It’s articles like this one from Reuters (click on screenshot below), as well as a recent one in the November 14 New York Times, that give me hope that the debate about transgender and transsexual youths (or adults) might be getting more sensible and less polarized. It’s not that either article is “transphobic”, or devoted to highlighting the dangers of transitioning. Rather, the articles are balanced, giving examples of successful transitions as well as those who regretted transitioning. They discuss the view that that therapy shouldn’t be completely “affirmative, but empathic and directed towards finding the best way to resolve gender dysphoria. This is a LONG article, but worth reading. Indeed, if you follow this debate, you’re not going to see all sides in a short piece.
Like the other article, there are stories from both sides of the fence. Here’s one example of where several sides are examined:
Thousands of children who, like Kulovitz, were assigned female at birth have sought gender-affirming care in recent years. And for reasons not well-understood, they significantly outnumber those assigned male at birth who seek treatment.
As Reuters reported in October, a growing number of the children receiving care at the 100-plus gender clinics across the United States are opting for medical interventions – puberty-blocking drugs, hormones and, less often, surgery. And they are doing so even though strong scientific evidence of the long-term safety and efficacy of these treatments for children is scant.
That has led to a split among gender-care specialists: those who urge caution to ensure that only adolescents deemed well-suited to treatment after thorough evaluation receive it, and those who believe that delays in treatment unnecessarily prolong a child’s distress and put them at risk of self-harm.
The outsized proportion of adolescents seeking treatment to transition from female to male has sparked parallel concerns. Professionals in the gender-care community agree that treatment of all transgender children should be supportive and affirming. The question, for some, is whether peer groups and online media may be influencing some of these patients to pursue medical transition, with potentially irreversible side effects, at a time in their lives when their identities are often in flux.
Corey Basch, a professor of public health at William Paterson University in New Jersey who researches health communication and teens’ use of social media, said she fears that some adolescents are susceptible to making faulty self-diagnoses without adequate input from medical professionals. “Teens are so incredibly vulnerable to information overload and being pushed in one direction,” Basch said. “They could be lacking the analytical skills to question who is giving this advice and if their advice is valid.”
I’m not going to summarize the piece, but merely call it to your attention. But I do want to mention one of the piece’s major issues: why, compared to not long ago, are so many more biological females choosing hormonal treatment and “top surgery” (removal of breasts, much more common than “bottom surgery”). By the way, the discussion of the way some surgeons advertise this treatment in a tacky way will make you queasy.
Here’s the sex-ratio conundrum:
Adolescents assigned female at birth initiate transgender care 2.5 to 7.1 times more frequently than those assigned male at birth, according to the World Professional Association for Transgender Health (WPATH), a 4,000-member organization of medical, legal, academic and other professionals. Several clinics in the United States told Reuters that among their patients, the ratio was nearly 2-to-1, and similar phenomena have been documented in Europe, Canada and Australia.
Not all of these patients receive medical treatment. Their gender-affirming care may entail adopting a name and pronouns aligned with their gender identity. It may include counseling and therapy. But an increasing number are opting to take hormones and have top surgery.
The article offers three explanations, and I’ll quote them (bold headings are mine):
1). A reduction in sexist attitudes.
Advocates of transgender rights and clinicians who treat adolescents see nothing out of the ordinary in the trend. While transgender children face significant prejudice and threats of violence, they say, increasing social acceptance of transgender identity has encouraged more children to seek treatment. At the same time, this reasoning goes, society is generally less accepting of what it deems an effeminate boy than of a masculine girl, and the greater stigma that those assigned male at birth face may make them less likely to pursue treatment, reducing their share of the patient population.
2). The “refuge effect”: seeking male privilege.
But other gender-care providers and some parents are skeptical. In interviews with Reuters, they expressed worry that some adolescents assigned female at birth may be dealing with significant mental health issues in addition to questions about their gender identity, or may be seeking to transition as a refuge in a culture of internalized misogyny, body hatred and early sexualization of girls.
3.) Sex differences in response to puberty (combined with male privilege).
“Girls have a harder time with the physical and emotional changes that come with the onset of puberty,” said Dr Erica Anderson, a clinical psychologist, transgender woman and former board member of WPATH. “And I think there is an element of truth that males have it better in many quarters of society than females.”
The first hypothesis does explain the rapid rise in biological women/girls seeking to transition to males, rather than the other way round, But the second and third ones don’t, since presumably difficulty with puberty and male privilege have been ongoing for decades. One would have to invoke a change social climate that favors transitions to explain why, all of a sudden, female-to-gender transitions have become predominant.
At any rate, the piece also goes into the unknown long-term effects of hormone treatment and other issues that we’re familiar with. The fact that these can be discussed openly in two respected journalism sites—and would have been taboo (“transphobic”) before—is a good sign.