5 ms·

The problem with adult-only transition is that it dooms trans people (at least, those who go on HRT) to go through two puberties, which has visible physical eff

by panic 1y ago

The problem with adult-only transition is that it dooms trans people (at least, those who go on HRT) to go through two puberties, which has visible physical effects that then have to be undone or worked around (breast growth, facial hair, deeper voice, etc.). The ideal for most people is that you'd just go through one.

calico96 1y ago
Those of us transitioning with hormones willingly go through puberty twice. Damn the social consequences, it's who we are. If transitioning were available as a minor it would greatly reduce suffering.
jart 1y ago
Yeah but if you're a trans woman for instance, there are benefits to going through some male puberty. You understand men better. You understand yourself better, to know that's not what you want. Also you never go through a puberty in exactly the same way as a cis woman. A lot of the effects are reversible, especially if you start at 18, since I don't think maleness fully develops until at least age 25. Treating people under 18 is a politically losing issue. When policies around it changed, that tipped the scales from the public ignoring trans women or seeing them as victims, towards many members of the public seeing them as monsters who are out to get their children. It's illegal in 27 states and the White House calls it child mutilation. Can you imagine what a burden it must be to live in a world where many ignorant individuals hold such a perception of you, due to no fault of your own, but rather physical characteristics about yourself you can't change?
- viamiraia 1y ago
  As a trans woman who has talked with many other trans women, the majority, including me would prefer not having gone through male puberty at all. The benefits do not outweigh the gender dysphoria. We would love to go through puberty the exact same way as a cis woman, but it's not like we don't realize HRT and current methods have room for improvement. The effects are only partially reversible, and only after tens or hundreds of thousands of dollars in surgeries, hair removal, voice training, other treatments. I understand it's a politically losing issue now, but I believe it's due to misinformation, outrage porn, and unfair application of rigor, from mostly the anti-trans side but even allies and trans folk themselves sometimes. To that end I hope this does not feel like an attack - let me know if you have any questions that you think my perspective would help.
  - jart 1y ago
    Look forward to the future. Superintelligence will invent better treatments for trans people. However there's not going to be any better treatments if trans becomes illegal due to the backlash caused by folks agitating for the use of the comparatively crude treatments available today on children. Trump has setup a legal regime for annihilating everyone in the medical community who's been providing trans care. You better hope there are still people around who are willing to help when the dust settles from all this political fighting.
- hemogloben 1y ago
  > Treating people under 18 is a politically losing issue. Treating people as 'a politically losing issue' is weird to me. There are certainly some nuances to <18 transgender care, but that statement doesn't address any of them and just suggests we embrace political cowardice. > When policies around it changed, that tipped the scales from the public ignoring trans women or seeing them as victims, towards many members of the public seeing them as monsters who are out to get their children. This is worse. It wasn't because politics around it changed, it was because republicans (upset that they could no longer target gay people), reused the same crappy arguments against trans people, and then wrapped it in a pedophilic flag. The change in policy is just effective propaganda making people concerned that random doctors are allowing their children to get sex change operations without consent, when that isn't how ANY of this works. Children <18 can socially transition, get puberty blockers, and MAYBE get hormone treatment. WITH parent consent. The fact that the media and comments like yours continues to pretend its a reasonable 'discussion' perpetuates the nonsense.
  - jart 1y ago
    We? Political cowardice? Have you considered that trans people might just want to live their lives, and not be force-teamed into your war? Trans has been a thing since the 1950s and that whole time flew under society's radar, happy minding their own business and not be noticed, until around 2020 when your war started.
    - deleted 1y ago
      [deleted]
    - Alghranokk 1y ago
      Have you considered that trans people just want to live their lives? As we all know, transitioning, social, hormonal, reduces incidence of suicide. This also applies to under 18 individuals. Should such options and approaches suddenly be revoked and discontinued, it will naturally follow that some will die who otherwise would not have. How many do consider reasonable to sacrifice in the name of political expedience?
- Llamamoe 1y ago
  > Also you never go through a puberty in exactly the same way as a cis woman. A lot of the effects are reversible, especially if you start at 18, since I don't think maleness fully develops until at least age 25. Treating people under 18 is a politically losing issue. Imagine trying to make the same argument about forcing cis women to go through male liberty to "understand men better". It's ridiculous. Further, studies show that the main predictor of bone structure is whether you started HRT before or after the beginning of puberty, and that outcomes get worse the more it progresses. At 18 you still get some change, but you really need to either block puberty or start HRT before it for optimal outcomes. And if you don't want to give HRT to trans children, at least get them on puberty blockers. There's pretty much zero evidence suggesting they do anything worse than temporary and reversible reductions in bone density.
  - jart 1y ago
