More Kids Are Getting Gender-Reassignment Surgery

Why the sudden upsurge in (positive!) news articles about Trans* youth? Not that I’m complaining, just curious.


by Lindsay Tanner
Monday Feb 20, 2012

A small but growing number of teens and even younger children who think they were born the wrong sex are getting support from parents and from doctors who give them sex-changing treatments, according to reports in the medical journal Pediatrics.

It’s an issue that raises ethical questions, and some experts urge caution in treating children with puberty-blocking drugs and hormones.

An 8-year-old second-grader in Los Angeles is a typical patient. Born a girl, the child announced at 18 months, “I a boy” and has stuck with that belief. The family was shocked but now refers to the child as a boy and is watching for the first signs of puberty to begin treatment, his mother told The Associated Press.

Pediatricians need to know these kids exist and deserve treatment, said Dr. Norman Spack, author of one of three reports published Monday and director of one of the nation’s first gender identity medical clinics, at Children’s Hospital Boston.

"If you open the doors, these are the kids who come. They’re out there. They’re in your practices," Spack said in an interview.

Switching gender roles and occasionally pretending to be the opposite sex is common in young children. But these kids are different. They feel certain they were born with the wrong bodies.

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Delay puberty for children with gender doubts, My Transsexual Summer star says
20 February 2012, 5:06pm

Primary school children should be taught about transsexuals from age ten and have the option of jabs which delay the onset of puberty, Drew-Ashlyn Cunningham has said.

Cunningham, who starred on Channel 4′s acclaimed My Transsexual Summer, was speaking while visiting Kingston University in London earlier this month to talk to students about her experiences.

She said: “If you think you are transsexual, pre-puberty is the time you want to start taking jabs to delay puberty because once you’ve gone through it, the physical changes are very hard to reverse.

“I am all for youngsters who are confused being helped to postpone puberty so they can decide what gender they really are. I only wish this option had been available to me.”

Her comments come after it was revealed that six children in Britain will be given jabs to delay puberty on the NHS because they are convinced they are the wrong sex.

“I also think if younger children are educated about it in school from the age of ten, they won’t question it,” she said.

“Adults question it because they were never educated about it, which explains all the prejudice. Once children understand that being transsexual isn’t a problem, meeting one of us will become as normal as meeting a gay person.”

The event was part of a series of educational talks Drew-Ashlyn is planning at universities and at schools in Yorkshire, where she lives.

“From a young age I was allowed to play with Barbie dolls,” she told students.

“My dad was away in the army and, having two sisters, I didn’t question it. I started getting bullied and called gay at school. I was even strangled by a group of kids when I first moved to Wakefield at around the age of ten. Because I used to hang around with girls, a group of boys threatened me and put their hands around my neck.”

A 22-year-old from West Yorkshire, Drew entered the public eye through the critically-acclaimed TV series in 2011. She came out as a woman in 2007, and despite the support of her family and friends, she still experiences prejudice. Drew now lives full-time as female and is saving up for surgery, although she hasn’t decided yet whether she will go ahead with it.

In November, she talked to PinkNews.co.uk about appearing on the Channel 4 documentary and the positive feedback she had received from the public.

“Some straight and married men have a thing for transsexuals,” she said. “They look at them as women but with a whole edginess to them. Now I am dating a guy and it doesn’t matter what’s between my legs.”

The event was organised by Will Brooker, head of Film and Television research in the School of Performance and Screen Studies, to tie in with his department’s undergraduate module ‘Identity and Difference’, which invites students to examine media representations of ethnicity, gender, sexuality and disability. “I am very proud that Kingston was the first university to host Drew and I think we had a very open and respectful discussion about trans issues that often aren’t discussed in a university setting,” he said.

“I think the representation of trans people is often stereotypical and this is a step in the right direction towards a more positive, sensitive representation.”

Katherine Kepa, Student Union Vice-President, Education, and former LGBT Executive Officer, was in the audience. “I was really pleased that this event was held on campus,” she said.

“I think it’s a really positive step forward for trans issues to be included in the curriculum as there is a huge need to educate people. This is still a taboo topic and if we inform people we can make it much easier for the transgender community.”

Kids Who Don’t Gender Conform Are at Higher Risk of Abuse
Swapping gender roles is common in childhood play, but a new study finds that non-conforming kids are at risk for physical and sexual abuse and post-traumatic stress.
Fuse / Getty Images
Fuse / Getty Images

Fitting in can be a tough business for kids, especially for the boy who wants to play dress-up and the girl with the short haircut. Now a new study finds that children who display such gender non-conformity — activity choices, interests and pretend play that don’t conform with what’s expected of their gender — are more likely to suffer physical, psychological and sexual abuse and experience post-traumatic stress disorder (PTSD) by early adulthood.

The abuse is most often perpetrated by parents or other adults in the household, the study found. And as many as 1 in 10 kids display gender non-conformity before age 11. It’s not clear why gender non-conforming kids suffer more abuse, but it may have to do with parents’ discomfort with their behavior. As lead author Andrea Roberts, a research associate in the department of society, human development and health at Harvard School of Public Health, told USA Today, parents “may have the idea, ‘If I force him not to be that way, he won’t be like that as an adult.’”

