In Australia today, the newspapers released the case of a young girl of 13 who has been allowed to embark upon gender-reassignment procedures despite the fact that she is a minor.
Overall, I am mightily chuffed that Alistair Nicholson was courageous enough to challenge the status-quo and give this young fellow the chance to have a happy and successful life in the gender orientation of his choice.
But I DO wonder whether 13 is too young to be determining such things? I know that the medical intervention will not start until he is 15, but STILL…
Should gender-reassignment interventions be started before the kid is of legal age to consent to such interventions?
It is a really dicky area (and no pun intended). On one hand, allowing kids who have gender misidentification issues to remedy the problem as early as possible sounds like a wonderful idea.
But on the other hand, does a kid of 13 have enough of a ‘misidentification’ problem to warrant medical intervention?
From the article, it looks as though the kid won’t legally be eligible for the actual surgery until turning 18. The hormone treatments, however, would start earlier:
Looks as though the point is that the hormonal treatments would be more successful/pronounced if initiated before the end of puberty?
In any case, this is hardly a case of mere “tomboyism”, considering that the kid in question has always strenuously resisted being identified as a girl, to the extent of refusing to use girls’ bathrooms.
My take: people’s own sense of their gender is very important to them, and it seems only logical to take their word for it about whether they’re really male or female “inside”. On the other hand, gender reassignment is a hell of a major operation for a teenager to go through. Why don’t we just take the kid’s word for it that he’s essentially a boy, call him a boy and let him identify as a boy, but not let him start medical sex reassignment until he’s a consenting adult?
I mean, I sympathize with the trauma that a self-identified boy has to be going through in undergoing the puberty changes of a girl’s body. But I bet it pales next to the trauma that a grown woman would go through in realizing that her teenage gender reassignment was a big mistake and deprived her of the chance to have the woman’s body that she now knows is right for her. (I personally doubt that this is what will happen to the boy in question: I tend to think that transgendered people know what they’re talking about when it comes to identifying their own gender. Still, it might happen, and I’d rather sentence a kid to wait several years for gender reassignment than sentence an adult to live forever in a mistakenly reassigned body.)
I think 13 is too young to be making major decisions that will have a huge impact on the rest of your life. It’s why we don’t allow kids of this age to vote, or to consent to having sex. This kid may “know” that (s)he’s a boy on the inside, but I just think that 13 is too young. By all means letting him identify as a boy is fine, but I wouldn’t be in too much of a rush to do anything irreversible.
Might I also add that I’m entirely grateful to have not had to deal with this kind of issue with my own kids. The angst I do have to deal with is difficult enough, thankyewverymuch!
I think the issue is that many teenagers who have misidentified genders end up committing suicide or have major psychiatric problems that take many years to remedy.
So, the point is, is it better to identify the problems EARLY (perhaps during puberty) and have them treated then, or let the kids ‘ride’ the problems until they are legally old enough to have them addressed…and in the meantime suffering immesurable harm and damage from the societal pressure to conform?
AFAIK most places that perform the operation require the patient to live as the opposite sex for something like a year before even starting hormone therapy, don’t they? If this is the case, then I see no problem with extending that period for minors. Let him live like a him until 18, and if at that time he still wants to undergo the procedure, then by all means.
If it were the states and the procedure were allowed to go through I could definitely see lawsuits in the future if the decision is regretted. The new man would say that they were emotinally undceveloped enough to make the decision and that the doctors took advantage of it to make a buck. We are very litigious here and I sure as hell wouldn’t want to be insuring the doctor that performed it.
kambuckta:I think the issue is that many teenagers who have misidentified genders end up committing suicide or have major psychiatric problems that take many years to remedy.
That is a serious problem, but I think the best way to deal with it is to loosen up on our gender categories a bit, and take kids’ own word on whether they’re really a girl or a boy without agonizing so much about whether their answer matches their plumbing. ISTM that most transgendered people report that their biggest problem is other people’s hostility and lack of acceptance for what they perceive as their true gender. If we can provide TG teens with more of that acceptance, I don’t think we need to be in such a rush to give them (irreversible) hormones and surgery.
