
Johns Hopkins surgeons perform world's first male genital transplant - chmaynard
https://hub.jhu.edu/2018/04/23/penis-transplant-surgery-johns-hopkins/
======
DoreenMichele
_The surgeons and Johns Hopkins volunteered their services, which would
otherwise have cost hundreds of thousands of dollars and wouldn 't have been
covered by veterans benefits or insurance, they say._ (because it's still
experimental)

Hats off to the team of 11 surgeons involved in this (no doubt grueling)
14-hour surgery without being paid. Wow.

Sources:

[https://www.npr.org/sections/health-
shots/2018/04/23/6050544...](https://www.npr.org/sections/health-
shots/2018/04/23/605054470/veteran-receives-penis-transplant-to-repair-war-
wound)

[http://time.com/5250397/penis-transplant-johns-hopkins-
unive...](http://time.com/5250397/penis-transplant-johns-hopkins-university/)

~~~
solatic
It's not like they aren't paid in reputation though. Because it's a novel
surgery, they're now the world's leading experts on applying this surgery
successfully, and that makes them the first phone call for anybody with deep
pockets who wants to make it happen. Not to mention being published, talking
about the surgery in conferences, etc.

The patient may not have paid in money, but they did pay in taking a very
significant risk of unforeseeable complications. It's not so clear cut.

~~~
refurb
This is really true. There was an interesting documentary about the docs who
did the first hand transplant. The docs were really pushing to do it since
they could be "first". The patient was so-so about the idea, but went ahead
anyways.

Fast forward a year and the hand is slowly disintegrating since they couldn't
get his immune system to accept it. The patient eventually stopped taking his
drugs.

The hand was then amputated and he got a prosthetic. Patient was much more
functional.

~~~
Balgair
As an aside: the abandonment rate for 'normal' prosthetics is about 35% to 45%
:

[https://www.ncbi.nlm.nih.gov/pubmed/17979010](https://www.ncbi.nlm.nih.gov/pubmed/17979010)

------
leroy_masochist
As a vet who knows a couple of guys who've suffered injuries to their genitals
I'm really happy to hear this news. There's a huge stigma around not having a
dick anymore and I can acutely remember thinking, before stepping out on
patrol, that I'd rather die than have that happen to me.

Hopefully this is just one step in a larger journey toward being able to
replace damaged/destroyed genitalia with functioning replacements (ie re-
growing new appendages using stem cells and patient DNA, etc).

~~~
nylonstrung
I've read the suicide rate among vets with genital injuries is over 25%.

Tragic.

~~~
cat199
Not to downplay the vast significance of such an injury, but seems to me the
far greater tragedy is that our society/culture places so much emphasis on
sexual function that a 25% rate of suicide in such cases 'makes sense'.

There's a lot more to life than sex - this is basically saying that 1 in 4
males don't think the rest of it is worthwhile otherwise..

~~~
merpnderp
Is it society and culture or the single most important biological imperative
our DNA can express, something hardwired into the parts of our brains older
than life on land?

~~~
textor
Certainly it isn't hardwired in any relevant manner, and people are in fact
just fine not reproducing, see vasectomy.

Don't just repeat platitudes. People are killing themselves over not being
able to have sex, or rather not being able to prove they're proper functional
men. It has at least as much to do with social status as with actual sex.

~~~
merpnderp
Knowing you aren't held in respect by your peers doesn't cause depression
because of culture or society - every single living organism with some sort of
higher brain function gets "depressed" when its peers hold it as less
valuable.

This isn't platitudes, this is science, and shows the solution likely isn't
down the path of telling people 'losing your junk" jokes are harmful. Choosing
to not have kids are far different than having that choice taken from you, and
the most viable solution is likely chemical intervention.

------
mikorym
So, just to clarify here; the first successful penis transplant was in 2014 in
South Africa [1] (the same team again performed a successful transplant in
2017 [2]).

The article posted however is the first penis and scrotum (without testicles
for perhaps obvious reasons) transplant.

[1]
[http://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=232...](http://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=2328)
[2] [https://www.health24.com/News/Public-Health/see-sa-
doctors-p...](https://www.health24.com/News/Public-Health/see-sa-doctors-
perform-second-successful-penis-transplant-20170522)

------
fastball
Does anyone have an idea as to why the testicles weren't included in the
transplant?

