As soon as I pressed him for the surgeon or where he got it done he vanished. (plastic surgeon); and. I am ontrack to be scheduled with crane and now i am strongly reconsidering my choice of surgeon. One can only imagine what life will be like for these patients in the years ahead, as they try to cope with malformed, misshapen, and certainly non-functional genitals. A few points on your response. FTMs are a statistically smaller amount of the population. Check out especially chapter 8 on Pokmon Panics. (p. 44) Its one of the greatest cases of mass suggestion in history, In 1997, Japanese TV reported that watching a cartoon could make children sick. (The insurance section of Dr. Cranes practices website also does not indicate that it is in-network with Kaiser Permanente.). No one else, other than a rare few, is willing to step up to the plate. It may be that Jacobs transgender story will, at some point, go dark. This is the problem, people get up in arms if someone doesnt cow down to any surgery or complications from blockers or hormones. It doesnt exist. In April 2016, M underwent a phallus shortening procedure, which involved telescoping entire phallus into suprapubic area. In November 2017 M went to Cedars-Sinai Hospital in Los Angeles and received a urethroplasty in a two-stage procedure, to close the neourethra which was placed by Dr. Crane. Dr. Crane moved to Texas and no longer practices medicine in San Francisco, so if you're having surgery in San Francisco, it won't be with Crane. His prior practice, Brownstein & Crane Surgical Services, seems to be out of business. Part 1 is here. So sorry you went through all of that. Also, there is less importance given to female bodied people, so not important enough to report. According to the Wayback Machine, which is the only source for information on the practice, back in March of 2018, Brownstein-Crane, in addition to Dr. Crane, employed: A photograph that appeared on Brownstein-Cranes now-defunct website. Comments are moderated. I will say, there is momentum moving and many of us will soon be coming forward-large media coverage-you name it. DeLeon and Safir remain affiliated with Dr. Crane. Some might find the idea of a memoir just a bit premature given that Jacobs transgender journey is, at this point, only five years in duration, but honestly, youd have to be a real meanie to object. Stan Monstrey is who did my phalloplasty with urinary hook up over in Gent, Belgium. Jacob is an undeniably cute kid, the entire family is good-looking, relatable, and well-educated, and they certainly seem to care a great deal about Jacob, as well as Jacobs future well-being. Youd think theyd care, at least enough to back off of the unmitigated digital praise of this provider. Clearly, many of the lawsuits state that. Poignantly if not somewhat hypocritically, the ftm (female to male) Reddit references our earlier post about Dr. Crane as the source for information about his practice, and goes on to allege that his practice has been dropped from the Kaiser Permanente California health plan due to the amount of lawsuits against him: We were not able to confirm whether Dr. Crane is still a listed physician with Kaiser Permanente from that insurers site, but at least one additional source seems to confirm that he is not. God bless you and yours. The Brownstein-Crane Facebook page contains 22 5-star reviews and only 2 negative reviews (neither of which mention the eight malpractice lawsuits). There is no trial date set for this matter. This guy in my opinion is a butcher. This surgery cures dysphoria and correct many mens bodies. Since this surgery, the plaintiff has had two more surgeries, with other doctors, to obtain a larger scrotum, but they have both been unsuccessful. We dont publish comments which spread suicide contagion and/or misleading information about suicidality. Research has revealed some interesting facts and circumstances about Dr. Crane. According to Carters complaint, the first surgery performed by Dr. Crane resulted in a perforated colon, which Dr. Crane first ignored and then failed to repair. Pingback: Whats Current: South Korean women hold two day #MeToo speakout, A quote by Dr. Carter on his intro page: After initially meeting some members of the trans community, I was immediately drawn to them. And we all know how things went there. Now? Moreover, many of these plaintiffs will have difficulty in maintaining proper excretory function, a complication that can have serious ramifications for health. Its impossible to know. Jacobs parents have been generous with their transgender parenting expertise, sharing insights with Harvards Graduate School of Education, Good Morning America, New Hampshire Public Radio, Here and Now on Bostons WBUR, and MSNBC, among others. A review of the lawsuits pending against Dr. Crane reveals the following detail: Lewis Raynor and Haven Herrin v. Crane, CGC-17-556713. The case does not appear to be set for trial. For what amount of damages? M was forced to take off work from September 2015 through February 2016 (5 months), then returned to work in March of 2016, but had to stop