FOX NEWS INVESTIGATES – Almost one year ago, Boston Children's Hospital said to the media and the public that it does not perform genital surgeries on minors at its gender surgery clinic. However, Children's senior leadership revealed it had policies to allow vaginoplasties on minors in published medical literature years and months before public scrutiny.
Boston Children’s Hospital originally faced a wave of backlash in August 2022 over since-deleted wording found twice on the hospital's website which claimed teens as young as 17 can get vaginoplasties. The hospital doubled down, claiming it was "misinformation" that it would offer genital surgeries on minors, and the media uncritically parroted the narrative.
For example, the liberal network CNN reported, "The threats picked up after misinformation spread online that suggested the hospital performed gender-affirming genital surgeries on young children."
In addition, federal prosecutors also said the claims the hospital would offer gender surgeries on patients under 18 years old were "false."
"According to federal prosecutors, false information began to spread online in August that doctors at Boston Children’s Hospital were providing… gender affirmation surgery to patients under the age of 18. The hospital does not perform those procedures on minors, prosecutors said," the New York Times reported.
Fox News Digital probed into literature published by its senior clinicians – such as Children’s employees directing the gender surgery program and other doctors who hold positions of leadership – which exposed a more nuanced picture.
The hospital implemented a policy to allow vaginoplasties on 17-year-old biological males, according to a 2019 medical journal article. The age of legal adulthood in Boston is 18.
A vaginoplasty is the creation of a vagina and vulva from existing genital tissue on a biological male. A surgical removal of the testicles is often performed at the same time as a vaginoplasty. The procedure renders a patient sterile.
Medical literature co-authored by BCH clinicians published as late as March 2022 acknowledged that BCH was the first pediatric center in the United States to offer genital surgeries for those over 17 years of age.
Boston Children's Hospital expanded its transgender program to open the Center for Gender Surgery, which was co-founded by Dr. Oren Ganor, a plastic surgeon, in 2017.
In 2018, Boston's NPR News station WBUR reported Ganor said in an email that BCH is "slightly flexible" when it comes to the age of biological males seeking genital surgery "because of the difficulty young women can experience accessing gendered spaces—like dorms and bathrooms—if they still have male genitalia."
The local NPR article was promoted on the hospital's website, according to the Wayback Machine.
Ganor, as well as other Children’s employees, described having a series of meetings with hospital legal counsel and its ethics board in order to institute the policies pertaining to age limits of its surgeries in a 2019 article published in the American Academy of Pediatrics
"[T]hrough collaboration among clinical providers, review by hospital leadership, discussions with key staff and hospital support services, consultation with the hospital’s ethics committee… and meetings with hospital legal counsel [we identified] [k]ey issues… during the process… [such as] the appropriateness of providing gender-affirming surgeries to adolescents," the clinicians said.
Children's eventually concluded "that it is appropriate to offer" the procedure to 17-year-olds, "before the age of majority so that they can safely embark on their adult lives," according to the directors' article.
At Children's, Ganor performs surgeries on young people in the gender clinic. According to searchable databases and his physician profile, Ganor is not listed as certificated in his specialty by the American Board of Plastic Surgery.
American board certifications are considered a minimum standard for high-quality physicians and is generally a requirement for hospital leaders, according to a doctor familiar with hiring practices of medical institutions who spoke with Fox News Digital on background.
Ganor completed his residency outside the U.S./Canada which likely makes him currently ineligible for the certification. The American Board of Plastic Surgery states that "residencies completed in locations other than the United States or Canada are not acceptable [for Board certification] in lieu of those specified under the acceptable pathways. This in no way implies that quality training cannot be acquired elsewhere, but the Board has no method of evaluating the quality of such programs and must be consistent in its requirements."
The Harvard hospital said in a statement to Fox News Digital that "Dr. Ganor is board certified… Physicians that complete their residency outside the United States are board certified in their home country."
BCH went on to state that Ganor's foreign board certification was "equivalent to the U.S. certification."
The American boards were founded to "protect the public by assessing and certifying doctors who meet specific educational, training and professional requirements," the plastic surgery boards said.
The hospital added Ganor was a fellow of the American College of Surgeons, a dues-paying organization, "which means he has passed a rigorous evaluation and meets the high standards established and demanded by the College. Dr. Ganor holds full medical licenses in MA and NH and completed two Harvard Medical School fellowships."