My best guess is that the testosterone produced wouldn't be "compatible" with
the recipient and they would want to avoid an immune system rejection?

Additionally, I suppose that if sperm is still being produced, you could
effectively impregnate a woman with someone else's DNA. That would be...
strange. I can see how that might be unwanted by both parties.

~~~
ocdtrekkie
The article I read earlier specifically said there were ethical concerns with
him potentially being able to father children with the donor's genetic code.
Which is a weird ethical concern I'd be intrigued to read more about.

~~~
badosu
That creates an interesting twist: since DNA test is legally acceptable as
fatherhood proof the recipient could create a lot of trouble for the donor.

~~~
fastball
I'd assume that the donor in every case (as in this case) would be diseased,
so I'm not certain how that could be an issue for the donor.

~~~
rdl
I assume you mean “donor deceased”. Even if I were dead I would not
necessarily want people using my DNA to father children.

I wouldn’t necessarily be against it, either, but I would feel I had some
interest in how sperm were used in a different way from other organs. I’d also
feel differently about something physically identifying like a face, and even
more so about the brain/cognition (if there were a way to do a partial brain
transplant which carried memories or something but didn’t transfer
consciousness — seems unlikely given what we know of the brain today, but I
wouldn’t count it out since we don’t really know all that much.)

~~~
DoreenMichele
_(if there were a way to do a partial brain transplant which carried memories_

Years ago, I saw an interview with a woman on TV. IIRC, she was the first
recipient of a heart and lung transplant.

She was asked a question shortly after surgery in which her reply was
something like "I'd love to have a beer!" though she did not drink. The young
male donor who died in a motorcycle accident did drink. She also reported
having dreams and other experiences in line with having somehow inherited some
piece of his consciousness. Over time, they faded.

If anyone is curious to read more, this might be her book:

 _A Change of Heart: A Memoir_ by Claire Sylvia

~~~
fjsolwmv
That's sounds like an urban legend / exaggerated story.

~~~
freedomben
I hope it is urban legend or exaggerated, because that is terrifying.

~~~
rrobukef
Or it's wishful thinking / placebo. The mind is very good at deceiving itself.

~~~
meric
Or the subconscious memories could have been transferred through other
methods, e.g. socialising with people who knew the donor.

------
userbinator
I like how the picture in the article almost looks like an access panel on the
side of an insulated appliance, seeming to imply that it was as easy as
connecting a few wires and pipes... if only[1]! The unrealistic "cleanliness"
of these sorts of detailed medical illustrations continues to fascinate and
slightly amuse me.

[1] [https://cdn2.tmbi.com/TFH/Step-By-
Step/display/FH12JUN_WATHE...](https://cdn2.tmbi.com/TFH/Step-By-
Step/display/FH12JUN_WATHEA_04.JPG)

------
jk2323
Yeah. Another reason for being an organ donor. Remember, even when you are
dead, you best friend could still be working :-)

------
toblender
I'm surprised they were able to reattach the nerves as well. Isn't that
something that can't be reattached after being severed.

If nerve reattachment now is possible, can't we cure quadriplegics?

------
akhatri_aus
The first transplant was actually in South Africa, in Dec 2014.

~~~
computerphage
Source?

~~~
mikorym
[http://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=232...](http://www.sun.ac.za/english/Lists/news/DispForm.aspx?ID=2328)

------
visitor7yu
without the testes. he would be able to function sexually and orgasm? will it
not be like castration

~~~
zik
While sperm is produced by the testes, most of the semen is produced by the
prostate gland which is inside the body - not in the testes.

~~~
purpleidea
Wrong. The semen is produced by the testicles. The ejaculate is produced by
approximately three different glands:

1) Testes - produces the semen (1% of the total volume) 2) Prostate - Sugars,
etc (30%) 3) Cowper's Gland - mucoproteins, etc...

~~~
delecti
_Sperm_ are produced by the testes, but sperm are a minority of the semen.

------
fwdpropaganda
They've been able to put penises in women for a while, but only just now
they've been able to put them in men?

