4 ms·

They Paused Puberty, but Is There a Cost?

12 points by rocketbop 4y ago

quattrofan 4y ago
rocketbop 4y ago
I hope such a story isn't off topic for being political (because although the issue is highly politicized it is actually an important medical and social issue). I've been really dismayed by the vitriol by which I hear a lot of people talking about these issues. On the one hand the "right" calling doctors child abusers - the article mentions how doctors both against and for puberty doctors did not want their names used in the article - while the "left" label the right as existence defying, and hate-crime committers. Looking for good reading materials on trans issues is very difficult too with most books I can find seeming to belong to one of these two camps also. I would love suggestions. My opinion is that there is a hard and maybe unsolvable problem at the heart of the matter; trans children/teenagers clearly exist, and it may be that puberty blockers are useful for people who will eventually transition. However, the effects of the drugs are profound and long lasting and may have a deleterious effect on some. And we are giving the choice to take them to people too young to be allowed to vote, drive, or have sex. It is a moral paradox that might not have a clearly correct solution, but a failure to accept this paradox seems to be leading the polarization of a large swathe of society and the long term effects of that polarization are hard to guess at. It seems that people want so much to be right and be on the right side of this issue that many of us our being blinded to the fact that moral paradoxes do not always have a right side. (I'm thinking of the example of whether you should swerve your car away from one pedestrian towards another one.)
- laura-media 4y ago
  There are studies and documentation about trans healthcare dating back further than Nazi Germany (medical research on trans people were one of the first books to be burned by the Nazis). While there is always a risk when having to take drugs for anything, the outcome compared to trans individuals who were force to go through puberty out-weight this risk.
- hobbitstan 4y ago
  In one study I read, >97% of children who identified as trans changed their mind as they reached adulthood, and the majority were just homosexual. There is literally no such thing as a ‘trans’ person. It’s medically and scientifically unproven. Political correctness is having a massive toll on these kids and everyone is too cowardly to stop it.
  - AussieWog93 4y ago
    Gender Dysphoria is definitely real and transitioning has made life a whole lot more bearable for many, many people. That's not to say that self-diagnoses of Gender Dysphoria should be taken at face value, or that it's always in the best interest to send a young person down the path of transitioning, but at the same time there is a population for which transitioning can greatly improve quality of life.
    - hobbitstan 4y ago
      It genuinely does not improve their quality of life at all. That ‘post-transition’ bliss fades fast then they’re faced with a brutal reality. Honestly, if society DID care about their well-being, it wouldn't allow puberty blockers, hormones, or surgeries.
      - AussieWog93 4y ago
        >Honestly, if society DID care about their well-being, it wouldn't allow puberty blockers, hormones, or surgeries. Let's say you're correct about even 90% of cases (I don't think it would be quite this high, but let's just assume). What then about the 10% where transitioning really helps them deal with life? Do we just make their life miserable? To be honest with you, I wouldn't suspect if this is where we end up in 20 years' time when the pendulum swings the other way, but either way it's not an ideal situation.
  - rocketbop 4y ago
    > In one study I read, >97% of children who identified as trans changed their mind as they reached adulthood, and the majority were just homosexual. A citation could be useful. I suspect that good data on this is difficult to generate, . > There is literally no such thing as a ‘trans’ person. This is a pretty difficult statement to contend with, because we need to unpack what you mean by `trans`. I've met transgender people, they certainly do exist, but if you're claiming that those people are not really transgender but just gay men dressing up as women and being performative, we'd have to dig deep into Judith Butler literature to find some common language.
- DanBC 4y ago
  > And we are giving the choice to take them to people too young to be allowed to vote, drive, or have sex. No we aren't. These are prescription only meds that are obtained after considerable, sustained, effort to engage in bio-psycho-social assessment and treatment programmes.
