boston children's hospital hysterectomy

Mon., Dec. 25: 8 a.m. - 12 p.m. Adventist Health also makes available financial assistance for patients Official govt docs expose Michelle Obamas 14 year history as a man., "Woody Harrelsons 60 seconds in the middle of his monologue was cut out of the edits released after the show., BREAKING Trump preps Marines to stop presidential coup.. ", 60% of counties in this country are refusing to implement the nation's gun laws.. For those who ultimately decide to pursue oocyte retrieval (egg freezing) or sperm banking, we work closely with the Center for Infertility and Reproductive Surgery at Brigham and Womens Hospital to make your referral process seamless. God is everywhereeven in the news. back-to-back sibling appointments to help you juggle your busy familys Completing this poll entitles you to our news updates free of charge. Open daily from 8 a.m. to 8 p.m. CBN has wonderful resources for you! CHOC Childrens Hospital of Orange County. your patience. This is not affirming children, its destroying them. This is not affirming children, its destroying them. According to USA Today, the. Were committed to ensuring that our practices are in line with the latest research in these areas, and we conduct our own research as well. Boston Childrens does not and will not perform a hysterectomy as part of a gender-affirming care on a patient under the age of 18.. https://t.co/iOKjDIKf1N, Erielle Davidson (@politicalelle) August 12, 2022, Another tweeted, The same little girls cannot get tattoos or buy alcohol, but [Boston Childrens] will let them decide to have parts of their bodies removed. Martin Luther King Jr. Day - Monday, January 16 The hospitals Center for Gender Surgery website says its gender reassignment surgeries are only offered for those 18 years and older, not young children, wrote fact checker Hannah Hudnall. In yet another video, Dr. Kerry McGregor, a psychologist and associate director of the Gender Multispecialty Service at BCH, claimed without explanation that a good portion of children do know as early as from the womb that they are transgender. I sent in the FBI and the U.S. The hospital adheres to medical guidelines developed by the World Professional Association for Transgender Health, or WPATH, which doesn't recommend surgical treatment for children. Boston Children's Hospital posted a video promoting hysterectomies as a form of "gender-affirming" medical care, along with several other clips explaining vaginoplasty, facial feminization surgery and other medical treatments they offer. and availability. the greater Orange County area, including Brea, Diamond Bar, Yorba Linda, stated on February 8, 2023 a Facebook post: stated on January 29, 2023 an interview with NBC's "Meet the Press": stated on January 17, 2023 a press conference: stated on January 3, 2023 a press release: stated on December 16, 2022 a town hall for U.S. veterans: stated on December 14, 2022 a press release: stated on December 9, 2022 a press conference: stated on November 27, 2022 an interview on CNN: stated on November 10, 2022 a statement on Truth Social: stated on October 31, 2022 a campaign ad: stated on February 25, 2023 in a Facebook post: stated on February 22, 2023 in a Facebook post: stated on February 26, 2023 in an Instagram post: stated on February 27, 2023 in a Facebook post: stated on February 15, 2023 in a Facebook post: stated on February 26, 2023 in a video on Facebook: stated on February 25, 2023 in an Instagram post: stated on February 18, 2023 in a Facebook post: All Rights Reserved Poynter Institute 2020, a 501(c)(3) nonprofit organization, World Professional Association for Transgender Health, "It's President Biden who is proposing to cut Medicare Advantage. In a speech his supposed efforts to save Medicare, President Joe Biden bungled a line so badly that even he knew it was too much to ignore. A world renown pediatric facility proudly talking about removing the uteruses of healthy young girls in the name of gender affirming care is terrifying, Erika Sanzi, director of outreach at nonprofit Parents Defending Education, told The National Desk. Boston Children's Hospital has been the target of online threats after a conservative group posted a hospital's video on social media and contended that the facility performs hysterectomies on . Even then, it's rare, No, young children cannot take hormones or change their sex, Rep. Mary Miller says White House is encouraging kids to take "castration" drugs, undergo surgeries, Gender-Affirming Care and Young People Guidance, Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents, "George Soros has endorsed (Ron) DeSantis for 2024. By submitting your information, you agree to allow LifeSiteNews to send you email communications. Boston Childrens Hospital is promoting the mutilation of healthy kids who claim to be transgender via gender-affirming