That intrigues me. It sounds simultaneously reasonable and kind.JesusA (imported) wrote: Thu Jul 24, 2008 8:13 pm I will try to put together a proper post on the Dutch experience (some of which has now been published in medical journals). They are willing to give puberty blockers to children as young as 12 who have been diagnosed with GID and then to provide intensive counseling for the child and his or her family. Nothing irreversible is done until 16 or later, after the child has had ample opportunity to consider all of the options for treatment.
This has been going on for several years now and there are many children who have had SRS and who are now adults. Thus far, not a single one has regretted the decision to transition. All have been spared the pain of puberty in the wrong gender.
Buying Time for Gender-Confused Kids
-
Blaise (imported)
- Articles: 0
- Posts: 2141
- Joined: Wed Oct 09, 2002 5:45 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
-
moi621 (imported)
- Articles: 0
- Posts: 4434
- Joined: Sat Jan 19, 2008 6:23 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
Sound like an Episode of South Park.
Bi-Curious.
Unfortunately thread is true.
I remember when they tried to give
young girls birth control pills to stop their
growing because they had promising
ballet careers. Did not work. And they were
exposed to the whore-moans.
And if surgery on ambiguous genetalia children,
etc. has demonstrated anything over time,
it is
"Don't Mess With Mother Nature"
Unfortunately, the whores are the medical
community. They can't leave it alone.
Gotta sell a service !
Bi-Curious.
Unfortunately thread is true.
I remember when they tried to give
young girls birth control pills to stop their
growing because they had promising
ballet careers. Did not work. And they were
exposed to the whore-moans.
And if surgery on ambiguous genetalia children,
etc. has demonstrated anything over time,
it is
"Don't Mess With Mother Nature"
Unfortunately, the whores are the medical
community. They can't leave it alone.
Gotta sell a service !
-
chilliwilli (imported)
- Articles: 0
- Posts: 593
- Joined: Sat Feb 02, 2008 4:39 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
moi621 (imported) wrote: Fri Jul 25, 2008 1:12 pm And if surgery on ambiguous genetalia children,
etc. has demonstrated anything over time,
it is
"Don't Mess With Mother Nature"
Unfortunately, the whores are the medical
community. They can't leave it alone.
Gotta sell a service !
Ain't that the truth. The old folks are more often than not the victims though. You take a medical system funded by capitalist dollars and unleash that on an uneducated non-selfaccualizing public and wow...the things that can happen.
But I know we have the highest level of medical care in the world...and we could do a heck of alot worse...it's just so damn expensive.
Anyway,
THANK GOD MOST DOCTORS HAVE A STRONG RELIGOUS BACK GROUND, unlike us freaks, deviates perverts, autophiles etc. who seem to strongly self identify on something other than our religion or family or community etc. I hate to imagine what would happen today if some of us were left to our own devices or were allowed to release our devices on the innocence of the world. And don't expect mercy or "understanding" from me if I ever catch someone harming an innocent. Unless you consider mercy a rapid decisive end to an otherwise worthless vile existance.
I think I was an executioner in a prior life...maybe that would be a good occupation for a eunuch...hmmm I'll have to post yonder.
whore for jesus
chilli-
-
JesusA (imported)
- Articles: 0
- Posts: 3605
- Joined: Wed May 16, 2001 6:37 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
Below is an article on the early development of gender awareness that, I think, adds to this discussion on delay of puberty.
Raising Gender
Children developing millisecond by millisecond
By Natalie Nokoff and Anne Fausto-Sterling
Mom, when is the good fairy going to come and change my peepee? asked two-year-old Jazz.
Jazz was born malewith XY sex chromosomes and a penisbut as a toddler he already felt certain that he was really a she. By age five his parents allowed him to present himself to the world as a girl. Jazz thus became the youngest documented case of a transgender child to openly transition from male to female.
Children such as Jazz have recently captured the publics attention. Barbara Walters interviewed Jazz and her family on an episode of 20/20, My Secret Self: A Story of Transgender Children. Transgender children have also recently appeared on Oprah and on the cover of Newsweek. Thanks, in part, to this media coverage the distinction between sexual orientation and gender identity is dawning on public consciousness. What still needs to be better understood, though, is that there is variation in gender identity beyond the strict binary of male or female. Not surprisingly, variation remains a contested term because many people view transgenderism as a genetic mistakethat something went wrong, that male and female are the only correct genders.
At the infant development lab at Brown University, we take the perspective that the behaviors and roles typically associated with gender in early childhood emerge from subtle events starting at or even before birth. Although we do not study gender identity or sexual orientation, we suspect that the techniques and approaches we are using will ultimately provide insights into these phenomena. We see the infants developing skills, capacities, and understandings of self and other as a series of events in which the social and biological intermingle. For example, a preterm infant is at a higher risk for learning disabilities later in life but not if he or she grows up in an attentive, responsive home environment. That is early damage thought of as biological can be healed by events we think of as social.
In our lab we focus microscopically on the behaviors of first born infants and their mothers. We observe five minute clips of the infant and mother in each of the following scenarios: playing alone, playing together, and care taking (feeding, diapering, etc.) during the first three to fifteen months of the infants life. We analyze behaviors for both the infant and mother on a second-by-second basis. The infant behaviors examined include gross motor movements, fine motor movements, vocalization, and play with specific types of toys. In mothers we look at stimulation (of infant), play (with infant), and vocalization. We are interested in the mother-infant pair because we believe that too often developmentalists (both biologists and psychologists) focus on the infant as if it were an autonomous unit. By analyzing the behaviors of both the mother and the infant, we hope to see not only how a parent can influence a childs behavior, but also how a child can shape a parents behavior. No infant develops alone. No infant learns to talk unless immersed in a surrounding sea of language. No infant thrives without physical touch and affection. We believe that gender itself emerges from the intimate daily dance of infant and social milieu.
We analyze our data, behavior recorded on a second-by-second basis, using dynamic systems theory. The late Esther Thelen, who revolutionized developmental psychology, emphasizes three critical principlescomplexity, continuity in time, and dynamic stability.
First, gendered behavior is complex. A girl may wear dresses but also play with trucks. Or, she and a little boy while playing together at home may happily invent a fantasy game involving cooking. But in the school yard these two best friends may avoid each others company and go to the boys or the girls side of the playground. Context is crucial to understanding the complexity of sex-related behaviors.
Second, a childs behavior, as Thelen writes, depends on its previous states and is the starting point for future states. If a child plays with only girls on the playground for nine straight days, chances are likely that she will do the same on day ten. However, the old pattern canand sometimes doesbecome unstable (say around puberty!) and that period of instability may predict a behavior pattern that becomes her new dynamically stable state.
