Transgendered children

[satopi]

Now that trans people are becoming recognized in a more positive view in the last 3-4 years, another hot topic is kids who start identifying early about the gender they feel inside. Whether you support it or not, what are your thoughts on it?

 

[EnglishALT]

I work with children four out of five days a week, and teens on a single day. Children are very fickle, they can change their mind on a whim, and many times do not consider other scenarios when they set their minds on something. Considering that we still do not know the full extent of what puberty blockers can do to a person's body, and that surgery is irreversible. I would say that children and teens should not be eligible for any kind of transgender drugs or surgery until they reach adulthood at the age of 18.

I understand this view may be controversial, and it would cause pain to alot of teens, but I honestly worry about the damage to someone if they change their mind at being transgender after having surgery or taking puberty blockers or testosterone/estrogen.

 

[satopi]

I work with children four out of five days a week, and teens on a single day. Children are very fickle, they can change their mind on a whim, and many times do not consider other scenarios when they set their minds on something. Considering that we still do not know the full extent of what puberty blockers can do to a person's body, and that surgery is irreversible. I would say that children and teens should not be eligible for any kind of transgender drugs or surgery until they reach adulthood at the age of 18.

I understand this view may be controversial, and it would cause pain to alot of teens, but I honestly worry about the damage to someone if they change their mind at being transgender after having surgery or taking puberty blockers or testosterone/estrogen.

I honestly feel the same way. While some trans people who transitioned later in life have stated that they would've loved to had transitioned at a young age, I feel like letting a kid transition into the other gender is a big life change that carries consequences & responsibilities that they, nor the parents are not entirely sure are mentally, physically, and emotionally capable of baring, which is why it's up to the parents to decide to let their child transition. There's a reason on why we have age restrictions on certain liberties like at age 12/13, you can sit in the front passenger seat with a seatbelt on, at 16, you can start to learn how to drive, at 18, you're legally an adult, at 21, you can drink/serve alcohol, etc. Kids can be easily influenced and manipulated into believing if they don't like/are into a specific traditional gender norm, they must be a boy/girl or be favored as the opposite gender they were born as by the parent.

I also feel that if you allow your child to transition, there should be a minimum age requirement like possibly 8. I understand at age 2-4, they can start vocalizing how they feel and think or distinguish the differences between genders but his/her brain is still developing. Deciding to let a 2 year old transition when it's still in diapers is way too young to figure out it's gender identity.

 

[chess-z]

I understand this view may be controversial, and it would cause pain to alot of teens, but I honestly worry about the damage to someone if they change their mind at being transgender after having surgery or taking puberty blockers or testosterone/estrogen.

Fun fact from a transgender gal: puberty blockers don't cause irreversible changes. Learn more about transitioning before throwing in your hat.

EDIT: I feel like this is gonna become a heated topic, especially for me; because, well, this issue is really close to me, but I want everyone in this thread to actually seek out as much literature about transitioning as possible before going forward. I'm going to end up very grumpy if y'all make me source everything, because most of what I'm gonna end up saying has been the consensus in the psychological and transgender communities for a couple of years now.

I can already sense that this is headed towards scaremongering about children ruining their lives by castrating themselves and what if they change their mind, but that narrative belies a total ignorance of the way the medical community treats transgender children. I had to fight tooth and nail to get myself hormones, and I don't want anyone else to go through the degrading process of gatekeeping that I was required to go through.

So please, for the love of God, do some research into this, don't fly by the seat of your pants, and don't dig in when my lived experiences, and the lived experiences of others contradict your preconceived notions.

Or else I'll own you on the internet.

 

[EnglishALT]

Fun fact from a transgender gal: puberty blockers don't cause irreversible changes. Learn more about transitioning before throwing in your hat.

Here is a report published recently by three doctors: Paul W. Hruz, a professor at Washington University School of Medicine; Lawrence S. Mayer, a scholar in residence at Johns Hopkins School of Medicine and a professor at Arizona State University; and Paul R. McHugh, university distinguished professor of psychiatry at Johns Hopkins University School of Medicine and the former psychiatrist-in-chief at Johns Hopkins.

