They Paused Puberty, but Is There a Cost?
nytimes.com
nytimes.com
I've been really dismayed by the vitriol by which I hear a lot of people talking about these issues. On the one hand the "right" calling doctors child abusers - the article mentions how doctors both against and for puberty doctors did not want their names used in the article - while the "left" label the right as existence defying, and hate-crime committers.
Looking for good reading materials on trans issues is very difficult too with most books I can find seeming to belong to one of these two camps also. I would love suggestions.
My opinion is that there is a hard and maybe unsolvable problem at the heart of the matter; trans children/teenagers clearly exist, and it may be that puberty blockers are useful for people who will eventually transition. However, the effects of the drugs are profound and long lasting and may have a deleterious effect on some. And we are giving the choice to take them to people too young to be allowed to vote, drive, or have sex. It is a moral paradox that might not have a clearly correct solution, but a failure to accept this paradox seems to be leading the polarization of a large swathe of society and the long term effects of that polarization are hard to guess at.
It seems that people want so much to be right and be on the right side of this issue that many of us our being blinded to the fact that moral paradoxes do not always have a right side. (I'm thinking of the example of whether you should swerve your car away from one pedestrian towards another one.)
While there is always a risk when having to take drugs for anything, the outcome compared to trans individuals who were force to go through puberty out-weight this risk.
There is literally no such thing as a ‘trans’ person. It’s medically and scientifically unproven. Political correctness is having a massive toll on these kids and everyone is too cowardly to stop it.
That's not to say that self-diagnoses of Gender Dysphoria should be taken at face value, or that it's always in the best interest to send a young person down the path of transitioning, but at the same time there is a population for which transitioning can greatly improve quality of life.
Honestly, if society DID care about their well-being, it wouldn't allow puberty blockers, hormones, or surgeries.
Let's say you're correct about even 90% of cases (I don't think it would be quite this high, but let's just assume). What then about the 10% where transitioning really helps them deal with life? Do we just make their life miserable?
To be honest with you, I wouldn't suspect if this is where we end up in 20 years' time when the pendulum swings the other way, but either way it's not an ideal situation.
A citation could be useful. I suspect that good data on this is difficult to generate, .
> There is literally no such thing as a ‘trans’ person.
This is a pretty difficult statement to contend with, because we need to unpack what you mean by `trans`. I've met transgender people, they certainly do exist, but if you're claiming that those people are not really transgender but just gay men dressing up as women and being performative, we'd have to dig deep into Judith Butler literature to find some common language.
[1] https://www.psychologicalscience.org/news/few-transgender-ch...
Did you used to identify as trans?
I occasionally chat with a person I know IRL about the potential destructiveness of a politicised approach to trans issues, and they're in education too. Used to self-harm, actually, and noticed that a lot of (mostly FTM) trans kids fit into the same demographic that they did as a kid.
I'm on the spectrum and had some pretty serious mental health issues myself as a teenager, so I see a different side to the same coin (mainly emotionally dysregulated MTFs).
On the flip side, Gender Dysphoria is 100% real and transitioning is an incredibly helpful medical option for those who happened to be born this way.
It's an incredibly hairy issue, and I don't think simply dismissing it as a "cult" is the right way to deal with it.
I understand the temptation to label something you don't believe in as a cult, and you can for sure observe some of the traits you'd expect in cults in some of the trans discourse online. Overall though it's too reductive; transsexualism has not been dreamed up by a cult leader, it's something recorded and observed for thousands of years.
The recent explosion in the discourse warrants more thoughtful and careful interrogation, and less casual dismissal.
There is historical evidence of cross-dressing, and of people (mostly men) being prescribed different societal roles that were apparently based on being effeminate. As far as I am aware, there is no evidence that such people were treated as if they were actually the opposite sex, as gender activists these days propose.
OP however was less nuanced and more reductive.
I got the impression that it is only a handful of individuals who are doing this, for example that guy who recently had a large cloud services provider shut down a website that exposed his unsavoury activities in this space.
Except it is. There's no research that show significant rates of desistence in the relevant population, which is children who want to transition. Rates of persistence are high in this population. Rates of regret are low, and are far lower than many other common forms of surgery.
https://www.sciencedirect.com/science/article/pii/S188898912...
We have decades of research on this. Rates of desistence are low. Rates of regret are low, and are lower than most other forms of medical care.
Edit: Even the submitted article admits that on one side you have medical opinion and science saying PBs are safe and reversible, but that you have Republican politicians saying they're harmful. It doesn't present any evidence that PBs are harmful. I notice that you haven't either.
And anti-trans campaigners can't, because their position is incoherent. PBs are apparently so dangerous we can't give them to children, but children who've had them are still so powerful we can't allow them to compete in sports because they'd win everything.
That doesn't really map onto the recent idea of 'non-binary', where one's sex is supposed to be entirely ignored, and the idea of someone being a 'non-binary man' or a 'non-binary woman' is generally considered wrong or even offensive to believers of this ideology.
No we aren't. These are prescription only meds that are obtained after considerable, sustained, effort to engage in bio-psycho-social assessment and treatment programmes.
I think you've accidentally set up a straw man. I didn't say they're not being prescribed, nor that they are being given without any consideration, but that they're being given to minors (12 or 13), which is true and discussed in the article. It's likely that are pros and cons to this, also discussed in the article.
I think it would be fairer to say that people who desire to be the opposite sex (or both, or neither) exist, and if this reaches the point of significant distress, then it fits the criteria for a medical diagnosis, with which they may be offered certain hormonal drugs and surgeries, as an attempt to alleviate that distress.
Whether this makes them "trans", an ideological viewpoint under which they are treated as if they are the opposite sex (expressed concisely in slogans such as "trans women are women") in various contexts, is a different matter.
Which makes this issue two separate but related questions:
- Are hormone blockers, exogenous hormones and surgery an effective treatment for this group of people? (And if so, how do we tell who is actually in this group? Does it include children?)
- Should people who desire to be a different sex to what they are, be considered as such in law and policy? (And if so, should there be limits to this? And how do we balance the rights of others who don't share this ideological viewpoint?)
Trans people consistently describe going through puberty without access to hormones or blockers as traumatic. Traumatizing children is bad and should be avoided. The thing is, the effects of going on HRT are pretty close to the effects of natural puberty, so we can reasonably assume that a cisgender child going on HRT unnecessarily is about the same level of badness as a trans child not being able to get puberty blockers or hormones.
The article says that 98% of kids who take hormone blockers go on to take HRT, and I've seen similar numbers elsewhere. Since you can't tell whether someone is in the 98% of true positives or 2% of false positives at the start, then you have to make the same decision for all of them, and it just doesn't make sense to sacrifice the 98% for the well-being of the 2%. This would be very bad for the 2%, of course; that's why doctors prescribe blockers in the first place. But if the best option isn't available, you have to go with the least bad option.
(I suspect the ratio in this situation would be even better than 98:2, since real life isn't an abstract ethical dilemma. For example, many of these kids would be willing to go on blockers but not hormones, and they would likely be disproportionately in the 2% category, so they would avoid getting the wrong treatment.)
That's hard to verify objectively, even if it feels true.
I would say it is the choice of the editorial board ultimately, who are beholden only to themselves and to some extent their advertisers.
I did find that the style of this article marked it as unusual for NYT, in that it doesn't come down strongly on one 'side' and is an unusually even handed discussion of the state of play.