Health
'Gender-affirming' breast removal surgeries may have been performed on hundreds of young girls since 2017
Since 2017, hundreds of females age 12 and younger with gender dysmorphia have undergone double mastectomies, according to analysis released by the Manhattan Institute this week.
The breast removal surgery, sometimes called “top surgery,” aims to create a “more masculine-looking chest,” as stated on Cleveland Clinic’s website.
Leor Sapir, PhD, a fellow at the Manhattan Institute whose areas of research include pediatric gender medicine, shared that anywhere from 5,288 to 6,294 double mastectomies were performed on girls under age 18 between 2017 and 2023 — and that 50 to 179 of those girls were just 12 years old or younger.
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This was based on analysis of an “all-payer national insurance database,” including patients who were previously diagnosed with gender dysphoria and had the treatment covered by insurance, Sapir wrote in an article revealing the findings.
The actual numbers could be higher, the Manhattan Institute claims, because researchers did not include patients who paid for the procedure themselves without submitting an insurance claim.
“The out-of-pocket costs of ‘top surgery’ can be as low as $3,000, a sum many middle-class families can afford,” Sapir wrote.
If any procedures were entered under different codes for billing, those would also not show up.
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Prior research has suggested different numbers.
An October 2022 study led by Vanderbilt University School of Medicine — published in JAMA Network — found that there were only 489 top surgeries performed on adolescents in 2019.
Since 2017, hundreds of females 12 and younger with gender dysmorphia have undergone double mastectomies, according to data analysis. (iStock)
In August 2023, however, researchers from Columbia University College of Physicians and Surgeons and the Department of Obstetrics and Gynecology at University of Southern California found that 3,678 minors received “gender-affirming surgery.”
That study was also published in JAMA.
Those studies both used different and more limited data sources than Manhattan Institute’s study, the company told Fox News Digital.
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In June, the Biden administration spoke out against gender-affirming surgery for transgender minors for the first time, as reported by The 19th.
“These are deeply personal decisions and we believe these surgeries should be limited to adults,” a White House spokesperson said in an email, according to the outlet.
“We continue to support gender-affirming care for minors, which represents a continuum of care, and respect the role of parents, families and doctors in these decisions.”
‘Of deep concern’
Psychologists have spoken out about the mental health consequences of these types of procedures — including Dr. Jonathan Alpert, a Manhattan-based psychotherapist and author.
“Taking a scalpel to a psychological disorder is of deep concern to me, especially when it comes to minors,” he told Fox News Digital.
Psychologists have spoken out about the mental health consequences of certain types of surgeries. (iStock)
Alpert said he takes issue with the phrase “affirming care and treatment.”
“What does it really mean to affirm?” he asked. “In many cases, I have seen people suffer significantly because they have sought treatment from therapists who do just that — affirm.”
“Taking a scalpel to a psychological disorder is of deep concern to me, especially when it comes to minors.”
“They nod their heads, agree with everything their patient says, and validate all their thoughts, feelings and behaviors — even if it’s clearly unhealthy.”
While it’s normal for kids and teens to question their evolving feelings about gender identity, Alpert said, “they are being rushed into gender-affirming treatment and surgeries, rather than having their thoughts explored and challenged.”
While it’s normal for kids and teens to question their evolving feelings about gender identity, “they are being rushed into gender-affirming treatment and surgeries, rather than having their thoughts explored and challenged,” a psychotherapist said. (iStock)
“This unhealthy trend can unwittingly trap therapy patients in a cycle where the patient relies heavily on the therapist to feel good and continue to get validation, and the therapist relies on the patient to maintain their business.”
Developmental concerns must be considered, the doctor emphasized, as minors are still undergoing physical and emotional changes.
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“Surgery is not appropriate for a child’s ever-changing sense of identity,” Alpert said, warning of long-term psychological consequences.
“Depression, anxiety and substance abuse are chief among these concerns,” he added.
