OHSU's Gender Chop-Shop 'Fesses Up

The strangest exclusive we will ever publish.

I have long believed that there is a sacred document hidden away in the locked desk drawers of the city’s top editors that lists the institutions and topics that…

must never ever under any circumstances

…be mentioned in what we charmingly call the “free press.”

The Portland list includes…

• Any real investigation of the Covid shutdowns, plus why almost no one in Oregon (or elsewhere) is taking the latest vaccine boosters.

• Cartels, the drug market, and politics.

• The sex-trade in homeless women.

• The dodgy world of nonprofits.

• Why some white people are so eager to plead guilty to centuries-old racial sins.

And so we come to a charter member of the Never Ever List: Oregon Health Science University, and, specifically, its clinics and medical personnel changing the appearance of people who, for various obscure psychological reasons, are utterly convinced they have something called “gender dysphoria.”

It’s a fact that “gender dysphoria” is a raging controversy not just in the US but world-wide. That alone ought to be catnip to journalists, Portland excepted.

Here’s a quick overview of recent stories that never attracted the curiosity of local editors…

• In recent weeks, two young women filed lawsuits against the American Academy of Pediatrics (AAP) and some of its affiliated doctors, arguing that the doctors harmed them irreversibly by subjecting them to “gender-affirming” hormonal treatments when what they needed was mental-health support.

• Deviating from his past legislative support of transgender youth in California, Democratic governor Gavin Newsom vetoed a bill that would have required parents to demonstrate affirmation of their child’s gender identity in custody court battles.

• Seven months after former pediatric gender clinician Jamie Reed blew the whistle on “affirming” care at Washington University Transgender Center at St. Louis Children’s Hospital, the New York Times has confirmed core elements of her story.

• A federal circuit court reinstated Alabama’s ban on gender-transition procedures and hormone therapy for children, ruling that a judge’s decision to block the ban was inappropriate.

• A leading Australian gender clinician, Dr. Stephen Stathis, has acknowledged that the evidence base for medicalized gender change with minors is of low quality and admitted there are questions about the reversibility of puberty blocker drugs.

• A letter in The Wall Street Journal from 21 clinicians and researchers from nine countries involved in care of teenagers presenting with gender distress said there is no good evidence that gender change prevents suicide, and politicized medical societies are exaggerating the benefits of these medical interventions while playing down the risks.

…and these are only stories from the last three months. Just to be fair, local media doesn’t have a total blackout on the OHSU Gender Clinics. Oregon Public Broadcasting breathlessly reported…

A bomb threat against Oregon Health & Science University is the latest in a string of attacks and harassment against health care facilities, spurred by far-right culture war issues and COVID conspiracies.

…and the Tribune limped into print with a story that had the odor of a rewritten press release…

A new study led by Oregon Health & Science University (OHSU) will evaluate the role of peer support for transgender and non-binary individuals seeking the gender-affirming surgery vaginoplasty.

According to OHSU, the Patient Centered Outcomes Research Institute will provide $7 million for research trials spanning over a five-year period.

…back in July.

Otherwise, silencio.

This prompts some obvious questions which any halfway competent editor might ask. Such as: Just how many people are being treated (or whatever you want to call it) at the OHSU clinic? And, mindful that one of their offshoot clinics is lodged at the Doernbecher Children’s Hospital (18 and under), how many of the patients are kids.

So, we sent an email to the ever-eager OHSU press relations department—available 24/7 as their web site proclaims—and awaited an answer to our routine query:

…which we filed on July 1st. And then we waited. And a month later came a response…

…whereupon began cat-and-mouse game too tedious to bore you with. The “public records coordinator” at OHSU mentioned during one of our phone calls that, well…this was sensitive stuff I had requested. Of course! That’s why journos tend to ask these sort of questions. Everywhere except Portland.

Fast-forward to OHSU’s semi-capitulation on October 20…

…for which PortlandDissent was billed $194.82, credit cards not accepted.

We’ll leave it to the reader to decide about the numbers; to our eye, it looks like gender reassignment is a rather big business over at OHSU—and, by golly! They’re doing a perfect job: no complications.

Including those the 11 kids who got, well..something done to them.

Which brings us to the world of billing codes: as with everything in modern medicine, it’s not simple. If you’re an insomniac, put yourself to sleep with this US government article, 15 dense pages, of how the magic numbers are devised.

Oddly enough, as we strapped on our tank for a deep dive, we couldn’t find anything that might pin down “DRG 0.” Not an auspicious beginning.

As for DRG 876, we were startled to read…

O.R. procedures with principal diagnosis of mental illness

…which one online source defines as…

Major Procedure with Principal Diagnosis of Mental Illness…

…which poses disquieting questions—unanswered by OHSU.