Lastly, dynamic refers to the fact that behaviors are usually not fixed. Highly stable behaviors appear to be fixed because the underlying dynamics that sustain them strongly reinforce one another. But even stable behaviors change when the systems contributing to them become unsteady. For example, the transition from crawling to walking is one from a highly stable behavior to one that is at first unsteady. (Picture those early, wobbly, fall-down steps of the almost-toddler).
What motivates such transitions? Traditionally, child development research has ignored the intricacies of such sudden changes and focused on the starting and ending states. By contrast, dynamic systems theory demands attention to smaller time scales, time scales on the order of milliseconds, as Thelen writes.
What is it about gender in the under-three age set that we think needs explaining? Our research group scoured the literature to find consistently demonstrated differences between boys and girls aged three and under. Surprisingly, given the constant hype in the news media, we didnt uncover much. The most consistent finding is that by age three boys and girls have different play patterns and toy preferences. They also have different patterns of physical activity at certain ages but not others. For example, young boys typically participate in more competitive, rough-house play, and girls in more cooperative play. Weaker evidence suggests that girls may learn to speak earlier and with greater proficiency than boys, although these findings are less clearly supported than those for toy preference. There are many other single findings of sex differences before aged three, but most have not been repeated in the scientific literature and thus remain interesting but unproven.
The other strong finding in the literature is that from day one parents start with a set of expectations and stereotypes. Their interactions with their children are saturated with a culture of maleness and femaleness. One only has to turn on the television to see commercials of young girls playing with pastel colored houses and fake make-up, or boys playing with brightly colored trucks. Or to look at the dominance of pink and other girly pastels in the gifts at a baby shower where the participants already know Mom is expecting a girl. We also know that mothers talk more to their daughters as compared to their sons. Such differences may result from the influences of both the parent and child. Since girls talk at a younger age than boys, their parents may talk to them more frequently. Or, since parents talk to girls more often, they may talk at a younger age.
The differences noted in the literature by age three are not present in children at three months. We hope to see differences emerge between the boys and the girls, or the ways in which mothers interact with boys versus girls, when they are between three to fifteen months. It may be that our results are indirectly related to gender. For example, infants may display different patterns of behavior when playing alone versus playing with their mothers. If it turns out that in the home mothers play more with girl babies, for example, girls emerging differences might be a secondary result of different mother infant play patterns.
A study conducted in Italy by Manuela Lavelli and Alan Fogel showed that after the first month of life, infants sustain face-to-face communication with their mothers significantly longer when they are propped up on the couch as opposed to in their mothers arms. Moreover, girls could sustain longer periods of face-to-face communication when held as compared to boys. What if a mother has a child that is more attentive while sitting on the couch, yet she continues to engage in face-to-face communication with the child in her arms? Such small differences, differences on the order of seconds to minutes, compile over time and may contribute to childhood behavior patterns.
Take Jazz for example. If her parents had insisted that she live as a boy, it would have been a constant battle as they put it. Merely choosing an outfit before school each day would have been a source of tensionJazz wanting to wear a dress, and her parents insisting on pants. At some point, Jazzs parents realized that their biological boy truly wished to live as a girl. Through a focus on individual variability and a more nuanced investigation of gender, we hope that someday Jazz can be viewed on a spectrum of gender variation, rather than a deviation from the norm. And we hope that our studies will provide a blueprint for studying the origins of gender variability in a way that truly acknowledges the indivisibility of nature and nurture.
Natalie Nokoff is a second year medical student at Brown Medical School. She received her BA in Gender Studies from Brown University in 2006. She is currently working in Anne Fausto-Sterling's infant development lab as a part of her scholarly concentration in medical humanities. She is co-leader of the student chapter of Physicians for Human Rights at Brown. She hopes to incorporate her work in gender studies into her future career as a physician.
Anne Fausto-Sterling is Professor of Biology and Gender Studies in the Department of Molecular Biology, Cell Biology and Biochemistry at Brown University. She is the author of Sexing the Body: Gender Politics and the Construction of Sexuality (http://www.amazon.com/Sexing-Body-Polit ... 0465077145) (Basic Books: 2000).
Ms. Nokoff and Dr. Fausto-Sterling would like to acknowledge the collaboration of undergraduate students at Brown University as well as their faculty colleagues Professor Cynthia Garcia Coll and Ronald Seifer, and the work of Professor Deborah Schooler, now at University of the Pacific.
American Sexuality Magazine
http://nsrc.sfsu.edu/MagArticle.cfm?SID ... ED30AE21B1 A&DSN=nsrc_dsn&Mode=EDIT&Article=821&ReturnURL=1
American Sexuality Magazine (www.americansexuality.com) is an on-line resource for sexuality education funded by the Ford Foundation and housed at San Francisco State University. New articles are added nearly every day. I have been asked for an article on the voluntary eunuch community as another example of the range of sex and gender variability in society. At some point Bonnie would like to find a volunteer in the Bay Area who would be willing to be interviewed on camera for posting on the American Sexuality site. She asked me again the last time I saw her at the NSRC office and I had no suggestion of anyone in the immediate area.
Please explore their site. There are a number of very fine articles available there.
Raising Gender
Children developing millisecond by millisecond
By Natalie Nokoff and Anne Fausto-Sterling
Mom, when is the good fairy going to come and change my peepee? asked two-year-old Jazz.
Jazz was born malewith XY sex chromosomes and a penisbut as a toddler he already felt certain that he was really a she. By age five his parents allowed him to present himself to the world as a girl. Jazz thus became the youngest documented case of a transgender child to openly transition from male to female.
Children such as Jazz have recently captured the publics attention. Barbara Walters interviewed Jazz and her family on an episode of 20/20, My Secret Self: A Story of Transgender Children. Transgender children have also recently appeared on Oprah and on the cover of Newsweek. Thanks, in part, to this media coverage the distinction between sexual orientation and gender identity is dawning on public consciousness. What still needs to be better understood, though, is that there is variation in gender identity beyond the strict binary of male or female. Not surprisingly, variation remains a contested term because many people view transgenderism as a genetic mistakethat something went wrong, that male and female are the only correct genders.
At the infant development lab at Brown University, we take the perspective that the behaviors and roles typically associated with gender in early childhood emerge from subtle events starting at or even before birth. Although we do not study gender identity or sexual orientation, we suspect that the techniques and approaches we are using will ultimately provide insights into these phenomena. We see the infants developing skills, capacities, and understandings of self and other as a series of events in which the social and biological intermingle. For example, a preterm infant is at a higher risk for learning disabilities later in life but not if he or she grows up in an attentive, responsive home environment. That is early damage thought of as biological can be healed by events we think of as social.
