Important Ethical Question

[erikboy (imported)]

I read an article about a clinic in Denmark recently that is treating young transexuals. They are doing it in the form of experiment. So far they have had about 35 patients. Treatment begins with puberty supression drugs when child has first signs of puberty. Logic behind it is to avoid excessive masculinisation. It is impossible or very expensive to undo some masculinisation after puberty. Boy normally changes his identity to girl living fulltime girl. And when he turn 16, he can decide what he really want to do. Either to continue with normal male puberty or have SRS surgery and continue with female puberty. So far no patient has changed their minds when reaching age 16.

There is a problem, that person is not able to experience male puberty before making decision.

but the results are much more satisfying in many aspects.

I even saw pictures of one young boy turning into a beautiful young woman on the net. Latest picture was taken when she was 22 or 23. It was impossible to tell that she was born as a boy. She looked really great.

Unfortunately I can not find these pages right now. But if I find, I'll post them here.

[Paolo]

Jema,

You raise an interesting point in the discussion of a multitude of possible genders.

However, whether it be MtF or MtE or MtO (other) in this case of an XY-child not CURRENTLY and fully identifying as "male" - and "pretty much" identifying as "female" - the same arguments and questions must still apply for something as radical and irreversible as castration surgery - not to mention total GRS - the answer at this age must still be NO.

Now, all questions of surgery aside, were this my kid, I'd be prone to let the little darling do what makes him/her happy - short of surgery. If the kid wanted to delay puberty, fine. If the kid wants to go through female puberty, fine. But that decision at a later date. If the kid wanted to stay on lupron to avoid it altogether until the age of 16, fine.

If the sweater is pink for 6 days a week and blue on Saturday, fine. If he wants a gray sweater, that's fine too. But like I said, we're not going to try and convince the local vet to do anything radical! Not at such an age.

For the record, we've got a boy on the Godson's baseball team that - at first glance - looks like a very pretty girl. He's very effeminate. But he's also a wicked good baseball player. With fashion at that age, it's sometimes hard to tell, but I've bought enough clothes to know that some of his came from the girls' section.

Is there a gender issue there?

I don't know.

I've read that coming out as wanting to be the opposite gender, and as well as donning that roll in ALL occasions can be a good thing for the child. When it's no longer taboo to wear a skirt, and everyone adapts to it, then the issue sometimes resolves itself and might even go away.

But for the age suggested, I still have to say "keep him away from sharp objects".

[Taylor (imported)]

I would say no to the individual in question at this point. There are a multitude of reason that could fill dozens of pages. I will simply defer to Paulo's writings on this subject.

T.

[jemagirl (imported)]

Paolo,

In my original post I favored going with suppressing puberty with drugs until three questions could answered with certainty.

The questions I think are most pertinent here are: Is she emotionally mature enough to make this decision? Does she understand that this is permanent and irreversible procedure? Is this what she wants or is it what she thinks her parents and family want from her?

I think one could not proceed ethically without first answering these questions. I feel the classic advice of "Rush Slowly" applies very well in this case. In the mean time there are other non-surgical alternatives to delay the onset of puberty.

However I did leave the door slightly ajar. If the all the questions can be answered with a high degree of certainty which I think is very doubtful. then her age should not be a factor at that point.

I agree with that most children are not emotionally mature enough to understand the consequences of castration. In any case since there are other less permanent options starting with surgery doesn't make much sense.

In my other post I wanted to raise the concept of multi dimensional genders because so often people of mixed gender do not get the help they/we need. When one expresses aspects of female and male so young it is often seen as gender ambivalence or confusion, when in fact that may not be the case.

[Hash (imported)]

Somehow, at least for me, this seems to fit into the "intersex" dilemma, where some girls with extra large clitoris's have them cut off when they are young or some boys with micro phalluses have their testicles removed and eventually have a vagina made for them. It's not quite the same, but the "intersexed" people who had no choice in the matter grow up angry because they had no say in the matter. Many of the intersexed people who went through these operations have poor sex lives from all that I've read and some boys who were castrated and turned into girls, eventually went back to being boys, though castrated.

What I'm saying is that the parents and the doctor are in a dilemma. What if the boy is wrong about wanting to be a girl? Who will take the blame? A child who does not understand all the ramifications of gender? Personally, a child should not be able to make a decision about elective surgery. That's what I think, but I know it's important to do the surgery before puberty. Someone will need to make a decision, but if I was the surgeon, I wouldn't do it. To many ethical questions and he might go to jail for endangering the life of a child if something bad happens. Hash

[jemagirl (imported)]

Hash,

You are right. I think that is why most here are advocating suppressing puberty with drugs as the first option, and that is primarily because it is reversible. Also all doctors all take an oath that basically says "First, do no harm" Since it is likely that they can't be sure of the outcome, most doctors would probably decline to do the operation regardless of what the parents or child actually want.

With respect to the inter-sex children who were operated on with out their permission, and then forced to live in the wrong gender, I think this situation is quite possibly just the opposite. If it is the child, who wants the intervention and is unable to receive appropriate intervention of some kind ( not necessarily surgery ), then it is the lack of action which causes the harm.

[Kangan (imported)]

I've got a real ethical problem with either the child or the parents consenting to a castration. A child cannot give informed consent. What if the parents really wanted a girl and are forcing the child to change gender to suit their egos? That line about trans-gender positive life style sounds a bit phony to me.

Bottom line: No way.

[Paolo]

Now that I've thought about it, a lot of this reminds me of the movie "Cachorro" aka Bear Cub.

It's about a 9 year old boy who goes to live with his gay uncle (and friends!) when his mom is arrested and sentenced to a very long term. She's convinced the kid is gay, since his uncle/her brother is, and she's bi, and treats him as if he were already gay. The outcome - he's not gay and tells his Uncle this.

I also have to wonder if the question posed here is as Kangan suggests.

Is this child trying to live up to the idea that he thinks he should be of the TG mindset from his environmental exposure in this family?

However, I have to restate how disturbed I am that the family even

brought this up to a professional

who would bring it up to said list.

Jesus, please convey my thoughts on this to them.

It REALLY bothers me.

[JesusA (imported)]

I agree with Paolo. This one bothers me a great deal. I just finished sending my third email to the person who sent me the original question. I have had no answer to the first two that I sent him. (He is a very busy person and often takes days to respond to my questions.) If I don't have an answer by noon (his time) tomorrow, I will be telephoning him.

What I can report is that this question was posed both here, on the Eunuch Archive, and on Sexnet, a listserve that is open only to professional sex researchers and sex therapists. You have to apply, giving references and your academic credentials, to be able to join. The EA respondents have been far more thoughtful and FAR more concerned about the boy himself than the professionals have been.

I'm happy to be associated with all of you. This is an excellent crew!

I will keep you posted with whatever I find out.

[JesusA (imported)]

FINALLY, on Sexnet, about ten minutes ago, a critical question that was raised almost instantly by the EA crew:

Much more importantly, and an issue that hasn't been raised here, is to what extent the child might be acting out the parent(s)' desire for him to be a daughter. Sounds to me like there could be some serious psychopathology masquerading in the guise of parental empathy.