Delaying is not stopping. Kids normally enter puberty at a pretty wide range over several years. The idea is to delay to the end of that wide normal range, not far beyond. A later teen who is confidently stating they want hormonal transition is, as above, unlikely to be changing their mind later.
Nothing, until hormones are delivered to the bloodstream - either by the child’s own gonads ( if the child ultimately decides they are cisgendered) or by artificial means (if the child decides they are transgendered). Puberty-blocking in these cases is not a permanent state of affairs; it just buys a little more time before the child has to commit to shaping their body into a male or female one.
They will grow up with a body that matches, as closely as possible, the gender they most strongly identify with in their minds. This is not a bad thing.
Why do you feel “not natural” is inherently bad?
Why do you feel “not normal” is inherently bad?
What if “not normal/not natural” is required in order for a person to live a happy life instead of being borderline suicidal all the time?
As it happens, CBS Sunday morning aired a segment two days ago about transgendered kids. These are kids who were featured in a piece five years ago, before they hit puberty; this week’s piece followed up on them.
Here’s the link. That webpage has a transcription of the whole piece, but it’s worth watching the video. If you saw these kids in person and didn’t know they were transgendered, you’d never have reason to suspect; they appear to be happy, normal, well-adjusted post-pubescent kids.
Anyone looking for a little more understanding of the experience of kids who grow up transgendered might find that piece informative. Annoyed, please take some time to watch it; it might soften your stance a bit.
It’s often said that biological physical sex is a social construct just as gender is. That statement is unfortunately often just tossed out there without much elaboration (aside from a gratuitous mention of intersex people) and it often seems to be used to justify a “just go with everyone’s gender identity and hey it’s not polite to conjecture about the merchandise in anybody’s underwear, that should be a taboo topic” viewpoint.
But, yeah, ultimately sex (the biological physical, split off from things like personality and behavior which we call “gender”) is social. The easiest working definition of “male” is “if the person in question appeared on a nude beach in front of 1000 non-blind strangers, at least 980 of them would classify them as ‘male’”. Likewise for “female”. Once you start trying to rely on physical data (chromosomes, ownership of a uterus, has a long external protruberant sex organ, prolific hair growth, wide hips, etc) you get into arguments about exceptions and the mindset of the people doing the classifying and the wide range of possible variations etc – it’s easier to treat it as social to begin with, and then establish that there’s a predictable and high level of inter-rater correlation and consistency and that, yeah, the overwhelming majority of people are assigned in this manner without any appreciable ambivalence from the assigners.
No one who was born male (using this social definition of ‘male’ – 980+ nude beach raters say ‘male’) knows from firsthand experience that their body should have been female instead. They can only arrive at that conclusion by extrapolation. Even given Julia Serrano’s notion of ‘brain sex’ – in which the human brain contains a sort of schematic diagram of what the body’s morphology ought to be like – interpreting the resulting feeling of “wrongness” as meaning “oh, my body should have been like theirs” (points to some female people) intrinsically requires some social extrapolation. (And, once again, likewise for female-to-male situations).
This makes it profoundly difficult to sort out what portion of a person’s dysphoria is composed of wanting to be perceived and interacted with as people of the other sex are perceived and treated, and what portion is specifically “I don’t want this body structure, I want that body structure instead, this one is wrong”.
To anyone whose inclination is to say, in response to that, that people with dysphoria should just be sex-expectation rebels and be loud proud gender nonconformists and thereby change how the world treats and regards people of their sex, I would say that, of the two, changing one’s own morphology is a shitload easier and can be accomplished in a matter of a few years, whereas the other objective is something that many folks have been attempting over the course of generations and yet there are still rigid and very polarized social notions still in force.
I don’t have a physical dysphoria. I have no sense that my brain thinks my body should be a different configuration. Like most people on this planet, I have a tendency to skew my beliefs about other folks’ experience so that I expect them to be like me, more so than they actually are. Do I tend to think a lot of trans folks’ issues are actually with gender and not with physical sex? Yeah, of course. But that doesn’t make me right.
I would never want to make transitioning less available to those who want it. I do see the necessity of establishing a “type of person”, socially recognized and spoken of, whose gender is the opposite of what usually goes along with their biological sex. I do think that opens up options for people who might not be the best candidates, in the long run, for surgery and hormones and the rest of what transitioning involves.
