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"Transitioned against their will" is a very crude way of articulating the tradeoffs of prescribing puberty blockers. The core issue at hand is that absent puber

"Transitioned against their will" is a very crude way of articulating the tradeoffs of prescribing puberty blockers. The core issue at hand is that absent puberty blockers, somewhere between 60-80% do not persist with a cross-sex gender identity after going through their natal puberty. Psychologists attempted to predict which patients would persist in a cross sex gender identity and which would not, but they were never able to do so. When patients are given puberty blockers, desistence rates are miniscule, in the single digits. Proponents of hormonal intervention insist that this is proof that doctors are selecting kids that would persist in a cross sex gender absent blockers. But that's hard to reconcile with psychologists previous failures to predict persistence. While they're billed as giving "time to think", it's pretty much impossible to deny that blockers are causing patients who would have desisted in their cross sex gender identity if they went through their natal puberty. It's not just conservative American States that are changing course on blockers for children: Finland, Sweden, the UK, Italy, Denmark, and Norway have all stopped prescription of blockers in children. Plenty of other countries never allowed it in the first place.

wreedtyt 1y ago
It seems like you're referring to a specific study, could you link it?
- Manuel_D 1y ago
  A multitude of studies, not just one. This is the review covering the outcomes of gender dysphoric children who aren't given blockers: https://news.ycombinator.com/item?id=44546443 https://news.ycombinator.com/item?id=44546443
Dylan16807 1y ago
> "Transitioned against their will" is a very crude way of articulating the tradeoffs of prescribing puberty blockers. That is an extremely generous interpretation. I think you're giving way too much credit to the average person that uses that argument. Also I really have to wonder how much of that desistance is giving up versus actually being satisfied.
- Manuel_D 1y ago
  What do you mean by "giving up"? These patients have the opportunity to transition later in life. Patients were followed up with for 10+ years, well past puberty and into adulthood. The minority that persisted transitioned as adults.
  - Dylan16807 1y ago
    The initial puberty is never going to be undone. If they'd rather live with it now that it happened, then it's great that they're probably not undergoing heavy dysphoria but that doesn't mean it's zero or that this was the best outcome.
    - Manuel_D 1y ago
      Given the disparity in life outcomes between trans people and cis people, the idea that the desisters would have been better off transitioning is quite the bold speculation.
      - KittenInABox 1y ago
        How much can the disparity in life outcomes be attributed to a trans person needing to undergo a second puberty in a society where doing so is discriminated against? I feel like as a society we put trans people in a situation where it is controversial for them to transition as children, but also controversial for them to transition as adults. (The notion of a man in a dress no longer exists if the man never had male puberty, but not only is it controversial for such a boy to never have male puberty, we villainize the now-man's attempts to become a woman!) But then we say that outcomes for trans people are bad so them staying in the closet is good. Which is weird, because the cause of the bad outcomes is that there is no stage of their life where trans people can transition noncontroversially.
        Manuel_D 1y ago
        Desisters are not "still in the closet". They have become comfortable in their cis gender and no longer want to transition. Many (~60% of the sample) live happily as same-sex attracted cis people.
heavyset_go 1y ago
The effects of puberty prevent people who are trans from living as their gender identities. Why bother when you'll need $400k in surgery post-puberty just for a chance to maybe look your gender? If you ask trans people, "it's too late to live as my gender" is a common sentiment. You even see it in the gay community, where gay/bi people who come to acceptance of their sexualities late in life, feel like it's "too late" to live with that identity, and choose to continue to live and identify as straight people. Hence the option for puberty blockers. Turns out trans people will opt to go through the puberty that matches their gender if the opportunity arises, just as more people come out gay/bi/etc at an earlier age now that the opportunity arose.
- Manuel_D 1y ago
  People can, and do, transition as adults. Natal puberty clearly does not prevent all people from transitioning. Effectively 100% of trans people prior to about 2010 transitioned as adults. Same thing with gay people, as per your example. I'm sure some do remain closeted their entire lives. But plenty of them come out as gay later in life.
  - Dylan16807 1y ago
    > Same thing with gay people, as per your example. I'm sure some do remain closeted their entire lives. But plenty of them come out as gay later in life. Plenty do, but the ones that don't give credence to the idea that forced closeting as a teenager makes it harder to follow your heart later. And that's in a situation where it doesn't get more difficult to come out later (if you're not married). Transitioning pre- and post- puberty is very different with current medical technology, so a lot more people will get "stuck".
    - Manuel_D 1y ago
      As per the linked study, the desisters tend to no longer experience gender dysphoria. It's not just that they don't transition later in life. The scenario you're describing - people struggling with gender dysphoria but reluctant to transition on account of having undergone natal puberty - does not describe the bulk of the sample.

