Britain’s High Court restricts medical treatment of teenagers who identify as transsexual

December 2, 2020 • 11:00 am

Lately we’ve been talking about several issues related to transsexual people, in particular the senses in which they can or should be distinguished from people of their biological sex, including their participation in sports; possible effects (or lack thereof) of hormone treatment; and recent books that call for caution in supporting and medically treating gender-dysphoric teenagers who may later regret actions taken when they weren’t capable of informed consent. While I think the discussion has been rational and certainly not “transphobic”, I’ve nevertheless been the recipient of a spate of emails, often nasty ones, excoriating me for promoting an “anti-trans” agenda. I’ve resisted the temptation to respond with recommendations for self-copulation.

The last issue, treatment of young children (mostly girls), is the subject of today’s post. It turns out that yesterday Britain’s High Court ruled that children under 16—and perhaps those between 16 and 18—might have to have a court ruling before they’re allowed to take “puberty blockers”, a somewhat reversible treatment that stops puberty in its tracks. Taking these blockers is usually the first step in further transitioning involving irreversible treatments like cross-sex hormone treatment or surgery. The court ruled that under-16s are largely incapable of giving “informed consent.” You can read about this case in the three article below from the BBC, The Guardian, and The Times of London (click on screenshots to access articles).

From the BBC:

From The Guardian:

From the Times (paywalled):

The High Court decision came in a case brought by two people against the Tavistock and Portman National Heath Service Trust, the clinic in England that counsels and treats those who consider themselves transsexual. One of the cases was brought by Keira Bell, 23, shown in the pictures above. She was treated with puberty blockers at Tavistock after she was referred there at 16, and regrets it. (I’m not implying that most teenagers later regret such treatment, as I have no data on that, but I suspect most of them have no regrets. Nevertheless, if an appreciable number do, that’s a reason for caution.)

The other person bringing the case was “Mrs. A”, the mother of a 15-year-old autistic girl who is awaiting treatment at Tavistock “Mrs. A.” is worried that her daughter will “get it wrong” before she can make a mature decision.

There are a fair number of young girls who have sought and received treatment at Tavistock: the paper reports that, in the last year, 161 children were referred to the Gender Identity Development Services (GIDS), and of these three were 10 or 11 years old and 95—nearly 60%—were under 16. The Times notes that those seeking treatment involve “a disproportionate amount of girls and young women.”  These numbers have been growing rapidly, from 97 children and young people referred to the clinic compared to 2,591 in 2018. Here’s a plot I showed recently:

Here’s a plot from a paper in the Archives of Sexual Behavior showing the number of people referred each year to the UK’s Gender Identity Development Service. It shows the strong rise in referrals of adolescent females compared to males, and some rise in children as well. In the last 7 years it seems to have gone from fewer then 40 to over 1700 in adolescent females—a roughly 43-fold increase!

We don’t know the reason for this rapid increase: among suggested causes are a freer climate that allows children to express their gender identities, or a faddishness that turns troubled or confused children to a form of treatment that is heavily supported and often makes them into a type of hero.

Regardless, here’s the papers’ summary of the High Court ruling (you can read the full ruling here); this is from The Guardian:

In their decision, Dame Victoria Sharp, president of the Queen’s bench division, Lord Justice Lewis and Mrs Justice Lieven, said a child under the age of 16 may only consent to the use of medication intended to suppress puberty “where he or she is competent to understand the nature of the treatment”.

Such an understanding must include “the immediate and long-term consequences of the treatment, the limited evidence available as to its efficacy or purpose, the fact that the vast majority of patients proceed to the use of cross-sex hormones, and its potential life-changing consequences for a child”.

The judges said there would be enormous difficulties for young children weighing up this information and deciding whether to consent to the use of puberty blocking medication.

“It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers,” the judges added. “It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.”

For treatment of those over 16 it is normally presumed that they have the ability to give consent. But in gender reassignment cases where puberty blockers may lead to subsequent surgical operations, the judges said: “Given the long-term consequences of the clinical interventions at issue in this case, and given that the treatment is as yet innovative and experimental, we recognise that clinicians may well regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment.”

The NHS, which is appealing the judgement, has immediately stopped the inception of puberty-blocking as well as cross-sex hormone treatment, and issued some statements. From the BBC:

An NHS spokesperson said: “We welcome the clarity which the court’s decision brings. The Tavistock have immediately suspended new referrals for puberty blockers and cross-sex hormones for the under-16s, which in future will only be permitted where a court specifically authorises it.”

