The problem with all of the arguments made in articles like this is that they can’t explain why giving puberty blockers to trans teens is bad, they just pretend like we don’t know the side effects of these drugs in children. We know the side effects.
I’m not aware of anyone who claims that side effects of the drugs are the issue. From my point of view, the concern is that successfully changing the gender of a child, with 0 side effects, might not be the best thing for the child in the long run.
Like I say, I’m not agreeing or disagreeing with the concern, just articulating it. I think the sensible thing to do is just to study it objectively and follow the science; if it seems like the mental health outcomes for the kids is better one way or another, than that way is the way to do it.
And, of course, there’s always the question of de-transitioning and people regretting the changes done to their body during the transition process. One thing I would like you to think long and hard about, is the fact that 20% of people who get total knee replacements are dissatisfied with their outcome. 1 in 5 that get knee surgery are unhappy with the results, and that’s a surgery that is generally very successful.
I also think the way we do joint replacements isn’t right, but that’s a totally separate topic.
Compare that to transitioning (this includes all forms of transition, however only 25% of trans people have any type of gender affirming surgery, source 2015 US transgender survey). Only 8% of trans people report de-transitioning. 62% of them do so temporarily and return to living as trans full time. So less than 4% of trans people de-transition permanently. And the great thing about puberty blockers is that if someone wants to de-transition during the course of taking them, all they have to do is to stop taking them, at which point they will go through puberty
This all seems like a pretty cogent argument. Actually, I’d take it a step further than what you’re saying – I’d say that if a fully functioning adult wants to get a knee replacement or a gender transition, it’s nobody’s business but theirs whether or not they should do it. It’s relevant to talk about the long term outcomes and etc, but at the end of the day it’s up to them.
But that whole thing is separate from the question of doing it in adolescents. I asked for something about them specifically, and you did send me specific studies, which was what I was asking for so that’s excellent. Here’s my reaction:
“Gonadotropin-releasing hormone analogues are commonly prescribed to suppress endogenous puberty for transgender adolescents. There are limited data regarding the mental health benefits of this treatment.”
“This is the first study in which associations between access to pubertal suppression and suicidality are examined. There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.”
I think this one is a very poorly formed study. When we study physical health, we’re careful to avoid the placebo effect because it will foul up the data severely if it’s not controlled for. Taking a group of people who have received life-altering care, and asking them on a timeline of 6 months whether the life-altering care they received benefited their mental health, creates a huge bias in favor of them saying that yes, it did.
That doesn’t mean the care doesn’t help them in the long run. But to me this study doesn’t indicate anything in particular about whether or not it does.
This one seems a little better, although it suffers from that same self-reporting issue, the sample size is 55, and the timeline ends at age 20, all of which are problems.
This is the first one that sounds rigorously structured to me, and that I was really starting to look at as capable of giving a good answer… and then when I got to the conclusions, I arrived at:
“Given the potentially life-saving benefits of these medications for TGD youth, it is critical that rigorous longitudinal and mixed methods research be conducted that includes stakeholders and members of the gender diverse community with representative samples.”
Well… I mean, I’d agree with that. It sounds like what they’re saying is exactly the same as what I’m saying – that a lot of studies in this area had some sort of moderate-to-severe flaws that made it difficult to draw rigorous conclusions from them, and that we need to study this with a lot of scientific rigor, because the potential impacts (positive and negative) on the lives of the people involved are huge.
That’s not me “concern trolling” or anything, and I’m really not trying to come at this from some kind of ignorant perspective. It just seems to me like a lot of people tend to take it for granted that of course giving gender-impacting hormones to adolescents who want them is a good thing, and any attempt to raise concerns about it, or argue that we need to study it with a lot of rigor, is some kind of coded hatred that’s designed to ruin their lives, and we need to attack that person and say they’re just covering up their malicious and hateful intent.
Can’t we agree on that? That studying the long-term impact of something so hugely impactful to a person’s life is a good thing to do, and not just assuming one side of it is right and attacking anyone on the other side?
I’m not aware of anyone who claims that side effects of the drugs are the issue. From my point of view, the concern is that successfully changing the gender of a child, with 0 side effects, might not be the best thing for the child in the long run.
Like I say, I’m not agreeing or disagreeing with the concern, just articulating it. I think the sensible thing to do is just to study it objectively and follow the science; if it seems like the mental health outcomes for the kids is better one way or another, than that way is the way to do it.
I also think the way we do joint replacements isn’t right, but that’s a totally separate topic.
This all seems like a pretty cogent argument. Actually, I’d take it a step further than what you’re saying – I’d say that if a fully functioning adult wants to get a knee replacement or a gender transition, it’s nobody’s business but theirs whether or not they should do it. It’s relevant to talk about the long term outcomes and etc, but at the end of the day it’s up to them.
But that whole thing is separate from the question of doing it in adolescents. I asked for something about them specifically, and you did send me specific studies, which was what I was asking for so that’s excellent. Here’s my reaction:
“Long-term follow-up studies are needed to determine the safety of these treatments in this age group.”
“Gonadotropin-releasing hormone analogues are commonly prescribed to suppress endogenous puberty for transgender adolescents. There are limited data regarding the mental health benefits of this treatment.”
“This is the first study in which associations between access to pubertal suppression and suicidality are examined. There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.”
So that sounds pretty good to me.
I think this one is a very poorly formed study. When we study physical health, we’re careful to avoid the placebo effect because it will foul up the data severely if it’s not controlled for. Taking a group of people who have received life-altering care, and asking them on a timeline of 6 months whether the life-altering care they received benefited their mental health, creates a huge bias in favor of them saying that yes, it did.
That doesn’t mean the care doesn’t help them in the long run. But to me this study doesn’t indicate anything in particular about whether or not it does.
This one seems a little better, although it suffers from that same self-reporting issue, the sample size is 55, and the timeline ends at age 20, all of which are problems.
This is the first one that sounds rigorously structured to me, and that I was really starting to look at as capable of giving a good answer… and then when I got to the conclusions, I arrived at:
“Given the potentially life-saving benefits of these medications for TGD youth, it is critical that rigorous longitudinal and mixed methods research be conducted that includes stakeholders and members of the gender diverse community with representative samples.”
Well… I mean, I’d agree with that. It sounds like what they’re saying is exactly the same as what I’m saying – that a lot of studies in this area had some sort of moderate-to-severe flaws that made it difficult to draw rigorous conclusions from them, and that we need to study this with a lot of scientific rigor, because the potential impacts (positive and negative) on the lives of the people involved are huge.
That’s not me “concern trolling” or anything, and I’m really not trying to come at this from some kind of ignorant perspective. It just seems to me like a lot of people tend to take it for granted that of course giving gender-impacting hormones to adolescents who want them is a good thing, and any attempt to raise concerns about it, or argue that we need to study it with a lot of rigor, is some kind of coded hatred that’s designed to ruin their lives, and we need to attack that person and say they’re just covering up their malicious and hateful intent.
Can’t we agree on that? That studying the long-term impact of something so hugely impactful to a person’s life is a good thing to do, and not just assuming one side of it is right and attacking anyone on the other side?