My DD's first boyfriend is transgender and I feel weird about it.

[Milicentbystander72]

I've always been a very liberal minded person. Supported gay rights all my life. My best friend and DN are gay. I support the rights of Trans people to live their life etc.

My dd15 has a nice group of friends (boys and girls). In that group is a Trans teen (Female to Male). He changed his name in Y8, He's totally accepted as Male at school. There are no issues. He looks completely Male and people who don't know him would never think that he'd been born female. He's a nice boy who is well liked. All good.

Except last night my DD told me she's going out with him. I've surprised myself that this has unnerved me.

My dd hasn't had a BF before. She's only ever snogged one boy before at a party. She says she's 100% straight. She says she fancies the cool older boys in Sixth Form. Has teenage celebrity crushes on boys like Tom Holland etc. So how does this work for her?

Last night I told her all was fine and just to be careful they didn't damage a friendship if they broke up etc, but I didn't make a big deal of it.

Would you find this weird if your dc said they were straight? Please be honest. I'm kind of hoping it fizzles out without any drama.

Funny thing about MN threads that you might observe if you visit often - threads move on from the OP, conversations evolve. And it is allowed!

Really? Not my experience on the FWR board at all.

WotchaTalkinBoutWillis

Cross posted with you. It makes you laugh doesn't it, the absolute and complete double standards.

The most important thing is that your DD is treated with love and respect. If that’s there then it really doesn’t matter how either of them label their gender or sexuality. If she is happy and safe then she will eventually work out what she wants from a relationship in a healthy way.

She doesn't suggest that the child concerned is on puberty blockers so I'm not sure what relevance it has to the op anyway.

Why would a 15-year-old be on puberty blockers?

The OP should be aware that testosterone use in female bodied trans people has not been studied. Anecdotally those who have taken it report an increase in aggression, increased libido and bouts of anger. The physical effects are many and varied and not all welcome or expected. If this child is taking testosterone it could have a negative effect on OP's daughter.

The fact that we know the side effects of a certain drug doesn't mean that unnecessary prescribing of them is not a concern and yet your outrage and those of other poster seems limited only to puberty blockers.

No, you are missing the point. There is actual research into the long-term side-effects of antipsychotics in children. The side effects are grim and concerning but they are known and can be factored into discussions when they are prescribed. The medications are very effective for ideally short-term use for violent and aggressive behaviour associated with ASD. My feeling is that these drugs should be used with caution but I can’t manufacture outrage about them because they are effective in these extreme situations. Puberty-blockers aren’t effective for gender dysphoria.

You seem confused so I’ll break it down.

Do both medications have severe side effects?
Yes
Have the long-term side effects for children treated with antipsychotics for severe behavioural disturbances been researched? If a doctor was prescribing this for a child could they definitively say those side-effects were?
Yes.

Have the long-term side effects of prolonged use of puberty-blockers been researched?
No

There are no studies into the long-term side effects of puberty blockers for children with gender dysphoria.

Is the efficacy of antipsychotic medication for severe behavioural disturbances known and studied (on licence herein Australia for this purpose when associated with ASD)?
Yes. It works, it’s calming and it reduces severe behavioural outbursts. This may mean the difference between being able to attend school and stay in the family home.

Has the efficacy of puberty-blockers for the treatment of gender-dysphoria been proven? Nope, not at all.

Puberty blockers given in this setting is experimental. There is research into the efficacy and side-effect profile of antipsychotic use in children. Can you see the difference?

Or: even simpler.

Parent of child with ASD with severe and aggressive behavioural outbursts:

• how does this medication work?

Doctor: actual answer based on this medication being used for this purpose for for many years Parent : what are the common side effects? What are the serious side-effects? Doctor: actual answer

Parent of gender dysphoric 10 year old being prescribed puberty blockers:

• how does this potentially long-term medication that leaves my child looking pre pubertal for the next 5 years work for gender dysphoria?

Doctor: it doesn’t, actually Parent: what are the side-effects associated with 5 years of use. I’ve read about loss of bone density. How bad is it? Doctor: I don’t know. There’s no research.

Why would a 15-year-old be on puberty blockers?
Are you asking because you don't know what they do or because you think that a 15 year old would be done with puberty?

No, you are missing the point. There is actual research into the long-term side-effects of antipsychotics in children.

So you think that drugs shouldn't be prescribed until the long term side effects are known? Do you realise that doesn't happen with any new drug? They are on the market for years before long term side effects are known whether licensed or not.

The medications are very effective for ideally short-term use for violent and aggressive behaviour associated with ASD. My feeling is that these drugs should be used with caution but I can’t manufacture outrage about them because they are effective in these extreme situations.

