Pediatric endocrinologists, psychologists, psychiatrists and ethicists are increasingly speaking out in opposition to the practice of diagnosing and treating children as transgender. Below is a collection of publications from professionals questioning the transitioning of children.
Sexuality and Gender: Conclusion
Lawrence S Mayer & Paul R McHugh
“Yet despite the scientific uncertainty, drastic interventions are prescribed and delivered to patients identifying, or identified, as transgender. This is especially troubling when the patients receiving these interventions are children. We read popular reports about plans for medical and surgical interventions for many prepubescent children, some as young as six, and other therapeutic approaches undertaken for children as young as two. We suggest that no one can determine the gender identity of a two-year-old. We have reservations about how well scientists understand what it even means for a child to have a developed sense of his or her gender, but notwithstanding that issue, we are deeply alarmed that these therapies, treatments, and surgeries seem disproportionate to the severity of the distress being experienced by these young people, and are at any rate premature since the majority of children who identify as the gender opposite their biological sex will not continue to do so as adults. Moreover, there is a lack of reliable studies on the long-term effects of these interventions. We strongly urge caution in this regard.”
Gender Dysphoria and Surgical Abuse
John Whitehall, Professor of Paediatrics, Western Sydney University
“Yet hardly any paediatricians recall any cases of gender dysphoria in almost 300 cumulative years of practice. Certainly, I have not seen one in fifty years of medicine. I accept cases must exist and consider them tragedies deserving as much compassion and medical care as the three cases of physical intersex I have encountered in my career.
“What astonishes me is the lack of evidence to support massive medical intervention in the face of evidence that it is not necessary. I cannot help wonder how the intervention was approved by the various ethics committees in hospitals, health regions and universities when it took some students and me over a year to get approval for a study that merely asked mothers when they introduced solid foods to their children.”
Layers of meaning: A Jungian analyst questions the identity model for trans-identified youth
“As a social worker and a Jungian analyst, I have become increasingly concerned about the rush to affirm children’s and young people’s transgender self-diagnosis, and then transition them to the opposite sex. I am particularly worried about social and medical transition among teens whose transgender diagnosis arose “out of the blue,” without a significant history of early childhood dysphoria. I fear that, via their well-meaning desire to validate young people in pain, therapists are discarding basic principles of psychotherapeutic care.”
Gender Dysphoria In Children And Suppression Of Debate
Michelle A. Cretella M.D.
“Currently there is a vigorous albeit suppressed debate among physicians, therapists, and academics regarding what is fast becoming the new treatment standard for GD in children. Modeled after a paradigm developed in the Netherlands, it involves pubertal suppression with gonadotropin releasing hormone (GnRH) agonists followed by the use of cross-sex hormones—a combination that will result in the sterility of minors. A review of the current
literature suggests that this protocol is rooted in an unscientific gender ideology, lacks an evidence base, and violates the longstanding ethical principle of “First do no harm.””
Early Medical Treatment of Children and Adolescents With Gender Dysphoria: An Empirical Ethical Study
Journal of Adolescent Health July 2015
These are (anonymous) statements from professionals worldwide who were consulted for this study.
