17-year-old Autistic son has started taking hormones without our knowledge or consent

[VeryWorriedMother]

Ok, so this isn't really a feminist topic but I need some help. This will be long, sorry.

My 17-year-old son was diagnosed with ASD last year. He is also gifted, and has struggled with fitting in and making friends. He has very black and white thinking, and thinks that his way is the only right way. He has struggled for many years with his executive functioning and emotional intelligence - he has difficulty planning and completing tasks, and regularly loses his temper. It has been the focus of our lives for a long time. After a very long struggle we finally convinced him to agree to therapy, in the hopes that it would help with his ups and downs, and in figuring out what his autism diagnosis means for him.

He has been on antidepressants for a couple of years, and increased the dose last year. A few weeks ago he asked for an appointment with our GP for another dose increase. DH took him to the appointment but stayed in the waiting room to allow him to speak with the doctor privately. DS went back for a follow up two days ago, and that night I received a notification from my pharmacy saying that his prescriptions were ready: Cyproterone Acetate (a testosterone suppressant) and Estradiol. I was absolutely shocked.

This has come out of absolutely nowhere. He refuses to speak to us about it and, being in Canada, doctors are allowed to prescribe hormones to children if they feel that they fully understand it, without parental consent.

There is no way my son understands the long-term ramifications of this. He has Autism, ffs, and hyperfixation, and he can't even manage to plan a school project, never mind consider the fact that he will be growing irreversible breasts!

He has never, ever talked about wanting to be a girl. Yes, he feels uncomfortable in his body, but, again, he has autism and he's 17! What 17-year-old DOESN'T feel uncomfortable in their body?! I am worried that he is just jumping on the trans bandwagon here, just because he feels different due to his autism. There is a very worrying correlation between Autistic teens and gender dysphoria.

I am so, so angry that our doctor, whom I trusted, has allowed him to do this so quickly. No thinking time, nothing.

DS has heard me voice appreciation for JK Rowling fighting for women's rights, and is under the impression that we are transphobic, so he has completely shut down. I am prepared to support him, but I very strongly disagree with giving children hormones, and so quickly. I don't know what to do.

Thank you if you have read this far.

As you're in Canada it's likely the therapist is affirmation only (not to be so would be career ending - see Amy Hamm) so it may be the suggestion this will solve all his problems has come from there.

It's probably difficult to find a non affirmative therapist in Canada, but I think you should consider whether this is doing more harm than good - especially if you're paying for it.

Edited to add: I'm so sorry you're going through this, I think finding other parents in the same situation is essential and there are some great links upthread. There are also some fantastic parents on here who've navigated this who hopefully can give some advice.

Mmn.

Reminds me somewhat of a social justice warrior careworker at a friend's son's respite centre, who insisted if he wanted sweetcorn at a meal he must be allowed to have it, as despite that he could not independently remember his significant food intolerances, he had a right to his choices. And despite the three days following where the poor lad would be crying and in miserable pain with IBS. I'm not sure whose feelings and best interests the careworker was actually focused on.

I am very sorry OP, this must be extremely worrying. It is awful that a vulnerable young man like this, reliant on parental care and support, can just be handed such impactful and permanently affecting meds on the strength of one visit, it is beyond irresponsible.

I would agree with PP that if he is unable to organise prescriptions himself, then he is not able to have or take them without your facilitating it, and I would have a lot of concerns about facilitating this. Particularly as the first line of support for a never before voiced need, not even yet fully considered, explored or less impactful ways of expressing any gender beliefs been a part of his daily life.

It seems extremely unlikely that he understands what he has been prescribed and what it means, given that he is operating emotionally several years younger than his age. Presumably he is unhappy and has been sold the idea that this will make him happy.

It would be extraordinary to go from nothing to cross-sex hormones. Has he transitioned among friends? Can you look at what he has been up to on the internet?

Ritchie Herron in the blogpost I linked upthread advises caution about using detransitioner stories because lot of transitioners are already closed against hearing them.

I actually mentioned Ritchie Herron to DC and got the response "oh he's just in it for the money" so I didn't take that any further.

The one thing I believe could make a difference to my DC and that doesn't (as far as I know) exist yet is a clear concrete overview of all the physical health outcomes of the medical transition processes, both short and long term. Proper detailed consumer information. A bit off-topic from your situation but I actually get frustrated by the focus on mental health. Sod that -- is a treatment successful if everyone is as happy as larry but a few who had strokes? Though it might not necessarily have stopped my DC from starting the hormones, young people don't really believe in the long term and he dismissed my geenral concerns as "well at least I'll have a few happy years" but it might support a rethink later on.

I don't have any experience of young people whose medication needs to be facilitated. I think that these days in the UK such a dependent young person wouldn't be likely to get a prescription without the family's agreement and support but I am not certain. There have certainly been threats to families in the UK though not AFAIK in these specific circumstances; and of course there have been all sorts of shenanigans in the US. It could be worth looking in to the legal position.