First, that the treatment is reversible. Puberty blockers are presented as a “let’s just hold off puberty” solution, meant to delay the development of the most prominent features of a child’s biological sex while the child wrestles with his or her gender identity. But Hruz, Mayer, and McHugh argue it remains unknown if regular sex-typical puberty will resume following suppression.

Indeed, “there are virtually no published reports, even case studies, of adolescents withdrawing from puberty-suppressing drugs and then resuming the normal pubertal development typical for their sex,” according to the authors.

Second, that the treatment is harmless.

“Puberty suppression hormones prevent the development of secondary sex characteristics, arrest bone growth, decrease bone accretion, prevent full organization and maturation of the brain, and inhibit fertility,” Hruz, Mayer, and McHugh write in a Supreme Court brief filed in the Gavin Grimm case. They go on to list other possible side effects of cross-gender hormones, oral estrogen, and testosterone, including sterility, coronary disease, cardiovascular disease, elevated blood pressure, and breast cancer.

https://world.wng.org/content/doctors_puberty_blockers_are_a_dangerous_experiment

Link to the paper: https://www.thenewatlantis.com/publications/growing-pains

 

[bobjr]

Shouldn't this be a thing where the heavy focus is on transgendered people themselves? You can hypothesize all you want, but only a trans person really knows, and from what I've seen major surgery isn't pushed at all, especially due to cost and time reasons alone, which is an issue for many trans people in the first place. Especially how it's phrased as "mutilating themselves permanently" often.

I've always thought it was more about pushing acceptance of themselves while young, instead of telling them that they're wrong for feeling a certain way. But as a Cis Male it's kind of something where I can't say definitively one way or the other because there's a layer I can't understand from an experience level.

 

[EnglishALT]

Shouldn't this be a thing where the heavy focus is on transgendered people themselves? You can hypothesize all you want, but only a trans person really knows, and from what I've seen major surgery isn't pushed at all, especially due to cost and time reasons alone, which is an issue for many trans people in the first place. Especially how it's phrased as "mutilating themselves permanently" often.

I've always thought it was more about pushing acceptance of themselves while young, instead of telling them that they're wrong for feeling a certain way. But as a Cis Male it's kind of something where I can't say definitively one way or the other because there's a layer I can't understand from an experience level.

I also want to defer to the life experience of a person in many aspects, but I also want to be couscous of the science and what is known and not known considering how delicate the situation is. Right now alot of the science seems to be a bunch of "We don't know" which is frustrating for a debate.

 

[bobjr]

I also want to defer to the life experience of a person in many aspects, but I also want to be couscous of the science and what is known and not known considering how delicate the situation is.

And science has been frequently known to make biases when they don't work with a different group of people. Look at all the "Well studies show black people perform worse at X" articles. It's less "We don't know" and more "We don't care to learn from Trans people"

Like that article literally used Sheep as proof instead of human subjects, and when I googled it a bunch of anti-trans websites came up. Things have gotten better for Trans people in America, but that doesn't mean things are good for them either and they still face a ton of discrimination.

 

[EnglishALT]

And science has been frequently known to make biases when they don't work with a different group of people. Look at all the "Well studies show black people perform worse at X" articles. It's less "We don't know" and more "We don't care to learn from Trans people"

Like that article literally used Sheep as proof instead of human subjects, and when I googled it a bunch of anti-trans websites came up. Things have gotten better for Trans people in America, but that doesn't mean things are good for them either and they still face a ton of discrimination.

The article does reference a University of Glasgow study about using GnRH in sheep to test spacial memory, I don't think that is exactly anti transphobic and more just the case of an animal study as engaging in testing on actual children would be frowned upon. The article does note there was a study done with actual human children with the results being relatively statistically insignificant.