    The first rule of medicine is to do no harm. It's an ethically grey area to intervene with something the body is doing naturally that isn't putting the person's life at risk. The technology available today for gender transition is crude compared to what will be available in the future. I know intersex people who are pretty unhappy because medical professionals chose the wrong intervention in childhood. Only adults of sufficient mental faculties who are under the care of a doctor should be making these tradeoffs. That's how trans worked for ~70 years before recent political activism forced the medical industry to loosen its standards.
    - Llamamoe 1y ago
      Puberty blockers are routinely prescribed for other indications, and there are countless other treatments with more risks that are prescribed to children every day.
    - seethedeaduu 1y ago
      Kids can't consent to being forcefully and irreversibly mutilated under the wrong puberty.
- znpy 1y ago
  > Treating people under 18 is a politically losing issue. This is the key point, imho. In the transgender rights discourse no margin for error is admitted, but there is like in any other human field (of course). There have been several cases of people being given a "gender disphoria" blanket diagnosis (eg: the case of Chlementine Breen[1]), which later caused issues. And of course some of those people are transitioning back and started doing activism against the trans rights movement. It's weird that minors are not allowed to do something trivial as drinking a beer or driving a car yet they're allowed to take on irreversible changes (sometimes involving surgery) to their bodies. This is hurtful to all people involved, and until this point is not understood, the attrition will continue. [1]: that case is a textbook example of "no margin error admitted" because in order for their voice to be heard they had to resort to talking to the extreme opposite political side.
  - seethedeaduu 1y ago
    The convenience of a hypothetical cis peerson is worth more than the lives of 100 trans people it seems. The wrong puberty is irreversible mutilation. It's not weird at all given that kids are being given treatment for cancer.
    - znpy 1y ago
      > The convenience of a hypothetical cis peerson is worth more than the lives of 100 trans people it seems. Complete nonsense. The ratio is generally the inverse: there are 100 cis people and 1 trans person. Those are just the numbers, otherwise trans people wouldn't be a considered a minority. Actually you're the one arguing that the convenience of one trans person is worth more than the life of 100 cis people.
      - seethedeaduu 1y ago
        I didn't know that the ratio of cis to trans people who were "falsely" "convinced" to take hormones were 100 to 1. Having the right hormones and not being permenantly mutilated by the wrong ones isn't simply "a convenience".
Manuel_D 1y ago
The issue with this framing is that it ignores blockers' influence on desistence rates. Without blockers, 60-90% of kids presenting with gender dysphoria desist in cross sex gender identity by adulthood. But when put on blockers, nearly 100% continue living as the cross sex gender. Even with a suppressed puberty, being transgender is extremely hard with high rates of depression and suicide. Any responsible analysis of the aggregate benefits of prescribing blockers needs to factor in the rates of desistence with and without blockers, but proponents of blockers almost always try to frame this discussion as though all kids with gender dysphoria persist in a cross sex gender. And indeed many try to claim that desistence is a "myth", despite most research into the topic.
- viamiraia 1y ago
  > Without blockers, 60-90% of kids presenting with gender dysphoria desist in cross sex gender identity by adulthood. But when put on blockers, nearly 100% continue living as the cross sex gender. You say "most research" shows this. From which source(s) do you draw these claims? If I recall correctly there were a lot of methodological issues with drawing this type of conclusion from those studies.
  - Manuel_D 1y ago
    This is one of the more recent studies: https://pmc.ncbi.nlm.nih.gov/articles/PMC8039393/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8039393/ The desistence rate for this study was 87%. Most other studies fall in the range of >70% > At the time of follow-up, using different metrics (e.g., clinical interview, maternal report, dimensional measurement of gender dysphoria, a DSM diagnosis of GID, etc.), these studies provided information on the percentage of boys who continued to have gender dysphoria (herein termed “persisters”) and the percentage of boys who did not (herein termed “desisters”).2 Of the 53 boys culled from the relatively small sample size studies (Bakwin, Davenport, Kosky, Lebovitz, Money and Russo, Zuger), the percentage classified as persisters was 9.4% (age range at follow-up, 13–30 years). In Green (47), the percentage of persisters was 2% (total n = 44; Mean age at follow-up, 19 years; range, 14–24); in Wallien and Cohen-Kettenis (52), the percentage of persisters was 20.3% (total n = 59; Mean age at follow-up, 19.4 years; range, 16–28); and in Steensma et al. (51), the percentage of persisters was 29.1% (total n = 79; Mean age at follow-up, 16.1 years; range, 15–19). Across all studies, the percentage of persisters was 17.4% (total N = 235), with a range from 0 to 29.1%.3 You can find studies that find a very low rate of desistence, in the single digits. But those are among children that were put on puberty blockers.
seethedeaduu 1y ago
This is true, but also, going through the wrong puberty and being forced to live as the wrong gender afterwards is also an inherently traumatic experience, even if it would be possible to fully reverse the mutilation caused by the first puberty.
- Fire-Dragon-DoL 1y ago
  Is mutilation the right term here? Mutilation is altering the physical appearance. Puberty by default follows what the body was designed to do, it seems confusing calling it mutilation: I couldn't tell if surgery is involved or this is just talking about the natural process of going through puberty

