How soon can AFAB trans adolescents expect physical changes from testosterone?

As of this month, it’s been seven years since I started HRT, and I can still recall the excitement, anticipation, and impatience of waiting for the first physical results to appear. (It turned out to be 10 days after starting, with the first noticeable hint of breast and areolar changes.) I also remember the acute discomfort and deep sadness, ten years prior to that, of seeing my body grow more and more unsightly and uncomfortable hair every day, heading in exactly the wrong direction. It would have been fantastic if the dread of the latter could have been replaced with the joy of the former, and with the advent of puberty blockers, trans youth today increasingly have the opportunity to access that very possibility.

But even the Endocrine Society’s most recent version of its transgender treatment guidelines offers only rough estimates of the timeframes of physical changes from hormone treatments for trans adults, apparently based only on the authors’ general clinical experience, and nothing on trans youth using puberty blockers and cross-sex hormones to induce the correct puberty. A recent study helps to change that, examining just what the course of puberty looks like for adolescent trans boys. Continue reading “How soon can AFAB trans adolescents expect physical changes from testosterone?”

Contra “ROGD”: A recent cohort of youth evaluated at Amsterdam’s gender clinic does not have less intense gender dysphoria or greater psychological issues

Attempts to legitimize the lay anti-trans narrative-slash-conspiracy theory of “rapid onset gender dysphoria” as a genuine health condition are risky business, as specifying particular features of an alleged new clinical phenomenon places it in the dangerous realm of that which can be disproven. Littman (2018), in her extensively criticized paper on this supposed condition, claimed that “clinicians have reported that post-puberty presentations of gender dysphoria in natal females that appear to be rapid in onset is a phenomenon that they are seeing more and more in their clinic”, and cites parental reports that “clinicians failed to explore their child’s mental health, trauma, or any alternative causes for the child’s gender dysphoria.” Zucker (2019), commenting on “ROGD”, asserted:

Over the past dozen or so years, it is my view (and that of others) that a new subgroup of adolescents with gender dysphoria has appeared on the clinical scene. This subgroup appears to be comprised—at least so far—of a disproportionate percentage of birth-assigned females who do not have a history of gender dysphoria in childhood or even evidence of marked gender-variant or gender nonconforming behavior.

Littman, Zucker, and others have further implied that a shift in the sex ratio of adolescents presenting for evaluation for gender dysphoria toward those assigned female is itself indicative of the emergence of an entirely new kind of dysphoria. These assertions – that a clinically distinct new phenomenon has emerged over the past decade, and that this is embodied largely by apparently gender-dysphoric AFAB adolescents assigned female who experience serious psychiatric comorbidities that may be presenting only the appearance of gender dysphoria – are testable. And a recent study from Amsterdam’s VUmc gender clinic puts them to the test. Continue reading “Contra “ROGD”: A recent cohort of youth evaluated at Amsterdam’s gender clinic does not have less intense gender dysphoria or greater psychological issues”

Minnesota Mom is Just… Terrible. Really Awful.

By Penny Robo

Already self-sufficient for years due to parents dealing with substance abuse issues, 13 year old “EJK” came out to her parents as gay, triggering a wave of verbal and physical abuse. Her mother permitted her to live with her biological father at 15, but he was soon incarcerated and, rather than returning to her mother, lived with friends and her grandmother, all while attending school and starting to work, eventually moving into her own apartment by 16. After more than 6 months without any contact with her mother, and considering the ongoing circumstances of her life (including her demonstrated self-sufficiency) she was considered for all intents and purposes to be an adult and in charge of her own medical decisions.

One of her first decisions was to begin hormone replacement therapy. Continue reading “Minnesota Mom is Just… Terrible. Really Awful.”

How trans youth and their parents decide to start medical transition

The process by which trans adolescents seek out and access medical transition treatment, including puberty blockers and/or cross-sex hormones, is one of the most widely misunderstood subjects in the public imagination. Initiating treatment is frequently depicted as something capricious, a decision made rashly by youth who may simply be experiencing a “phase”, with little or no in-depth consideration of its significance and impact; their parents are portrayed as either going along with this under the coercion of threats of suicide, or swept up in an alleged “trend” themselves; trans-supportive clinicians are in turn maligned as reckless enablers who supposedly allow immediate access to these treatments on the basis of mere adolescent whims. This bizarre caricature is the image of adolescent transition most commonly promoted in alarmist and sensationalist media outlets today. Continue reading “How trans youth and their parents decide to start medical transition”

A closer look at trajectories of childhood social gender transitions

I’ve previously covered certain popular misuses of figures on the proportion of gender-dysphoric children whose dysphoria desists or persists into adolescence following the onset of puberty. While the figure, commonly repeated as an 80% rate of desistance, is actually subject to a wide variety of estimates and may be much lower, of greater concern to me is how this statistic is often misinterpreted and misapplied.

Even granting an 80% desistance rate as accurate for the sake of argument, this figure is frequently used to assert something else entirely. Under the assumption that gender-dysphoric children are an essentially homogeneous group, many who oppose gender-affirmative approaches for trans children and adolescents will use this figure to suggest that any given individual trans child can safely be assumed to have overwhelming odds of their dysphoria desisting before or at the onset of puberty, meaning that affirmation of their cross-gender identity will likely be inappropriate over the longer term. Continue reading “A closer look at trajectories of childhood social gender transitions”