4 ms·

"In 2016, there’s fairly solid agreement about the proper course of treatment for otherwise healthy, stable young people who have persistent gender dysphoria, a

by bruceb 11y ago

"In 2016, there’s fairly solid agreement about the proper course of treatment for otherwise healthy, stable young people who have persistent gender dysphoria, and who are either approaching puberty or older than that: You help them transition to their true gender. The process is different from person to person, but for an 11-year-old, it might include a round of puberty-blocking hormones to prevent the development of secondary sex characteristics and buy time to figure out the best course of transition, followed by the administration of male or female hormones, and, later on, possibly sex-reassignment surgery or surgeries." Giving an 11 year-old hormones...

vidarh 11y ago
Your point being? In this case it is hormone blockers that delay the onset of puberty, to essentially "buy time" until the patient can competently make a decision on more invasive transitioning. This is reversible (just stop taking the drugs), and for young people with gender dysphoria, the onset of puberty can be extremely traumatic and often triggers a range of sometimes severely self-destructive behaviour, and so delaying puberty is for many seen as by far the safest and best option.
- personjerry 11y ago
  I feel like "reversible" is a generous term for hormone therapies. And additionally, I suspect that puberty and its associated natural hormones is a big part of what allows a teen to feel comfortable.
  - andrelaszlo 11y ago
    "I suspect that puberty and its associated natural hormones is a big part of what allows a teen to feel comfortable" Sorry but I couldn't help laughing out loud. I do not share your suspicion. You probably meant that the hormones makes you feel more comfortable with your gender identity (is there research on this?), but it looks like a general comment about how comfortable teens are with their raging hormones.
  - vidarh 11y ago
    You can feel like that all you want, but the facts are that puberty delaying hormone blockers have a well known safety profile, and that the benefits in reducing emotional and behavioural problems and reducing onset of depression as a result of onset of puberty, amongst others, is well established.
- dingo_bat 11y ago
  >This is reversible I do not think delaying puberty is reversible. Puberty is an integral part of growing up and maturing into an adult. Delaying it will change the child's mental make-up and I do not consider that to be natural or something that should be done with anybody. IMO the safest thing is to let the child attain majority, and then allow them to make whatever choice they want.
  - vidarh 11y ago
    > I do not think delaying puberty is reversible Then you are wrong. Simple as that. There's been plenty of published research investigating these drugs and their effect, both physical and otherwise. > Puberty is an integral part of growing up and maturing into an adult. Delaying it will change the child's mental make-up and I do not consider that to be natural or something that should be done with anybody. Going through puberty as the "wrong gender" for someone with gender dysphoria is associated with a long range of substantial mental health issues that also changes a child mental make-up, and in very negative ways. > IMO the safest thing is to let the child attain majority, and then allow them to make whatever choice they want. The research disagrees with you. These drugs are not used for fun. They are used because they have been shown to ameliorate substantial health issues for these patients. Waiting until they attain majority is too late - the damage has already been done.
  - Dylan16807 11y ago
    Puberty hits at different ages. An artificial delay is not a big problem. Doing nothing until 18 causes massive irreversible changes.
    - Chris2048 11y ago
      Does messing with puberty in this way not affect health and mortality probabilities?
      - dragonwriter 11y ago
        > Does messing with puberty in this way not affect health and mortality probabilities? One of the compelling reasons for treating gender dysphoria -- including by this means -- is that doing so (or not doing so, in the other direction) does, yes, substantially affect health and mortality.
kbenson 11y ago
The current climate seems to force us into a "dammed of you do and damned if you don't" type of situation. Not doing reassignment is seen by some as forcing a gender upon someone, and doing it is seen by others as taking drastic action on youths which may be experiencing gender confusion but might not eventually settle on needing gender reassignment. Lose lose all around.
- Gibbon1 11y ago
  I get twitchy, the whole thing makes me twitchy. Partly because I know a few who eschew the whole hormones and surgery. Somewhat or not so somewhat defiantly. I'd really hate for those people to be pressured into something that not only do they not need, but results in a lower quality of life.
