ZINNIA: Hi, welcome to Gender Analysis.
So, someone by the name of Blaire White made a video about gender transition treatment
for transgender children and adolescents.
And I’m going to fact check it!
BLAIRE WHITE: And of course, it begs the question of transgender children in real life.
And I’m sure I chose a title for this video that lets you guys know up-front my feelings
about children transitioning, but let me just say, I am against it, I am against it, I am
against it.
I have dealt with so many people trying to convince me that it’s a good decision to
allow children to go on hormones or puberty blockers, and, you know, start their transition
really, really early, and I’ve never been convinced.
ZINNIA: It’s important to be clear on the respective roles of puberty-blocking drugs
and hormone therapy in the treatment of trans youth.
Many of these kids have already been consistently presenting and living socially as their identified
gender for years.
When this treatment is indicated by thorough evaluation and proper diagnosis, puberty-blocking
drugs – not sex hormones – are given to trans children near the onset of their initial
puberty, usually starting around ages 10 to 12.
These drugs reduce their testosterone or estrogen to very low levels, temporarily halting the
physical changes of puberty due to hormones.
Trans children receive these injections or implants regularly for years in order to hold
off these changes.
This allows more time for them to be evaluated frequently by medical and psychological professionals
and helps children be certain of whether they ultimately want to transition.
If they choose not to transition, they can stop taking puberty blockers at any time,
and their initial puberty will simply resume and continue normally.
This is why the medical field, including the American Academy of Pediatrics and the American
Psychiatric Association, classifies these blockers as fully reversible.
These are safe medications that have been in use among both trans and cis children for
decades now.
Again, puberty blockers are not hormones.
They stop hormones.
If, after this time on puberty blockers, a teenager does choose to transition, they can
start taking estrogen or testosterone at age 16.
These hormones do produce more permanent changes that are not necessarily reversible.
While Blaire White describes this as “really, really early”, keep in mind that this treatment
results in a puberty that occurs years later than it usually would, along with being subject
to ongoing medical monitoring and control.
BLAIRE WHITE: And listen, there are very few topics in this world that I feel like being
transgender myself I have a bit more of an expertise on, but this is definitely one of
them.
ZINNIA: There are others who also have expertise on this topic, such as major medical organizations
and many hospitals.
In addition to the American Academy of Pediatrics and the American Psychiatric Association,
the proper use of puberty blockers for trans youth is also supported by the American Psychological
Association, the American College of Osteopathic Pediatricians, the American Academy of Child
and Adolescent Psychiatry, the American Academy of Family Physicians, the Endocrine Society,
the World Professional Association for Transgender Health - and me, being transgender myself.
This treatment is available via clinics at major institutions, such as Johns Hopkins
Children’s Center, Boston Children’s Hospital, Children’s Hospital Los Angeles, Columbia
University Medical Center, Children’s Hospital of Philadelphia, Lurie Children’s Hospital
of Chicago, Children’s National Medical Center, and Hasbro Children’s Hospital,
to name just a few.
Not only is this a broad medical consensus, it’s a widespread and accepted practice
affirmed by decades of clinical experience.
So:
BLAIRE WHITE: I am against it, I am against it, I am against it.
ZINNIA: The American Academy of Pediatrics is for it; the American Psychological Association
is for it; Johns Hopkins is for it.
Blaire White is against it.
Why?
Why do tens of thousands of physicians and specialists endorse and provide a treatment
that’s not good enough for Blaire White?
BLAIRE WHITE: So here’s my first reason and honestly the biggest reason why I think
that children should not be able to medically transition.
Being on hormones sterilizes you.
A lot of people don’t really seem to know that it sterilizes you, I think in part due
to all the trashy tabloid headlines like every other week talking about ‘Transgender Man
Gets Pregnant’.
But it really does sterilize you.
I’ve been on hormones for about a year and a half and I am completely, 100% sterile.
I can never procreate.
And if there’s anyone out there who thinks that a child, a minor, has enough foresight
and the capability of deciding for themselves to sterilize themselves for the rest of their
life, I don’t know, get your head checked.
ZINNIA: If an adolescent starts taking puberty blockers before they’ve reached a stage
of maturity where sperm begins to be produced, and later goes on to start hormone therapy,
then yes, they likely will not be able to reproduce using their own biological material.
