Puberty blockers, cross-sex hormones and surgery for transgender minors? UPDATE-New WPATH Standards of Care

[SilverBear]

I cannot ignore something that was never presented.

Posts #94 and #95 and again in post #184

 

[SilverBear]

The studies show that not everyone who has dysphoria continue with dysphoria. Some resolve it.

debatable


but still not evidence that ALL children are born straight and "cisgendered" unless an outside influence convinces them otherwise

Many find they don't need medical interventions, which is the topic of the thread.

People tend to figure out more who they are as they go through the usual development process. We should let them.

Very few things are only about genetics. Like most things there may be genetic predisposition, environment, choice, faith, etc. involved.

and any evidence about any causal connections environments factors? any experiences?

 

[SilverBear]

I think it is fair to say the study of such issues is relatively recent. But that is also why discussion of the various possible ways to handle it is important, because there are different notions among those treating youth in such a situation.

Because we don't know as much about it, and because the interventions can be quite severe, there needs to be caution, especially when dealing with minors as young as 8.

and what interventions to 8 year olds are you talking about?

 

[SilverBear]

Go start your own thread. You clearly have a topic you wish to discuss, but it is not the topic of this thread.

This is not the thread for discussing whether homosexuals are born that way. And you prompting @SilverBear to drop two long lists of studies (with no discussion) and then you saying he didn't over and over is not on topic either, and is rather silly. You look like you are running away from what he posted. He looks like he can't be bothered to explain what he posted. But you can both do that elsewhere.

This is focused on whether medical interventions for those with Dysphoria should be legal.

I was operating on the assumption that if I did go into the findings of the short list of individual studies i posted you would scold me. Was I wrong?

 

[tall73]

I was operating on the assumption that if I did go into the findings of the short list of individual studies i posted you would scold me. Was I wrong?

I understand you are in a difficult spot because he is continually broadening the topic to include Lesbians, Bisexuals, Homosexuals, and any thing else he includes in LGBT, rather than sticking to the focus on gender dysphoria in the context of transgender identification, and medical interventions. And there are aspects you want to try to set the record straight on once he raises that.

It is certainly not my first choice to start "scolding" people, as you put it, but it is that or have him take the topic off somewhere else, or report him, and I don't like to do that.

I should have thought through better how to characterize what I now see was restraint on your part. I apologize.

 

[tall73]

and what interventions to 8 year olds are you talking about?

You know what interventions, the hormone blockers discussed earlier.

And if they find the right 8 year old, hormones too, as the study included them in the criterea. And you could address the same with hormones for 11 year olds.

 

[Pommer]

I think it is fair to say the study of such issues is relatively recent. But that is also why discussion of the various possible ways to handle it is important, because there are different notions among those treating youth in such a situation.

Because we don't know as much about it, and because the interventions can be quite severe, there needs to be caution, especially when dealing with minors as young as 8.

“Proceed with caution”? Sure, but, do not fail to proceed whatsoever. Without a doubt “mistakes” will be made.
Since this is all “new”, there will be some tragic results and casualties of overzealousness (on both sides, where “iffy” candidates are coerced into life changing decisions and conversely talked out of treatments that would have benefited the individual tremendously (though the latter will have been “invisible” for the most part)).
Again, there’s less than a million transfolk at any given time in our nation, the best-practices metric will change over time as we learn more.

 

[tall73]

He didn't drop "two long lists of studies." He provided two studies for another individual regarding kids growing out of their gender disphoria.

No, he really did make two posts with a list of studies. And we all saw it. And we wondered why you couldn't see it, especially when he linked again to it.

And the studies he listed were in many cases about sexual orientation, because you keep including that when you say LGBT.

Either you are trying to make his argument look better, by saying he didn't post it when we all saw he did, or you are really not paying attention.

Posts #94 and #95

Now, my suggestion would be to go start a thread to address those posts if you have a burden to discuss whether people are born with a particular sexual orientation. This thread is more focused than people being born "LGBT"

 

[tall73]

Lastly, regarding the topic, the entire conversation was to explain why puberty blockers and cross sex hormones should be illegal for minors because I reject the premise that they can choose their gender. A boy who thinks he is a girl is still a boy no matter what chemicals are pumped into their system or cosmetic surgeries are performed.

You see how you managed to say that without referencing "LGBT" which includes things not related to the above? That is fine, and on topic. Stick to that.

Stop talking about "LGBT". We are not discussing in this thread people who claim to be born gay, or not to be born gay, or bisexual, or whatever else.

We are taking about transgender identification, gender dysphoria, and related medical procedures.

You have a whole forum to go discuss with whoever you like about whether people are born gay, or lesbian or bisexual, or even as pedophiles. But that is not this conversation.

 

[tall73]

All of this is accurate, but doesn't support creating legislation banning treatment. As with most issues involving medicine, different people will have different circumstances. Some people are able to resolve their dysphoria with no medication/surgery, while others experience crippling mental distress due to it that completely destroys their ability to function in society. Therefore, it makes sense that this be left up to the discretion of medical professionals

Yet we do draw lines for medical professionals. For instance, a ban was enacted for surgeons performing amputation for those who are transabeist, even for adults, though they are in distress.

Understanding transableism: Why do some people want to be physically disabled?

There are many kids who suffer mental distress from a host of issues. They are supported without resorting to removing functioning body parts. And if they want surgery once they are of age, and have had time to work it through, that will still be up to them.

But we do not know whether surgery will work for a given child to release dysphoria. And we do know some resolve their dysphoria without such intervention. We could support them while they figure that out, without blocking them or altering them so that it is harder to figure out, because you have changed the natural process.