  - stemforth 4y ago
    I think this is not universally true. There are reports from the US of testosterone being prescribed to gender dysphoric girls (i.e. who express a desire of wanting to be boys) after only one or two sessions with a medical professional.
  - rocketbop 4y ago
    > No we aren't. These are prescription only meds that are obtained after considerable, sustained, effort to engage in bio-psycho-social assessment and treatment programmes. I think you've accidentally set up a straw man. I didn't say they're not being prescribed, nor that they are being given without any consideration, but that they're being given to minors (12 or 13), which is true and discussed in the article. It's likely that are pros and cons to this, also discussed in the article.
    - DanBC 4y ago
      But those minors aren't making the decision. Doctors are.
- stemforth 4y ago
  > My opinion is that there is a hard and maybe unsolvable problem at the heart of the matter; trans children/teenagers clearly exist, and it may be that puberty blockers are useful for people who will eventually transition. I think it would be fairer to say that people who desire to be the opposite sex (or both, or neither) exist, and if this reaches the point of significant distress, then it fits the criteria for a medical diagnosis, with which they may be offered certain hormonal drugs and surgeries, as an attempt to alleviate that distress. Whether this makes them "trans", an ideological viewpoint under which they are treated as if they are the opposite sex (expressed concisely in slogans such as "trans women are women") in various contexts, is a different matter. Which makes this issue two separate but related questions: - Are hormone blockers, exogenous hormones and surgery an effective treatment for this group of people? (And if so, how do we tell who is actually in this group? Does it include children?) - Should people who desire to be a different sex to what they are, be considered as such in law and policy? (And if so, should there be limits to this? And how do we balance the rights of others who don't share this ideological viewpoint?)
  - rocketbop 4y ago
    That's a good summary, I agree those are two separate issues.
- a_shovel 4y ago
  If research comes out that puberty blockers are too dangerous to be prescribed to transgender children, then the ethical alternative is not to make them wait until adulthood, but to let them start hormone replacement therapy immediately. I think that's something a lot of people don't get. Trans people consistently describe going through puberty without access to hormones or blockers as traumatic. Traumatizing children is bad and should be avoided. The thing is, the effects of going on HRT are pretty close to the effects of natural puberty, so we can reasonably assume that a cisgender child going on HRT unnecessarily is about the same level of badness as a trans child not being able to get puberty blockers or hormones. The article says that 98% of kids who take hormone blockers go on to take HRT, and I've seen similar numbers elsewhere. Since you can't tell whether someone is in the 98% of true positives or 2% of false positives at the start, then you have to make the same decision for all of them, and it just doesn't make sense to sacrifice the 98% for the well-being of the 2%. This would be very bad for the 2%, of course; that's why doctors prescribe blockers in the first place. But if the best option isn't available, you have to go with the least bad option. (I suspect the ratio in this situation would be even better than 98:2, since real life isn't an abstract ethical dilemma. For example, many of these kids would be willing to go on blockers but not hormones, and they would likely be disproportionately in the 2% category, so they would avoid getting the wrong treatment.)
g42gregory 4y ago
I am very curious as to who is telling the New York Times that this is currently an "allowed"/desirable topic to publish on? A few short months ago this was a taboo to speak on, for the fear of being cancelled/deplatformed/etc... Is it Ok to have this discussion now? Who makes these decisions?
- rocketbop 4y ago
  > A few short months ago this was a taboo to speak on That's hard to verify objectively, even if it feels true. I would say it is the choice of the editorial board ultimately, who are beholden only to themselves and to some extent their advertisers. I did find that the style of this article marked it as unusual for NYT, in that it doesn't come down strongly on one 'side' and is an unusually even handed discussion of the state of play.
aysfrm11 4y ago
https://archive.ph/glqDL https://archive.ph/glqDL

