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By Rowan Jetté Knox (he/him). Facebook post. Sept 2023. Ontario, Canada.
Rowan is Canadian, a transgender parent, the parent of a trans child, and author of Love Lives Here: A Story Of Thriving In A Transgender Family and One Sunny Afternoon: A Memoir of Trauma and Healing. He is also a fierce advocate for the trans and gender diverse community. Rowan made this post in September 2023 in response to the misinformation about affirming care for children.
Post by Rowan Jetté Knox, 2023
No, children are not being "mutilated" by trans-affirming healthcare.
If you are being told this, you are being lied to.
Let me explain how affirming trans kids usually looks:
1. A child/teen comes out as trans. Their parents take them to their doctor, who will usually refer them to a team of specialists at a gender identity clinic. These are usually inside hospitals and involve mental health professionals, endocrinologists (hormone specialists) and nurses.
2. The team will perform an assessment that involves sessions with the child and their caregivers. These assessments are very thorough. They examine both the possibility of gender dysphoria and any accompanying mental health issues like anxiety and depression (which are common in people experiencing untreated gender dysphoria - it's hard to live with that level of self-incongruence every day).
3. if gender dysphoria is found to be the case, the team takes several things into consideration, including a child's age, level of support they receive from those around them, and what has already been done outside of medical care to alleviate that dysphoria.
4. if a child is pre-pubescent, there is no need for any medical treatment. Young children will often socially transition to some extent, and that's it. This can include everything from dressing in ways that are more comfortable to them to using a new name and pronouns.
NO SURGERIES ARE PERFORMED ON YOUNG CHILDREN. NO HORMONES ARE ADMINISTERED. These common misconceptions drive a lot of anti-trans sentiment.
5. When a child reaches puberty or is in puberty at the time they are found to be dysphoric, puberty blockers may be administered. These have been in use in young people for decades - not just trans kids but cis kids with precocious (early) puberty, too. They have been rigorously tested over the years, and any potential side effects are closely monitored. The biggest concern is bone density loss. Endocrinologists will usually prescribe vitamin D and calcium to counter this.
Puberty blockers simply hit the pause button and allow for some time where unwanted changes to the body aren't happening. They are fully reversible. We know this because children with precocious puberty will take them for a time, stop taking them, and then go through their natal puberty.
Studies show very few kids who are seen at gender identity clinics step off puberty blockers - these kids tend to know who they are. But when they do stop taking them, they experience their natal puberty, too.
6. After a time, a trans teen on puberty blockers will begin hormone replacement therapy, or HRT.
"But why can't they wait until they're 18?"
a. because a growing body needs hormones of some kind, so remaining on blockers indefinitely can cause harm, and
b. because if we deny blockers until adulthood, the body goes through puberty in what the child strongly believes is the wrong direction, causing many irreversible changes and often leading to intense depression/suicidality.
HRT is the first step in a trans person's medical care that is not entirely reversible.
However, there are two important things to note:
a. Teens generally have a good while on blockers before they start HRT. It is not a quick process.
b. Doctors administer these hormones at slow, incremental doses. Changes happen over years, not overnight. (Anecdotally, my own trans child only had their estrogen bumped up every 6 months. This gives plenty of time to potentially hit the brakes & reverse course.)
7. Surgery. This is the big sticking point for a lot of people who oppose gender transition in minors. There are a few things to consider.
a. Not all trans people need or want surgery.
b. For those who do, most trans teens don't access them until adulthood.
c. Of those who do, only very limited procedures are available to them.
d. Once again, no young children are having surgery or being "mutilated".
An important thing I want progressive people who are concerned about trans teens giving consent to gender affirming care to consider:
The laws allowing trans teens to give medical consent are the same laws that allow ALL teens in that part of the world to give consent to ANY medical care. This can include birth control, abortion, cancer treatments, and other critical care that affects their body autonomy. It's a slippery slope to try and remove this out of "concern."
"But what if a trans kid regrets their decision to transition?"
Studies show that fewer than 1% of trans people experience any kind of regret after undergoing gender affirming care. It's an extraordinarily low number by medical standards.
Lower still is the number of people who once believed they were trans and now don't feel that way.
The numbers don't lie. This is the only proven treatment, and it works well for nearly everyone of all ages.
I hope this helped shed some light on what is an often misunderstood and misrepresented population.
Trans kids deserve our understanding and our protection.
And by "protection", I mean ensuring they have access to the care that is proven to help them. Let's make sure we keep fighting for them.
Thank you from a trans person and the parent of a trans kid.