A doctor helps children change their gender

[FireStarterRN]

What do you think, if a little kid wants to be a different gender, should they start hormone therapy right away? I was a tomboy as a girl and wanted to be a boy, but it was a passing phase. I grew up to be a sexually normal adult woman who doesn't like make up, likes gender neutral clothes, and is totally satisfied with being a woman.

http://www.boston.com/bostonglobe/ideas/articles/2008/03/30/qa_with_norman_spack/?p1=Well_MostPop_Emailed5

Last year, the pediatric endocrinologist started a new clinic at Children's Hospital Boston; it is one of a few in the world to give children treatments that change their bodies. Working on a model borrowed from Dutch researchers, Spack uses drugs to delay the first stirrings of youngsters' puberty, granting them a few more years before they develop bodies that are decidedly male or female. The effects of these puberty-blocking drugs are reversible; that is, patients can later change their minds. Unfortunately, this is not the case with hormones. Therefore, Spack prescribes estrogen and testosterone to only a few teenagers - after months of consultation with the patient, his or her caregivers, and psychiatrists. When kids take this step, they are rewriting their own future: The hormones have a powerful, pervasive effect, changing their height, breast development, and the pitch of their voices

[FireStarterRN, BSN, RN]

I hardly think that stating my agreement with another poster as "the voice of reason", is unkind.

I think it's very plausable that some of these children will change their minds. I guarantee that this doctor will be sued by one of them down the road.

Mentally disturbed children cut themselves for a variety of reasons. So, when they think the reason is gender confusion, then we start them on an irreversable road towards reassignment?

What if they are cutting themselves because they are reacting to the birth of a younger sibling, or they hate their mother?

There is something deeper wrong with a child that wants to cut him/herself or is suicidal.

As far as adults, they can make their own decisions in a free society. Children need protection from ideologues who think they know best for them, whether they be pioneer psychiatrists or leaders of religious cults...

[kxvc]

Please do not misconstrue my words. I strongly believe in providing help for transgendered children. The "rash decision" I was referring to was making irreversible changes in a child for the reasons I have previously stated.

I know not all 1.9 million hits of your search were on the topic of making such changes in children because I googled it myself.

Lastly, straight out of the link you provided us, I believe you just supported my logic...

"Any decision you make about your child’s adulthood should come only after you have a thorough understanding of all the consequences.

The best advice this author can give is "never say never". Do not plan too far ahead and never make a decision that cannot be changed. Surgical changes are forever and should be left up to the individual whenever possible."

This said, I refuse to discuss this with you further unless you're able to make any valid points which could make me see differently; I strongly doubt you will. Lets just agree to disagree and leave it at that.

[leslie :-D]

you know, i think it would benefit everyone here, to read about the plights of transgendered kids, before deeming it unethical or abusive.

just google 'help for transgender children'...

soooo much information out there.

and w/that, i have nothing more to add (at this time).

educate yourselves.

this is NOT a transient stage that goes away.

these kids have tried all sorts of therapies, including aversion therapy. and still, their feelings get stronger as they get older.

there are all sorts of transgenders out in mainstream society.

this is their identity.

let's give these kids a chance at growing up in healthy, loving relationships.

you just cannot appreciate the depth of their anguish, unless you choose to become informed.

please, just take some time and read about these kids.

and then, you can make an educated decision.

leslie

[chenoaspirit, ASN, RN]

I hardly think that stating my agreement with another poster as "the voice of reason", is unkind.

I think it's very plausable that some of these children will change their minds. I guarantee that this doctor will be sued by one of them down the road.

Mentally disturbed children cut themselves for a variety of reasons. So, when they think the reason is gender confusion, then we start them on an irreversable road towards reassignment?

What if they are cutting themselves because they are reacting to the birth of a younger sibling, or they hate their mother?

There is something deeper wrong with a child that wants to cut him/herself or is suicidal.

As far as adults, they can make their own decisions in a free society. Children need protection from ideologues who think they know best for them, whether they be pioneer psychiatrists or leaders of religious cults...