“‘Wait and see’ might be preferred over taking action, as regret could very well be a consequence of surgical intervention, especially if gender identity evolves,” a doctor said. (iStock)
It’s also important to ensure that the minors and their parents fully understand the implications of such a “drastic intervention,” according to Alpert.
“‘Wait and see’ might be preferred over taking action, as regret could very well be a consequence of surgical intervention, especially if gender identity evolves,” he warned.
Dr. Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at NYU Langone Medical Center, said his view is the same as the current policy in the U.K. — “which is that gender-affirming surgery, including mastectomies, should not be performed on minors.”
“There is too great a risk of [the patients] changing their minds later on,” he told Fox News Digital.
The doctor also warned of the potential long-term risk of puberty-blocking drugs on bones, fertility and mental health.
“‘Wait and see’ might be preferred over taking action, as regret could very well be a consequence of surgical intervention.”
“I think younger patients with gender dysphoria should be treated initially with psychotherapy and years spent exploring how they really feel — without the superimposition of politics or ideology,” Siegel added.
“I think way too many of these [procedures] are done in the U.S., as the data shows.”
Medical groups’ stances
Earlier this month, the American Academy of Pediatrics (AAP) reaffirmed its policy on supporting gender-affirming care for transgender youth, with plans to review new data and research that has been conducted since the original policy was released in 2018.
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The American College of Pediatricians (ACP) and allied groups styling themselves as “Doctors Protecting Children” have published a declaration urging mainstream American medical associations like the AAP to abandon support for gender-affirming care.
Hundreds of people attend the “1 Million March for Children” rally organized by the parents’ group “Hands off Our Kids” at Queens Park in Toronto, Ontario, Canada, on Sept. 20, 2023. (Mert Alper Dervis/Anadolu Agency via Getty Images)
“As physicians, together with nurses, psychotherapists and behavioral health clinicians, other health professionals, scientists, researchers, and public health and policy professionals, we have serious concerns about the physical and mental health effects of the current protocols promoted for the care of children and adolescents in the United States who express discomfort with their biological sex,” the declaration states.
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The American Society of Plastic Surgeons (ASPS), for its part, provided the below statement to Fox News Digital on Thursday.
“ASPS does not issue policies favoring or opposing any surgical procedure. The Society does issue Evidence-Based Clinical Practice Guidelines, which provide recommendations for patient care based on the best available evidence in the scientific literature. To date, ASPS has not issued a clinical practice guideline on gender surgery for adolescents or adults. We are currently in the stage of assessing the available evidence regarding gender surgery in minors, which, as we stated, is generally viewed as low quality/low certainty.”
Fox News Digital also reached out to the AAP and the American Gynecological & Obstetrical Society (AGOS) for comment.
Chris Pandolfo of Fox News Digital contributed reporting.
Health
Brain Health Challenge: Try a Brain Teaser
Welcome back! For Day 4 of the challenge, let’s do a short and fun activity based around a concept called cognitive reserve.
Decades of research show that people who have more years of education, more cognitively demanding jobs or more mentally stimulating hobbies all tend to have a reduced risk of cognitive impairment as they get older.
Experts think this is partly thanks to cognitive reserve: Basically, the more brain power you’ve built up over the years, the more you can stand to lose before you experience impairment. Researchers still don’t agree on how to measure cognitive reserve, but one theory is that better connections between different brain regions corresponds with more cognitive reserve.
To build up these connections, you need to stimulate your brain, said Dr. Joel Salinas, a neurologist at NYU Langone Health and the founder and chief medical officer of the telehealth platform Isaac Health. To do that, try an activity that is “challenging enough that it requires some effort but not so challenging that you don’t want to do it anymore,” he said.
