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Comment by Elinvynia | Hacker News Reader

Transitioning for small children is literally just wearing different clothing.

When they get a bit older, at most they can extremely rarely (due to people pushing against it, even though it reduces suicide rates and saves lives!) get puberty blockers.

Those can then be stopped with minimal consequences if they decide that's not something they wanna do. What is actually cruel is FORCING kids to undergo their AGAB puberty against their will.

We know they are safe, we know they save lives. The vast majority of uses for puberty blockers are still cis children that have early puberty.

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> undergo their AGAB puberty against their will

It's also weird mental gymnastics like this that people are pushing against. For anyone who is not familiar with the acronym, AGAB means "Assigned Gender At Birth", and is push back against the fact that we broadly lump all people into either the male / female camp when they are born. It can be useful when talking about gender norms, etc – which are discussions worth having. But when you start to move into the region of "biological sex is unimportant" it takes on an entirely different slant.

"AGAB puberty" is an oxymoronic statement. If the gender was merely "assigned" to them, then why is their body naturally going through puberty in a certain direction. It's not their AGAB, it's their biological sex. We are not saying "this is a boy" and then giving them testosterone when they hit 12 so that they match their "assigned" gender. Their body is the body of a boy which naturally produces (much) more testosterone (and other obvious hormonal and physical differences) than that of what we broadly call a girl.

Nobody is FORCING anything – that is just something our bodies do naturally because we are a sexually reproducing species of mammal so our DNA causes us to split broadly into male and female.

> We are not saying "this is a boy" and then giving them testosterone when they hit 12 so that they match their "assigned" gender.

That's literally what happens, especially to inter people, though.

And sometimes even done for cis people if their natural hormone levels are too low, or rather their parents and doctors deem them too low (the child is never asked).

We literally do not give 99% of the population any sort of hormonal treatment in order to ensure they match their "assigned gender". For the overwhelming majority of people we say "wow this looks like a boy" and that person ends up a boy with no intervention and no gender identity issues.

Yes, there are intersex people and they are a special case that need to be handled differently than the rest of the population. And just "assigning" a gender to those people like we've been doing for most of medical history is probably not the right move. But the vast majority of trans people are not even intersex so injecting that into a conversation about trans issues is just muddying the waters.

When we do intervene, yes, of course the child is never asked. As far as I'm aware there isn't any medication/intervention we give to children where we ask for their permission. Because they are children. One of the main reasons we distinguish between children and adults in our society is because we have decided that children do not have the mental maturity to make such decisions of large import, so we place that responsibility on parents/guardians/doctors/etc.

What do you mean "of course"?

Children have a right to take part in their own medical decisions as early as 7 years old, and teens make the majority of the decisions themselves after 14yo.

If teens can get tattoos (16+), can drink alcohol (16+), can work part time jobs (14+), under conditions (12+) and can get jail time (14+), then they can just as well make at least part of their own medical decisions.

Delaying permanent changes to a point in time where they can decide for themselves is the perfect solution if teens want to make such a decision, as long as it's safe (which even the cass review admits has been proven safe for AMAB people)

> Children have a right to take part in their own medical decisions as early as 7 years old

Where is this right enshrined?

> and teens make the majority of the decisions themselves after 14yo

Do you have a source for this claim? Where in particular is this the case? You say 14 but then most of the examples you give about choices with long-term consequences are at 16, since I wouldn't really include part-time jobs (not really a major life decision to bus tables or whatever) and jail time at 14 is the exception not the rule. We default to not putting 14 year olds in jail because again, we assume children are not entirely culpable for their actions at that age. Jail is reserved for particularly egregious infractions that we otherwise don't have a better social response for.

> Delaying permanent changes to a point in time where they can decide for themselves is the perfect solution

Right but isn't part of maturing going through puberty? If we block puberty, what is the point at which you can decide for yourself? Where do you draw the line?

Denying puberty blockers, which are easily produced, known to be acceptably safe, and can prevent physical changes, is forcing teens through a harmful puberty against their will.

Allowing puberty blockers, allows children to make uninformed decisions with lasting and harmful consequences to their own body and future. That's why this issue has went to various courts, ascending the hierarchy, in England where it has been found illegal, legal etc. See https://en.wikipedia.org/wiki/Bell_v_Tavistock and think how Keira Bell is likely to feel about your simplistic "it is safe" comments.