by panic 1y ago

calico96 1y ago

Those of us transitioning with hormones willingly go through puberty twice. Damn the social consequences, it's who we are. If transitioning were available as a minor it would greatly reduce suffering.

jart 1y ago

Yeah but if you're a trans woman for instance, there are benefits to going through some male puberty. You understand men better. You understand yourself better, to know that's not what you want. Also you never go through a puberty in exactly the same way as a cis woman. A lot of the effects are reversible, especially if you start at 18, since I don't think maleness fully develops until at least age 25. Treating people under 18 is a politically losing issue. When policies around it changed, that tipped the scales from the public ignoring trans women or seeing them as victims, towards many members of the public seeing them as monsters who are out to get their children. It's illegal in 27 states and the White House calls it child mutilation. Can you imagine what a burden it must be to live in a world where many ignorant individuals hold such a perception of you, due to no fault of your own, but rather physical characteristics about yourself you can't change?

viamiraia 1y ago
As a trans woman who has talked with many other trans women, the majority, including me would prefer not having gone through male puberty at all. The benefits do not outweigh the gender dysphoria. We would love to go through puberty the exact same way as a cis woman, but it's not like we don't realize HRT and current methods have room for improvement. The effects are only partially reversible, and only after tens or hundreds of thousands of dollars in surgeries, hair removal, voice training, other treatments. I understand it's a politically losing issue now, but I believe it's due to misinformation, outrage porn, and unfair application of rigor, from mostly the anti-trans side but even allies and trans folk themselves sometimes. To that end I hope this does not feel like an attack - let me know if you have any questions that you think my perspective would help.
- jart 1y ago
  Look forward to the future. Superintelligence will invent better treatments for trans people. However there's not going to be any better treatments if trans becomes illegal due to the backlash caused by folks agitating for the use of the comparatively crude treatments available today on children. Trump has setup a legal regime for annihilating everyone in the medical community who's been providing trans care. You better hope there are still people around who are willing to help when the dust settles from all this political fighting.
hemogloben 1y ago
> Treating people under 18 is a politically losing issue. Treating people as 'a politically losing issue' is weird to me. There are certainly some nuances to <18 transgender care, but that statement doesn't address any of them and just suggests we embrace political cowardice. > When policies around it changed, that tipped the scales from the public ignoring trans women or seeing them as victims, towards many members of the public seeing them as monsters who are out to get their children. This is worse. It wasn't because politics around it changed, it was because republicans (upset that they could no longer target gay people), reused the same crappy arguments against trans people, and then wrapped it in a pedophilic flag. The change in policy is just effective propaganda making people concerned that random doctors are allowing their children to get sex change operations without consent, when that isn't how ANY of this works. Children <18 can socially transition, get puberty blockers, and MAYBE get hormone treatment. WITH parent consent. The fact that the media and comments like yours continues to pretend its a reasonable 'discussion' perpetuates the nonsense.
- jart 1y ago
  We? Political cowardice? Have you considered that trans people might just want to live their lives, and not be force-teamed into your war? Trans has been a thing since the 1950s and that whole time flew under society's radar, happy minding their own business and not be noticed, until around 2020 when your war started.
  - deleted 1y ago
    [deleted]
  - Alghranokk 1y ago
