4 ms·

>If there is a diagnostic of gender dysphoria which increase as their body develop, they might choose to use puberty blockers at the start of adolescence to sto

>If there is a diagnostic of gender dysphoria which increase as their body develop, they might choose to use puberty blockers at the start of adolescence to stop the body from going through a puberty that increases this distress. Interesting position that we're in as a society where you can't be trusted to make decisions about almost anything thing until you're 18 but would allow a child and help them stunt/alter their physiological growth process because the they insist this is the correct thing for them. Right or wrong, mental illness or suffering or natural variance aside, it's an tough problem of doing the right thing for the child.

nissimk 7y ago
I used to think like that and then I learned that suicide rate is extremely high among young people with gender dysphoria and these medicines are known to reduce that risk.
- DuskStar 7y ago
  > and these medicines are known to reduce that risk I'd known the first, but I've seen very few sources for actual studies on this. Do you happen to know of any? Even a 5 year study of people transitioning vs people denied the ability to transition would be greatly appreciated. There's a lot of people out there saying that transitioning doesn't lower lifetime suicide risks and I'd love something to push back on that.
  - nissimk 7y ago
    The population is small and more studies are needed. I found this: https://www.emeraldinsight.com/doi/abs/10.1108/MHRJ-05-2014-0015 https://www.emeraldinsight.com/doi/abs/10.1108/MHRJ-05-2014-... Unfortunately the suicide risk is still very high even for post transition trans population.
    - DuskStar 7y ago
      So I'm unfortunately unable to access that paper - well, without paying $32 which is a bit steep - but does it have anything on the difference between people who transitioned and ones who did not? That's what matters after all, not the base rates. (Base rates being high tells us we really need to find a treatment, but it doesn't tell us what that treatment might be)
  - Raphmedia 7y ago
    Most studies focus on how safe the therapy is. The questions are will it cause lifelong issues, how does it affect life expectancy, etc. You would need a study that begins before a diagnostic to be able to have any significant data. Any trans person who is denied transition will likely not be available to participate in such an experiment. Those that were denied that do make it to a scientist or expert would instead promptly begin to transition. It would be unethical to deny them transition for a longer period just to see how it goes. There's a few that focus on how it increase quality of life but I don't know any hard comparaison. "The present study suggests a positive effect of hormone therapy on transsexuals' QoL after accounting for confounding factors." [1] "evidence suggests that sex reassignment that includes hormonal interventions in individuals with GID likely improves gender dysphoria, psychological functioning and comorbidities, sexual function and overall quality of life" [2] "Psychological evaluation has shown that sex reassignment increases the well-being of transsexuals, but it should not be considered as a cure-all; it is rehabilitative relieving gender dysphoria, but some transsexual subjects may still experience other problems (e.g. comorbid psychiatric problems, social isolation, troubled relationships, prejudice, and discrimination)." [3] "A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults." [4] "Using data draw from the follow-up literature covering the last 30 years, and the author's clinical data on 295 men and women after SRS, an estimation of the number of patients who regretted the operations is made. Among female-to-male transsexuals after SRS, i.e., in men, no regrets were reported in the author's sample, and in the literature they amount to less than 1%. Among male-to- female transsexuals after SRS, i.e., in women, regrets are reported in 1-1.5%. Poor differential diagnosis, failure to carry out the real-life- test, and poor surgical results seem to be the main reasons behind the regrets reported in the literature." [5] --- [1] "Is Hormonal Therapy Associated with Better Quality of Life in Transsexuals? A Cross-Sectional Study" https://www.ncbi.nlm.nih.gov/pubmed/22145968 https://www.ncbi.nlm.nih.gov/pubmed/22145968 [2] "Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes" https://www.ncbi.nlm.nih.gov/pubmed/19473181 https://www.ncbi.nlm.nih.gov/pubmed/19473181 [3] "A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones" https://www.ncbi.nlm.nih.gov/pubmed/21266549 https://www.ncbi.nlm.nih.gov/pubmed/21266549 [4] "Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment" https://pediatrics.aappublications.org/content/134/4/696 https://pediatrics.aappublications.org/content/134/4/696 [5] "Regrets After Sex Reassignment Surgery" https://www.tandfonline.com/doi/abs/10.1300/J056v05n04_05?journalCode=wzph20 https://www.tandfonline.com/doi/abs/10.1300/J056v05n04_05?jo...
CydeWeys 7y ago
It may help to think of it as a medical treatment. We don't withhold heart surgery from a child just because they aren't 18 and can't legally consent to it, and likewise we don't withhold treatment for gender dysphoria just because of age. Note that the diagnostic criteria for this treatment are very strict. It's not gonna accidentally be given to a mere "tomboy".
Raphmedia 7y ago
> Interesting position that we're in as a society where you can't be trusted to make decisions about almost anything thing until you're 18 but would allow a child and help them stunt/alter their physiological growth process because the they insist this is the correct thing for them. This seem to be written from the point of view that children improvise their gender identity to get attention, or that gender transition isn't the method used to alleviate the serious mental health issue that is gender dysphoria. It is a lifelong source of anguish and suffering if not treated correctly. Children have a quite clear idea of their gender and gender dysphoria is usually serious enough so that a professional won't confuse it from something else. "A total of 55 young transgender adults [...] who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression, when cross-sex hormones were introduced and and at least 1 year after gender reassignment surgery [...] After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being." [1] "On both more-controllable self-report measures and less- controllable implicit measures, our group of transgenderchildren showed a clear indication that they thought of themselves in terms of their expressed gender. Their responses were indistinguishable from those of the two cisgender control groups, when matched by gender identity. [...] In summary, our findings refute the assumption that trans- gender children are simply confused by the questions at hand, delayed, pretending, or being oppositional." [2] "While they may not have had language for it at the time, 59% knew that their gender identity did not match their body before the age of 10, and 80% had this knowledge by the age of 14." [3] The differential diagnosis of gender dysphoria makes it quite clear that GD is not to be confused with other similar issues which won't require an hormone replacement therapy (body dysmorphia, the transvestism paraphilia, borderline personality disorder and psychosis, Asperger's syndrome possible obsessive preoccupations with gender, etc.). It is not the child which request how the therapy will go but the health professional. Blockers are used because they are relatively safe and reversible without serious sequelae. When compared to a the lifetime of issues that would happen in the person's life should they go through an extra puberty are considered worth the risk. [1] Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment https://pediatrics.aappublications.org/content/134/4/696 https://pediatrics.aappublications.org/content/134/4/696 [2] Gender Cognition in Transgender Children"https://journals.sagepub.com/doi/abs/10.1177/0956797614568156 https://journals.sagepub.com/doi/abs/10.1177/095679761456815... [3] Challenging the BinaryGender Characteristics of Trans Ontarians http://transpulseproject.ca/wp-content/uploads/2015/06/Trans-PULSE-Statistics-Relevant-for-Human-Rights-Policy-June-2015.pdf http://transpulseproject.ca/wp-content/uploads/2015/06/Trans...