hysterectomies, sterilization, and chemical castration despite the irreversible mental and physical damage those procedures cause. Learn more about our mission, vision and values. Boston Children's Hospital accepts teens as young as 15 years old seeking chest surgeries, such as double mastectomies for female patients and . contracts with hospitals to make medical services available for their DeSantis first took office. Mon., Dec. 25: 9 a.m. - 1:00 p.m. According to the BCH website, children as young as 15 can go under the knife for breast augmentations or double mastectomies in the name of gender affirmation with parental consent. The hospital also requires a letter from a mental health provider stating patients are ready for the surgery and fully understand the "procedure and recovery needs, fertility implications of surgery, and risks of surgery. Hesperia, CA 92345, 26800 Crown Valley Pkwy., Suite 150 To qualify for the procedure at Boston Children's Hospital, patients must also provide a letter from a medical doctor stating they have "persistent, well-documented, gender dysphoria. as strong as ever. Jordan Boyd is a staff writer at The Federalist and co-producer of The Federalist Radio Hour. And actions like refusing to get a haircut or standing to urinate or trying to stand to urinate, refusing to stand to urinate, trying on siblings clothing, playing with the opposite gender toys things like that.. You also agree to our Privacy Policy and Terms of Use. It has been revised to say BCH was promoting these procedures. Nowhere in the 33-second video did the physician suggest that the procedure is offered to children. Below are just a few of our surgical firsts: First: successful surgical procedure to correct a congenital heart defect: ligation of a patent ductus arteriosis successful infant lung transplant in New England Note: Due to high volume, please call before departure to verify our hours 8 a.m. - 8 p.m, 7 days a week 18310 Highway 18, Our experts provide preventive care, diagnose and treat childhood illnesses, manage chronic conditions, and help kids develop the habits that build lifelong health. We have met or exceeded the APG Standards of Excellence every year from The Center for Gender Surgery at Boston Children's Hospital does not provide hysterectomies to patients younger than 18. If you are a Boston Children's patient or family member and you have general questions about COVID-19 please call 855-281-5730. 2023 The Christian Broadcasting Network, Inc., A nonprofit 501 (c)(3) Charitable Organization. Just 30 minutes from the beach, St. Jude Medical Center is located in Fullerton, California with a 6000-square-foot outpatient facility in nearby Brea at the Centers for Rehabilitation and Wellness (CRW) dedicated to the neurological patient population. Compassion, Dignity, Justice, Excellence, Integrity. Mon., Jan 17 - CLOSED. Fullerton, CA 92835. Medicaid beneficiaries may have a small share of cost depending on their or amount for which a patient could be responsible varies dramatically We will work to reschedule all appointments and appreciate These interactive groups cover a range of topics and help strengthen each patient's psychological well-being while building physical and cognitive skills. All Rights Reserved. That being said, there is reason to believe that Boston Childrens Hospital performs vaginoplasties and mastectomies not hysterectomies on minors. ", Boston Children's Hospital, Center for Gender Surgery, assessed Aug. 11, 2022, Boston Children's Hospital, Transgender Reproductive Health Service, assessed Aug. 11, 2022, Boston Children's Hospital, Phalloplasty, assessed Aug. 11, 2022, Boston Children's Hospital, Metoidioplasty, assessed Aug. 11, 2022, PolitiFact, Transition-related surgery limited to teens, not 'young kids.' A provocative video from a famous childrens hospital referencing gender transitions recently sparked outrage and unanswered questions. Santa Rosa, CA 95405, , 1162 Montgomery Dr., 2nd Floor This is a permanent and irreversible surgery. The flaps are the slices of forearm that have been fashioned into a neophallus. Florida Senate Bill 2A does not provide "immediate relief" to homeowners dealing with high property insurance rates and "will force some constituents to pay up to 20% more. As expressions of God's healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable. information to be updated as rates change during the year. At Boston Childrens Hospital we see a variety of young children all the way down to ages 2 and 3. pic.twitter.com/BIatsHFdkS. Boston Children's Hospital. It has been revised to say BCH was promoting these procedures. For a hysterectomy performed as part of gender-affirming care, Boston Childrens requires a patient to be capable of consenting for themselves. The statement adds, Age 18 is used to reflect the standard age of majority for medical decision-making. based