  - kbenson 11y ago
    Well, that's the rub, isn't it? Everyone thinks they are working in the best interest of the children. At least that's what they tell themselves, regardless of whether their own agendas are coloring their perception of reality, which is probably happening somewhat on both sides. Unfortunately what's best for one child may be the opposite of what's best for another child in this situation.
andrelaszlo 11y ago
Most people are perfectly happy giving hormones to kids with other problems (growth hormone deficiency, for example). You seem to think it's morally wrong somehow ("think of the children") but maybe I'm reading your comment wrong? "Professionals who treat gender identity disorder in children have begun to refer and prescribe hormones, known as a puberty blocker, to delay the onset of puberty until a child is believed to be old enough to make an informed decision on whether hormonal gender reassignment leading to surgical gender reassignment will be in that person's best interest." https://en.wikipedia.org/wiki/Gender_dysphoria#Prepubescent_children https://en.wikipedia.org/wiki/Gender_dysphoria#Prepubescent_... I can see how that could be an uncomfortable idea for some people, but maybe it's the best option available? What would be your solution?
- deleted 11y ago
  [deleted]
zyxley 11y ago
It's worth keeping in mind that the particular hormones being referenced delay puberty, rather than causing a permanent transition. The whole reason they're the accepted course of treatment is that, if the child changes their mind before reaching the age of majority or near-majority when the treatments actually used for the physical transition begin, the effect can be reversed just by stopping the blockers and letting puberty take its natural course.
DanBC 11y ago
11 year olds have a pretty good idea about their gender identity. Puberty blockers are a temporary measure to avoid the trauma of the child going through puberty as the wrong gender - and it is traumatic. Young people are at generally at low risk of suicide, but that risk increases for trans children.
- Cyph0n 11y ago
  11 year olds 100 years ago, maybe. Nowadays they are children in slightly larger bodies.
  - ascorbic 11y ago
    It's pretty much exactly the other way around. Puberty was much later, mainly due to nutrition. Edit: I should add a source. It's dropped by five years since 1920, and 7 years since 1860. That's massive. http://www.theguardian.com/society/2012/oct/21/puberty-adolescence-childhood-onset http://www.theguardian.com/society/2012/oct/21/puberty-adole...
    - Cyph0n 11y ago
      I'm not talking about puberty, but mental maturity. An 11 year old boy back then would likely be working to support his family. Thanks for the info though.
      - dragonwriter 11y ago
        > I'm not talking about puberty, but mental maturity. An 11 year old boy back then would likely be working to support his family. That doesn't mean that they would have more "mental" maturity (particularly, in any sense relevant to the instant discussion.)
TazeTSchnitzel 11y ago
Er, if you don't block them, 11-year-old trans kids will get the wrong ones. That's what puberty does. At a certain age, your body starts producing high amounts of sex hormones. Blocking them means that these kids won't immediately develop permanent secondary sex characteristics which don't match their gender and would cause then suffering. Surely it is better to block hormones at 11 and then go on the right ones at 16, rather than otherwise needing a mastectomy, facial surgery, vocal surgery, hair removal etc. in later life?
dragonwriter 11y ago
I'm kind of disturbed by this and think that we will eventually look back on it as a sign of the primitive barbarism of today's society [0], but for nearly opposite reasons from the usual right-wing transphobic reasons: I suspect a substantial source of gender dysphoria -- if not the dominant source -- isn't a fundamental incompatibility of internal identity with biological sex features, but a fundamental incompatibility of internal identity with imposed social gender stereotypes where socially-perceived gender is tied to outward biological sex characteristics. To the extent this is the case, this approach amounts to making children conform their outward sex characteristics to society's gender stereotypes that most closely correspond to their internal identity. Which may be less barbaric than trying to force them to conform their behavior to the gender stereotypes that most closely match their outward sex characteristics, but not much less. [0] I do want to emphasize that, in saying that, I am not arguing against the idea that its the best approach we have available now, or that parents and clinicians shouldn't choose this approach; I'm saying that I strongly suspect that the reason that it may be the best approach we have available is a much more fundamental problem with our social approach to gender.