    Have you considered that trans people just want to live their lives? As we all know, transitioning, social, hormonal, reduces incidence of suicide. This also applies to under 18 individuals. Should such options and approaches suddenly be revoked and discontinued, it will naturally follow that some will die who otherwise would not have. How many do consider reasonable to sacrifice in the name of political expedience?
Llamamoe 1y ago
> Also you never go through a puberty in exactly the same way as a cis woman. A lot of the effects are reversible, especially if you start at 18, since I don't think maleness fully develops until at least age 25. Treating people under 18 is a politically losing issue. Imagine trying to make the same argument about forcing cis women to go through male liberty to "understand men better". It's ridiculous. Further, studies show that the main predictor of bone structure is whether you started HRT before or after the beginning of puberty, and that outcomes get worse the more it progresses. At 18 you still get some change, but you really need to either block puberty or start HRT before it for optimal outcomes. And if you don't want to give HRT to trans children, at least get them on puberty blockers. There's pretty much zero evidence suggesting they do anything worse than temporary and reversible reductions in bone density.
- jart 1y ago
  The first rule of medicine is to do no harm. It's an ethically grey area to intervene with something the body is doing naturally that isn't putting the person's life at risk. The technology available today for gender transition is crude compared to what will be available in the future. I know intersex people who are pretty unhappy because medical professionals chose the wrong intervention in childhood. Only adults of sufficient mental faculties who are under the care of a doctor should be making these tradeoffs. That's how trans worked for ~70 years before recent political activism forced the medical industry to loosen its standards.
  - Llamamoe 1y ago
    Puberty blockers are routinely prescribed for other indications, and there are countless other treatments with more risks that are prescribed to children every day.
  - seethedeaduu 1y ago
    Kids can't consent to being forcefully and irreversibly mutilated under the wrong puberty.
znpy 1y ago
> Treating people under 18 is a politically losing issue. This is the key point, imho. In the transgender rights discourse no margin for error is admitted, but there is like in any other human field (of course). There have been several cases of people being given a "gender disphoria" blanket diagnosis (eg: the case of Chlementine Breen[1]), which later caused issues. And of course some of those people are transitioning back and started doing activism against the trans rights movement. It's weird that minors are not allowed to do something trivial as drinking a beer or driving a car yet they're allowed to take on irreversible changes (sometimes involving surgery) to their bodies. This is hurtful to all people involved, and until this point is not understood, the attrition will continue. [1]: that case is a textbook example of "no margin error admitted" because in order for their voice to be heard they had to resort to talking to the extreme opposite political side.
- seethedeaduu 1y ago
  The convenience of a hypothetical cis peerson is worth more than the lives of 100 trans people it seems. The wrong puberty is irreversible mutilation. It's not weird at all given that kids are being given treatment for cancer.
  - znpy 1y ago
    > The convenience of a hypothetical cis peerson is worth more than the lives of 100 trans people it seems. Complete nonsense. The ratio is generally the inverse: there are 100 cis people and 1 trans person. Those are just the numbers, otherwise trans people wouldn't be a considered a minority. Actually you're the one arguing that the convenience of one trans person is worth more than the life of 100 cis people.
    - seethedeaduu 1y ago
      I didn't know that the ratio of cis to trans people who were "falsely" "convinced" to take hormones were 100 to 1. Having the right hormones and not being permenantly mutilated by the wrong ones isn't simply "a convenience".

