#gonadectomy

[thethcministry]

[theforesteldritch]

Reading about how intersex athletes have been treated is so fucking horrible. The countless lies and human rights violations. The discrimination and how it's ruined the lives of so many people is so awful. There has been no apologies from any athletics comptetions or organizations. They have blood on their hands. Just a tw for intersexism and mental health issues and suicide in the next paragraph because it can get pretty heavy.

Annet Negesa, who was a middle distance runner. She was suddenly barred from competing due to her hormones. No one told her why. She was then told she needed to take medication to lower her testosterone, then what she was told was switched. She was lied to about a surgery that she was told was like an injection and would let her compete again. She woke up with scars and had had a gonadectomy. That violation of basic human rights and medical ethics combined with inadequate postsurgical care basically ended her career. She deserves justice. She deserves apologies from the Olympics and everyone single doctor who was involved in it, and compensation and the promise that it should never have happened and will never happen again. She. Needs. Justice.

Pratima Gaonkar needs justice. She was a rising track and field star. After forced sex verificatiom she killed herself. The way media and news treated her after her death was disgusting. She deserves and needs justice. Her family deserves justice.

Santhi Soundarajan had her medals stripped and was treated as an outcast after forced sex verification showed she had androgen insensitivity syndrome. She was treated as an outcast, her gender was mocked. She's spoken out about how much discrimination she's faced, and how badly she's been treated. She now works as a coach, but was barred from competing. She deserves justice.

Caster Semenya deserves justice. Francine Niyonsaba deserves justice. Margaret Wambui deserves justice. Barbra Banda deserves justice. Beatrice Masilingi and Christine Mboma deserve justice.

The racism and intersexism and horrible human rights violations and medical abuse these women have faced for the supposed crime of being intersex and good at a sport is horrible. They deserve justice, but the organizations that perpetuate these atrocities don't seem to care. It's so fucking horrible.

[genderkoolaid]

Is there anywhere I can read more about nonbinary medical transitions? I’ve never heard about it before, but as a cis woman, I am trying to educate myself about the issues others face and make sure that I don’t perpetuate myths / falsehoods.

Anything else that you think could help me understand about being non binary too would be appreciated. Again, I’m learning as I go.

Thank you.

Phallo.net and metoidioplasty.net both have sections on nonbinary bottom surgery; I don't know if they have sister sites for vulval/vaginal-making surgeries. transfemscience.org has an article on nonbinary estrogen HRT options.

Some basics on nonbinary* medical transitions:

Nonbinary people can want any or all of the same things a binary trans person can want out of medical transition. We should be allowed to get any or all of the same treatments a binary person can get without having to lie about who we are.

(Also its just generally important to remember that abinary people (those who do not identify as men or women) are only part of "nonbinary" which can include a wide variety of men, women, menwomen, womenmen, others and etc.)

Hormones: Some people will go on HRT for a certain period of time to get some effects, and then go off it (or switch to a different kind, if they've had a gonadectomy) to get other effects. Some people will go on a lower dose of hormones to get effects slower or to a lesser extent. Some people will use certain hormones to counteract certain effects (for example, DHT blockers inhibit androgenic hair loss & growth, SERMS inhibit breast growth)

Surgery: Some people will transition by getting sterilized a way cis people typically do (hysterectomy, vasectomy, gonadectomies). Some people will get breast reduction but not removal. Some people will get breast implants. Some trans people will only get "part" of bottom surgery (vaginectomy, orchiectomy). Some people will get both a penis and a vagina (through phallo/meta or peritoneal pull through vaginoplasty). Some people will get a large clitoris or a small penis. Some people will get "nulloplasty" and remove external genitals entirely.

*nonbinary here not so much referring to gender identity as much as medical processes that are used to actively creating an outside-the-binary body.

[intersex-support]

hi! i have known i am intersex for a while now but it wasn't until recently that i learned i possibly had surgery done on me as an infant, as i had to stay in the hospital for a few extra days for supposed lung issues when i cried just fine, and did find out later i am intersex. that being said, i know one tell tale way of knowing is looking for scarring or anything else off. i tried really hard to look online for any indication of what exactly to look for or what scarring might look like 25 years after the fact, but found nothing. i had my partner look and she really couldn't tell since she didn't know what she was looking for. on someone who has a vagina, what would be some defining features to look for? i already know my enlarged clitoris and inner labia are related to me being intersex, i am just looking for signs of surgery having been done!