Thank you, (almost) everyone, for the advice. It's the fact that he is so vulnerable, and has such a history of poor decision-making and lack of foresight. I don't think he is capable of making such a big decision on his own. I will look at the links suggested and consider what we can do. Thank you again.

What the buggery bollocks are you on about? Are you on the wrong thread? This one is about concerns for a son. Clearly stated.

Stay calm with him to keep communication open.

Speak to the GP urgently. Ask for full notes on the assessment, how they evaluated his capacity given his ASD/executive function issues, whether comorbidities were fully explored, and any psychological evaluation. Request a pause or second opinion.

Get independent advice: Contact a lawyer familiar with mature minor cases and medical consent in your province. Some parents have successfully challenged or delayed via court if they can show the youth may not fully appreciate the risks. Also consider a private autism-informed psychologist or psychiatrist for a fuller neurodevelopmental assessment.

Explore alternatives: Push for more therapy focused on emotional regulation, social skills and body image distress without assuming it's innate gender dysphoria. Many autistic teens feel "different" and latch onto explanations that seem to explain everything.

Have you considered not making massive assumptions and dramatic overstatements?

Do you have autistic children for whom you have had to battle systems for years? Children you would protect with your life? Children who do not always recognise their own needs? Children who disagree with everything you say out of pathological demand avoidance? Teens who tip into severe mental health problems?

Bugger off with your "worst person in the world" nonsense. Parents usually are trying their best in difficult circumstances.

I see you've been a thoughtless idiot twice in one thread, Kasiopia. Please go and think about your behaviour.

Let's not let the poster above derail the thread. Please just ignore them. I am very grateful for everyone else's help and advice.

Well, if that random thought makes you happy, I suppose.

Sympathies, OP. I wouldn't be rushing to pick up that prescription, let's say. Even antibiotics have had bizarre effects on my child's mood, and autistic teens don't tend to cope well with discomfort.

'Bodily autonomy' doesn't confer the ability to fly.

He won’t open up to you because of your views.

OP, you have had some good advice re your son.

Mine is to actually also take the time to care for your own needs. This is a lot of stress and heartache, and sounds like it has been for a long time.

Have you a good support netwrok? Coping strategies?

Sending you all my best.

Also, inevitably as this is such a hot button issue its hard to talk about. Plenty on this thread demonstrating the tendency for tantrums and personal attack for non believers.

You will need to find a way past all that so that you can communicate with your son. Active listening, always.

Aha parenting has lots of good advice on that topic.

https://www.peacefulparenthappykids.com/guide/teenagers

If he’s gifted approach it from the science angle. There’s a lot of research regarding the impact of this type of medication on young minds. I’m out and about at the moment but will dig some stuff out for you if that helps. Let me know if you’re happy for me to message you directly. I’ve been through similar with a slightly older son.

Yes please!

I have to go to work now, but I will check back in later. Thank you, everyone!

Males taking exogenous oestrogen are 10x more likely to have an ischaemic stroke than a man who is not taking oestrogen. Likewise chances of a Venous thromboembolism (VTE) like a Deep Vein Thrombosis (DVT)in the calf or a pulmonary embolus (PE) are 5x higher than those of other men who are not taking oestrogen. Either stroke or PE may lead to death.

This collection of journal articles is a bit old now, but the research is still relevant and valid:

https://mungeribabu.substack.com/p/estrogen-is-really-bad-for-men

But also, from a parent of a gifted boy who started down this path: be cautious with simply presenting facts to your child. They were not “logicked” into this, and they aren’t likely to be logicked out of it, and any such conversation could be seen as an attack. There was a discussion here about this recently:

https://www.mumsnet.com/talk/womens_rights/5519763-on-the-certainty-of-the-trans-identifying-teen-guidance-for-parents

“One of the most challenging aspects for parents, teachers, and clinicians, to understand and to manage, is the absolute certainty with which many trans identifying teenagers present. It is not the tentative, exploratory uncertainty that characterises most adolescent identity questions. It is categorical, resistant to examination, and often experienced by the young person as an existential matter. To question it feels to them like a denial of their existence. To suggest alternative explanations feels like an attack. The adults around them, trying to engage carefully and honestly, frequently find that careful and honest engagement is precisely what the young person cannot tolerate.”

“The identity is managing an internal state that was, before its adoption, genuinely overwhelming. To threaten the identity is to threaten the regulatory system. The young person does not experience a parent raising questions about their gender identity as an intellectual challenge to be engaged with. They experience it as an attempt to return them to the unbearable state the identity rescued them from. The ferocity of the response is proportionate not to the strength of the argument being made against them but to the psychological function the identity is performing.”

Placemarking.