So I’ve been having a lot of conversations in regards to trans kids and the medical support available to them. There are a lot of concerns from people and I’ve been doing my best to try and keep on top of them and talk it out with folk. Most of whom realise there is no need to be concerned once its properly explained and we have a pretty nice conversation about it. Not always, but most. That’s when Blaire White dropped a le so funny tweet mentioning this.
If you follow my blogging adventures you’d know I’ve already posted this image making fun of her for blocking me, making her an SJW too. However that’s not why I posted it here. I posted it because of her dismissal of blocking puberty for children as if its bad. In reality it really isn’t, yet 3,600 people have liked this tweet and 830 have shared it. That spread of misinformation needs to be challenged. So I figured I’d do a blog post with all the information in one place and you can share it with you friends whenever they tell you blockers are so dangerous and wrong.
First lets discuss what blocker medication is and where it came from. Blockers are medication which, as Blaire suggests, block puberty. This medication was originally used to treat something known as “precocious puberty” – which we’ve known about since the 19th century. In short precocious puberty is puberty happening before it should, hence the need to block it. You don’t need an 8 year old with a deep voice and a moustache giving you back chat. No way no how.
An 8 year old you say? Yes. An 8 year old I said. Here’s a study in which the author specifies the current lower limit for puberty to be considered “precocious” is 8 years old in girls, who can be as far a long the tanner scale of puberty as stage 2. For those who don’t know what that means, here’s a pic.
Basically. Little girls with pubic hair and small boobs. Not super and that’s why puberty blocking medication is often prescribed to these children for several years until they reach an age where its more appropriate to begin puberty for them. Nobody has ever bat an eye lid about this, because its medical professionals prescribing medical treatment to patients based on their medical condition. Something which somehow seems to disappear when we talk about trans kids.
Now we know what puberty blockers are and that they have been used for many years before trans kids were given access to them, lets discuss some of the common concerns people have about them in regards to trans kids.
The easiest one to get out of the way is they’re too young!!! Which if you’re speaking about how they’re too young to take puberty blocking medication; then you’re objectively wrong about that. See the whole above section about precocious puberty. However if you’re talking about how they’re too young to decide to transition – you would be correct. They are. This is the entire point of puberty medication, it buys them some more time to decide what they want to do.
Natural puberty in someone who is trans causes dysphoria, which is traumatic as all heck. I remember my youth and puberty too well; wearing my PE kit under my clothes, changing in bathrooms for PE classes, wearing tshirts in swimming pools. I started drinking, smoking cannabis, making poppy seed tea; basically anything I could do to escape what was happening. I was rarely sober, even in school I would sneak vodka in mixed with juice drinks. I got suspended twice and had my parents called in several times. I was struggling and nobody, not even me, knew why.
See dysphoria isn’t merely just hating your body, its far more insidious than ugh I feel a bit fat. If I could have avoided experiencing that through my teens, you betcha I would have. I would have taken any medication you could give me to help those feelings stop. To help me get some kind of control back over my mental state. It’s truly an awful experience, one of the worst of my life. Nobody is too young to experience this pain and want to stop it. I’m not so sure I would’ve wanted to transition there and then – but having the ability to put a pause button on everything while I worked it all out would’ve been super.
Next concern is the the long term side effects are unknown! argument. Which again, doesn’t really hold as much water as you think. Trans kids take this medication from around 12 years old according to NHS policy. According to the same NHS policies, we know that children are offered hormone replacement therapy around their 16th birthday. So that’s four years, that’s not really long term by medical standards at all. That’s a hop skip and a jump.
Yet people still bring concerns such as bone density to the table and use it as though it totally destroys the option. Which its true, long term use of puberty blocker medication will in fact make you have lower bone density. Hormones during puberty are responsible for increasing bone density and if you block them, you don’t begin that process. However, its not like puberty is going to be blocked indefinitely, its blocked temporarily after which patients are given hormone replacement therapy beginning puberty and reversing that bone density issue entirely. There have been no studies to suggest that bone density is permanently reduced – at least none of which have followed people through adulthood & been repeated.
Another concern is the what if puberty makes the trans go away? argument. Which is a totally fair one and in fact is one that is totally mitigated against by medical professionals. This is why trans kids are forced to wait until 12 here in the UK before puberty medication, and until tanner stage II/III under the care of Dr Norman Spack in the USA. Here’s another pic:
As you can see, the average age of puberty beginning in girls is 8 years old and in boys is about 1/3rd through 10 years old. This is a minimum of 2 years before boys can receive hormone blockers and 4 years before girls can. Obviously this isn’t perfect or applicable to every child, that’s why trans kids are dealt with on a case by case basis. No two trans kids are treated exactly the same, they really are the special-est snowflakes.
As Dr Spack above and Dr Polly Carmichael in the UK suggest – some puberty is necessary before giving children blocking medication. This is because the brain is still developing and perhaps the feelings of gender dysphoria will fix themselves given time. Which in a lot of cases they do and this is absolutely great. However we still have some trans kids whose dysphoria won’t simply develop itself away. If puberty exacerbates dysphoria, they are given hormone blocker medication to stop that pain. Make no mistake though, they do experience natural puberty up until a point where it becomes too hard for them to continue.
This feeds into the isnt this just gay conversion therapy? argument. Which is a less fair concern, some people even quote figures as high as 80% at me in regards to trans kids who ended up just being gay instead. If you have statistics which show 80% of kids who visited gender services for gender dysphoria later decided not to transition and were just gay the whole time. Then doesn’t that kind of prove that the system works and that there isn’t a gay conversion therapy conspiracy going on?
For those statistics to exist, 80% of the kids must have made the decision, after being given the time and support to understand themselves a bit better, to not transition. So clearly they’re not erasing gay kids by making them trans, clearly this isn’t some sort of twisted gay conversion therapy. Clearly the system of “lets wait and see if they need medication” is working out perfectly. Even despite how the 80% statistic itself has been debunked separately to this already anyway.
The only real concern we’re left with is so there will be 16 year olds who haven’t began puberty? Isn’t that hard for them? Which yeah, I imagine it is. Not as hard as dealing with dysphoria would be, but still difficult. Ideally speaking, I would love for it to be possible to mitigate this concern too. The only way everyone wins here is if we find some sort of way to diagnose – with a high accuracy – who is trans and who isn’t. That way we wouldn’t need to give puberty blocking medication at all, we could just give them the ability to transition as soon as they wanted it.
Unfortunately that’s not where we’re at right now. Currently all we have is a bunch of kids coming forward and saying they’re experiencing something strange and then going through a system which in the majority of cases helps them work through the problem they’re experiencing. Most of whom don’t become trans or want to take medications, and instead realise they were just gender non conforming kids. The rest who, fortunately, are able to access treatment to help put off the dysphoria for as long as possible until they have to make a decision on what they want to do. This system is currently the best of both worlds, and until we have new information available on how to diagnose trans kids properly, I don’t think it should change.
In closing, no – bone density is not a problem. Gay conversion is not happening here. Long term effects being unknown don’t apply here. And yes, doctors do take precautions to make sure trans kids are actually trans before giving them these medications. There is nothing to worry about, and frankly if you still have a problem with any of the things above after reading this, you should probably just admit the truth. You’ve got a prejudice against trans people for some, probably irrational, reason.
I totally get the initial concerns and if you have any others that I haven’t discussed here, feel free to post them at me, and I’ll try and find out the information about it for you. I think we’re all on the same team of trying to do the best thing we can regarding kids, we just need someone giving clear and concise information, rather than spewing misinformation and fuelling the fires of confusion and anger.