Adolescence seems like a long time for an unhappy kid, but it’s really a blink of an eye relative to a lifetime. Puberty blockers and hormones can have permanent impacts on the body, so it is really, really important to balance the short-term gains with the long-term risks.
I would absolutely allow my child to transition, if, after a suitable course of therapy, that seemed like the right choice. What I wouldn’t let my child do is make irreversible changes to their bodies that would prevent them changing their mind later.
So, I’d allow my child to go on hormone blockers, change their name, wear clothing suitable to the gender they identified with, etc. I wouldn’t allow my minor child to have their sex organs surgically removed. I don’t think it’s legal to do that even if I gave permission. (barring a life-threatening cancer or something.)
fwiw, my son did like to wear skirts in high school. Maybe he still does. He borrowed money from me when he bought the first one, and I opined that the green one looked nicer than the orange one.
A lot of people asked me “do you KNOW that your son is wearing skirts?!” I said I did. One woman asked my why he was wearing skirts. I said I thought he was exploring his gender identity.
He seems relatively happy living as a cis straight man, who chose to marry a cis straight woman. I don’t think he took any harm from cross dressing.
The NHS has prescribed puberty blockers as young as 9, which are almost invariably followed by cross sex hormones at 16. They do require waiting until 18 for surgery, however. But the UK is one of the most conservative countries. Others allow cross sex hormones much younger, and surgery at 16. I’ve heard of a surgeon in the US carrying out a double mastectomy on a 14 year old. And that’s the official path. Susie Green who runs the Mermaids charity took her daughter to the US to get hormones at 12, and to Thailand at 16 to get SRS (which they’ve since banned for under 18s).
Families now do not have to go abroad, they can order drugs online from GenderGP, run by a doctor couple who were suspended in the UK for prescribing hormones inappropriately. They are also recommended by Mermaids.
Never having had to deal with those kinds of issues with my kids, I can barely imagine the sorts of challenges that presents. I’d be disinclined to allow hormone blocker therapy. Everything else would be up for compromise or full acceptance. But again, having never dealt with these things IRL, I can only speculate about my positions given those circumstances.
Surgery is absolutely done on minors in the US. I believe in Oregon kids as young as 15 don’t even need parents to consent. Doctors are doing mastectomies on 13 year olds in California. Boston Children’s hospital does vaginaplasties starting at age 17. Some states are trying to pass laws to make it illegal to perform surgery on minors but unless those pass, it’s not against the law.
Yup. Just found this by googling.
interesting. I learned something today.
Vaginoplasty at 17 does sound like it’s pushing it to me. If it were my kid, I’d want them to wait.
(And when my gender-non-conforming friend was contemplating that, I opined against it. He was an adult, and well able to make up his own mind. But he asked my opinion, and it was “keep the functional organs”.)
For me it would totally depend on the child. There’s a big difference between someone who’s had dysphoria since the age of 4 and still has it halfway through puberty, and a teenager who’s always been ordinary and gender conforming who suddenly claims to be trans after suffering a sexual assault or mental health issues. But AIUI it’s important to let kids experience at least partial puberty because this is what leads to desistence in many cases, and without going through natural puberty they will never develop sexual function or fertility.
Is there no oversight at all on surgery in the US? This is appalling.
Here’s a link to the actual study, rather than an article about it.
The study was done by surveying people who went to a “hospital-affiliated ambulatory clinic specializing in transgender youth care”, and included some who had had their breasts removed, and an approximately equal number who hadn’t had surgery.
It barely talks about parental consent because the only consent needed for this study was consent to conduct a short verbal questionnaire. “One or more parents or legal guardians provided consent for eligible minors. All participants provided verbal consent before completing the survey.”
It’s silent on who consented to the surgery because that’s not really relevant to this study, which was about how happy or unhappy the youths were with their chests, and what sort of side effects those who had surgery had suffered from the surgery.
Obviously it’s a huge decision to get chest reconstruction, but it sounds like a reasonable procedure for cases of dysphoria where breasts are causing significant distress. Since they may be hard or troublesome to obscure, the breasts may create an appearance they don’t want to have. If they decide it’s a mistake, it doesn’t really matter a whole lot. Small breasts are fine on women, and there’s always the possibility of reconstruction. And there are other options if they have a baby and breast feeding is no longer a possibility. It could be analogous to a well-endowed girl getting breast-reduction because she didn’t like the attention of having such large breasts or they interfered with sports. And boys who have excessive breast tissue might get breast reduction as well. Genital surgery seems much more significant in many ways and should be delayed until older except for extreme cases of dysphoria.
