Suppressing Puberty to ‘Treat’ Gender Dysphoria. Really?

Both a cure and cause.

By William M Briggs Published on June 22, 2017

Who’s for pumping confused kids full of hormones to suppress the onset of their puberty? It’s a common “therapy” given to boys who think they are girls and vice versa.

According to the must-read new paper “Growing Pains: Problems with Puberty Suppression in Treating Gender Dysphoria” by Paul W. Hruz, Lawrence S. Mayer, and Paul R. McHugh in The New Atlantis, puberty suppression “advocates argue that it represents a prudent and ‘fully reversible’ way to give young people with gender dysphoria and their families time to sort out the difficult issues surrounding gender identity.”

Gender dysphoria is the learned name for the mental malady of men thinking they’re women and vice versa.

The Problems With Suppressing Puberty

The problem, as Hruz and the others outline, it is that drugging kids up is a “radical and experimental” procedure “based more on subjective judgments and speculation than on rigorous empirical studies.” The so-called treatment is “being applied in an uncontrolled and unsystematic manner” and is endangering kids.

Worse is that “the claim that puberty-blocking treatments are ‘fully reversible’ is not supported by scientific evidence, and possible side effects include abnormal bone and muscle development, neurological problems, and infertility.”

And worst, “These treatments may make it more likely that patients whose cross-gender identification would not have persisted past childhood will continue to identify as the opposite sex into adulthood.”

Given the faddish and hip nature of transgenderism, where experimentation is increasing, this is no small worry.

As the authors rightly point out, “Children are not fully capable of understanding what it means to be a man or a woman. Most children with gender identity problems eventually come to accept the gender associated with their sex and stop identifying as the opposite sex.” Drugging confused kids or guiding them with “gender-affirming” words transforms what is often a temporary infatuation into a lifelong affliction.

What LGBT Advocates Say

Now some medical groups, such as the Endocrine Society and World Professional Association for Transgender Health, advocate giving kids who are confused about their biology chemicals to slow the onset of puberty. They do this because, they claim, “gender dysphoria ‘rarely desists after the onset of pubertal development'” and because, they claim, “suppression causes no irreversible or harmful changes in physical development and puberty resumes readily if hormonal suppression is stopped.”

Slowing puberty “gives adolescents more time to explore their gender nonconformity” and β€” and this a big and β€” the treatment “may facilitate transition [to living as the opposite sex] by preventing the development of sex characteristics that are difficult or impossible to reverse if adolescents continue on to pursue sex reassignment” (brackets original).

Anywhere from 70% to 97.8% of boys and 50% to 88% of girls snap out of their gender dysphoria.

In other words, if a boy imagines he is a girl, stopping his testes (and so on) from developing makes it easier for him to pretend he is a girl. That he will ever become a girl (or woman) is, of course, impossible. Stopping a girl who thinks she’s a boy from developing her breasts makes it easier for her to pretend to be a boy, but that she will ever become a boy (or man) is also impossible.

This new “treatment” is also advocated by the “LGBT advocacy group” the Human Rights Campaign, who have partnered with the American Academy of Pediatrics and the American College of Osteopathic Pediatricians. They have put out a guide which says “to prevent the consequences of going through a puberty that doesn’t match a transgender child’s identity, healthcare providers may use fully reversible medications that put puberty on hold.”

When “Treatment” Can Actually Cause the Malady

But, say Hruz and the others,

Whether puberty suppression is safe and effective when used for gender dysphoria remains unclear and unsupported by rigorous scientific evidence. … In the case of gender dysphoria, however, we simply do not know what causes a child to identify as the opposite sex, so medical interventions, like puberty suppression, cannot directly address it.

According to the industry standard Diagnostic and Statistical Manual of Mental Disorder, anywhere from 70% to 97.8% of boys and 50% to 88% of girls snap out of their gender dysphoria. So there seems little justification for chemical intervention.

Even worse, as Hruz et al. say, “The interventions could, in some cases, be harmful, if they lead children whose gender dysphoria may have resolved in adolescence to instead persist in a dysphoric condition.”

In other words, the treatment can cause the very malady it’s said to be curing.

Hormonal Treatments are Not the Answer

The claim that suppressing puberty in patients with gender dysphoria is “fully reversible” is also thin on evidence. “Given how little we understand about gender identity and how it is formed and consolidated, we should be cautious about interfering with the normal process of sexual maturation.”

And there “have been no controlled clinical trials comparing the outcomes of puberty suppression to the outcomes of alternative therapeutic approaches.” Plus, there is evidence from trials in animals that puberty suppression causes direct harm in neurological development.

We frequently hear from neuroscientists that the adolescent brain is too immature to make reliably rational decisions, but we are supposed to expect emotionally troubled adolescents to make decisions about their gender identities and about serious medical treatments at the age of 12 or younger. And we are supposed to expect parents and physicians to evaluate the risks and benefits of puberty suppression, despite the state of ignorance in the scientific community about the nature of gender identity.

It is obvious some kind of treatment is necessary for children suffering from gender dysphoria. “But as scientists struggle to better understand what gender dysphoria is and what causes it,” the authors argue, “it would not seem prudent to embrace hormonal treatments and sex reassignment as the foremost therapeutic tools for treating this condition.”

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