I promised to continue this thought, and my boss is gone for the day. While I wait to see if I receieve any more support requests in my email, I may as well keep one promise. Yes, this is a legitimate function of work. Waiting for someone to need me, I mean. I’m listening to Peter Case on the turntable and rabble rousing about gender on my personal PC, but waiting for emails is a part of my job so my conscience is clear.
“When you write ‘continue this thought,’ Mike, what do you refer to?” you may ask. And rightfully so. If you came here from a link, or twitter, or email, it’s quite possible you aren’t aware of the first post in this series. You may want to go back to
“Stunting Their Growth” and read the first part before you read this. It will make more sense.
Parents are getting a relatively new message regarding gender non-conforming kids, and that message is that their kids may have been assigned the wrong gender identity at birth, either by transphobic medical personal who look at a penis and think “boy” and rush him off to the circumcision room (if they’re American and not Jewish. If they are Jewish they get an eight day reprieve before the bris.) Or said transphobic medical personnel maybe get fooled by the labia where the penis should be and slap a pink bow on their ball head1 and tell the parents with complete confidence that they’ll have to pay for the wedding 20 years down the road.
Assigned Male at Birth, and Assigned Female at Birth, are terms used to replace the more sensible “boy” and “girl” that actually refer to the recognition of sex at birth, or before, in sonograms. To make it easier, we are allowed to use the acronyms “AMAB” and “AFAB.” “ACAB” is a totally unrelated acronym, so be careful not to use it inappropriately. I think it’s quite possible that medical personal are actually recording observed sex rather than assigning gender, so they maybe aren’t being transphobic. Admitting that would be giving them the benefit of the doubt, however, and we really don’t have room for such niceties when so many trans kids are committing suicide for misgendering. 2
What do parents do if they suspect that their doll-carrying boy, or their Batman-costumed daughter, may be trans? The internet is a source of information. Notice I didn’t write “great” source information. I did a search in Google for “How do parents know if their child is trans” and found this listicle on WikiHow:
How to Determine if Your Child is Transgender
In the opening paragraph the writers do pay lipservice about not jumping to conclusions, so, yay them!
If your child regularly goes outside of gender norms, you might wonder if they are transgender. You can listen to how your child expresses gender identities and pay attention to gender non-conforming tendencies. But be careful not to read too much into things, as many gender norms are actually stereotypes. For example, a little boy who loves to play with dolls is not necessarily transgender. In all situations, you want to help your child explore their feelings and identity. If they are transgender, offer them love, support, and resources.
With that caveat aside, the writers carry on and tell us to observe the child to see if they present any of the behaviors that are associated with the other sex, or the other gender identity. “Their gender” is referred to as if it is an actual attribute that is, words are awkward when it comes to this subject, and I am struggling to explain what an innate trait would be in this sense. Gender Identity is assumed to be as real as the Velveteen Rabbit and Pinocchio (spoiler alert) turn out to be at the end of their respective stories. It’s a case of begging the question that never gets addressed. Whatever it is, your kid has one and if they habitually like the wrong kind of toys, theirs is mismatched from their actual physical body.
Tell me if you can make sense of this:
Notice if your child has gender non-conforming tendencies. Maybe you have seen that your daughter likes to play with toys that are generally considered masculine. Keep in mind that just because your daughter likes to play with trucks does not mean that she is transgender. However, if your child consistently displays a strong preference for things that don’t conform to gender expectations, it could be something to keep an eye on.
A child that is different in a few ways might just be gender non-conforming. A child who is different in a lot of ways, and shows extreme unhappiness at being forced to act like the gender they were assigned at birth, is probably transgender.
Remember, most notions of gender are stereotypes. Boys are not genetically predisposed to prefer the color blue, for instance.”
Yes, the authors pay lipservice to skepticism, but with that little “is probably transgender” we have come to a quick diagnosis. The article advise seeking professional help, but the idea that one can have a Gender Identity counter to their actual sex is not questioned. I am skeptical about the entire notion, of course, but that seems to be a strange notion to most people.
Now you’ve read the article, spoken to affirming experts and decided that your child is trans. Probably. And you think that in the future that child might want to have some affirming top or bottom surgery. This is where actual paid professionals ectomize healthy body parts that mark sex characteristics in order to help people pretend they are physically the sex matching their superior3 gender identity.
And through all of this affirmation that your child is probably trans, there is still the question that he or she, or they, or ve, may or may not decide to transform their body when they are older and can make an adult decision. An mature, adult decision, that has not been unduly influenced by social pressure, but come about through careful weighing of the costs and benefits of finally connecting your body to the matching gender identity that has been an innate feature of your soul since birth.
So, how can modern medicine help prepare a child for such a future? You see, adolescence and puberty happen between childhood, and adam’s apples develop and hair begins to grow on the chests of AMABs and those secondary sexual characteristics that mark one as AMAB would be inconvenient. Hormone therapy such as providing androgen and testosterone to AFAB boys or estrogen to AMAB girls, is not indicated to youngsters before they start puberty. Hormones shouldn’t be given until kids turn 18 I (and 18 is not an age limit based on scientific styudies, it’s the commonly accept age of adulthood.) But kids shouldn’t despair because modern medicine has found a way to block puberty using drugs off-label that have never been approved for children. But never mind that, if we don’t do something kids will kill themselves. So we do something even if it’s probably dangerous. This is where puberty blockers come into play.
