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Gender Surgeries Nearly Tripled From 2016 Through 2019, Study Finds

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Gender Surgeries Nearly Tripled From 2016 Through 2019, Study Finds

Gender-affirming care has become a key political issue for conservatives in the run-up to the presidential election. At least 20 states led by Republicans have restricted or banned such care for minors.

Gender-affirming surgery is endorsed by a wide array of medical groups. Yet surprisingly little has been known about how often these operations are performed.

“There’s been a sense that more patients are asking about it, and ultimately pursuing it, but there wasn’t good data,” said Dr. Jason D. Wright, the chief of gynecologic oncology at Columbia University Vagelos College of Physicians and Surgeons, who led the research.

“Ours is one of the first studies to quantify the age groups and the procedures they’re undergoing.”

Past analyses have shown that such surgeries have been increasing. Health experts anticipated a sharper increase in recent years, in part because of changes in federal and state laws that often require coverage of transition-related care.

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Dr. Wright and his colleagues drew patient counts from two databases maintained by the federal Agency for Healthcare Research and Quality in order to account for both inpatient and outpatient procedures, and weighted the figures to produce estimates for the entire country.

According to the analysis, about 48,000 patients underwent surgeries from 2016 through 2020. Breast and chest surgeries were the most common: There were about 27,187, or 56.6 percent of all gender-affirming surgeries.

Researchers estimated there were about 16,872 genital surgeries (35.1 percent of the total) during the period, and about 6,669 facial and cosmetic surgeries (13.9 percent).

Just over half of all patients were ages 19 to 30; about 22 percent were ages 31 to 40; and almost 8 percent were ages 12 to 18. The number of genital surgeries in particular increased with age, which researchers attributed to the higher complexity and “definitive nature” of the procedure.

The number of procedures overall rose from 2016 to 2019 but declined slightly in 2020, which the researchers said might have resulted from the onset of the Covid pandemic.

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The data accounted only for surgeries in inpatient and ambulatory settings, and did not include cases in which surgeons omitted certain gender-related diagnosis codes. As a result, the study’s findings are “almost certainly under-captures” of the real figures, Dr. Wright said.

Much of the national discussion has centered on treatment for adolescents. Earlier this month, the American Academy of Pediatrics reaffirmed its guidelines regarding the gender-affirming treatment but also commissioned a fresh review of the research, after European health authorities found uncertain evidence for its effectiveness.

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LAX passenger arrested after running onto tarmac, police say

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LAX passenger arrested after running onto tarmac, police say

A Los Angeles International Airport passenger was arrested early Saturday morning after he became irate and ran out of Terminal 4 onto the tarmac, according to airport police.

The passenger appeared to be experiencing a mental health crisis, said Capt. Karla Rodriguez. “Police responded and during their attempt in taking the suspect into custody, a use of force occurred,” she said.

The man, who was not identified, was arrested on suspicion of battery against a police officer and trespassing on airport property, she said. He was taken to a nearby hospital for a mental health evaluation.

A video obtained by CBS shows a shirtless man in black shorts running on the tarmac past an American Airlines jetliner with a police officer in pursuit. The officer soon tackles the man and pushes him down on the pavement.

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Video: How SpaceX Is Harming Delicate Ecosystems

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Video: How SpaceX Is Harming Delicate Ecosystems

On at least 19 occasions since 2019, SpaceX’s operations have caused fires, leaks and explosions near its launch site in Boca Chica, Texas. These incidents reflect a broader debate over how to balance technological and economic progress against protections of delicate ecosystems and local communities. The New York Times investigative reporter Eric Lipton explains.

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Live poultry markets may be source of bird flu virus in San Francisco wastewater

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Live poultry markets may be source of bird flu virus in San Francisco wastewater

Federal officials suspect that live bird markets in San Francisco may be the source of bird flu virus in area wastewater samples.

Days after health monitors reported the discovery of suspected avian flu viral particles in wastewater treatment plants, federal officials announced that they were looking at poultry markets near the treatment facilities.

Last month, San Francisco Public Health Department officials reported that state investigators had detected H5N1 — the avian flu subtype making its way through U.S. cattle, domestic poultry and wild birds — in two chickens at a live market in May. They also noted they had discovered the virus in city wastewater samples collected during that period.

Two new “hits” of the virus were recorded from wastewater samples collected June 18 and June 26 by WastewaterSCAN, an infectious-disease monitoring network run by researchers at Stanford, Emory University and Verily, Alphabet Inc.’s life sciences organization.

Nirav Shah, principal deputy director of the U.S. Centers for Disease Control and Prevention, said that although the source of the virus in those samples has not been determined, live poultry markets were a potential culprit.

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Hits of the virus were also discovered in wastewater samples from the Bay Area cities of Palo Alto and Richmond. It is unclear if those cities host live bird markets, stores where customers can take a live bird home or have it processed on-site for food.

Steve Lyle, a spokesman for the state’s Department of Food and Agriculture, said live bird markets undergo regular testing for avian influenza.

He said that aside from the May 9 detection in San Francisco, there have been no “other positives in Live Bird Markets throughout the state during this present outbreak of highly-pathogenic avian flu.”

San Francisco’s health department referred all questions to the state.

Even if the state or city had missed a few infected birds, John Korslund, a retired U.S. Department of Agriculture veterinarian epidemiologist, seemed incredulous that a few birds could cause a positive hit in the city’s wastewater.

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“Unless you’ve got huge amounts of infected birds — in which case you ought to have some dead birds, too — it’d take a lot of bird poop” to become detectable in a city’s wastewater system, he said.

“But the question still remains: Has anyone done sequencing?” he said. “It makes me want to tear my hair out.”

He said genetic sequencing would help health officials determine the origin of viral particles — whether they came from dairy milk, or from wild birds. Some epidemiologists have voiced concerns about the spread of H5N1 among dairy cows, because the animals could act as a vessel in which bird and human viruses could interact.

However, Alexandria Boehm, professor of civil and environmental engineering at Stanford University and principal investigator and program director for WastewaterSCAN, said her organization is not yet “able to reliably sequence H5 influenza in wastewater. We are working on it, but the methods are not good enough for prime time yet.”

A review of businesses around San Francisco’s southeast wastewater treatment facility indicates a dairy processing plant as well as a warehouse store for a “member-supported community of people that feed raw or cooked fresh food diets to their pets.”

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