What has really struck me in conversations with and observations of doctors providing puberty blockers and cross-gender hormones to gender dysphoric youth is their utter conviction that they are saving lives.
"Would you rather have a dead daughter, or a live son?"
"Would you rather have a dead daughter, or a live son?"
At a talk at #AAP19, Katherine Greenberg MD, who's on the speaker's bureau for Merck, said that trans youth denied treatment have "8 times" the risk of suicide. Sounds terrible!
In this article: medpagetoday.com/meetingcoverag…
Kevin Wang MD says suicide attempts are 9 to 10x higher.
In this article: medpagetoday.com/meetingcoverag…
Kevin Wang MD says suicide attempts are 9 to 10x higher.
But when you look at the data, the rates of suicide and self harm are "more similar than different" to the rates of youth referred for other mental health concerns. I'm quoting from @ZUCKERKJ's excellent article from earlier this year:
rdcu.be/bVvtQ
rdcu.be/bVvtQ
In other words, yes, these children are stressed and unhappy, and they need care. I'm just not convinced that puberty blockers, cross gender hormones, and significant surgeries are the best response, at least not in childhood.
Suicide is super scary, which shuts down discourse.
Suicide is super scary, which shuts down discourse.
If a doctor tells a parent that their child has a "very high" risk of suicide if we don't go along with their demands to embark on a sex change, what is the parent to do?
A child, even a young teenager, is likely to have incredibly unrealistic ideas about how transition goes.
A child, even a young teenager, is likely to have incredibly unrealistic ideas about how transition goes.
Who is the adult in this conversation? Who is looking at the risks over the long term? Not the kid!!
The parent might, but now we've told them that the choices are medical transition, or death.
There are deaths from medical transition as well, and risks of stroke, heart Dz.
The parent might, but now we've told them that the choices are medical transition, or death.
There are deaths from medical transition as well, and risks of stroke, heart Dz.
I don't want to shut down medical transition. I do believe that it's helpful and improves the lives of some people.
It's just that as a pediatrician, I see a frightening lack of caution with regards to very significant body changes and creation of lifelong medical patients.
It's just that as a pediatrician, I see a frightening lack of caution with regards to very significant body changes and creation of lifelong medical patients.
I don't think that children are able to give truly informed consent to puberty blockers followed by cross gender hormones.
Children don't know if they will want to have kids when they are adults. They can't understand that they are unlikely to have orgasms. How could they?
Children don't know if they will want to have kids when they are adults. They can't understand that they are unlikely to have orgasms. How could they?
Teens are also developmentally unready to make decisions about removing breasts, penises, uteruses, testicles, ovaries.
We limit access to driving, to alcohol, to tattoos.
We limit access to surgical sterilization by age, unless you are gender dysphoric.
We limit access to driving, to alcohol, to tattoos.
We limit access to surgical sterilization by age, unless you are gender dysphoric.
We need solid data on suicide, not scare-mongering. We need to make decisions based on evidence, not feelings.
Sometimes, we don't let kids get what they want, and that's the right thing to do. We need to be the adult.
Sometimes, we don't let kids get what they want, and that's the right thing to do. We need to be the adult.
Addendum: for those who say "but kids aren't getting irreversible surgeries!
Yes. Yes they are. (Age at surgery is at the bottom.)
Yes. Yes they are. (Age at surgery is at the bottom.)