“I find it extremely dangerous to let an adolescent undergo a medical treatment without the existence of a pathophysiology and I consider it just a medical experimentation that does not justify the risk to which adolescents are exposed. Gender dysphoria is the only situation in which medical intervention does not cure a sick body, but healthy organs are mutilated in the process of adapting physical and congruent psychological identity” (Psychiatrist)
“I have met gay women who identify as women who would certainly have been diagnosed gender dysphoric as children but who, throughout adolescence, came to accept themselves. This might not have happened on puberty blockers” (Psychologist)
“I believe that, in adolescence, hypothalamic inhibitors should never be given, because they interfere not only with emotional development, but [also] with the integration process among the various internal and external aspects characterizing the transition to adulthood” (Psychiatrist)
“The positive attitude of many health care providers in giving hypothalamic blockers[…] is based on the need to conform to international standards, even if they are conscious of a lack of information about medium and long term side effects” (Psychiatrist)
“The fact that somebody wants something badly, does not mean that a health care provider should do it for that reason; a medical doctor is not a candy seller” (Professor of health care ethics and health law)
“I believe that hypothalamic blockers treatment satisfies health care providers anxiety, pathologizing individuals with gender dysphoria, inducing them to follow the sex-gender binarism” (Psychiatrist)
“You might think that the experience of gender dysphoria is kind of a solution [for all their problems] that is culturally available for adolescents nowadays[…] I think that the culture is kind of offering or allowing this idea that all problems are stemming from the gender problem. And then they stick to this fixated idea and [they] seek for assessment and we readily see that they have numerous and relatively serious psychological and developmental problems and mental health disorders” (Psychiatrist)
“They [adolescents] are living in their rooms, on the Internet during night-time, and thinking about this [gender dysphoria]. Then they come to the clinic and they are convinced that this [gender dysphoria] explains all their problems and now they have to be made a boy. I think these kinds of adolescents also take the idea from the media. But of course you cannot prevent this in the current area of free information spreading” (Psychiatrist)
Puberty is Not a Disorder
Letter by Trumbull D, Cretella MA, Grossman M. Pediatrics 2015
“The recommendations of the authors to reinforce the delusions of gender identity–confused children, and to prescribe puberty-blocking hormones as though puberty were a disorder, are outrageous. This approach violates the oath physicians take to “do no harm.””
Listening to Children Imagining Gender: Observing the Inflation of an Idea
David Schwartz PhD, Journal of Homosexuality 2012
“…the child longs inchoately for an emotional experience like respect and rapidly gains unconscious awareness of the power of gender complaints to bring such gratification.”
“…the trans child has learned, and then enacts, encouraged by these interactions […] that the idea of gender is very powerful, and if you want to get a rise out of people, play with it daringly. The lesson for the parent or clinician should be: Stop talking about gender.”
Using three of the clinical articles in this special issue of the Journal of Homosexuality as examples, the author attempts to show how their views of gender may influence clinicians’ conceptualizations and treatment choices in response to children diagnosed with gender identity disorder (GID), or gender dysphoria. In particular the author argues that the belief that gender is a psychophysiological entity that is organismic and transhistorical, that is, the view known lately as essentialism, promotes more invasive interventions (e.g., endocrinological and surgical) and mistakenly deemphasizes psychological therapies as a clinical response to the suffering of trans children. He tries to show that the drawbacks of essentialism and its correlated treatment approaches are twofold, that a) they promote treatments with insufficient attention to our limited knowledge regarding their safety and efficacy, and b) they advance a reified differentiation of the genders that is politically problematic. The author suggests that a better response to trans children would be one that emphasizes the child’s broadly subjective role in his or her construction of transgressive, gender-related psychological and interpersonal phenomena (both painful and not), thus, offering a deeper validation for trans children’s challenges to our gender system.
To view the whole article, which is well worth doing, you must register at the website of Taylor & Francis Online.
Exiles in their own flesh: A psychotherapist speaks
A guest post submitted (anonymously) by a practicing psychotherapist to the site 4th Wave Now (2015)
“As professionals, if we don’t loudly prioritize their identities as being the most important thing about them (and identities do shift constantly in kids and teens), we risk coming across as unsupportive and even immoral. Identity development has always been a teen task, but in the past it wasn’t necessarily supposed to become a lifestyle, or colonize the entirety of your existence.”
Ihlenfield Cautions On Hormones
TRANSITION no 8 (1979)
“Among the reasons for exercising extreme care in giving hormones, according to Ihlenfeld, is the fact that 80 percent of the patients who want to change their sex shouldn’t do it. “There is too much unhappiness among people who have had the surgery,” he said. “Too many of them end as suicides.” The transsexual candidate, he added, has been described as “the only patient who diagnoses himself and prescribes his own treatment.”
Ihlenfeld is against giving hormones to persons under the age of 18; in fact, he prefers that they be at least 20 to 21 years old before they start on this route. “I did have one patient who had surgery at 17 and is doing well” he said. “But in general, identity is still fluid in adolescence. There’s a chance that gender feelings still might change.”