In September, the NHS announced an independent review into gender identity services for children and young people.

The Tavistock and Portman NHS Trust said it was “disappointed by today’s judgment and we understand that the outcome is likely to cause anxiety for patients and their families”.

It added: “Our first duty is to our patients, particularly those currently receiving hormone blocking treatment, and we are working with our partners, University College London Hospitals NHS Foundation Trust and Leeds Teaching Hospitals NHS Trust, to provide support for patients concerned about the impact on their care.”

In contrast, groups like the “trans children’s charity Mermaids” decried the decision:

Lui Asquith, from trans children’s charity Mermaids, said the ruling was a “devastating blow” and “a potential catastrophe for trans young people across the country”.

The charity said: “We believe very strongly that every young person has the right to make their own decisions about their body and that should not differ because somebody is trans.”

You can see more about Mermaids’ reaction here. But their last statement skirts the question that the Court was asked to decide: How old must you be before you are capable of making a medical decision that may be irreversible?  And it’s not just trans people to whom this applies: what if a 13-year-old boy wanted his penis removed because he didn’t like it? Should he be able to make “his own decision about his body”?

I think that reasonable people should agree that there is an age below which a child isn’t deemed capable of making a medical decision like this one, even if they feel strongly that they are transsexual.  Surely 6 is too young and 20 sufficiently old to make a “mature” judgement. But it’s also clear that children differ in the level of “maturity”, so there might be some flexibility (though there isn’t in things like drinking ages). The court, in ruling that 16 is a cut-off point, was surely being subjective, and they realized it, for they affirmed that even older teenagers might require a court judgment to begin puberty blockers. For those younger than 16, it seems reasonable to me to wait until they turn 16 until they can give “informed consent,” or be able to bring their case to legal judgement.

Those who think that 10-year-olds should be able to make their own decisions, and take puberty blockers or cross-sex hormone treatment at will (counseling is surely required), seem to me unreasonable. After all, courts have set age limits for other decisions that require “informed consent”, like age limits for statutory rape (in Illinois, 17 is the legal age of consent for sexual acts. If you’re 16, are you too young to consent to sex but old enough to have your sex transformed to another?) It’s a sign of the valorization of all desires to be transsexual that a charity like Mermaids wants anyone, no matter how old, to have their own decisions not just respected, but acted upon.

54 thoughts on “Britain’s High Court restricts medical treatment of teenagers who identify as transsexual

  1. Most adults have internalised the Choice-Effect connection. When does this begin to happen?
    e.g. there have been quite a few instances of people having regretted a tattoo.

    1. Your forebrain doesn’t actually finish growing and developing until the age of something like 25. Now, I don’t think anyone’s suggesting or demanding that society raise the age of ‘adulthood’ and legality for various things to align with that, but that information on human biology should inform and should make us think carefully about suggestions to lower the age of consent for life-changing medical decisions.

  2. The blow back from trans activists on this is both depressing and unsurprising. I don’t think any reasonable person can argue that children are mature enough for these kinds of decisions yet because they are so vested in the politics and social reform of the trans movement, they can’t let themselves admit the harm they are doing. Endless arguments will now go on about where to set these age limits. It will not be easy. Drawing these kinds of legal lines is always difficult and in the end make little sense; at 23:59 on the date before his 21st birthday, my brother’s son sent me a photo of him with an unopened can of beer while he was sitting in a tent surrounded by his comrades somewhere in Kandahar. Attached to the photo was this message “in one minute I become an adult”.

  3. I do not see allowing the person to make such a decision before 18 without some consent from the parents. Think back about yourself in those younger years if you can. There is a reason why insurance companies charge more bucks when the male child starts driving your car but not the female. There is a reason for the drinking age, the legal smoking age. I started fooling around with smoking when I was around 13/14 years old and that was way back before cancer was known by anyone. Kids don’t care because they cannot see ahead. They don’t comprehend the future very well. If you screw up after 18 it’s on you. If you do it earlier it’s also on your parents.

  4. This is a very good decision. I think our host touched a pertinent point when he suspected it is some kind of fad, becoming a trans-hero and the like.
    It is insane to let an under 16 decide upon irreversible sex change treatments, IMMO.
    I do not think that real trans personalities do not exist, but I do not think either that a majority of trans-genders in the present wave really are. The high number of ‘regrets’ is testimony there, or at least an indication.
    Note, it is said (and I think well established) that transsexuals have a high suicide rate, but actual transition does not positively impact on those numbers, the opposite if anything (although numbers are admittedly difficult to come by).