It looks like breast enhancement surgery in cis teenage girls is somewhat common, too, although they often wait until they are 18 and it’s often a “graduation present”. Even so, and even though it’s “off label” for children under 18, more than 2000 underage girls had purely cosmetic breast implants in 2011.
“Reasons for surgery were evenly divided between purely cosmetic augmentation and correction of deformities…”
It’s not the study I was objecting to, but performing double mastectomies on 13 year olds. Kids aren’t even allowed to get a tattoo until 18 in case they regret it! I can’t believe you think this is ethical. And I don’t think minors should be getting breast implants either, WTH? At least that’s reversible, unlike removing healthy organs.
Damn, we’re sorely in need of some body positivity in this appearance obsessed culture!
If any had detransitioned, they wouldn’t have been visiting the clinic. It looks like they did try to contact former surgical patients by telephone, but not all replied. Anyway, since for most patients it had only been one or two years since their surgery, I don’t think it’s very valuable. They’re not likely to have changed their minds within that short time and the great majority still haven’t finished maturing.
I feel you on the implant thing, but I’m curious how you feel about reduction surgery. I recently stumbled upon a thread written by a parent seeking advice for how to handle her daughter’s request for reduction surgery. A 14-year-old very passionate about gymnastics, endowed with double-Ds. The parent was adamantly against it, but her daughter was suffering from pain (she was binding herself so she could perform halfway decently) and low self-esteem.
I thought the parent was kind of an asshole because she/he felt like her daughter was just being vain. And it’s super hard to do anything athletic when you’ve got big uns, but the parent thought the daughter could just power through the difficulty (cuz obviously there are a huge number of successful buxom gymnasts she can emulate 
) . But it is also true that surgery may not the best thing for someone so young, whose body is still changing. So I could see how parent in this situation wouldn’t know what to do.
That’s a difficult one, I wouldn’t know what to do about that as a parent either. I’d at least look into better support options rather than dismissing the problem. DD isn’t even that big, but all the gymnasts I’ve seen had pretty much no boobs. I assumed it was because they are so skinny and train so hard, but maybe it’s rather that only someone with that body type can succeed?
I knew someone who got a reduction, but she was in her 20s. I think doctors like to wait until you’ve finished growing, anyway.
I didn’t actually comment on the ethics of removing the breasts of thirteen year old children. In general, it seems like a bad idea to me. Although as someone upthread pointed out, breasts aren’t that important, as bodily organs go.
The gymnast growing DD breasts is exactly what I meant when I wrote about elite sports being unfair. No, she has no chance of continuing at the top levels with that kind of shape. Sometimes life sucks.
I used to want breast reduction surgery, but you can’t nurse if you’ve had it, it messes up the internal structure. And i was close to having kids when i was considering it, so I decided to wait. Post child, I’m a lot fatter, and my breasts are a lot softer. So they are both easier to contain and a lot less visible, and i no longer want them smaller. (Although if i had breast cancer and needed them removed, i wouldn’t get falsies inserted.)
Anyway, I’d be loath to approve any cosmetic surgery on a kid, unless it was to fix some obvious deformity. And the cosmetic breast enhancement of cis children freaks me out more than breast reduction surgery for either the gymnast or a trans kid. But I’m also not going to get all that excited about what’s done with breasts.
Yes, life often sucks for the female athlete. They’ve got an anatomy and physiology that work against them in sports. So this is why people get so het up about folks competing against female athletes who are spared from everything that comes with being born (and currently existing) in a female body. Life is unfair, but we should not use this fact to justify not leveling the playing field as much as we can.
Regret from a mastectomy might be an insignificant issue if we’re talking about a mentally well person who isn’t overly concerned with image and conformity. But I think that’s a big assumption.
From the stories of detransitioners I’ve read, losing their breasts means their already poor self-image becomes even worse, once they realize that transitioning isn’t the solution they need. The Dutch study kind of backs this up. If the suicide rate among transmen is not different before and after mastectomy, this suggests their breasts are not the real problem.