Speaking a second language has been shown to be good for cognition, as has playing a musical instrument, visiting a museum and doing handicrafts like knitting or quilting. Reading is considered a mentally stimulating hobby, and experts say you’ll get an even bigger benefit if you join a book club to make it social. Listen to a podcast to learn something new, or, better yet, attend a lecture in person at a local college or community center, said Dr. Zaldy Tan, the director of the Memory and Healthy Aging Program at Cedars-Sinai. That adds a social component, plus the extra challenge of having to navigate your way there, he said.
A few studies have found that playing board games like chess can be good for your brain; the same goes for doing crossword puzzles. It’s possible that other types of puzzles, like those you find in brain teaser books or from New York Times Games, can also offer a cognitive benefit.
But there’s a catch: To get the best brain workout, the activity should not only be challenging but also new. If you do “Wordle every day, it’s like well, then you’re very, very good at Wordle, and the Wordle part of your brain has grown to be fantastic,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School. “But the rest of your mind might still need work.”
So play a game you’re not used to playing, Dr. Selwa said. “The novelty seems to be what’s driving brain remodeling and growth.”
Today, we want you to push yourself out of your cognitive comfort zone. Check out an online lecture or visit a museum with your challenge partner. Or try your hand at a new game, below. Share what novel thing you did today in the comments, and I’ll see you tomorrow for Day 5.
Health
Popular intermittent fasting diets may not deliver the health benefits many expect
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Time-restricted eating has gained popularity in recent years, but a recent study suggests that intermittent fasting — while effective for weight loss — might not live up to the hype in terms of wider benefits.
The small German study found that participants who were placed on two different time-restricted eating schedules lost weight, but experienced no improvement in blood glucose, blood pressure, cholesterol or other key cardiometabolic markers.
The participants included 31 overweight or obese women. One group ate between 8 a.m. and 4 p.m. and the other group ate between 1 p.m. and 9 p.m. for a two-week period, while maintaining their typical caloric intake, according to a press release.
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The findings, which were published in the journal Science Translational Medicine, suggest that the widely touted cardiometabolic benefits of intermittent fasting may be a result of eating fewer calories rather than meal timing, the researchers say.
The participants also showed a shift in their circadian rhythms (sleep/wake cycles) when they were placed on the time-restricted eating schedules, but the associated health impacts are not known.
A recent study suggests that intermittent fasting — while effective for weight loss — might not live up to the hype in terms of wider benefits. (iStock)
The study did have some limitations. Some researchers have cast doubt on the significance of the study due to its small size.
“It is severely underpowered to detect any difference, considering how gentle the intervention is,” Dr. Dr. Jason Fung, a Canadian physician, author and researcher, told Fox News Digital. He also noted that the participants were fasting for 16 hours a day instead of the normal 12 to 14 hours.
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Lauren Harris-Pincus, a registered dietitian nutritionist in New Jersey, agreed that the findings could be due to the fact that there was no intentional caloric restriction, and reiterated that the sample size is “quite small.”
“As a registered dietitian, I only recommend time-restricted eating when it is carefully planned and shifted earlier within the day,” Harris-Pincus, who was not involved in the study, told Fox News Digital.
One group in the study ate between 8 a.m. and 4 p.m. and the other group ate between 1 p.m. and 9 p.m. for a two-week period, while maintaining their typical caloric intake. (iStock)
“Only one in 10 Americans consumes the recommended number of fruits and veggies, and 93% miss the mark on fiber goals. Restricting an eating window necessitates more careful meal planning to ensure adequate intake of macro- and micronutrients.”
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The expert also cautioned that skipping breakfast to enable a later eating window may result in lower intake of the “nutrients of concern” in the American diet, including calcium, potassium, fiber and vitamin D.
Looking ahead, the researchers said more studies are needed to explore the effects of time-restricted eating over longer time periods. It also remains to be seen how the combination of caloric restriction and time-restricted eating may affect outcomes. Future research could also explore how different populations may respond.
“I only recommend time-restricted eating when it is carefully planned and shifted earlier within the day.”
