In a now-deleted video from last year, Dr. Blair Peters with Oregon Health and Science University (OHSU) described to Dr. Brianna Durand his use of robotic procedures in genital surgery to be experimental as they are still "learning and figuring out what works" and that they will know more in the next "five to ten years."
In the video, posted by the Daily Mail, Dr. Peters says that his passion "lies in genital surgery," and that the number of adolescents requesting the operation is expanding.
Dr. Peters notes that children who are placed on puberty blockers present unique challenges, especially for males, because there is not enough tissue to create a neo-vagina and the surgeon has to graft skin from elsewhere.
"The adolescence for sure presents some unique challenges," he said. "Obviously there's great evidence supporting pubertal suppression for a whole variety of benefits. But the one thing that is very new is genital surgery and someone that has underwent pubertal suppression."
"Those of us that do a fairly high volume of general gender-affirming surgery. You know, we've maybe done a couple, a handful of puberty-suppressed adolescents as a field and no one's published on it yet," Peters added. "OHSU is just putting our first series together as we're kind of learning and figuring out what works. But it's really changing things because you don't have enough tissue to line the vaginal canal. So you either have to take a skin graft or take skin from elsewhere or use an artificial product. The way that we're dealing with it is by using a robot, and we're basically performing intra-abdominal components of the surgery."
He goes on to say that robotic surgery itself is a "sub-niche of training." Of the complications, he says that patients can suffer "rectal injury and urinary incompetence," and others may have issues with "sexual satisfaction" and lower chances of "future childbearing."
For almost all males who undergo a vaginoplasty, the canal ends up shortening over time. "We've seen patients coming back even 20-plus years out from a vaginoplasty that have something happened in their life, that they just don't dilate, and aren't having sex for a year, and they will lose a lot of a lot of depth," he said.
In January, OHSU announced sn expansion of its "gender-affirming services" when it hired Dr. Peters, who is widely known for his social media presence as a queer doctor making jokes about the gruesome phalloplasty surgery. He one time joked that he had so many operations lined up he was renaming the season on his calendar as "phall."
He was also asked by Nike, in June, to speak at its pride month event to discuss performing double mastectomies on young females.
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