Puberty blockers: Can a drug trial solve one of medicine's most controversial debates?

Turns out there is this amazing hack which lets you jump developmental rails so all of this stuff never becomes an issue, but it only works for a brief window during your youth and Wes Streeting is about to ban it for good.

Sure.

I look in the mirror and don't want to cry.

I walk down the street and don't get transphobic abuse.

I board an aircraft and staff say 'good afternoon madam' without hesitation, awkwardness or uncertainty.

I walk into a toilet desperate for a pee and don't inspire nervous or hostile looks.

I share knowing glances with other women to silently communicate a situation has bad vibes.

I can easily find clothes that fit me. I can walk into a shop to buy them and not feel awkward or unwelcome.

I talk on the phone and people reflexively address me correctly.

I can see photos of myself without feeling a crushing pang of sadness.

I get cast in acting roles as female characters. I do not have to automatically be portraying a trans person.

I don't hate how my body looks or feels.

I feel comfortable in my own skin.

This is the fundamental flaw in the trans worldview I keep coming across - the idea that a person has the right to dictate how everyone else sees them.

This is so true - the narcissism, the sheer chutzpah of the trans movement is encapsulated in that issue. No one gets to dictate how others perceive them, nor how they are referred to in their absence.

I can't be taller, younger or a super athlete like Simone Biles by wanting others to see me that way. I'm tethered to reality. I can't change sex and have DH be pregnant next time (because I've definitely done my fair share of that) no matter how much I might wish it so.

We can't bend reality to our preferences. We also can't bend other people's perceptions to suit ourselves.

@ButterflyHatched
I live a life where I generally experience gender congruence.

Can you explain what this means?

My child is indeed my child (though he is adult). He remains my son, from my perspective. He cannot be my daughter to me unless that makes sense to me. It doesn't . Far more of his relatives see him as a man than as a woman, even if some are prepared to pretend. They have known him, factually and perceptually, for many years as male. Does he have the ability unilaterally to change his identity, or is his identity formed in community? Is this the reason people "go no contact", because their identity in community cannot stand up if it is not totally affirmed? Is this healthy?

He is not "she" unless one believes that third person pronouns now refer to the social construct "gender" and not to sex. Gender is societal expectations and roles; one can only measure gender against adherence to stereotypes. Even then, I know no-one who is totally "feminine" or totally "masculine".

He, by his own admission, did not experience "gender dysphoria" until after he came to the conclusion he is transgender. I do not know what "transgender" means to him; he has been unable or unwilling to articulate this. At first, he was relaxed about "chosen" name and pronouns, but he has hardened to a position of demanding compliance. I believe that this has come about because of the societal pressure from those around him, self-described trans allies who are, to put it bluntly, loading on to him their expectations of how a trans person has to behave.

And yes, you have made a number of assumptions, which is fully understandable. I appreciate the opportunity to see what those assumptions are, and to have my assumptions challenged. It is refreshing to see some recognition that other people's stories (parents' for example) are valid, not just trans people's stories in isolation from those who love them. My wife and other close relatives are also severely impacted, and I believe my son is being damaged by the pressure he is under to see his family as bigoted. Deep down he knows we love him, but he is being drip fed a narrative of "anything other than complete agreement is unacceptable and means lack of acceptance of you". He knows he does not have to agree with us to be loved. Does he still know that we do not have to agree with him to love him? Does he still know that he can still love us if he disagrees with us? Does he know that we would drop everything if he was in trouble and called for help?

If he wants us to accept him as the image of himself he is presenting, he has to allow us to spend time with him. It's not possible to get used to the new behaviour of someone we are no longer permitted to see and to relate to. It is utterly unreasonable to expect an instant realignment of our perception of him. And it is only possible to relate to anyone based on the reality of our own perception of them - not on their perception of themselves. This is the fundamental flaw in the trans worldview I keep coming across - the idea that a person has the right to dictate how everyone else sees them.

I would question what gender dysphoria even is. I think for kids in particular it tends to be an iatrogenic condition, in the sense that we have created a medical landscape where people interpret their other issues through that lens and it causes symptoms and worries based on that.

I don't see how treatments can be assessed without a better definition of the disease.

It’s body dysmorphia. There is no gender incongruence.

I went through a period of eating little as a 15-16 year old (pretending I'd eaten, throwing food away, passing out) as I was convinced I was fat. If there was a trial to keep weight off I'd have taken it. It wasn't natural and I was wrong. If the people around me told me I was right, I would have damaged myself.

Thank you also for engaging.