nissimk 7y ago

I used to think like that and then I learned that suicide rate is extremely high among young people with gender dysphoria and these medicines are known to reduce that risk.

DuskStar 7y ago
> and these medicines are known to reduce that risk I'd known the first, but I've seen very few sources for actual studies on this. Do you happen to know of any? Even a 5 year study of people transitioning vs people denied the ability to transition would be greatly appreciated. There's a lot of people out there saying that transitioning doesn't lower lifetime suicide risks and I'd love something to push back on that.
- nissimk 7y ago
  The population is small and more studies are needed. I found this: https://www.emeraldinsight.com/doi/abs/10.1108/MHRJ-05-2014-0015 https://www.emeraldinsight.com/doi/abs/10.1108/MHRJ-05-2014-... Unfortunately the suicide risk is still very high even for post transition trans population.
  - DuskStar 7y ago
    So I'm unfortunately unable to access that paper - well, without paying $32 which is a bit steep - but does it have anything on the difference between people who transitioned and ones who did not? That's what matters after all, not the base rates. (Base rates being high tells us we really need to find a treatment, but it doesn't tell us what that treatment might be)
- Raphmedia 7y ago
  Most studies focus on how safe the therapy is. The questions are will it cause lifelong issues, how does it affect life expectancy, etc. You would need a study that begins before a diagnostic to be able to have any significant data. Any trans person who is denied transition will likely not be available to participate in such an experiment. Those that were denied that do make it to a scientist or expert would instead promptly begin to transition. It would be unethical to deny them transition for a longer period just to see how it goes. There's a few that focus on how it increase quality of life but I don't know any hard comparaison. "The present study suggests a positive effect of hormone therapy on transsexuals' QoL after accounting for confounding factors." [1] "evidence suggests that sex reassignment that includes hormonal interventions in individuals with GID likely improves gender dysphoria, psychological functioning and comorbidities, sexual function and overall quality of life" [2] "Psychological evaluation has shown that sex reassignment increases the well-being of transsexuals, but it should not be considered as a cure-all; it is rehabilitative relieving gender dysphoria, but some transsexual subjects may still experience other problems (e.g. comorbid psychiatric problems, social isolation, troubled relationships, prejudice, and discrimination)." [3] "A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, followed by cross-sex hormones and gender reassignment surgery, provides gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults." [4] "Using data draw from the follow-up literature covering the last 30 years, and the author's clinical data on 295 men and women after SRS, an estimation of the number of patients who regretted the operations is made. Among female-to-male transsexuals after SRS, i.e., in men, no regrets were reported in the author's sample, and in the literature they amount to less than 1%. Among male-to- female transsexuals after SRS, i.e., in women, regrets are reported in 1-1.5%. Poor differential diagnosis, failure to carry out the real-life- test, and poor surgical results seem to be the main reasons behind the regrets reported in the literature." [5] --- [1] "Is Hormonal Therapy Associated with Better Quality of Life in Transsexuals? A Cross-Sectional Study" https://www.ncbi.nlm.nih.gov/pubmed/22145968 https://www.ncbi.nlm.nih.gov/pubmed/22145968 [2] "Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes" https://www.ncbi.nlm.nih.gov/pubmed/19473181 https://www.ncbi.nlm.nih.gov/pubmed/19473181 [3] "A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones" https://www.ncbi.nlm.nih.gov/pubmed/21266549 https://www.ncbi.nlm.nih.gov/pubmed/21266549 [4] "Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment" https://pediatrics.aappublications.org/content/134/4/696 https://pediatrics.aappublications.org/content/134/4/696 [5] "Regrets After Sex Reassignment Surgery" https://www.tandfonline.com/doi/abs/10.1300/J056v05n04_05?journalCode=wzph20 https://www.tandfonline.com/doi/abs/10.1300/J056v05n04_05?jo...