Manuel_D 1y ago

The issue with this framing is that it ignores blockers' influence on desistence rates. Without blockers, 60-90% of kids presenting with gender dysphoria desist in cross sex gender identity by adulthood. But when put on blockers, nearly 100% continue living as the cross sex gender. Even with a suppressed puberty, being transgender is extremely hard with high rates of depression and suicide. Any responsible analysis of the aggregate benefits of prescribing blockers needs to factor in the rates of desistence with and without blockers, but proponents of blockers almost always try to frame this discussion as though all kids with gender dysphoria persist in a cross sex gender. And indeed many try to claim that desistence is a "myth", despite most research into the topic.

viamiraia 1y ago
> Without blockers, 60-90% of kids presenting with gender dysphoria desist in cross sex gender identity by adulthood. But when put on blockers, nearly 100% continue living as the cross sex gender. You say "most research" shows this. From which source(s) do you draw these claims? If I recall correctly there were a lot of methodological issues with drawing this type of conclusion from those studies.
- Manuel_D 1y ago
  This is one of the more recent studies: https://pmc.ncbi.nlm.nih.gov/articles/PMC8039393/ https://pmc.ncbi.nlm.nih.gov/articles/PMC8039393/ The desistence rate for this study was 87%. Most other studies fall in the range of >70% > At the time of follow-up, using different metrics (e.g., clinical interview, maternal report, dimensional measurement of gender dysphoria, a DSM diagnosis of GID, etc.), these studies provided information on the percentage of boys who continued to have gender dysphoria (herein termed “persisters”) and the percentage of boys who did not (herein termed “desisters”).2 Of the 53 boys culled from the relatively small sample size studies (Bakwin, Davenport, Kosky, Lebovitz, Money and Russo, Zuger), the percentage classified as persisters was 9.4% (age range at follow-up, 13–30 years). In Green (47), the percentage of persisters was 2% (total n = 44; Mean age at follow-up, 19 years; range, 14–24); in Wallien and Cohen-Kettenis (52), the percentage of persisters was 20.3% (total n = 59; Mean age at follow-up, 19.4 years; range, 16–28); and in Steensma et al. (51), the percentage of persisters was 29.1% (total n = 79; Mean age at follow-up, 16.1 years; range, 15–19). Across all studies, the percentage of persisters was 17.4% (total N = 235), with a range from 0 to 29.1%.3 You can find studies that find a very low rate of desistence, in the single digits. But those are among children that were put on puberty blockers.

seethedeaduu 1y ago

This is true, but also, going through the wrong puberty and being forced to live as the wrong gender afterwards is also an inherently traumatic experience, even if it would be possible to fully reverse the mutilation caused by the first puberty.

Fire-Dragon-DoL 1y ago
Is mutilation the right term here? Mutilation is altering the physical appearance. Puberty by default follows what the body was designed to do, it seems confusing calling it mutilation: I couldn't tell if surgery is involved or this is just talking about the natural process of going through puberty