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.
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Fireworks have been a quintessential part of Fourth of July celebrations across the nation for generations.
But as Independence Day festivities light up the night sky, the colorful displays can also pose serious health risks — especially to the lungs.
Nearly 300 million pounds of fireworks are released into the atmosphere each year in the U.S., according to the American Lung Association. This creates smoke filled with tiny particles, as well as gases like sulfur dioxide, carbon dioxide and carbon monoxide, which are “very harmful to our lungs.”
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The smoke from fireworks can also release harmful metals, like aluminum, manganese and cadmium, into the air.
Some illegal fireworks may contain lead, which the association describes as “extremely dangerous” due to its potential to cause lasting health damage.
Attendees watch the Independence Day fireworks display along the National Mall in Washington, D.C. (Probal Rashid/LightRocket via Getty Images)
“Inhaling any of these chemicals can irritate the lungs, making it hard to breathe and causing serious health problems, which is why it is important to avoid firework smoke whenever possible,” the group said in a public advisory.
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Air pollution levels increase by an average of 42% on the Fourth of July, according to a 2015 study.
Smoke from fireworks can worsen symptoms and cause flare-ups in those who have asthma or chronic obstructive pulmonary disease (COPD).
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Fine particle pollution has also been linked to more serious health consequences, including heart attacks, stroke, lung cancer and premature death, according to the American Lung Association.
The organization warned that children, older adults and pregnant women, as well as people with lung and heart disease, are especially vulnerable.
Smoke from fireworks can worsen symptoms and cause flare-ups in those who have asthma or chronic obstructive pulmonary disease. (iStock)
Dr. Afif El-Hasan, member of the Lung Association’s board of directors, shared some advice for high-risk fireworks spectators in an interview with Fox News Digital.
Instead of using fireworks at home, El-Hasan recommends watching them from a distance.
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People with asthma who use a rescue inhaler should keep it close at hand in case fireworks trigger wheezing or other symptoms, the expert advised. Wearing a well-fitting N95 mask can also help reduce exposure to fine particles from fireworks smoke and debris.
“If you are familiar with the area and the wind patterns, try to be upwind from the fireworks display and avoid areas where smoke may accumulate,” he said.
An expert recommends watching fireworks from a distance to avoid exposure to air pollution. (iStock)
The expert also recommends attending fireworks events with friends or family, so someone is available to help if a medical emergency arises.
“Make sure you have taken all of your preventative medication before a fireworks show,” El-Hasan advised. “If possible, take a car to the fireworks display. Try to park as close as possible to the event in case you have to get to the car quickly.”
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The expert also recommends drinking water immediately after the show to clear the upper airway. Changing and washing clothes upon returning home can also help to prevent smoke particles from accumulating in the home.
If case of shortness of breath or chest pain, it’s important to seek medical care immediately.
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A study of World Trade Center responders found that PTSD is associated with molecular changes linked to accelerated biological aging and a higher risk of chronic disease.
The study, led by Stony Brook University in New York, could offer new clues to the long-term physical health effects of post-traumatic stress disorder.
The researchers tested blood samples from 393 WTC responders, collected approximately 18 years after the September 11, 2001, attacks, according to a university press release.
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Out of the sampled responders, 232 were diagnosed with PTSD and 161 were not. Between the two groups, 114 proteins and seven metabolites were significantly different.
Firefighter Gerard McGibbon, of Engine 283 in Brownsville, Brooklyn, prays after the World Trade Center buildings collapsed on September 11, 2001. (Mario Tama/Getty Images)
In particular, the researchers detected changes in blood markers linked to brain function, immune activity, energy metabolism, protection against cell damage and how cells communicate and repair tissues.
Also reported were signs of accelerated biological aging in multiple organs — including the heart, kidneys, liver and lungs — among responders with PTSD.
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These discoveries could help explain why people with long-term PTSD are at greater risk for chronic conditions such as heart disease, lung disease, cognitive decline and other age-related illnesses.
“This study found that chronic PTSD is associated with long-lasting biological changes throughout the body, affecting multiple organs and biological systems decades after their traumatic exposure,” lead study author Benjamin Luft, director and principal investigator at the Stony Brook WTC Wellness Program, told Fox News Digital.
“Traumatic experiences can produce lasting biological changes that persist for decades.”
The study reinforces the view that PTSD is a “whole-body illness” rather than simply a mental health disorder, he noted.
“Traumatic experiences can produce lasting biological changes that persist for decades,” Luft said. “These changes appear to accelerate aspects of biological aging and may increase the risk of many chronic diseases.”
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Several proteins that are critical for healthy brain function were also altered in those with PTSD, the researchers found.
“Many of these proteins play critical roles in helping brain cells communicate with one another, repair damage and maintain healthy connections that support memory and thinking,” Luft said.
A New York firefighter is pictured amid the rubble of the World Trade Center following the 9/11 attacks in 2001. (Universal History Archive/Universal Images Group via Getty Images)
The study – which was funded in part by the CDC, the National Institute for Occupational Safety and the National Institutes of Health – was published in Nature Communications.
Luft said the findings should be viewed with “cautious optimism.”
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“The research provides compelling evidence that PTSD is associated with long-lasting biological changes throughout the body, including signs of accelerated aging, altered metabolism and changes in proteins involved in brain health,” he said.
“These findings strengthen the growing recognition that PTSD is not simply a mental health disorder, but a condition that can have lasting effects on physical health as well.”
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Dr. Marc Siegel, Fox News senior medical analyst, was not involved in the study but called the results “fascinating.”
“This speaks to the complex reality that PTSD is not an isolated psychiatric event due to emotional trauma alone, but that it is also tied in with physical trauma,” he told Fox News Digital. “The stress is both emotional and physical, and leads directly to immune dysregulation and aging processes.”
“These findings strengthen the growing recognition that PTSD is not simply a mental health disorder, but a condition that can have lasting effects on physical health as well,” the researcher said. (iStock)
“The chronic diseases that resulted from high exposure in the aftermath of the 9/11 World Trade Center attacks were conjoined in terms of the impact on physical and emotional well-being, longevity and effects on multiple organ systems, as well as core metabolic and immunological processes,” the doctor added.
Study limitations
There were some limitations to the findings, the researchers noted.
“Because all measurements were taken at one point in time, the research can only show an association — not that PTSD directly caused the changes,” Luft noted.
“We are currently doing studies in these patients examining multiple time points to see whether the changes in specific proteins and metabolites precede clinical changes.”
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Also, because the study was done on a unique population – World Trade Center responders who experienced very specific trauma and environmental exposures – the findings may not apply to everyone with PTSD, “such as combat veterans, survivors of abuse or people who experienced other types of trauma.”
Several proteins that are critical for healthy brain function were also altered in those with PTSD, the researchers found. (iStock)
Women are not well-represented in the study, comprising only 10% of responders.
“Blood tests cannot tell us exactly what is happening inside the brain,” Luft said. “Although many of the altered proteins are related to brain function, blood measurements are only an indirect reflection of processes occurring in the brain.”
Looking ahead
Additional studies are needed to determine whether these blood markers can predict disease progression or treatment response.
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“From a public health and policy perspective, the study reinforces the importance of recognizing PTSD as a chronic medical condition with significant long-term health implications,” Luft said.
“Investing in early diagnosis, comprehensive treatment and long-term follow-up for trauma survivors, including our first responders and veterans, may improve quality of life while reducing the burden of chronic disease.”
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