1. Rapid's son remains his son. It's not about discovering a "genotype". It's about his son discovering a belief that we all have a gender identity. Some people believe this to their core, some people don't think it's true at all. Rapid's son's belief in gender identity sounds genuine from everything I've read on other threads. But that doesn't mean Rapid has to share it, nor that you should force him to do so.
2. Losing someone to their belief is indeed a loss. It's grief. I can also believe it works the other way: if someone genuinely believes that they have a gender identity but it's not something their parents share, they've now "lost" their parents and are grieving. There will be parents grieving their children and children grieving their parents. It's a heartbreaking situation 😢
3. Yes. And Rapid is clearly trying to tell his son who he is: his son's dad.
4. What on earth have DSDs got to do with this?!
5. Yes, Rapid's child still exists. I imagine that most people reading this thread will recognise that he knows this.
6. To be fair, this bit sounds genuine. But.. that doesn't change anything.
7. No. That's just a guilt trip. Everyone who is a parent knows that at some point, their child will do things they regret. But the general idea in this acceptance is that it's not something that has a permanent, irreversible effect. If any parent sees their child doing something that has this much risk, they'll be faced with a decision: act to prevent it, actively go with it or watch and wait for the moment where they are needed. Depending on their child's age, acting to prevent something that's likely to be harmful may no longer be an option.

I would say that if you have reached the point where this is enough of a consistent point of contention for enough years that you are a regular poster on this board, there is clearly something going on here that is worthy of serious investigation - children don't just spontaneously express gender dysphoria for years for no reason.

?!?!

not a day goes by when I do not thank my parents for listening to me and believing me even when it was confusing or frightening or difficult.

It's great that you have a strong bond with your parents and that they support you. There are different ways that parents can listen to their child. From everything I've read on other threads, Rapid has listened lots.

Edited to sort formatting re numbers

I've never really got over Opal Fruits being renamed Starburst 😟

I look like the version of me who was spared the majority of pubertal development under endogenous testosterone and was allowed to commence exogenous oestrogen at 18. I was able to identify this was the right path at a young age, helped along by some genetic quirks that ended up proving quite useful in the long run.

That is me. I'm very happy that my body largely matches my perception of it, especially since I lived just long enough in a state where it didn't to be able to understand the difference!

I live a life where I generally experience gender congruence. It's really hard to overstate how much of a difference that makes. I got a very lucky break, all told. Most people in that situation, especially back then, never get a chance to 'jump the rails' in so complete and drastic a fashion.

It is now no longer possible for trans kids - especially trans girls for whom this treatment really does define a life trajectory - to decisively fix their gender incongruence in this way in the UK. That road is closed - potentially forever - or at least until compassion and sense allow us to revisit the topic once the neoreaction movement has burned itself out.

I hope you can understand how horrifying it is to hear the despair of desperate teenagers who can see the path I was allowed to walk and the life it has enabled, and know that there is now nothing that can be done to spare them from the needless suffering that lies ahead.

They've tried being themselves in the bodies they have. They try, desperately, every day.

Your child is trying to tell you who they are.

Nobody is the opposite sex to that which they actually are. A boy who says he's a girl or a girl who says she's a boy is mistaken or lying.

Thankyou for engaging.

1. Your child remains your child. They were your child prior to your discovery of their genotype and your adjustment to that. They remain your child after it.
2. It's very reasonable to feel a sense of loss over what can be a profound change in dynamic with your child. I'm sorry - it's not easy.
3. Your child is trying to tell you who they are.
4. Yes. If you discovered your child had a DSD that meant they had XX chromosomes, would this change your perspective at all?
5. Your child still exists. The past still exists. Your child is not asking you to pretend she doesn't exist; only that this is who she is and would prefer to be treated as.
6. I can only see the direct reflection of what my own parents went through. The grief; the uncertainty; the guilt; the fear. It's hard. I'm sorry.
7. This is a very reasonable and understandable fear and I can see why you would want to be cautious. Your child will inevitably make some bad choices in life - there is a small chance that this will turn out to be one of them. Nobody has perfect hindsight nor insight into their own mind and I understand your desire to protect them from making one they may regret.

I would say that if you have reached the point where this is enough of a consistent point of contention for enough years that you are a regular poster on this board, there is clearly something going on here that is worthy of serious investigation - children don't just spontaneously express gender dysphoria for years for no reason. Perfect happiness and perfect health are, by definition, impossible things to achieve - but decisions that can impact them don't want to be rushed into. The difficult balancing act comes from the devastating impact of waiting for the clock to run out just in case - withholding treatment is not a neutral act in this situation. It is taking a massive gamble upon the idea that your child has been consistently lying to you (and clinicians? not that they can meaningfully do anything now) for years about their own experiences and feelings and will, at some blissful point in the future, desist and go on to have genetically related children with a partner.