    As mammals (contrary to eg. some fish) we cannot possibly transition completely, at least not with our present day and any foreseeable future techniques. A male can never fully become a female, nor can a female fully become a male. It is important, possibly the most important fact, to point that out to prospective ‘transitioners’.

    1. “A male can never fully become a female, nor can a female fully become a male.”

      I presume you mean in biological sense.

        1. To me (and by definition) those are biological terms. Not everyone uses the words in that way, though. Therein lies the premise for my comment.

    2. I agree that there is some degree of faddishness involved, although I couldn’t tell you exactly how much. There seems to be an awful lot of hoopla happening around yesterday’s announcement by Elliot Page (formerly Ellen Page). I don’t dispute his decision but stars have followers and following is pretty much at the heart of fads.

  5. The other question to ask yourself, at what age should you be allowed to get married? Is that decision left to the 15 or 16 years old. When should you be allowed to just go down and join the army? If you are doing any of these things on your own at 16, good luck on that.

  6. The connection between autism-spectrum conditions and gender dysphoria is very interesting. There is growing evidence that autism is caused by the inheritance of a large number of genetic factors each of small effect, that many people with ASD are only a little bit different from neurotypical people, and that autism phenotypes are largely caused by the number of those genetic factors that we all inherit (plus some de novo mutations that some of us acquire but our parents did not have).

    The extreme male brain theory of autism (and the extreme female brain theory of schizotypal disorders) helps to explain the higher frequency of autism among males (and the higher frequency of schizotypy among females).

    Together they also suggest a possible link to the higher frequency of gender dysphoria among females: if this dysphoria is largely found among people with a lot of genetic markers for ASD, then the mismatch between perceived internal gender identity and physical sex might be more strongly felt in some females with ASD who have many genetic factors that predispose them to developing a more male-like brain (more male-like compared to other females without ASD-related genetic factors).

    Those ideas also help to account for some of the possible biological basis for a perceived internal gender identity. Trans activists assert that this identity is a thing without explaining what it could be. The theory tends to support the assertion that this internal identity really is a thing, because it has a plausible genetic basis and it can go wrong (in the sense of producing dysphoria).

    This 2020 article in Nature Communications lays out the ideas. Fun fact – the last author of the paper is the cousin of Borat.

    https://dx.doi.org/10.1038%2Fs41467-020-17794-1

    1. Welp. This was hung up in moderation for what seemed like a long time. Sorry for double posting below 🙁 I didn’t mean to hog the comment thread.

  7. What are the costs for a family to litigate such a request in court?

    I’m not opposed to society setting a high “confidence bar” on informed consent for such treatments for children and teens. However I am a bit worried that this particular implementation of a high bar could have the unintended consequence of making these treatments accessible to the rich and not accessible to the poor.

    For that reason, I’d rather the decision be made my medical professionals accessed through the NHS, so that pretty much every family seeking this out has a roughly equivalent ability to get through (or be turned away by) the hurdles.

    Again, I’m not opposed to setting a high bar here. Just opposed to a process that links a teen’s chance of success to their family’s pocketbook.

  8. @Eric 9 Yeah that’s an important point. One reason for the lawsuits seemed to be to force the NHS to treat all families and patients the same way. But it does leave open the possibility that a rich family who wants treatment and is denied could sue to overturn the clinic decision (and a poor family could not do so). Is that an unavoidable problem?

  9. Nobody knows yet how many of these people will regret the transition in 10, 15, or 20 years, since the big trend towards this is so recent. Those who transitioned 10 to 20 years ago are not representative of those who are transitioning now, since it wasn’t “popular” in the way it is now; you needed to have formed a much more individualized need to transition.

  10. I’ve resisted the temptation to respond with recommendations for self-copulation.

    An option, I take it, available only to those who’ve undergone a partial surgical transition.

    1. Your WP profile says ” electricacontentservicesblog.wordpress.com is no longer available.The authors have deleted this site.”

      Are you the “authors”?

  11. Yes, Dr. Coyne, you are an anti-transgender bigot. You may not like being lumped together with the religious wing of the anti-(LGB)T movement, but the differences in your bigotry amount to ideological preferences.

    For a supposed intellectual, your lack of curiosity and research are pretty telling. Case in point: No one really thinks that JK Rowling is a bigot because she asserts the reality of biological sex; she’s a bigot because, for starters, she’s a vocal supporter of other bigots’ “right” to create hostile work environments for her most reviled out-group. A few Google searches would have enlightened you on her bigotry.

