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[–]MarkTwainiac 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (0 children)

Also, just want to add that this laxity is not new in the field of "transition medicine." It's been built in from the start. So it's a feature, not a bug.

Georges Burou, the physician in Casablanca, Morocco who was the first surgeon in the world to pioneer penile inversion "vaginoplasty" in "transsexual" males in the 1950s, operated on thousands of males from around the world over the following decades. Burou was well known for not doing any psych or extensive medical evaluations on his patients. If a guy had the money, obtained proper travel documents, made an appointment, booked a flight and showed up in Burou's clinic and had healthy BP, a normal EKG, and no glaringly obvious risk factors that would've made surgery super risky, he'd be admitted and prepped for surgery the next day - no questions asked.

However, Burou did refuse to operate on minors. Officially, Burou claimed "all of his vaginoplasty patients to have been prepared, to have undergone psychiatric care, and hormonal therapy," but in reality he did not. From the entry about him on Wikipedia:

...patient Jan Morris wrote that Burou did not bother too much with diagnosis or previous treatment. Burou later confirmed that he did not ask his patients too many questions, but sought to fulfil their wishes, and that he did restrict his services to male-to-female (MTF) transsexuals with a distinct “feminine” appearance or character. He refused his services to minors even if they had parental consent, because he felt “the operation is definitive and irreversible and one… could not risk making a mistake.” His international patients were often admitted the afternoon they arrived at the clinic, and were prepared for surgery as soon as that evening or the next morning.

Burou died in 1987, but by then tons of other "sex change" clinics had been set up around the world. Most of these have very lax standards. When Johns Hopkins started doing "sec change" operations in the USA in the 1960s, it made extensive psych evals mandatory and instituted strict gatekeeping in order to try to weed out males with "unseemly" motives.

In part because the Hopkins program was the basis for the fictional Baltimore hospital where Hannibal Lecter worked in "The Silence of The Lambs" - and it rejected Buffalo Bill from "sex reassignment surgery" due to his being an AGP with sociopathic and murderous tendencies - many people think that "gatekeeping" has always been the norm for all clinics, hospitals and physicians involved in "trans medicine" throughout the world. But in fact, this is not the case.