So. As a heads up the number of kids who actually have surgery before 19 are very tiny. The only surgeries available to people over 16 but under 18 are non-destructive breast reductions. That’s also available to cis girls without issue. Breast augmenting is off the table because the breasts are still developing and outcomes are usually reduced in quality so that’s not a thing. Bottom surgery is usually the last thing and the average age for that is in people’s early 20’s and not all trans people opt for it because there are tradeoffs and some people are okay without. The standout here is usually hormones and I think there’s somr things people really don’t understand about this process.
Mostly it’s three things
They don’t understand how actually stable trans identity is and how unified the psychological markers are.
They think access is way simpler and directed by the child than it is
They aren’t aware of the actual monetary and physical cost of NOT using Horomone. Not talking psychological. Those are definitely a huge thing too but most people have been introduced to those concepts.
On the first count : Trans people aren’t subtle. There’s specific markers of behaviour , the way they conceptualize specific things is actually really different from cis people. If you are talking about gender theory it gets complicated because they are dealing with something that is incredibly different under the hood. Identify is also very stable. It is vanishingly rare to find a kid who doesn’t keep identifing as trans if they are past the one year mark. Usually the only changes you see to the co-hort is them identifing as a different type of transness between non-binary or binary trans and oftentimes the things they physically require don’t change.
On the second. It’s a panel of experts. No kid is making this decision alone. All legal guardians need to sign on and then you need to have a panel agree it’s the best long term choice. Here’s what that looks like
Pediatric Doctor - Makes sure they are at the stage of puberty and the general health is at a point where blockers and maybe later hormones are a good fit.
Social Services Worker - Makes sure there isn’t something hinky with the home environment and the family is in a position to make an informed decision .
Trans specialized Psychology - Makes sure the identity has been stable and trial run at a social level and that all the markers of a trans patient make the child a risk if they don’t physically transition. They really try to hold off as long as they can.
Endocrinologist - A specialist on horomones. Assesses the patient routinely to make sure there’s not any underlying issues. If a trans kid reacts bad to blockers or later Horomones then it stops.
So for the last part.
Trans adults who don’t go through horomones during the stage of their development end up needing more surgeries and more costly and invasive surgeries than those who were allowed to go through the process of developing through hormonal changes. As an example You don’t need breast reductions if you never develop that tissue in the first place. If you are on blockers and then later testosterone you develop as a male and you still have all the internal bits that if you change your mind later you can swap to estrogen and have perfectly female phenotypic breasts. If you are forced to develop breasts and then remove them later you remove all the inside features and there’s not really any takebacksies.
A lot of trans development looks like this. There are a lot of details and the issues when presented to the public don’t give all the information for the public to make a well informed opinion on trans health. It really is kind of a specialist medicine .
They’ve been used to help cis kids who would otherwise be going through puberty at like 6 or something for decades. You stop any permanent changes from happening due to puberty. The child can choose to go off them if they change their mind and go through a “normal”’puberty, or stay on them and decide to get on HRT as an adult.
In the long run, this means less medical intervention. If you don’t grow breasts you won’t need top surgery; if you don’t experience a testosterone puberty you won’t have your vocal cords deepen and need voice training or surgery.
It is the “let’s wait until you’re an adult and can make a choice” option.
If someone takes hormone blockers for several years before deciding to stop, does puberty proceed the same as in a younger person?
Since this is a controversial thread, I feel at liberty to say: while I was never trans, I was pretty ambivalent about my gender as a young person. It wasn’t until after I’d gone through puberty and had multiple years of estrogen (through the natural process of puberty) that I felt “feminine”. Gender kind of partly feels like a process you go through vs an identity.
This is actually one of the key things about cis versus trans psychological makeup. It’s kind of more useful to look at the majority cis experience as a sort of flexibility of sexual phenotype (- what looks or appears male or female). The majority of cis people are actually fairly fluid in their concept and Preferrence of not really gender - but sex characteristics and they mentally adapt to meet whatever gender expectations and circumstances they end up in usually as a path of least resistance.
Transness (and a small theoretical subset of cis people ) actually experience the opposite of this : sexual phenotype rigidity. It’s like there’s a setting in the brain dailed all the one to one side of the brain’s expectation of physical sex characteristics. Gender as a concept of “feminine and masculine” as categories of social expectations of behaviour and culture is kind of is just the performative baggage on top. What is really happening is almost 100% about the body’s characteristics and the reason social engineering is such a big deal is because language is a mirror. If someone calls you by the wrong name or pronoun that is actually mapping onto you perceiving your own body’s through someone else and you can’t control how the feedback makes you feel because you are rigidly stuck on an independent internal reward/punishment system. Disparity brings pain, matching the expectation brings joy. Nothing is neutral.
