Study find trans kids thrive after early transition

[Wakame]

pediatrics.aappublications.org/content/early/2014/09/02/peds.2013-2958

A study has found that young adults who transitioned in childhood through puberty suppression and cross sex hormones are thriving. Here's an excerpt:

"After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being."

It's a small study, but of course, when the results are so unambiguous, they become statistically significant even with smaller studies. You can of course counter this study with more science - just find a larger study that shows the opposite.

"No male pelvis will be able to support a gestation, it's too small and the wrong shape."

Women's pelvises are quite varied:

www.parent24.com/Pregnant/Birth/Different-pelvic-shapes-and-what-they-mean-for-your-birth-experience-20150826

However, the typical female pelvis shape happens under the influence of estrogen at puberty so trans girls who have puberty suppression followed by estrogen develop typical female pelvises.

Which is another reason why early transition helps.

@Bowlofbabelfish I would be interested in seeing the study that says decapeptyl (blockers) has such effects which is mainky used as a cancer treatment in hospitals

Can you please link me

Thank you

Wakame, that sentence about transitioning early so that the pelvic can form as female instead of male wants to make me cry. Whenever humans feel they can play God or are better than nature (whatever you believe in) it always ends in disaster. What you are suggesting is a science fiction world where humans are engineered, not grown and nurtured. It is right up there with embryo selection, cloning and robotic humans. I for one do not want to live in a world like that.

Wakame and GibbertyFlibbert
Can you explain to me why you think that children being helped to come to terms with the body they were born with is such a bad idea?

Boys will never experience a Female puberty, they don’t have fucking ovaries. Jesus, Wakame needs to see the work of Dr David Page on the myriad of genetic differences between Male and Female humans.
Fuxsake !

I thought this was pretty relevant

I am going to propose that no one else answers this thread ... Wakame is aiming to derail a Feminist Chat board... has done it before and is doing it again....Really great that Bowl has pasted one cogent response - Let's not add any more

Controls means denying treatment to people whom the doctors believe would benefit from it. That raises huge medical ethics issues.

The same used to be said of lobotomies and forced sterilisations.

GibbertyFlibbert
"Where are the controls?"

Have you ever sat down and shared a bottle of wine with doctors in this field? Controls means denying treatment to people whom the doctors believe would benefit from it. That raises huge medical ethics issues.

Have you ever met anybody with an incurable disease who has partaken in a medical trial? They are very common. Nobody is forced to go on a trial but those that choose to understand they might be able to access a potentially life saving treatment or they might be allocated the control group. My relative was in the control group (we discovered later). Perhaps if they had not been they might have lived longer. A personal tragedy yes but nonetheless I'd rather live with a system that rigorously tested drugs and treatments before offering them to the general population. We don't yet have a better way.

Also the doctors I know remain remarkably unemotional about their patient's lives. They have to be slightly detached to do their work. There are other healthcare professionals who can provide empathy etc.

I don't think Jazz Jennings is thriving, sadly.

I am going to propose that no one else answers this thread ... Wakame is aiming to derail a Feminist Chat board... has done it before and is doing it again....Really great that Bowl has pasted one cogent response - Let's not add any more

I'm sorry but I totally disagree with this. We often discuss trans issues in FWR and it's useful to hear the other "side".

Womans Place UK, whom I support, are asking for debate. Let's not suppress debate, eh?

The OP, Wakame, wrote - "A study has found that young adults who transitioned in childhood through puberty suppression and cross sex hormones are thriving."

The word "thriving" does not appear in the report of the study.

The study is of 55 young adults. It is a very small study. Although it is a contribution to the study of treating transgender children, it is scientifically unwise at this time to extrapolate this very small sample to claim wider validity.

For future studies to be taken more seriously than this study, sample sizes much larger than this study will be required. There is no shortage of transgender children to study. I have heard that there are more than 600 transgender children on puberty blockers administered by UCL Hospital in London alone.

