GenderCritical

IMO, none of the doctors doing trans-related surgeries on reproductive organs, or medically unwarranted double mastectomies on girls and young women, can be considered ethical or reputable.

Now that a lot of surgery is being done in free-standing clinics or suites rather than in hospitals, it seems many of these doctors don't have to abide by the same ethical standards or go through the same review processes and oversight procedures that doctors in hospitals used to all be subject to routinely, and still often are subject to in many medical settings. Also, many surgeons who do trans surgeries seem to be running their own shops with no supervision, nor even any peer-level colleagues likely to challenge or question them.

When these doctors do get into trouble with supervisors and regulators because of their own lack of ethical standards, or because too many medical malpractice suits have been filed against them, it seems they customarily move to another state and begin anew there. Curtis Crane MD is one such doctor. So is the guy who used to be at the U of Miami Med School & Center who lost his position for posting on social media pics of his patients' severed penile skin that he'd made into heart shapes on a tray. However, I don't know if the "top surgeon" who's posted pics of buckets filled with all the breasts he's removed has been professionally censured for his vile behavior.

Is your acquaintance female? If so, and she's still young (teens to near 50), she's not already given birth to at least two children, and she has no life-threatening or other serious, major medical condition for which hysterectomy long has been considered a reasonable and prudent treatment, she'd find it pretty much impossible to get her reproductive organs removed by a reputable ob/gyn and conventional hospital.

But use the magic words "trans" and "gender affirming," and the usual rules are being thrown out the window nowadays even by decent doctors and hospitals with otherwise high ethical standards.

If your friend is male, there might be different standards when it comes to removing/reconfiguring the reproductive organs. The custom of doing "sex reassignment surgeries" that involve castration on males goes back much further, and until recently most of the patients seeking "SRS" used to be males. (Now it's the opposite: hardly any males get their dicks and balls messed with nowadays, and amongst the younger population today, girls and young women are much more likely to seek trans medical surgeries affecting reproductive organs than boys and men are.)

Ever since trans-affirming genital surgeries first became a thing, a good number - in fact, the majority - of the males seeking out such surgeries have been middle-aged men who've already fathered a number of children. Jan Morris, Renee Richards, Jenner, Marci Bowers, Zoe Tur, Martine Rothblatt, India Willoughby, Debbie Hayton, Jennifer Pritzker and thousands of other men like them are typical in that they decided they were really women born in men's bodies after they had been been putting their dicks inside female bodies for years or decades and had succeeded in impregnating their wives/partners - in most cases, multiple times.

As a result, the issue of fertility loss/preservation seems not to be as much of a core consideration in "trans medicine" that got built into the field from the very start the way it is in most other fields of medicine such as oncology and, of course, gynecology. Moreover, the doctors doing trans-related surgeries today tend to come from medical specialties and have mindsets that aren't necessarily concerned all that much with such matters as their patients' fertility, sexual functioning, or longterm health.

Traditionally, removal of female reproductive organs have been done pretty much exclusively by extensively-trained ob-gyns because these are major operations that involve removal of internal organs. Whereas castration of males involves only removal of external organs, and is a much simpler procedure that was done worldwide long before modern medicine and surgery were developed: hence the castrati, and the routine castration done to black African males taken into captivity during the Arab and Ottoman slave trades that go back to the 7th century.

Today, a lot of trans-related genital surgeries done on males - and now apparently some done on females as well - are being performed by urologists and/or cosmetic or general surgeons, not specialists in the female reproductive organs. Similarly, all the labioplasties, "vaginal rejuventation" surgeries and other such procedures now being done on the external genitals of females for aesthetic reasons are not being done by ob-gyns whose focus is on women's health. They're being done by cosmetic or plastic surgeons for the $$$.

At the same time, many of the doctors willing to do trans-related genital surgeries on young people before they've procreated nowadays might be a bit more blithe about destroying a male's fertility than a female's because of sexism. Sexist people tend to think being able to be a father is not as important or central to male psychological well-being as they assume being able to bear children is to female mental health.

This could be one of the reasons that the various doctors who rendered Jazz Jennings infertile by putting him on puberty blockers at 11, and estrogen at 12, and then surgically castrated him when he was only 17 were all so breezy about it. If those doctors - and Jazz's parents - truly did see Jazz as real girl/young woman, I doubt they would've been so quick to destroy Jazz's ability to procreate. On the contrary, they very likely would've cautioned Jazz against blocking puberty and having his gamete-producing organs surgically removed, saying that many girls and women who have zero interest in having children in their teens and 20s find that later on in their 30s they change their minds and decide they do want to have a child after all.