The “gender performativity” concept a’la Judith Butler is actually more in line with a cis person’s concept of gender than a trans persons and untangling the two is really difficult because there’s not as much backwards engineering what cis people are actually like to properly compare. I can tell you though after speaking to a lot of both cis and trans people about their experiences that this is actually more like two entirely unique theories of how the idea of “gender” works where “gender” is actually meaning two kind of related concepts but not quite 1 to 1. There’s a fundamental difference that lies deep under this thing.
If you got any questions feel free to fire away. I am a part of a block of citizen research by a group of trans people trying to gain a better understanding of what is actually going on in the heads of cis people regarding gender. There’s some stuff we’re beginning to sketch out as these two groups talking across each other both with improperly established expectations of what the other experiences.
We are a long way from publishing anything because a lot of us are rag tag academics due to us being kind of a minority but there’s something up. We may be verging on a way easier future explanation for what trans people are in relation to cis people and it could be particularly disruptive to some limited sections of the non-binary community.
If someone takes hormone blockers for several years before deciding to stop, does puberty proceed the same as in a younger person?
Pretty much, yeah. There’s legitimate concern regarding bone growth (height, density) but it’s usually fine and nothing compared to the known problems with being forced to live in dysphoria.
I was pretty ambivalent about my gender
Gender kind of partly feels like a process you go through vs an identity.
Gender is a lot of things and different for everyone. I remain very ambivalent about my gender as a man in my 30s. It’s probably most accurate to call myself agendered but biologically and socially I’m male so I don’t think it’s worth the fuss. It strains my imagination to contemplate “feeling masculine/feminine”. The point is that you can’t necessarily apply your (perfectly valid) experience to others and making trans people go through natural puberty dooms them to irreversible changes that can cause severe psychological distress.
Girls treated in childhood with GnRHa have normal BMI, BMD, body composition, and ovarian function in early adulthood. FH is not increased in girls with ICPP in whom GnRHa was initiated at about 8 yr. There is no evidence that GnRHa treatment predisposes to polycystic ovary syndrome or menstrual irregularities.
I also want to say here that I have known two kids to be on blockers. Both had to drive several hours out of state to access their treatment. One of them almost was removed from their home by the state solely because they were trans and receiving blockers - a family friend who has received death threats and harassment and has had to go to court several times because she recognizes her son for who he is. The right wing propaganda sphere likes to pretend blockers are being handed out like candy, but that is not the case.
I’m not trying to push an agenda here. As a parent, I’m honestly trying to understand the ramifications of these treatments. Because as a leftists, asking these questions becomes verboten, as if you hate trans people to question any treatment.
But really (since this is a controversial thread) I just don’t want my child taking a knife to, and hindering the functionality of, any part of their body that was already working just fine. This is especially true for parts that enables an enormous amount of human bonding and the human experience, like sexuality. It feels akin to circumcision/ genital mutilation in my mind, and if that’s what they decide they want as an adult, I wouldn’t stop them. But as their guardian, who safeguards their person for their future self, I would have been willing to divorce my husband over circumcision (at the time we disagreed on it, but we only had daughters). There’s no way most parents without an ideology want to risk long term damage to their child for something uncertain or fluid.
I know I already replied to you in another comment but I posted a big breakdown of how trans healthcare for kids actually works and isn’t as scary as people think. If you are interested just check my post history. I Included the actual less destructive nature of horomone treatment during puberty in regards to the total number, invasiveness quotient and surgeries experienced later in life. But surgery isn’t really a thing for trans kids.
A lot of what you are experiencing with trans discourse is a poisoned well. The issue of trans health care has been sold to the masses as being too quick, lead by the whims of the child, involving a lot of medically scary things that seem irreversible and it operates in a weird blind zone where people don’t really understand trans people’s biological capabilities well or their psychological dispositions.
In some places it can be good to step back and ask where your opinion is actually coming from because this is a very convoluted and non-intuitive branch of medicine for a casual outsider. Parents of trans people and young trans people themselves essentially learn decently advanced pediatric and endocrinology concepts as part of the basic consent process and as a parent of cis kids that is going to seem a lot more scary without an individual personal proof of psychological benefit you get from seeing a child develop.
Here is the very common trans parent scenario :
Your child who has had massive anxiety all their life, They have stress related physical symptoms, they have neurotic behaviours that appear as psychological disorders, they get sick often and are withdrawn from social groups and have a hard time making friends.