There is actually a lot of concern about that fact that these drugs are given to children and adults off-label with little good reason in a lot of cases. They aren't just given in extreme circumstances at all.

Are you asking because you don't know what they do or because you think that a 15 year old would be done with puberty?

The second one.

Why would a 15-year-old be on puberty blockers?

It does seem odd to put children who do not have an illness on such powerful drugs. Especially as the effects of these drugs are so negative for the child's future health and wellbeing.

So you think that drugs shouldn't be prescribed until the long term side effects are known

No, they shouldn’t be prescribed because there’s no evidence that they work and because there has been no research into any of the side-effects.

I’m going to disagree with you about Risperidone in children for behavioural disturbances as it’s proven to be effective in treating acute and severe aggressive outbursts. I applaud your concern though and the need for its usage is a testament to the wider issues about how children with severe autism manage and are treated in mainstream society. Bottom line for me though is that it works and it’s been well researched.

Puberty blockers don’t work for gender dysphoric children. Why are you advocating so strongly for their use? Why do you never answer this question?

I’ve patiently explained the rationale for Risperidone usage in children and outlined why I’m more comfortable with its usage that puberty blockers. We may not agree but I’ve given you the courtesy of my views and debate.

Why are you advocating for the use of puberty blockers in gender dysphoric children when they don’t work?

FamilyOfAliens The transgender pathway means that a child is put on puberty blockers (GnRH agonists) soon after starting puberty, and continues until they are old enough to be prescribed cross sex hormones, 16 in the UK, 14 or 15 in some other countries.

These children do not go through puberty. This is a bizarre experiment on children.

These children do not go through puberty. This is a bizarre experiment on children.

It’s very disturbing.

(I’m going to disagree with you about Risperidone in children for behavioural disturbances as it’s proven to be effective in treating acute and severe aggressive outbursts. I applaud your concern though and the need for its usage is a testament to the wider issues about how children with severe autism manage and are treated in mainstream society. Bottom line for me though is that it works and it’s been well researched.*

You asked me "what other drugs were off-label treatment for children that pathologised their healthy bodies" and I have you the example of antipsychotics. I didn't specifically say risperidone for autism so why do you keep bringing it back to that? Antipsychotics other than risperidone are sometimes used in children and adults with learning disorders for example. They aren't licensed for that use and and they are healthy before taking the drug.

(I’m going to disagree with you about Risperidone in children for behavioural disturbances as it’s proven to be effective in treating acute and severe aggressive outbursts. I applaud your concern though and the need for its usage is a testament to the wider issues about how children with severe autism manage and are treated in mainstream society. Bottom line for me though is that it works and it’s been well researched.

You asked me "what other drugs were off-label treatment for children that pathologised their healthy bodies" and I have you the example of antipsychotics. I didn't specifically say risperidone for autism so why do you keep bringing it back to that? Antipsychotics other than risperidone are sometimes used in children and adults with learning disorders for example. They aren't licensed for that use and and they are healthy before taking the drug.

They aren't licensed for that use and and they are healthy before taking the drug.

What’s your understanding of when and why antipsychotics are prescribed in this setting? They don’t help with the learning disorders per se, why and when do you think they are used?

And, why do you never answer this specific question? Why are you advocating for the use of puberty blockers in gender dysphoric children when they don’t work?

I’ve patiently discussed antipsychotic usage in children with severe behavioural disturbances and explained my impression of their clinical usefulness for maybe 6 posts now.

You’ve explained your support for puberty blockers in gender dysphoric children in exactly zero.

On the one hand you say there is no evidence as to what the long term effects of puberty blockers might be and so a Dr can't factor this into discussions with the patient.

Then you list long term side effects and say that they don't work - but how can you say this if there have been no studies into the use in gender dysphoria not into their long term usage?

Either there is evidence, in which case the Dr can earn the patient, or there isn't in which case on what basis are you claiming that they cause harm and have no benefit?

*This is where we are at:

The World Health Organisation declared in May 2019 that transgenderism is not a mental illness.

Children who present as transgender are not, therefore, mentally ill.

The UK's NHS clinic to which gender questioning children are referred reports a 5,337% increase in girls (1,460% increase in boys) presenting as transgender in under a decade. The gap between boys and girls being referred continues to widen year on year.

80% of children who claim they are transgender reconcile their gender identity with their biological sex over time if they are monitored and supported but left unmedicated.

Advocates of prescribing puberty blockers, designed for short-term use for the treatment of a specific medical condition (precocious puberty) claim that children will suffer mental distress and suicidal ideation if they are denied medication, contrary to the WHO's announcement that transgenderism is not a mental illness.