Interestingly, however, Roberts also noted that children are likely to display a wide variety of behaviors that have no connection to their future sexual orientation: 85% of gender-non-conforming children in the study were heterosexual in adulthood.

Yet boys who displayed gender non-conformity before age 11 were nearly three times as likely to suffer sexual abuse in childhood, compared with gender-typical boys. Non-conforming girls were 60% more likely to be abused sexually than conforming girls. Rates of physical and psychological abuse among non-conforming kids were similar across genders.

Harvard researchers gathered the data by administering childhood behavior questionnaires among nearly 9,000 young adults ages 17 to 27, who were enrolled in 1996 in the long-term Growing Up Today study. The questionnaires, given in 2007, asked participants to recall their childhood experiences: their favorite games and toys, media characters they had imitated or admired, and whether they took male or female roles in pretend play. The participants were also asked about physical, sexual and emotional abuse in childhood, and were screened for PTSD.

The researchers found that by young adulthood, rates of PTSD were almost twice as high among those who had been gender non-conforming as kids than among those who had not. PTSD has been linked to risky behaviors such as engaging in unprotected sex and to physical symptoms like cardiovascular problems and chronic pain, according to the study, published in Pediatrics.

“Parents need to be aware that discrimination against gender nonconformity…affects kids at a very young age, and has lasting impacts on health,” Roberts said in a statement.

While many children display temporary gender non-conformity during play, according to another study in the same issue of Pediatrics, others display much strong cross-gender behaviors. For them it goes beyond gender non-conformity — these children believe they were born in the wrong body. The study finds that a small but growing number of such teens and young children — many of whom may be diagnosed with gender identity disorder (GID) — are receiving counseling and medical sex-change treatment. By some estimates, as many as 1 in 10,000 children may have GID.

The study authors recommend early evaluation of children exhibiting GID, but hormonal sex-change treatment isn’t advised until puberty. Doctors note that treating kids and teens — despite the fact that long-term sex-hormone therapies can carry serious side effects like blood clots and cancer — is less damaging than doing nothing. Kids with GID may be more prone to stress, depression and suicide, and some may resort to self-mutilation to change their sex.

For the welfare of any child, Roberts says, parents must be aware that intolerance and abuse have lasting harmful effects. Roberts’ advice to parents, she told CBS, is: “accept your children and let go of how you thought things were going to be.”

Seventh Circuit Strikes Down Ban On Hormone Treatment For Transgender Prisoners

Last week, the Seventh Circuit struck down Wisconsin’s “Inmate Sex Change Prevention Act,” which, as the name suggests, prohibits transgendered prisoners from receiving hormone therapy and other medical treatments which cause their physical characteristics to match their gender identity. Significantly, the court rooted its decision in the Eighth Amendment’s bar on cruel and unusual punishment, which establishes that “[r]efusing to provide effective treatment for a serious medical condition serves no valid penological purpose and amounts to torture.”

The core of the Seventh Circuit’s decision is that gender identity disorder (“GID”) must be accorded the same respect given to other medical conditions. Left untreated, the court explained, GID leaves to severe anxiety, depression, and even suicide or mutilation of one’s own genitals. Worse, if an inmate who has previously undergone hormone therapy is suddenly cut off from those treatments, it can have severe physiological consequences including muscle wasting and “neurological complications.”

Although earlier decisions suggested that the Eighth Amendment does not require inmates to receive “esoteric” treatments like hormone therapy, the court disposed of this suggestion by noting that it lacks any basis in fact:

The court’s discussion of hormone therapy and sex reassignment surgery in these two cases was based on certain empirical assumptions—that the cost of these treatments is high and that adequate alternatives exist. More than a decade after this court’s decision in Maggert, the district court in this case held a trial in which these empirical assumptions were put to the test. At trial, defendants stipulated that the cost of providing hormone therapy is between $300 and $1,000 per inmate per year. The district court compared this cost to the cost of a common antipsychotic drug used to treat many DOC inmates. In 2004, DOC paid a total of $2,300 for hormones for two inmates. That same year, DOC paid $2.5 million to provide inmates with quetiapine, an antipsychotic drug which costs more than $2,500 per inmate per year. […] The district court concluded that DOC might actually incur greater costs by refusing to provide hormones, since inmates with GID might require other expensive treatments or enhanced monitoring by prison security. […]

More importantly here, defendants did not produce any evidence that another treatment could be an adequate replacement for hormone therapy. Plaintiffs’ witnesses repeatedly made the point that, for certain patients with GID, hormone therapy is the only treatment that reduces dysphoria and can prevent the severe emotional and physical harms associated with it.

In other words, rather than rely on stereotypical assumptions regarding the nature of GID or the cost of treating it, the court actually engaged with the medical science surrounding the condition. In this sense, the Seventh Circuit’s decision closely resembles Judge Vaughn Walker’s opinion striking down California’s Prop 8, which carefully and meticulously examined each of the anti-gay claims that same-sex couples are somehow inferior and found no factual support for any of these claims.

For this reason, both Walker’s decision and the Seventh Circuit’s transgender inmates decision reflect an important positive trend in the judiciary’s treatment of sexual minorities. The only basis for laws that single out LGBT individuals for special restrictions are outdated prejudices with no basis in reality. The sooner courts begin testing the assumptions behind those prejudices, the faster anti-LGBT discrimination will become a thing of the past.