Michelle Cretella, president of the American College of Pediatricians (ACP)—a group that includes conservative physicians—compared the magazine’s approving displays to “institutionalized child abuse.”
“You don’t treat medical confusion by putting people, especially children, on toxic hormones and cutting off healthy body parts,” she said. “Just because a person thinks and feels something does not make it true.”
It’s one of the most perplexing dynamics regarding transgender youth: Adults allow children to lead the way.
Though it’s critical to listen to children, Allan Josephson, a psychiatrist and member of the Christian Medical & Dental Associations, says parenting involves guiding kids in what is true: “Children aren’t sure of much of anything, let alone their identity.”
Indeed, studies show as many as 80 percent of children who express signs of gender dysphoria grow out of those feelings by adulthood.
Still, the Endocrine Society approves the use of puberty-blocking drugs to “pause” sexual development and give children a couple of years to figure out one of the most fundamental pieces of their identity.
‘You don’t treat medical confusion by putting people, especially children, on toxic hormones and cutting off healthy body parts.’ —Michelle Cretella, president of the American College of Pediatricians
If children decide to live as the opposite sex, they may begin taking cross-sex hormones at as young as 13. Some of the obvious results: Boys grow breasts, and girls grow facial hair.
Neither process is without peril. Though physicians have prescribed puberty blockers to children entering puberty too early, the practice of giving such drugs to healthy children before natural puberty begins is relatively recent. Some say the drugs could interfere with neurological development and bone growth, since the blocked hormones promote those functions.
In the case of cross-sex hormones, the dangers are more serious: Many will stay on hormones for a lifetime, and doctors warn of increased risk for heart disease, diabetes, and blood clots.
Even more tragic: Cross-sex hormones can induce sterility. That means children as young as 13 or 14 must make momentous decisions about whether they are willing to forgo having biological children later in life. Courtney Finlayson, a pediatric endocrinologist who prescribes such drugs to children, acknowledged the magnitude of children making those decisions during a PBS interview: “I do worry that at that stage in life many of them may not be able to realize how important that would be to them someday.”
Nevertheless, the number of children visiting gender identity clinics is growing. The numbers are hard to track, but the first transgender clinic for children in the United States opened in Boston in 2007. Ten years later, some 40 such clinics exist.
Parents don’t always encourage a child’s gender confusion, but other adults sometimes intervene. In Oregon, the group TransActive Gender Center provides teenage girls with free chest binders—a compression garment for girls who want to compress their breasts to appear male. The group says it’s mailed over 1,500 garments in plain envelopes in the last five years.
At least one “top surgeon”—a doctor dedicated to performing mastectomies on healthy women who want to live as males—has warned of the dangers of chest binding: compressed ribs, collapsed lungs, and back pain.
On the social media site Tumblr, a site full of networking for transgender teens, one woman said she bound her breasts for two years before a mastectomy: “I still can’t take a full, deep breath like I used to.”
If the physical risks seem overwhelming, some parents of young children still are willing to follow the lead of physicians who tell them transition is healthy. An article on the gay website The Advocate told the story of a mother of a “transgender toddler.”
The mother said her 10-year-old child transitioned at age 5, but she knew her daughter was different by 18 months old. Her adamant advice to parents: “Never let anyone question you. If your child is happy and a nice person, you are doing the right thing.”