A 30 year Swedish study found that "mortality from suicide was strikingly high among sex-reassigned persons...after adjustment for prior psychiatric morbidity. In line with this, sex-reassigned persons were at increased risk for suicide attempts." Physical transition (of which puberty blockers is the first step, as children medicated in this way are significantly more likely to go on to cross sex hormones and surgery in their late teens) does not decrease suicidal ideation amongst transpeople.

The evidence available relating to puberty blockers indicates that their use leads to osteoporosis, compromised immune systems, sterility, arthritis, impaired pituitary function and lowered IQ. These adverse effects become more severe the longer the drug is taken. Research suggests these effects can not be completely reversed by stopping the medication.

Trans-supportive websites play down the side effects, tending to refer only to bone density and emphasising that any side effects are completely reversible, contrary to most current available evidence.

Children who are physically and (officially) mentally healthy are being prescribed medication designed for short-term use over the long term, in some cases for 6-7 years.*

decomposing I’m reposting tit’s excellent summary from upthread. It succinctly answers your questions. You may have missed it the first time

Thanks nolongersurprised.

No I didn't miss the post. I was just confused as to how you could be arguing 2 opposing points. As I said on the one hand you claim that a Dr can prescribe anti psychotic drugs to a child because they know the adverse side effects and so can properly inform the patients of the risks, but you object to them prescribing puberty blockers because the adverse side effects are not known and so they cannot inform the patient.

Then you quote this:

The evidence available relating to puberty blockers indicates that their use leads to osteoporosis, compromised immune systems, sterility, arthritis, impaired pituitary function and lowered IQ. These adverse effects become more severe the longer the drug is taken. Research suggests these effects can not be completely reversed by stopping the medication.

Which appears to show evidence of adverse effects. So, either the evidence exists to show potential adverse effects, in which case drs know about them and can inform patients, in line with drugs such as anti psychotics (which you are ok with) or the evidence doesn't exist (which is what you claimed) in which case the above paragraph (which you quoted) is untrue.

Maybe you could clarify?

Trans-supportive websites play down the side effects, tending to refer only to bone density and emphasising that any side effects are completely reversible, contrary to most current available evidence

The thing that confuses me most is that the activists ( and many trans people are against this and have spoken up. But there are many many activists who have been campaigning for this) have been lobbying for self ID which means they are who they say they are without any form of transition even necessary. So why, when they are campaigning to have self ID in place do we even need to medicate children. Why do we need to when they can just say the words and leave their healthy bodies alone?

The evidence available relating to puberty blockers indicates that their use leads to osteoporosis, compromised immune systems, sterility, arthritis, impaired pituitary function and lowered IQ. These adverse effects become more severe the longer the drug is taken. Research suggests these effects can not be completely reversed by stopping the medication.

I think I clarified this up thread but I’m happy to go over again.

Most idiopathic precocious puberty happens in girls aged 6-7 years. Younger girls and all boys are more likely to have intracranial pathology so other procedures and pathologies confounding any medication. Girls will be let to go through puberty naturally at 8 years. Historically “long term use” was 18 months or so. That’s how the side effect profile was derived.

But - now there’s the unprecedented use of blockers for much longer periods. The exact side effect profile is unknown because no one has been on it for that long before and these children/young adults are too young to appreciate longer-term effects.

The risks are known up to a point which is in keeping with previous prescribing patterns. But thereafter - who knows? How are their bones, cognition and libido and sexual function at 30?

While we’re clarifying stuff I’m unclear where you posted why you support puberty blockers for gender dysphoric children.

So why, when they are campaigning to have self ID in place do we even need to medicate children. Why do we need to when they can just say the words and leave their healthy bodies alone?

No one ever answers this question either. Lots of obfuscation, whataboutism and

It does seem odd to put children who do not have an illness on such powerful drugs.

It seems even odder to put a post-pubescent child on puberty blockers.

It is normal to be shocked, I am also a great defender of gay and trans people rights, but just got a new colleague who I very much suspect is trans (female to male).

Unlike other trans people I know, who I cannot imagine them in their previous gender, my colleague is somewhat down the middle and I have found it interesting that I struggled at first to know how to talk to him.

There are slight variations on how we relate/communicate with people of the same or other gender. In this case I didn’t know if I should keep the usual more affectionate natter I keep with other women or put that little bit of distance I keep with men in professional settings.

I suspect that something similar is happening here, you like the boy but do not know what is involved in dating someone who is trans and feel you are in unchartered waters. The advice you may have given to your DD may not apply so it is natural you don’t know how to deal with it. It will pass, I hope, don’t worry too much but if you do, please be reassured that any relationship she has at this age is likely to be short lived.