Concern for children transitioning

At age four, Jazz Jennings expressed that she was not the boy she was thought to be.  At age five, she began social transitioning.  Her story went nationwide when, at age six, she was interviewed by Barbara Walters, which launched her to her own reality TV series.

I recently received a message from a woman’s whose concerns I suspect are those of enough people that this warranted more than a reply only to her. Here is her note, which I have mildly edited to focus on the key points.

Gina, I have some qualms about all the children who are being treated with hormones for dysphoria. We have long held the attitude that children do not have the ability to make life-changing decisions such as marriage and signing binding legal contracts because they are not mature enough to comprehend the ramifications involved. Yet on the simple assertion of a five-year-old that s/he is the other gender, we are now being ordered to treat the child as if this were truth and even begin medical treatments that have lifelong consequences. From what I have read, most children who make these assertions, if not treated, eventually come to terms with who and what they were created to be. If they don’t, then adulthood is maybe a more rational point for them make these decisions? I know I was something of a “tomboy” as a kid, yet there is now no way I would want to have missed being a woman and a mother. I know that isn’t quite the same thing yet why are we encouraging little children to make these decisions? Not just encouraging but actively forcing reluctant parents in some cases.

I have located three areas of concern to address: 1) children transitioning, 2) a child only going through a phase regarding gender, and 3) the encouraging of children to transition, or the forcing of parents for these children to do so. I will work backward through these topics.

I am horrified at the thought of any parents being forced to set a child onto the path of transitioning, or even encouraging a child, which I heard as “pushing” a child.

Yet, I can imagine the scenario. An over-zealous therapist or doctor, who speaks so strongly with the diagnosis that the child is transgender and will only be benefited by transitioning and that the path should be started immediately, and the parents themselves feel pushed—backed into a corner of guilt if they don’t act.

Sadly, there are people in every profession who do not remain inside their boundaries, whose insights and opinions turn into insistence, which virtually bullies a person into the action which they espouse. It happens with teachers and students, with politicians and citizens, with ministers and congregations, in every sphere of life. I can easily imagine it in the area of gender dysphoria and transitioning. Should it happen, that doctor or therapist should be reported to the appropriate person or group.

You are correct in asserting that most children, who express wanting to be the opposite sex, will move on from this, perhaps even quickly. I addressed this and more in the following:

In that piece, I discuss PIC—persistent, insistent, consistent. Parents should take a PIC of these children. Does she persist in her desire to be a boy? Is he insisting that you see him wrongly by seeing a boy? Is s/he consistent in what s/he is saying about this?

Parents should not be quick in seeking professional help while they calmly and lovingly listen to these children. If a clear PIC forms, that will be the time to act.

Finally, regarding children transitioning. It is correct that some children transition socially, how they dress and what name is used. It is incorrect that they are given hormones—this is to the best of my knowledge and, below, I explain why—or that any medical steps are taken.

The goal of a child’s socially transitioning is to alleviate the dysphoria—that is, the ill feelings regarding the mismatch of mind and body—and to see if this benefits the child. It is a testing period. If the child finds what s/he seeks, displays and expresses peace and joy in finally living as the gender s/he experiences her- or himself, and if this persists, then good has been achieved for the child.

Not only are children not given hormones, there is no need to do so. The accepted path is this:

  1. Transition socially. If this is sustained, then
  2. when the child nears puberty, prescribe blockers, which arrest puberty.  (For more about puberty blockers in children who begin puberty when very young, see the end of this post.) By postponing puberty, if the child continues into the later teen years and decides to fully transition, the affects of puberty have not adversely affected the child. If the child does not continue, blockers can be stopped and puberty would commence. If s/he desires to transition, at the appropriate time or age
  3. the child, who now likely is at least eighteen or near it, would begin hormone replacement therapy (HRT) and experience puberty in the desired sex.

It may be argued that one in the late teens is still a child and should not take measures which profoundly affect the future. I appreciate serious caution. Where I depart from the caution is that, by the time a person would begin the hormone phase of transitioning, several years have elapsed. If anyone has passed the PIC for this long, we are not talking about a passing phase. Even more, as we know of the great emotional and physical distress caused by gender dysphoria, we never forget the 41% attempted suicide rate. HRT often is healing therapy—it was for me—and even a life-saving measure.

In summary, no children, nor their parents as they are advised regarding their children, should be encouraged to transition, especially if information provided causes them to feel they must do so. Parents should listen closely and patiently to their children, showing them love and compassion. If their children pass the PIC, then they should engage a professional. As puberty nears, medical action can then be taken. Hopefully, if these steps are taken, these children will mature into healthy, well-adjusted adults.