In our lab we focus microscopically on the behaviors of first born infants and their mothers. We observe five minute clips of the infant and mother in each of the following scenarios: playing alone, playing together, and care taking (feeding, diapering, etc.) during the first three to fifteen months of the infants life. We analyze behaviors for both the infant and mother on a second-by-second basis. The infant behaviors examined include gross motor movements, fine motor movements, vocalization, and play with specific types of toys. In mothers we look at stimulation (of infant), play (with infant), and vocalization. We are interested in the mother-infant pair because we believe that too often developmentalists (both biologists and psychologists) focus on the infant as if it were an autonomous unit. By analyzing the behaviors of both the mother and the infant, we hope to see not only how a parent can influence a childs behavior, but also how a child can shape a parents behavior. No infant develops alone. No infant learns to talk unless immersed in a surrounding sea of language. No infant thrives without physical touch and affection. We believe that gender itself emerges from the intimate daily dance of infant and social milieu.
We analyze our data, behavior recorded on a second-by-second basis, using dynamic systems theory. The late Esther Thelen, who revolutionized developmental psychology, emphasizes three critical principlescomplexity, continuity in time, and dynamic stability.
First, gendered behavior is complex. A girl may wear dresses but also play with trucks. Or, she and a little boy while playing together at home may happily invent a fantasy game involving cooking. But in the school yard these two best friends may avoid each others company and go to the boys or the girls side of the playground. Context is crucial to understanding the complexity of sex-related behaviors.
Second, a childs behavior, as Thelen writes, depends on its previous states and is the starting point for future states. If a child plays with only girls on the playground for nine straight days, chances are likely that she will do the same on day ten. However, the old pattern canand sometimes doesbecome unstable (say around puberty!) and that period of instability may predict a behavior pattern that becomes her new dynamically stable state.
Lastly, dynamic refers to the fact that behaviors are usually not fixed. Highly stable behaviors appear to be fixed because the underlying dynamics that sustain them strongly reinforce one another. But even stable behaviors change when the systems contributing to them become unsteady. For example, the transition from crawling to walking is one from a highly stable behavior to one that is at first unsteady. (Picture those early, wobbly, fall-down steps of the almost-toddler).
What motivates such transitions? Traditionally, child development research has ignored the intricacies of such sudden changes and focused on the starting and ending states. By contrast, dynamic systems theory demands attention to smaller time scales, time scales on the order of milliseconds, as Thelen writes.
What is it about gender in the under-three age set that we think needs explaining? Our research group scoured the literature to find consistently demonstrated differences between boys and girls aged three and under. Surprisingly, given the constant hype in the news media, we didnt uncover much. The most consistent finding is that by age three boys and girls have different play patterns and toy preferences. They also have different patterns of physical activity at certain ages but not others. For example, young boys typically participate in more competitive, rough-house play, and girls in more cooperative play. Weaker evidence suggests that girls may learn to speak earlier and with greater proficiency than boys, although these findings are less clearly supported than those for toy preference. There are many other single findings of sex differences before aged three, but most have not been repeated in the scientific literature and thus remain interesting but unproven.
The other strong finding in the literature is that from day one parents start with a set of expectations and stereotypes. Their interactions with their children are saturated with a culture of maleness and femaleness. One only has to turn on the television to see commercials of young girls playing with pastel colored houses and fake make-up, or boys playing with brightly colored trucks. Or to look at the dominance of pink and other girly pastels in the gifts at a baby shower where the participants already know Mom is expecting a girl. We also know that mothers talk more to their daughters as compared to their sons. Such differences may result from the influences of both the parent and child. Since girls talk at a younger age than boys, their parents may talk to them more frequently. Or, since parents talk to girls more often, they may talk at a younger age.
The differences noted in the literature by age three are not present in children at three months. We hope to see differences emerge between the boys and the girls, or the ways in which mothers interact with boys versus girls, when they are between three to fifteen months. It may be that our results are indirectly related to gender. For example, infants may display different patterns of behavior when playing alone versus playing with their mothers. If it turns out that in the home mothers play more with girl babies, for example, girls emerging differences might be a secondary result of different mother infant play patterns.
A study conducted in Italy by Manuela Lavelli and Alan Fogel showed that after the first month of life, infants sustain face-to-face communication with their mothers significantly longer when they are propped up on the couch as opposed to in their mothers arms. Moreover, girls could sustain longer periods of face-to-face communication when held as compared to boys. What if a mother has a child that is more attentive while sitting on the couch, yet she continues to engage in face-to-face communication with the child in her arms? Such small differences, differences on the order of seconds to minutes, compile over time and may contribute to childhood behavior patterns.
Take Jazz for example. If her parents had insisted that she live as a boy, it would have been a constant battle as they put it. Merely choosing an outfit before school each day would have been a source of tensionJazz wanting to wear a dress, and her parents insisting on pants. At some point, Jazzs parents realized that their biological boy truly wished to live as a girl. Through a focus on individual variability and a more nuanced investigation of gender, we hope that someday Jazz can be viewed on a spectrum of gender variation, rather than a deviation from the norm. And we hope that our studies will provide a blueprint for studying the origins of gender variability in a way that truly acknowledges the indivisibility of nature and nurture.
Natalie Nokoff is a second year medical student at Brown Medical School. She received her BA in Gender Studies from Brown University in 2006. She is currently working in Anne Fausto-Sterling's infant development lab as a part of her scholarly concentration in medical humanities. She is co-leader of the student chapter of Physicians for Human Rights at Brown. She hopes to incorporate her work in gender studies into her future career as a physician.
Anne Fausto-Sterling is Professor of Biology and Gender Studies in the Department of Molecular Biology, Cell Biology and Biochemistry at Brown University. She is the author of Sexing the Body: Gender Politics and the Construction of Sexuality (http://www.amazon.com/Sexing-Body-Polit ... 0465077145) (Basic Books: 2000).
Ms. Nokoff and Dr. Fausto-Sterling would like to acknowledge the collaboration of undergraduate students at Brown University as well as their faculty colleagues Professor Cynthia Garcia Coll and Ronald Seifer, and the work of Professor Deborah Schooler, now at University of the Pacific.
American Sexuality Magazine
http://nsrc.sfsu.edu/MagArticle.cfm?SID ... ED30AE21B1 A&DSN=nsrc_dsn&Mode=EDIT&Article=821&ReturnURL=1
American Sexuality Magazine (www.americansexuality.com) is an on-line resource for sexuality education funded by the Ford Foundation and housed at San Francisco State University. New articles are added nearly every day. I have been asked for an article on the voluntary eunuch community as another example of the range of sex and gender variability in society. At some point Bonnie would like to find a volunteer in the Bay Area who would be willing to be interviewed on camera for posting on the American Sexuality site. She asked me again the last time I saw her at the NSRC office and I had no suggestion of anyone in the immediate area.
Please explore their site. There are a number of very fine articles available there.