Male subjects whose puberty had been suppressed had lower accuracy scores than any of the groups tested (including female gender dysphoria patients, male gender dysphoria patients whose puberty had not been suppressed, and control groups of boys and girls who did not have gender dysphoria). However, the differences between the groups’ scores were not all statistically significant: the scores of the male subjects who had undergone puberty suppression were statistically significantly different from the control boys and girls, as well as from the female gender dysphoria patients whose puberty was not suppressed, but were not statistically significantly different from males with gender dysphoria who had not undergone puberty suppression, or from females with gender dysphoria who had undergone puberty suppression.

http://www.psyneuen-journal.com/article/S0306-4530(15)00094-3/fulltext

 

[bobjr]

What would the tower of london task have anything to do with this? Especially with a sample size of less than 10 people sometimes? Last I checked anything less than 100 usually isn't good.

Plus that article seems to think that mental disorders and suicide are a trans thing specifically, when that's a thing with every nearly minority group in America. The issue there is usually less access to good treatment options.

 

[EnglishALT]

What would the tower of london task have anything to do with this? Especially with a sample size of less than 10 people sometimes? Last I checked anything less than 100 usually isn't good.

Plus that article seems to think that mental disorders and suicide are a trans thing specifically, when that's a thing with every nearly minority group in America. The issue there is usually less access to good treatment options.

Suicide is high sadly in the trans community, ranking upward between 32 to 50% due to: Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system

http://www.psyneuen-journal.com/article/S0306-4530(15)00094-3/addons

However those who have transition from one sex to another also continue to have a high suicide rate. However many studies about transsexualism and follow up post operation are pretty rare at the time.

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

And science has been frequently known to make biases when they don't work with a different group of people. Look at all the "Well studies show black people perform worse at X" articles. It's less "We don't know" and more "We don't care to learn from Trans people"

Just wanted to follow up on this, trans bias may not be the reason we see such low frequency of studies and information:

The methodological shortcomings have many reasons. First, the nature of sex reassignment precludes double blind randomized controlled studies of the result. Second, transsexualism is rare and many follow-ups are hampered by small numbers of subjects. Third, many sex reassigned persons decline to participate in follow-up studies, or relocate after surgery, resulting in high drop-out rates and consequent selection bias. Forth, several follow-up studies are hampered by limited follow-up periods. Taken together, these limitations preclude solid and generalisable conclusions.

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0016885

 

[chess-z]

Suicide is high sadly in the trans community, ranking upward between 32 to 50% due to: Gender-based victimization, discrimination, bullying, violence, being rejected by the family, friends, and community; harassment by intimate partner, family members, police and public; discrimination and ill treatment at health-care system

And what makes you think that making it harder for trans teenagers to get access to treatment would help the issue?

 

[EnglishALT]

And what makes you think that making it harder for trans teenagers to get access to treatment would help the issue?

As I previously posted the suicide rate for post operation trans people is also high, there are many notable cases of regret even. Considering the suggested problems that might arise with puberty blockers: cancer, bone development, infertility, etc etc,. Not to mention the finality of a surgical operation, I just believe it is best to wait until a person has reached adult hood before making such a life changing decision. Plus such a thing would solve the question as to what to do with transgender children in middle school/high school sports that is currently being argued about.

 

[chess-z]

As I previously posted the suicide rate for post operation trans people is also high, there are many notable cases of regret even. Considering the suggested problems that might arise with puberty: cancer, bone development, infertility, etc etc,. Not to mention the finality of a surgical operation, I just believe it is best to wait until a person has reached adult hood before making such a life changing decision.

See the issue with the study you've cited is that suicide rates are still higher when compared to the general population, but even that study showed a drop in morbidity post transition, falling in line with the general LGB suicide rate. Expecting the suicide rate to match those of people without a history of institutionalized oppression is wrong. You seem to have a fundamental methodological flaw when reading studies.

Not to mention the finality of a surgical operation, I just believe it is best to wait until a person has reached adult hood before making such a life changing decision.[

I think you're overestimating how easy it is to get bottom surgery lmao. Not only is the cost prohibitively high, but most physicians won't offer it until you've been living fulltime for like a year. The idea of children suddenly making this decision and then getting it within the year is ridiculous and unrealistic, let alone immediately.

Anecdotally speaking, transgender people are pretty cautious about bottom surgery. I haven't had it yet (partially because cost, but also cause I haven't really figured that who situation out yet), and I've been transitioning for almost to years now.