I have worked with a lot of transgendered youth, and I think it’s extremely important that we find a way to address their problems as early as possible. Medically, it’d be ideal to perform the surgery before puberty. This of course raises huge problems as far as psychology maturity in the face of such a decision. It’s very difficult: the body matures much earlier–or at least begins its maturation process much earlier–than the legally prescribed psychological maturity.
My take on it is that the age of majority–18–is a political arbitrarity, and it’s imperative that each child in this situation be treated entirely as an individual. This is where some creative solutions have to be invented by someone, somewhere. With unlimited resources, each of these children would have a team of doctors to address his or her medical AND psychological needs, and would, as a committee, determine the best age at which to begin reassignment for each individual person. This is of course almost entirely impractical under current reality, but is an ideal which should be strived for by those of us who are involved with such youths.
Another obstacle is that parents are often opposed to reassignment in their children, so the transgendered person must wait until he or she is legally old enough to act against the parents’ wishes. Unfortunately this necessitates a “second puberty,” which is not much funner than the first.
A difficult situation with no clear or easy solutions.
I’m not sure it’s an either/or situation. I think the childs’ concerns and issues can be addressed, counseling obtained, etc., without taking measures that will alter them for the rest of their lives. I think most of the suicide, etc. stems more from lack of acceptance than from failure to have surgery. And if the acceptance isn’t there, the surgery isn’t going to change that. Kids are cruel. Do you think they would be any less cruel to a teen that is undergoing the process of changing genders? I don’t believe so. Therapy and counselling to deal with the cruelty seems the way to go at this age. Also, I believe that there are some teens who may think they want to change genders, but have psychological issues that are making them think that (as opposed to true cases of being one gender inside and another on the outside). Therapy would help clear away this kind of confusion, too. You would have to be very careful about picking a therapist who is compassionate and has experience with this kind of thing, so you don’t end up making the problem worse.
Surgery and hormone therapy has much better results when performed earlier- to the point that photos of transgendered people will sometimes mention if they had sexual reassignment surgery before or after eighteen. Those that have it younger will almost always have a more conventional appearance that will make their personal, professional and emotional lives a heck of a lot easier.
norinew, therapy and counciling don’t work in these situations. That is why the rather drastic step of sexual reassignment is the standard procedure right now- for most transgendered people it is the only thing that will allow them to have any sort of peace with their body. While other people’s reactions is a big issue, the primary problem is waking up every morning in a body that feels as wrong as anything can feel.
In this case we have a well documented situation of a transgendered person that has always rejected the sex they were born as. In all ways this person fits the critera as transgendered, and is consistant with other transgendered people in the past. The standard medical practice right now (should the patient wish) is counicilling, hormone treatment and eventual but timely sexual reassignment surgery. Given that this is a time sensitive issue, I see no reason not to begin now. It’s not like this is so bizarre thing that has never happened before. There is a well recogized problem and a well known and oft-performed medically recognized solution.
I believe the decision should be left to a panel of therapists. Standards of care already require a patient to live as their desired gender for at least a year. The therapy sessions they are required to attend during that time give ample opportunity for a therapist to discover whether the patient is ready for SRS. IMO Making minors wait until they are eighteen seems designed to decrease the doctors’ liability rather than from concern on what’s best for the patient.
I’ll have to a search for figures and a cite, but the suicide rate among pre operative transgendered individuals is rather high. The odds that waiting will result in Alex deciding he doesn’t want sexual reassignment are extremely low. The odds that waiting will result in abuse by other teens, depression, and loss of the will to live are much better.
The patient is also at risk from others. When it was discovered that Brandon Tina was a biological female living as a male, his former friends gangraped and murdered him.
