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.

Supermatch did you not see the previous comments and link to the detransitioners survey? There appear to be quite a range of ways to deal with dysphoria other than transition. Indeed, for these 203 women, transition deepened their dysphoria whereas coming to terms with their sex helped.

guideonragingstars.tumblr.com/post/149877706175/female-detransition-and-reidentification-survey

That Stella Creasy response pretty much summed up the current political mindset to me.

Just disgraceful. The "wait til there is a crisis" approach to child protection grieves me, having been through one with my own child. Which the response to was largely clueless and arse covering.

The problem is child protection is a low, low, low priority to governments, LAs, schools, and Social Services. It is completely fragmented and there is no cohesion, only buck passing.

I recommended using the Judicial Review process.

I did this when a school repeatedly lied to me about their actions, once they had to get a barrister to respond to a Judicial Review they admitted that child protection was "not set in stone". In fact they ignored it because they did know any of it and had not read any of their obligations.

Agree. I think we need to get a strategic safeguarding judicial review for a blatant breach.

I think, I hope JR become the norm, that will soon make the Government sit up and take notice.

I disagree entirely that child protection is a low priority to schools, local authorities and social services. I do however think there is a lack of clarity in schools and local authorities around what is the best way to support young people who believe they are trans. This reflects similar confusion in the wider community.

They may talk about it being high priority, however when a complicated situation arises, and they all are, they act first and think later, if ever.

There is zero understanding of the complexities. School leaderships are dominated by white middle class males whose default view is, middle class male innocent, child the problem.

White middle class male (dressed however he wants) enters school advising that males take priority over females, white males are not going to think, oh heck I maybe should reflect on what I encounter online whilst indulging my porn habits at this point in time and consider the children. Hell no.

Supermatch
The first article you linked to is from 1973 and refers to gay conversion therapy in someone who did not want to be gay.

The second one is more recent, but the bit you quote has no references to back it up.

Psychotherapy with the objective of “curing” transsexualism, in order to get the patient to accept oneself as a man or a woman, is useless with the currently available methods. The transsexual mind cannot be changed into a false gender orientation. Every attempt there that has been to do so has failed.

If that is true, why not cite some of the studies that showed it?

Vaccinations do not have significant risks.

Very rarely, something goes wrong. That happens to a tiny minority of people.

Vaccinations are extremely safe, generally speaking

Hey, I am going to try and summarise everything that people have asked of me and cover off a few other points I picked up whilst reading back.

If I miss you out please let me know an I will be happy to answer specifically. Will try to be concise...

CharlieParley - I agree that those that DO desist need to be allowed to desist. Without screwing up their endocrine system. They are after all not trans. Possibly non conforming and that is fine too, but I do think that the key in this regard is that medical professionals need better ways of separating out those that will persist in to adolescence. How we do this? Beyond my knowledge but I think if we could know with far more certainty.. This is far preferable to blockers/hormones for those that would have otherwise not turned out to be trans.

Keeptrudging - I started researching this stuff in the middle of my teens. I would say that by 17 I had the knowledge I needed. The reason I held back was not because I was unsure of myself but I still reliant upon my parents. And given that they disowned me at 27 when I came out, I was right to do so. Once I was out from under their roof, and more independent the only thing that stopped me was a string of serious relationships, two of which I was still hiding who I was out of a combination of shame and also commitment to my partners and a third who supported me the best way she could but ultimately the relationship ended because I needed to transition.

Even by 16 I knew what I wanted.. desperately. But fear/shame/relationships/hoping it was a phase is what stopped me. Which is a common theme among trans people.

Also, with regards to your statement about taxes - I pay taxes too. And over the years, Shouldn't I get to benefit from what I have paid in to the NHS? I would say that I paid for the treatment of a lot of other people's needs and I do not begrudge this. But the whole point of the NHS is that it is there when it is needed. If society expects me to be a fully developed male first to be certain I won't change my mind about something I have known for 25 of my nearly 29 years on this planet then society should not begrudge me reversing as much of it as possible. Again - a system I have paid in to.

spontaneousgiventime - Perhaps I am biased. But I am coming at this from being in the same situation that many young trans people are in. One of feeling hopeless whilst my body continued to change. I may have been old enough to make the decision to start at 27 in many people's eyes but the knowledge I gained 13+ years prior was still valid. If there were more options available to me (or I knew they existed) I would not have had to research DIY in the first place.

