Kids... Should they get gender affirming surgery, take HRT, etc?
This is a hot topic right now, there seems to be very emotional and heated discussion all over the place. I know my feelings on the topic but what are others in the community really thinking?
I have mixed feelings about this, some based on history, more on the years I spent in therapy and studying psychology, and more based on personal life experiences. A lot of it depends on the kids themselves. Are we talking about the average teen with an average IQ of 100, or are we talking about someone like myself that has scored above the 99th percentile on half a dozen IQ tests? Historically, 150 years ago the average late teen was probably already married, running their own farm or had completed an apprentice and was working a a journeyman craftsman and raising a family. Now we seem to think that kids aren't old enough to learn to drink responsibly at 18 but they're responsible enough to go kill for whatever the corporations currently want us to kill. Do I think it's okay for young teens to start HRT or SRS, I would say in almost all cases no. Do I think it's okay for them to take puberty blockers until they're old enough and have learned enough about themselves to make a permanent decision regarding HRT and surgery, yes. Do I think parents should have the final say? Absolutely not. I think by the time a kid is 13 or 14, they have enough education and knowledge about themselves to make a decision that is reversable4 or 5 years down the road should they decide against continuing. I knew I was very different from my male peers by the time I was 6. Did I know enough when I was 14 to make a permanent decision like SRS, no. I was 14 in 1967 and I don't think the word transgender was even in the common vocabulary at that time. I did know I hated being a male and would have preferred being a girl, but my knowledge back was limited to two different genders and two types of sexuality, hetero and homo. Granted, things have changed a lot in the last 50 years, but I still don't think most teens are educated enough, or have had enough time to learn and understand about themselves to make that sort of permanent decision.
It’s a great pity and shame that most of the above choices are now criminalized in some parts of the world despite the wealth of medical evidence in support of gender affirming care for children and youth.
I think puberty blockers are appropriate for kids until at least 18 years of age. That should allow them sufficient time to really consider the life altering question of surgery. I disagree with any surgery before that age. I also believe the parents should participate in blockers decisions but should also strongly consider the kids needs and desires.
This topic seems to be a real hot button for conservatives, but I also think that some misinformation has been spread. They leave the impression that affirmation surgeries have been performed on children. From what I remember, the youngest was 13 and there are very, very few cases like that.
There is a danger with allowing parents to decide what happens. The granularity of the questions don’t make a distinction between parents being the sole decision makers or sharing the decision with their kid, a therapist and a medical doctor. In theory, yes the parent should be involved, but that can totally block the process for what the kid really needs help. Worse, they could force their kid into conversion therapy, but as we know, that does not work. But, it you took the patents completely out of the loop and the kid started HRT or later started affirmation surgeries, what sort of support would they come home to?
In general, I do not like the idea of moving forward with transition only based on the person’s consent. There has to be checks and balances. The danger is that if they detransition, based on what it didn’t do for their dysphoria, it becomes easy for conservatives to say that transition should not be allowed because it doesn’t work. The fact that transitioning has helped MANY, MANY people is lost in the smoke and haze. Notice how conservatives trot out Walt Heyer to talk about transitioning/detransitioning. The truth of the matter is that he gamed the system. He lied and distorted what he told his therapist in order to get them to sign off. However, I believe that he should have never transitioned in the first place. It used to be that the bar was living as your target gender for a year. While I think that should be reduced, I think it is a good idea.
I question waiting until 18 to do any sort of affirmation care. That would mean that the kid would likely have gone through several years of misery. To me, that would be hard to justify. It would likely mean that anti-depressants and anti-anxiety drugs would be used and I don’t feel that’s a good idea as it doesn’t address the root of the problem. It only puts a band-aid on the symptoms.