Hi anon 💜

Unfortunately, I have a really hard time answering asks about how to tell exactly what scarring looks like, and I wish I had better resources and answers to share. Part of this is because scars look different on everyone depending on what type of surgery you potentially received, how long it's been, and also just depending on your body. I don't feel comfortable linking to medical journals with surgery or scarring photos, because most of those are all children and I have serious doubts about whether doctors actually received consent for that kind of medical photography, and I don't want to continue to perpetuate that exploitation. I'm familiar with what some types of scars look like, but I have a very hard time trying to figure out how to put it into words in a way that makes sense.

This recent ask from someone else trying to figure out answers about surgery talks a little bit more about the types of intersex surgeries, if you are interested in researching more in depth in the medical literature about those surgeries. It can also be easier to find results of some of those surgeries (such as vaginoplasty) that were performed on consenting trans adults in places like reddit, transbucket, etc. I'll also say that gonadectomy scars are usually more visible and higher up on your pelvis or abdomen, rather than on your genitalia.

Even if you're not really able to visibly determine if you have scarring, sometimes we can figure out that we have scar tissue--either external or internal--based on the sensory experience, sensation, pain, factors like that.

If you've had frequent UTIs, that can be another piece of the puzzle.

Researching your medical records can also be another way to try to get more information, but I know how difficult that process can be.

I wish I had better resources or answers to share with you, but I'm sending so, so much love and solidarity. I know that for many people exploring the possibility of surgery can be an emotional and overwhelming process, and we're always here if you need to vent, need support, advice, anything. Truly wishing you the best, anon, and I hope you're able to find the answers you're looking for.

💜💜💜

[ashekirk]

Tomorrow I get to find out whether my gonadectomy is going to be a simple or complex surgery. Yay?

Either way I have never had surgery before and that makes me nervous.

[ect0-writes]

Writing Stantzler fanfiction will have you reading a medical article from the 60s about the process of a gonadectomy in transsexual males.

[theforesteldritch]

I’m wondering if I should ask for my hormones to be tested. Because it’s been years since the first one that first indicated I was intersex but I really don’t know anything besides that my T was in the upper ‘male’ range, and obviously enough of that got aromatized to estrogen to make me go through a more ‘female’ puberty but I wonder how my estrogen levels would compare to the typical range for cis perisex women and if HRT without gonadectomy would be worth it to potentially bring those levels up and potentially improve stuff like wellbeing or bone density. I can’t find any research on HRT in CAIS without gonadectomy and first I’d have to get my hormone levels checked to see if my E is low but I wonder if it’d be worth a shot. First I’d have to convince one of my doctors to let me do that to get the testing referral so idk.

I mean, my care plan rn is ‘idk this is our best guess’ given the lack of research on proper gonad monitoring instead of gonadectomy because of systemic medical intersexism, so maybe I can be my own guinea pig for this too but I don’t know. I feel like if my E levels are below the typical ‘female’ range it might be worth a shot to try supplemental HRT to see if that leads to any improvements in well-being or bone density or whatever, the issue is just getting a doctor to go along with it.

I don’t know, I genuinely have no idea what messing with my hormones would be like since I have no frame of reference otherwise. If lower E is contributing to lower well being, I genuinely just wouldn’t know because I wouldn’t know anything different. Which is why I want to do this because I’d rather increase my sex hormones and have nothing happen or feel worse and then just stop taking the HRT than just never know.

[intersex-support]

Hi, thank you sm for running this blog

I wanted to ask if you maybe had any resources to figure out if like, natal surgeries to "fix" intersex traits were done to someone?

I don't have acess to a doctor atm and I'm worried I might have genital scarring. Ik it's a legally mandatory practice here if the kid is intersex, but I can't find any resources on my own

Thank you so much again, sorry if my language isn't appropriate, I'm still new to this

Content note: discussion of genitalia and surgery

Hi anon,

Hope you're doing well. Unfortunately, there aren't a ton of resources out there, but I can try to share what I have. A lot of this will depend on what kind of variation you have and what kind of surgery might have happened.

One thing that can sometimes be a sign that you've had intersex surgery is if you had to see a urologist a lot as a kid, or if your medical records show that you went to a urologist as a baby. If you ever remember having any unexplained surgeries that might have been explained as for removing a cancer risk, or for fixing urinary function, or things like that, sometimes intersex surgeries are put in the medical record under those terms instead.

This article has a photo of an intersex adults scars from a surgery they had as a kid. This study has diagrams of clitoroplasty (tw for cissexist language, medical talk, and genital surgery diagrams). The intersex reddit has some people sharing photos or discussing scars in a way that might be helpful. If you have genital scar tissue, another way to notice it might be if you have a lot of unexplained pain down there or issues with urination such as frequent UTIs. In general, if you want to search to do your own research, the most common types of intersex surgery are gonadectomy, clitoroplasty, clitoral recession, vaginoplasty, hypospadias repair, and sometimes phalloplasty.