This is a known issue that’s been recognized by professionals in the field and identified
as needing further exploration.
For instance, at the WPATH symposium this year, one panel reviewed potential fertility
issues facing trans youth, and noted that it is possible for children to delay taking
puberty blockers in order to store gametes.
Researchers are also investigating the feasibility of extracting and preserving gonadal tissue
for future use in reproduction, an experimental process which has successfully resulted in
live births.
Additionally, a clinical review by the LGBT Health and Development Program at Northwestern
University noted that trans people who took blockers in adolescence and continue to take
hormones in adulthood can discontinue those hormones until fertility becomes possible,
although this is not certain for everyone.
The effect of hormone therapy on trans people’s fertility has been described in literature
as “partially reversible” – for instance, trans women may still be able to provide viable
sperm.
Quote:
"For trans people already using hormones, a suspension of hormone treatment is recommended
for a few months so that sperm production and quality can recover prior to banking.
A study examining the effect of high doses of estrogen suggests that testes’ function
can recover if the dosage is stopped.
If interrupting hormone treatment is not an option, poor quality semen can still be frozen
for later use…"
ZINNIA: Trans women and trans men on hormones who haven’t had surgery should not trust
that sex will never result in pregnancy – it can.
Medical literature makes note of this risk because it is real.
Trans men on testosterone who become intentionally or unintentionally pregnant are not just “tabloid
headlines”.
Thomas Beatie and the three children he gave birth to are not “tabloid headlines”.
This has actually happened a number of times . Telling trans people across the board that
they are “completely, 100% sterile” and that they will “never” be able to reproduce
is simply wrong – and more than that, it’s dangerous to trans people.
It encourages them to delay or forego transitioning on the basis of a supposedly absolute outcome
that actually consists of many different outcomes and options, and it discourages them from
taking steps to prevent unwanted pregnancies.
This is irresponsible.
BLAIRE WHITE: So, another reason.
Hormones change your body a lot, especially if you’re young.
A lot of these are actually permanent changes.
Like these, for instance.
And I’m sorry, but the reality is, if that child ever decides to revert, or tries to
go back, a lot of those things are going to be permanent.
ZINNIA: It’s true – hormones do change your body a great deal, particularly during
puberty.
But children who are not on puberty blockers will undergo those hormonal changes at a much
earlier age, whether they’re ready for it or not.
The onset and progression of their puberty will not be controlled, and it will not be
subject to routine and detailed endocrinological and psychiatric monitoring.
So how are these hormonal changes of puberty supposed to be considered unacceptable in
a tightly controlled and deliberately managed setting, but acceptable in a completely uncontrolled
setting?
If it’s bad for a 16-year-old girl to be able to decide to grow breasts after years
of consideration and professional consultation, why is it good that an 11-year-old girl will
grow breasts without any consideration and any consultation?
BLAIRE WHITE: You know, we seem to be on the right track with, you know, not letting children
get tattoos and piercings, so why exactly would we let them dramatically alter their
body’s physiology?
ZINNIA: Being a woman is not a tattoo.
And this is not an accurate parallel.
Suppose that every child’s body simply began to tattoo itself automatically in certain
patterns at puberty.
Suppose you knew that for children properly diagnosed with a particular condition, there
was a significant likelihood that they would find their emerging pattern of tattoos to
be highly distressing throughout the rest of their life.
There’s a concerning possibility that, as an adult, they will need extensive and scarring
tattoo removals as well as the addition of the tattoos they wanted in the first place.
Suppose you had a treatment that would stop this child’s body from developing these
tattoos for a few years, during which time they can consider and choose which set of
tattoos they want, under the care and consultation of a team of professional tattoo experts.
Eventually, they may choose to get the tattoos that they wanted to begin with, avoiding years
of bodily discomfort and painful procedures in adulthood.
Why shouldn’t that option be available to these children?
When you let their puberty happen without intervention, you’re already letting them
get the very real and often permanent markings of adolescent development.
Even if you cast your inaction as somehow ‘neutral’, the weight of the results is
not diminished.
An absence of action is not an absence of consequences.
I'm Zinnia Jones.
Explaining why something is wrong can take a very long time - please continue to part
2 for more.