A child cannot properly comprehend all the issues associated with fertility, sexuality, and various health risks in order to give consent.

 

[tall73]

tall73 said: ↑

The studies show that not everyone who has dysphoria continue with dysphoria. Some resolve it.

debatable

You can debate how many, but no, it is not debatable that some desist. Even the most ardent advocates for child medical interventions admit some desist. The question is how many, and how much it should inform the process.

but still not evidence that ALL children are born straight and "cisgendered" unless an outside influence convinces them otherwise

Since in the response you were quoting I already acknowledged some genetic propensity, and referenced a twin study, but also mentioned other factors, you are not addressing my actual position.

and any evidence about any causal connections environments factors? any experiences?

Already posted those in clinical practice giving their experience and view that it impacts it.

In fact, several have pointed out that people may hear about transgenderism, think it may be what they are dealing with, but later decide that they have same sex attraction.

In one of the articles I posted earlier the author noted a gender clinician helping a person work through their dyshporia, and the person admitted that she was having trouble accepting same sex attraction, and thought transition to a boy would resolve it, but then decided she was not transgender.

And of course the desistence studies themselves are evidence. Not everyone who has dysphoria persists.

 

[tall73]

“Proceed with caution”? Sure, but, do not fail to proceed whatsoever. Without a doubt “mistakes” will be made.

Some are not even using caution. One of the current debates, linked to in the articles earlier is whether they even need to go through psychological evaluation, etc. before initiating treatment. The new revised WPATH standards of care will still recommend it, but many are not following the guidelines anyway.

Here is Olson-Kennedy discussing how she doesn't think you need to put people through evaluations.


When Children Say They’re Trans

Not everyone agrees about the importance of comprehensive assessments for transgender and gender-nonconforming youth. Within the small community of clinicians who work with TGNC young people, some have a reputation for being skeptical about the value of assessments. Johanna Olson-Kennedy, a physician who specializes in pediatric and adolescent medicine at Children’s Hospital Los Angeles and who is the medical director of the Center for Transyouth Health and Development, is one of the most sought-out voices on these issues, and has significant differences with Edwards-Leeper and Leibowitz. In “Mental Health Disparities Among Transgender Youth: Rethinking the Role of Professionals,” a 2016 jama Pediatrics article, she wrote that “establishing a therapeutic relationship entails honesty and a sense of safety that can be compromised if young people believe that what they need and deserve (potentially blockers, hormones, or surgery) can be denied them according to the information they provide to the therapist.”​

​

This view is informed by the fact that Olson-Kennedy is not convinced that mental-health assessments lead to better outcomes. “We don’t actually have data on whether psychological assessments lower regret rates,” she told me. She believes that therapy can be helpful for many TGNC young people, but she opposes mandating mental-health assessments for all kids seeking to transition. As she put it when we talked, “I don’t send someone to a therapist when I’m going to start them on insulin.”​

But the larger issue is that there is no cautious way to start cutting off working body parts. That is not cautious, that is reckless.

Since this is all “new”, there will be some tragic results and casualties of overzealousness (on both sides, where “iffy” candidates are coerced into life changing decisions and conversely talked out of treatments that would have benefited the individual tremendously (though the latter will have been “invisible” for the most part)).

Again, there’s less than a million transfolk at any given time in our nation, the best-practices metric will change over time as we learn more.

Since this is all new we might think that people were supported previously through such circumstances without removing body parts. I don't think we need to change children physically in the now to recognize it as a tragedy later. I think we can see it is a tragedy now, and avoid any further instances of it.

 

[Pommer]

I think we can see it is a tragedy now, and avoid any further instances of it.

You wrote “avoid” yet I heard “ban”.

 

[Oompa Loompa]

It would look like published peer reviewed research documenting in some way what you claim.

No. 50 - Fall 2016 — The New Atlantis

Now I await for you to dismiss the evidence because it disagrees with your ideology.

 

[Oompa Loompa]

Posts #94 and #95 and again in post #184

Now look at the results of those studies and tell me they have concluded people are born LGBT.

 

[Oompa Loompa]

Posts #94 and #95 and again in post #184

Now. Take the next few days to actually read the studies you provided and tell me if any of them actually concluded that people are born transgender.

 

[rjs330]

I think it is fair to say the study of such issues is relatively recent. But that is also why discussion of the various possible ways to handle it is important, because there are different notions among those treating youth in such a situation.

Because we don't know as much about it, and because the interventions can be quite severe, there needs to be caution, especially when dealing with minors as young as 8.

This is precisely why we shouldn't be drugging children and giving them surgeries. They need to be allowed to grow up before they are pharmaceutically and surgically altered and it's too late to go back.

 

[rjs330]

All of this is accurate, but doesn't support creating legislation banning treatment. As with most issues involving medicine, different people will have different circumstances. Some people are able to resolve their dysphoria with no medication/surgery, while others experience crippling mental distress due to it that completely destroys their ability to function in society. Therefore, it makes sense that this be left up to the discretion of medical professionals

No this is foolish. Since the medical professionals are NOT prophets and have NO idea whether the kid will desist later or not they should leave them alone and allow them to grow up until they finally decide as adults what they want. Preferably wait at least until they are 21.

 

[rjs330]

no no .... NO!!!! Transgendering in any Physical way should be a decision one makes when they are an adult (age 18).

I think it ought to be illegal until they are 21.

 

[Yttrium]

I think it ought to be illegal until they are 21.

Sounds reasonable. i could agree with that.