Sending all the good wishes your way, anon, and please feel free to come back if you have any other questions we can help answer.

💜💜💜

[ramlionbam]

oh the intersexism in the original tweets... every time the forced gender (re)assignment of intersex people is considered a "cis privilege" my intersex rage grows tenfold. that isn't "cis supremacy". that is an attempt to exorcize the intersex specter from our bodies and force us into a mythical, nonexistent sex binary through medical violence, whether it be through medicine or through surgery.

this also doesn't consider the forced medical infantilization of disabled children via sterilization and/or the ashley treatment (mastectomy, gonadectomy, and high-dose estrogen). that isn't "cis supremacy". that is an attempt to infantilize disabled people, as well as to sterilize them and strip them of their reproductive freedoms.

also: cis perisex people, for the most part, do not get chest reduction/enlargement, or facial surgeries, covered by insurance. an exception might be if, for example, a cis woman has breast cancer or has a genetic predisposition for it, or if a cis woman has breasts so large that they cause medical issues (and even then, sometimes this isn't always approved by insurance). they may be able to get facial surgeries after a face injury, but it is not something they will be able to access at any time.

cis perisex people are accessing these surgeries not through "cis supremacy" but because they are paying out of pocket for these services, which insurance considers cosmetic and will not cover.

i paid out of pocket for my top surgery. i did not have to get any letters written by any doctors or deal with my insurance in any way. i did, however, gain a lot of medical debt.

instead of talking about "cis supremacy", people should talk about the need to ban intersex genital mutilation, to ban forced sterilization of disabled people, and to grant bodily autonomy to intersex and to disabled people so we can decide what to do with our bodies - and not talk about the medical violence forced upon us as a good thing.

[paynomindtomyidiocy]

Goddamnit I’m so fucking hungry

Ugh going into surgeryyyy in like a few hours so won’t be active for probably the rest of today dhfjfjdhsjf idk

[myragewillendworlds]

98% of adolescents who started puberty suppression and subsequently hormone treatment, continued with gender-affirming medical treatment at follow-up around age 20.

In the Netherlands, treatment with puberty suppression is available to transgender adolescents younger than age 18 years. When gender dysphoria persists, testosterone or oestradiol can be added as gender-affirming hormones in young people who go on to transition. We investigated the proportion of people who continued gender-affirming hormone treatment at follow-up (approx. 3-6 years) after having started puberty suppression and gender-affirming hormone treatment in adolescence.

720 people were included in the study. 704 (98%) people who had started gender-affirming medical treatment in adolescence continued to use gender-affirming hormones at follow-up.

Age at first visit, year of first visit, age and puberty stage at start of GnRHa treatment, age at start of gender-affirming hormone treatment, year of start of gender-affirming hormone treatment, and gonadectomy were not associated with discontinuing gender-affirming hormones.

[theforesteldritch]

having to get a bone density scan because you’re at high risk for it while not being an old lady over the age of 60 is so funny to me because one of the questions on the form they gave me was something about how long I’d been in menopause. Buddy the period hasn’t and never will start to begin with, forget it stopping. Even for like the physiological symptoms of menopause I’d probably only get them if I had to get my gonads removed and then didn’t go on HRT (which I’m not planning to do. Because not going on HRT after gonadectomy would be Bad and I also want to avoid gonadectomy in the first place if possible). Some of us who are at a higher risk for osteoporosis aren’t little old ladies dammit! (admittedly not the majority given that I think the majority of those referred for bone density scans are little old ladies. But I’m 18. And was 17 when this happened. So)

[epochryphal]

just saw someone crediting me for coining xenogenital and clicked through to a post where i indeed mark it as i coined it, and

i completely fucking forgot that i did

doubly hilarious given i was just thinking “i bet all these definitions focusing on Imagination are just same phenomenon as quoi and originally it was more nuanced and could indeed fit Transition” (answer: yes)

apparently i originally described it as Conceptualizing and linked it to alien… whereas now i would emphasize it as a Relationship To Body and that it should be understood as agnostic about physical transition/modification, but certainly not understood as Unaltered or as Just Fun Fiction Narrative (nor about “always a dream, alas, definitely physically impossible, mustn’t get hopes up, let’s preempt any innovation and always specify it is hopeless wish”)

which of course is the whole. issue. and probably requires more intentional careful pushback (but also, is simplification and flattening just inevitable)

how do we open up the cognitive space to think about “hey, some people have genital setups that don’t occur naturally”