It is a complex issue and perfectly OK to be on one side or the other - what's not OK is pretending that only one side is right and the other is evil and abandoning all nuance - that seems to be the trans activist way tho.

It’s a bit silly that you’ve essentially written here “abandoning all nuance is bad, that’s what the other side does!”

This is ironic of course, since you’ve ignored the nuance that the Keira Bell case was specifically regarding the ability of children under the age of 16 to consent to this treatment themselves. It does not question the lawfulness of the treatment or guidance itself, and it has been clearly established that parents or guardians can give consent. I have absolute sympathy with Keira Bell and the struggles she has gone through, but it seems clear we should want to avoid using the legal system to intervene in clinical decision making to the greatest extent possible.

For the record though, I disagree with you - I don’t think it’s a particularly complex issue. It has certainly been ratcheted into a hot-button culture-war topic by quite a lot of ignorance and deliberate muddying of the waters though, which can have the effect of making things seem more complex than they really are. You’ve just done this yourself—even if unintentionally—in your comment.

How have they ignored the nuance of the Keira Bell case?

> It does not question the lawfulness of the treatment or guidance itself

Nobody is saying it does. The nuance is in fact what people are talking about. Many advocates for the trans community argue that under-16s should be able to choose such treatments for themselves without parental consent/oversight. The other side argues that trans issues should not be treated any differently than anything else, where generally children have limited say in medical interventions applied to them and that the responsibility is ultimately the parents'.

Just checking you know that Kiera Bell lost.

Given as they linked the wikipedia article, it seems likely they are aware. Just because she lost on appeal does not detract from the parent's point, which is that clearly these things are not harmless otherwise there probably wouldn't be such a court case.

Why link to wikipedia and not the court judgments?

Almost no healthcare is harmless. Anyone can sue for almost anything, there's a low threshold to bring a case. Notably she didn't sue for a personal injury case because she knows she would have lost that - she was strongly advised by her doctor not to proceed, but she ignored that advice and went ahead anyway. She was over 16 at the time, and capacitous, and so she got the treatment that she asked for.

Puberty blockers aren’t known to be safe. The FDA just issued a new series of warnings on blockers in the last month due to the severe side-effects being experienced by children on them, including brain swelling and vision loss: https://abcnews4.com/amp/news/nation-world/fda-warns-puberty...

That's besides the point the parent is making.

Nobody is FORCING anything – that is just something our bodies do naturally

This is just a silly semantic game. Our bodies naturally do a lot of things that in some cases we’d prefer they not do. They love growing babies, or tumours, or falling apart in uncountable ways.

Withholding access to an available and desired medical treatment is broadly equivalent to forcing a patient to experience the effects of whatever the treatment is intending to prevent.

We are just far more likely to use the explicit term “forcing” in cases where that treatment is being withheld for ideological reasons - such as abortions or puberty inhibitors.

> Nobody is FORCING anything

Well except Texas law makers

Idk what the effect of taking blockers for 3 years and then realizing its a mistake would be. Do you experience puberty for the same duration, to the same extent? If youre male, are you going to be shorter for instance?

Regarding clothing, maybe its just wrong to emphasize gender in the first place? I think a lot of people are cool with kids doing whatever, its just weird when the people around them start really reaffirming the decisions made by someone we dont trust to have autonomy in most things.

Maybe transgendered people have some biological or psychological drive thats distinct and not related to the people around them, but if I were around this rhetoric as a kid I can very easily see how it could have wrecked me, considering how I dealt with the subject of gender from pre to late teens. Maybe itd be a worthy price, Im skeptical but trying to make sense of it

> Idk what the effect of taking blockers for 3 years and then realizing its a mistake would be. Do you experience puberty for the same duration, to the same extent? If youre male, are you going to be shorter for instance?

There's no negative effects, as long as you only delay it for a few years (e.g. 10-13) and not too long (you should have entered some puberty around 16, or things get complicated).

As soon as you'll stop, your natural puberty starts, with the same duration and effects it'd have normally.

Puberty blockers are actually an off-label use when used for trans people. Puberty blockers are originally used for cis kids who enter puberty too early, and this use is far far more common than the use for trans kids.

So if they're safe to use on cis kids to delay transition, they're definitely safe for the trans usage as well.

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