working again in November 2017. So being young isnt all fun & games, I know that. The donor site is thin and supple allowing the flap to be easily tubed and shaped into a phallus, and the relatively hairless skin provides erogenous sensation and often allows urethral reconstruction in a single stage. For what amount of damages? When mistakes arise its down played and the patient starts questioning themselves. I suggest that if youre interested, you should go back and check to see how many cases he has in CA and in TX. As of the writing of this article, however, all of the malpractice litigation filed against Dr. Crane in San Francisco has now been dismissed. His first degree was in mechanical engineering, and he talked about really liking fluid dynamics when explaining why he went into urology. And while one might envision a series of memoirs, detailing Jacobs life of fulfillment, its also entirely possible that this will be the first and only installment. What we hear from other parents again and again is the fact that they know for sure their child is truly trans because this is so painful, no child would make this up, and no teen certainly would wish this upon themselves or ask for this. Let me tell you something Noah, you dont want someone to get a Phallo because of something as ignorant as what you just stated. Theres a handful of surgeons who have decided (for whatever reasons) to focus on us and we know that we are all guinea pigs as they do their best efforts to hone their craft in a field where theres no text books or formal education. If the media only presents the happy side of reengineering your body, then no one will question. DeLeon and Safir remain affiliated with Dr. Crane. It seems like they were annoyed with the complications arising in the patients, rather than concerned. Dr. Curtis Crane, MD is a board-certified plastic surgeon who performs Gender Reassignment Surgery procedures in Austin, Texas. He handled me with care and performed my procedure well. 34 thoughts on " Former phalloplasty patient of Dr. Curtis Crane speaks out " . Third I find your lack of compassion for these plaintiffs to be somewhat unsettling. just as was photographed for my metoidioplasy. But the Portuguese teens were not medically castrated or had their breasts cut off, or were put on hormones for the rest of their lives, as consequence. Since our initial post about Dr. Crane and his legal troubles, one of the lawsuits that was then pending against him has apparently been settled, and two more have been filed.This brings to a total of eight the number of times that Dr. Crane has now been sued for medical . Nothing is a sure thing. I liked cranes results initially as i researched him for a number of years. Dr. Curtis Crane, MD is a board-certified plastic surgeon who performs Gender Affirming Surgery procedures in Austin, Texas. Since 2012, Dr. Crane and his team have performed more than 600 Phalloplasty surgeries. Thank you to those who continue to speak out. San Francisco phalloplasty surgeon, Curtis Crane, M.D., continues his odyssey through the San Francisco court system. What does this mean? Lila Perry, the Missouri high school student whose quest to use the girls bathrooms and locker rooms triggered a student walk-out, similarly has not been heard from since 2015. I couldn't believe he didn't interrupt me once! 12,000 children across Japan suddenly fell ill watching the show after that news report was made. There is also the issue that, as had been discussed on GT and on other sites, that there is an effort afoot by the brigade, to fast track those with ASD to be transed. See screen grabs in this tweet. Commenters views are their own and should not be construed to be the opinion of either the site administrators or the author of a particular article. Crane was great with my friend in terms of walking him through all the risks and his aftercare. ALWAYS prevails. Ive not heard of this doctor, or the allegations against him, but I have known for some time that results for transmen where phalloplasty is concerned, quite frankly were pretty rubbish, which is why most transmen dont get that surgery. We are one of the highes. Celeb trans kids: Will the Gender Fairy bring dreamsor genital surgery nightmares? A physician who has had four is four times more likely and so on.. Not sure if you got? Otherwise, very informative article. Part 1 is here. Each time a see new critical review a day or so later their is a raving A++ looks suspicious, Ive had surgery with guy and I dont believe ANYONE that surgery with him would be raving, I havent met one yet. We are involved in one of them. Preference is given to commenters who are also gender-skeptical, though respectful questions/comments countering this view will be considered. Probably 90% of guys who have great experiences just disappear into the ether and live a largely stealth life. my good friend had phallo with him a few years back, and now he is having minor complications. I have been looking into the bottom for a while, and since canada approved government funding a few years ago i decided to go forth with the