(without activating dysphoria and anti-trans cooptation along the lines of “-plasty surgery results are never ~real~ genitals”)

and this is where eunuchs and nullos are obvious but often forgotten examples. assumed archaic, or always only coercive. no thought about changes in healthcare experience or needs (eg risk of osteoporosis after gonadectomy unless on a hormone therapy; i wonder what preventative care some folks may still need and get denied because it’s tied into assumptions about organ inventories; how much does disgust reaction activate and prevent life-saving care)

but even then, how do we avoid the sort of “male / female / neuter” trinary?

i’ve been about removal (literally, blockers-and-ectomies) of sexed organs and tissue and traits, and it’s led me to yearn for transmutation into something visibly notably unrecognizable

and i don’t know what “not penis, not vagina, not a smooth doll crotch either; not scrotum, not labia, not smooth skin either” looks like, still — even as i literally have it, lmao.

like… how does this visually, conceptually (there’s the original word i used again) register? and how do we create the possibility to register something new? something possible. literally able to be noted/noticed.

i think a lot of xenobio designs focus on the physically humanly impossible for the foreseeable future - prehensile, especially.

probably all of this is very directly tied to phallocentrism. and it generates a binary yes/no, where further details are irrelevant (beyond coercive intervention to reinforce and reify that binary).

and anyway for all discussion there’s this looming spectre of “it’s sexual harrassment to discuss your own genitals, tmi inappropriate predatory creepy, can’t hide behind the veneer of fictional and have to be explicit (anything less gets misunderstood and elided back into penis/vagina/neuter) so that makes it real life sexual boundary crossing” - when uh how does one “get consent” to arguing with a paradigm of what can/does exist

mm. i threw this in my drafts for two weeks trying to think further and/or encourage myself to Formalize this into a bigger Plea For Paradigm Shift Around Genital Reality, and i hope i’ll be able to articulate that better in the near future but i’m gonna share this now as is

[intersex-support]

I found out about 10 years back that I had some kind of I surgery on my genitals as a child (when I was 1), but I didn't really think much about it at the time. I've since become more curious about what the surgery might have been for. It was listed as a 'labia separation', but as far as I can tell they don't normally perform that kind of surgery unless there is an urgent medical need (usually if the child isn't able to pee properly). I asked my mum for some more details (1/?)

(cont) She told me that the doctors said it was because they "didn't think my hole was big enough" and that my grandma (on my father's side) had a similar problem as a child also. I'm trying to find out more information as to why they would do this to a 1 year old, especially as this doesn't sound like a labia separation at all. Does this sound like the kind of surgery that might be performed on an intersex individual? 2/2

TW: detailed surgery talk

Hi anon,

It is definitely possible that this is a surgery that might be performed on an intersex person. Generally, surgeries that happen on intersex children at birth/early childhood include surgeries like vaginoplasty, clitoral reduction, gonadectomy, hypospadias repair, labiaplasty and some other outdated surgical techniques. This can actually include labia separation-some intersex variations like Congenital Adrenal Hyperplasia sometimes cause labial fusion, although they don't always and aren't the only cause of labial fusion.

The fact that the doctor said the reason was that the vagina wasn't big enough makes me think it's even more likely that it could have been some sort of procedure like vaginoplasty. In intersex kids who get vaginoplasty but still have a uterus, cervix and upper vagina, the procedure usually involves separating the fused labia and then creating a wider vagina. (source-tw for photos and explicit medical language). Of course, we can't confirm anything 100% over the internet-but a lot of the things you're describing, as well as the vague way that doctors talked about it, are things that are really common in a lot of intersex people's experiences with surgery. It's possible it could have just been labial fusion surgery to allow for urination, but the doctor's comment is really sticking out to me as something that a lot of doctors say in intersex surgeries.

If you ever had follow up surgeries, felt like you visited an OB/GYN or endocrinologist a lot more than average growing up, had frequent UTIs, pain during sex, or had other unexplained things in your medical record, those could all also be signs that would point towards intersex being more likely.

I know that thinking about the possibility of being intersex and learning that you might have undergone intersex surgery as a child can be a really overwhelming experience, so please feel to reach back out for as much support as you need. Whatever emotions you might be feeling about the possibility are valid. It can be a really big shock to think about being intersex, even if you've known about the surgery for years, and you don't need to go through that alone. We have a resources page and I can also direct you towards support groups if you're interested.

Sending love and solidarity your way anon, and please feel free to reach back out with any follow up questions.

💜💜💜

-Mod E

[ceescedasticity]

I don't generally go looking for omegaverse fic so for all I know there's a thriving subgenre, but you know what I've never run into? Gonadectomy. Bam, true heats and ruts gone forever.

