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55% of trans women who have 'bottom surgery' are in so much pain they need medical care years later,
According to study of dozens of cases, up to a third struggle to use the toilet or have sex
January 21, 2023
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Researchers from the Women's College Hospital (WCH) in Ontario, Canada, analyzed the medical records of 80 patients who sought care from the clinic between three months and five years after having the operation.

Campaigners say the findings demonstrate that complex surgeries like vaginoplasty often carry risks that patients are unaware of - at a time when there has been a dramatic uptick in the number of gender reconstruction surgeries in the US and Canada.

Of the 80 trans women sampled in the Canadian study, almost 54% reported ongoing pain up to two years after their vaginoplasty surgery. Many had more than one symptom, which included vaginal dryness, numbness, malodor and issues with the wound's healing

Research in October indicated the number of patients going under the knife increased more than 150-fold between 2010 and 2018.

It is thought that the reduced stigma and heightened awareness around trans issues have contributed to the rise.

In the latest study, Canadian researchers looked at the medical records of patients who sought care between 2018 and 2020 at WCH's newly opened Postoperative Care Clinic.

All 80 patients had the original vaginoplasty procedure outside of the Women's College health system but were experiencing symptoms that needed follow-up care.

Of the 80 trans women sampled in the Canadian study, almost 54% reported ongoing pain up to two years after their vaginoplasty surgery. Many had more than one symptom, which included vaginal dryness, numbness, malodor and issues with the wound's healing

 

Some had traveled as far as India and Thailand to have the operations, which the researchers say may explain the relatively high number of medical complaints.

The most common symptoms reported by post-op patients were pain (53.5 percent), bleeding (42.5 percent) and dilation issues (46.3 percent). 

Severe side effects were much rarer, but in 12 cases - or 15 percent - patients experienced vaginal stenosis, the narrowing and shortening of the vagina.

In two other cases, patients had severe infections around the surgical site, and another two were hospitalized with mental health problems.

Much more common were minor outcomes like difficulty urinating (22.5 percent), sexual problems (33.8 percent), and poorly healing wounds (21.3 percent).

A total of 15 patients (18.8 percent) also told the clinic they were dissatisfied with the appearance of their new vulva and wanted some cosmetic revision.

Researchers from the Centers for Disease Control and Prevention (CDC) used data from the Youth Risk Behavior Survey, which was administered to around 6000 high school students in three school districts in Florida and California.(Graph provided by Medscape.com)

 

Most complaints of ongoing pain were treatable with topical medication or more regular check-ups. 

Although classified as 'minor' in medical records, many of these symptoms had the potential to grow into much more serious difficulties had patients not sought treatment, the study emphasized. 

For this reason, 'surgical centers should be providing ongoing post-operative care, especially in the first year after surgery,' researchers urged. 

This is especially crucial given the rise in popularity of the procedure in recent years and its high cost, which can push those seeking the surgery to cheaper and less well-regulated surgeons overseas.

Bottom surgeries such as vaginoplasties and phalloplasties - genital reconstruction undergone by women transitioning to men - cost around $25,000. 

The above map shows the population of transgender adults and children across America in 2020, according to the Williams Institute at the University of California, Los Angeles. Its estimate for children aged 13 to 17 has doubled since 2017. It shows the highest population is in southern states, followed by those along the east coast

 

'It is quite clear from the most up-to-date studies that vaginoplasty and other genital surgeries don’t work in the way that people hope they will,' says Stella O'Malley, psychotherapist and director of campaign group Genspect.

'The reason why there is so many problems is because this is an incredibly difficult surgery. Young vulnerable people need to know about the challenges they will face post surgery but few of them do.' 

In recent years, an increasing number of de-transitioners - those who regret their decision to transition and later reverse it - have spoken out about medical side effects to the procedures that they were not previously made aware of. 

One such detransitioner by the name of Shape Shifter claimed he regretted his mastectomy and vaginoplasty after they led to fistula and other painful consequences. He says he realized he was simply a gay man who liked showing his feminine side, and began to detransition.

The latest study was published in the journal Neurourology and Urodynamics.

In Canada, the first country to collect and publish data on gender diversity from a national census, 100,815 transgender individuals make up 0.33 percent of over-15s. 

There are approximately 1.6 million transgender and non-binary adults living in the US, which makes up around 0.5 percent of the adult population. 

Gender-affirmative care for US adults and adolescents can include a number of medical, behavioral and social changes, as well as surgery.