I think it’s interesting that, on one hand, people are shocked at the idea that a child might know that they are transgender at a young age, but on the other hand have no problem whatsoever pushing gender stereotypes onto them and punishing them if they rebel against those. It’s also especially odd given that most of the ‘gender norms’ are only about a century old; notably in the early part of the 20th century it was normal for all young children to wear dresses (not just girls) and the gender coding of pink and blue were the reverse of what they are now. When you get down to it, color coding babies so that strangers know what their genitals look like is a much weirder practice than listening to what children say about how they fit into gender roles.
That phrase is commonly used to trivialize the experience of transgender youth. But you’re right, I don’t think you meant it that way, and I shouldn’t have lumped you in with the others, even indirectly. I apologize.
I’m not an expert on young children, so take this for what it’s worth. But I think treating it like pretend play is fine at that age initially (I assume that means you support and encourage imagination, not telling them “quit being silly”). Think of it as helping the child explore what gender means, not making a decision.
If it continues (remember - persistent, consistent, and insistent), then you can involve the parents and determine if a more formal social transition is appropriate.
But “transgender” does not mean a boy wearing pink or a girls wearing blue. If my wife wears blue, she is not transgender in the sense that word is currently meant.
Yes, I believe that ignoring the familys psychology is very foolish in these situations. I don’t believe a child can independently choose these things at 3, outside of the psychology of their parents. If that is the case they all need to be in family therapy.
Toddlers are not competent (by definition). Is it likely that they need to be making decisions as big as that? I tend to see family issues here, not little monarchs who are ordering their universe.
Good thing no one said anything remotely like that then, isn’t it?
Puberty blockers DELAY puberty, they don’t prevent it. By keeping the kids on blockers until they are of legal age the parents are NOT doing any such thing. In such cases any decision to proceed with gender surgery/hormones/other treatments is made by the** legally adult person** and NOT the parents.
If the decision is NOT to proceed the blockers are discontinued and NORMAL PUBERTY ensures. The person will achieve normal fertility, “full testicles” (assuming they are male), full bone structure (whatever that means - presumably normal bone structure for their gender), and so forth.
Puberty not occurring until 18 or 20 is actually within the NORMAL range for human beings and can occur naturally with no other side effects. Other than a reduced chance of breast cancer for women (early puberty is associated with a higher risk of that cancer).
Or maybe it will be praised as getting people appropriate treatment for a condition no one would willing acquire but that some people suffer from nonetheless.
If you use puberty blockers then yes, when they are stopped the child will undergo “full puberty”. Delaying puberty does not reduce fertility, does not screw up “bone structure”, or reproductive organs in either gender. The kid might end up slightly taller than otherwise, but that’s not usually seen as a problem, particularly for men.
Well, THERE’s your problem - you don’t understand the difference between "hormone blockers" and actual hormones.
NO ONE is putting hormones into these underage kids. There are medications that BLOCK the actions of certain hormones and that is what they are given. Standard procedure is NOT to give hormones until the child is legally an adult and able to make such a decision for themself.
By that argument we shouldn’t repair harelips, which occur “naturally”. Or any other birth defect.
The real test of whether or not a treatment is justified is how the outcome with treatment compares to the outcome without treatment. People who have gender/body dysphoria that isn’t treated have ludicrously high rates of suicide and other problems. Preventing death can justify a lot of things that would otherwise be repugnant. It’s not about how YOU feel about it, it’s about how well people with this condition can function. Their health and well being outweighs your personal squeamishness on the subject.
Yep. You use a person’s preferred pronoun. It can change. There’s nothing wrong or Earth shattering a out that, and is the norm where I live.
And some kids don’t want to be called either of those. I have a kid who, since around age 3 has said that he sometimes feels like a girl and sometimes feels like a boy. We’ve been listening to what he says, and talking to him about what that means for him for 3 years now. He is still developing and exploring, but gender is clearly not a black and white subject for him. He identifies as non-binary, and uses the pronouns he or they. Lately, he’s been more clear that he’s a boy, so we support that. Kids give him a hard time at school for using the boys’ bathroom because he has long hair, and many kids insist he’s a girl.* That may be part of why he is being more assertive about being a boy, or his view of himself might be changing. Either way, we’ll keep supporting him and let him tell us what feels comfortable and right for him.
The rest of this post is not directed to Weedy, but more generally.
There are people who make assumptions on both sides. People who think of themselves as supportive of trans rights are often locked into binary thinking. Like, seeing my kid in certain clothes, and with long hair, they’ll ask questions or choose pronouns assuming that he identifies as a girl. It’s super complicated though, so asking questions is fine with me. The people I have a problem with are the ones who don’t just accept the answers about a person’s own identity.