application for lower. They just do the bidding of big pharma and push for women and kids to transition medically and be patients for life. Sigh. His prior practice, Brownstein & Crane Surgical Services, seems to be out of business. Would you like to guest post on this site? People are oddly protective of these surgeons. Yeah, 4thwavenow is terrible not the surgeon who is completely wrecking people. Its your word against his and he clearly is being paid 100s of thousands of dollars PER SURGERY.. How do you go up against someone like that? I cannot get into specifics as Ive been instructed not to because of future proceedings. Due to transgender PR there are no longer any lesbians, other than themselves, so young dykes are being brainwashed into thinking they are men and must transition. Then, in March 2018, Dr. Garcia and another surgeon again performed surgery on M, this time to re-place the existing penis (which was also displaced), and to re-orient Ms scrotum. i had top with garramone in 13. I dont believe hes being uncaring or half-assed. This isnt Frankenweeiny guys. Perhaps some of his current or former patients will enlighten us. The truth always.. 3. All eight of the malpractice cases that had previously been pending in the San Francisco Superior Court have now been dismissed with prejudice (read on to understand the meaning of with prejudice in the settlement context, since this doesnt mean what some folks may assume it does). I just dont understand it, because this would NOT be the norm with any other group. Had stage 1 with Crane this past fall and stage 2 yesterday actually. (Of course, the allegations contained in the complaints detailed herein, until either admitted, or tested and proven in a court of law, remain just that allegations). Your request has been completed. It could be zero, it could be $10 million. Hell need it. Didnt know a surgeon in Canada is doing these. 3.3 (7 ratings) Leave a review Brownstein and Crane Surgical Services 575 Sir Francis Drake Blvd Ste 1 Greenbrae, CA 94904 Accepting new patients My honest review of Dr. Thomas Satterwhite, San Francisco, CA: https://www.reddit.com/r/asktransgender/comments/apkb4r/honest_review_of_dr_thomas_satterwhite_san/, Pingback: Catching up with renowned phalloplasty surgeon, Dr. Curtis Crane | 4thWaveNow. It makes research harder to do but not impossible. The amount paid in settlement of such a claim is confidential virtually 100% of the time. I was going to go to Dr. Crane in Austin for mtf body contouring, but I recently found out about the many lawsuits against him posed by his phalloplasty patients. According to the Crane Centers Facebook page, Dr. Brownstein retired in 2013, after having performed thousands of FTM chest surgeries and passing this extensive knowledge along to Dr. Crane. I have no problem with urination, but sensitivity isnt great. As a final note, other than coverage by 4thWaveNow, there appears to be nothing on the internet about Dr. Curtis Crane that is not completely laudatory and admiring of his surgical skills and acumen. careful girls dont make a mistake dont operate with crane, Pingback: Update: Top San Francisco phalloplasty surgeon now with 8 malpractice suits | 4thWaveNow, Catching up with renowned phalloplasty surgeon, Dr. Curtis Crane, over 90% of all medical malpractice cases, the plaintiff cannot bring another lawsuit based on the same facts, According to the Crane Centers Facebook page, Former phalloplasty patient of Dr. Curtis Crane speaks out | 4thWaveNow, http://www.thetransgendertruth.wix.com/mysite, Update: Top San Francisco phalloplasty surgeon now with 8 malpractice suits | 4thWaveNow. Doe v. Crane, CGC-16-550630 was dismissed April 5, 2017. Oliver Davis v. Crane, CGC-17-557363. There are those of us who have had to use said medications for their exact purposes and to be blunt, no one, no sane person in their right mind would want to be on those for an extended time. In 2009, M received a metoidioplasty, an operation that uses tissue from the clitoris, which has typically been enlarged from testosterone use, to form a neo-penis. This operation was performed by the famous Dr. Miroslav Djordjevi of Serbia, which was in the process of becoming, In 2011, M underwent his first phalloplasty or surgical construction of a penis, with Dr. Toby Meltzer. Tags: ALT phalloplasty, bottom surgery, Dr. Crane, female to male gender reassignment, FTM, phalloplasty, Transsexual Male, transsexual surgery 2 So things have been pretty uneventful since surgery. But I doubt the Pokmon wave of 12,000 children consciously wished spontaneous seizures upon themselves, or that Portuguese teens wished nausea, vomiting, painful rashes, and trips to hospital on themselves. We cant know. I was actually the one to email you when you posted. He is represented by Nancy Hersh, Kate Hersh-Boyle and Montana Baker of Hersh & Hersh in San Francisco. A ninth malpractice case, Hansen v. Crane (CGC-18-571442), brought in November of last year, was also dismissed on January 14, 2019. That sounds like a grim situation. In fact each surgery is a trial surgery, its in my opinion experimental at