Boston Children’s Hospital boasts about having the first pediatric transgender surgery center in the country offering a “full suite of surgical options for transgender teens.”

Boston Children’s Hospital promotes their surgeries through a video series on their official YouTube channel, with titles like “What You Need To Know Before Phalloplasty Surgery.” The 90 videos in the series paint a rosy picture of the genital, chest and face surgeries they offer, accompanied by upbeat background music.  

Chris Elston, otherwise known as “Billboard Chris,” shared a tweet on Tuesday of a video in the Children’s Hospital playlist called “What happens during a gender-affirming hysterectomy?”

In that video, Dr. Frances Grimstad describes the process of getting a “gender affirming hysterectomy.”

It is “very similar to most hysterectomies that occur. Hysterectomy itself is the removal of the uterus, cervix, which is the opening of the uterus, and the the fallopian tubes which are attached to the sides of the uterus,” Grimstad says with a smile. Grimstad says that some “gender affirming hysterectomies will also include the removal of the ovaries,” in short, the entire female reproductive system.

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A bulletin on the Children’s Hospital Gender Multispecialty Service (GeMS) homepage reads, “At Boston Children’s, we are proud to be home to the first pediatric and adolescent transgender health program in the United States” that has treated “more than 1,000 families to date.”

Boston Children’s Hospital founded the Gender Multispecialty Service (GeMs) program in 2007 and welcomes patients as young as 3 years old. “At GeMS, our mission is to assess and care for gender-diverse children, teens, and young adults.”

GeMS provides “a variety of options for medical transition” that include prescribing puberty blockers, testosterone, estrogen and plastic surgery from their surgery center. “Our skilled team includes specialists in plastic surgery, urology, endocrinology, nursing, gender management, and social work, who collaborate to provide a full suite of surgical options for transgender teens and young adults,” the website reads.

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But Safer cites a conceptually flawed study which he claims is proof that “gender identity is rooted in biology” that changed his mind. “Which makes it so logical that an option for people in 2016 is to change the external appearance to meet that gender identity,” he said.

The WPATH lists surgical complications of genital surgeries in their Standards of Care guidelines. Vaginoplasties may incur “complete or partial necrosis of the vagina and labia, fistulas from the bladder or bowel into the vagina, stenosis of the urethra, and vaginas that are either too short or too small for coitus.”

WPATH warns that patients who obtain phalloplasty may suffer “frequent urinary tract stenoses and fistulas, and occasionally necrosis of the neophallus. Metoidioplasty results in a micropenis, without the capacity for standing urination. Phalloplasty, using a pedicled or a free vascularized flap, is a lengthy, multi-stage procedure with significant morbidity that includes frequent urinary complications and unavoidable donor site scarring,”

Amir Taghinia, a plastic surgeon who is a member of Boston Children’s transgender surgery team, says that 30 to 50 percent of phalloplasty patients seek treatment for a blocked or leaking urethra.