-
Danya (imported)
- Articles: 0
- Posts: 1971
- Joined: Tue Mar 06, 2007 7:28 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
IbPervert (imported) wrote: Wed Jul 23, 2008 10:33 pm ABC News
Buying Time for Gender-Confused Kids
Misunderstood Procedure Delays Puberty in Children
By JOSEPH BROWNSTEIN
ABC News Medical Unit
May 21, 2008—
A procedure that some are mistakenly calling a sex change treatment for children has been drawn into the spotlight in recent days -- although it has been going on for many years.
In an interview with National Public Radio broadcast earlier this month, Dr. Norman Spack, a pediatric endocrinologist at Children's Hospital in Boston, revealed that he has at least 10 pediatric transgendered patients to whom he has been giving a hormone-blocking treatment to delay puberty.
National Public Radio interview referenced by the ABC New Medical Unit:
Children's Health
Q&A: Doctors on Puberty-Delaying Treatments
by Alix Spiegel
NPR.org, May 8, 2008 · A small group of doctors around the world have introduced a controversial approach to the treatment of preteens and teenagers who believe they are the opposite sex.
Right before puberty begins, they prescribe children hormone-blocking medication. This allows the child to continue growing without developing physical characteristics such as breasts, facial hair or Adam's apples. Later, the child can elect to resume their natural puberty development or can begin a gender transition by taking the sex hormones of the opposite sex.
Researchers in the Netherlands pioneered this treatment. Its prevalence in the United States is unclear, because most physicians using this approach keep it secretive. NPR talked with two doctors about the treatment's benefits and risks: one who practices it in the United States and another from the United Kingdom, where the treatment is not practiced by the National Health Service.
Dr. Norman Spack
Spack is an
He has worked with transgender adults for over 20 years and was one of the first doctors in the country to offer hormone-blocking treatments to teens.IbPervert (imported) wrote: Wed Jul 23, 2008 10:33 pm endocrinologist at Children's Hospital in Boston.
How many patients do you have on this treatment?
About 10 people are now on the treatment, but we hear from one or two new people a week for some kind of service.
How confident are you that you can identify a kid who will become a transgender person as an adult?
It's a very good question.
And they've run 100 kids through the treatment.IbPervert (imported) wrote: Wed Jul 23, 2008 10:33 pm My confidence comes partly because I've yet to see one change their mind and partly because we're using the psychological testing methods the Dutch have perfected, and they've yet to see one person change their mind.
What physically happens to a child who undergoes treatment?
Ultimately, in a girl it blocks her ability to make estrogen. That means her breasts will not grow. The uterus lining will not get built up enough to ever flow, and because growth plates stay open, it allows a girl to grow for four more years. So genetic females have potential to get height [closer to a male height].
For boys, it prevents body hair, facial hair, Adam's apple. And remember, hair, along with aspects of the skeleton, can never be reversed. If a person goes all the way through puberty and develops facial hair, [he or she] will spend, on average, $120,000 in their lifetime on electrolysis.
How long do you use the hormone blockers to suppress puberty?
Until around 16. Then you use the cross hormones to bring on the characteristics of the opposite sex. And remember, if you just stop the hormone blockers at 16, the person will go right back to genetic puberty within months. So the beauty of the suppressant is not as a treatment but for prolonging the evaluation phase ... 'til a young person has greater ability for abstract reasoning. It buys you time without a tremendous fear of their body getting out of control.
And the treatment can really enable them to look like a person of the opposite sex?
Well, that's what the Dutch have shown. It's quite amazing.
Talk to me about how transgender kids experience puberty.
In the cases of people we see, they are horrified. It's a very risky time; many attempt self harm. The development of the first period in someone who thinks they're a boy — you can only imagine.
So do groups say you should not do this treatment?
There's been very little criticism. If anything, it's been totally opposite to what I expected. Transgender people have written in saying, 'Thank God for you. Now another generation won't have to suffer.'
[Transgender people are] a group of people who historically have been among the most unhappy in the world — and in some cases the most poorly accepted. Now I think we can make them happy, and the Dutch have shown that they can fit in — in the way they want to. And I think we owe it to them.
Dr. Polly Carmichael
Carmichael is a psychologist at the Portman Clinic in London, where national guidelines say hormonal treatment of transgender teenagers should take place only after puberty. Carmichael has worked with dozens of kids with gender identity issues. In 2000, the Portman Clinic, which specializes in gender issues, published a study of all the children treated at the clinic who had been diagnosed with gender identity disorders. There were 124 children in all.
I understand that you have done a study of all 124 children who have gone through your clinic, and that 80 percent of those under 12 chose not to pursue sexual reassignment as adults. The kids who didn't continue — what were their reasons?
It's very tempting to be looking for similarities that might predict it, but there's a very wide range. I can think of one [boy] who came first at 6 or 7 and we saw on a regular basis. And over that time, he felt more comfortable being the sort of boy he was: having female friends, being very theatrical. At first, he really wanted to wear pink — and the mother was torn between wanting her child to choose his own clothes and the teasing. That changed, and at a later stage he said he just felt OK as he was — that he still sometimes had those feelings, but he felt happy being a boy. And that's how he wanted to continue.
I wouldn't say it's impossible to identify individuals [who] will go ahead with sex reassignment. Clearly, the Dutch have an assessment battery that they feel is quite accurate at identifying them at an earlier stage. But I think there's a lot of flexibility.
Do you have reservations about identifying kids under 12 as transgender?
I think some of the children under 12, as well as over, would fulfill diagnostic criteria for transgenderism. But I would say, in general, my experience is that in younger age groups there is greater flexibility, and the figures support that.
How do you feel about giving hormone treatments to young transgender individuals?
There are debates to be had around the impact of giving hormone blockers at an early stage. One of the debates is, indeed, does one's own sex hormones have an impact on identity development in adolescence? So if one intervenes, is that affecting the final outcome? I think that's just one part of the debate, but important to debate.
What we're doing now is new, so it's appropriate to be exploring and discussing. And it's a plausible question — is one of the effects a change in final outcome?
There's not evidence, though. It's just a question?
I don't know where you'd get that evidence from, really. It's relatively new treatment, so in general individuals have been exposed to their own sex hormones — and some will go on to be transgender, some not. It's more important to have a debate.
Have you been around transgender children going through puberty?
I have been around them, kids up to 16 to 18. It's exceedingly distressing for many of them. If you have a strong conviction that you are in the wrong body, then to feel your body developing in an alien way is extremely distressing. Often, what individuals seek to do is avoid any contact or thought of their sexual characteristics. For instance, girls bind their breasts in part because they're presenting as male outside, but also because they just don't want to see themselves. And for adolescent boys, they wouldn't want to look at their penis, they would find that incredibly distressing and would wee sitting down or would always shower wearing underpants.