OldCrone - This boils down to the fact that to the trans person their body is not complete. It disgusts them. The level and specific areas in this change but the end result is the same. How can you lead a happy and fulfilled life when every time you look in a mirror you want to be physically sick or you can feel your skin crawling. Yes transition is extreme. Therapy can help to an extent. I will probably get shot for this.. but it is like expecting a gay person to accept that they are gay but that they need to lead a heterosexual life. That is what I liken it to. Trying to remove a persons 'need' to transition through therapy is no different to conversion therapy.

I will say though, since my stance is that 16 is an age where medical transition should be an option that prior to this, therapy can help with adolescents figuring themselves out and also as a way to teach patience. Something that through lack of support, breeds the desperation that leads them to recklessly buy medication online without understanding the ramifications. One look at places like reddit shows threads asking if blood work is even necessary when they could buy their next x number of months worth of estrogen/anti androgen/testosterone. It is painful to read. Also I use the word naive because many, whilst coming from a place of empathy, do not have an understanding of what it is truly like. I am happy to withdraw the word if another would have been more appropriate or it caused offence then I am sorry.

With regards to the dangers of buying medication online, it can be if you don't do the research. But honestly.. finding a reputable online pharmacy is not difficult, it is not like I was buying brandless pills off a craiglist chemist who claims to synthesise the estrogen/anti-androgens himself. I was getting the real thing, the market for counterfeited Estradot patches and Androcur Cyproterone is just not profitable when having to stay up to date with packaging, batch numbers and presentation. But also, I was getting regular blood work done. I knew the warning signs and what to look out for and I was (and am, though now on NHS prescription - omg the money I am saving..) seeing doctors regularly. I was upfront with the GIC when I returned for my second consultation (typically where they will offer hormones) and I told them what I was taking, what dosages, frequency, blood work levels etc. I am being continued on the dosages I was already taking.

But I do acknowledge that too many young people rush in to this and regret it later. Reducing stigma and waiting times to see a GIC specialist (adult and adolescent) and also access to intermediate support would go along way to reduce the number of people having to go DIY like I did.

Prawnofthepatriarchy - I think a lot of people confuse this.. It is less about wanting to look convincing and more about wanting a body that did not go through puberty and thus cause them increased dysphoria. I get told all the time I am pretty by friends, colleagues, random people that I end up in conversation with. I am sceptical of their sincerity, but nonetheless I think I have been incredibly lucky with what I have achieved considering the age I was when I started. But truly I do not think it is about passing or looking pretty or handsome for most, it is about development that was avoidable. But yes perhaps you are right about looking back retrospectively though I would never suggest someone DIYs. It has to be something that they choose themselves and I will dissuade whenever I can because I do not think most that consider it are as informed as I was.

That was less concise than I had hoped for.. Sorry :(

Beyond my knowledge but I think if we could know with far more certainty.. This is far preferable to blockers/hormones for those that would have otherwise not turned out to be trans.

I think you are massively downplaying this. If children have their lives ruined by blockers and hormones and sterility when they don't have gender dysphoria and would have desisted it's tragic. The bar needs to be much higher than "wouldn't it be great if we could know better who is trans but we can't at the moment so that's too bad".

for these 203 women, transition deepened their dysphoria whereas coming to terms with their sex helped.

Prawn is it not possible that those that detransitioned either had gender identities that were fairly in the middle of the spectrum? Their transition and subsequent detransition were part of a process they needed to go though to come to terms with themselves? Or they transitioned possibly for the wrong reasons?

If transition make someone worse, not better, then I think that is a sure sign that it isn't right for them.

That is not the case at all. The margin of error is clearly unacceptable. Especially given the massive increase in referrals. I am completely with you all when it comes to diagnosis. We need to be better and more careful.

Ultimately though.. if you are planning on hormones and other interventions then sterility is ultimately a consequence. Maturity and forward planning can minimise this.

I also clearly don’t know nearly enough about blockers or the effects so this is something I need to review.