What am I missing?

~~~
pbhjpbhj
In construction of simulation organs the person's own tissues are used.

~~~
fwdpropaganda
Got it, thank you.

------
bayesian_horse
I can't really sympathize. At least to me, the risks involved in foreign
transplants, and the drug regimen with all its effects, seem to outweigh the
benefits.

For others it may be different.

------
garmaine
Serious question, not wanting to be crass, but does it “work”? That would be a
huge breakthrough over reconstruction options that often require an implanted
device to mimic an erection. It also, I imagine, requires a great deal of
accuracy regarding the surgically connected plumbing in order not cause
rupture and internal bleeding as a result of blood pressure.

~~~
ofcourseianal
Did you read the article, or just the headline?

~~~
garmaine
Yes I read the article. My question was not answered in it.

~~~
Harvey-Specter
> "We are hopeful that this transplant will help restore near-normal urinary
> and sexual functions for this young man." \- W.P. Andrew Lee Director,
> plastic and reconstructive surgery

~~~
garmaine
“We are hopeful” did not indicate success or failure.

------
DoctorOetker
"They transplanted from a deceased donor the entire penis"

Is there any research on the statistics of people signing up for organ
donation, wealth, death rate etc. to objectively measure if people are ...
left to die if the resulting organs are more profitable? A macabre thought
indeed.

"It's a real mind-boggling injury to suffer; it is not an easy one to accept,"
the recipient says. "When I first woke up, I felt finally more normal … [with]
a level of confidence as well. Confidence … like finally I'm OK now."

^ this is exactly what worries me on the subjects of sex-change,
-transplantation etc. : without even any time to recover, time to repeatedly
re-assess the new condition, without anonimity (or rather a pseudonym signed
by say the government, so that they can prove they actually underwent such an
operation, without giving up their identity) how do we know they tell the
truth? how can he already be happy without trying his new dick out? or is he
really just being happy about _officially having a dick again_ ? how do we
prevent people who are fantasizing about a sex change from deciding something
they will come to regret, especially if their only source of information is
people who 1) did not provably undergo such an operation 2) are no longer
anonymous to be able to speak freely how they feel about it?

~~~
jobigoud
There are several Internet communities where transgenders can talk
pseudonimously.

~~~
aninhumer
Indeed, I think part of the problem is that the only interactions a lot of
people have with trans people is with political advocacy, where people are too
busy trying to deal with rampant misinformation to ever get into nuance. And
people then assume this is the only form of discourse that trans people ever
engage in.

Much as people like to deride "safe spaces" as echo chambers, actual safe
space trans communities are far more open to discussing conflicting feelings,
doubts, regrets etc. because they know people won't use those admissions to
judge or invalidate them. Which is of course, exactly the point of a safe
space.

(PS: The preferred term is "transgender people" or more commonly just "trans
people".)

~~~
DoreenMichele
_I think part of the problem is that the only interactions a lot of people
have with trans people is with political advocacy,_

I've personally been attacked a few times on HN as transphobic for trying to
talk about women's issues and my personal problems as a woman in a man's
world. My experience suggests the trans community frequently takes approaches
that are openly and unnecessarily hostile.

I also spent 9 months being very supportive of a MTF trans youth met through
HN whose life was in serious crisis at the time. Several other members of HN
are well aware of the support I provided her. None of them ever stepped
forward in my defense during the time when I was being repeatedly randomly
attacked as supposedly transphobic.

The MTF individual in question was incredibly ugly to me during the months
that I was supportive. Every single personal problem I had as a divorced
single mom, problems very typical of divorced single moms, was dismissed as me
being incompetent, not wanting success badly enough, etc.

I got badly burned for being sympathetic and supportive. I have reason to
believe this individual still has the ear of powerful people and there is
evidence they are still telling lies about me and dragging my name through the
mud.

If my experience is at all representative, then your description of the
problem space doesn't begin to capture the issue.

~~~
aninhumer
>If my experience is at all representative

I don't really see any reason to think that your interactions with one trans
woman would be representative?

~~~
DoreenMichele
You are glossing over large parts of my comment. This is hardly limited to
interactions with one individual.