When you see that, does it seem cruel to not allow children to have hormonal therapy?
It's a really hard question. Obviously, in working with families, one is trying to ameliorate distress. It's important to remember these are very complex cases; gender disorder is part of a complex presentation.
Why haven't Netherlands researchers had any kids who decided transitioning was a mistake?
Because I think they've selected that group. They identify individuals through a battery, a group who they feel would go on and seek sex reassignment. So it's very positive. But they're a selected group. One of the Dutch criteria is a stable biological background, and certainly many of the children we see wouldn't fulfill that criterion in that they're not psychologically stable.
Is it immoral to give 10-year-olds hormone blockers?
My personal view is no, I don't think it's immoral, but my personal view isn't relevant, really. The arguments are complex, and what's not helpful is to have a very polarized debate, because that's not the issue. It creates a lot of distress among gender identity-disordered individuals who feel strongly that they want treatment. But it's important to have a proper debate.
The tragedy is we all want the same thing: We want to do our very best to support individuals to do what's right for them in the long term and short term. The problem is, managing anxiety in the short term is very difficult. Suddenly something comes along and offers a solution, and I know families have gone to America to seek treatment. It's horrible to be cast as withholding something that's the solution to everything. But we have to keep the bigger picture in mind, think long term, and develop an approach based on evidence.
http://www.npr.org/templates/story/stor ... d=90234780
-
Danya (imported)
- Articles: 0
- Posts: 1971
- Joined: Tue Mar 06, 2007 7:28 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
A detailed look at many issues involved in transgenderism by Dr. Norman Spack. Includes description of differences in treatments available in the US vs. the Netherlands. References are at bottom of page. Reported by Lahey Clinic http://www.lahey.org/NewsPubs/Publicati ... eature.asp
Feature:
Transgenderism
Fall, 2005
Norman Spack, MD
Assistant Professor of Pediatrics, Harvard Medical School
Clinical Director, Endocrine Division, Children's Hospital, Boston, MA
Transgendered individuals are people who, by all known biologic measures, are male or female, yet feel like a member of the opposite sex. The discomfort they suffer is called gender dysphoria. Theirs is a relatively rare condition and cannot be explained by factors such as chromosomes, prenatal hormones or toxin exposure, genital variability, postnatal circulating hormone levels, gender of rearing, birth order, or the presence or absence of same-sex siblings.
Is it possible that the brains of the transgendered are uniquely "wired"? Subtle differences between female and male brains have been reported for decades in research studies that identify gender-related size differences between specific brain nuclei by staining slices of post-mortem specimens.1 One recent study showed that the nuclei of transgendered male-to-females (MTFs) are the size of the nuclei of genetic females. 2 An earlier study revealed that males dying of prostate cancer who had been treated for years with female hormones, and females dying of virilizing adrenal tumors, had nuclei consistent with their genetic sex. 3 Their hormonal exposure did not affect the gender-specific nuclei of their brains.
Gender dysphoria is listed as a psychiatric condition in the psychiatric diagnostic coding manual DSM-IV. I believe that the psychiatric manifestations are a reaction to the situation, not the underlying condition. A transgendered individual who has not had hormonal therapy or surgery may require psychopharmacologic medications, but after a patient receives medical and/or surgical treatment, psychotropic medicines are often unnecessary.
Nearly all transgendered adults recall feelings of being in the wrong body early in childhood. Patient histories resonate with the common theme of dressing secretly in the clothes of the opposite gender during childhood. However, the age at which a transgendered individual fully acknowledges his or her gender identity varies from mid-childhood to middle age. Delayed acknowledgment can usually be traced to a fear of stigmatization and rejection by family, friends and employers.
The majority of children who express recurrent interest in being the opposite sex are not transgendered, although many become homosexual. 4 A small percentage of children who are emphatic and consistent in their desire to be the opposite gender (less than 20% of the above) prefer to be called by a pronoun and name consistent with their gender identity. Their friends, dress and activities correspond with that identity. Their greatest fear is puberty because of the irreversible changes that threaten how they are perceived (their "gender attribution"). During adolescence, when unwanted and permanent secondary sexual characteristics transform the patient's body into an adult form that is asynchronous with the brain, depression and anxiety are typical reactions. When menses become a monthly reminder of femaleness in a teenager with a male identity, self-abusive behavior is common. The incidence of suicide among transgendered youth is high. 5 Adult transgendered individuals who find it threatening to acknowledge their gender identity publicly may adopt a lifestyle of marriage and parenthood that matches their genetic sex. Inevitably, maintaining this charade takes its psychic toll.
Who is qualified to assess a patient's condition for referral for endocrine treatment and ultimate surgery? "Standards of care" have been created by the Harry Benjamin International Gender Dysphoria Association, a professional society that includes mental health professionals, endocrinologists, internists and surgeons (www.hbigda.org). The standards define stages of treatment, beginning with "extensive exploration of psychological, family and social issues" by a mental health professional who has abundant experience working with this population, and only then moving to physical intervention, which should take place in stages, from reversible to irreversible interventions.
Physicians may be uncertain how to address transgendered patients who have not legally changed their name and gender but have transitioned to a gender role consistent with their gender identity. Some states require reconstructive surgery - genitoplasty or mastectomy - before allowing name and gender changes on documents such as driver's licenses and health insurance cards. Whether or not patients have made legal changes or undergone surgery, they are entitled to the dignity of being referred to by the name and pronoun of choice. Male-to-female patients should be offered a gown in the exam room, and female-to-male (FTM) patients should be asked what they prefer to wear during the exam. No assumption should be made about the patient's sexual orientation. Like anyone else, a transgendered individual may be straight, gay or bisexual. Sexual orientation reflects physical attraction, not gender identity.
The labeling of transgenderism as a psychiatric condition has the ironic effect of inducing psychological problems in transgendered individuals. This fuels the notion that a psychiatric disorder is at the heart of the condition, which influences the diagnostic coding and billing structure. Under the DSM-IV code, few health insurers in the United States cover the cost of hormonal replacement therapy. Mastectomies in FTMs, which cost $6,000 to $10,000, and genitoplasties (sex reconstructive surgery) in MTFs, which cost $15,000 to $25,000, are considered by almost all health insurers to be cosmetic surgeries on patients with a mental illness.