CydeWeys 7y ago

It may help to think of it as a medical treatment. We don't withhold heart surgery from a child just because they aren't 18 and can't legally consent to it, and likewise we don't withhold treatment for gender dysphoria just because of age. Note that the diagnostic criteria for this treatment are very strict. It's not gonna accidentally be given to a mere "tomboy".

Raphmedia 7y ago

> Interesting position that we're in as a society where you can't be trusted to make decisions about almost anything thing until you're 18 but would allow a child and help them stunt/alter their physiological growth process because the they insist this is the correct thing for them. This seem to be written from the point of view that children improvise their gender identity to get attention, or that gender transition isn't the method used to alleviate the serious mental health issue that is gender dysphoria. It is a lifelong source of anguish and suffering if not treated correctly. Children have a quite clear idea of their gender and gender dysphoria is usually serious enough so that a professional won't confuse it from something else. "A total of 55 young transgender adults [...] who had received puberty suppression during adolescence were assessed 3 times: before the start of puberty suppression, when cross-sex hormones were introduced and and at least 1 year after gender reassignment surgery [...] After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being." [1] "On both more-controllable self-report measures and less- controllable implicit measures, our group of transgenderchildren showed a clear indication that they thought of themselves in terms of their expressed gender. Their responses were indistinguishable from those of the two cisgender control groups, when matched by gender identity. [...] In summary, our findings refute the assumption that trans- gender children are simply confused by the questions at hand, delayed, pretending, or being oppositional." [2] "While they may not have had language for it at the time, 59% knew that their gender identity did not match their body before the age of 10, and 80% had this knowledge by the age of 14." [3] The differential diagnosis of gender dysphoria makes it quite clear that GD is not to be confused with other similar issues which won't require an hormone replacement therapy (body dysmorphia, the transvestism paraphilia, borderline personality disorder and psychosis, Asperger's syndrome possible obsessive preoccupations with gender, etc.). It is not the child which request how the therapy will go but the health professional. Blockers are used because they are relatively safe and reversible without serious sequelae. When compared to a the lifetime of issues that would happen in the person's life should they go through an extra puberty are considered worth the risk. [1] Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment https://pediatrics.aappublications.org/content/134/4/696 https://pediatrics.aappublications.org/content/134/4/696 [2] Gender Cognition in Transgender Children"https://journals.sagepub.com/doi/abs/10.1177/0956797614568156 https://journals.sagepub.com/doi/abs/10.1177/095679761456815... [3] Challenging the BinaryGender Characteristics of Trans Ontarians http://transpulseproject.ca/wp-content/uploads/2015/06/Trans-PULSE-Statistics-Relevant-for-Human-Rights-Policy-June-2015.pdf http://transpulseproject.ca/wp-content/uploads/2015/06/Trans...