You discover your child identifies as trans and asks to go by a different name. You adjust, you change their hair and clothes. Almost immediately health conditions you didn’t know were related start to clear up, nervous ticks evaporate. They start forming better and stronger attachments to peers. They start showing more verve for life and pursuing hobbies and sports. The behaviour is so startling and overwhelmingly positive it is impossible not to link it to that choice.
It really is the case where the science and care plans aren’t super intuitive for someone just dipping their toes in this water. If you don’t have a trans kid then chances are good you haven’t seen the day and night psychological changes to thriving from not thriving that social transition brings. It’s a process and parents know their children. Parents, as a general rule, don’t sign onto things that seem scary unless they are convinced. A psychotic parent also would have a really hard time getting a cis kid through trans healthcare because there’s a panel of experts that check all the angles from school and home life to a lot of developmental markers. Doctors treat children’s long term outcomes as sacrosanct so the burden of proof of benefit is way higher than the average person knows.
But really (since this is a controversial thread) I just don’t want my child taking a knife to, and hindering the functionality of, any part of their body that was already working just fine.
But that isn’t happening. You have to recognize that there is a huge fucking propaganda campaign being held to convince you that children are walking to clinics and getting their dicks and breasts chopped off. Surgery doesn’t even make sense until all the parts are fully developed anyway.
Care is mostly affirming pronouns and names, sometimes puberty blockers.
Sexual reassignment surgery and top surgery are types of treatment. Another type is puberty blockers, which I asked about and you responded with talking points instead of information.
Also, what is the end game of puberty blockers? I assumed if you were a trans boy and took them, you got surgery as an adult to remove for example, breast buds so they never develop into breasts. Are you saying people stay on puberty blockers their whole lives?
Right, but puberty involves a series of hormone changes that have permanent physiological effects. If HRT can be started before puberty then it’s much easier to transition, and that would really help with body image insecurities.
I can’t speak about this from the perspective of a trans person, but I was pretty sure I was a boy at 12 years old, I think if I felt like a girl trapped in a boy’s body, I would have been equally sure of that. What’s the harm in allowing someone to be on puberty blockers until they are 18, or however arbitrarily old they need to be, in order to decide what they want to look like, and who they want to be? Obviously disregarding the very well documented harm of not transitioning and building an identity during some of the most formative and social years of a person’s life.
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So. As a heads up the number of kids who actually have surgery before 19 are very tiny. The only surgeries available to people over 16 but under 18 are non-destructive breast reductions. That’s also available to cis girls without issue. Breast augmenting is off the table because the breasts are still developing and outcomes are usually reduced in quality so that’s not a thing. Bottom surgery is usually the last thing and the average age for that is in people’s early 20’s and not all trans people opt for it because there are tradeoffs and some people are okay without. The standout here is usually hormones and I think there’s somr things people really don’t understand about this process.
Mostly it’s three things
They don’t understand how actually stable trans identity is and how unified the psychological markers are.
They think access is way simpler and directed by the child than it is
They aren’t aware of the actual monetary and physical cost of NOT using Horomone. Not talking psychological. Those are definitely a huge thing too but most people have been introduced to those concepts.
On the first count : Trans people aren’t subtle. There’s specific markers of behaviour , the way they conceptualize specific things is actually really different from cis people. If you are talking about gender theory it gets complicated because they are dealing with something that is incredibly different under the hood. Identify is also very stable. It is vanishingly rare to find a kid who doesn’t keep identifing as trans if they are past the one year mark. Usually the only changes you see to the co-hort is them identifing as a different type of transness between non-binary or binary trans and oftentimes the things they physically require don’t change.
On the second. It’s a panel of experts. No kid is making this decision alone. All legal guardians need to sign on and then you need to have a panel agree it’s the best long term choice. Here’s what that looks like
Pediatric Doctor - Makes sure they are at the stage of puberty and the general health is at a point where blockers and maybe later hormones are a good fit.
Social Services Worker - Makes sure there isn’t something hinky with the home environment and the family is in a position to make an informed decision .
Trans specialized Psychology - Makes sure the identity has been stable and trial run at a social level and that all the markers of a trans patient make the child a risk if they don’t physically transition. They really try to hold off as long as they can.
Endocrinologist - A specialist on horomones. Assesses the patient routinely to make sure there’s not any underlying issues. If a trans kid reacts bad to blockers or later Horomones then it stops.
So for the last part.