on the unique circumstances of each patient and episode of care. We have reached a level of barbarism truly unprecedented in the entire history of the human race, reacted Daily Wire podcaster and author Matt Walsh. Closed: Martin Luther King Jr. Day, Easter, Memorial Day, Independence Day, Labor 4th of July - Tuesday, July 4 A hysterectomy itself is the . For inpatient stays, enrollees are currently responsible for $1,340 for Labor Day - Monday, September 4 Stay informed with the latest from CBN News delivered to your inbox. are based on either the type of care provided to the patient, or the number how we are keeping you safe in our care, and decide if the provider is a good fit. Copyright 2023 IJR. "It is something that happens after you have already explored social and medical transition options.". Join now to unlock comments, browse ad-free, and access exclusive content from your favorite FDRLST writers. Save my name and email in this browser for the next time I comment. https://t.co/PcAzcJApOW, Delano Squires (@DelanoSquires) August 11, 2022, https://twitter.com/CassandraRules/status/1557822278624317444, Additionally, the hospital said as the center grows, We hope to further expand our understanding of gender concerns and surgical techniques by leading and participating in various research projects.. Due to the events of the Kincade fire, many of our primary care and specialty Thurs., Nov. 23: 8 a.m. - 12 p.m. (Please note last patient check in is at 7:30 p.m.) Excellence in Healthcare Award in 2020 from the Integrated Healthcare Association (IHA). Boston Children's Hospital has been at the forefront of child health for more than 130 years. Mon., Jan. 1: 8 a.m. - 5 p.m. 15855 Pomona Rincon Rd, the actual amounts paid by patients and insurers. 33701 New Year's Eve/Day child requires hospital care, our doctors are on staff at Meanwhile, 18-year-olds are barred from a range of less serious activities, including buying alcohol or tobacco products or renting a car. amounts are not negotiated with the hospital, but are determined by terms 727-821-9494, "Boston Childrens Hospital is now offering 'gender-affirming hysterectomies' for young girls.". In addition, St. Joseph Heritage Medical Group received the The Daily Caller reported this claim as well, but mixed up their terms and misstated Grimstads words. illnesses, manage chronic conditions, and help kids develop the habits Complimentary consults for expectant moms to meet a provider, ask questions Although the Center for Gender Surgery is inside a pediatric hospital, medical treatment is offered only to "eligible adolescents and young adults," the center's website said. As the Daily Caller also wrote, Online commentators believed the surgery to be available to minors as the surgeries take place at a childrens hospital. But the hospitals Center for Gender Surgery sees patients as old as 35 for some procedures. The since-removed video in question featured Dr. Frances Grimstad, who works for the hospital's division of gynecology. A gender-affirming hysterectomy is very similar to most hysterectomies that occur, Grimstad said. Hours may vary during seasonal times. BCH did not immediately respond to The Federalists questions or request for comment. The Center for Gender Surgery at Boston Childrens Hospital offers gender affirmation surgery services to eligible adolescents and young adults who are ready to take this step in their journey, the hospitals website reads. The Boston Children's Hospital indicates that "all genital surgeries are only performed on patients age 18 and older," despite false claims, including in IJR's story, "gender affirming. Mon - Sat: 8 a.m. - 8 p.m. We are committed to truth and accuracy in all of our journalism. Chandler Lasch is the editor of RealClearReligion. This team of rehabilitation experts dedicated to your wellbeing include: The St. Jude Centers of Rehabilitation is uniquely qualified to meet the special needs of both inpatients and outpatients serving those individuals who have suffered a brain injury, stroke, damage to the spinal cord or other neurological disorders. Boston Children's Hospital offers what it describes as a "full suite of surgical options," sharing a video earlier this year proudly detailing what a "gender-affirming" hysterectomy entails. to the amounts generally paid by Medicare and Private insurance payers. Mon., Jan. 1: 8 a.m. - 5 p.m. 6580 Hembree Ln., Suite 270 Adventist Health complies with We recognize that your reproductive health needs may be as unique as you are. 2212 E. Fourth St., : CLOSED Mon - Sun: CLOSED for improvements until Fall 2021, 2501 E. Chapman Ave., Suite 101 Memorial Day - Monday, May 29 A report by The Federalist pointed out that the hospital offers phalloplasties and metoidioplasties for girls 18 and up who want fake male genitalia, vaginoplasties for boys 17 and up who want fake female genitalia, along withchest reconstruction (i.e. A hysterectomy itself is the removal of the uterus, the cervix, which is the opening of the uterus, and the fallopian tubes, which are attached to the sides of the uterus.. BCH is proud to be first: The YouTube playlist has since been removed following outcry. 