My Letter to the Surgeon Who Performed My Double Mastectomy: Detransitioner Perspective

This is a copy of the letter I mailed to the surgeon who performed my double mastectomy or “top surgery” when I was 20 years old. This letter, addressed as a “Notification of Detransition” was mailed to the cosmetic surgeon.  I wrote this letter to inform the doctor and his staff that a former patient of his 100% regrets the operation performed on her, and has detransitioned and is now living as a biological female with no functioning breasts.

I kept the letter short and emotionally detached and, despite my traumatic feelings around this loss of self and body parts in my private life, knew it was crucial to maintain a rational composure in stating the facts of my situation. I described how my gender dysphoria was not cured by surgery or medical transition, but instead was fully resolved within 2 years through cognitive behavioral therapy, because the “gender dysphoria” was in reality, complex post-traumatic stress disorder. I described how I realized, only 2 years later at age 22, that the surgery had been a mistake, and that I didn’t receive proper mental health treatment when I was obtaining the surgery, the supposedly necessary gatekeeping he required to perform the operation.

This was important to include because, although I doubt as a cosmetic surgeon who has made his career entirely dedicated to performing double mastectomies on young women and girls as young as 16, that he cares about the mental wellbeing of his cliental, he advertises his practice as being a legitimate medical service by insisting that he follows the “WPATH Standards of Care”, the leading organization of trans medicine which requires at least 2 letters of referral from mental health providers for a patient to receive medical transition. The Standards of Care advocate for thorough screening for mental wellness, and selecting only appropriate patients who would truly benefit from transition.

It was crucial to inform the doctor that, in my case, the Standards were not met, as the mental health care I was receiving, and the subsequent referral letters, were negligent in providing assessment of my mental health situation, and therefore, his practice was not actually following the WPATH Standards of Care. Furthermore, what I did not include in the letter due to a desire to preserve my anonymity, was the fact that I openly discussed being suicidal with the doctor during our consultation, and feeling suicidal on the day of the actual surgery. Regardless of the recommendation letters, I presented to my doctor as not of sound mind to make a major elective surgical decision, but he performed the operation anyway.

After relaying my personal beliefs that this treatment was unethical in my case, I made it known to my doctor that I am far from the only former FTM patient who regrets medical transition, and cited Dr. Lisa Littman’s study of detransitioners showing how high the comorbidity rates are of various mental disorders in the FTM population, and how this issue is not just a personal error, but a growingly widespread phenomenon. I closed the letter with a call to action for the doctor to reconsider what his practice views as ‘medical treatment’ to treat mental disorders. I plainly asked him to confront the reality that he removes young women’s and even minor children’s breasts to treat problems inside their minds, and if he truly believes that is following the medical oath to “Do No Harm.”

My story is similar to many detransitioners who share why they felt they needed to transition. I grew up on the autism spectrum, experienced verbal, emotional, and psychosocial abuse from family resulting in PTSD, depression, and anxiety, had severe depression from attachment issues and hormonal dysregulation from PCOS, felt chronically othered and different as a girl, young woman, and person, suffered with relationship difficulties with romance, sex, and friendship due to undiagnosed trauma, and latched onto “gender dysphoria” as the cause of most of my difficulties.

I sought treatment for my gender related distress and learned online that the only solution was to accept being transgender and transition to live as a gay man. I followed the usual coaching of the process to “healing”, first, to socially transition and come out as nonbinary and transgender, second, to receive hormones from an informed-consent clinic, with no mental health evaluation or gatekeeping, and finally to have top surgery, the greatest rite of passage for the FTM cult. Throughout this process I saw multiple doctors, a psychiatrist, and therapists, none of whom questioned my identity, traumas, or provided help for my complex mental health issues. I had just turned 20 and was fresh out of an inpatient psychiatric ward for suicidal ideation when I desperately made my appointment to try and heal my depression through altering my body with surgery.

There is no need for further explanation. I was 20, developmentally immature, mentally ill, suicidal, had PTSD, and not in a rational state of consciousness, yet the mental health system failed to provide its due service, and my doctor and other cosmetic surgeons hungrily leapt at the opportunity for fresh meat to profit from operating on, in this unchecked, wild west market for “gender medicine.”

I share this letter with you to showcase real-life consequences of trans medical propaganda, and the repercussions our young people and children are facing. The last I checked; my doctor operates on girls as young as 16. I’ve done my soul-searching, grieving, extensive therapy, and self-punishment for the mistakes of my childhood self, but am healed enough to have progressed into self-forgiveness, acceptance, and upholding unrelenting boundaries around my peace, sanity, and healing process. I did not provide a return address on the letter I mailed, as I did not want to endure excuses or shaming correspondences.

The letter remains a rallying cry from the young women of the detrans movement to advocate for better medical treatment, no placation or bullshit apologies desired. I don’t claim to speak on behalf of anyone else, but unfortunately appreciate that my story is identical to countless other girls, and I hope that sharing this will somehow help them heal, or better yet, prevent the need for their healing in the first place.

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Dear Dr. XXXX and Top Surgery Clinicians,

I am a former patient who you performed a double incision mastectomy on in 2017 while I was 20 years old. I am writing to inform you and your office that I have detransitioned and no longer identify as male/transgender and have returned to living fully as my biological female sex. I want to inform you that I fully regret having the surgery to have my breasts removed. My symptoms of gender dysphoria were the result of CPTSD from childhood abuse and my transgender identity was a maladaptive coping mechanism to deal with the reality of the trauma.

I have fully resolved my feelings of gender dysphoria through cognitive behavioral therapy and view the surgery and transition as a placebo that gave me only false hope of feeling better about myself. I 100% regret the surgical outcome of my body and miss having my healthy breasts. I was 20 when I had my identity crisis and detransitioned 2 years later at 22. I believe I did not receive proper mental health screening by my psychiatrists who wrote my surgery recommendation letters because they said I was mentally stable while I was actually suicidal and exhibiting symptoms of undiagnosed PTSD.

I have found healing and community within the online population of other detransitioned women with similar experiences of trauma, and I want to inform you that I do not believe removing the breasts of young women, especially minors, is medically ethical given the severe rates of comorbid mental health issues in the FTM population. I do not believe I was stable or mature at 20 to transition and I don’t think a minor child under 18 in any circumstance is stable or mature to consent to having her breasts removed.

There is a rising number of detransition cases just like mine as evidenced by the rapid increase of detrans stories on Youtube, and the Subreddit r/detrans. There has also been a recent study by Lisa Littman at littmanresearch.com on detransition which shows that 60% of the detrans study participants transitioned due to underlying mental health and trauma reasons, and 25% due to being lesbian or gay.

I ask you to consider my story and the stories of others as your ethical duty as a clinician to first do no harm, and rethink if removing healthy breasts of women and children so they can pretend to be men is physically or mentally doing no harm.

Your patient, Laura