Puberty blockers may help your emotional and social development. They may help you feel more comfortable in your body. Hormone treatment is shown to help transgender people with depression and boost self-esteem. Puberty blockers prevent changes in your body that you are not comfortable with. They may also prevent the need for future surgery, such as removal of the breasts ("top surgery").
As my fellow volunteer stated in the pitter-patter from the first post in this series, puberty blocking drugs put a pause on developing body parts you’ll later want chopped off. Probably. Most likely, because when kids have been on puberty blockers they have a greater tendency to want to transition to their desired sex.
No less an authority than the Mayo Clinic’s website staff claims that these puberty blockers are barely a concern. One simply pops them like Pez for a long enough time to determine if their Gender Identity is persistent, and then when the stop taking them it’s just a simple matter of going through puberty like any other young adult.
Use of GnRH analogues pauses puberty, providing time to determine if a child's gender identity is long lasting. It also gives children and their families time to think about or plan for the psychological, medical, developmental, social and legal issues ahead.
If an adolescent child decides to stop taking GnRH analogues, puberty will resume and the normal progression of the physical and emotional changes of puberty will continue.
There are a few side effects to watch for, so don’t operate heavy equipment while you are on them:
Possible side effects of GnRH analogue treatment include:
Injection site swelling
Weight gain
Hot flashes
Headaches
Use of GnRH analogues might also have long-term effects on:
Growth spurts
Bone growth and density
Future fertility — depending on when pubertal blockers are started
Children may have their height checked every three months. Bone density is also checked periodically. If bone growth or density is a concern, your child's health care provider might prescribe a different medication, stop treatment with GnRH analogues or recommend the best time to start cross-hormone therapy.
If children with male genitalia begin using GnRH analogues early in puberty, they might not develop enough penile and scrotal skin for certain gender affirming genital surgical procedures, such as penile inversion vaginoplasty. Alternative techniques, however, are available.
That last bit sounds ominous, but I’m sure there’s nothing to worry about. More seriously, though, that bit about Future Fertility issue is one of great concern. Kids who are asked to make a decision about taking a drug that might cause them to be sterile do not have the adult capacity to understand the implications well enough to make an informed decision.
Keira Bell sued the GIDS at Tavistock in England and I’ll refer you to her telling of the tale:
By the time I got to the Tavistock, I was adamant that I needed to transition. It was the kind of brash assertion that’s typical of teenagers. What was really going on was that I was a girl insecure in my body who had experienced parental abandonment, felt alienated from my peers, suffered from anxiety and depression, and struggled with my sexual orientation.
After a series of superficial conversations with social workers, I was put on puberty blockers at age 16. A year later, I was receiving testosterone shots. When 20, I had a double mastectomy. By then, I appeared to have a more masculine build, as well as a man’s voice, a man’s beard, and a man’s name: Quincy, after Quincy Jones.
…
The consequences of what happened to me have been profound: possible infertility, loss of my breasts and inability to breastfeed, atrophied genitals, a permanently changed voice, facial hair. When I was seen at the Tavistock clinic, I had so many issues that it was comforting to think I really had only one that needed solving: I was a male in a female body. But it was the job of the professionals to consider all my co-morbidities, not just to affirm my naïve hope that everything could be solved with hormones and surgery.
If a child believes that they are transgender, it is certainly worth exploring the nature of that belief before beginning a course of medical treatment that may cause them to be sterile or have other effects.
Puberty itself is the worst part of most people’s lives, and for me I think it was even worse than that time that I spiraled downwards in drugs and drink following my first divorce. Puberty started when I was 11 with a high-pitched voice that suddenly dropped to a basso profundo, and returned to a soprano at a whim. I really couldn’t control it and it was embarrassing, and even more embarrassing were the showers after basketball practice because I developed maleness sooner than the other boys and those twerps spread the news through the school.
Puberty was necessary for more than just giving me pubic hair and a fully developed penis. 4
In the third installment (and perhaps final, I don’t plan these out in advance and it’s all rough drafts on here from me) I will write about the necessary phases of development in adolescence and the consquences of a avoiding any of them.
And, lo, here it is:
I’m being facetious about the “where the penis should be,” but I think it’s in the proper spirit of the gender regressive nature of our times. And yes, when I lived in Texas I had co-workers who referred to ball headed babies rather than bald.
This isn’t really true, but it’s used as a scare tactic against discussing the issue of gender in any way but affirming.
Gender affirmation surgery is based on the notion that a person’s conflicting gender identity is superior to their sex in determining their sex class. IT MAKES NO SENSE TO ME EITHER.
And an Adam’s Apple and all the other secondary sex characteristics that make their appearance at the time when you’re trying to figure out how to talk to girls in a way that will lead to hearts and initials carved into desktops.