by bruceb 11y ago

vidarh 11y ago

Your point being? In this case it is hormone blockers that delay the onset of puberty, to essentially "buy time" until the patient can competently make a decision on more invasive transitioning. This is reversible (just stop taking the drugs), and for young people with gender dysphoria, the onset of puberty can be extremely traumatic and often triggers a range of sometimes severely self-destructive behaviour, and so delaying puberty is for many seen as by far the safest and best option.

personjerry 11y ago
I feel like "reversible" is a generous term for hormone therapies. And additionally, I suspect that puberty and its associated natural hormones is a big part of what allows a teen to feel comfortable.
- andrelaszlo 11y ago
  "I suspect that puberty and its associated natural hormones is a big part of what allows a teen to feel comfortable" Sorry but I couldn't help laughing out loud. I do not share your suspicion. You probably meant that the hormones makes you feel more comfortable with your gender identity (is there research on this?), but it looks like a general comment about how comfortable teens are with their raging hormones.
- vidarh 11y ago
  You can feel like that all you want, but the facts are that puberty delaying hormone blockers have a well known safety profile, and that the benefits in reducing emotional and behavioural problems and reducing onset of depression as a result of onset of puberty, amongst others, is well established.
dingo_bat 11y ago
>This is reversible I do not think delaying puberty is reversible. Puberty is an integral part of growing up and maturing into an adult. Delaying it will change the child's mental make-up and I do not consider that to be natural or something that should be done with anybody. IMO the safest thing is to let the child attain majority, and then allow them to make whatever choice they want.
- vidarh 11y ago
  > I do not think delaying puberty is reversible Then you are wrong. Simple as that. There's been plenty of published research investigating these drugs and their effect, both physical and otherwise. > Puberty is an integral part of growing up and maturing into an adult. Delaying it will change the child's mental make-up and I do not consider that to be natural or something that should be done with anybody. Going through puberty as the "wrong gender" for someone with gender dysphoria is associated with a long range of substantial mental health issues that also changes a child mental make-up, and in very negative ways. > IMO the safest thing is to let the child attain majority, and then allow them to make whatever choice they want. The research disagrees with you. These drugs are not used for fun. They are used because they have been shown to ameliorate substantial health issues for these patients. Waiting until they attain majority is too late - the damage has already been done.
- Dylan16807 11y ago
  Puberty hits at different ages. An artificial delay is not a big problem. Doing nothing until 18 causes massive irreversible changes.
  - Chris2048 11y ago
    Does messing with puberty in this way not affect health and mortality probabilities?
    - dragonwriter 11y ago
      > Does messing with puberty in this way not affect health and mortality probabilities? One of the compelling reasons for treating gender dysphoria -- including by this means -- is that doing so (or not doing so, in the other direction) does, yes, substantially affect health and mortality.

kbenson 11y ago

The current climate seems to force us into a "dammed of you do and damned if you don't" type of situation. Not doing reassignment is seen by some as forcing a gender upon someone, and doing it is seen by others as taking drastic action on youths which may be experiencing gender confusion but might not eventually settle on needing gender reassignment. Lose lose all around.

