for those not aware (I worked in the healthcare reimbursement part of this) in Washington State, just about anything goes, such as reducing the length of the femur (leg) bone to reduce height; reducing the width of the scapula bones (part of the shoulders), removal of the penis and creating an opening, with females removing breasts and all female organs and then creating a bump ... it is VERY SICK what so called "professionals" recommend to treat "gender dysphoria." Most patients are teenagers or in their twenties. Pharma and some surgeons are making a lot of $$$$ on "treating" these patients.... one more thing, I have never seen one of these patients that also did not have a major mental health diagnosis (depression, bi-polar, schizophrenia) ... delusional behavior is nothing new (working in direct care I have met the Pope, Jesus, Lincoln, etc.) we just treated the delusion and the patient cleared .. I really believe historians will write about this as a very dark time in healthcare... rant over...