Trans adults who don’t go through horomones during the stage of their development end up needing more surgeries and more costly and invasive surgeries than those who were allowed to go through the process of developing through hormonal changes. As an example You don’t need breast reductions if you never develop that tissue in the first place. If you are on blockers and then later testosterone you develop as a male and you still have all the internal bits that if you change your mind later you can swap to estrogen and have perfectly female phenotypic breasts. If you are forced to develop breasts and then remove them later you remove all the inside features and there’s not really any takebacksies.
A lot of trans development looks like this. There are a lot of details and the issues when presented to the public don’t give all the information for the public to make a well informed opinion on trans health. It really is kind of a specialist medicine .
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Thank you, excellent answer. I learned stuff.
Most children do not get hormones or surgery. Usually, the most intervention that happens is puberty blockers.
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What are puberty blockers if not hormones?
More like they are “anti hormones.”
They’ve been used to help cis kids who would otherwise be going through puberty at like 6 or something for decades. You stop any permanent changes from happening due to puberty. The child can choose to go off them if they change their mind and go through a “normal”’puberty, or stay on them and decide to get on HRT as an adult.
In the long run, this means less medical intervention. If you don’t grow breasts you won’t need top surgery; if you don’t experience a testosterone puberty you won’t have your vocal cords deepen and need voice training or surgery.
It is the “let’s wait until you’re an adult and can make a choice” option.
If someone takes hormone blockers for several years before deciding to stop, does puberty proceed the same as in a younger person?
Since this is a controversial thread, I feel at liberty to say: while I was never trans, I was pretty ambivalent about my gender as a young person. It wasn’t until after I’d gone through puberty and had multiple years of estrogen (through the natural process of puberty) that I felt “feminine”. Gender kind of partly feels like a process you go through vs an identity.
This is actually one of the key things about cis versus trans psychological makeup. It’s kind of more useful to look at the majority cis experience as a sort of flexibility of sexual phenotype (- what looks or appears male or female). The majority of cis people are actually fairly fluid in their concept and Preferrence of not really gender - but sex characteristics and they mentally adapt to meet whatever gender expectations and circumstances they end up in usually as a path of least resistance.
Transness (and a small theoretical subset of cis people ) actually experience the opposite of this : sexual phenotype rigidity. It’s like there’s a setting in the brain dailed all the one to one side of the brain’s expectation of physical sex characteristics. Gender as a concept of “feminine and masculine” as categories of social expectations of behaviour and culture is kind of is just the performative baggage on top. What is really happening is almost 100% about the body’s characteristics and the reason social engineering is such a big deal is because language is a mirror. If someone calls you by the wrong name or pronoun that is actually mapping onto you perceiving your own body’s through someone else and you can’t control how the feedback makes you feel because you are rigidly stuck on an independent internal reward/punishment system. Disparity brings pain, matching the expectation brings joy. Nothing is neutral.
The “gender performativity” concept a’la Judith Butler is actually more in line with a cis person’s concept of gender than a trans persons and untangling the two is really difficult because there’s not as much backwards engineering what cis people are actually like to properly compare. I can tell you though after speaking to a lot of both cis and trans people about their experiences that this is actually more like two entirely unique theories of how the idea of “gender” works where “gender” is actually meaning two kind of related concepts but not quite 1 to 1. There’s a fundamental difference that lies deep under this thing.
This a really interesting response. Thank you!
If you got any questions feel free to fire away. I am a part of a block of citizen research by a group of trans people trying to gain a better understanding of what is actually going on in the heads of cis people regarding gender. There’s some stuff we’re beginning to sketch out as these two groups talking across each other both with improperly established expectations of what the other experiences.
We are a long way from publishing anything because a lot of us are rag tag academics due to us being kind of a minority but there’s something up. We may be verging on a way easier future explanation for what trans people are in relation to cis people and it could be particularly disruptive to some limited sections of the non-binary community.
Pretty much, yeah. There’s legitimate concern regarding bone growth (height, density) but it’s usually fine and nothing compared to the known problems with being forced to live in dysphoria.
Gender is a lot of things and different for everyone. I remain very ambivalent about my gender as a man in my 30s. It’s probably most accurate to call myself agendered but biologically and socially I’m male so I don’t think it’s worth the fuss. It strains my imagination to contemplate “feeling masculine/feminine”. The point is that you can’t necessarily apply your (perfectly valid) experience to others and making trans people go through natural puberty dooms them to irreversible changes that can cause severe psychological distress.
This study on several cis girls suggests that there’s nothing unusual about puberty post blockers.