The problem is NO-ONE knows enough about the long term use of blockers on children. It is wholly unacceptable that children are given them, or have access to them due to the possibility of a social fad. TRA are encouraging children to take these blockers, it's not going to be them who face the long term effects it's going to be the easily led and gullible children.

Anyone who even suggests blockers to children is guilty of child abuse and that people are encouraging children is a stain on this country.

NatLuc I had a hysterectomy when I was 40 yrs old for medical neccesity. In order for me to take the lowest dose of estrogen (this would be specifically hormone replacement therapy) it required discussion with my consultant, a proffesor at a centre of excellence and discussion at MDT meeting.

I also read a great deal about HRT as it was a decision based on potential risk vs potential benefit.

I only say this out of deep concern.

Use of HRT for women is a still contentious despite a long history with large clinical trials.

I am influenced by the fact that I have spent a lot of time in recent years involved with women who have had a gynaecological cancer diagnosis.

spontaneousgiventime- I meant my stance on blockers needs to be reviewed because my understanding was that the effects in the short run (around a year) are not permanent. Obviously I was wrong.

NatLuc if you have read a report stating blockers are safe in the short term, would you post it please? I've yet to see anything that states giving blockers to children is safe.

My husband died when my youngest was 17, due to that she became depressed (hardly surprising). Our family Doctor took advice from a specialist before he would give her any AntiD's yet blockers are handed out like smarties.

Blockers are also associated with a 5-7 point drop in IQ. And it's not simply sterility - depending on the age started, it's also a complete loss of sexual function/sensation. While they're not being handed out like sweeties here - I think about a thousand kids, which is a thousand too many - they certainly are stateside. Probably several tens of thousand, at least. It's unconscionable.

R0wantrees I am incredibly sorry you had to go through that. It must have been heartbreaking.

I know I can only empathise.. but I am sorry.

I know that all forms of HRT of all varieties are a trade of for risk and benefit.. for example I have sky rocketed my changes for breast cancer but my chances of testicular or prostate cancer are must lower. And yes, I have likely sterilised myself (I’ve moved beyond cyproterone. I should actually be having my second decapeptyl injection in a couple days time) after 9 months and I did not store sperm, but this was my choice as it was not something I wanted to do.

I’m not an expert on mental maturity nor trans issues but being around many trans issues and people and hearing their stories as shared experience rather than empathy, I can imagine I at least have been influenced in that respect in a similar way you have regarding gynaecological cancer issues.

4thwavenow.com/about/

Search for the authors of the research that Wakame features a link to and there are numerous 'take downs' of their methodology and findings.

4th Wave Now seems to have the most comprehensive database of articles.

You are, but also it wouldn't be a year if they took them at Tanner Stage 1 (9-12ish) They would have to stave natural puberty off until they went on cross sex hormones so it would be more like 5/6 years.

OldCrone

The first article you linked to is from 1973 and refers to gay conversion therapy in someone who did not want to be gay.

It is a transsexual case study. Some of the techniques used are the same as for gay conversion therapy. We can't see that from the abstract but the paper is elaborated on in an old text book I have, ironically called "Abnormal Psychology" (bet they don't make titles like that any more). The case is a 17 year old male transsexual who quote: 'felt himself to be female'. There was an attempt to change the sexual orientation as well as the behaviour and fantasies.

The second one is more recent, but the bit you quote has no references to back it up. If that is true, why not cite some of the studies that showed it?

Fair question - it was the only other reference I could find on the internet quickly. The main reference for that is reference 4, a book by R.J. Stoller: Sex and gender from 1968/ 74. I've just managed to dig it out here.

There are a couple of chapters on the possible different treatments, the ethics, pros and cons etc. It was an authoritative text in its day and even though it is clearly 'of its time' it is of historical interest. It also illustrates how even in the 60s and 70s the search for an alternate cure was unsuccessful (and I find old psych books fascinating!):-

The most troubling aspect is that the easier it is to have such procedures done, the more patients request them. As the word gets around, as it has in the last decade or so, more and more effeminate men request to be changed.

