LogFAQs > #968423771

Lily Osler (who is, disclosure, a friend) perfectly captures the terror of puberty for trans kids in a Waco Tribune-Herald piece exploring Texass ongoing crackdown on trans youth:

Puberty blockers are reversible, but the puberty that transgender kids would go through without them isnt. Puberty writes itself into your bones. Without blockers and, at an appropriate age, hormones, it forces transgender girls, who are girls like any other, to grow facial hair and broad, angular features, and forces transgender boys to grow breasts and wide hips. Its effects can only be reversed by very expensive and difficult-to-access surgeries in adulthood, and even then only partially.

This is not experimental care. This is care thats been around, in a very formal fashion, for over 50 years, says Michelle Forcier, a professor at Brown Universitys medical school and co-editor of Pediatric Gender Identity. We know that there are studies that demonstrate efficacy and safety.

The recent hyperfocus on trans youth is largely a media invention, says Jules Gill-Peterson, a history professor at Johns Hopkins University. Trans people and trans youth were never really objects of the media [until recently]. I really dont think most people ever encountered the idea that they shared the world with trans youth until the last 10 years.
The recency of that hypervisibility powers the notion that trans health care is somehow still experimental, abstracting something that is fraught with life-and-death stakes. For a trans person, the changes dictated by the body they were born into might prove incredibly painful, destabilizing, or even life-threatening.

The risks of withholding gender-affirming care vary from patient to patient but often involve things like worsening anxiety, depression, and suicidality, says Jack Turban, a professor of child and adolescent psychiatry at the University of California San Francisco. Recent legislation to take gender-affirming medical care as an option away across the board is extremely dangerous and will lead to bad outcomes. A 2022 study published in the Canadian Medical Association Journal found that trans teens were 7.6 times more likely to attempt suicide than their cis peers.

The risk of not allowing trans kids to begin living as themselves compounds the longer they are alive. In 2001, Anne Vitale, a California psychotherapist who has specialized in gender-nonconforming patients since 1984, published a groundbreaking paper in the journal Gender and Psychoanalysis surveying trans women at all stages of life who did not transition as young people. The picture she painted of these women in middle and old age is deeply sad. This anxiety, if left untreated, is manifested in confusion and rebellion in childhood, false hopes and disappointment in adolescence, hesitant compliance in early adulthood, feelings of self-induced entrapment in middle age, and if still untreated, depression and resignation in old age, she writes.

Theres an existential component to going through unwanted puberty, too, because with every day that passes, it becomes harder to get the world to treat you as who you are instead of what it perceives. If you are a cis person, imagine for a moment that, all evidence to the contrary, everyone in the world becomes convinced your gender is not what it is. If you are a man, everyone starts using she/her pronouns for you and calling you by a womans name. One day, you start insisting to the world you are who you are, and the world insists otherwise, because it cannot conceive of a self that doesnt begin from the body.

Are there people who later regret transition? Yes, but the data shows that the vast majority of people who pursue transition do not regret it. In the handful of studies conducted around this question, an average of about 2 percent of respondents express regret. A separate survey questioning why people detransition found the most common reason was social pressure, often from a parent. Many of those detransitioners retransitioned later, when it felt safe to do so. (See more on all of this data here.)

Not every trans person knows they are trans when they are young, and not every trans person decides to undergo medical transition. Decisions around how and when to come out as trans are private and can be made at any age. Ultimately, all medical decisions made should be between a patient and a doctor. However, for the trans people who know their gender identity from a young age and want to medically transition, every year spent not doing so often becomes all the more punishing.

Its hard to do this as an adult. Ive had patients that have had 60 years of gender hormones affecting their body. They have that internal trauma of living in this physical entity that doesnt necessarily reflect who they know themselves to be, Forcier says. If you look at the data of gender-diverse kids who grow up with parents who provide them the support and resources they need, their depression rates are equal to peers and siblings, and their anxiety rates are so much lower than what weve found for other gender-diverse persons [who arent supported]. Its shocking.

What drives so many parents to insist their child simply cannot be trans? Turban theorizes that it stems from an overly rigid fear of gender nonconformity, one that arose from the gender exploration all children naturally indulge in being met with mockery or punishment.

Those early experiences can stick with people and lead them to want to repress any nuance around gender, for fear that it may bring up difficult reflections about themselves, Turban says. Often, parents are afraid that their own children will be treated poorly by others due to their gender diversity, and so they may try to force their children to be gender-conforming, thinking they are protecting them.

That insistence is also fueled by the idea that trans kids are a new phenomenon that has popped up extremely recently, thanks to the increasingly flexible ideas about gender that have become popular online in the 21st century. Yet that notion, too, is inaccurate.

When we make the assumption that trans kids just showed up in 2015, the least generous version of that is that there were no trans children, period, before that. Thats empirically untrue and easily [disprovable], says Gill-Peterson. The more sophisticated version of that assumption is, Of course, there were trans kids, but they didnt medically transition. That didnt start until really recently. Thats also flat-out untrue. Trans youth have been transitioning as long as there has been medical transition.

Gill-Peterson wrote the 2018 book Histories of the Transgender Child, which traces the last 100 years of trans childhood and the hidden history of American trans children who transitioned either socially or medically from the 1920s onward. The medicine we use to treat trans children today often dubbed experimental has, in actuality, been used to help trans youths transition with the support of parents and doctors since the mid-20th century.