For adolescents who have not yet gone through puberty, puberty-blocking medication can suppress the release of the sex hormones testosterone and estrogen, which halts the development of secondary sex characteristics like breasts and facial hair.

Whether or not original puberty was blocked, trans adults and adolescents can also begin hormone therapy, which essentially initiates the puberty of their gender identity. These hormones can be taken as pills, patches and gels, and are taken continuously throughout adulthood, or until the desired physical traits are achieved.

Surgical options include facial, chest and genital altering procedures, and are generally the last step of the transition process. 

According to the World Professional Association for Transgender Health, anyone seeking bottom surgery is recommended to have completed certain criteria such as: reaching the age of adulthood in their location; having persistent, diagnosed gender dysphoria; having the capacity to make an informed decision; and completing 12 continuous months of hormone therapy while living the congruent gender identity. 

Vaginoplasty - the procedure undergone by patients in the new study - is a particularly invasive procedure, requiring a surgery during which the penis and testicles are removed and a functional vagina is created.

The most common form of vaginoplasty is a Penile Inversion, whereby skin removed from the penis is inverted to form a pouch and inserted into a cavity created between the urethra and rectum. The urethra is then partially removed, shortened, and repositioned. 

Medical Graphic showing Vaginoplasty, an invasive surgical proceedure (source:https://bca.org/ )

 

For female-to-male genital reconstruction, doctors can construct a penis by using a flap of skin, fat, nerves and arteries - usually taken from the arm or thigh - and grafting it on to the groin. In some cases, surgeons will lengthen the urethra to allow for urination from the tip of the penis, or add testicle implants and an erectile device.  

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AMA Suspension Signals Growing Institutional Reassessment of Pediatric Gender Medicine

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Repeat Arrests Raise Concerns After Watertown Woman Charged Twice in Four Days

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AMA Suspension Signals Growing Institutional Reassessment of Pediatric Gender Medicine

Several days after the American Medical Association announced it would suspend its involvement in pediatric gender surgeries and chemical transition for minors, the broader implications of the decision are beginning to come into focus. While early coverage framed the move as another flashpoint in a polarized cultural debate, the action more closely reflects a loss of institutional confidence in a medical model long presented as settled.

The AMA’s decision follows a growing international reassessment of pediatric gender medicine, most notably outlined in the United Kingdom’s Cass Review, an independent, multi-year evaluation of gender services for children and adolescents commissioned by the National Health Service. The review found that many commonly cited claims about the benefits of medical transition for minors were based on low-quality evidence, including small observational studies, short follow-up periods, and heavy reliance on self-reported outcomes (Cass Review, Final Report, Evidence Base Overview).

 

Dr. Hilary Cass also warned gender questioning children experiencing "distress" were being passed to identity clinics because many doctors were "fearful" of the toxic debate about the issue.

 

The Cass Review did not conclude that all medical intervention was inappropriate. Instead, it emphasized that the evidentiary foundation supporting routine medicalization of gender-distressed minors failed to meet the standards typically applied in pediatric care; particularly when interventions carry irreversible consequences and long-term outcomes remain largely unknown (Cass Review, Clinical Standards and Safeguards).

Within the United States, institutional messaging often conveyed a higher degree of certainty than the evidence warranted. Parents were frequently asked to consent to life-altering medical decisions under conditions of urgency, with clinicians and professional organizations assuring them that benefits were well established and risks minimal. The Cass Review found that alternative explanations for a child’s distress including trauma, autism spectrum conditions, and comorbid mental health disorders were often underexplored prior to medical intervention (Cass Review, Mental Health and Neurodevelopmental Factors).

As those medical decisions became irreversible, a shift occurred in the public discourse. Parents whose children had already undergone medical transition increasingly emerged as some of the most prominent advocates for the model itself, often positioned as uniquely authoritative voices in policy discussions. Their testimony, grounded in lived experience, was frequently treated as dispositive rather than contextual.

 

Minnesota Lt. Governor Peggy Flemming wearing a "Protect Trans Youth" shirt featuring a military style blade on the day the state Governor Tim Walz declares Minnesota a "Refuge for Trans Youth"

 

The Cass Review helps illuminate why this dynamic took hold. When evidence is limited but decisions are permanent, uncertainty becomes difficult to accommodate. In such conditions, personal medical choices can be reframed as universal necessities; an approach that diffuses responsibility across families, clinicians, and institutions alike. If a treatment pathway is presented as appropriate for all, accountability for adverse or unintended outcomes becomes harder to assign.

