The original video post from last year appears to have been deleted, but then retrieved from an archive and shared recently on social media. Viewers called the procedures ‘evil’ and compared them to Nazi-era experiments.

Patients frequently have problems after surgery, added the doctor.

They can suffer ‘rectal injury and urinary incompetence,’ he said. Others struggle to achieve ‘sexual satisfaction’ from altered body parts and have worse chances of ‘future childbearing.’

Some have a ‘really demanding post-operative care process,’ he added.

Pretty much every male-to-female genital surgery recipient sees their neo-vagina canal shorten over time, he said.

‘We’ve seen patients coming back even 20-plus years out from a vaginoplasty that have something happened in their life, that they just don’t dilate, and aren’t having sex for a year, and they will lose a lot of a lot of depth,’ said Dr Peters.

Dr Peters said his techniques and success rates were improving as ever more Americans — both young and old — opted for genital surgery, but that there was still much to learn on this new frontier of medicine.

‘We’re going to learn a lot more about it in the next five to 10 years as we’re doing just increasing numbers of these cases,’ he said.