To enable patients to transition physically, endogenous gonadal sex steroid output must be lowered to levels consistent with the gender of choice, which may not be easy. Both MTFs and FTMs require supraphysiologic doses of "crosshormones": estrogen for MTFs, testosterone for FTMs. High dose estrogen poses a risk of blood clots, which can be fatal if they travel to the lungs (pulmonary embolism) and doses of testosterone sufficient to prevent menses can induce hypertension, cystic acne and excess red blood cell production with the risk of blood flow "sludging." Alternatively, endogenous sex steroids can easily be suppressed by GnRH analogues, which block pituitary gonadotrophin (LH and FSH) release, enabling cross-hormone treatment to be accomplished with safer physiologic doses of estrogen or testosterone. Unfortunately, GnRH analogues are prohibitively expensive in the US, and patients are forced to take the higher doses of sex steroids until they have their gonads removed. Genitoplasty in MTFs and reduction mammoplasty in FTMs are not covered by most health insurers, and patients may have to wait years saving for it.
In the Netherlands and Belgium, national health insurance covers all costs related to evaluation and treatment of transgendered individuals, including children. 6 Interdisciplinary gender teams evaluate patients psychologically, and patients become potential candidates for sex reconstructive surgery at government expense after living for at least a year in the gender of choice (the "real-life experience") while taking corresponding sex steroid hormones. This discrepancy in coverage across nations raises questions about US health insurance policy decisions.
Because treatment with cross-gender hormones has irreversible effects, challenging choices inevitably arise. For the MTF, estrogen produces breast enlargement and diminished sperm production. Some MTFs request sperm banking before estrogen treatment or gonadectomy just to maintain their reproductive capacity, regardless of who will receive that sperm. For the FTM, testosterone produces a deeper voice, facial hair, temporal balding. Loss of ovulation and menses ensue, and the ovaries become polycystic while retaining retrievable ova. When cryopreservation of ova becomes technically routine and successful, some FTMs will request the procedure to serve as egg donors for their partner or surrogate.
A significant ethical question in transgender care concerns potential intervention with children. Should transgendered children who have had a careful and protracted evaluation by a skilled gender specialist be compelled to complete puberty before being offered the same therapy used for adults? No national or international protocol exists, and there are opposing views on how to proceed. One side argues that physical intervention should be delayed until the completion of puberty because teenagers are more likely than adults to change their minds about their gender identity. The opposing view, with which I concur, argues for early endocrinologic intervention to prevent the severe depression that accompanies the onset of an unwanted puberty and to avoid the physically and psychologically painful procedures required to reverse puberty's physical manifestations.
A model protocol currently employed in the Netherlands begins with a lengthy screening process in gender-variant pubescent teens at the "Tanner 2" stage of pubertal development: breast budding in girls and testicular volumes of 8 cc, preceding phallic enlargement in boys. At this stage the pubertal manifestations are reversible. GnRH analogues are given for at least two years, potentially until age 16, when adolescents in the Netherlands are capable of giving informed consent to receive crosshormones. By blocking puberty, GnRH treatment buys time for FTMs to achieve a height more typical of males and for continued assessment of all patients' desire to transition. If the Dutch clinical trial proves medically and psychologically safe, it will become the standard of care in the Netherlands, and treatment will be covered by the government health insurance.
Adoption of such therapy in the US, except by a research protocol, is unlikely to be reimbursed by most health insurers as long as transgenderism continues to be coded and billed as a psychiatric condition. The only alternative drug capable of achieving comparable gonadotrophic suppression is high dose progesterone, which has effects similar to high dose prednisone or cortisone and can produce ACTH suppression, fluid retention, "moon face," central obesity and insulin resistance.
"Precocious puberty" is the only approved indication for pediatric use of GnRH analogue therapy in the US. For a patient's insurance to pay for this drug a physician would have to use this diagnosis for an 11-year-old FTM or 12-year-old MTF, even though the patient hardly meets the age criteria of sexual precocity. If the Dutch protocol is approved by the Harry Benjamin Society, would it be right for US health insurers to withhold payment for GnRH in properly screened transgendered teens?
Transgendered individuals have long faced discrimination in medical institutions, including physicians' offices and hospitals. 7 Reminiscent of the medical/psychiatric approach to homosexuality not so long ago, some physicians and psychologists maintain that the goal of psychiatric treatment is to convince transgendered individuals to remain in the gender role of their genetic sex, which is an impossibility for most patients. Everyone involved in patient care should have some awareness of gender identity disorders, however rare they may be. Primary care physicians interested in providing hormonal replacement therapy for transgendered patients should consult the Harry Benjamin Society Standards of Care. Physicians and mental health professionals who are neither comfortable nor sufficiently knowledgeable to treat transgendered patients should refer them to more experienced colleagues.
Footnotes
1 Woodson JC and Gorski RA. Structural differences in the mammalian brain: reconsidering the male/female dichotomy. In Matsumoto A (ed.) Sexual Differentiation of the Brain, New York and London: CRC Press, 2000.
2 Kruijver FP et al. Male-to-female transsexuals have female neuron numbers in a limbic nucleus. J Clinical Endocrinology & Metabolism. 85(5):2034-41, 2005.
3 Zhou JN et al. A sex difference in the human brain and its relation to transsexuality. Nature. 378(6552):15-16, 1995.
4 Zucker KJ and Bradley SJ. Gender Identity Disorder and Psychosexual Problems in Children and Adolescents, New York and London: The Guilford Press, 1995
5 Kreiss JL and Patterson DL. Psychological issues in primary care of lesbian, gay, bisexual, and transgendered youth. Journal of Pediatric Health Care. 11(6):266-74, 1997
6 Cohen-Kettenis PT and Pfafflin F. Transgenderism and intersexuality in childhood and adolescence. Making choices, Thousand Oaks and London: Sage Publications, 2003
7 Feinberg L. Transgender warriors, Boston: Beacon Press, 1996 Additional readings Boylan JF. She's not there. New York: Broadway, 2003
Additional Reading
Brown ML and Rounsley CA. True Selves: Understanding transsexualism - for families, friends, coworkers, and helping professionals, San Francisco: Jossey Bass, 1996
Israel GE and Tarver DE. Transgender Care, Philadelphia: Temple U. Press, 1997
Feature:
Transgenderism
Fall, 2005
Norman Spack, MD
Assistant Professor of Pediatrics, Harvard Medical School
Clinical Director, Endocrine Division, Children's Hospital, Boston, MA
Transgendered individuals are people who, by all known biologic measures, are male or female, yet feel like a member of the opposite sex. The discomfort they suffer is called gender dysphoria. Theirs is a relatively rare condition and cannot be explained by factors such as chromosomes, prenatal hormones or toxin exposure, genital variability, postnatal circulating hormone levels, gender of rearing, birth order, or the presence or absence of same-sex siblings.
Is it possible that the brains of the transgendered are uniquely "wired"? Subtle differences between female and male brains have been reported for decades in research studies that identify gender-related size differences between specific brain nuclei by staining slices of post-mortem specimens.1 One recent study showed that the nuclei of transgendered male-to-females (MTFs) are the size of the nuclei of genetic females. 2 An earlier study revealed that males dying of prostate cancer who had been treated for years with female hormones, and females dying of virilizing adrenal tumors, had nuclei consistent with their genetic sex. 3 Their hormonal exposure did not affect the gender-specific nuclei of their brains.