You could start a riot in this town arguing that gender dysphoria is really a mental illness. Or that “treatment” ought to start with mental counseling and a psychological workup before the hormones and cutting starts. As the recent open letter in the Wall Street Journal referenced above said…

…more and more European countries and international professional organizations now recommend psychotherapy rather than hormones and surgeries as the first line of treatment for gender-dysphoric youth.

Yes, OHSU’s list of staffers in its clinics indicates there’s exactly one clinical psychologist for those nearly 2000 patients in an eight month period.

Her bio…

Dr. Mary Marsiglio (they/them) is a clinical psychologist in the Transgender Health Program and an assistant professor in Family Medicine who provides gender-affirming mental health care for gender diverse, transgender and non-binary individuals.

…prompts doubts that OHSU/Doernbecher is doing much rigorous screening to separate the confused from the committed.

Much of the stuff happening in the operating rooms billed under a code for mental illness. Wonders never cease.

As for the other codes listed by OHSU…

OHTVOZZ (listed twice, who knows why): “Resection of Bilateral Breast, Open Approach.” Which, in common parlance, is a mastectomy. It’s a prevalent form of gender-reassignment surgery, although OHSU doesn’t mention how often breasts are removed. A quick DuckDuck produces a flood of images of breastless trans-whoevers who have gotten OHTVOZZed…

…which, if nothing else, proves your mileage may vary.

OW4M070: “Creation of Vagina in Male Perineum with Autologous Tissue Substitute, Open Approach.” As for photos…

Just for the record, PortlandDissent wrote about OHSU’s ace surgeon, Dr. Blair Peters and his robotic vagina-sculpting machine back in August. OHSU gives no hint about how often this major surgery, which has a list of complications as long as your arm, is performed—or if children under 18 are reworked.

Oddly, there’s no code supplied for the work of Dr. Jens U. Berli, head of OHSU’s Division of Plastic & Reconstructive Surgery, who “predominantly focuses on phalloplasty and facial gender confirmation surgeries.” The phallo-thingy involves…

Phalloplasty is an exceptionally complicated reconstructive procedure that attempts to create a structure that is penis-like. As patient goals vary widely, it is helpful to think about phalloplasty as a modular set of procedures that can be combined, mixed and matched to meet the needs of each individual patient while also taking into account their anatomy. Each module—but particularly the shaft and penile urethra—can be performed using a variety of techniques. To date, there is no consensus among surgeons regarding the optimum staging of the reconstructive steps.

Hard to believe Dr. Berli wasn’t doing any procedures.

OCQSOZZ: “Repair Larynx, Open Approach.” Which is a slight misnomer, since OHSU describes the surgery thusly…

Laryngochrondoplasty is also known as Adam’s apple reduction or a tracheal shave (though the trachea, or windpipe, is not affected). A surgeon removes thyroid cartilage at the front of the throat to give your neck a smoother appearance.

This is part of a suite of services, including…

Vocal surgery: “We use a surgery called a Wendler glottoplasty. It’s done through the mouth under general anesthesia. The surgeon creates a small controlled scar between the two vocal cords, shortening them to increase tension and raise pitch. Unlike techniques that can lose effectiveness over time, this surgery offers permanent results.”

…along with…

Browlift; Cheek augmentation; Chin surgery (genioplasty), including reductive, implants or bone-cut options; Eyelid surgery; Forehead reduction, including Type 3 sinus setback and orbital remodeling; Hairline advancement; Jawline contouring; Lip lift and/or augmentation; Lipofilling (transferring fat using liposuction and filling); Nose job (rhinoplasty)…

If you scan the supplied list of codes against the procedures mentioned above, you might wonder if the list reflects what’s really happening over there. OHSU advertises “puberty blockers,” but there’s no magic code listed for that intervention. How about the variety of sex-simulating stuff, such as chest-binding and augmented underwear? Do they or don’t they?

OHSU remains silent. It’s…sensitive.

But at least you—and you alone—actually know how many people (and kids) have been put on the reassembly line to a new sexual identity.

As for the essential question: are they really members of the opposite sex when they’re checked out of the clinic? That’s at the heart of the argument, along with how many angels can dance on the head of a pin.

No local editors want to venture into that swamp. Although other states seem to have answered: no more swamp. At least in much of America’s fly-over country…

…and in the U.K., Sweden, Finland, Norway, and France, which now urge caution in their use of hormones and other therapies for minors, stressing a lack of evidence that the benefits outweigh the risks.

Well, we do things differently in Portland. Which means the silence is deafening.

As for the $194.82…the check’s in the mail.