Boston Children’s Hospital establishes a framework for gender-affirming surgeries on minors

Throughout the past decade, there’s been no shortage of popular alarmism surrounding the spectre of “children being given sex changes” – a misconception borne of either incidental or deliberately cultivated ignorance about what transition entails at various ages, suggesting the image of five-year-olds being given irreversible surgeries. In response to this, trans people and allies point out for the thousandth time that young transgender children undergo social transitions consisting of nothing more than changes of names, attire, and presentation, only those adolescents whose gender dysphoria persists past the onset of puberty are given puberty blockers that pause development without producing any permanent changes, and only legal adults aged 18 or older are able to access any irreversible gender-affirming surgeries such as vaginoplasty or chest surgery.

And this reply is largely accurate – just not entirely. Continue reading “Boston Children’s Hospital establishes a framework for gender-affirming surgeries on minors”

Michael Laidlaw and friends still misunderstand the basics of affirming care for trans youth

I’ve previously covered Dr. Michael K. Laidlaw et al.’s (2019) remarkable feat of fitting so many inaccuracies and distortions about trans youth treatments into an eight-paragraph letter to the editor in the Journal of Clinical Endocrinology & Metabolism, it took several thousand words to dissect these errors thoroughly. These included:

  • Claims that gender-affirming medical care causes “sexual dysfunction”, without acknowledgment that untreated gender dysphoria can itself be a significant source of sexual dysfunction and gender-affirming care is associated with improvements in sexual function.
  • Asserting that youth with untreated gender dysphoria are “healthy”, omitting any recognition of the many severe comorbidities that can accompany these.
  • Asserting the existence of new “rapid onset” form of gender dysphoria developing “suddenly” in teenagers through “social contagion”, supported by a single study that examined only parental reports and perceptions without including a single transgender, gender-nonconforming, or gender dysphoric youth.
  • Incorrectly claiming that all transgender adolescents who take puberty blockers will continue on to take cross-sex hormones as well.
  • And the utterly groundless assertion that use of puberty blockers induces persistence of adolescent gender dysphoria that would supposedly otherwise remit spontaneously.

As it turns out, that last item appears to be a persistent point of confusion for Laidlaw and his coauthors. In their letter to the editor, Laidlaw et al. stated that most “children” would “outgrow” their gender dysphoria “by adulthood”, inaccurately suggesting that adulthood rather than the onset of adolescence is the point at which gender dysphoria is observed to persist or desist. This is not the case: statistics about “desistance”, which are themselves often questionable and highly variable, are about whether or not childhood gender dysphoria persists beyond the onset of adolescence. Past that point, these dysphoric youth are unlikely to experience spontaneous remission of their dysphoria upon reaching adulthood – but Laidlaw et al.’s misrepresentation makes it seem as though this is the case. This is an attempt to provide a pretext for the continued denial of medically necessary care to gender-dysphoric adolescents, based on the false belief that it will simply go away within a few years and any affirming care would be unnecessary and inappropriate. Continue reading “Michael Laidlaw and friends still misunderstand the basics of affirming care for trans youth”