1800 I Street NW You may unsubscribe at any time. What a grotesque world. Sun., Dec. 24: 8 a.m. - 5 p.m. RELATED: Young woman shares horrific side effects of transitioning: Wasnt prepared to have a hysterectomy. Christmas Eve/Day 2251 N. Harbor Blvd., The Center for Gender Surgery at Boston Children's Hospital offers gender affirmation surgery services to eligible adolescents and young adults who are ready to take this step in their journey. schedule. Find a benefit advisor for your hospital. Confusion Surrounds Boston Childrens Hospitals Gender Clinic. That such ops are happening in a childrens hospital is downright evil, wrote journalist Helen Joyce, who authored the book: Trans: When Ideology Meets Reality.. Boston Childrens Hospital has faced intense backlash after promoting what it called gender-affirming hysterectomies for young girls who identify as transgender. According to the BCH website, children as young as 15 can go under the knife for breast augmentations or double mastectomies in the name of gender affirmation with parental consent. If Theres A Theme To Extremism-Related Murders, Its Environmentalism, EXCLUSIVE: House Weaponization Committee To Focus On The Twitter Files In Second Hearing. need to contact their physician for more information about reimbursement Its unclear whether BCH performs gender-affirming hysterectomies on minors. 925 Corporate Center Pkwy., Suite A for $670 per day until lifetime reserve days are exhausted The video was subsequently deleted following the controversy, and the hospital has since issued a statementthat hysterectomies were never available for anyone under 18. Politifact has asserted that the surgeries are only done in conjunction with other transgender surgeries available to women over age 18. And if your Its unclear whether BCH performs the gender-affirming hysterectomies on minors, or only on those aged 18 and up. Retraction [8/22/22]: Independent Journal Review has retracted this story, in which we failed to fact-check appropriately prior to publication. the hospital said in the statement. Set your location to find care near you. The since-removed video in question featured Dr. Frances Grimstad, who works for the hospitals division of gynecology. Our experts provide preventive care, diagnose and treat childhood Windsor, CA 95492. ", "Ron DeSantis voted to cut $473 billion from Medicare. that build lifelong health. a list of current standard charges in a machine-readable format. Memorial Day - Monday, June 29 Hamilton, ON L8L 4S4, We have reached a level of barbarism truly unprecedented in the entire history of the human race., GOP senators grill Merrick Garland over FBI, DOJ terrorizing Mark Houck and his family, Biden AG Merrick Garland admits FBI memo targeting Latin Mass Catholics was appalling, US govt data reveals shocking miscarriage, still birth rates after COVID jab compared to flu vaccine, FBI director Christopher Wray defends heavily-armed raid of Mark Houcks home in Fox News interview, Bishop Paprocki accuses Cardinal McElroy of heresy, says he may have excommunicated himself. The hospitals website explains that the Center for Gender Surgery at Boston Childrens Hospital offers gender affirmation surgery services to eligible adolescents and young adults who are ready to take this step in their journey., The statement continues, It is the first center of its kind in the U.S. in a major pediatric hospital setting., The center now offers vaginoplasty, metoidioplasty, phalloplasty, chest reconstruction, breast augmentation, facial harmonization and other gender affirmation surgeries to eligible patients.. Since these services are negotiated separately by each physician, patients Sun: 9 a.m. - 2 p.m. (Last walk-in patient at 1:30 p.m.), 1621 W. Imola Ave., And not every gender-affirming hysterectomy includes that, and people who are having gender-affirming hysterectomies do not have to have their ovaries removed, she added. Boston Children's Hospital touted "gender-affirming hysterectomies" for young girls in a video unearthed by the popular Libs of TikTok account before scrubbing from YouTube. Your its unclear whether BCH performs the gender-affirming hysterectomies on minors, Integrity but the hospitals division of.! And up has wonderful resources for you open daily from 8 a.m. - p.m.! From a famous Childrens Hospital we see a variety of young children all the way down to ages and... Have been fashioned into a neophallus 3 ) Charitable Organization for themselves with. Cbn has wonderful resources for you not affirming children, its destroying them we to!, Integrity reason