That is an awful lot to gamble your child's future over, especially when they are trying to tell you who they are and presumably have been doing so for years.

I don't know your personal situation; I'm sorry if I'm making assumptions here. Based upon my own experiences of being there as a child desperate for this treatment at an extremely precarious age where all of this was very novel and uncharted, not a day goes by when I do not thank my parents for listening to me and believing me even when it was confusing or frightening or difficult.

Point D is hanging my happiness on the actions or inactions of strangers. Point A would be my problem to deal with.

-A. Feeling that your body is wrong (incongruence) can make you sad (dysphoria)

I'm sure most of us dislike some part of our bodies. The solution is to accept that is the body you have and learn to accept the parts you dislike. Or do you believe that you can literally be "born in the wrong body"?

-D. Feeling that your body is wrong AND knowing that treatment exists which can ease the feeling of incongruence

I don't think a child could possibly know this.

But this bit makes me think you're talking about stereotypes:

people are defining your existence using a surface-level impression of the parts that are making you sad

Surely you're not suggesting that children should be medicated for not conforming to stereotypes?

Agreed with pretty much all of this, for ref.

👍

You can't force people to perceive others in a particular way;

👍

you can only help them understand the impact of their actions and beg them to act with compassion. Most people manage to do this in good faith.

Yes (although hopefully no begging is required) most people do act in good faith.

The difficult bit is where some people are trying to force people to perceive others in a particular way e.g. where TW are forcing women to accept them in women's sports.

All the compassionate begging in the world doesn't change the fact that this is wrong. Whilst I'm empathetic to someone who genuinely believes that they have a gender identity and that it's different from their sex, even though I don't believe in gender identity myself, I'm not going to accept their belief as justification for this. It's not good faith to force me to do so. So hopefully "most people" would see that good faith starts and ends with recognising that some people have gender dysphoria, but this doesn't mean that their strong feelings of being the opposite sex need to be accepted as fact by everyone else.

It's a hard no. Nobody should be able to self identify into the sports, spaces and services of the opposite sex. Sex (our physical bodies) is fact. Gender identity (a feeling that some people have) is belief. I don't accept anyone imposing their belief in gender identity on others, any more than I would another belief.

Exactly this. And the idea that it's necessary to change your body to look like someone you're not (in order to be your "true self"), and then expect everyone to go along with the pretence that you've changed sex in order to be happy is just ludicrous.

Be yourself in the body you have. It's so much easier - and more honest.

See points A and D above.

Thanks. In that case, may I ask you to consider these questions? I'm not particularly looking for an answer, so please don't feel obliged to reply.

Is my son still my son if he would like me to refer to him as "she"? If he is not my son, how should I process my loss? And if he is my son, how do I reconcile that with pretending he is a woman? If he is a woman, that makes him my daughter, does it not? But I know that, in fact, he is my son. You see, that act of "begging me to act with compassion" is an act of asking me to deny my son's existence. Unless you are astonishingly empathetic, you can have no idea of the turmoil, dissonance and distress that causes a parent. And that is without even going near the worry that my son will ruin his health in pursuit of an impossibility.

Lots of stuff makes me sad. I deal with it. Hanging my hopes of happiness on strangers means I would never be happy.

Allow me to rephrase:

-A. Feeling that your body is wrong (incongruence) can make you sad (dysphoria). This is an internal source of dysphoria. If you were the only human on earth you would still feel this.

-B. Feeling that your body is wrong AND that people are defining your existence using a surface-level impression of the parts that are making you sad can also make you (even more) sad. This is an external source of dysphoria. If you were the only human on earth you would not feel this.

-C. Feeling that your body is wrong AND that people are actively abusing you over feeling sad about your body being wrong can also make you (even more) sad. This is an external source of dysphoria. If you were the only human on earth you would not feel this.

-D. Feeling that your body is wrong AND knowing that treatment exists which can ease the feeling of incongruence (A) but you are being deliberately denied it by policy because some people don't believe you are really experiencing (A), or that (B/C) is the correct way for you to be treated, can also make you (even more) sad. This is an external source of dysphoria but it feeds back into the internal root source.

This is so well put.

All the more so because of your personal journey on all of this (that you've shared on other threads) 💐💪

Agreed with pretty much all of this, for ref.

You can't force people to perceive others in a particular way; you can only help them understand the impact of their actions and beg them to act with compassion. Most people manage to do this in good faith.

Bit cruel of John Lewis to expose Ruby like that imo.

Ruby…. “now presents as a woman full-time.”

I don’t know any woman who presents in that way, leather cat-o-nine-tails whip in hand or not.