Puberty Blocker Trial Paused

Your definition is only your definition. You are not entitled to decide that is the only definition available for the rest of the world

I have a gay son and straight trans daughter. Where do your conclusions come from? Really, you are in bad shape.

They didn't give a reason. That's the honest answer.
The diagnosis was gender dysphoria. The assessment confirmed that her distress was persistent, consistent, and longstanding. That it wasn't better explained by other factors they could identify. That she met the criteria for treatment.
But did they say "your daughter has gender dysphoria because of X"? No. They didn't. And at the time, I didn't push for that answer as hard as perhaps I should have, because I was focused on helping her and she was in so much distress.
I can see why that troubles you. It troubles me too, when I sit with it. Medicine is supposed to understand the cause before it treats. We don't give chemotherapy without knowing someone has cancer.
But I also watched what happened when she was treated. I watched her come back to life. I watched her stop talking about not wanting to exist. I watched her start making friends, planning for the future, laughing again.
Does that prove the treatment was right? Maybe not in a way that would satisfy you. But when your child is drowning, and someone throws a rope, and it works, you don't always have the luxury of demanding a full explanation of rope mechanics before you let them grab it.
I don't know why my daughter has gender dysphoria. Neither did the clinicians, not really. If you think that means no one should ever be treated until we have that answer, I understand the logic. I just couldn't apply it to my own child when she was suffering in front of me.
Is there a version of "we don't fully understand why" that you could accept alongside "but the treatment appears to help this individual"?

My definition is the only available definition.

Your son is gay. If he's attracted to boys, he's gay. Same sex attraction is about sex, not gender identity.

Perhaps you don't agree with having a gay son?

What I can tell you is what I've ruled out, at least to my own satisfaction. My daughter isn't same-sex attracted, or at least that's not the whole picture. She's attracted to boys, which as a trans girl would make her straight, not gay. So "transing away the gay" doesn't fit her. She hasn't experienced sexual trauma. We've explored this carefully, with professionals, and there's nothing there. She's not autistic.
So the categories you've listed, same-sex attraction, trauma, autism, emerging fetishism, none of them apply to her. And yet here she is, consistent since early childhood, distressed by puberty, relieved by treatment, thriving now in a way she wasn't before.
I understand the desire for a neat explanation. I'd quite like one myself. But my daughter doesn't fit the pattern you're describing, and I suspect she's not the only one.
You ask why a child would feel disconnected from their body if none of those factors apply. I don't have a satisfying answer. I don't think anyone does yet. But I'm not sure "we don't fully understand the cause" is sufficient reason to withhold treatment from someone who is suffering and who responds well to it. We treat many conditions without fully understanding their origins. The question is whether the treatment helps.
What would you need to see to accept that some cases, even if you can't explain them, might be genuine?

The pathway my daughter followed began with extensive assessment through GIDS, which at the time involved multiple appointments over many months, exploring her history, her feelings, her mental health, family dynamics, and whether there were other factors contributing to her distress. It wasn't a single conversation and a prescription.

So, Sarah after multiple appointments over months, examining the family dynamics other factors, and your child's mental health,what was the diagnosis??

Why does your child have gender dysphoria?

What did they say the reason was??

She is glowing and thriving, so I don't care about your definition of adult female. By using that definition, nobody was born as woman then

What I can tell you is what I've ruled out, at least to my own satisfaction. My daughter isn't same-sex attracted, or at least that's not the whole picture. She's attracted to boys, which as a trans girl would make her straight, not gay. So "transing away the gay" doesn't fit her. She hasn't experienced sexual trauma. We've explored this carefully, with professionals, and there's nothing there. She's not autistic.
So the categories you've listed, same-sex attraction, trauma, autism, emerging fetishism, none of them apply to her. And yet here she is, consistent since early childhood, distressed by puberty, relieved by treatment, thriving now in a way she wasn't before.
I understand the desire for a neat explanation. I'd quite like one myself. But my daughter doesn't fit the pattern you're describing, and I suspect she's not the only one.
You ask why a child would feel disconnected from their body if none of those factors apply. I don't have a satisfying answer. I don't think anyone does yet. But I'm not sure "we don't fully understand the cause" is sufficient reason to withhold treatment from someone who is suffering and who responds well to it. We treat many conditions without fully understanding their origins. The question is whether the treatment helps.
What would you need to see to accept that some cases, even if you can't explain them, might be genuine?

