All,
As the originator of this thread, it is good to see this level of interest in this topic.
First, in answer to the questions of appropriate age, please see: Transition in Childhood (
13058)
Though this covers BtG and GtB instances, the same thing should be considered an appropriate approach to BtE issues.
My original thinking was it would be best to directly castrating a boy with thorough evaluation to determine if it should be done. This was before I was aware of androgen-blockers like Androcur. After considerable discussion in this thread, I have come to agree with the positi
delayed until the boy can make an informed decision.
Given that Dr. Spack allows transitioning to begin at age 16, after several years of review (usually by the time they come to his clinic, the gender is not in question, the child has been living in the way they feel is proper for them), that should be the appropriate age for a BtE also. Again, Holland starts transitioning at 14, with a 100% success rate. That success rate speaks volumes about a child's maturity about an issue that this important to and about them.
Started before puberty, Androcur (and other blockers) allows a boy to remain that, while he observes other boys of his age becoming (young) men. If he remain comfortable as he is, rather than becoming an adult as his classmate are, castration, at 16 (or 14? Tim...), is then appropriate. This the same age that is the baseline for BtG and GtB.
It is now (generally) recognized, by psychiatrists, that sexual identity (male or female) is set by the age of three. From the discussion here, it seems that the common rough age for a boy's desire to remain a boy is between 7 to 10. Tim seems to have been around 9 or so.
See Jesus' article about a NPR broadcast concerning the issue for "presenting" (transgenderism in children) for further reference:
Support Your NPR Station (
100952), for an excellent review of preadolescent gender identity disorder and how to address it.
Here comes the biggest issue of those that boys that simply want to remain boys - "presenting." In each of the cases cited in the above referenced threads, the children (BtG) "presented" at between 2 and 3 year of age. For BtE, there is no ready way to make it clear to parents that they want to remain boys.
At 14 though, Tim was able to convince his mother (single parent) that castration was appropriate. Without the overriding dominance of a father, he was allowed to make the decision on his own (though decision is not really accurate, I guess acknowledgment is more accurate). The one thing he never told me directly was when he came to the realization that he wanted to remain a boy. I think though, it was around 9 or 10 (not atypical). He was very lucky that his testes were never functional, since at 14, it would have have otherwise been too late in all likelyhood. (see previous posts about him for additional information). He was castrated shortly after he turned 15.
In his case, I think music and remaining a boy are indivisible. From my many discussions with him, it was more that just his singing that was part of the reason to remain a boy. He saw other boys mature into (young) men, and he felt that it would be wrong for him to become one. The key indicator here is that he is comfortable as he is, he watched the boys around him mature physically, even before he would have hit puberty, and never wanted to be like them.
Medically, it would not have happened, but that was not discovered until he was castrated, he had vestigle testes. It's why puberty had not started by the time he was 15.
A unique intersection: A boy with a love of music and the desire to remain a boy, a consenting mother, and a lack of functional testes. The lack of either of the latter would have made the first impossible.
I have a very serious concern about "bricks meeting balls," yet I do not know what the best method is that can allow boys to make their concerns known before age 16, when it has become too late to prevent the changes already occurring.
I would like to get Dr. Spack involved in the BtE issue, but I would not know how to approach him about this topic. As with BtG, the danger of self-mutilation for BtE is just as real.
See my initial thread and post #3 in this thread, and you can understand why I started this thread.
There remains a considerable difference in age between "knowing" and being to act on that knowledge, but the child should not be forced to live in the body that was forced on them by parents and doctors because they were too young to have any input into the discussion (if there even is any).
We need many more Dr. Spack's and the retirement (though not soon enough) of "Doctors" like Dr. Zucker.
My 10-million question: how can boys really get their needs across?
It will take a lot of education of doctors, like Dr. Spack. to understand that there is, in fact, a third group, BtE, who's needs must be addressed in an appropriate manner, without the need for a trip to Holland.
The last time I chatted with Tim, his voice was up to high E, and he slowly lowering the bottom end of his range. He does not regret, at all, the choice he made. He was on in the last month or so, but I was not on at the same time.
Contrary to Consider's statement above, castrati are not counter-tenors, they are sopranos that are able to develop a broader voice range, higher in range than a counter-tenor (even sopranos), clearer, brighter and richer. The lungs become larger giving him more power, the voice box gets slightly bigger as the boy continues to grow slowly, and the vocal cords get tighter as a result, giving the boy the unique range and qualities. Since the boy's voice is in his natural range, not a falsetto, the voice can develop more vibrato.
Counter-tenors are tenors that use falsetto to reach into the alto range. Their voice is flat in comparison to a soprano, and even more so to a castrati's, and the vibrato is very weak or missing. It would NOT the Vienna Men's Choir, the voices would still be that of the soprano (and castrati, if there are any in the choir; I have come across statements that claiming one or the other).
A "high" tenor does not reach the sames octave that a counter-tenor does, but no falsetto is used, so the voice remains strong, bright and clean within the singer's normal range.
Very few boys in the Vienna Boys Choir would want to become castrati (I would think, though a position on that choir is an extreme achievement, so?), but that choir might have boys like Tim that want to stay boys because of their discomfort in the changes wrought on by puberty, and their depth of involvement in music, similar to Tim's. Vienna to Holland is not a long trip.
As i have said many times before, a BtE remain the boy forever, the change wrought by puberty never occur, simply nothing changes.
They remain as they are when blockers are started or castration (accidental of medical) is performed. Typically, they appears to be age 12 or so, but with the development of longer limbs. Tim's still appears to be 14 or 15, but his limbs are a bit longer now. Without castration, he would have been about 5'7, with the longer period for limb growth, he will be around 5'11.
In his eyes, nothing about puberty was worth the changes. For him, remaining prepubescent was not ever a "choice" and an appropriate course of action was castration. From all he told me, since he first started discussing castration, was his seriousness about it, and his present comfort level with his "choice." It was not a choice, but the answer waiting for him to find the right question.
What is crucial here is that boy be given the knowledge about puberty, and with that the option of going on blockers, until they are in a better position to insure that the decision is the correct one. The approach I like best is that starting at age 8, during annual, or semi-annual physical exam, the boy be given the necessary information to start him thinking about his on-coming physical development. Few boy would see any need to delay puberty.
This is alsothe time when he should start to watch for things that could indicate possible issues in his soon-to-be developing genitals. How many teenagers developed testicular cancer because they were never told how to check their genital health and so they never looked for lumps. I was never told any of this (no, I remained healthy, but still...). These visits are also the perfect time to insure that the boy is ready to start puberty, or that he does not want it yet (if at all).
With the age of the start of puberty getting lower (more growth/hormonal ingredients in animal feed is the suspected cause), the body is getting mature faster than the mind can. Thus it becomes more imperative that BtE's be identified as early as possible.
As I have observed in the past, few boys will express any desire than to become men. The few that do have to be treated in a manner appropriate to meet the child's needs. And that is NOT the approach "Dr." Zucker takes. (I have nothing but contempt for the man and his potentially devastating methods he and the others that use them.)
The three males I have known that this topic is most relevant about: Tim: Very happy as a castrato; Alex: Very happy as a nullo (Amsterdam again); and Jay, still looking at back at age 12 with at least a little regret.
For all of us: The answer await us, it for us to find the question.
-YC