Plus such a thing would solve the question as to what to do with transgender children in middle school/high school sports that is currently being argued about.

This is a bad reason to deny children life saving medical care.

Seeing as being transgender is largely a very personal and very intimate experience, I feel like implementing restrictive guidelines (like waiting until adulthood) will do far more harm to the children who need medical treatment than it will hurt those who regret it. Finally, I want you to notice that you've created a nice little logical trap here for yourself: We can't let children go on puberty blockers because we don't have enough information on the effects, but there might be some negative effects so we can't let them go on puberty blockers. How will we know if we can't study?

 

[satopi]

EnglishALT never meant any harm on his statements. He's just being cautious on the future side effects it'll have on a child who hasn't reached puberty and how it'll be a more safer choice to wait until adulthood so that they can distinguish the confusion of it being a phase or if they truly felt that way all along. If the child regrets or wants to detransition back to his/her biological sex, there are some physical side effects that won't go away without surgery. What comes to mind is this video: https://www.youtube.com/watch?v=nkRjQcdNjB8 You're right in saying how will we know if we don't study it but since we don't know, all we can do is decide on what's best for the child who feels/is transgendered as each child is different. Rushing into a rash premature decision could cause more harm than waiting it out when the child reaches the age of maturation. Though I think it really determines what kind of drug is given like puberty blockers which are completely reversible when taken off.

Shouldn't this be a thing where the heavy focus is on transgendered people themselves? You can hypothesize all you want, but only a trans person really knows, and from what I've seen major surgery isn't pushed at all, especially due to cost and time reasons alone, which is an issue for many trans people in the first place. Especially how it's phrased as "mutilating themselves permanently" often.

Transgender people don't have get bottom surgery if they don't want to and I don't think it's pushed either. The recovery post surgery is also a huge obstacle to go through. Major surgery like that is never pushed on children (minimum age is 17) and even before it comes to that decision, so many factors have to come to be considered transgender. I haven't heard people saying "mutilating themselves permanently" unless they're being blunt but as far as I saw, for the vaginoplasty, it's inverting the penis to create the shape of a vagina but that isn't mutilating.

I've always thought it was more about pushing acceptance of themselves while young, instead of telling them that they're wrong for feeling a certain way. But as a Cis Male it's kind of something where I can't say definitively one way or the other because there's a layer I can't understand from an experience level.

They can't push acceptance for themselves when they don't know how they feel. Acceptance of one's self whether you're transgender or not, doesn't come until years later while before adulthood even begins, you're still developing, getting influenced by the people around you, and trying to find your own identity. It's encouraged to experiment on yourself and only you know how you feel instead of someone telling you how you should feel. Yes, only a trans person would only know from their own personal experiences but it shouldn't be discouraged to hypothesize as it includes taking into account trans people's experiences. That's just how science works to achieve more understanding on how the body & brain works.

 

[chess-z]

Detransitioning is strikingly uncommon among transgender teenagers, and transgender people as whole for that matter. Yes, there are always people with regrets, but trans people who regret medical treatment make up 1-3% of the overall transgender population.

Anecdotally speaking again, at my gender clinic, my doc has had about 20 people detransition, and most of that was due to outside pressures, such as financial strain and social exclusion.

If you have a spare hour, I recommend reading the WPATH standards of care, so you can see what most trans activists actually push for.

EDIT: After stewing on it more, I'm pretty peeved that EnglishALT any medical transition would be restricted until the child is 18. The closest I came to the suicide that everyone in this threat decried was when I became fundamentally aware of the irreversible changes that puberty was causing to my body. I felt like I was trapped by biology, and I can confirm that being told that I wasn't old enough for my feelings to be valid literally directly worsened the problem. And I know, because that's what my parents did to me.

It boils my blood that you want to institutionalize that mindset, especially with the veneer of caution. What's more reckless, taking hormones that you have a statistically low chance of regretting or ending your life? This was the choice laid before me, and I'm glad I made it out alive, but many have been far less lucky than I have, which is reflected in my community's suicide rate. I'm sorry to say, but the gatekeeping being advocated for in this thread is far more dangerous than easy access to puberty blockers.

