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.
Over the two and a half years following the 2022 rollout of the 988 national suicide prevention hotline, the rate of suicides among young people in the United States dropped 11 percent below projections, decreasing most sharply in states with a higher volume of answered 988 calls, a new study has found.
The findings, published today as a research letter in JAMA, compared suicide deaths from July 2022 to December 2024 with sophisticated mathematical projections that were based on historical trends. This yielded good news, with 4,372 fewer suicides of adolescents and young adults, ages 15 to 34, than had been projected.
To ensure that the decline was related to the use of the hotline, researchers at Harvard Medical School teased out the trends in states with high and low usage of the hotline. The findings were striking: The 10 states with the largest increases in 988 calls experienced an 18.2 percent reduction in observed suicides compared with expected suicides; in the 10 states with the lowest uptake, the reduction was smaller, 10.6 percent.
The results suggest that the government’s investment in the 988 rollout has translated into “a measurable reduction of deaths,” said Dr. Vishal Patel, a resident physician at Brigham and Women’s Hospital and one of the authors of the study.
“What our study has added,” he said, “is evidence for the deeper benefit of the program, and that is, that at the population level, among young people at least, suicide mortality is lower than it would have been without the program.”
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He added, “The implication of that is that sustained funding for this program matters.”
The United States rolled out the three-digit hotline with bipartisan support in July 2022, replacing a 10-digit hotline number, and augmented it with a $1.5 billion investment in crisis center capacity. Since its inception, the service has fielded more than 25 million contacts, according to the Department of Health and Human Services. The agency has asked Congress for $534.6 million to fund the program for 2027.
Last summer, the Trump administration terminated one element of the hotline, the Press 3 option for L.G.B.T.Q.+ callers. The Substance Abuse and Mental Health Services Administration said that the Press 3 option was being discontinued because it had exhausted its funding from Congress and that the hotline would “focus on serving all help seekers.”
But advocacy groups and policymakers protested the decision, and in testimony before the Senate on Tuesday, the health secretary, Robert F. Kennedy Jr., said his agency was planning to restore the Press 3 option.
Dr. Patel said his group had become curious about measuring the program’s effectiveness after Press 3 was eliminated. While call volume and satisfaction surveys suggested that 988 was succeeding, he said, the harder question was, “Did the creation of this 988 program, the transition from the old hotline to this hotline, actually move the needle on suicide mortality?”
Experts said it was difficult to tease out the beneficial effect of 988 from other things that changed in 2022, the year that the new hotline was created. Around that time, suicide prevention programs were being introduced in schools, in faith communities and on social media, but more important, the pandemic was ending.
“We were finally out of this crazy time, and there was a sense of optimism and hope,” said Jonathan B. Singer, a professor of social work at Loyola University Chicago and a co-author of “Suicide in Schools.” He called the downward trend in youth suicides “encouraging, but it is tempered by the fact that we don’t have a good explanation as to why.”
The authors acknowledged that their findings could not account for the influence of social and economic changes, changes in mental health services or public awareness about services.
But they did make comparisons to exclude other possible explanations. The authors looked for similar effects among American adults over 65, who are less likely to use the hotline. In that group, there was a reduction in suicides that exceeded expectations, but it was smaller, at just 4.5 percent.
To ensure the decline in suicides did not reflect a general improvement in young-adult mortality, the researchers tracked cancer deaths, and found there was no change. They also looked at the rates of suicide among young people in England, where no change had been made to the national crisis line in that time period; they found no reduction in youth suicides there.
Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, said she was persuaded that the hotline had contributed to the improvement in suicide rates, in part because it did not appear among English youths or in older Americans.
“To me, that really helps hone in that this might really be the differentiator,” she said. “We are seeing potentially a pretty significant decline in suicides among young people. For public policy, this is strong evidence to double down on that we are doing.”
Emily Hilliard, a senior press secretary at the Department of Health and Human Services, said H.H.S. and SAMHSA are “committed to ensuring that all Americans have access” the 988 line, which she said “clearly provides lifesaving support, helping millions of people every year.”
If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.
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A highly contagious digestive virus is surging across the U.S., experts warn.
Rotavirus, a double-stranded RNA virus, causes acute gastroenteritis — inflammation of the stomach and intestines — which can lead to severe diarrhea, vomiting, fever and stomach pain.
The virus primarily affects infants and young children, but there have also been outbreaks in elderly populations, such as nursing homes.
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Data from the Centers for Disease Control and Prevention shows that in the week ending April 4, out of 2,329 rotavirus tests, 7.3% were positive for the infection. Last year’s highest infection rate was 6.77% as of the week ending April 19.
Rotavirus, a double-stranded RNA virus, causes acute gastroenteritis — inflammation of the stomach and intestines — which can lead to severe diarrhea, vomiting, fever and stomach pain. (iStock)
“We’re seeing a lot of rotavirus in the wastewater right now,” Dr. Marc Siegel, Fox News senior medical analyst, confirmed to Fox News Digital. “Testing for rotavirus is way down, but the percentage of positive tests is up.”
While the virus typically peaks in the spring, it is not currently slowing down, he noted.