She went from someone who could barely leave her room to someone who has friends, goes to school, talks about the future.

At 16 do you think your child fully understands that there is no possibility of becoming an adult female?

The pathway my daughter followed began with extensive assessment through GIDS, which at the time involved multiple appointments over many months, exploring her history, her feelings, her mental health, family dynamics, and whether there were other factors contributing to her distress. It wasn't a single conversation and a prescription.

GIDS was shut down in part because they were prescribing these drugs on the basis of just a few appointments.

while preventing changes that would have been irreversible and deeply distressing for her.

The change is reaching sexual maturity. How do you think your child will navigate adult life if they are maintained in a permanent pre-pubscent state?

Fourthly, I'd like a consistent rational explanation for the explosion of trans-identifying young people in recent years.

For me, this is the crux.

I don't know if you know Transgender Trend, sarahd89? But Stephanie Davis Arai, who runs it and has seen and heard from thousands of trans identified children and their parents, has said that every child she comes across is either same sex attracted, has suffered from some kind of trauma, often sexual, or is on the autistic spectrum.

And presumably, in the cases of boys, there might be an emerging fetishistic element.

The clinicians at the Tavistock also confirmed that the children going through their doors were similar. In fact, they were worried that they were 'transing away the gay'.

So for me, the obvious question is that once you have eliminated any of those reasons, why would a child feel so disconnected from their own body?

I honestly don't see how you can prescribe lifelong medication with very serious side effects without understanding that.

Do you have any idea why your daughter has gender dysphoria?

That's a fair question.
The pathway my daughter followed began with extensive assessment through GIDS, which at the time involved multiple appointments over many months, exploring her history, her feelings, her mental health, family dynamics, and whether there were other factors contributing to her distress. It wasn't a single conversation and a prescription.
After that assessment, she was prescribed puberty blockers, which paused the development of secondary sex characteristics that were causing her significant distress. The purpose was to give her more time to mature and be certain, while preventing changes that would have been irreversible and deeply distressing for her.
More recently, she's begun cross-sex hormones, which will cause feminising changes. This decision came after further assessment, after years of living consistently in her gender, and with full understanding that some effects are permanent.
What the pathway doesn't involve, at least not until adulthood and after years of living in role, is surgery. The narrative that children are being rushed into operating theatres isn't what's actually happening in the UK system.
I want to be clear: I don't think this pathway is right for every young person who questions their gender. I don't think assessment should be cursory. I think careful, individualised assessment matters enormously.
But I also watched my daughter before and after. The difference isn't subtle. She went from someone who could barely leave her room to someone who has friends, goes to school, talks about the future.

That's a fair question.
The pathway my daughter followed began with extensive assessment through GIDS, which at the time involved multiple appointments over many months, exploring her history, her feelings, her mental health, family dynamics, and whether there were other factors contributing to her distress. It wasn't a single conversation and a prescription.
After that assessment, she was prescribed puberty blockers, which paused the development of secondary sex characteristics that were causing her significant distress. The purpose was to give her more time to mature and be certain, while preventing changes that would have been irreversible and deeply distressing for her.
More recently, she's begun cross-sex hormones, which will cause feminising changes. This decision came after further assessment, after years of living consistently in her gender, and with full understanding that some effects are permanent.
What the pathway doesn't involve, at least not until adulthood and after years of living in role, is surgery. The narrative that children are being rushed into operating theatres isn't what's actually happening in the UK system.
I want to be clear: I don't think this pathway is right for every young person who questions their gender. I don't think assessment should be cursory. I think careful, individualised assessment matters enormously.
But I also watched my daughter before and after. The difference isn't subtle. She went from someone who could barely leave her room to someone who has friends, goes to school, talks about the future.

What I can't accept is the assumption that the right answer for every young person is no medical pathway ever, regardless of their individual presentation and regardless of how they respond to other approaches.

Very few people (and I'm not one of them) assume that no medical pathway, ever, would be the best option for some young people.

What would evidence need to show for you to consider that medical intervention might be appropriate for some young people?

Firstly, some clear guidelines to be able to distinguish for whom medical intervention would be the best option, and for whom it wouldn't.

Secondly a good evidence base that medical intervention can produce a beneficial outcome over a person's entire life. Not just making them happier in their teens - but adulthood too.

Thirdly, some genuine acceptance across the communities that even with the most extreme medical interventions, people's legal sex remains unchanged.