I'll try to remain level headed throughout this discussion, but as I said before, this is a very close issue to me, intimately even.

 

[Deadeye]

Children and even adults can be fickle. In my humble opinion people can identify with whatever they want, but when we think of transition progresses in financial terms, it should be restricted to adulthood and although the psychological and social testing may feel shallow or-limiting, they can still give clarity to any person going through the progress. It can also test their confidence, if they're really authentically sure deep within they want the transition.. not to compensate by fixing something else, like their inner sense of self. Sexuality is connected to gender as well so most people would often end up examining this side of themselves too sooner or later. I wouldn't want to pay taxes so someone (especially if they're complete stranger who'll never be significant to my life in any way) can have free hormones and surgeries and then change their mind later which would end up into them reversing the surgery! Even while I understand there are worse recipients (bums still exist) my taxes can go into. There's still lots of transgendered people can affect in theirselves before taking operations, like their appearances and body language. Not all of it is easy though, some families can be very restricting and conservative about it, but that's part of the less humane side of life. I'll accept its existence, but I wouldn't accept those restrictions imposed on my life without a fight.

He's just being cautious on the future side effects it'll have on a child who hasn't reached puberty and how it'll be a more safer choice to wait until adulthood so that they can distinguish the confusion of it being a phase or if they truly felt that way all along. If the child regrets or wants to detransition back to his/her biological sex, there are some physical side effects that won't go away without surgery.

Going to second this one.

Not every teenager has even developed their sense of self beyond what's socially acceptable (stereotypes and group-based thinking still run high), such sense of belonging is still important to teenagers and pretty much to young adults as well... so what would it be for children relatively? If some people are lucky to have developed stable and socially independent self-assurance sooner, good for them, but since we can't see that on general level from every individual, we can't assume that is the truth for all teenagers. This is why the psychological tests and interviews are important. And how hard it would be for medical personnel to work with anyone if they had no common standards nor order to base their insights and decisions on? If they have authority to choose if the treatment is going to help or worsen their patients well-being, there's an equal responsibility for such position... even while every system has its less humane side.

 

[Baba Yaga]

EnglishALT never meant any harm on his statements. He's just being cautious on the future side effects it'll have on a child who hasn't reached puberty and how it'll be a more safer choice to wait until adulthood so that they can distinguish the confusion of it being a phase or if they truly felt that way all along. If the child regrets or wants to detransition back to his/her biological sex, there are some physical side effects that won't go away without surgery.

It doesn't seem like you're really seeing the point that chess-z is raising.

Is it morally responsible to make children wait to transition if

A) De-transitioning is extremely rare and
B) The psychological risk present in denying them transition arguably outweighs any possible risk of simply being confused.

I admit that if I had a child under the age of ten or so that expressed the desire to transition, I would be hesitant too and unsure of what to do, but it's probably wise to defer to someone much closer to the issue than you are.

One other point I forgot to mention is that even if a child is young, you still have enough time to determine whether or not their expressions of gender dysphoria are a "phase" or not. For example, if it's as early as 7 years old and they haven't swayed from their convictions by the time they're eleven, there would be little point in making them wait until they're 16 or 18. I just hope no parent would sit by and watch their kid act out psychologically disturbing coping mechanisms like cutting or other forms of self harm until some magic age of maturity.

 

[Zazie]

I work with children four out of five days a week, and teens on a single day.

And how many of those kids you work with are transgender?

I have worked with some transgender kids in my job and they don't seem to be all that fickle about it.

Fun fact from a transgender gal: puberty blockers don't cause irreversible changes. Learn more about transitioning before throwing in your hat.

EDIT: I feel like this is gonna become a heated topic, especially for me; because, well, this issue is really close to me, but I want everyone in this thread to actually seek out as much literature about transitioning as possible before going forward. I'm going to end up very grumpy if y'all make me source everything, because most of what I'm gonna end up saying has been the consensus in the psychological and transgender communities for a couple of years now.