    It’s also telling how willing you are to accept shoddy “research” and highly specious hot takes as if they were inscribed on stone tablets and handed down from God — as long as that research and those hot takes adhere to the anti-transgender gospel. When was the last time this blog, maintained by an academic in biology, featured any research from actual experts in, say, transgender medicine? Why do the experts and the real researchers suddenly become suspect once the topic is anything transgender?

    Just like Linda Sarsour, you can’t complain about being labeled a bigot when the label is accurate.

    1. I have done the Googling and I cannot find any references to JK Rowling actually being bigoted (as opposed to being called a bigot by people who disagree with her, which is pretty common).

      1. Yeah, it’s complete, utter bullshit. This fool, like many wedded to being victims of transphobia, is deeply intellectually dishonest. Note that they carefully did not give ANY EXAMPLES. This is done intentionally; they’ve learned from anti-vaxxer crazies to smugly pretend they’ve countered with evidence by simply telling you to do your own research.

        1. Pathetic.

          This is the entirety of Rowling’s hate filled tweet that this fool is talking about;

          “Dress however you please. Call yourself whatever you like. Sleep with any consenting adult who’ll have you. Live your best life in peace and security. But force women out of their jobs for stating that sex is real?

          FFS. Grow the hell up. There is nothing NOTHING hateful about that comment.

          The real tragedy here is that most people have sympathy for the ways (sometimes horrific) trans people are treated, but this kind of stupidity is going to cause people to stop listening to the real problems trans people face. These woke idiots sometimes seem like sleeper cells in the movement intent on destroying it from within. They are succeeding.

        2. I don’t think it’s fair to claim that Tweets of opinions on a *personal* Twitter account amount to “creating a hostile work environment”. Her co-workers need not follow her on Twitter, and so wouldn’t see the Tweets — no?

        3. I’ll address the link.
          Maya Forester continuously explained the distinction between discussions on the topic of Gender Identity which took place outside of work, and her interactions with coworkers and clients while at work. For the former she would sometimes use sex-specific pronouns and delve into the distinction between sex and gender. For the latter, she would courteously use preferred pronouns and keep off the topic.

          Yet the Judge ignored this and claimed “it is a core component of her belief that she will refer to a person by the sex she considered appropriate even if it violates their dignity and/or creates an intimidating, hostile, degrading, humiliating or offensive environment.” He also said that, if the government gives a male a certificate stating they are officially a woman,, she had no legal right to “ignore” this — even, apparently, on Twitter.

          My conclusion is that the ruling doesn’t support your point because the judge is wrong. Forrester’s appealing, of course.

        4. And just to add, your link is written by Veronica Ivy, a trans person and a trans activist (and a male-bodied athlete who never won anything when cycling against men, but who thinks that cycling faster than women is somehow big and clever), so is not an un-biased commentator.

        5. As noted that author of that article is a sports cheat. I see a massive lack of integrity in claiming those championships. Ideology driven cheating.

          As is obvious from your points you want al women to accept any hairy, muscled, male looking individual with balls and a penis, to be allowed to be a women and to be in womens spaces. Any womens spaces in any context.

          That some women do not like that idea is not surprising, and they ought to be able to voice that opposition.

        1. You speak of logical fallacies, but there has been a wealth of substantive responses to your post, and yet the only one you respond to is a sarcastic one-liner.

          This is tone trolling. So you might want to go easy on talking about other people’s logical fallacies.

    2. “Why do the experts and the real researchers suddenly become suspect once the topic is anything transgender?”

      Here are some real researchers with expertise.

      https://www.nature.com/articles/s41467-020-17794-1

      That research (and hundreds of studies like it) shows that high rates of autism-spectrum disorder among individuals experiencing gender dysphoria likely has a genetic basis, and is probably linked to the large number of genetic factors (each of small effect) that contribute to higher rates of ASD among males compared to females. This linkage between biological sex, autism, and gender dysphoria would help to partially explain why some individuals experience a conflict between their internal sense of gender and their biological sex. Ironically (relative to your point of view), this research and its genetic analysis would tend to support (not denigrate) the trans activist’s view that this inner sense of gender is a real thing, because that real thing appears to have a genetic basis and because it can go wrong (in individuals who experience dysphoria).

