The number of American children mutilated and sterilized on "trans" ideology grounds

Over 6,000 American children have been mutilated, and likely more than that number sterilized, because they say something to the effect of “I’m trans”, “I’m nonbinary”, or a newer “gender” after learning those constructs at school, or from the web, or having been transed by their parents from a young age (e.g. 4 years old).

Here I gather the relevant data in one place.

“Gender affirming care” consists of puberty blockers, sterilizing hormones (testosterone for girls, estrogen for boys), and mutilating surgeries. My sense is that virtually everyone underestimates the number of children subjected to these ministrations, even conservatives fighting to ban these practices. Many leftists still deny they’re happening, when they’ve been documented in journal articles for at least six years. Here’s the data:

Mutilation

For our purposes, I define mutilation as removing or destroying major body parts for non-medical reasons.

Girls

The most common form of mutilation on leftist grounds is cutting off girls’ healthy breasts — double mastectomy.

1. Using an all-payer national insurance database, the Manhattan Institute found 5,288 to 6,294 “gender affirming” double mastectomies for girls aged 12-17, from 2017 through part of 2023.

2. In a different insurance claims study, Reuters found 776 double mastectomies from 2019 through 2021 for girls age 13-17 with a gender dysphoria diagnosis.

3. A 2018 journal article by Johanna Olson-Kennedy and colleagues proudly reports how they cut the healthy breasts off ≈46 girls age 13-17 in just half of 2016 at Children’s Hospital LA. Read my breakdown of this study here.

4. A 2022 journal article by anesthesiologists at Boston Children’s Hospital proudly reflects on their experience knocking out 65 girls age 15-17 so that their colleagues could cut off their healthy breasts.

5. A 2022 journal article reports that Kaiser Permanente Northern California cut the healthy breasts off 209 girls age 12-17 from 2013 through mid-2020.

So what do we have here? Our largest estimate, from the Manhattan Institute, is an underestimate. As you can see, it excludes everything before 2017, including Olson-Kennedy’s victims at CHLA and whatever was going on at Kaiser Permanente in 2013-2016. More broadly, it only counts mutilation covered by insurance, and only if there was a gender dysphoria diagnosis. All out-of-pocket cases are excluded.

When did American doctors start mutilating children? Likely no earlier than 2007. That’s when Norman Spack opened a gender clinic at Boston Children’s Hospital (see Biggs for more). They started with drugs/hormones — it’s not clear when they expanded to mutilation, or if they were the first in America to do so.

In summary, we can confidently and conservatively say that over 6,000 girls age 12+ have been mutilated, given the Manhattan Institute estimate and how much it excludes.

Orwell Alert: Leftists use various unethical Orwellian terms to describe cutting off girls’ healthy breasts, such as: top surgery, chest surgery, chest reconstruction, masculinizing chest surgery, and transmasculine chest surgery.

Girls and Boys

Activist surgeons also genitally mutilate children, at lower rates than the breast removal. We have one data point. In the same insurance claims study, Reuters found 56 genital surgeries for children aged 13-17 with a gender dysphoria diagnosis from 2019-2021.

The Reuters figure will be a severe underestimate, since it excludes 2007-2018¹ and 2022 onward, and it only counts insurance-covered instances. Conservatively figure a few hundred victims.

What are the genital surgeries?

1. For boys, castration (orchiectomy) and penectomy, typically paired with “vaginoplasty” (carving out an imitation vagina).

2. For girls, vaginectomy, typically paired with “phalloplasty” (attaching an imitation phallus, made from forearm flesh). I think a hysterectomy is common in this scenario, but there’s no data.

Reuters didn’t break it down by sex or procedure, and the practitioners are not forthcoming.

Orwell alert: When leftists talk about castrating boys and genitally mutilating girls, they usually call it “bottom surgery”, “gender confirmation surgery”, or genital surgery.

Sterilization

All the genitally mutilated children will be sterilized, but most of the sterilization is chemical. In their insurance study, Reuters found that 14,726 children had started cross-sex hormones, and 4,780 had started puberty blockers, from 2017-2021 (a different period from their surgery numbers, which was 2019-2021). There will be some overlap (some children got both).

This excludes 2007-2016 and 2022 onward, and all out-of-pocket cases.

I can’t find concrete data or rates, but cross-sex hormones should be sterilizing in most cases, given a full regimen. The sterilization risk should also vary by sex. Taking puberty blockers first will increase the odds of sterilization, and blockers will prevent development of the phallus, for example, creating a de facto sterilization situation — at a certain point, size does matter and procreative intercourse is infeasible. Note also that in many cases blockers permanently destroy a child’s ability to orgasm in the future, before they’ve ever experienced it.

In summary, we can easily estimate that tens of thousands of children have been given puberty blockers and/or sterilizing hormones on leftist ideological grounds, extrapolating from the 14,726+ Reuters’ snapshot of 2017-2021. The number of those children who have been sterilized is unknown, but I’d bet on more than the 6,000+ mutilated.

False claims

I was motivated to gather this data by repeated false claims by leftist media and academics. They’ve accrued a massive corpus at this point, but for now I’ll point out two.

1. Politifact is notoriously unreliable and partisan. Their activist Yacob Reyes claimed there were only two examples of teenagers receiving “transition-related surgeries”, and none under the age of 14, in decreeing that Ron DeSantis spoke falsely when he told the truth about these surgeries.
   
   This was in 2022, four years after Olson-Kennedy had published her study cutting the healthy breasts off ≈46 girls age 13-17. At the time that Politifact published its “fact check”, well over a thousand American children had been mutilated on leftist grounds. They made no apparent effort to find anything, cited none of the journal articles, did not cite any non-leftists who could’ve filled them in, and seemed to know nothing about the topic.

2. Harvard is notoriously unreliable and partisan. They recently published a bizarre one-page journal article comparing the number of “breast reductions” for boys to the number of breast reductions for “trans and gender diverse” minors (girls?). This comparison is as relevant to this issue as yesterday’s weather in St Louis, but their obfuscation and the efforts of leftist activists made many people think this showed that mutilating surgeries for trans-indoctrinated children were rare. “Breast reduction” is not a relevant procedure in this topic.
   
   Attentive reading is critical. Harvard did everything it could to deceive the public, but there was one word that was a critical clue. From their press release: “…utilization of analogous gender-affirming surgeries.”
   
   Normal people don’t get castrated or have their healthy breasts cut off (absent high-risk BRCA/cancer calculus). There’s nothing analogous, so Harvard dug up breast reduction. Their journal article is a rich example of obfuscation and deception, worthy of inclusion in textbooks and museums. I invite you to read it. It’s only one page long, but you’ll need more time than you think — figure 30 minutes. The only hint I’ll give you is that you simply must pay attention. If you think you understand it on your first reading, you don’t.

NOTE: DoNoHarm, an excellent medical group fighting the sterilization and mutilation of children, recently released estimates of their own. I’ll fold theirs in after reviewing them, but it looks like they’re slightly smaller than the Manhattan Institute’s, and it might a shorter span of years.

1. The castration of Jazz Jennings is one notable example that is not included in the Reuters estimate because it happened in 2018.