Johnny Bravo Female to male transexuals are quite different from tomboys. A tomboy may exhibit many behaviors and interests viewed as typically male. But, tomboys are identify as female and like it that way. An FTM may or not exhibit typical male behaviors and interests. But, they don’t identify as female.
While it is possible to detect certain intersex or transgendered conditions, such as XXY, through medical tests, AFAIK when brain chemistry is transgendered, this cannot be determined except in a post mortem, (by some measurement of the cortex?) I believe there was a very illuminating thread on this a while back.
If so, surgeons have to take a leap of faith, and rely on what the patient is telling them, and the best that they can observe behaviourally, rather than scientifically show or prove.
And if it is better that this be done as early as possible - eg before puberty - then so be it.
Well, it seems that some others around here know a lot more about this stuff than I do, so I will defer to their opinions. I appreciate the enlightenment.
Istara You are correct. I believe the structure is somewhere in the thalmic bed. There were some objections to the findings (small sample size, the possibilty that hormone therapy was responsible for the changes). I’ve since read an article adressing and refuting these objections.
Sexual Dimorphism In The Human Brain
The only real question is whether Alex has gender dysphoria. If he does, there is no treatment other than sexual reassignment. In the unlikely event Alex wants srs for some other reason (my folks always wanted a son and I think this is the only way they’ll stop resenting me, the angels from planet grelon told me I have to get the surgery,) then hormone therapy and surgery would not be in the best interest of the patient. But, the procedures already have safeguards in place. There is no need to make Alex wait longer than a patient who is legally an adult.
I read up on this case some more, and found something that disturbs me in this article:
That makes me uneasy. While on one hand, the father’s treatment could have been due to him unconsciously sensing that his child had dysphoria, I find it more believable that the gender identity problem derives (at least in part) from the father’s rearing of Alex. I have read of cases where an intersexed child was raised as one gender by parental choice, and despite years of pink dresses and dolls it still identified as a male, and vice versa.
I cannot help feeling that stopping female puberty for Alex may remove a potential way for “nature” (call it what you will) to establish once and for all whether Alex is really a female with psychological issues that prevent him/her from feeling comfortable with a female gender identity. At thirteen you cannot truly know if you ever want to have children or not. At thirteen you are still a child - many thirteen year olds are pretty mixed up from teenageness, hormones and puberty - regardless of whether they have had a disturbed upbringing (as Alex has).
I can only hope that Alex’s doctors are right in that Alex’s gender orientation choice (eg if it is not dysphoria, but the result of the father’s rearing) is permanent and irreversible. Because Alex will spend the rest of his life as a eunuch as the result of this treatment, and that is no easy life for anyone.
Anyone read the book about the boy who was a twin and some doctor messed up his circumcision and some gender “expert” who later turned out to be a pedo talked his parents into raising him as a girl? He went his whole life knowing he was a boy, but ended up living as one in his teens after he found out the truth. His life before that, though, was terrible.
Anyhow, in cases like the one I just mentioned, I can see letting a kid decide and doing the surgery. Or like if the kid has something genetically wrong, like an extra X or Y chromosome.
But going from a full-fledged boy to girl (or vice versa) at 13? Nah. Although this kid sounds really, really messed up, I think she’s too young.
And then what if she becomes a guy and she’s still messed up?
IMO she should be treated the same as any person in the same situation over 18 - if she passes as the opposite sex for a year and remains stable, she gets the surgery. I don’t believe in discounting people’s wishes just because they’re under 18.
No amount of acceptance by society is going to change how the body reacts to hormones. If hormones are given before the bones stop growing, then the bone structure can be changed as well. There are some transsexuals that do know solidly at that age what gender they really are and with the right care early they can get a body that is a much closer to their true gender than can be given with any amount of medical care given after puberty. It doesn’t matter how accepting we are as a society, bones stop growing and beards and breasts start growing and the only thing that can change that is hormones.