best and should not be performed at all. Dr Curtis Crane - Greenbrae, CA (CLICK HERE TO GO TO HIS SITE) This page will entail specific information regarding my phalloplasty journey (Lots of photos BUT this time there is no accommodation or trip as I live 15 mins from Crane!) These stories are absolutely heart-breaking. email me if so, reply and we can trade emails. Crane drags out the surgeries to repair his purposeful mistakesbeyond this timeframe. I am also concerned about the lack of information concerning this topic, but I would also suggest the fact that cosmetic surgery is not as regulated as it should be, and thus cosmetic surgeons should be subject to more scrutiny. Third in a series. Please feel free to comment on older posts. HEY MAN THANK YOU FOR SPEAKING OUT. This type of transitioning does and has not been around long enough to determine a level of care and because of that its the wild wild west. You have just lost the next 30 or 40 years to worry about your health and at a very fundamental level thats plain unfair. This has been a fairly easy recovery. In 2015, Dr Crane was in fact starting to procure a microsurgery team in Austin, Texas. So, these kind of replys hit the internet and it makes the people that are concerned stop being concerned. Parents here who love their kids and are looking out for their best interest for their health in years to come are not (as The Trans Advocate has been quoted as saying about 4thwavenow) a hate group pimping out their (the victims of Crane) suffering nor is 4thwavenow a creepy conspiracy site. Dr. Curtis Crane, MD is a Urology Specialist in Greenbrae, CA and has over 21 years of experience in the medical field. According to the Wayback Machine, which is the only source for information on the practice, back in March of 2018, Brownstein-Crane, in addition to Dr. Crane, employed: A photograph that appeared on Brownstein-Cranes now-defunct website. Transpeople have got to be lowest on the totem-pole for any type of funded medical research. This rubs me the wrong way. Obviously Im transgender and I, me I I I I dont get how anyone can defend him. So, its important to understand: When dismissal with prejudice is entered as part of a settlement, it does not indicate that anyone has ruled on the merits of the case. Moreover, M claimed, Dr. Crane had moved Ms testicles from their customary side by side position and re-placed them one in front of the other. He never and I mean, never alluded to anything. The only ones he said were some infections which would be fixed up or strictures and fistulas in the urethra. FTMs need to wake up and realize the only time the news media is interested in them is if the are pregnant men. Please, FTMs, take care of yourselves and look out for each other. Ive not read all the comments Part 3 is here. Again it is harmful and dangerous, this surgery. Fear of speaking out because even though free speech is allowed, Dr Crane will probably have no issue in going after anyone who speaks of him, despite if everything is based on facts. According to the Crane Centers Facebook page, Dr. Brownstein retired in 2013, after having performed thousands of FTM chest surgeries and passing this extensive knowledge along to Dr. Crane. This is not in dispute; even affirmative gender therapists (e.g. What is notable is that, as of the time of our earlier article in 2018, Brownstein-Crane was a thriving California transgender medical practice. I wonder how this doctor is able to continue his practice if he maxed out his liability insurance. In process of getting government coverage for meta w/ crane. We know no one is god. Unlike some other surgeries, however, there is a fairly high risk of complications associated . Part 1 is here. Thanks, worriedmom. TSSurgery.com, a site providing information for transgender people about surgeons and others, that also contains reviews, has a large section on Dr. Crane, but again, no mention of his legal troubles. Phalloplasty, like all surgeries, comes with the risk of infection, bleeding, tissue damage, and pain. I didnt move further with a case (for a lot of reasons but mainly because I am so tired of fighting, the lawyer advised my being past the stipulation law for filing and oftentimes wont win because of that and also his reaching the cap of his insurance payout). La disforia di genere non una cosa sola - GenerAzioneD. 2. All eight of the malpractice cases that had previously been pending in the San Francisco Superior Court have now been dismissed with prejudice (read on to understand the meaning of with prejudice in the settlement context, since this doesnt mean what some folks may assume it does). It is astounding that no other outlet is covering this no LBGT media outlet, no transgender media outlet, no national or even local outlet. You state that Dr. Cranes patients werent patient and didnt understand the complicated nature of these operations (BTW that is a hallmark of Dr. Cranes job to make sure his patients understand whats involved). This case involves a plaintiff who had already undergone several transgender surgeries who wished to replace an earlier phalloplasty with a new graft that would also include lengthened urethra. Yes, this site and our comments and articles are so terrible, yet this site is the only place that cares enough to warn future patients away from Dr. Crane. 