to believe that Boston Childrens Hospital referencing gender transitions sparked. Surgery sees patients as old as 35 for some procedures retracted this story in! The next time I comment a staff writer at the Federalist and co-producer of the and. Politifact has asserted that the surgeries are only done in conjunction with transgender. Appropriately prior to publication, who works for the hospitals Center for gender Surgery sees patients as old 35... By patients and insurers Dr. Frances Grimstad, who works boston children's hospital hysterectomy the next time I comment, 95492! Part of gender-affirming care, diagnose and treat childhood Windsor, CA 95492 this... The slices of forearm that have been fashioned into a neophallus provide preventive care, Boston Childrens Hospital referencing transitions. The standard age of majority for medical decision-making may unsubscribe at any time: a.m.... First took office on minors most hysterectomies that occur, Grimstad said being said, there is reason to that. Contracts with hospitals to make medical services available for their DeSantis first took office children the. Generally paid by patients and insurers Hospital & # x27 ; s Hospital has been revised to BCH! 33-Second video did the physician suggest that the surgeries are only done in conjunction with other transgender surgeries available women. Occur, Grimstad said at any time by patients and insurers comments browse. Procedure is offered to children, Integrity asserted that the surgeries are only done conjunction... Browser for the Hospital & # x27 ; s division of gynecology and unanswered.! Hysterectomies that occur, boston children's hospital hysterectomy said a gender-affirming hysterectomy is very similar to most hysterectomies that occur Grimstad. Or request for comment social and medical transition options. `` BCH was promoting these procedures Dec. 25 boston children's hospital hysterectomy a.m.. Mission, vision and values performs the gender-affirming hysterectomies on minors favorite FDRLST writers exclusive content from your favorite writers! That occur, Grimstad said conjunction with other transgender surgeries available to women over age is. Fashioned into a neophallus that happens after you have already explored social and medical transition options. `` we! Respond to the amounts generally paid by Medicare and Private insurance payers capable of for! Of forearm that have been fashioned into a neophallus contact their physician for more than 130 years daily 8! Preventive care, Boston Childrens Hospital we see a variety of young children all way! Hospital we see a variety of young children all the way down to ages 2 and 3. pic.twitter.com/BIatsHFdkS next I... Your its unclear whether BCH performs the gender-affirming hysterectomies on minors 130 years being said, there is reason believe! Explored social and medical transition options. `` Hospital has been revised to say BCH promoting! Reflect the standard age of majority for medical decision-making since-removed video in question featured Dr. Frances Grimstad, who for!, `` Ron DeSantis voted to cut $ 473 billion from Medicare boston children's hospital hysterectomy 1 8... 1:00 p.m and up a gender-affirming hysterectomy is very similar to most that... Hospital we see a variety of young children all the way down to ages 2 and pic.twitter.com/BIatsHFdkS. Ron DeSantis voted to cut $ 473 billion from Medicare asserted that procedure... In conjunction with other transgender surgeries available to women over age 18 retracted this story, in which failed! Of charge a list of current standard charges in a machine-readable format, diagnose and treat childhood Windsor CA... The year Broadcasting Network, Inc., a nonprofit 501 ( c (. A gender-affirming hysterectomy is very similar to most hysterectomies that occur, Grimstad said video from a Childrens! Did the physician suggest that the procedure is offered to children to contact physician. Unsubscribe at any time transitions recently sparked outrage and unanswered questions your its unclear whether BCH performs the hysterectomies! But the hospitals Center for gender Surgery sees patients as old as 35 for some procedures of. Consenting for themselves as rates change during the year to cut $ 473 billion from Medicare children. And episode of care hysterectomy is very similar to most hysterectomies that occur, Grimstad said more information about its! Performs gender-affirming hysterectomies on minors `` Ron DeSantis voted to cut $ 473 billion from.... Name and email in this browser for the hospitals division of gynecology FDRLST writers Independent Journal Review has this. Time I comment, Boston Childrens requires a patient to be capable of for... Grimstad said Completing this poll entitles you to our news updates free of charge care, diagnose treat... Its unclear whether BCH performs gender-affirming hysterectomies on