~ ~ ~ ~ ~ ~ ~ ~ ~

I am thankful for a friend, who is highly educated in these issues, who posted this comment on Facebook regarding puberty blockers:

One point that people miss – hormone blockers that delay puberty have routinely been prescribed for the last 30 years for children with early onset puberty. There are kids who suddenly start puberty at the age of 4 or 5. Helping them put off puberty until they are 16, 17, 18 has been standard procedure for decades and we have years of research that this has no ill effects on young people at all. So delaying puberty for trans kids until they can make informed decisions about their lives isn’t really different.

4 thoughts on “Concern for children transitioning

  1. Gina thanks so much for this well done article on transgender kids. I would like to add a little bit from my perspective as a parent of a transgender child, who is now an adult. I’ve also worked with a lot of parents of transgender kids in peer support groups. So I know something of the experience from the point of view of parents.

    Let me first of all affirm what you have said. Medical interventions do not happen to young children. The first step that may be used as you point out are puberty blockers which have been safely used for decades for precocious puberty. And they are safe and reversible. HRT is not reversible — but neither is puberty. They do have to pick either natal puberty or HRT. PIC is the language we use as well — persistent, insistent, and consistent. It’s not something done on a whim. The risk of suicide that you point out is very real as well and often transgender kids either make attempts or are hospitalized for suicide ideation (even for very young children). What I’ve seen over and over is that behavior drops as the kids transition and start to feel comfortable in their own skin.

    Let me bring in a couple points from the original question which I’ll divide in three parts “can kids make life-changing decisions at young ages?”, “do kids eventually come to terms with these things”, and finally are professionals “actively forcing reluctant parents”?

    So first “can kids make life-changing decisions at young ages?”. What research has found is that kids gain a gender identity at about ages 2-6 years old. It’s also found that identity isn’t able to be changed. Even the conservative Dr. Kenneth Zucker has admitted that if a child’s gender identity is firmly transgender at about age 12 — they aren’t likely to change and he recommends medical transition treatment as needed. Here’s some great advice from the AAP which is the US organization for Pediatricians (60,000 strong).

    Do kids eventually come to terms with their natal sex? There’s better articles on this than I. But, let me point out a major new understanding on this. In the past the diagnostic criteria for Gender Identity Disorder included kids who don’t identify themselves as being the opposite gender — but only display behavior that is stereotypical of the opposite gender. Most of those kids will desist. But, the kids with PIC as Gina pointed out — don’t. Hence, the new criteria for Gender Dysphoria has to do with what gender the child identifies with themself.

    Lastly are professionals “actively forcing reluctant parents”? As a parent I understand this fear. It’s not something that I’ve seen however, and I think it could only be done very rarely. I also understand that parents in this position are very terrified — I certainly was. And that is what I see in the majority of parents, especially at first, they don’t understand, and they are scared to death. Since, parents have parental rights for a child, a professional can’t force a parent to do anything they don’t want for their child — unless the professional can prove it’s in the child’s best interest. In one study that opened my eyes the likelihood of attempted suicide for a person that is transgender and has family that is highly rejecting of them is a horrific — 57%, while for supportive family it’s near normal of 4% (to put a human face on it remember Leelah Alcorn). Other metrics are similarly horrifying. Even with that a professional can’t force a parent to act. A parent has to consent for medical interventions on their child, until the child is 18. The only way that can be overturned is in the rare case, where a child can be legally emancipated. That process is long and difficult, and multiple people have to agree that it’s in the child’s best interest.

    I used to think it was outrageous that my kids school can’t give my child aspirin without my consent — but they can send them for a highly dangerous medical procedure of abortion. What I know now is that having parents that are unsupportive of their transgender child is very dangerous for that child. Is there a point where a child is so unsafe with their parents — that parental rights should be taken away? Yes, there is. Does that happen very often — no. And I suspect it only happens in the most egregious cases, and probably not as often as it should. As I say just witness Leelah Alcorn.

    Liked by 2 people

    1. Erik, thank you so very much for this. Not only do you have the insights and experience of a parent, you clearly demonstrate that you have done your homework, which I always and especially appreciate. You included one item of which I was unaware, yet which came as no surprise, and that is the 57% and 4% suicide rates of, in order, unsupportive and supportive parents.

      You provide so much valuable information that I want to make this a blog post of its own, crediting you as the author. May I do that? I would preface your writing by informing my readers that you wrote in response to “Concern for Children Transitioning.”

      Liked by 1 person

      1. Hi Gina

        Yes, absolutely you can post this on it’s own. By, the way here is the graphic that has that statistic that had an impact on my wife and I as parents and helped clarify to us that supporting our child was the right thing to do….

        There’s now a couple of other studies that show similar kinds of statistics. The Family Acceptance Project out of San Fransisco University is another great resource.

        Thanks so much. Take care.

        Liked by 1 person

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