Capitulation: "Convenient" Advocates

The Abandonment of Trans Youth by Gender Affirming Surgeons

In late 2007, I was contacted by a friend working with me at a Portland, Oregon, youth group about speaking with a pediatric endocrinologist who worked at one of Portland’s leading children’s hospitals. This physician was interested in learning more about psychological and emotional trauma that transgender children and adolescents experienced due to being forced to experience pubertal changes that, while congruent with their biological sex, were in complete opposition to their gender identity. She had recently been reading about Dr. Norman Spack’s work at Boston Children’s Hospital in suppressing pubertal changes for such youth, and she was interested in exploring the establishment of clinical services that would deliver the same gender-affirming care to pediatric patients here in Portland.

We first met hunched over a cluttered desk in my friend’s work office. I was showing her a slide presentation I’d created as part of my early advocacy work for trans children, youth, and their families. I covered the long history of mental health awareness of the existence of transgender children, mostly from adult narratives of their early recognition of ‘being different’ from their peers. I also shared with her my direct engagement with trans kids and their families, and the benefits that had been witnessed from not only delivering gender-affirming care in the form of pubertal suppression, but from simply supporting a young person in their desire to express themselves socially as their true gender.

We became fast friends and continued working together on what would be needed logistically to establish such a clinical practice. This included introducing her to youth and families that would benefit from her services. Within a year, I was invited to give a presentation as part of the hospital’s ‘grand rounds’, and the clinic was taking new patients.

Roughly within the same time frame, I had begun consulting and collaborating with other pediatric endocrinologists at Oregon Health & Science University on the same topic. I was invited to present to a cohort of physicians who were part of a pediatric endocrinology Fellowship about the benefits of pubertal suppression treatment for trans youth, starting at Tanner Stage 2. Soon, those discussions expanded beyond the confines of pediatric endocrinology to a working group seeking to establish a Center of Excellence for transgender healthcare at OHSU.

I was invited to join the OHSU Partnership Project development committee, which was a great and humbling honor for me, as I was neither a physician nor a mental health provider. I was, and still am, just an advocate. A passionate, well-informed, (autodidact) advocate.

By 2014, the OHSU Transgender Health Program had secured funding and, in 2015, began offering a range of services, including gender-affirming care in the form of pubertal suppression and gender affirming hormone therapy for transgender adolescents and teens. It also collaborated with the organization I founded, TransActive Gender Center (later TransActive Gender Project at Lewis & Clark Graduate School), to provide support groups, education, and advocacy to the families of those youth.

This was (and still is) an amazing team of intelligent, compassionate, and committed individuals who understood the benefits of gender-affirming care and were unafraid to deliver such care to the best of their ability. As a result, I have little doubt that hundreds of lives have not only been vastly improved, but in many instances, literally saved.

My involvement with the OHSU Transgender Health Program did not end there, and the next step came about in the most obtuse way imaginable.

I’d been having issues with recurring kidney stone attacks. Annoying and exceedingly painful. As a patient at OHSU, my primary care physician made a surgical referral to a urologist named Daniel Dugi. I met with him, and not only did I feel an immediate sense of trust in his skills, but I was deeply moved by his bedside manner. As we discussed my upcoming surgery, I mentioned that I was trans (so he didn’t encounter any potential surprises as he navigated my surgically revised urethra).

Dr. Dugi was unfazed and showed genuine, non-invasive curiosity about my experiences as a trans woman. I was to be, as far as he knew, his first trans woman kidney stone ‘blasting’ patient. As we chatted, and with the OHSU Transgender Health Program on my mind, I mentioned to him that (putting it crassly), looking into becoming proficient at performing gender-affirming ‘bottom surgery’ might be both highly beneficial to the trans community and a potential revenue stream for him.

At the time, OHSU did not have any surgeons performing those procedures, and I knew demand for gender-affirming ‘bottom’ surgeries was going to increase because I had just played a role in securing expanded coverage under Oregon Medicaid for gender-affirming care.

“You ought to do this surgery!” I said. And no shit…he did.