Why cases may be rising
Patricia Pinto-Garcia, M.D., a medical editor at GoodRx who is based in California, said there are several possible reasons for the rotavirus spike.
“Vaccine rates are down overall among young children, as they decreased during COVID,” she told Fox News Digital. “This means there’s a growing number of infants and young children who are vulnerable to infection.”
The rotavirus vaccine series must be completed by the time a child is 8 months old, she noted.
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As a result of the declining vaccinations, herd immunity isn’t protecting vulnerable children, according to Pinto-Garcia. “Children who haven’t finished the vaccine series yet, are too young to get vaccinated, or can’t get the vaccine due to medical illness are more likely to get exposed to the illness because other children aren’t vaccinated,” she said.
Siegel noted that before the vaccine became available, rotavirus resulted in 55,000 to 70,000 in the U.S. per year.
“Vaccine rates are down overall among young children, as they decreased during COVID,” a doctor told Fox News Digital. “This means there’s a growing number of infants and young children who are vulnerable to infection.” (iStock)
“I am concerned that the vaccination rate has been declining over the past seven years and is continuing to decline in the current climate of vaccine skepticism,” he said.
Surveillance methods are also much better than they used to be, Pinto-Garcia noted, which means public health experts are able to pick up and track cases better than ever before.
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“But we see that rotavirus-related healthcare visits are also up, so improved detection is not the only reason we are seeing this spike,” she said.
The COVID pandemic also disrupted the pattern of infections, according to Pinto-Garcia, so it’s “tricky” to compare the current levels against older cycles.
“It’s possible that what we are seeing is still some post-pandemic rebound, but it’s unlikely that this year’s pattern is fully explained by just this factor,” she added.
Transmission and risk
Dr. Zachary Hoy, a pediatric infectious disease specialist at Pediatrix Medical Group based in Nashville, Tennessee, often sees young patients with rotavirus.
“Rotavirus is spread via the fecal-oral route, meaning that a person comes into contact with virus droplets from contact with other children or adults, or from contact with objects such as toys that have been contaminated with the virus from someone who is sick,” he told Fox News Digital. “This can lead to outbreaks, especially at schools where many young children share the same toys.”
“It’s possible that what we are seeing is still some post-pandemic rebound, but it’s unlikely that this year’s pattern is fully explained by just this factor.”
Rotavirus is associated with many dehydration cases in the hospital due to the degree of diarrhea, according to Hoy.
In some severe cases, the virus can lead to seizures due to electrolyte imbalances from dehydration and loss of electrolytes in the stool.
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“Younger children do not have the reserves that older children and adults have, so they can become more dehydrated quicker and develop more severe electrolyte imbalances, leading to more severe infections,” Hoy said.
“Patients with problems with their immune systems or on medications that can decrease their immune systems can have more severe and prolonged infections, too.”
Treatment and care
Because rotavirus is a viral infection, antibiotics are not effective against it. There is no specific antiviral treatment for the condition, with doctors typically recommending supportive care.
“The mainstay of treatment is hospitalization for rehydration via intravenous (IV) fluids,” Hoy told Fox News Digital. “Sometimes it can take up to two to three days of IV fluids to help get patients rehydrated.”
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Blood draws are often necessary to evaluate patients’ electrolyte levels, such as sodium, potassium, calcium and magnesium, according to the doctor.
“If these electrolyte levels are significantly low, sometimes patients need special IV solutions or individual electrolyte medications,” he added.
“The mainstay of treatment is hospitalization for rehydration via intravenous (IV) fluids,” a doctor told Fox News Digital. (iStock)
Dr. Daniel Park, medical director of the Pediatric Emergency Department at UNC Health in Chapel Hill, North Carolina, noted that most children recover with supportive care, but parents should seek medical attention if a child shows signs of dehydration. Those include decreased urination, lethargy or inability to keep fluids down.
“While rare, rotavirus can be life-threatening in vulnerable populations, especially very young infants or children with underlying medical conditions,” Park told Fox News Digital.
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Prevention strategies
Given the lack of antiviral medications for rotavirus, doctors emphasize the importance of prevention, primarily the vaccine.
There are two rotavirus vaccines – Rotateq (a three-dose series) and Rotarix (a two-dose series). They are given starting at age 2 months as oral drops, not injections, according to Hoy.
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“It’s important to get the rotavirus vaccines on schedule, because these younger infants are at greatest risk if they get rotavirus,” he advised.
Other recommended prevention methods include handwashing with soap and water.
Every day we’re faced with a zillion small choices: Go to sleep early, or watch one more episode of that Netflix drama. Call an old friend to catch up, or cruise social media. Of course, no single action will guarantee a long, healthy life or doom you to an early grave. But those little daily decisions do add up, and over the long term they can make a difference when it comes to both your longevity and your health span, the amount of life spent in relatively good health.
Scroll through this theoretical “day in the life” and select the option that best fits your typical day. Not every situation will apply perfectly, but think about which choice you’d be most likely to make. This isn’t a formal scientific assessment. The goal here isn’t to assign you a “good” or “bad” score, but to help you understand the central factors that shape the way we age and how long we live.
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