The general rule that applies to the treatment of the transsexual is that no matter what one does - including nothing - it will be wrong. First, what happens if the procedures are completed? That many are better adjusted (we won't pause to document that vague term) postoperatively than they were before is a conjecture that can be proven only by having seen transsexuals (not pseudotranssexuals) in intensive follow-up from months to years after they have completed their sex-transformation procedures. Their anguish before the procedures is intense and genuine (one of the many points distinguishing their reactions from pseudotranssexuals). Nonetheless, they are left more or less dissatisfied feeling that although the necessary procedures have feminized some of their apperaance and functions, the results are far from complete. The transsexual will wish to have not only breasts, vagina and female-like external genitalia, absent facial and body hair (all of which can be supplied) but also ovaries, uterus and fertility. So if the surgeon complies with the patient's request, he is likely to be still harassed by the patient who wants more...

On the other hand, if one does not assist transsexual patients they are deeply unhappy. The argument against treating this unhappiness by surgery or hormones is exemplified by the following statement "..if... the demand for a change of sex operation is based upon a delusion [sic] conviction, then only the treatment of the underlying psychosis or personality disorder is in my view admissible or correct".

One would not provide a throne for psychotics who delusionally felt he was a king; is it not as irrational to grant the transsexual his request just because he is unhappy? The cases are not identical. Psychotics who want thrones do not become less disturbed even when they become kings, but most transsexuals are less depressed and anxious, more sociable and affectionate, and so forth after "the change". Also very few transsexuals are clinically psychotic.

However, for all this, if there were any psychiatric treatment that was even partly useful, it would probably be better than this disquieting "psychosurgery." It has been suggested that "no psychotherapeutic procedure less than intensive, prolonged, classic psychoanalysis would have any effect. If properly done, it could probably reduce the patient's agitation and the level of his unhappiness. It is not impossible that his major symptoms may decrease in frequency and urgency."

This statement has the vigorous ring of sober caution; it also must have been written by someone who has never tried to get such a patient into analysis. Unfortunately, no one has ever reported having reached such success by any psychotherapeutic technique. We must search for such techniques, but in the meanwhile it seems haughty to say that "only such treatment as will enable them to come to terms with the reality of their condition is open to the psychiatrist to offer or endorse." Since we have nothing to offer or endorse that can give these patients any relief, to make this a rule to put into practice when sitting in one's office with the patient who asks for your help means to do nothing. The problem for the psychiatrist then is only: Should he do this nothing gracefully or horsewhip the bloody beggar off the compound?

--
There are those that have been waiting ever since to find this alternative to either 'psychosurgery' or doing 'nothing'. No-one seems to have found it yet...

NatLuc
Thank you, that's kind. I am very fortunate to have NED (no evidence of disease) its sadly very different for many women.

I think you might have missed the point I was trying to make, that I have read a great deal about HRT and have spent time with clinicians at conferences etc.

I'm not questioning your own decision, you've descibed how you came to it and I respect that.

My concern is that I see such a keeness to start taking hormones and for many young people at a time which would likely mean taking it for many years. The hormones are not replacements and I don't think there are any long term extensive clinical trials about possible implications.

We do though have large studies about HRT taken by women (however flawed they may be) and these are mostly for much shorter periods of time.

Statistics about cancer can seem very abstract (its probably a naural thing as we keep ourselves from worry) but I do see things differently having had the expeience of diagnosis.

NatLuc
I am aware, from what you have said, and also other trans identified people who have posted on here that gender dysphoria is extremely distressing. I am also aware that for some people, physical transition is the only way to treat the condition. What you do with your own body, as an adult, is up to you.

This thread was discussing early transition in children, and I still think that therapy for those children is better than medication - even puberty blockers should not be given to children.

Trying to remove a persons 'need' to transition through therapy is no different to conversion therapy.
This is a poor analogy. Someone who is gay does not require body modification. A better comparison would be with someone with Body Integrity Identity Disorder. I can't see how anyone can argue that hormonal treatment and major surgery on a healthy body to relieve mental distress is preferable to trying to find a way to live in that body without those interventions. And for children, therapy is the only treatment that should be used.

Bollux

Trying to remove a persons 'need' to transition through therapy is no different to conversion therapy.

Nonsense. Do we treat Anorexics by giving them liposuction?