Pullman hospital board approves sex reassignment surgery

The Pullman Regional Hospital will be the first in Washington to offer sex reassignment surgery, after its Board of Commissioners agreed Wednesday to expand service for people with gender dysphoria.

The board voted unanimously to provide the surgery. The hospital expects to perform no more than two operations per month, according to a report presented at the meeting, and anticipates this will result in an annual net loss of about $49,000.

“This is not a moneymaker procedure,” Commissioner Margaret Werre said, “but many of the procedures we do are not moneymakers.” She pointed to behavioral and women’s health as two examples.

Scott Adams, the hospital’s chief executive, said he views the surgery as just another form of care for a demographic they have been helping for years with other procedures.

“While we learned that certain types of gender reassignment surgery have an element of controversy to them,” Adams said, “it was fairly consistent for us to be able to say that this is a new way of providing a service to these people.”

Though the Pullman hospital is referring to the surgery as “gender reassignment,” the National Lesbian and Gay Journalists Association recommends using the term “sexual reassignment” to describe the treatments and surgeries used by transgender people to match their sex to their gender.

The surgery proved polarizing when the hospital asked for public comment in June on whether they should offer it. More than 400 people weighed in by mail or email over a month-long period, 260 in support and about 80 in opposition. The rest took no stance.

They also received three petitions, two from local churches. Including those signatures they counted more than 2,000 in favor of the surgery, and just under 400 against.

Some opposed the surgery for religious reasons, or on the grounds that the small public hospital is not the place for such procedures. Others questioned the relevance of public opinion altogether, arguing it should depend only on the hospital’s ability to offer the surgery.

Board President Patricia Grantham said it is not unusual for them to ask for public comment, especially regarding controversial issues.

For example, she said, they requested public input on hospital policies after Washington passed the Death with Dignity initiative, which allows physician-assisted suicide.

Using what Adams called “more aggressive” assumptions for the operation rate, the hospital assessed their ability to offer two surgeries per week, though they only expect two per month. They found that with a recently completed fourth operating room, they will have 160 hours of operating time each week.

Allowing 16 hours for a surgery, 90 percent of operating time would be open for other surgeries. They concluded in the report that this would leave other surgeons enough time to perform their operations.

After performing two trial surgeries under the supervision of a preceptor in June, the hospital decided they have the resources and personnel necessary.

Commissioner and retired general surgeon Michael Murphy noted that while the techniques for sexual reassignment surgery have changed, the procedure itself has become well-established in the medical community over the past 30-plus years.

“This is not, in the world of surgery, a new revolutionary procedure of some sort,” he said. “This is something that’s been done for years and years.”