I first thought of this in relation to that post about short lifespans in alphas due to rut stress — well, here's a way to lengthen that lifespan. Have the kids you want, then bow out and live as a beta.

It might not be safe until development of modern surgical methods for… whoever has internal gonads. (Five minutes of internet research suggests spaying for pets became available in the 1930s.) It might not be legal for omegas, that would fit with some common worldbuilding. But it's there.

(And my mind went to voluntary gonadectomy first, but… I suspect any non-utopian society is going to at least have a history of involuntary gonadectomy. Vulnerable populations have been involuntarily sterilized in the real world where there is considerably less concrete advantage in it.)

[capybarad]

Excellent twitter thread re: the UK government’s conversion therapy bill from @AlisonTunley:

Twitter does not lend itself to nuance or subtlety, but legislative proposals and clinical best practice are ill-served by simplistic sloganeering. So, let me optimistically use Twitter to try to unpack the conflicting views on the govt's conversion therapy bill.

Apologies in advance for another epic thread, but hopefully this will underscore that differences of opinion on the wisdom of the proposed conversion therapy legislation are not a case of "pure, cold-eyed evil" (thanks Philip Pullman) versus enlightened progressives.

Those questioning the bill have immersed themselves in the detail: consultation documents, multiple reference studies, a range of responses pro & contra, the interim Cass Review. Before you dismiss them, do them the honour of a similar breadth of research.

The first thing to understand is that people with qualms about the transgender aspect of the bill are not "in favour of conversion therapy". (Sigh - this should be obvious, but Twitter loves a cheap insult, so it needs saying.)

A vital question to ask is whether the term "conversion therapy" is even applicable in this context, but to answer that we need to address a more fundamental problem: what did the original proposals mean by "being transgender".

The lack of definitional clarity over what is meant by "being transgender" is the crux of the problem with the entire bill. The question for legislators is how to define "being transgender" so they could outlaw attempts to convert someone to or from this state.

There are a couple of options. One is to tie a definition to "having gender dysphoria", but this is not popular with trans lobby groups who seek to de-medicalise trans (while simultaneously demanding easier access to "trans healthcare").

Any definition of "being transgender" that links to gender dysphoria quickly reveals the risk of the bill impinging on holistic therapeutic support for people in distress. This is unlikely to wash, especially as Cass acknowledges the multiple causes of gender incongruence.

The second option for defining "being transgender" is to link it to having a "gender" (i.e. a "gender identity") that does not match the individual's sex. The belief/lack of belief in an internal "gender identity" cuts to the heart of the current sex/gender debate.

Legislators are rightly nervous about cementing in the statute a belief-based system (that we all have an internal "gender identity") & requiring everyone to subscribe to that belief. "Gender identity" currently has no status in UK law: introducing it is a serious step.

Crucially, protecting trans people against discrimination does not require "gender identity": the protected characteristic "gender reassignment" in the Equality Act offers protection without this concept. The Gender Recognition Act does not refer to "gender identity".

Nor does explaining and treating gender dysphoria require a belief that everyone has an internal gender that can be misaligned from our sex. This is important: not all trans or gender dysphoric people subscribe to gender identity theory or find it helpful.

Still, you might say that no-one should be pressurised in or out of their personal identity, whether that's a belief in an internal gender or anything else. But there is a major caveat for "gender identity": namely medicalisation. This particular identity has consequences.

No other aspect of individual identity is tied to lifelong medicalisation and irrevocable surgical interventions, with gender identity advocates declaring that children can be so sure of their inner gender that age should be no barrier to such decisions.

Slogans about being your "authentic self" or trans being "a sacred journey of becoming whole" (looking at you, senior church leaders) skip conveniently over the paltry clinical evidence for cross-sex hormone treatments & double mastectomies or the risks of gonadectomy.

The NHS NICE surveys of GnRH analogues and cross-sex hormones are not a pithy read, and the conclusion that the available evidence is very weak does not make for a catchy tweet to garner likes or a clickable newspaper headline.

The medical consequences of a trans declaration mean the utmost caution is required to legislate here. I'm no fan of the current government, but at least they have realised that bad legislation, no matter how well-meaning, comes with reputational damage and can cause harm.

Mounting evidence from desisters/detransitioners undermines claims that "being transgender" is just something you are & not subject to external influence or likely to change. We ignore their accounts at our peril.

Cass describes how "parents and carers play a huge role and are instrumental in helping young people to keep open their developmental opportunities." As originally proposed, the bill risked making such interventions prosecutable as "attempts at conversion".

Criminalising parents who reject the idea that their child's distress is caused by a misaligned internal gender identity would have had the potential for immense harm. It's not catchy, but complexity rarely is.