Puberty-delaying treatment for transgendered kids

[kate jack]

What are your thoughts on puberty-delaying treatment for transgendered kids?

http://www.npr.org/templates/story/s...oryId=90247842

I think that the most interesting and informative piece of this article would be:

"I remember her talking to the therapist and saying something to the effect of, like, you know, 'I'd be OK if Jonah just was gay, I just don't want ... him to be transgender.' And the therapist just laughed, she said, 'You know, 15 years ago, I had people on this couch saying, 'I don't mind him being a little effeminate, as long as he's not gay,'"

It's a helpful reminder of quite how much times have changed over the last few decades in terms of tolerance and acceptance, and although plenty of people think that we're now entering a 'PC crazy age' (which I'm inclined to agree with in certain ways) there is still a lot of stigma, misinformation and bigotry out there, and I think it can be easy to forget about this or not even realize, particularly if one's own circle and lifestyle tends to contain more liberal people.

Fairly predictably I fully prefer the approach to the second case. While I'm no expert, I think that it's a bit of an artifact of the psychological world that even when no negative impact is being experienced by an individual (given an accepting environment), their uncommon state of being is defined as a 'disorder'. The idea of discrimination also links to what I think is a weakness with the first doctor's argument where he juxtaposes gender identity with that of race. He suggests that a black child may wish to be/see themselves as a white child as a result of a problem with their environment. It has to be said that sadly, in some parts of the world, the hypothetical ability for a black person to become a white person would provide certain advantages, in no longer being the target of racism. The point being that in this scenario, a black child wishing/believing to be a white child is a movement towards a less discriminated group, whilst in the actual gender identity scenario the inverse is happening, whereby a voicing of the issue makes one more of a minority, a parallel with 'coming out' for a gay or bisexual person. This boils down to the old argument 'why would I choose to be something that makes life more difficult?'.

The first psychiatrist also claims that viewing the scenario as entirely the product of biology to be "astonishingly naive and simplistic". I agree to some extent, in that I think any aspect of a person such as this is going to receive influence from both one's genes, and one's environment. However he appears to be guilty of favoring one side of things as far as I'm concerned. I can't imagine daring the treatments he advocates unless he believed the individual's differences to be entirely environmental, or at least pathological. And this goes back to what I said earlier; how can this be defined as a pathology, when if the issue is considered independently from secondary negative social pressures no ailment is found by the individual? As the second case showed with supportive parents and schooling (by the sound of the article), the little girl Jona was a happy, well adjusted child.

The first psychiatrist also believes that "taking the view that kids are born transgender ultimately produces more transgender people". I think this rather obviously gets it wrong, and a juxtaposition to now dated and clearly wrong views on homosexuality is rather suitable. Perhaps it isn't that transgender people are being 'created' but more 'revealed'? In an environment where such things will cause people to grab their torches and pitchforks of course it's going to be less prevalent. To put a bit more personal postulation on this I wouldn't be surprised in the slightest if perhaps some complex genetic loci served to justify a crude spectrum of gender identity, much as there is the Kinsey scale of sexuality. The comparison isn't perfect I know, and certainly social and personal roles would make this virtually impossible to get meaningful work done on the idea, but I think most people would agree that even among one sexuality and gender group, say, men who know that they are both male and straight, you're likely to see that some are more 'manly' and others more 'womenly'. I don't mean in appearance or haemaphroditic issues, but the mental component of gender. It's all SO difficult, especially when considering what defines 'man' and 'woman' past the obvious biological facts is essentially socially defined anyway! One could argue that the fact that it isn't the norm for girls to be playing with trucks and boys with barbies is entirely a coincidence of social evolution.

An important thought that I had never really considered until I attended a transgender group meeting with some friends is the idea that 'even if it is partially or entirely a choice, why does that change things?' Having always rather stuck to my guns of the genetic argument, I was surprised to hear this from the transgendered woman, who was also educated as a scientist, who was giving the talk. While she was not trying to dissuade anyone from thinking or believing that there is very possibly genetic components, her point was more that why should this be required as a justification? Being a transgendered person in and of itself isn't harmful to the person themselves, or people in their environment. Therefore what's the problem? The first doctor points out the fact that serious surgery shouldn't be done lightly, which is of course true. However not only do plenty of people who identify as the opposite gender live perfectly well without genital alteration but also that he doesn't even consider the idea that living as the gender that a person is born can also be a gender. The way his arguments are presented in this article suggest either a bias within said article, or a lack of empathy and objectivity by the first doctor.

The issue of halting puberty is a difficult one for me. Assuming that nothing irreversible occurs by the taking of such pills (I don't know very much about this at all...) then I would advocate it. If the child naturally adjusts to identify with the gender of the body they're in I think it's important that there shouldn't be a decision that results in a 'point of no return' at a young age. If there's anything in my tentative thoughts about a possible gender identity spectrum then this might happen with people who are closer to the middle, able to identify with both genders to some extent, or experience doubt for a longer period of time. Even though it's lagging behind the social views on homosexuality, I would like to think that a less 'black and white' view on gender is becoming more and more acceptable also.

I'm in danger of expressing a rather subjective bias here, but any 'success stories' of the first doctor or those who treat using similar methods I would view with extreme caution and skepticism. Much in the way that there are homosexuals who claim to have been 'cured' by the church, I think it more a sad show that whilst the human mind is a powerful and incredible thing, so are the techniques that have been developed to shape and mold people and how they think. I just find it slightly scary. If you take the results as they are presented in the article, then I think it's very clear which line of thought the article supports, and why.

[Reese]

Did I miss a paragraph where they talked about halting puberty? I don't see anything about it. What exactly does that accomplish?

I do kinda believe it's genetic. If it is, It's affecting the basic natural instincts and it pretty much makes the person who they are. I think changing that about someone is far worse that letting them live with the harmless condition. Letting them live with it and making it more acceptable is the far better choice than condemning it as a sickness and "curing" very few via brainwashing while outcasting all those that can't and don't want to be "cured."