      Also ironic is that this kind of research helps to bridge the apparent gap between people experiencing dysphoria, people with ASD, and cis-gendered or neurotypical people. There is increasing good evidence that ASD is largely caused by a large number of genetic factors that are inherited from parents plus a dose of de novo mutations that some of us acquire (but our parents lacked). Individuals who get a really big dose of those genetic factors develop ASD; individuals who get a small dose of those genetic factors become mathematicians and computer programmers (joke); and most others fall into the great bland middle.

      [aside: there is also excellent evidence that other alleles at the same genetic loci directly contribute to schizotypal disease, and that autism and schizophrenia are largely opposite sides of the same genetic coin, and are just opposite ways in which sex-specific differences in brain development can sometimes go awry, leading to males and some females who have extreme male-brains with autism, and leading to females and some males who have extreme female brains with schizophrenia)]

      The genetics of ASD and gender dysphoria tend to blur the distinction between neurotypical or cis-gendered people and those who are less typical in their behaviour or gender identity or sexuality. That work tends to support the idea that there really is an underlying genetic continuum from neurotypical behaviour or sexuality to the less common expressions of those identities or tendencies. This seems like directly positive support for the trans activist view that we should be accepting of everyone wherever they fall along that continuum, because we are all just a few mutations away from being or feeling or looking like someone else who identifies differently from us. Kumbaya eh?

      1. Question: It has been proposed that the higher incidence of gender dysphoria among autistic individuals is largely due to social factors (especially among girls.) Adolescents with autism typically have a history of feeling different, awkward, and “wrong,” socially/emotionally/physically. They are culturally presented with an explanation which is also a cure: they’re transgender. Simply put, their outside doesn’t match their inside. Once they’ve transitioned, they’ll finally feel at home. And it’s important that they’re welcomed and supported.

        This is a slightly different way of linking gender dysphoria and autism. Do you know if any of the research addressed this possibility, to rule it out?

        1. Hi Sastra. Sorry for the very slow reply. No I don’t know of research like that. I have friends who work on the genetics of autism but it’s not my direct area of work.

          It would be hard to distinguish the social vs. genetic correlation between autism and gender dysphoria if there is a strong genetic correlation to start with. More females with autism seem to also experience gender dysphoria compared to males with autism, and that seems to point to a genetic (rather than a social) cause of the dysphoria. But it’s also a social difference: females with autism are overall more different from other females (in the sense that Kanner autism tends to feature “male”-stereotypical personality and behaviour syndromes including a focus on objects rather than on people, lack of eye contact, reduced verbalization, and reduced theory of mind) and by contrast males with autism are sort of more male-ish (not in the macho sense but in the objects vs. people sense), so that would make females with autism maybe more prone to feeling more like they are not at home in their own bodies.

          Maybe the best comparison would be males versus females with schizotypal disorders. Those disorders tend to feature “female”-stereotypical personality and behaviour syndromes including a focus on people, indifference to objects, and hyper-active theory of mind (including imagining other peoples’ motivations), often leading to delusions or hallucinations. Among males and females with schizotypal disorders, is there a higher incidence of gender dysphoria among males (and more MtF transitioners)? If so, that would mirror the higher incidence of gender dysphoria among females with autism compared to males with autism, and would argue for a genetic (rather than a social) cause of the dysphoria in both groups. That would reinforce the idea that the dysphoria and the schizotypy (like dysphoria and ASD) share some common genetic factors. I haven’t looked for research like that in PMC, it would be the mirror image of the study by Baron-Cohen that I linked to.

          Also I should say that I don’t think that genetic covariation would argue against social contagion as at least a partial cause of the huge recent increase in female (and less so male) teens identifying as trans.

    3. OK, so:

      (1) Maya Forstater did not create a hostile work environment. (2) J. K Rowling did not support Forstater creating a hostile work environment. (3) No-one here has supported creating a work environment that is hostile to trans people. (4) What “real research” are you referring to, that would refute positions taken on this blog?

    4. Whooo.

      Okay first, while the issue before the court was about trans, the court actually didn’t address at all whether they thought puberty blockers were okay or not. They rules solely on how informed consent applies to young people, and created a gradated system in which those under 13 have the highest bar to show informed consent, 14-15 year olds have a slightly lower bar, and 16-17 year olds have a lower one. This would apply to all medical cases, not just gender transition.

