Health Professionals Taking a More Critical View of Youth Gender Dysphoria Treatment
NEWS
Recent blog posts on the GD Working Group website (a site generally taking a more skeptical view of immediate affirmation and medical transition) indicate some doctors are concerned enough about current gender dysphoria protocols (often recommended by official health entities) to write some of their own information.
Professor Dianna Kenny, PhD (”KEY ISSUES IN DECISION-MAKING FOR GENDER TRANSITION TREATMENT: Questions and answers”):
In this article, I address key issues in the transgender debate as they pertain to children and young people. These include: Are “gender transition treatments” safe, “curative” and in the child’s best interest? In considering these questions, I explore the known negative consequences of puberty suppression and cross-sex hormones, including infertility and other medical conditions and the purported increase in suicidality without treatment. Can children and young people give truly informed consent to these interventions? What role should parents play in decision-making? On what basis are decisions made to proceed to gender transition? Are the foundations of such decisions logical and scientific? and What social forces are at play in this decision-making process?
Safety: Does the current scientific evidence support a conclusion that the administration of Gender Transition Treatment (social transition, puberty blocking agents and cross-sex hormones) can be safe for children and adolescents?
Answer: No.
She goes on to list many of the associated health problems with medical transition also covered on our site. These include circulatory health risks, risks to bone health and cognition, sexual problems, and other issues.
She also addresses the data on suicide risk:
…though the suicide risk in this population is high, as the table below attests, there is scant research evidence that gender transition treatment results in lower risk for suicide. There is also a problem in studies on gender dysphoria and suicidality related to how suicidality is measured. Different rates will be obtained in different studies because of the use of different forms of measurement. For example, being asked if you have suicidal ideation will produce higher rates than counting the number of potentially lethal suicide attempts (Aitken, VanderLaan, Wasserman, Stojanovski, & Zucker, K. (2016).
She makes a more definitive statement:
Transgender treatment does not prevent suicide, and may have other adverse effects on mental health post transition.
This assertion may be debatable. Suicide risk post transition remains high. Many studies show improved mental health and suicide risk post transition. A few show that transition does not resolves many problems dysphoric people face. GHQ has a review of most of the pertinent studies surrounding the issue of suicide with a motivation to present the issue as honestly as possible.
Most associated with GHQ would agree with her concern about the affirmative model and lack of mental health support in favor of transition offered as a solution to all problems:
The vexed question is one of causality. Does gender dysphoria cause suicidality or is it the discriminatory treatment and social exclusion suffered by the transgender community that is causative, or are suicidality and gender dysphoria caused by a third factor, such as mental illness, family dysfunction, parental or social factors? In my work with transgender adolescents, I have noted with great concern the serious underlying emotional disturbance in these young people who need intensive psychotherapy and parental and family therapy to resolve these disturbances. I wonder about those who go straight to gender clinics and gender affirming professionals who skate over these cracks in their personalities and social adjustment and proceed to gender transition in the naïve belief that this will resolve all of their presenting difficulties
She goes on to address issues of age of consent, the politcized climate shutting down debate, and the importance of the inclusion of parental feedback.
Dr, William Malone, critical of the medical establishment’s embrace of the affirmative mode (which includes medical treatment on minors) has written up some of his own guideline suggestions (“Gender Dysphoria Resource for Providers”).
REFERENCES:
GD Working Group. (2019, August 9). Key Issues in Decision-making for Gender Transition Treatment: Questions and answers. Retrieved from http://gdworkinggroup.org/2019/08/09/key-issues-in-decision-making-for-gender-transition-treatment-questions-and-answers/
GD Working Group. (2019, August 2nd). Gender Dysphoria Resource for Providers. Retrieved from http://gdworkinggroup.org/2019/08/02/gender-dysphoria-resource-for-providers/
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