Q&A: Doctors on Puberty-Delaying Treatments

by Alix Spiegel

http://www.npr.org/templates/story/story.php?storyId=90234780

NPR.org, May 8, 2008 · A small group of doctors around the world have introduced a controversial approach to the treatment of pre-teens and teenagers who believe they are the opposite sex.

Right before puberty begins, they prescribe children hormone-blocking medication. This allows the child to continue to grow without developing physical characteristics like breasts, facial hair, or Adams Apples. Later, the child can elect to return to their natural puberty or can begin a gender transition by taking the sex hormones of the opposite sex.

i've read a lot oabout this in bits and pieces (mainly new scientist a while ago)

I used to think it was a really good idea, but now i'm not so sure, i've been doing a lot of reading on childhood GID and apparently only about 10-20% of the children who show signs of GID go on to develop GID in adulthood. In some cases they just grow up gay but identifying with their biological gender, in some cases it's just a phase (appologies for the cleche).

This treatment is a bit risky. There are no immediately apparent health risks, but new and a bit of an unknown. Though puberty seems to start normally if they discontinue it there are quite a few ill effects that seem plausable: future fertility problems, psychological development, or cancers in reproductive organs (including breasts). I'd be reluctant to privide it to any except the most severe cases.

However by providing it to only severely destressed cases you risk driving moderate cases to destructive behavious (like self-harm) to get what they want at the time, even if it's not in their best interest long-term. Adolecents are strange beasts... quite hard to treat. I'm only in my 20s but there are already a few things that i want to go back and give my adolecent self a good slap for.

In the interview, Dr. Spack takes the attitude that if the studies show substantial success they must be true.  That none of the kids in the Dutch programs changed their minds about transitioning is a powerful finding and one no one should ignore.  But Dr. Carmichael was very reluctant to lend across the board credibility to the Dutch program and remained of the belief that the pre-pubescent hormone blocker programs had not proven itself sufficiently for her to adopt or condone that practice.

What stood out to me in the Carmichael interview was how she repeatedly said this was a very complex issue.  With my own eyes I saw this as meaning FOR HER this is a very complex issue.  It seemed she was really struggling with idea it is better to suppress hormone production until the child was of sufficient age to decide for themselves.  But, as someone who has to deal with the realities of trying to undo what male hormones did to me, I am completely convinced the Dutch program is the far better method.

I wonder what Dr. Carmichael would say if she had to undergo a couple hundred hours of electrolysis, work constantly on keeping her voice in the female range, have FFS to to give her face a more feminine appearance and wonder every day, even after all this, if the world will gender her as male or female.  I think she'd be singing a different tune.

Julie