I also want to say here that I have known two kids to be on blockers. Both had to drive several hours out of state to access their treatment. One of them almost was removed from their home by the state solely because they were trans and receiving blockers - a family friend who has received death threats and harassment and has had to go to court several times because she recognizes her son for who he is. The right wing propaganda sphere likes to pretend blockers are being handed out like candy, but that is not the case.
I’m not trying to push an agenda here. As a parent, I’m honestly trying to understand the ramifications of these treatments. Because as a leftists, asking these questions becomes verboten, as if you hate trans people to question any treatment.
But really (since this is a controversial thread) I just don’t want my child taking a knife to, and hindering the functionality of, any part of their body that was already working just fine. This is especially true for parts that enables an enormous amount of human bonding and the human experience, like sexuality. It feels akin to circumcision/ genital mutilation in my mind, and if that’s what they decide they want as an adult, I wouldn’t stop them. But as their guardian, who safeguards their person for their future self, I would have been willing to divorce my husband over circumcision (at the time we disagreed on it, but we only had daughters). There’s no way most parents without an ideology want to risk long term damage to their child for something uncertain or fluid.
I know I already replied to you in another comment but I posted a big breakdown of how trans healthcare for kids actually works and isn’t as scary as people think. If you are interested just check my post history. I Included the actual less destructive nature of horomone treatment during puberty in regards to the total number, invasiveness quotient and surgeries experienced later in life. But surgery isn’t really a thing for trans kids.
A lot of what you are experiencing with trans discourse is a poisoned well. The issue of trans health care has been sold to the masses as being too quick, lead by the whims of the child, involving a lot of medically scary things that seem irreversible and it operates in a weird blind zone where people don’t really understand trans people’s biological capabilities well or their psychological dispositions.
In some places it can be good to step back and ask where your opinion is actually coming from because this is a very convoluted and non-intuitive branch of medicine for a casual outsider. Parents of trans people and young trans people themselves essentially learn decently advanced pediatric and endocrinology concepts as part of the basic consent process and as a parent of cis kids that is going to seem a lot more scary without an individual personal proof of psychological benefit you get from seeing a child develop.
Here is the very common trans parent scenario :
Your child who has had massive anxiety all their life, They have stress related physical symptoms, they have neurotic behaviours that appear as psychological disorders, they get sick often and are withdrawn from social groups and have a hard time making friends.
You discover your child identifies as trans and asks to go by a different name. You adjust, you change their hair and clothes. Almost immediately health conditions you didn’t know were related start to clear up, nervous ticks evaporate. They start forming better and stronger attachments to peers. They start showing more verve for life and pursuing hobbies and sports. The behaviour is so startling and overwhelmingly positive it is impossible not to link it to that choice.
It really is the case where the science and care plans aren’t super intuitive for someone just dipping their toes in this water. If you don’t have a trans kid then chances are good you haven’t seen the day and night psychological changes to thriving from not thriving that social transition brings. It’s a process and parents know their children. Parents, as a general rule, don’t sign onto things that seem scary unless they are convinced. A psychotic parent also would have a really hard time getting a cis kid through trans healthcare because there’s a panel of experts that check all the angles from school and home life to a lot of developmental markers. Doctors treat children’s long term outcomes as sacrosanct so the burden of proof of benefit is way higher than the average person knows.
But that isn’t happening. You have to recognize that there is a huge fucking propaganda campaign being held to convince you that children are walking to clinics and getting their dicks and breasts chopped off. Surgery doesn’t even make sense until all the parts are fully developed anyway.
Care is mostly affirming pronouns and names, sometimes puberty blockers.
Sexual reassignment surgery and top surgery are types of treatment. Another type is puberty blockers, which I asked about and you responded with talking points instead of information.
Also, what is the end game of puberty blockers? I assumed if you were a trans boy and took them, you got surgery as an adult to remove for example, breast buds so they never develop into breasts. Are you saying people stay on puberty blockers their whole lives?
So, in this same train of thought… Should we prevent children from going through puberty until they are 18?
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Right, but puberty involves a series of hormone changes that have permanent physiological effects. If HRT can be started before puberty then it’s much easier to transition, and that would really help with body image insecurities.
I can’t speak about this from the perspective of a trans person, but I was pretty sure I was a boy at 12 years old, I think if I felt like a girl trapped in a boy’s body, I would have been equally sure of that. What’s the harm in allowing someone to be on puberty blockers until they are 18, or however arbitrarily old they need to be, in order to decide what they want to look like, and who they want to be? Obviously disregarding the very well documented harm of not transitioning and building an identity during some of the most formative and social years of a person’s life.
OMG, this is exactly my opinion.