12 points by rocketbop 4y ago

I hope such a story isn't off topic for being political (because although the issue is highly politicized it is actually an important medical and social issue). I've been really dismayed by the vitriol by which I hear a lot of people talking about these issues. On the one hand the "right" calling doctors child abusers - the article mentions how doctors both against and for puberty doctors did not want their names used in the article - while the "left" label the right as existence defying, and hate-crime committers. Looking for good reading materials on trans issues is very difficult too with most books I can find seeming to belong to one of these two camps also. I would love suggestions. My opinion is that there is a hard and maybe unsolvable problem at the heart of the matter; trans children/teenagers clearly exist, and it may be that puberty blockers are useful for people who will eventually transition. However, the effects of the drugs are profound and long lasting and may have a deleterious effect on some. And we are giving the choice to take them to people too young to be allowed to vote, drive, or have sex. It is a moral paradox that might not have a clearly correct solution, but a failure to accept this paradox seems to be leading the polarization of a large swathe of society and the long term effects of that polarization are hard to guess at. It seems that people want so much to be right and be on the right side of this issue that many of us our being blinded to the fact that moral paradoxes do not always have a right side. (I'm thinking of the example of whether you should swerve your car away from one pedestrian towards another one.)

laura-media 4y ago
There are studies and documentation about trans healthcare dating back further than Nazi Germany (medical research on trans people were one of the first books to be burned by the Nazis). While there is always a risk when having to take drugs for anything, the outcome compared to trans individuals who were force to go through puberty out-weight this risk.
hobbitstan 4y ago
In one study I read, >97% of children who identified as trans changed their mind as they reached adulthood, and the majority were just homosexual. There is literally no such thing as a ‘trans’ person. It’s medically and scientifically unproven. Political correctness is having a massive toll on these kids and everyone is too cowardly to stop it.
- AussieWog93 4y ago
  Gender Dysphoria is definitely real and transitioning has made life a whole lot more bearable for many, many people. That's not to say that self-diagnoses of Gender Dysphoria should be taken at face value, or that it's always in the best interest to send a young person down the path of transitioning, but at the same time there is a population for which transitioning can greatly improve quality of life.
  - hobbitstan 4y ago
    It genuinely does not improve their quality of life at all. That ‘post-transition’ bliss fades fast then they’re faced with a brutal reality. Honestly, if society DID care about their well-being, it wouldn't allow puberty blockers, hormones, or surgeries.
    - AussieWog93 4y ago
      >Honestly, if society DID care about their well-being, it wouldn't allow puberty blockers, hormones, or surgeries. Let's say you're correct about even 90% of cases (I don't think it would be quite this high, but let's just assume). What then about the 10% where transitioning really helps them deal with life? Do we just make their life miserable? To be honest with you, I wouldn't suspect if this is where we end up in 20 years' time when the pendulum swings the other way, but either way it's not an ideal situation.
- rocketbop 4y ago
  > In one study I read, >97% of children who identified as trans changed their mind as they reached adulthood, and the majority were just homosexual. A citation could be useful. I suspect that good data on this is difficult to generate, . > There is literally no such thing as a ‘trans’ person. This is a pretty difficult statement to contend with, because we need to unpack what you mean by `trans`. I've met transgender people, they certainly do exist, but if you're claiming that those people are not really transgender but just gay men dressing up as women and being performative, we'd have to dig deep into Judith Butler literature to find some common language.
DanBC 4y ago
> And we are giving the choice to take them to people too young to be allowed to vote, drive, or have sex. No we aren't. These are prescription only meds that are obtained after considerable, sustained, effort to engage in bio-psycho-social assessment and treatment programmes.
- stemforth 4y ago
  I think this is not universally true. There are reports from the US of testosterone being prescribed to gender dysphoric girls (i.e. who express a desire of wanting to be boys) after only one or two sessions with a medical professional.
- rocketbop 4y ago
  > No we aren't. These are prescription only meds that are obtained after considerable, sustained, effort to engage in bio-psycho-social assessment and treatment programmes. I think you've accidentally set up a straw man. I didn't say they're not being prescribed, nor that they are being given without any consideration, but that they're being given to minors (12 or 13), which is true and discussed in the article. It's likely that are pros and cons to this, also discussed in the article.
  - DanBC 4y ago
    But those minors aren't making the decision. Doctors are.
stemforth 4y ago
> My opinion is that there is a hard and maybe unsolvable problem at the heart of the matter; trans children/teenagers clearly exist, and it may be that puberty blockers are useful for people who will eventually transition. I think it would be fairer to say that people who desire to be the opposite sex (or both, or neither) exist, and if this reaches the point of significant distress, then it fits the criteria for a medical diagnosis, with which they may be offered certain hormonal drugs and surgeries, as an attempt to alleviate that distress. Whether this makes them "trans", an ideological viewpoint under which they are treated as if they are the opposite sex (expressed concisely in slogans such as "trans women are women") in various contexts, is a different matter. Which makes this issue two separate but related questions: - Are hormone blockers, exogenous hormones and surgery an effective treatment for this group of people? (And if so, how do we tell who is actually in this group? Does it include children?) - Should people who desire to be a different sex to what they are, be considered as such in law and policy? (And if so, should there be limits to this? And how do we balance the rights of others who don't share this ideological viewpoint?)
- rocketbop 4y ago
  That's a good summary, I agree those are two separate issues.
a_shovel 4y ago
If research comes out that puberty blockers are too dangerous to be prescribed to transgender children, then the ethical alternative is not to make them wait until adulthood, but to let them start hormone replacement therapy immediately. I think that's something a lot of people don't get. Trans people consistently describe going through puberty without access to hormones or blockers as traumatic. Traumatizing children is bad and should be avoided. The thing is, the effects of going on HRT are pretty close to the effects of natural puberty, so we can reasonably assume that a cisgender child going on HRT unnecessarily is about the same level of badness as a trans child not being able to get puberty blockers or hormones. The article says that 98% of kids who take hormone blockers go on to take HRT, and I've seen similar numbers elsewhere. Since you can't tell whether someone is in the 98% of true positives or 2% of false positives at the start, then you have to make the same decision for all of them, and it just doesn't make sense to sacrifice the 98% for the well-being of the 2%. This would be very bad for the 2%, of course; that's why doctors prescribe blockers in the first place. But if the best option isn't available, you have to go with the least bad option. (I suspect the ratio in this situation would be even better than 98:2, since real life isn't an abstract ethical dilemma. For example, many of these kids would be willing to go on blockers but not hormones, and they would likely be disproportionately in the 2% category, so they would avoid getting the wrong treatment.)

g42gregory 4y ago

I am very curious as to who is telling the New York Times that this is currently an "allowed"/desirable topic to publish on? A few short months ago this was a taboo to speak on, for the fear of being cancelled/deplatformed/etc... Is it Ok to have this discussion now? Who makes these decisions?

rocketbop 4y ago
> A few short months ago this was a taboo to speak on That's hard to verify objectively, even if it feels true. I would say it is the choice of the editorial board ultimately, who are beholden only to themselves and to some extent their advertisers. I did find that the style of this article marked it as unusual for NYT, in that it doesn't come down strongly on one 'side' and is an unusually even handed discussion of the state of play.

aysfrm11 4y ago

https://archive.ph/glqDL https://archive.ph/glqDL