The issue of what "gender confirmation surgery" means frequently comes up on various threads, so I'm sharing some information for clarity.
"Gender confirmation surgeries" are on the rise, and have been so for a number of years. But most of the "gender confirmation" and "sex reassignment" surgeries done nowadays that we are constantly told are "life saving" do not involve the genitals.
The most commonly done "gender confirmation surgeries" by far nowadays are double mastectomies and removal of internal reproductive organs (uterus and ovaries) in TIFs, and facial feminization surgeries, tracheal shaves, hairline lowering and implants of sacs of fluid or gel into the chests of TIMs.
(Other "gender confirmation procedures" that TIMs most commonly get today are facial and body hair removal by laser or electrolysis, dental contouring, and fillers in the hips, butt and lips, but these are procedures not surgeries. Moreover, not all of them count as "medical," though that's how they're often portrayed.)
It is extremely rare for TIMs in the US to get any kind of genital surgery.
Article published in the journal Translational Andrology and Urology in June 2019 said:
Genital GCS is generally less common than chest surgery, with prevalence rates of ...5–10% for transgender women. For transgender women, genital GCS comprises a number of procedures, including vaginoplasty (most commonly intestinal or penile inversion) with labiaplasty and/or clitoroplasty, penectomy, and orchiectomy. Transgender women report bottom surgery at rates between 5–13%.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626314/
A report in the US journal Transgender Health in 2016 showed that out of the 234 TIMs studied, only 11 - or 4.7% - had undergone genital surgery.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012371/
A high percentage of TIMs will tell pollsters, online surveys, HCPs and researchers that of course they intend to get genital surgeries at some point down the line, but they rarely actually do so.
This is because the vast majority of TIMS are very much into their dicks just as most other males are. Which is why they the trans movement is so intent on simply rebranding male genitals as female organs by pushing for normalization of the ridiculous concept of "girl dick," "glitter wand" and "outie vagina."
Even males who are basically "professionally trans" and base their entire lives and livelihoods around claiming to be women, such as Gigi Gorgeous, Blaire White and Munroe Bergdorf, usually end up deciding not to get genital surgeries.
In fact, Gorgeous and White have made videos saying they see the results of such surgeries as repulsive in appearance, smell and function. If a woman made a video expressing the sort of revulsion that GG and BW displayed in their videos on the topic, YouTune probably take it down as transphobic hate speech. But being "trans," these guys are afforded much more license and leeway.
Moreover, since these guys base their entire lives and "identities" on lying, lots of TIMs have no qualms about claiming to have had genital surgery when they have not actually done so.
Jenner, for example, told Diane Sawyer in a TV interview that he'd had genital surgery, whilst at the same time he shamed her as impolite and pervy for even wondering about such a thing - and told her sternly that asking a "transwoman" about "her" surgeries is disrespectful, ignorant and just not the done thing. But a couple of years later Jenner revealed that he was lying to Sawyer when he claimed in another television appearance (during the roast of some celeb) that as a matter of fact he really didn't remove his dick and balls after all, he just "retired" them.
The low rates of genital surgeries amongst TIMs in the US is often attributed to the fact that these surgeries are very costly. But the three TIMs I've just mentioned are all extremely well off. Jenner is a multi-millionaire celebrity; Gorgeous comes from a well-off background and is married to one of the heirs to the Getty billions; and White seems to be well fixed for cash. All three of these persons have had a large number of other, highly expensive cosmetic surgeries - and all seem to spend freely on designer clothing and shoes, accessories, salon visits, makeup, manicures and hair extensions.
Moreover, since 2014, most US private insurance companies as have provided coverage for genital surgeries in TIMs, and since 2015 Medicare and other taxpayer-funded programs such as Medicaid and Medi-Cal in a number of states have covered these surgeries too.
Plus, even in the US, a country that is pretty stingy when it comes to government welfare, many programs have been set up in recent years to provide medical insurance, access to health care, special services and benefits for people who ID as trans, particularly the male ones.
Also, since HIV rates are so sky high amongst black TIMs in the US (44% of black TIMs have HIV, the CDC says), many of these men are eligible for federal Social Security disability benefits, which automatically makes them eligible for Medicare (16-20% of Medicare recipients are non-elderly people claiming SSDI), as well as a host of other state and local programs such as government-subsidized housing and services specially set up for "transwomen with HIV." Which this fawning front-page story in the NY Times from 2015 demonstrates:
https://www.nytimes.com/2015/12/13/us/kricket-nimmons-transgender-surgery.html
As the NY TIMs story shows, this guy not only got several costly "gender confirmation surgeries" done at taxpayers' expense, he had to have his genital surgery to create a fauxgina and fauxlva redone all over - again courtesy of the public purse - coz he failed to comply with the post-op care instructions after the first one.
Another reason trans activists claim that most TIMs don't get genital surgeries is coz so few doctors are trained in doing them and there are long waiting lists as a result. But in US medicine, where there's a demand for a service and it's covered by health insurance and Medicaid, usually there are plenty of physicians willing to meet the demand. This is particularly true of surgeons, who love to play god and do work that's literally "cutting edge." Moreover, for people able to pay out of pocket, there's always the option of going abroad. There long have been numerous private clinics in various countries that specialize in these surgeries.
The three well-off TIMs in the USA I mentioned above - Gigi Gorgeous, Blaire White and Jenner - all have had plenty of time since coming out as trans to make it to the top of American surgeons' waiting lists several times over. And to travel to top-notch surgeons in other countries. But funny thing, none of them have ever gotten around to it.
Also, Jazz Jennings, Jazz's friend Nicole and some of the other young males shown on the TV show I Am Jazz had or were scheduled to have genital surgeries in their teens without being made to wait years and years like the activists say. This suggests that if there's a will and insurance coverage or private funds to pay, then there's a way in the US.
I am not suggesting that TIMs should have genital surgeries to prove they are "true trans." I'm just sharing how rare these surgeries are.
For the record, I think these are cruel, dangerous surgeries that lead to high rates of complications, poor outcomes and do not make recipients happy they way it's often claimed and they have been led to believe. I don't want to see the rates of these surgeries rise.
However, knowing the facts about how rare they are is essential to making people aware that nearly all "transwomen" have fully intact dicks and balls.
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