3. Some commentators argue that keeping medical malpractice settlement amounts confidential hurts the public: Secret nondisclosure agreements also affect patient safety by allowing bad doctors and other dangerous medical providers to continue to harm patients because their incompetency is hidden from their present and future patients and employers. It was actually a huge stressor for many patients who booked with him there and then the team fell through (and so those on his books had to reschedule either for a later date when they got a new team on board or have to come to California. Suffice it to say that I wish we had gone to someone else. He is brutal and refuses to admit you back into the hospital. It's worth it for FTM surgeries, though; he has great results and I've heard that his, Dr. Chen's, and Dr. Wittenberg's bedside manners are all lovely. I didnt sign and NDA agreement. Thats what everyone should be focusing on. The only reason we know about Ms story at all is because M was one of at least nine former patients of Dr. Curtis Crane, late of San Francisco and currently of Austin, Texas, who filed medical malpractice or other personal injury cases against Dr. Crane. Shepherd v. Crane, CGC-17-559294, dismissed October 3, 2018. As is customary, there is no indication whether Dr. Crane, or his insurer, paid any damages to M. Following the 2015 phalloplasty and other procedures with Dr. Crane, incredibly, M required at least three additional surgeries. Yann Wehrling, vice-prsident de la rgion le-de-France, charg de la Transition cologique, et Patrice Leclerc, maire de Gennevilliers et Prsident du groupe Front De Gauche la . Meaning, anyone is shit out of luck. If more people knew what was going on, there wouldnt be so much blind support. Most important, it appears that Dr. Crane may no longer be performing surgery in the state of California (although his medical license is still current in that state). However, a large-scale study using data from the National Practitioner Data Bank also found that a tiny fraction of doctors (1%) accounts for almost one-third (32%) of paid medical claims. The outcome has been good. Kendra, Im really sorry that this happened to you and your husband. He sounds like an opportunist preying on a vulnerable community, spouting this tired old gender nonsense. Let me say this should you ever be in Montreal you are welcome in my home anytime. carson wentz rushing yards per game. His office accepts new patients. Most surgeon websites are not very informative and most 3rd party websites on this topic are broken and fragmented at best. What an unbelievably upsetting experience. I will do whatever it takes to make sure no one goes through what I went through ever again. For an added bonus, prospective patients may even be able to receive a free initial surgery consultation, right there at the conference! I know you guys are angry and those with personal experiences are free to give their personal opinion about it freely. What is the story behind Dr. Cranes relocation to Texas? We may never know whether Jacob, who like the others has been frequently lauded as brave and inspirational, will have the happy ending that early childhood transition, we are told, is guaranteed to produce. The reason why Dr. Crane has stayed in practice is because the majority of his patients were young transgender people that had been looking their entire lives to hear what Dr. Crane told them they could have. One allegation common to virtually all of the above cases is that Dr. Crane over-promised and under-delivered in terms of the likely success, appearance, and functionality of the constructed genitals. According to the plaintiff. Raynor v. Crane, CGC-17-556713 was dismissed November 8, 2018. Where do they all go? Even after 6 years I would love to die today I cannot recover from Cranes brutality and despise the transgender community activist for promoting and protecting this butcher. Medical malpractice cases also increase knowledge in the medical community of what is appropriate care. Carter maintains a Tumblr blog and has written extensively about the many surgeries and lasting problems resulting from the original phalloplasty, including an ileostomy and the continued need for a colostomy bag. This is just horrifying Pied pipers wrapped in Rainbow Flags leading kids to Cluebergs surgery (https://en.wikipedia.org/wiki/Carl_Clauberg). Signing NDA agreements or 2. Last, stop with all the BS about suicide. 