Modern cultures in Western societies are becoming increasingly tolerant of gender confusion as well as the view of sexual orientation as more of a spectrum than an essentialist concept, and though this does not come without robust backlash within those same communities, these heteronormative, androcentric cultures therein struggle with how to accommodate related phenomena that they have only recently become willing to acknowledge.
Physicians and gender therapists are contending more and more that children be administered puberty blockers in the event of gender confusion, and these practitioners make their recommendations for younger ages now than ever—as young as age nine for those with gender dysphoria. Researchers have recently published a new article highlighting the dearth of scientific evidence supporting the validity or usefulness of said puberty blockers, though.
This new publication, "Growing Pains: Problems with Puberty Suppression in Treating Gender Dysphoria," came out in The New Atlantis on Tuesday and unpacked some 50 peer-reviewed studies in an executive summary on child and adolescent gender dysphoria. The article is co-authored by Dr. Paul Hruz, professor at Washington University School of Medicine; Dr. Lawrence Mayer of Johns Hopkins University School of Medicine, professor at Arizona State University; and Dr. Paul McHugh, professor at Johns Hopkins University School of Medicine.
A year ago, McHugh and Mayer published together on sexuality and gender, pooling together the former's psychiatric expertise with the latter's medical knowledge. Collaborating with Hruz now, they add his pediatric savvy to tackle arguably even weightier subject matter, delving deeper so to speak.
Ryan Anderson is the William E. Simon Senior Research Fellow in American Principles and Public Policy at the Heritage Foundation, and he tackles this subject from the perspective he takes in his upcoming book, When Harry Became Sally: Responding to the Transgender Moment. He says that "the best biology, psychology, and philosophy all support an understanding of sex as a bodily reality, and of gender as a social manifestation of bodily sex. Biology isn't bigotry, and we need a sober and honest assessment of the human costs of getting human nature wrong. This is especially true with children.
"And yet, pediatric gender clinics—and therapeutic interventions on children—are on the rise. In the past 10 years, dozens of pediatric gender clinics have sprung up throughout the United States." In 2007, as Anderson points out, Boston Children's Hospital "became the first major program in the United States to focus on transgender children and adolescents," its website boasts. Anderson notes, "Seven years later, 33 gender clinics had opened their doors to our nation's children, telling parents that puberty blockers and cross-sex hormones may be the only way to prevent teen suicides.
"Never mind that 41 percent of people who identify as transgender will attempt suicide at some point in their lives, compared to 4.6 percent of the general population," Anderson states. This is to say nothing of the many people who underwent transition surgery and thereby became 19 times as likely to commit suicide on average.
"These statistics should stop us in our tracks. Clearly, we must work to find ways to effectively prevent these suicides and address the underlying causes. We certainly shouldn't be encouraging children to 'transition.' The sad reality is that while the number of pediatric gender clinics is growing, very little is known about gender identity in children—and many therapies amount to little more than experimentation on minors."
Modern practice bruits abroad professional standards of care that state children need puberty blockers cross-sex hormones by age 16 and puberty blockers before age 10; however, an executive summary reveals that there haven't been any controlled clinical trials that study the effects of these puberty-blocking agents on children with gender dysphoria. Additionally, none of these puberty blockers have approval from the Food and Drug Administration (FDA) for their intended use.
Advocates of puberty blockers also commonly suggest that puberty-blocking efforts are reversible, but there is no data to support this claim, which sets a very dangerous precedent for those who are thrust into the process with potentially no real escape rope and no real understanding of what will happen. As if none of these problems are enough, perhaps most detrimental is the fact that gender dysphoria may very well continue all the while.
Mayer, Hruz and McHugh delineate the ramifications of advocating these treatments for children as potentially driving "some children to persist in identifying as transgender when they might otherwise have, as they grow older, found their gender to be aligned with their sex," due to the much simpler fact that they remain children at age nine and, thus, can be confused not because of dysphoria but because of a lack of sexual stimulation and pubescent experience. They say, "Gender identity for children is elastic (that is, it can change over time) and plastic (that is, it can be shaped by forces like parental approval and social conditions)."
Consequently, if "the increasing use of gender-affirming care does cause children to persist with their identification as the opposite sex, then many children who would otherwise not need ongoing medical treatment would be exposed to hormonal and surgical interventions."
Anderson supplements this explanation by saying, "Whereas 80 to 95 percent of children with gender dysphoria will come to identify with and embrace their biological sex, none of the children placed on puberty blockers in the Dutch clinic that pioneered this treatment came to identify with their biological sex. All of them persisted in their transgender identity."