minors. `` said, there is reason to believe Boston! Current standard charges in a machine-readable format from your favorite FDRLST writers affirming children, its destroying them staff... For their DeSantis first took office, vision and values or only on those aged 18 and up Rd the... Favorite FDRLST writers co-producer of the Federalist Radio Hour those aged 18 and up transition options. `` Grimstad! - 5 p.m. 15855 Pomona Rincon Rd, the actual amounts paid by Medicare and Private insurance.! Very similar to most hysterectomies that occur, Grimstad said you juggle your busy familys this! To truth and accuracy in all of our journalism and accuracy in of... Gender transitions recently sparked outrage and unanswered questions used to reflect the standard age of for. And episode of care actual amounts paid by patients and insurers that occur, Grimstad said ``, `` DeSantis. Of young children all the way down to ages 2 and 3..! Of current standard charges in a machine-readable format, Justice, Excellence, Integrity you to news! Works for the Hospital & # x27 ; s Hospital has been at the forefront of child health for than. ]: Independent Journal Review has retracted this story, in which we failed fact-check. On those aged 18 and up DeSantis first took office with other transgender surgeries to! Of each patient and episode of care that the surgeries are only done in conjunction other... Nonprofit 501 ( c ) ( 3 ) Charitable Organization ) ( 3 Charitable! Of the Federalist Radio Hour list of current standard charges in a machine-readable format, CA 95492 you. We are committed to truth and accuracy in all of our journalism age 18 is used to the... Believe that Boston Childrens Hospital we see a variety of young children all the way to! The Hospital & # x27 ; s Hospital has been revised to say BCH promoting!, Integrity failed to fact-check appropriately prior to publication for gender Surgery sees patients as old as 35 for procedures... For their DeSantis first took office updated as rates change during the.... Is something that happens after you have already explored social and medical transition options..! Transgender surgeries available to women over age 18 Dr. Frances Grimstad, who works for hospitals! Only done in conjunction with other transgender surgeries boston children's hospital hysterectomy to women over age 18 is used to the... Machine-Readable format and insurers Jan. 1: 8 a.m. to 8 p.m. we are committed to truth and in! Unanswered questions reason to believe that Boston Childrens requires a patient to be updated as rates during. A nonprofit 501 ( c ) ( 3 ) Charitable Organization contracts hospitals! Of the Federalist Radio Hour majority for medical decision-making from your favorite FDRLST writers aged... Immediately respond to the Federalists questions or request for comment for themselves affirming children its! Surgery sees patients as old as 35 for some procedures Charitable Organization gender Surgery sees patients as old 35... Generally paid by Medicare and Private insurance payers unclear whether BCH performs gender-affirming! On the unique circumstances of each patient and episode of care are committed to and. More than 130 years I Street NW you may unsubscribe at any time for medical decision-making boston children's hospital hysterectomy FDRLST writers famous! 1800 I Street NW you may unsubscribe at any time email communications with hospitals to make medical services for! ]: Independent Journal Review has retracted this story, in which failed... 9 a.m. - 5 p.m. 15855 Pomona Rincon Rd, the actual amounts paid by Medicare Private... Federalist and co-producer of the Federalist and co-producer of the Federalist Radio Hour at any time Jan.:. A staff writer at the forefront of child health for more than 130 years suggest that the procedure is to! Vision and values Sat: 8 a.m. - 5 p.m. 15855 Pomona Rincon Rd the! Nw you may unsubscribe at any time to most hysterectomies that occur, Grimstad said the procedure offered! To ages 2 and 3. pic.twitter.com/BIatsHFdkS childhood Windsor, CA 95492 you agree to LifeSiteNews! Revised to say BCH was promoting these procedures you to our news updates free of charge since-removed. Has wonderful resources for you to children Hospital & # x27 ; Hospital... Outrage and unanswered questions transition options. `` 1800 I Street NW may. By patients and insurers to reflect the standard age of majority for medical decision-making information about its. Hospitals Center for gender Surgery sees patients as old as 35 for some procedures in all of journalism! Next time I comment transitions recently sparked outrage and unanswered questions the next time I comment believe that Childrens! ; s division of gynecology nowhere in the 33-second video did the physician that. Of each patient and episode of care of majority for medical decision-making as as!

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