As for whether 3 year olds can know for sure how they identify, I think some can. It’s important to think about how gender is socialized into kids. All people start out with some mix of traits and interests and abilities. Almost all of those will be traditionally associated with either male or female gender. Like, being sensitive, nurturing, and a good communicator would be traditionally associated with the feminine, and being strong, stoic, and mechanically inclined are associated with masculinity. For both boys and girls, there is pressure to conform to gender expectations. But research has shown that there are some critical times when these norms are strongly enforced.
A particular researcher has referred to a “halving” process where enormous pressure is applied societally to reject or tremendously de-emphasize the traits etc. that fall on the “wrong” side of the line. The punishment for not confirming can be brutal. For boys, the “halving” (rejecting a great deal of one’s self) starts during the preschool and kindergarten years. For girls, the most brutal enforcement occurs in middle school. 3 year olds may not fully understand what is happening, but they most definitely are getting strong messages about what is accepted or not accepted about them, and for boys, this is a time when there is enormous pressure. Kids who can’t or won’t jettison that part of themselves suffer. (As do the kids who do – gender norm enforcement hurts everybody.) As a parent, you can see the difference between a kid who is confused and upset about how gender is being applied to them, vs a kid who likes to imagine being the opposite sex sometimes.
So what was the point in bringing up what color people dress girls and boys in?
It is not clear that this are correct. There is evidence that puberty blockers do in fact reduce fertility/virility and reduce bone density. In truth, the registries for puberty blockers are in the very early stages of being filled in with data, and so one cannot comment on the long term effects with a great deal of confidence either way. There is not yet a lot of phase IV study to draw from.
When someone asks to be called a certain name, why is it such a big deal? I don’t get it? I mean, you don’t freak out when someone says, “Hey, I’m William, call me Bill”, right? So why when someone asks for different pronouns do people get so anal?
Especially since it used to be pink for boys, blue for girls. It switched at some point.
I would imagine – at least I would hope! – that doctors don’t just say, “oh here you go, here are some blockers” at a first meeting. Because there have been reports of some particular blockers causing long term side effects, and they’re not just used for trans children. For example – precocious puberty. You have a kid who starts puberty at age 3 or 4, you want to stop that.
And I would think ANY parent would be concerned about what ANY kind of medication might do to their child’s body. Not because they’re transphobic, or because they don’t want to see their child happy, or succeed, but because they’re concerned and want to make sure – hey, am I going to hear years from now that this drug causes cancer, or heart disease, or whatever?
Hell, I had to go through a year’s worth of counseling, between being diagnosed with ADHD, and being prescribed RITALIN. (Granted that was 30 years ago). It wasn’t because they wanted me to fail. It was because hey, is this really ADD, or is she just upset because of the new baby?
I don’t think a parent worrying somewhat about the drug part – even if it’s just puberty blockers – makes them bad parents. Just, normal.
May we ask for cites for this?
Concerning the age of puberty:
“For girls, puberty usually starts around age 11. But it can start as early as age 6 or 7. For boys, puberty begins around age 12. It can start as early as age 9. Puberty is a process. It occurs for several years. Most girls finish puberty by age 14. Most boys finish puberty at age 15 or 16.” (Source) Perhaps puberty not occurring until 18 or 20 happens naturally in some cases, but clearly those are extreme outliers, so it does make sense that some patients or their parents wouldn’t be totally sanguine about pushing puberty into that age range by artificial means.
Concerning the effects of puberty blockers, one of the most common is Lupron. “More than 10,000 adverse event reports filed with the FDA reflect the experiences of women who’ve taken Lupron.” Among the side effects reported: brittle bones, faulty joints and need for joint replacement at an early age, chronic pain, seizures (sometimes deadly), deteriorating vision, and depression, for starters.
