitting cloth or specific undergarment products to give the appearance of a masculine chest. It can be associated with side effects like fractured ribs, pain, and difficulties breathing. As a result, surgical removal of the breasts is seen as a preferable, permanent solution.
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The current study recruited patients ranging in age from 13 to 24 years old. The average age of participants was reported to be 18. All were presenting for the purposes of receiving treatment in the context of “gender-affirming” care. Most were undergoing testosterone, regardless of whether they were included in the treatment (surgical) group or the control group (and thereby not receiving surgery).
Study participants were surveyed at enrollment and three months post-operation. Results suggested an improvement in patients’ body image, chest-related dysphoria, and congruence in gender identity. The study concluded, “There is no evidence to support delaying surgery for eligible patients based on age.”
Methodologically speaking, any study assessing outcomes related to transition would benefit from having a control group consisting of individuals with gender dysphoria who are not in the process of transitioning or who are perhaps attempting to resolve their bodily discomfort through other avenues, like therapy. It’s possible that girls who did not transition would show mental health outcomes similar to, or better than, those who did. In today’s climate, however, such a control group could not exist because withholding transition would be deemed harmful.
The authors reported that one-year follow-up data are in the process of being collected to determine the long-term effects of surgery. I wonder whether this is an adequate amount of time for a young person to reflect on having a double mastectomy.
I am also skeptical as to whether there is a woman out there who hasn’t felt discomfort in her body after going through puberty. An entire generation of girls is now being told by society that a once-normal phase in life would benefit from surgical treatment.
It’s been a curious process, observing the way some supporters of gender-affirming care have clung to claims that surgeries are not happening in minors. Going forward, they’ll have yet more ammunition when arguing why children should be allowed access.
Dr. Debra Soh is a sex neuroscientist, the host of The Dr. Debra Soh Podcast, and the author of The End of Gender: Debunking the Myths About Sex and Identity in Our Society.