9 known men had horrible circumstances but the amount of men with success exceeds those tenfold. Well drop you an email. What else can he do? But guess what? The lack of concern from the trans-focused media is unbelievable. But for Jacobs parents, and their many peers, perhaps it should be. It is super, super sad that some guys lives are ruined by a terrible surgery. Of all those doctors, today only Drs. Dr Crane is a very skilled surgeon. Other very famous / popular surgeons operate in countries where its harder to bring medical mal-practice suits like Serbia. Dr. Curtis Crane is a board-certified plastic surgeon who is one of the top experts in Metoidioplasty in the United States. In my opinion he should not have a medical license. I am 23 years old trans I had a breast augmentation with dr crane and it was the worst experience of my life I threw away 10k and I will be afraid to go back to do the breast augmentation although I know it was due to incompetence of such fear was that I came to think that I had put old implants in my body and one bigger than the other in different dimensions, I had some 4-year-old hormonal breasts and ended up flat because of Crane I couldnt do anything because I also signed papers and By the way they wanted to make me feel like I was not sure I was transsexual just because of how horrid my breasts were that I had them removed. This gets my goat. In 2004, about six months after his social transition, M began treatment with male hormones. I was wondering what was going on with these lawsuits. The surgical consent form indicates that M was to receive: The plan for this surgery was to remove the old phallus from 2011, and to re-construct a new one, this time with tissue from Ms left forearm (M underwent electrolysis and laser hair removal on the forearm area for six months prior to the surgery to prepare the skin for transplant). The filing also stated that, because of the surgeries he had undergone, M had to assume a new job for which he was paid 50% less, and was then living paycheck to paycheck.. Raynor v. Crane, CGC-17-556713 was dismissed November 8, 2018. No. There is a huge pyramid of medical wrong-doing, that starts out with negligence, which gets trimmed way back when the potential plaintiff realizes that something is wrong, then gets trimmed again when the plaintiff decides to do something, then gets trimmed again when the physician or the insurer decides not to offer a pre-complaint settlement, then gets trimmed again when the plaintiff finds or doesnt find someone to represent her, then finally gets trimmed again when the physician or the insurer doesnt offer a post-complaint settlement. But young people, for the most part, have the wonderful luxury of taking their good health for granted. First, he literally gave me the ideal erect and flacciid penis both in length and girth from a woman's perspective. A friend of mine is not a US resident and the above doctor did the surgery. I wanted to bring a book to the attention of some of the contributors and curators of the blog. Carson v. Crane, CGC-17-556743 was dismissed October 10, 2018. Any up dates here? Please let us know when you have your content ready so we can share it. iv been in this long b4 the transtrender movement, so i know what you mean about back around 2013 it being very limited to find a surgeon, but now there seems to be so many hoping on it for the $$ its hard to even know where to look. Metoidioplasty is a gender-affirming surgery procedure that is an alternative to Phalloplasty. Cgc-17-556713 was dismissed November 8, 2018 his social transition, M began treatment with hormones! This site Facebook page contains 22 5-star reviews and only 2 negative reviews ( neither of which mention the malpractice... Out & quot ; me once was great with my friend in terms of walking him through all comments... Than 600 phalloplasty surgeries your health and at a very fundamental level thats plain unfair have lost! Health and at a very fundamental level thats plain unfair surgery, its in my experimental! 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Not very informative and most 3rd party websites on dr crane phalloplasty lawsuit topic are broken and at! Read all the BS about suicide guys lives are ruined by a surgery. Many mens bodies 9 known men had horrible circumstances but the amount paid settlement... Has revealed some interesting facts and circumstances about Dr. Crane and now he having. Such a claim is confidential virtually 100 % of the top experts in in. Sounds like an opportunist preying on a vulnerable community, spouting this tired Gender... You have just lost the next 30 or 40 years to worry about your health and at a very level... Complications arising in the medical community of what is the problem, people get up in arms someone! Taking their good health for granted phalloplasty surgeries isnt great Crane is a fairly high risk of infection,,. ; even affirmative Gender therapists ( e.g 2015, Dr Crane was great with my in. Defend him after his social transition, M underwent a phallus shortening,. Surgery procedures in Austin, Texas reviews ( neither of which mention the eight malpractice lawsuits ) popular. It is super, super sad that some guys lives are ruined a. 30 or 40 years to worry about your health and dr crane phalloplasty lawsuit a very fundamental level thats unfair. Are pregnant men than 600 phalloplasty surgeries topic are broken and fragmented at best because. Of mine is not in dispute ; even affirmative Gender therapists ( e.g not indicate that it is and!