In boys, puberty blockers may be linked to testicular cancer. “Combining our data with that of Feuillan et al. [19], a prevalence of 10% results, which is approximately fourfold the prevalence demonstrated in large young male asymptomatic populations [54]. Albeit the clinical significance of ultrasound imaging for testicular microcalcifications in subjects without any other risk factors for testicular neoplasia is still unclear [54,55], some data suggest a possible association with testicular cancer [56].” (Source)
Also: “Though there is very little scientific evidence relating to the effects of puberty suppression on children with gender dysphoria — and there certainly have been no controlled clinical trials comparing the outcomes of puberty suppression to the outcomes of alternative therapeutic approaches — there are reasons to suspect that the treatments could have negative consequences for neurological development. Scientists at the University of Glasgow recently used puberty-suppressing treatments on sheep, and found that the spatial memory of male sheep was impaired by puberty suppression using GnRH analogues,[117] and that adult sheep that were treated with GnRH analogues near puberty continued to show signs of impaired spatial memory.[118] In a 2015 study of adolescents treated with puberty suppression, the authors claimed that “there are no detrimental effects of [GnRH analogues] on [executive functioning],”[119] but the results of their study were more ambiguous and more suggestive of harm than that summary indicates.[120] (It is also worth noting that the study was conducted on a small number of subjects, which makes the detection of significant differences difficult.)” (Source)
Regarding the particular question of whether the effects of puberty blockers can be reversed: “In addition to the reasons to suspect that puberty suppression may have side effects on physiological and psychological development, the evidence that something like normal puberty will resume for these patients after puberty-suppressing drugs are removed is very weak. This is because there are virtually no published reports, even case studies, of adolescents withdrawing from puberty-suppressing drugs and then resuming the normal pubertal development typical for their sex. … Because the major studies of puberty suppression have not reported results of patients who have withdrawn from treatment and then resumed the puberty typical of their sex, we also do not know how normally the primary and secondary sex characteristics will develop in adolescents whose puberty has been artificially suppressed beginning at age 12. And so the claim that puberty suppression for adolescents with gender dysphoria is “reversible” is based on speculation, not rigorous analysis of scientific data.” (Same source as above.)
I’m not sure if you know anything about the main source you quoted or if you just picked the first study that fit your bias. But Paul. McHugh is pretty well known for his strong anti-transgender views, arguing that gender dysphoria doesn’t exist. The study in the New Atlantis you cited was not peer reviewed, and neither McHugh nor Mayer specializes in sexuality or LGBTQ health. The entire report contains no original research, and instead represents cherry-picked data selected from other studies that matched their views.
I can find research indicating adverse effects for any drug out there. It’s meaningless without a balanced examination of all the data, both pro and con. You know, actual science.
I quoted four different sources, not one main source. If you have any evidence that the conclusions quoted are not correct, I will be happy to read it.
Regarding the claim that puberty blockers can cause brain damage, here’s a commentary on the issue from a peer-reviewed journal. It says the same thing. There are two studies that have found kids taking puberty blockers have lower IQs. The result was statistically significant in one case, not in the other case (narrowly). That, combined with results from research on animals, provides some evidence that the drugs hurt brain function. More research on the question would be nice, but as things stand now, nobody should say that puberty blockers are safe and free from side effects.
Lots more evidence about side effects can be found here.
I agree, science is good. Some posts about puberty blockers in this thread have been entirely about the pro and not the con. As noted in the PBS article that I linked to, the FDA is reviewing the evidence for the safety of GnRH antagonists after receiving a massive number of reports of nasty, and sometimes fatal, side effects. If we want to look at pro and con, surely harmful side effects that include death should be mentioned.
Bear in mind that the standard here is not that we should be aiming to eschew treatment such as puberty blockers unless we can show conclusively that there’s no risk involved. This isn’t something where safety should be assessed on the same basis as (say) a cis woman’s breast augmentation. Safety must be assessed relative to the considerable risk in doing nothing at all to help people with gender dysphoria, since doing nothing means potentially committing people to either live in the “wrong” body or to live with the result of much less satisfactory post-pubescent transition procedures.
FWIW not very hard to find evidence-based guidelines from the Endocrine Society. First of all it reinforces that early gender incongruence has much fluidity:
Again, labelling a three year old who expresses gender incongruence as “trans” would most often be premature at best. One can accept a child’s non-congruent behaviors and wishes as they are expressed at the time without any judgement while being completely open to the idea that they may or may not change in the future.
Regarding the potential risks of delaying puberty with gonadotropin releasing hormone analogues (GnRH analogs) -
Bolding mine.
The risks of GnRF analogue treatment are non-zero but small while the harms of allowing puberty to proceed at that point, at an age that a child cannot be reasonably expected to be competent to make a decision of such life-long import, are very sizable.
I’m no expert and haven’t done a full literature review … but these people are experts and have.
I don’t think anyone’s disagreeing here. No drug out there has zero risk or side effect. (Fucking TYLENOL does) You want to make sure it’s not going to cause something like cancer, but there’s never going to be a non-zero risk for any kind of medical treatment.
But parents will worry, because they’re parents, that’s all I’M saying.