Dr. Daryl Gioffre, a gut health specialist and celebrity nutritionist in New York, noted that the study didn’t account for critical factors like chronic stress, sleep quality, medications, hormone status and baseline metabolic health.
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“All of these can significantly blunt fat loss and cardiometabolic improvements,” Gioffre, who also was not involved in the research, told Fox News Digital.
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“Cortisol, the body’s primary stress hormone, is naturally highest in the morning, which overlaps with one of the fasting windows studied,” he went on. “If stress is elevated, cortisol alone can block fat burning, disrupt blood sugar regulation, and mask cardiovascular improvements, regardless of calorie intake or eating window.”
Growing research shows intermittent fasting — when done correctly and sustained over time — can improve insulin regulation, reduce inflammation, support fat loss and contribute to better cardiovascular health, an expert said. (iStock)
Gioffre did agree, however, that growing research shows intermittent fasting — when done correctly and sustained over time — can improve insulin regulation, reduce inflammation, support fat loss and contribute to better cardiovascular health.
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“These are outcomes that simply cannot be captured in a short, stress-blind study like this,” he added.
Fox News Digital reached out to the researchers for comment.
Health
Brain Health Challenge: Workouts to Strengthen Your Brain
Today, you’re going to do perhaps the single best thing for your brain.
When I asked neurologists about their top behaviors for brain health, they all stressed the importance of physical activity.
“Exercise is top, No. 1, when we’re thinking about the biggest bang for your buck,” said Dr. Gregg Day, a neurologist at the Mayo Clinic.
Numerous studies have shown that people who exercise regularly tend to perform better on attention, memory and executive functioning tests. There can be a small cognitive boost immediately after a workout, and the effects are sustained if people exercise consistently. And while staying active can’t guarantee you won’t develop dementia, over the long term, it is associated with a lower risk of it.
Researchers think that moving your muscles benefits your brain in part because of special signaling molecules called exerkines. During and after a workout, your muscles, fat and other organs release these molecules into the bloodstream, some of which make their way up to the brain. There, those exerkines go to work, helping to facilitate the growth of new connections between neurons, the repair of brain cells and, possibly, the birth of new neurons.
Exercise also appears to improve blood flow in the brain. That ramps up the delivery of good things to brain cells, like oxygen, glucose and those amazing exerkines. And it helps remove more bad things, namely toxic proteins, like amyloid, that can build up and damage brain cells, increasing the risk for Alzheimer’s.
All of the changes brought on by exercise are “essentially allowing your brain to age more slowly than if you’re physically inactive,” said Kirk Erickson, the chair of neuroscience at the AdventHealth Research Institute.
The benefits are particularly pronounced in the hippocampus, a region critical for learning and memory. In older adults, the hippocampus shrinks 1 to 2 percent a year, and it is one of the main areas affected by Alzheimer’s. Researchers think physical activity helps to offset some of that loss.
The best exercise you can do for your brain is the one you’ll do consistently, so find something that you enjoy and that fits easily into your life.
Walking is one option; two neurologists I spoke to said they got their exercise in by walking at least part of the way to their offices. Recent research suggests that just a few thousand steps a day can reduce the risk of dementia. It’s important to get your heart rate up, though, so “walk as though you’re trying to get somewhere on time,” said Dr. Linda Selwa, a clinical professor of neurology at the University of Michigan Medical School.
Or you could try swimming, cycling, Pilates, weight lifting, yoga, pickleball, dancing, gardening — any type of physical exertion can be beneficial.
If the thought of working out feels like a drag, try pairing it with something else you enjoy doing, like listening to an audiobook. This is a trick that Katherine Milkman, a professor who studies habits at The Wharton School of the University of Pennsylvania, calls “temptation bundling.”
For Day 3, we’re asking you to spend at least 20 minutes exercising for your brain. Go for a walk with your accountability partner if they’re nearby. (If not, call them and do a walk-and-talk.) Or let us find you a new workout to try, using the tool below. As usual, we can all meet in the comments to catch up and check in.
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