Las Vegas gender surgeon claims doctors who wait to do sex changes until patient is 18 are protecting themselves, not the patient

A gender surgeon has become the first in the state of Nevada to perform sex-change genital surgeries, offering risky vaginoplasty surgeries to males who believe themselves to be women and has his set his sights on expanding his services to offer phalloplasty to females who believe themselves to be men in the near future.

Dr. John Brosious, a board certified gender and reconstructive surgeon in Las Vegas and founder and director of the Gender Surgery Program at the University of Nevada Las Vegas (UNLV) School of Medicine, sees himself as a trailblazer in the field of gender surgery. He performs sex-change chest surgeries on both males and females, including minors, as well as risky vaginoplasty surgeries involving amputating a male patient’s penis and using the tissue to create a cavity to resemble a vagina.

Brosious, who opened the Vegas Plastic Surgery Institute with his partner, Dr. Joshua Goldman last year, hopes to be able to offer phalloplasty surgery to his gender-confused female patients soon. Phalloplasty surgery involves stripping the skin and flesh from either the forearm or thigh of a female who identifies as male, and then fashioning a non-functional appendage which is then attached to the patient’s crotch. This procedure comes with an extraordinarily high complication rate.

“Many of my patients come to me feeling like they've lived their entire lives in someone else's body and I have the privilege of helping them fix that,” says Brosious in the gender surgeon episode of Med School Insider’s So You Want to Be series unearthed by @MythinformedMKE and shared on Twitter.

He goes on to say that unlike treating transgender patients with hormones that can take years to make significant physical changes, “gender surgery provides you with near instant gratification.”

“Within hours, I can remove a body part that someone has lived their entire life being too ashamed to look at and replace it with a new body part that finally makes them feel whole. In my opinion, there's no other specialty that gives you a more profound yet instant gratification than gender surgery,” says Brosious.

Brosious is also willing to perform his surgeries on minors, and believes that anyone who insists upon waiting until a young person is 18 is doing so to “protect the surgeon, not the patient.” 

In the Gender Surgeon episode of the series Day in the Life, Brosious says he has “no problem operating on minors in order to save their lives.” 

“I know there's a lot of surgeons out there that say I have an aged 18 cut off or any gender surgery but in my opinion, that's really to protect the surgeon, not the patient. And if you think about the suicide rates of the transgender population, 20 percent of transgender people will attempt to commit suicide in their lives,” he explains. 

There is no solid evidence showing that medical sex change reduces suicidality in this vulnerable cohort.

Brosious gives the example of a trans-identified female student who is uncomfortable changing in the male locker room at high school.

“I'm not going to force this child to live through high school in the locker room with their buddies with breast tissue, and be self conscious, potentially suicidal in order to protect my licence, and a lot of surgeons will say ‘I'll just wait till age 18’ but you know what a lot of these patients may not make it to 18,” he said. Again, there is no evidence to support this transition-or-suicide myth.

He does not specify whether or not he is willing to perform genital surgeries on under 18s.

Brosious says becoming a gender surgeon was something that just happened to him. He said he went out into plastic surgery practice during the recession, meaning he had to be willing to do anything in order to eat. This landed him the reputation of being a surgeon who was willing to do anything and transgender patients started seeking him out.

Brosious claims that his vaginoplasty surgeries create a “fully functional vagina and vulva from the male anatomy,” but goes on to explain that by fully functional, he means “these patients are able to have sex; they're able to have orgasms, potentially.”

He also claims the “reconstructions are very aesthetic and look very natural,” and says they are his favorite operations.

“I do have to spend a lot of time with the vaginoplasty patients postoperatively. They do require a lot of care.” he concedes. “If you think about it…I just created a new hole within this body, and the body wants to kind of scar that down. So the patients require a lot of work to keep that to keep their vagina open.”

Brosious feels that his long hair and tattoos make him more approachable for the transgender community, who have been judged on their appearance their entire lives.”

“It's like a judgment free zone in my clinic,” the gender surgeon explains. “I don't judge you, you don't judge me. We are who we are. We're authentic people. And in a way I would say that the majority of my patients think that it's a good thing. They're more willing to open up to me, They think I'm down to earth.”