Gibberty if you are going to start a post by saying "factual nonsense" you should endeavour to make sure that your subsequent "correction" [sic] is not complete bullshit. You wrote: "Fertility - Sperm and ova can be banked. Surrogacy is just as possible as it is for any gay couple and womb transplants etc are already in medical trials."

Puberty blockers are given at Tanner stage one of puberty. Sperm production starts at Tanner stage three or four. Similarly, menstruation in girls (signally the start of ovulation) typically starts at Tanner stage three or four.

If you give puberty blockers at Tanner stage one, there are no sperm or ova available to be banked.

That's before we even get onto issues like osteoporosis.

"After gender reassignment, in young adulthood, the GD was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being."

The key is long term well being though.

The youngsters who have transitioned may well have had a whole host of cormorbid conditions between them, for example anorexia, trying to escape abuse, autism, depression etc.

Transition is a massive intervention, and given the current climate, involves much more than the actual blockers and surgery. It can also involve

• counselling
• online communities who are accepting and who validate and empower you
• the feeling you're part of something important and bigger than you - the trans movement
• a massive feeling of accomplishment for having managed to achieve transition
• schools taking you seriously and rearranging things to accommodate you
• finding your "tribe" - other trans kids who understand you

How much of that is available to anorexics, or abuse survivors, or kids with depression?

At the beginning of transition, they haven't had to deal with things like repeated surgeries, coming to terms with being infertile as an adult, or being unable to breastfeed their children, the awareness that they lack sexual function, a smaller dating pool, perhaps even the realisation they were gay all along, not trans.

I don't doubt that transition might make teenage years easier for GNC kids. But at what price. Suffering throughout adulthood? Sterility. FFS?! This is barbaric.

What we should be asking, is is there another way for those kids to be happier in themselves without the need for such drastic intervention as hormones and chopping bits of their bodies off?

Controls means denying treatment to people

No they don’t. VERY few clinical trials use placebo alone in the control arm. Trial design is a field in itself, but for something like a cancer trial it’s not designed like one group get nothing and one get treated. A more likely design would be current gold standard treatment in the control arm and then either that plus study drug or study drug alone or something else for the active arm. Most trials these days have multiple arms (it gets pretty complex) but you cannot disadvantage a patient in a trial.

Incidentally, was there a study to look at how their brains responded to puberty?

How does Lupron affect the natural brain development that happens when kids go through puberty -if we're suppressing puberty? Does anyone know?

Controls means denying treatment to people

What if children were given access to all the support and validation trans kids got for transition, for their other conditions?

Not a control group as such, but without this kind of comparison you can't say what's down to actual transition and what's down to making these children just feel respected and valued and part of something.

I'm sorry but I totally disagree with this. We often discuss trans issues in FWR and it's useful to hear the other "side".

There is a balance to be found though and one which is often difficult to maintain.

For example a recent thread (below) had important examples of how women, girls & charities supporting vulnerable people were affected by legislation which was designed to protect the rights of people who were transgender. The implications are serious and discussion of this is made difficult by those who might consider themselves 'the other side'.

Its unfortunate that this is so often framed as 'trans issues', the issues concern everyone especially women and girls. We need to be able to talk about women and girls, especially those who are vulnerable.

www.mumsnet.com/Talk/womens_rights/3266198-No-True-Transwoman-transadvocates-question-whether-TW-is-genuine-after-said-TW-sexually-harasses-women-in-homeless-shelter

Controls means denying treatment to people whom the doctors believe would benefit from it. That raises huge medical ethics issues.

It's done in every other circumstance...

Controls could also be non-trans youth given access to therapy etc. - the study says that these people are comparable to non-trans people of the same age - but that's not quite true if the non-trans people haven't had similar professional therapy and support is it?