      Send, yes in fact NHS did or is doing research on the subject. The study, started in September, is chaired by Dr Hilary Cass OBE, former President of the Royal College of Paediatrics and Child Health. It is supported by Dr. Michael Brady, the UK’s National Adviser for LGBT Health. Mermaids, the UK’s leading trans children’s charity, also supports it. Moreover, they strongly support reviews such as the one done to Tavistock, stating “We also support the Care Quality Commission’s focused inspection of GIDS, due in the autumn, and we trust it will further support the work of the service’s hard-working clinicians.”

      Lastly, one of the findings of the review was that Tavistock was providing these drugs to 13 year olds after three one-hour meetings. I had more medical discussions with doctors than that before my herniated disk surgery in my 20s, something frankly far more standard and far less consequential. Perhaps some people want to deny these treatments to people out of bigotry. But you should not assume such malice. The fact is lots of people would support a stronger review (than that) for any serious drug regimen or medical procedure on kids, and they support a stronger review process in the case of transition drugs and surgeries because they are treating it equally to other kid medical requests.

  12. Are puberty blocking medications dangerous for growth? Remember the abuse of girls in gymnastics back in the 70s (a time I like to refer to as “the age of savagery”, when we weren’t allowed to have a drink of water during the day unless we lined up and all drank with our mouths only, out of the same tap, when no one gave a crap if we had breakfast or lunch as long as they didn’t bother them, and when we had to go outside for recess even if it was -20C) where they were prevented from entering puberty and then they didn’t really grow very much after they came off the drugs?

  13. As I understand it, the ruling wasn’t just about whether children and adolescents are old enough to make such a drastic decision. It also had to do with the meaning of “informed consent” in view of the fact that puberty blockers and cross-sex hormones are still in the experimental stage when used for transgender teens . If even the doctors don’t know what the long term results of a drug will be, then the patient doesn’t know what they’d be consenting to regardless of their maturity.

    One damning fact was that the GID wasn’t even trying to do decent research. The judges apparently “expressed surprise” that

    1.)In respect of the ages of children treated with puberty blockers between 2011 and 2020, the data has not been collated for each year.

    2.)In respect of the number or proportion of young people referred by GIDS for puberty blockers who had a diagnosis of ASD or any other mental health diagnosis, the data has not been collated and there has been a lack of investigation or analysis.

    3.)In respect of the proportion of those on puberty blockers who progress to cross-sex hormones there is no data available, even for those who commence cross-sex hormones within the GIDS itself. Children were not tracked into adult services.

    4.) The GIDS puberty blocker ‘trial’ did not even track outcomes.

    If so, this isn’t science; it’s ideology.

  14. If I am understanding the story a patient of this client claimed damages due to the treatment given. If I understand the person accusing Dr Coyne of being a bigot correctly then they do not believe that the individual had been harmed and should have STFU and gotten on with their trans life….

    1. That would seem likely and therein lies the harm from the woke on this issue – they would gladly throw (some) children to the wolves of life long regret just to appease their religion.

  15. I think it’s prudent for children to wait until legal age before making such a huge decision. Other than that I wholeheartedly support any individual who believes that making the change would increase their happiness.

    1. I agree. A short while ago, someone posted a link in a comment section on WEIT showing a roughly five year old child’s coming out as “trans”. In front of a group of applauding grown ups. In that climate, the parents may well seek out treatment next.

      My younger daughter is also five years old and since the topic of bodily differences between girls and boys came up repeatedly told me and others she “wants a penis” and “wants to be a boy”. Is it time to seek out a doctor to start a transition? Surely not. She may well grow out of it, or she may not. As I remember a similar time in my own childhood, I assume she will. And if not, so be it. Until then, I will take my child as it is, I will just listen and try to understand without either condemning or applauding. Is that attitude trans-phobic? It is actually the same attitude I have towards my children’s very interesting religious ideas (my seven year old is a proud polytheist and believes ALL gods are real, but the ancient Greek ones are the coolest..).

      I guess it is more difficult with teenagers, since it is likely psychologically difficult for someone identifying as male to develop a more and more female body (or vice versa). I would still hesitate to let them (or the parents) make potentially irreversible decisions, as their identity is still developing and may yet change.

      A friend of mine transitioned and is a happy male and father now – married to a woman he fell in love with when still identifying as a lesbian female. I am glad people are free to make such choices nowadays, that there is both the medical know-how to help and growing societal acceptance. While my friends parents have never acknowledged his choice and are no longer in contact with him, most people today, me included, would accept their child’s decision. If I am still trans-phobic for not allowing it before the child is old enough or for not applauding it, so be it.

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