Surgeon Shocked During Surgery on Transgender Woman’s Body: “Oh, There’s Still Some Left

Transgender Patient Sues hospital Over Alleged Discrimination During Cancer Surgery

New York, NY – December 2, 2025 – A transgender woman in New York City has filed a lawsuit against Memorial Sloan kettering Cancer Center (MSK), one of the nation’s leading cancer hospitals, alleging discriminatory behavior and privacy violations during her cancer treatment. Jennifer Capasso,42,claims hospital staff made “sexist remarks” about her gender identity while she was under anesthesia for lung surgery in March 2022.

Capasso was diagnosed with stage 4 metastatic rectal cancer in 2020 and has undergone multiple surgeries and treatments at MSK as the cancer spread to her liver, lungs, and colon. Prior to her lung surgery, concerned about potential mistreatment, Capasso secretly recorded audio during the pre-operative period.

The recording, reviewed by the New York Times, allegedly captured medical staff discussing Capasso’s anatomy with disparaging comments, including a staff member stating, “He still has man parts.” Other voices reportedly expressed confusion and discomfort, with comments like “It doesn’t make sense” and “I don’t understand.”

The lawsuit further alleges that a nurse discovered capasso’s gender was listed as ‘female’ in her patient records during the surgery and contacted hospital administration to request a change. Capasso claims her gender was subsequently altered to ‘male’ in the hospital system without her consent and remained so until January 2024.

MSK has vehemently denied the allegations,stating that Capasso’s “secret recordings” violated the privacy of its staff. The hospital also denies misrepresenting Capasso’s gender or altering her records.

This case highlights ongoing concerns about discrimination within the healthcare system faced by transgender individuals and raises questions about patient privacy and the ethical implications of surreptitious recording in medical settings. The lawsuit is expected to draw important attention to the challenges transgender patients encounter when seeking medical care and the importance of respectful and affirming treatment.

What are the ethical considerations regarding informed consent when unexpected anatomical findings are discovered during gender affirming surgeries?

Understanding Unexpected Anatomical Findings in Gender Affirming Surgeries

The reported statement, “Oh, there’s still some left,” during surgery on a transgender woman, while sensationalized, highlights a crucial, though often unspoken, reality in gender-affirming surgical procedures: anatomical variation. This isn’t about shock value; it’s about the complexities of human biology and the importance of thorough pre-operative assessment. This article will delve into the reasons why this can occur, the implications for surgical planning, and the ethical considerations surrounding informed consent in transgender surgery, gender affirmation, and gender reassignment surgery (GRS).

Why This Happens: Biological Sex vs. Gender Identity

The phrase refers to the unexpected presence of testicular tissue after a presumed complete orchiectomy (testicle removal) as part of female gender confirmation surgery or during subsequent procedures like vaginoplasty. Several factors can contribute to this:

* Incomplete Orchiectomy: While rare, it’s possible for a portion of testicular tissue to be missed during the initial orchiectomy. This can be due to anatomical variations, surgical technique, or unforeseen circumstances during the procedure.

* Retained Wolffian Duct Structures: The Wolffian ducts are embryonic structures that, under typical male development, contribute to the formation of parts of the male reproductive system. In transgender women, these structures may persist and, in some cases, contain residual testicular tissue.

* Mosaicism: Though uncommon, genetic mosaicism – where an individual has cells with different genetic makeups – can lead to variations in tissue development, potentially including the presence of testicular tissue in unexpected locations.

* Variations in Descent: Testicles don’t always descend fully. Undescended or partially descended testes can present surgical challenges and increase the risk of retained tissue.

Implications for Surgical Planning & Techniques

This potential for unexpected findings underscores the need for meticulous surgical planning and advanced techniques.

* Pre-operative Imaging: High-resolution ultrasound and MRI are crucial for detailed anatomical mapping before surgery. these scans can help identify potential retained tissue or unusual anatomical structures. Transgender healthcare relies heavily on accurate imaging.

* Exploratory Surgery: Surgeons may incorporate an exploratory phase during surgery to thoroughly assess the anatomy and identify any unexpected tissue.

* Pathological Examination: All removed tissue must undergo pathological examination to confirm complete removal of testicular tissue and rule out any potential for future hormonal activity. This is a standard practice in gender affirming care.

* Surgical Expertise: Choosing a surgeon experienced in transgender surgeries and specifically in vaginoplasty and orchiectomy is paramount. Experience translates to a better understanding of anatomical variations and refined surgical techniques.

Informed Consent and Patient Expectations

The possibility of unexpected findings is a critical component of the informed consent process.

* Realistic Expectations: Patients need to understand that while surgery aims for complete anatomical alignment with their gender identity, variations can occur.

* Open Communication: Surgeons must openly discuss the potential for unexpected findings, the implications for future health, and the need for potential revision surgeries.

* Psychological Support: The revelation of retained tissue can be emotionally distressing. Access to psychological support and counseling is vital for patients navigating this situation. The APA Guidelines for Psychological Practice with Transgender and Gender Nonconforming People emphasize the importance of affirming care and addressing potential emotional impacts.

* Long-Term Monitoring: Even after surgery, ongoing hormonal monitoring and regular check-ups are essential to ensure complete suppression of testosterone production and monitor for any signs of retained tissue activity.

Case Study: Importance of Detailed Imaging

In 2018, a case was published in The Journal of Sexual Medicine detailing a transgender woman who underwent vaginoplasty. Pre-operative imaging was limited, and during the procedure, residual testicular tissue was discovered within the space of the rectus abdominis muscle.This highlights the necessity of comprehensive imaging protocols to minimize the risk of such occurrences. The patient required a revision surgery to completely remove the tissue.

Benefits of Thorough Pre-Operative Assessment

Investing in detailed pre-operative assessment yields meaningful benefits:

* Reduced Risk of Complications: Identifying potential issues beforehand minimizes the risk of complications during and after surgery.

* Improved Surgical Outcomes: Better planning leads to more precise and effective surgical results.

* Enhanced Patient Satisfaction: Realistic expectations and open communication contribute to greater patient satisfaction.

* Minimized Need for Revision Surgeries: Thorough assessment reduces the likelihood of needing additional procedures.

Resources for Transgender Healthcare

* World Professional Association for Transgender Health (WPATH): https://www.wpath.org/

* American Psychological Association (APA) – Transgender Guidelines: https://www.apa.org/practice/guidelines/transgender.pdf

* GLMA (Gay & Lesbian medical Association): https://www.glma.org/