I totally agree. My stepdaughter used to cut herself and it had nothing to do with gender identity. And if this is to become accepted, it will not remain for only "last resort", it will become our future and its scarey. There would be alot of children grow up and realize, but it would be too late. I think these children should be allowed to identify and express themselves but not to that degree. This world is getting scarey. Also, I can google "life sucks" and get approximately the same return of results too. No offense, but you can find anything on both sides of everything on the internet, but you have to weed out what is trustworthy

[traumaRUs, MSN, APRN]

Everything on the internet isn't true, reputable and/or ethical. Just because you can find someone to perform this surgery, does not mean you should have it done as a CHILD. When one becomes an ADULT and presumably can make rational decisions and has some degree of maturity, then that is clearly their decision. However, to do this to a CHILD is unthinkable except in the case of ambiguous genitalia. This is too new a procedure to have any long-term research studies so how do we know the consequences. Adolescence and puberty are normal parts of growing up. Much angst occurs even to those who are not transgendered. Here is one source found in Up To Date (used by practitioners, not info usually provided to pts):

"Juvenile gender dysphoria — Adult transsexuals often recall that their gender dysphoria started early in life, well before puberty. Children with gender identity problems increasingly come to the attention of the psychomedical care system. A reliable estimation indicates that only about 20 percent will become transsexuals in adolescence [23] . Homosexuality will more often be the outcome"

http://www.uptodate.com/online/content/topic.do?topicKey=r_endo_m/11460&selectedTitle=3~5&source=search_result#29

My concern (and seemingly a legitimate concern) is that childhood and adolesnce is a time of rapid growth and development and not one where this decision should be made.

[CHATSDALE]

puberty is difficult enough it being postponed, drugs potent enough to cause this are going to cause some other problems

many children who hate their bodies are having problems with the parent of the same sex, they don't want to grow up to be their fathers/mothers

another factor is, i believe, that this is ripe for munchasens by proxy

i believe that postponing this to after the child is going to understand that this is something they will have to live with for the rest of their lives

[leslie :-D]

you just cannot appreciate the depth of their anguish, unless you choose to become informed.

please, just take some time and read about these kids.

and then, you can make an educated decision.

leslie

ok, so this is exactly what i have been doing:

reading article after article about transgendered kids and their needs.

i will concede that any permanent surgery, is best saved for late adolescence.

but i remain just as convinced that giving meds to delay puberty, is ethical and necessary...

knowing that it is fully reversible.

most of these kids know as early as 2-4yo, that they are in the wrong body.

and this sense of self only deepens as they get older, thus the high suicide rates amongst teens.

the despair is overwhelming if parents make them feel abnormal.

my bottom line is this:

as long as the child can safely be raised in an environment where their feelings are respected and supported, then that is half the battle.

ea and every article i read, showed exactly this:

that when 'allowed' to be a girl/boy, they were so much happier and well adjusted.

love and support is everything.

so as long as parents take the time and energy needed to invest in the well being of their child, the child can make his/her own decisions later in life.

it's imperative to remember, that w/o this support, i.e., "no, you cannot wear your sister's dress", or "whether you like it or not, you are a boy", the child is much more likely to fail and even succumb to other desperate measures.

so listen to your kids, and love them for who they are.

all the rest should fall into place.

leslie

[birdgardner]

We watched a video on this for a psych class. There was one boy who absolutely identified as being a girl, who truly gave me the impression of in the wrong body.

There was another boy who seemed always to have always been timid and fearful from toddlerhood (family videos) and who seemed to feel safer as a girl exempted from male competition and physicality. His mother seemed to have played to his fears rather than trying to build his confidence, and to have indulged him in dressing as a girl very early as a comfort measure and in secrecy from her husband, a conspiracy between the two of them, with all the strain of "We won't tell your father." Very sad, very sick, and yet the mother was portrayed as a sensitive, noble advocate for her child.

There was also an adult male-female transsexual who'd gone as far as castration and breast augmentation, who seemed to be completely narcissistic, fascinated with his own body as an erotic object. He lived in partnership with another male-female transexual - so why go to all the surgery and trouble to be a woman (with a member) just to end up like that?

There seem to be many motivations for transsexualism beyond the sense of being in the wrong-sexed body. IMO the physicians ought to be more careful about who they give the go-ahead to.

[bassandtea]

.... Children are children, not little adults. They should not be allowed to make decisions of this magnitude on their own, nor should their parents make them for them.

... There is no way these children are giving informed consent because their minds do not see beyond the here and now. I believe this to be completely unethical. They have no right.:angryfire

I mentioned earlier that I see this as also offering benefit to children born with ambiguous gender. Currently the parents of such children choose what gender their children will be often leading to surgery as a baby or child. In such cases children are too young to give any kind of consent. In the case I know of personally the parents chose the gender of their child, and even as an adult this individual finds it difficult to live with the choices of the parents and undergoes treatment with a number of hormones to live as the gender their parents chose.