Gender dysphoria is listed as a psychiatric condition in the psychiatric diagnostic coding manual DSM-IV. I believe that the psychiatric manifestations are a reaction to the situation, not the underlying condition. A transgendered individual who has not had hormonal therapy or surgery may require psychopharmacologic medications, but after a patient receives medical and/or surgical treatment, psychotropic medicines are often unnecessary.
Nearly all transgendered adults recall feelings of being in the wrong body early in childhood. Patient histories resonate with the common theme of dressing secretly in the clothes of the opposite gender during childhood. However, the age at which a transgendered individual fully acknowledges his or her gender identity varies from mid-childhood to middle age. Delayed acknowledgment can usually be traced to a fear of stigmatization and rejection by family, friends and employers.
The majority of children who express recurrent interest in being the opposite sex are not transgendered, although many become homosexual. 4 A small percentage of children who are emphatic and consistent in their desire to be the opposite gender (less than 20% of the above) prefer to be called by a pronoun and name consistent with their gender identity. Their friends, dress and activities correspond with that identity. Their greatest fear is puberty because of the irreversible changes that threaten how they are perceived (their "gender attribution"). During adolescence, when unwanted and permanent secondary sexual characteristics transform the patient's body into an adult form that is asynchronous with the brain, depression and anxiety are typical reactions. When menses become a monthly reminder of femaleness in a teenager with a male identity, self-abusive behavior is common. The incidence of suicide among transgendered youth is high. 5 Adult transgendered individuals who find it threatening to acknowledge their gender identity publicly may adopt a lifestyle of marriage and parenthood that matches their genetic sex. Inevitably, maintaining this charade takes its psychic toll.
Who is qualified to assess a patient's condition for referral for endocrine treatment and ultimate surgery? "Standards of care" have been created by the Harry Benjamin International Gender Dysphoria Association, a professional society that includes mental health professionals, endocrinologists, internists and surgeons (www.hbigda.org). The standards define stages of treatment, beginning with "extensive exploration of psychological, family and social issues" by a mental health professional who has abundant experience working with this population, and only then moving to physical intervention, which should take place in stages, from reversible to irreversible interventions.
Physicians may be uncertain how to address transgendered patients who have not legally changed their name and gender but have transitioned to a gender role consistent with their gender identity. Some states require reconstructive surgery - genitoplasty or mastectomy - before allowing name and gender changes on documents such as driver's licenses and health insurance cards. Whether or not patients have made legal changes or undergone surgery, they are entitled to the dignity of being referred to by the name and pronoun of choice. Male-to-female patients should be offered a gown in the exam room, and female-to-male (FTM) patients should be asked what they prefer to wear during the exam. No assumption should be made about the patient's sexual orientation. Like anyone else, a transgendered individual may be straight, gay or bisexual. Sexual orientation reflects physical attraction, not gender identity.
The labeling of transgenderism as a psychiatric condition has the ironic effect of inducing psychological problems in transgendered individuals. This fuels the notion that a psychiatric disorder is at the heart of the condition, which influences the diagnostic coding and billing structure. Under the DSM-IV code, few health insurers in the United States cover the cost of hormonal replacement therapy. Mastectomies in FTMs, which cost $6,000 to $10,000, and genitoplasties (sex reconstructive surgery) in MTFs, which cost $15,000 to $25,000, are considered by almost all health insurers to be cosmetic surgeries on patients with a mental illness.
To enable patients to transition physically, endogenous gonadal sex steroid output must be lowered to levels consistent with the gender of choice, which may not be easy. Both MTFs and FTMs require supraphysiologic doses of "crosshormones": estrogen for MTFs, testosterone for FTMs. High dose estrogen poses a risk of blood clots, which can be fatal if they travel to the lungs (pulmonary embolism) and doses of testosterone sufficient to prevent menses can induce hypertension, cystic acne and excess red blood cell production with the risk of blood flow "sludging." Alternatively, endogenous sex steroids can easily be suppressed by GnRH analogues, which block pituitary gonadotrophin (LH and FSH) release, enabling cross-hormone treatment to be accomplished with safer physiologic doses of estrogen or testosterone. Unfortunately, GnRH analogues are prohibitively expensive in the US, and patients are forced to take the higher doses of sex steroids until they have their gonads removed. Genitoplasty in MTFs and reduction mammoplasty in FTMs are not covered by most health insurers, and patients may have to wait years saving for it.
In the Netherlands and Belgium, national health insurance covers all costs related to evaluation and treatment of transgendered individuals, including children. 6 Interdisciplinary gender teams evaluate patients psychologically, and patients become potential candidates for sex reconstructive surgery at government expense after living for at least a year in the gender of choice (the "real-life experience") while taking corresponding sex steroid hormones. This discrepancy in coverage across nations raises questions about US health insurance policy decisions.
Because treatment with cross-gender hormones has irreversible effects, challenging choices inevitably arise. For the MTF, estrogen produces breast enlargement and diminished sperm production. Some MTFs request sperm banking before estrogen treatment or gonadectomy just to maintain their reproductive capacity, regardless of who will receive that sperm. For the FTM, testosterone produces a deeper voice, facial hair, temporal balding. Loss of ovulation and menses ensue, and the ovaries become polycystic while retaining retrievable ova. When cryopreservation of ova becomes technically routine and successful, some FTMs will request the procedure to serve as egg donors for their partner or surrogate.
A significant ethical question in transgender care concerns potential intervention with children. Should transgendered children who have had a careful and protracted evaluation by a skilled gender specialist be compelled to complete puberty before being offered the same therapy used for adults? No national or international protocol exists, and there are opposing views on how to proceed. One side argues that physical intervention should be delayed until the completion of puberty because teenagers are more likely than adults to change their minds about their gender identity. The opposing view, with which I concur, argues for early endocrinologic intervention to prevent the severe depression that accompanies the onset of an unwanted puberty and to avoid the physically and psychologically painful procedures required to reverse puberty's physical manifestations.
A model protocol currently employed in the Netherlands begins with a lengthy screening process in gender-variant pubescent teens at the "Tanner 2" stage of pubertal development: breast budding in girls and testicular volumes of 8 cc, preceding phallic enlargement in boys. At this stage the pubertal manifestations are reversible. GnRH analogues are given for at least two years, potentially until age 16, when adolescents in the Netherlands are capable of giving informed consent to receive crosshormones. By blocking puberty, GnRH treatment buys time for FTMs to achieve a height more typical of males and for continued assessment of all patients' desire to transition. If the Dutch clinical trial proves medically and psychologically safe, it will become the standard of care in the Netherlands, and treatment will be covered by the government health insurance.