I can already sense that this is headed towards scaremongering about children ruining their lives by castrating themselves and what if they change their mind, but that narrative belies a total ignorance of the way the medical community treats transgender children. I had to fight tooth and nail to get myself hormones, and I don't want anyone else to go through the degrading process of gatekeeping that I was required to go through.

So please, for the love of God, do some research into this, don't fly by the seat of your pants, and don't dig in when my lived experiences, and the lived experiences of others contradict your preconceived notions.

Or else I'll own you on the internet.

I think we should listen to chess-z here on account of her being someone who actually transitioned as a child. She's probably the one here most qualified to talk about it.

I didn't transition until my mid 20s, but I kind of agree here, back when I was young there was poor information out there and little help if you wanted to transition, I kind of feel like I lost years of my life as female because of this. I don't want to see it being done too other people.

Plus that article seems to think that mental disorders and suicide are a trans thing specifically, when that's a thing with every nearly minority group in America. The issue there is usually less access to good treatment options.

They kind of are a trans thing though. I mean lot's of groups have higher prevalences, but with trans people it tends to be particularly bad. That is actually why not making it more difficult to transition is a bad thing. The bad mental health is not caused by transition, it's already there, the transition can potentially help alleviate it and the sooner in life the more effective it can be.

 

[chess-z]

Children and even adults can be fickle.

I'm trying my best to be reasonable, but I've got a feeling you didn't read a word of what I wrote. You definitely didn't read the WPATH standards of care, which I will link here again, so that you don't really have an excuse. I'm going to do a point by point response, but I want you to know after this, it'll be harder for me to engage with you in good faith.

In my humble opinion people can identify with whatever they want, but when we think of transition progresses in financial terms, it should be restricted to adulthood and although the psychological and social testing may feel shallow or-limiting, they can still give clarity to any person going through the progress. It can also test their confidence, if they're really authentically sure deep within they want the transition.. not to compensate by fixing something else, like their inner sense of self.

Yeah, you clearly didn't read the WPATH standards of care. I've heard all of this before, from lots of people (my parents, a couple of therapists, my pediatrician, etc), even after the point where it was clear that I was dedicated to transitioning, and not compensating for something else.

Fascinatingly, being trans is intrinsically linked to the sense of self, at least for me. Transitioning was a way of fixing my outer self to match my inner self. I'm not sure I see the difference here.

Sexuality is connected to gender as well so most people would often end up examining this side of themselves too sooner or later. I wouldn't want to pay taxes so someone (especially if they're complete stranger who'll never be significant to my life in any way) can have free hormones and surgeries and then change their mind later which would end up into them reversing the surgery! Even while I understand there are worse recipients (bums still exist) my taxes can go into. There's still lots of transgendered people can affect in theirselves before taking operations, like their appearances and body language. Not all of it is easy though, some families can be very restricting and conservative about it, but that's part of the less humane side of life. I'll accept its existence, but I wouldn't accept those restrictions imposed on my life without a fight.

As I said before, detransitioning is rare, so there's that. And besides, the entire spiel you've laid out isn't relevant to the question at hand, ultimately making this entire chunk doubly irrelevant, but as long as we're playing around in the field of irrelevancy, your tax dollars go to paying for other men's viagra. That's probably worth more whining than giving teenagers medicine.

Not sure what that one sentence about sexuality is about though.

Going to second this one.

Oh, you mean the statement I provided a thorough rebuttal to? I mean, ok, your choice.

Not every teenager has even developed their sense of self beyond what's socially acceptable (stereotypes and group-based thinking still run high), such sense of belonging is still important to teenagers and pretty much to young adults as well... so what would it be for children relatively? If some people are lucky to have developed stable and socially independent self-assurance sooner, good for them, but since we can't see that on general level from every individual, we can't assume that is the truth for all teenagers. This is why the psychological tests and interviews are important. And how hard it would be for medical personnel to work with anyone if they had no common standards nor order to base their insights and decisions on? If they have authority to choose if the treatment is going to help or worsen their patients well-being, there's an equal responsibility for such position... even while every system has its less humane side.

Read the WPATH standards of care.