I mean, I was terribly unhappy as a 13 year old, I hated puberty, by 20 I was slowly starting to come into myself, but I didn't really get there until I was about 26-28 - it seems to me that this is provisionally showing that there's no difference, and that's the best they can show.

Fertility - Sperm and ova can be banked.

There won’t BE any sperm or ova!

Surrogacy is just as possible as it is for any gay couple yup that’s true.

and womb transplants etc are already in medical trials.. Not cross sex they aren’t. The only successful one was mother to daughter.

Puberty - the whole point is that they will go through the correct puberty for them, rather than the incorrect one.They will therefore not retain pre-pubescent features. Yes they will. You don’t turn a boy into a woman by giving cross sex hormones. You don’t have a female puberty. You have a cessation or block of Male puberty followed by female associated hormones. It’s not the same as a female puberty undergone by a female.

They will be very capable of having a full sex life if they want they will not - a Male will have a micropenis, their sex organs will not be developed at all. How is a Male, with a micropenis, going to have a full sex life?

On hormones, the change in osteoporosis risk is small and might even be decreased. data I’ve seen is the opposite of that

There is no known link to diabetes. incorrect. Metabolic disturbances such as fat redistribution will have an influence on diabetic potential.

Cancer is more complex because the risk is a trade off between prostrate and breast cancer, one increasing while the other decreases. it’s so much more complex than that. Metabolic disturbances from blockers can potentially cause cancer. Cross sex hormones can cause a range of cancers, not just restricted to prostate and breast.

Fertility - Sperm and ova can be banked. Surrogacy is just as possible as it is for any gay couple and womb transplants etc are already in medical trials.

Puberty - the whole point is that they will go through the correct puberty for them, rather than the incorrect one. They are taking charge of their own bodies - something which has been a basic tenet of feminism for decades. They will therefore not retain pre-pubescent features.

They will be very capable of having a full sex life if they want.

On hormones, the change in osteoporosis risk is small and might even be decreased. There is no known link to diabetes.

Cancer is more complex because the risk is a trade off between prostrate and breast cancer, one increasing while the other decreases.

It is worth stating very plainly that much of the above is complete nonsense, to anyone who doesn't have any scientific knowledge of transitioning.

Given a boy cross-sex hormones will not make them go through 'correct puberty for them'. That is physically impossible. There is no evidence at all a boy can literally have a female brain. The end result might be the alleviating of a mental health condition but that is different to the body literally changing sex.

As said sperm and ova can't be banked if someone hasn't gone through puberty. If someone has done, eggs can only be frozen for 10 years in the UK and there are ethical issues around using surrogates.

Some trans people will be capable of having a full sex life. Great, good for them. Many won't because of complications from surgery or there being a limited number of willing partners. We simply don't know long term how adults will function if they have taken puberty blockers/cross-sex hormones from a young age. There isn't the data. I cannot imagine it having no impact on sexual functioning for many. Bottom surgery is occasionally botched or has serious complications.

The long term cancer risk we don't really know about but a transwoman will keep taking cross-sex hormones into old age which is nothing like experiencing the menopause.

"The whole point is to allow the puberty which is natural to those involved."
Good. So you agree that children should be allowed to go through the natural puberty. Which their bodies will natural start without artificial intervention.

Its unfortunate that this is so often framed as 'trans issues', the issues concern everyone especially women and girls. We need to be able to talk about women and girls, especially those who are vulnerable

Agreed.

And sorry, you're right, that was clumsy language.

long term cancer risk we don't really know about

To clarify I meant there is no data. We need to look at people over the next few decades for there to be any concrete answers on risks. It is incorrect to say it's an issue because there's no science on this at present

the study says that these people are comparable to non-trans people of the same age - but that's not quite true if the non-trans people haven't had similar professional therapy and support is it?

Exactly.

To clarify I meant there is no data

Indeed.

Lupron do NOT advise their product is used in this way. They can't, there have been no proper clinical trials of hormone blockers for trans kids.