These Kids Are All Right, Too
An ethical debate intensifies as a growing number of transgender children receive drug and hormone treatments.
by Jennie Wood
A growing number of teens and young children are opting for puberty-blocking drugs and hormones. They are doing so with the support of their parents and doctors. However, the issue raises ethical concerns. It is common for many young kids to pretend to be the opposite sex and gender role play, but a study, recently published in Pediatrics, suggests that 1 in 10,000 children have brain differences, making them more similar to the opposite gender. These kids are certain they were born in the wrong bodies.
Some doctors are against offering sex-change treatments to kids under 18, saying treatments are harmful if done too early. These doctors also warn that the parents' motive for approving the treatment needs to be carefully examined. Some parents may feel more at ease with their child having a sex change than dealing with the scrutiny that may come from having a homosexual child. These doctors also suggest that some children might be wrongly diagnosed with gender identity disorder. The situation for some children might simply be a case of not fitting into society's well-defined gender roles.
Doctors who provide the treatments to children say that not doing it would harm them even more. These kids can become depressed, self-mutilate or attempt suicide. The effects of the puberty-blocking drugs are reversible, giving kids time to decide if they want the permanent sex change.
Transgender Kids Face Psychiatric Risks
The study, published in the March 2012 issue of Pediatrics, showed that transgender kids face psychiatric risks. Of the 97 children who were diagnosed with gender identity disorder from 1998–2010 and involved in the study, 44 percent had a history of psychiatric symptoms, 21 percent had performed self-mutilation, and nine percent had attempted suicide. The study also showed that these problems usually disappear in children who've been treated and can live as the opposite sex. Of the 97 adolescents and children in the survey, only one decided against permanent treatment. The puberty-blockers caused no complications in the kids. One of the study's authors, Dr. Norman Spack, said in an interview with the Boston Globe, "Transgender kids have a high level of suicide attempts. Of the patients who see me, three out of the four have made very serious suicide attempts. And I've never seen any patient make [an attempt] after they've started hormonal treatment."
The Endocrine Society endorsed early hormone and puberty-blocking treatment, but with strict guidelines. The treatment should not start until puberty begins. At that time the puberty-blocking drugs should be administered until age 16. Then lifelong sex-changing hormones should begin. The guidelines also state that mental health professionals should be involved throughout the process and the kids should be regularly monitored for physical health risks. Finally, transgender individuals must be at least 18 years old before undergoing gender-reassignment surgery.
With the treatment, trans children may avoid being harassed or bullied. They are allowed to go through adolescence feeling more comfortable in their skin. Blocking puberty and starting sex hormones early allows young boys transitioning to girls to develop breasts. And girls transitioning to boys will get to remain flat-chested. Early treatment also prevents more drastic treatment later in life. While the early treatment raises some ethical concerns; the Pediatrics study shows positive results in allowing kids to mature in the gender they feel is right for them.
Source: International Endocrine Society, Pediatrics - Official Journal of the American Academy of Pediatrics, The Boston Globe