Fourthly, I'd like a consistent rational explanation for the explosion of trans-identifying young people in recent years. Thirty years ago the equivalent was anorexia and bulimia - in epidemic proportions. Unlike being 'trans', however, treatment for eating disorders didn't involve irreversible body modification.

I feel that since this is a psychological issue, the constant societal background of "yes you really can become a man/woman" is immensely damaging.

That's a fair question.
The pathway my daughter followed began with extensive assessment through GIDS, which at the time involved multiple appointments over many months, exploring her history, her feelings, her mental health, family dynamics, and whether there were other factors contributing to her distress. It wasn't a single conversation and a prescription.
After that assessment, she was prescribed puberty blockers, which paused the development of secondary sex characteristics that were causing her significant distress. The purpose was to give her more time to mature and be certain, while preventing changes that would have been irreversible and deeply distressing for her.
More recently, she's begun cross-sex hormones, which will cause feminising changes. This decision came after further assessment, after years of living consistently in her gender, and with full understanding that some effects are permanent.
What the pathway doesn't involve, at least not until adulthood and after years of living in role, is surgery. The narrative that children are being rushed into operating theatres isn't what's actually happening in the UK system.
I want to be clear: I don't think this pathway is right for every young person who questions their gender. I don't think assessment should be cursory. I think careful, individualised assessment matters enormously.
But I also watched my daughter before and after. The difference isn't subtle. She went from someone who could barely leave her room to someone who has friends, goes to school, talks about the future.

That's a fair question.
The pathway my daughter followed began with extensive assessment through GIDS, which at the time involved multiple appointments over many months, exploring her history, her feelings, her mental health, family dynamics, and whether there were other factors contributing to her distress. It wasn't a single conversation and a prescription.
After that assessment, she was prescribed puberty blockers, which paused the development of secondary sex characteristics that were causing her significant distress. The purpose was to give her more time to mature and be certain, while preventing changes that would have been irreversible and deeply distressing for her.
More recently, she's begun cross-sex hormones, which will cause feminising changes. This decision came after further assessment, after years of living consistently in her gender, and with full understanding that some effects are permanent.
What the pathway doesn't involve, at least not until adulthood and after years of living in role, is surgery. The narrative that children are being rushed into operating theatres isn't what's actually happening in the UK system.
I want to be clear: I don't think this pathway is right for every young person who questions their gender. I don't think assessment should be cursory. I think careful, individualised assessment matters enormously.
But I also watched my daughter before and after. The difference isn't subtle. She went from someone who could barely leave her room to someone who has friends, goes to school, talks about the future.

I hear you, and I don't think we're as far apart as it might seem.
I agree that psychological support should be the first line of response, and that it should be well funded and readily available. The current situation where young people wait years for any help at all is failing everyone, regardless of what treatment they eventually need.
On the specific concerns you raise: yes, there are questions about bone density and blockers. The research is ongoing, and monitoring matters. But "preserving IQ" isn't quite accurate to the current evidence. The studies that raised cognitive concerns were small and methodologically limited. I'm not dismissing them, but they're not settled science either.
Here's what I keep coming back to though. You say "speaking therapy which is evidenced to help in distress from dysmorphia." But gender dysphoria isn't the same as body dysmorphia. They present differently, respond to different interventions, and have different trajectories. Treating them as interchangeable leads to approaches that don't actually address what the young person is experiencing.
My daughter had therapy. Lots of it. It helped with her anxiety, her depression, her ability to cope with school. What it didn't do was make her feel at home in her body. That's what blockers, and later hormones, did.
I'm genuinely open to better research, longer assessment periods, more psychological support alongside any medical intervention. What I can't accept is the assumption that the right answer for every young person is no medical pathway ever, regardless of their individual presentation and regardless of how they respond to other approaches.
What would evidence need to show for you to consider that medical intervention might be appropriate for some young people?

Can you clarify exactly what you think the medical pathway involves?

So she's 16.

Well that's laid my mind to rest about the long term effects of blockers and how it leads to further medicalisation and how they are safe and she and everyone like her will be happy and fulfilled without problems in her 40s. Based on one child.

(Slaps forehead about the absence of understanding of absolutely anything and the mentality of 'we must do something, anything even if unproven because we'll someone said blockers are great and are a magical long term bullet')

That sounds you hear may well be the kicking of the can down the road for an unavoidable clash with reality that's merely been delayed a couple of years. Only with added steroids.