Importantly, this pattern does not describe all parents of gender distressed children. Many acted in good faith, relying on guidance from medical authorities they trusted. However, Cass underscores that institutional confidence preceded and shaped parental consent, not the other way around.

The AMA’s suspension does not introduce new scientific findings. Instead, it reflects what the Cass Review documented years earlier: that the medical consensus was far more fragile than public assurances suggested. As major institutions now step back from categorical support, unresolved questions about evidence standards, informed consent, and responsibility are returning to the center of the debate. These things are no longer avoidable, and no longer abstract. 

 

Many conversations continue to take place about over representation do to political rhetoric and progressive policies making gender transitioning as a trend that children can join in.

 

Despite vocal pushback and instances of harassment and violence from some quarters of the transgender community, the medical consensus is increasingly clear: transitioning minors is not the definitive solution. Leading experts now emphasize the importance of comprehensive mental health treatment that addresses underlying conditions and causes contributing to gender dysphoria and body dysmorphia. No amount of intimidation or threats can alter the fundamental principle that care must be guided by evidence, caution, and the best interests of the child.

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The Vanishing Father: How a Culture Built on Emotion Pushes Men Out of Protecting Their Own Children
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Inside the Quiet Shuffle
How Watertown City School District Removed a Troubled Art Teacher, Buried the Trail, and Quietly Rehired Her the Same Day

For months, the Watertown City School District has insisted that the concerns emerging from within the art department were being addressed through the appropriate channels. But new information reveals a very different story—one that suggests the district’s priority was not accountability, but silence.

Trash Media Group has learned that the art teacher at the center of a long-running series of complaints allegedly resigned effective December 1st. That resignation, however, did not remove her from the school environment. Instead, sources indicate she was rehired into the English Department on the very same date. No announcement was made, no explanation was offered, and no effort was taken to inform families, staff, or the public about the stunning same-day transition.

 

Information Obtained By Trash Media Shows The Resignation & Rehire Effective The Same Date December 1st 2025.

 

Quiet transfers like this are sometimes used by school districts to shift problematic employees without drawing outside attention, triggering public records, or risking union disputes. But in this case, the timing and secrecy raise serious questions about what the district was trying to avoid. A teacher whose conduct reportedly generated repeated warnings, internal complaints, and growing concern among students and staff was quietly removed from one classroom only to be placed into another, with full access to students, without so much as a pause or public acknowledgment.

People familiar with the art department describe months of strain and disruption. Complaints were raised through proper channels for an extended period, yet the district stalled, redirected, and downplayed issues rather than addressing them head-on. Staff members reported feeling frustrated and dismissed, and students described the classroom environment as unstable and sometimes distressing. These concerns were not isolated or sudden; they formed a pattern the district could not credibly claim to be unaware of.

This covert December 1st shuffle fits into a larger trend within the Watertown City School District, which has faced repeated criticism for downplaying serious issues, withholding timely information from families, and failing to communicate transparently with the community. Over the past year, the district’s public posture has routinely emphasized stability and control, even as teachers, parents, and students have described the exact opposite.

 

The key issue now is why the district chose to move this teacher quietly into another department rather than take meaningful action. If her conduct warranted removal from the art department, what justified immediately placing her in the English Department? If the district believed her to be fit for continued employment, why was the move handled in a way that ensured no one outside the central office would know it had even occurred? The decision to make the resignation and rehiring effective on the same day appears designed to eliminate any visible separation in her employment record, raising further questions about what the district hoped would remain hidden.

Trash Media Group has formally asked the Board of Education to clarify the circumstances surrounding the resignation, the rehiring, the complaints from the art department, and the lack of public disclosure. As of publication, the district has not responded to any request for comment.

 

A Screenshoot of Graphic Images Displayed In 7th Grade Art Class At Case Middle School.

 

Now that the story has reached national platforms, including Libs of TikTok with its enormous audience reach, the district can no longer rely on quiet transfers and internal fixes to escape scrutiny. Parents deserve to know why their children’s classrooms have been treated as pieces on a chessboard. Teachers deserve to understand why their concerns were ignored. And the community deserves honesty from a district that has repeatedly chosen secrecy over accountability.

Trash Media Group will continue investigating this situation as more information becomes available. Anyone with direct knowledge of the events surrounding the art department or the teacher’s reassignment is encouraged to reach out confidentially through email or phone at: [email protected] or (315) 783-6732.

 This story is far from finished; and the district’s silence will not make it go away.

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