While this is different from being transgendered some of the same principles apply. Furthermore the main focus of what this Doctor is doing is to delay puberty - in a reversible manner - to either a time when the individual and parents feel a decision can be made about gender re-assignment or for gender re-assignment to not happen.

[SuesquatchRN, BSN, RN]

We watched a video on this for a psych class. There was one boy who absolutely identified as being a girl, who truly gave me the impression of in the wrong body.

There was another boy who seemed always to have always been timid and fearful from toddlerhood (family videos) and who seemed to feel safer as a girl exempted from male competition and physicality. His mother seemed to have played to his fears rather than trying to build his confidence, and to have indulged him in dressing as a girl very early as a comfort measure and in secrecy from her husband, a conspiracy between the two of them, with all the strain of "We won't tell your father." Very sad, very sick, and yet the mother was portrayed as a sensitive, noble advocate for her child.

There was also an adult male-female transsexual who'd gone as far as castration and breast augmentation, who seemed to be completely narcissistic, fascinated with his own body as an erotic object. He lived in partnership with another male-female transexual - so why go to all the surgery and trouble to be a woman (with a member) just to end up like that?

There seem to be many motivations for transsexualism beyond the sense of being in the wrong-sexed body. IMO the physicians ought to be more careful about who they give the go-ahead to.

I know some transgendered people. One is a woman who has Klinefelter's syndrome - genetically XXY. Sterile, never fully masculinized, and is now very happy as a woman. Another was a male born with undescended testicles and a member that never fused who was wrongly assigned a femal identity in childhood without any genetic testing having been done. He had reassignment surgery done, wow, three decades ago, and last seen was in a very happy heterosexual relationship.

I agree that not everyone is truly transgendered - the erotically-fixated male-to-female individual might have a disorder (a controversial diagnosis) called "autogynephilia," in which getting and having a lady parts becomes a fetish all its own.

That said, if the only thing that made sense to me about my gender was that I was attracted to the "right" sex, that would not be a reason to remain that gender.

The help being proffered to these children is the opposite of rash. It allows them MORE time in which to make an irreversible decision.

[SillyStudent, ASN, RN]

Wow, this thread took off. Thanks, OP! :)

Bottom line, the children are being offered more opportunity to make their decision before the irreversible changes brought on by puberty happen. Whatever you think of Gender Dysphoria, or Trans people in general, this doctor is helping teens make a responsible decision....rather than kill themselves (in many cases)...and WITHOUT making irreversible changes to their bodies. No one is suggesting that 10 year old boys get estrogen as their first treatment. No one is lobbying for breast implants or SRS for said kid. Just a little more time to think about it.... Win-Win according to me.

You might wonder why I am so opinionated about this subject. My best friend is a M-to-F transexual. She is lucky to be alive, because of people that do not understand her disorder and make irresponsible, crass remarks...or feel that she can somehow be 'fixed' by meds...or that she can just 'get over it'. I wish she had been offered this opportunity 30 years ago.

Thanks

SS

[Spidey's mom, ADN, BSN, RN]

Thank you, the voice of reason.

I spent my entire childhood wanting to be a boy. I even had an elborate fantasy that I actually believed that I was really a Martian boy named Jupiter who had come to Earth in this body (a female) in order to study the human race. I believed this for a year, I had an invisible member. Since I was adopted, it all fit together nicely.

Once I hit puberty I started coming to terms with my gender and have had a normal (average, ordinary, not unusual) sexual life as a heterosexual woman, borne several children, enjoyed breastfeeding, etc.

When I was a girl, the thought of getting breasts appalled me! They sounded like totally inconvenient appendeges.

I agree that childhood is the wrong time to do this.

I too had an elaborate fantasy that I was from Venus and was dropped down onto Earth because my REAL family needed to fight a war in outer space. They sent a man named "Marshy" from Mars to check up on me and keep my informed regarding their fight.

The reason for the fantasy?? My own family was so dysfunctional. My parents fought all the time - physically and verbally. I just wanted out.

I think childhood is the time for questions about absolutely everything. Making permanent decisions at that time is premature.

I too was a tomboy. Maybe the problem isn't with the kids - it is with the definitions.

Let girls be tomboys without teasing them. Let boys play piano and dance without teasing them.

Then maybe they wouldn't have sex changes. They would be comfortable with who they were and with their bodies.

Maybe we are coming at this from the wrong end . . . . instead of changing the body - change peoples' expectations.

Change my family - get my parents some counseling and show them how to raise children without being selfish.

Instead of surgically removing me.

That seems easier to me.

steph