Adoption of such therapy in the US, except by a research protocol, is unlikely to be reimbursed by most health insurers as long as transgenderism continues to be coded and billed as a psychiatric condition. The only alternative drug capable of achieving comparable gonadotrophic suppression is high dose progesterone, which has effects similar to high dose prednisone or cortisone and can produce ACTH suppression, fluid retention, "moon face," central obesity and insulin resistance.
"Precocious puberty" is the only approved indication for pediatric use of GnRH analogue therapy in the US. For a patient's insurance to pay for this drug a physician would have to use this diagnosis for an 11-year-old FTM or 12-year-old MTF, even though the patient hardly meets the age criteria of sexual precocity. If the Dutch protocol is approved by the Harry Benjamin Society, would it be right for US health insurers to withhold payment for GnRH in properly screened transgendered teens?
Transgendered individuals have long faced discrimination in medical institutions, including physicians' offices and hospitals. 7 Reminiscent of the medical/psychiatric approach to homosexuality not so long ago, some physicians and psychologists maintain that the goal of psychiatric treatment is to convince transgendered individuals to remain in the gender role of their genetic sex, which is an impossibility for most patients. Everyone involved in patient care should have some awareness of gender identity disorders, however rare they may be. Primary care physicians interested in providing hormonal replacement therapy for transgendered patients should consult the Harry Benjamin Society Standards of Care. Physicians and mental health professionals who are neither comfortable nor sufficiently knowledgeable to treat transgendered patients should refer them to more experienced colleagues.
Footnotes
1 Woodson JC and Gorski RA. Structural differences in the mammalian brain: reconsidering the male/female dichotomy. In Matsumoto A (ed.) Sexual Differentiation of the Brain, New York and London: CRC Press, 2000.
2 Kruijver FP et al. Male-to-female transsexuals have female neuron numbers in a limbic nucleus. J Clinical Endocrinology & Metabolism. 85(5):2034-41, 2005.
3 Zhou JN et al. A sex difference in the human brain and its relation to transsexuality. Nature. 378(6552):15-16, 1995.
4 Zucker KJ and Bradley SJ. Gender Identity Disorder and Psychosexual Problems in Children and Adolescents, New York and London: The Guilford Press, 1995
5 Kreiss JL and Patterson DL. Psychological issues in primary care of lesbian, gay, bisexual, and transgendered youth. Journal of Pediatric Health Care. 11(6):266-74, 1997
6 Cohen-Kettenis PT and Pfafflin F. Transgenderism and intersexuality in childhood and adolescence. Making choices, Thousand Oaks and London: Sage Publications, 2003
7 Feinberg L. Transgender warriors, Boston: Beacon Press, 1996 Additional readings Boylan JF. She's not there. New York: Broadway, 2003
Additional Reading
Brown ML and Rounsley CA. True Selves: Understanding transsexualism - for families, friends, coworkers, and helping professionals, San Francisco: Jossey Bass, 1996
Israel GE and Tarver DE. Transgender Care, Philadelphia: Temple U. Press, 1997
-
Danya (imported)
- Articles: 0
- Posts: 1971
- Joined: Tue Mar 06, 2007 7:28 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
This section of the article describes the treatment of transsexual children in the Netherlands and the high success rate. The entire article can be found at:
http://www.sfgate.com/cgi-bin/article.c ... MT7C9C.DTL
Gender identity and the chemical delay of puberty
A call for more clinics and treatment for children at an early stage in their growth
Stephanie Brill, Herbert Schreier Sunday, November 18, 2007
In the Netherlands, the children must meet certain criteria of wanting to be the opposite sex from an early age. Then they are evaluated by more than one psychiatrist or psychologist experienced with such children. The children must be reasonably free of serious mental illness, which does not include anxiety and/or the dysphoria of living in the wrong body.
Such children are then candidates for delaying advanced puberty - and a two-year trial period in which they must live out life as the opposite sex. The length of the trial period gives them time to reflect on their decision. (Our British colleagues object to the fact that because the trial period delays the development of secondary sexual characteristics, it does not provide a child the opportunity to live in the advanced adolescent body of their biological sex.)
However, when this procedure is followed, the Dutch have not had one case of surgical regret in more than 25 cases published in peer-reviewed journals.
Herbert Schreier practices child psychiatry in Oakland and is co-founder of a support group for parents of gender-variant and transgender children.
Stephanie Brill, the other co-founder of the support group, also founded Gender Spectrum Education and Training (genderspectrum.org) and is program director of Gender Odyssey Family (genderodysseyfamily.com), a national conference for families with a gender-variant or transgender child.
http://www.sfgate.com/cgi-bin/article.c ... MT7C9C.DTL
Gender identity and the chemical delay of puberty
A call for more clinics and treatment for children at an early stage in their growth
Stephanie Brill, Herbert Schreier Sunday, November 18, 2007
In the Netherlands, the children must meet certain criteria of wanting to be the opposite sex from an early age. Then they are evaluated by more than one psychiatrist or psychologist experienced with such children. The children must be reasonably free of serious mental illness, which does not include anxiety and/or the dysphoria of living in the wrong body.
Such children are then candidates for delaying advanced puberty - and a two-year trial period in which they must live out life as the opposite sex. The length of the trial period gives them time to reflect on their decision. (Our British colleagues object to the fact that because the trial period delays the development of secondary sexual characteristics, it does not provide a child the opportunity to live in the advanced adolescent body of their biological sex.)
However, when this procedure is followed, the Dutch have not had one case of surgical regret in more than 25 cases published in peer-reviewed journals.
Herbert Schreier practices child psychiatry in Oakland and is co-founder of a support group for parents of gender-variant and transgender children.
Stephanie Brill, the other co-founder of the support group, also founded Gender Spectrum Education and Training (genderspectrum.org) and is program director of Gender Odyssey Family (genderodysseyfamily.com), a national conference for families with a gender-variant or transgender child.
-
chilliwilli (imported)
- Articles: 0
- Posts: 593
- Joined: Sat Feb 02, 2008 4:39 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
...it sure is nice being simple. And my gym socks are soooo stinky too!!!!
chilli-
chilli-
-
Danya (imported)
- Articles: 0
- Posts: 1971
- Joined: Tue Mar 06, 2007 7:28 pm
-
Posting Rank
-
chilliwilli (imported)
- Articles: 0
- Posts: 593
- Joined: Sat Feb 02, 2008 4:39 pm
-
Posting Rank
Re: Buying Time for Gender-Confused Kids
Danya
Danya-
Now you sound like my mom~!
It's to damn peaceful to do the serinity prayer.
Stinky
chilli -