Gibbon1 11y ago
I get twitchy, the whole thing makes me twitchy. Partly because I know a few who eschew the whole hormones and surgery. Somewhat or not so somewhat defiantly. I'd really hate for those people to be pressured into something that not only do they not need, but results in a lower quality of life.
- kbenson 11y ago
  Well, that's the rub, isn't it? Everyone thinks they are working in the best interest of the children. At least that's what they tell themselves, regardless of whether their own agendas are coloring their perception of reality, which is probably happening somewhat on both sides. Unfortunately what's best for one child may be the opposite of what's best for another child in this situation.

andrelaszlo 11y ago

Most people are perfectly happy giving hormones to kids with other problems (growth hormone deficiency, for example). You seem to think it's morally wrong somehow ("think of the children") but maybe I'm reading your comment wrong? "Professionals who treat gender identity disorder in children have begun to refer and prescribe hormones, known as a puberty blocker, to delay the onset of puberty until a child is believed to be old enough to make an informed decision on whether hormonal gender reassignment leading to surgical gender reassignment will be in that person's best interest." https://en.wikipedia.org/wiki/Gender_dysphoria#Prepubescent_children https://en.wikipedia.org/wiki/Gender_dysphoria#Prepubescent_... I can see how that could be an uncomfortable idea for some people, but maybe it's the best option available? What would be your solution?

deleted 11y ago
[deleted]

zyxley 11y ago

It's worth keeping in mind that the particular hormones being referenced delay puberty, rather than causing a permanent transition. The whole reason they're the accepted course of treatment is that, if the child changes their mind before reaching the age of majority or near-majority when the treatments actually used for the physical transition begin, the effect can be reversed just by stopping the blockers and letting puberty take its natural course.

DanBC 11y ago

11 year olds have a pretty good idea about their gender identity. Puberty blockers are a temporary measure to avoid the trauma of the child going through puberty as the wrong gender - and it is traumatic. Young people are at generally at low risk of suicide, but that risk increases for trans children.

Cyph0n 11y ago
11 year olds 100 years ago, maybe. Nowadays they are children in slightly larger bodies.
- ascorbic 11y ago
  It's pretty much exactly the other way around. Puberty was much later, mainly due to nutrition. Edit: I should add a source. It's dropped by five years since 1920, and 7 years since 1860. That's massive. http://www.theguardian.com/society/2012/oct/21/puberty-adolescence-childhood-onset http://www.theguardian.com/society/2012/oct/21/puberty-adole...
  - Cyph0n 11y ago
    I'm not talking about puberty, but mental maturity. An 11 year old boy back then would likely be working to support his family. Thanks for the info though.
    - dragonwriter 11y ago
      > I'm not talking about puberty, but mental maturity. An 11 year old boy back then would likely be working to support his family. That doesn't mean that they would have more "mental" maturity (particularly, in any sense relevant to the instant discussion.)

TazeTSchnitzel 11y ago

Er, if you don't block them, 11-year-old trans kids will get the wrong ones. That's what puberty does. At a certain age, your body starts producing high amounts of sex hormones. Blocking them means that these kids won't immediately develop permanent secondary sex characteristics which don't match their gender and would cause then suffering. Surely it is better to block hormones at 11 and then go on the right ones at 16, rather than otherwise needing a mastectomy, facial surgery, vocal surgery, hair removal etc. in later life?

dragonwriter 11y ago

I'm kind of disturbed by this and think that we will eventually look back on it as a sign of the primitive barbarism of today's society [0], but for nearly opposite reasons from the usual right-wing transphobic reasons: I suspect a substantial source of gender dysphoria -- if not the dominant source -- isn't a fundamental incompatibility of internal identity with biological sex features, but a fundamental incompatibility of internal identity with imposed social gender stereotypes where socially-perceived gender is tied to outward biological sex characteristics. To the extent this is the case, this approach amounts to making children conform their outward sex characteristics to society's gender stereotypes that most closely correspond to their internal identity. Which may be less barbaric than trying to force them to conform their behavior to the gender stereotypes that most closely match their outward sex characteristics, but not much less. [0] I do want to emphasize that, in saying that, I am not arguing against the idea that its the best approach we have available now, or that parents and clinicians shouldn't choose this approach; I'm saying that I strongly suspect that the reason that it may be the best approach we have available is a much more fundamental problem with our social approach to gender.