Fast forward to why I’m writing this now, in the summer of 2025. I must tell you that being the first to report what is happening both breaks my heart and infuriates me.

It has come to my attention from multiple reliable (confidential) sources that several surgeons who perform gender-affirmation surgery of all kinds at OHSU (and have done so for several years) have now declared they will no longer perform these surgeries on anyone younger than 19 years of age. Full Stop.

[To the best of my knowledge, as of December 2025, gender-affirming hormone therapy (GAHT) and pubertal suppression (“blockers”) continue to be available.]

It would be easy for readers to jump to the conclusion that this development came as the result of OHSU administrative fuckery or pre-compliance with Project 2025/MAGA executive orders, and the intention to commit a slow ‘genocide by denial of care’ pogrom against transgender, nonbinary, Two-Spirit children, adolescents, teens, and their families. I admit, writing this off to administrative cowardice is almost always a convenient scapegoat.

But no. It ain’t ‘The Man’ in this case. OHSU itself is not (as of this writing) the evildoer. Instead, it’s a cabal of OHSU surgeons acting independently of the institution who are shutting down delivery of safe, effective, best practice, life-saving gender affirmation surgery at OHSU. This includes people I formerly held in high esteem, including Dr. Jens Berli and the self-described “queer surgeon” Dr. Blair Peters.

Dr. Peters has made quite a name for themself around the country, talking about how important it is to stand up to disinformation about trans healthcare, and how we should not surrender to anti-trans persecution (check them out on Instagram and YouTube).

Uh-huh…you go, girl.

Sources tell me that the rationale for this betrayal is a movable feast that includes fear of prosecution by Marjorie Taylor Greene, fines, loss of licensure, and other amorphous penalties associated with the nonsensical “Protect Children’s Innocence Act”, which was amended on September 26, 2025, and is waiting to be scheduled for a floor vote in the House of Representatives.. Additional sources tell me that some of these surgeons have been drinking ‘Detransition Narrative Kool-Aid’. This imbibing from the poisonous well of the Lisa Littman/Abigail Schrier/Robert F. Kennedy/Julia Mason/Genspect ‘detransition’ idiocy is also (potentially) influencing other clinical service providers.

“The fault, dear Brutus, is not in our stars,
But in ourselves, that we are underlings.”

In the end, isn’t becoming an “underling” exactly what everyone and everything from John Money, to Richard Green, to WPATH, the DSM, and the New York Times has tried to corral us into being? Mere players in the multi-millennial patriarchal psychodrama perpetrated on a humanity struggling only to express what every rational person either does, or is capable of recognizing to be a natural variation in human development.

I’m a nobody. Just another trans woman who has survived thus far by knowing when to duck, when to hide, and when to step the fuck up and say “no more!”

To these forementioned former colleagues and ‘friends’ at OHSU, I say shame on you. Shame on you for the lives you are disrupting and, yes, destroying. Shame on you for disengaging from those who would hold you accountable, who would remind you of who you once were, and why you are no longer that. Shame on you for your hypocrisy, for wanting to be seen as trans care heroes while throwing away the currency of the very trust that trans-spectrum people have graced you with.

We will fight this. We will band together and email/petition Oregon Attorney General Dan Rayfield to enforce Oregon law (HB 2002)¹ which requires access to gender-affirming care. We will elevate and celebrate our TRUE ALLIES, and stand beside them when they fight for us. We will CALL OUT and IDENTIFY those who betray our children, youth, and families.

This is not the time for turning the other cheek or giving our LGBT, queer, queer-adjacent, and so-called feminist friends and allies the benefit of the doubt when they side with our oppressors, or actively and passively facilitate the intentions of our oppressors.

Shame on anyone self-centered or narcissistic enough to believe medically deserting trans children, youth, and their families is justifiable, and that such actions will protect you from the neo-fascist, Christian Nationalist horrors being inflicted upon our most vulnerable.

1. Oregon Legislative Assembly, House Bill 2002; Gender-Affirming Treatment, Section 20.