Having been in the group health business for 30+ years I would often write reports giving an overview of a problem and possible outcomes. So let's take this from the beginning so as to see all the ramifications.
First some significant percentage of teen aged boys develop some degree of nipple or breast swelling around puberty. Most are in the category of cup A-- or so. A very few are significantly larger, like the D cups I grew up with.
Because of societal cultural assumptions, many of the teenaged boys are near hysterical if they even imagine that they might have a tiny bit of uneven nipple swelling. Nobody is absolutely symmetrical, male or female, yet some get totally upset about it. According to an outside article surgery as a solution has increased by 70% in this past year, up to a total of 5700_ cases in the USA last year. Assuming an average total cost of surgery and followup and compression garments etc of $10,000 that comes to $57 million this year. There is obviously no long term followup on most of these cases, certainly not lifetime followup.
Having just returned from 6 weeks at a nudist club I can see the real picture that everybody hiding in clothing isn't going to see. It is the dirty little secret totally hidden in plain sight as if there was a conspiracy to cover them up. The truth of the matter is that when one is surrounded by men in their 40s and older without shirts on there is about 50% incidence of gynecomastia in the range of A- to D cup. So the teenager who has a pair cut off at 18 might have to repeat surgery at 40, at 50, at 60 and at 70 as hormones change, hair is treated for balding, prostate enlargement is treated, pain is treated, mood disorders are treated and some 70 other drugs, soaps, lotions and herbs etc are used all of which may increase male breast size, not to mention a gain in weight which leaves fat deposits in those two once again forbidden places on a mans chest.
The "pretty boys" who took nude pictures of me and made hundreds of copies distributed all over the schools of the area in the 1960s now all have gynecomastia. The ultimate joke is that the fat they gave me such a tough time about (I graduated at 235lbs) and I am now 195 and they who graduated at 170 are now 250 lbs or so with breasts. And now WE ALL HAVE BREASTS. From what I have read here, the remnant can flower forth over and over again, and likely will. There is no long term record. The surgery is too new. Most group health plans have "re-do" intervals. So for a crown, the re-do interval is generally 5 years before the plan will pay again. So for this how long a minimum redo period is needed? If 1,000,000 teen boys decide they need their beginning breasts chopped off the cost is $10,000,000,000 a year and is that really where our healthcare dollars are best spent, on what amounts to psychotherapy by cosmetic surgery. If they all need several redos through the years, we could be looking at lifetime costs of $50,000,000,000 per annual cohort with 50 or so such cohorts. This comes down to potentially trillions of dollars lifetime costs for those currently alive if this form of body phobia continues to grow. If this becomes popular it is a health plan buster.
What is upsetting is that those most eager and desperate for surgery are those with the least visible problem, the ones way down at the bottom 5 percentile on size as far as I can see. These guys are beginning to sound like a skin and bones anorexic talking about being way too fat. This is beginning to sound like a form of body dysmorphic disorder or outright phobia.
Anything in which the odds are 50% or so is NORMAL by definition. So here we are medicalizing and converting a normal developmental occurrence into a psychological disorder that can't be cured. At best a temporary fix is possible for many. How many deaths from anesthesia, infection and other complications is worth the psychological relief?
The surgeons can't even give realistic long term statistics. There are not any. They don't know. They are just trying to provide relief to an admittedly distressing psychological-sociological problem. At 16 I was as desperate as any of these kids now
A few years ago Florida noticed that the fattest kids who needed exercise swam the least because of body shame at the pools. So they designated 1 Saturday a month as the FAT DAY where fat kids could come and swim with other fat kids and everybody there would pretend they were normal for a day. You know, instead of "Queen for the DAY" its "Let's pretend you are not fat and accept you as normal for today" Everybody should see the problem with that. Separate and unequal doesn't work. What is needed is acceptance of the huge variation of bodies that is entirely normal instead of some standard designed by a set of narcissistic idiots that serves to make 95+% unhappy with their bodies.
I violated the udderly forbidden. I talked to dozens of people, male and female, with gynecomastia and without. I did not speak to anybody who wasn't an adult about such matters. Not a single woman was aware of the torture the men go through unless they were married to a guy with gyne and even then most had never found out the inner torture. There was not a single woman who made any nasty remarks at all. In fact virtually all were completely clueless. "With half the men growing breasts as they age I just supposed it was normal and no big deal" was the most typical response. When you see hundreds of people nude each year and watch as they age one gets a pretty good idea of normal aging. Same goes for childhood to teen years. Anybody growing up surrounded by seeing real bodies all the time will know what is actually normal. Everybody is accepted.
Only ignorance of the real can come up with the puritanical, "nobody is normal" and "everybody should be ashamed" of their body" thereby giving every bully the perfect handle for taking on anybody insecure in their body. Nobody at all ever bothers me any more in the textile world. It's hard for the aging bullies to keep up the jr high harassment when they could put on the Hooters shirt themselves. If they try, I make them look like silly has-been bullies. The ultimate comeback was suggested to me by another nudist. He said to say to a troublesome male "Well, you take off your pants and you can show us your micro-penis to go with your micro-brain". We'll all feel sorry for you then instead of merely thinking you are an not a nice person.
I don't have any solutions. The surgical option can be available until it gets too expensive. Maybe this becomes one of those optional things in future health plans, one either opts into the optional coverage covering cosmetic surgery for the rest of their life or they choose the plan not covering cosmetic surgery. Switching in later might require a 5 year waiting period for cosmetic surgery or something. Clearly this will have to be settled and premiums paid appropriately as there are no free lunches.
This year one couple made a comment about me. They appeared to be around 60. The man asked his wife about my very obvious D-cups, more outstanding than ever having taken off 35 pounds recently. She said" Well, that isn't ordinary fat. It must be glandular". And that was the end of it. Something noticeable. Something explained. End of story.
Topic: A Preliminary Report to the Trustees (Read 2714 times)
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