THOUGH SOME CRITICS lambasted the study, Littman isn’t alone in her findings.
Lisa Marchiano, a secular therapist in Pennsylvania, wrote a blog post in 2016 cautioning parents about plunging into medical interventions with children and teens claiming to be transgender. Afterward, she began taking phone consultations with parents of teens experiencing ROGD. A year later, she wrote, “I am overwhelmed by the sheer volume of parents who call me.”
Some parents plead with Marchiano to allow them to fly their children into town for therapy or to help them find a therapist who won’t push their teens to transition with cross-sex hormones.
“At times I am able to offer advice that helps a family steer clear of drastic medical intervention of dubious benefits or necessity,” she wrote. “But sometimes all I can do is stand helpless and watch the wreckage.”
Marchiano described working with a family whose daughter declared transgenderism at age 18. The young woman had experienced other mental health problems but hadn’t expressed a conflict with her sex until high school. The parents had taken her to a clinician, and after a 30-minute consult, a physician’s assistant made an appointment for the teen to begin testosterone injections the following week.
Her parents convinced her to wait, but by the end of her freshman year of college the teenager had begun taking cross-sex hormones and had undergone a mastectomy—paid for by student health insurance. (Eighty-six colleges nationwide have student health plans that include cross-sex hormones and cross-sex surgery.)
Marchiano says the parents reported the radical physical steps didn’t decrease their daughter’s mental anxiety. She had dropped out of college and remained mostly isolated in her home.
Some teenagers report feeling relief after taking hormones or pursuing surgery, and some transgender activists claim social acceptance is a key to transgender adolescents becoming happy. But given that many parents who worry about their teenagers’ decline after experiencing ROGD also expressed left-leaning views of sexuality, social conditions alone don’t account for the distress some adolescents and young adults still feel.
And short-term relief doesn’t negate the long-term consequences of a person rejecting his or her sex and beginning lifelong medical interventions. For example, cross-sex hormones can cause sterility, leaving teenagers to decide whether to forgo having biological children later in life.
Other experts say cross-sex hormones increase risk of stroke and that puberty blockers could decrease bone density in adolescents. And since the practice of giving cross-sex hormones to children is only about a decade old, even pro-transgender physicians admit they don’t know the long-term outcomes.
More studies make sense, including research into the dangers of pursuing such paths. But while studies like Littman’s are under fire, the federally funded National Institutes of Health has given more than $5 million in grants to a group of doctors and psychologists tasked in part with studying transgender children over a period of decades.
The views of at least some of the researchers seem clear from the outset: Norman Spack is a Boston physician who opened the nation’s first gender clinic for children. Johanna Olson-Kennedy is a pro-transgender pediatrician who sees hundreds of children at the Center for Transyouth Health and Development at Children’s Hospital Los Angeles.
Late last year, the American Academy of Pediatrics (AAP) for the first time officially recommended that parents accept and encourage the preferred gender expression of their children.
That cuts across decades of therapists who argued parents should encourage their children to embrace their birth sex, knowing that some studies show as many as 80 percent of children who express gender dysphoria will outgrow those feelings by adulthood.