wreedtyt 1y ago

It seems like you're referring to a specific study, could you link it?

Manuel_D 1y ago
A multitude of studies, not just one. This is the review covering the outcomes of gender dysphoric children who aren't given blockers: https://news.ycombinator.com/item?id=44546443 https://news.ycombinator.com/item?id=44546443

Dylan16807 1y ago

> "Transitioned against their will" is a very crude way of articulating the tradeoffs of prescribing puberty blockers. That is an extremely generous interpretation. I think you're giving way too much credit to the average person that uses that argument. Also I really have to wonder how much of that desistance is giving up versus actually being satisfied.

Manuel_D 1y ago
What do you mean by "giving up"? These patients have the opportunity to transition later in life. Patients were followed up with for 10+ years, well past puberty and into adulthood. The minority that persisted transitioned as adults.
- Dylan16807 1y ago
  The initial puberty is never going to be undone. If they'd rather live with it now that it happened, then it's great that they're probably not undergoing heavy dysphoria but that doesn't mean it's zero or that this was the best outcome.
  - Manuel_D 1y ago
    Given the disparity in life outcomes between trans people and cis people, the idea that the desisters would have been better off transitioning is quite the bold speculation.
    - KittenInABox 1y ago
      How much can the disparity in life outcomes be attributed to a trans person needing to undergo a second puberty in a society where doing so is discriminated against? I feel like as a society we put trans people in a situation where it is controversial for them to transition as children, but also controversial for them to transition as adults. (The notion of a man in a dress no longer exists if the man never had male puberty, but not only is it controversial for such a boy to never have male puberty, we villainize the now-man's attempts to become a woman!) But then we say that outcomes for trans people are bad so them staying in the closet is good. Which is weird, because the cause of the bad outcomes is that there is no stage of their life where trans people can transition noncontroversially.
      - Manuel_D 1y ago
        Desisters are not "still in the closet". They have become comfortable in their cis gender and no longer want to transition. Many (~60% of the sample) live happily as same-sex attracted cis people.

heavyset_go 1y ago

The effects of puberty prevent people who are trans from living as their gender identities. Why bother when you'll need $400k in surgery post-puberty just for a chance to maybe look your gender? If you ask trans people, "it's too late to live as my gender" is a common sentiment. You even see it in the gay community, where gay/bi people who come to acceptance of their sexualities late in life, feel like it's "too late" to live with that identity, and choose to continue to live and identify as straight people. Hence the option for puberty blockers. Turns out trans people will opt to go through the puberty that matches their gender if the opportunity arises, just as more people come out gay/bi/etc at an earlier age now that the opportunity arose.

Manuel_D 1y ago
People can, and do, transition as adults. Natal puberty clearly does not prevent all people from transitioning. Effectively 100% of trans people prior to about 2010 transitioned as adults. Same thing with gay people, as per your example. I'm sure some do remain closeted their entire lives. But plenty of them come out as gay later in life.
- Dylan16807 1y ago
  > Same thing with gay people, as per your example. I'm sure some do remain closeted their entire lives. But plenty of them come out as gay later in life. Plenty do, but the ones that don't give credence to the idea that forced closeting as a teenager makes it harder to follow your heart later. And that's in a situation where it doesn't get more difficult to come out later (if you're not married). Transitioning pre- and post- puberty is very different with current medical technology, so a lot more people will get "stuck".
  - Manuel_D 1y ago
    As per the linked study, the desisters tend to no longer experience gender dysphoria. It's not just that they don't transition later in life. The scenario you're describing - people struggling with gender dysphoria but reluctant to transition on account of having undergone natal puberty - does not describe the bulk of the sample.