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An Iowa family is sounding the alarm after realizing that the University of Iowa Health Care’s Internal Medicine department as well as Scott Boulevard Clinic in Iowa City perform “top” surgery for minors.

South Dakota just signed into law a bill that prohibits sex-change surgeries and hormone replacement treatments for minors Monday.

The surgery is the removal of breast tissue, also known as a mastectomy. The name “top surgery” is directed toward those who identify themselves as transgender, according to the family.

On Feb. 13, the family contacted the University of Iowa Health Care and discussed a situation in which a 14-year-old daughter who identifies as transgender would like to pursue top surgery as soon as possible. (***There is no actual 14-year-old daughter.***)

The scheduler shared that the Internal Medicine Department and the Iowa City – Scott Boulevard Clinic perform top surgery for minors.

The lady on the phone for UIHC said she had to check the latest update staff received on approved ages for such a procedure.

“After checking this update, she shared that my daughter being 14 would not be a problem,” the family told The Iowa Standard.

They were told they’d have to establish care by scheduling a consultation with a surgeon and then most likely have a session with a psychologist. She did let the family know that Internal Medicine is booked out until October of 2023 but noted the Scott Boulevard Clinic would likely be able to perform the surgery within a couple of months.

A day later the family called back in hopes of speaking with the Scott Boulevard Clinic. After being transferred to three different people who were not as forthright with the information and instead “probed” the caller for information to create an account for the child, the family called the Scott Boulevard Clinic directly. The Iowa Standard obtained audio of the phone call. The family talked with a person called Amy at the clinic.

CALLER: Hi, I’m calling just to inquire if you guys do perform top surgery for minors there.

AMY: Um, I believe so. Um, they’d have to have a consultation with a provider first before they are referred over there. 

CALLER: I had talked to someone yesterday at the hospital and they said Internal Medicine does it there but they’re booked out until October and that you might be an option. She’s 14, and will be 15 in a couple of weeks. Yeah, we’d need to establish care and all of that, but, we were, I didn’t even think it was an option in Iowa, but I had just heard that it might be. So, just trying to get some info.

AMY: Yeah, um, let me pull up the clinic information here. Go to my LGBTQ page. Where is it? (delay) And you said she’s 14?

CALLER: Yeah. She’ll be 15 in a couple of weeks. I didn’t know. Yesterday they thought that that wouldn’t be a problem, but I just want to confirm.

AMY: No, not at all. I can schedule her with Dr. Imborek or James Kinney at my location.

CALLER: OK. And that’s for the consultation right?

AMY: Yes. Yep. And they’ll discuss everything with you.

CALLER: So do you think it’s like possible within the year, because I know they said Internal medicine is booked until like October, how far out do you guys typically, I mean, if it all worked out.

AMY: I should be able to get her in within at least James in the next few weeks.

CALLER: Just to get the ball rolling at least?

AMY: Yeah. 

The University of Iowa Health Care’s website states on its transgender care webpage that it offers transgender medicine “not available anywhere else in Iowa.”

“When you choose the UI Health Care LGBTQ Clinic for your gender-affirming care, you’re choosing Iowa’s only comprehensive academic medical center, home to world-class experts in more than 200 medical specialties. Our doctors are also researchers who use, and often help create, the most advanced therapies and procedures available anywhere. We’re the only center in Iowa that offers gender-confirming genital surgeries for trans feminine persons, including zero-depth vaginoplasty (also called vulvoplasty) and full-depth vaginoplasty. And our extensive staff of expert physicians in every field allows us to offer the most comprehensive transgender medical care in the state.”

It notes that their “pioneering clinic” is a “national leader” in gender-affirming care and surgery and offers procedures “not available anywhere else in Iowa.”

This is also from the UIHC’s transgender care webpage:

One place for all of your gender-affirming care

As you progress toward gender confirmation, you’ll need physicians, surgeons, pharmacists, mental health professionals, and other providers who specialize in working with transgender patients and who understand your goals and concerns.

Whether you’re just beginning to consider hormone therapy or you’re recovering from gender-affirming surgery, you’ll receive your care every step of the way from professionals who are trained to provide transgender medicine.

If you’re already on your path to gender confirmation, our team will work with you to review your medical history and create a treatment plan that will help you achieve your goals.

The Iowa Standard contacted the University of Iowa Health Care’s media relations team on Thursday to ask a few questions. The representative said they would try to get us in touch with someone who could provide answers. Shortly after the phone call, we also sent the following questions via email on Thursday afternoon:

  1. What transgender medicine is available at U of I that isn’t available anywhere else in Iowa specifically?
  2. At what age does the U of I begin to see AND treat patients for transgender medicine?
  3. Does the U of I offer gender-affirmation surgeries for minors? If so, at what age can this procedure be performed? And what procedures are offered (top, bottom, etc.)?
  4. Does the U of I offer hormone replacement therapy for minors? If so, at what age can this treatment begin?
  5. If the U of I transgender medicine department does perform gender-affirmation surgery on minors, how many minors have received this procedure in the last five years and the last 10 years? What is the age of the youngest person who received this surgery?
  6. Is there an “ideal” timeline for standard of practice in terms of a timeline from the initial consultation to when a gender-affirmation surgery is performed?
  7. Is there such a timeline for standard of practice from the initial consultation until hormone replacement therapy is started?
  8. Is parental notification & approval always necessary in every situation?
  9. In a situation where the minor’s parents are separated, do both parents have to consent?

We have not yet received a response from UIHC, but will provide an update when we hear from them.

Author: Jacob Hall



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