Before the policy decision on allowing minors to get vaginoplasties was finalized, Director Ganor expressed uncertainty whether Massachusetts laws would allow the procedure since it can render a minor patient permanently sterile.
"MA Law is unclear on whether parents can consent to procedures that result in sterilization," Ganor said in a publication from Harvard Medical School.
In order to address the possible legal concerns, the hospital came up with a policy to offer a court order option for a genital surgery on a minor.
The article said in 2019 that when the policy was first implemented, it offered the court order a pathway to a family who accepted. "[T]he only family to which this option has been offered has decided to pursue the court order," according to the medical journal article.
Upon being confronted by Fox News Digital with the journal article, Children's said that it "follows all laws and regulations. We do not and have not provided genital surgeries on patients under 18-years-old in connection with Gender Affirming Care."
Fox News Digital asked whether the hospital was accusing its clinicians of lying about the policy they had noted in multiple medical journal articles, and whether it would launch an investigation, but it did not offer a response specifically addressing that question.
It appeared that at some point BCH shifted its policy on genital surgeries on 17-year-olds as demonstrated, at least in part, by the removal of language regarding vaginoplasty eligibility for 17-year-olds from its website.
Medical literature co-authored by BCH chief anesthesiologist Joseph Cravero and Director Ganor, published in March 2022, a few months before the controversy broke, acknowledged that BCH was "the first pediatric center in the United States to offer… genital surgeries for those over 17 years of age."
New England Gender CARE, which is partnered with BCH, said on its website as of May 16, 2023, that Children's offers psychological gender identity counseling to kids as young as 4. It added that BCH offered vaginoplasties to 17-year-olds. CARE was founded by a current researcher and social worker at BCH's Center for Gender Surgery, Elizabeth Boskey.
Boskey was involved from the beginning in creating the seed policy of the gender surgery center. She presented to the hospital ethics committee in order to formulate the gender surgery unit at Children’s, according to the medical journal article from 2019.
"In the four years since its inception, [the Center for Gender Surgery] has completed over 300 gender-affirming surgeries," including chest surgeries, which are eligible for 15-year-olds, BCH clinicians said in an article published at the Journal of Clinical Medicine.
Another issue considered by the hospital when implementing the vaginoplasty policy for minors was the "extensive post-surgical care required by the procedure," the article said.
Patients recovering from vaginoplasties have to be in the intensive care unit for at least a week and will use a catheter to urinate temporarily.
The recovery time runs up to 18 months, and requires a lifetime of dilating the "vagina to keep it open," according to Boston Children's Hospital.
"[W]e are deeply disappointed that Fox News continues to mischaracterize the lifesaving and life changing medical care we provide to young people," Boston Children's Hospital said in a statement. They did not accept a request to be interviewed for this article.
When Fox News Digital requested the research upon which the institution relied to perform gender surgeries on minors such as double mastectomies, BCH did not offer a response specifically addressing that request.
In fact, Children's own senior doctors – including Ganor – have admitted the lack of research on the topic.
"Unfortunately, there is extremely limited published research on the impact of chest surgeries on the pediatric and young adult population," they said in a published medical journal article. They similarly reiterated the lack of research on genital surgeries for the young adolescent population.
One of Children's first phalloplasty patients – who was over 18 – was in and out of the ICU for weeks after the procedure due to several complications, the patient told WBUR.
The surgery took 14 hours.
A phalloplasty is a procedure with a high-complication rate in as high as 51%, according to an article entitled "Reconstructive Urology and Trauma" from Temple University Hospital. It entails surgeons harvesting one or more flaps of skin and other tissues from a donor site, such as a forearm, and using it to form a penis and urethra.
"Doctors took a rectangle of skin, tissue and blood vessels from [the patient's] right forearm to shape a penis and extend the urethra to the tip. [The patient] was in and out of the hospital for several weeks with complications," the local WBUR article said about the Children's procedure.
A surgeon at Children’s Center for Gender Surgery program, Dr. Amir Taghinia, told a local outlet that phalloplasties have routine complications, but the more the hospital is able to perform, the better the outcomes will be for future patients.
"We at Children's have the resources to look at these types of procedures through many different angles and develop ways of improving those," Taghinia said.
Boston Children's Hospital received nearly $300 million last year from the federal government, such as the Department of Health and Human Services, the Centers for Disease Control and Prevention, the Department of Defense, and the Department of Homeland Security.
