One major point of contention in the
modern world is transgender rights and what those rights entail. This debate
affects people on both sides, but none are affected as much as
gender-questioning youth. Children are often seen as being too young to
understand gender identity, even their own. Questioning and transitioning
gender is called a phase, a sin, or even a mental illness, and adults all over society
are debating whether children should be allowed to contemplate transitioning or
be forced to wait until they reach adulthood before proceeding with their
transition. Transgender activists and allies argue that denying puberty
blockers for trans children negatively impacts their mental health, while the
other faction of the debate claims that allowing children to transition during
puberty will negatively impact both their physical and mental health. It’s a
hot topic, and one that doesn’t have an easy answer. With both sides vehemently
opposed to one another, it’s unlikely to be peaceful if one side succeeds, and
neither side appears interested in compromise, as they both work to protect
children across the world in diametrically opposed ways.
To talk about puberty blockers, it’s
important to understand what puberty blockers are. According to the Mayo Clinic,
puberty blockers are a medicine used to prevent the production and release of
hormones such as testosterone and estrogen. By preventing these hormones from being
produced in the body, puberty blockers prevent the growth of unwanted sexual
dimorphic characteristics such as breasts on people assigned female at birth
(AFAB) and increased body hair on people assigned male at birth (AMAB). Usually,
puberty blockers are just one step towards gender transition in children, used
to stop the development of unwanted sex characteristics while the child, their
family, and their care team discuss next steps. Often therapy and sometimes
gender-affirming hormones will be included in gender transition, depending on
the age of the child, their medical history, and their family’s medical
history, among other mitigating factors. The side effects of puberty blockers,
according to the Mayo Clinic, range from more benign symptoms like weight
change and inflammation surrounding the injection site, to more long-term
concerns such as decreased bone density and complications with fertility in
both AMAB and AFAB users. It is recommended to take vitamin supplements to
counteract the decrease in bone density, and the side effects stop when the
patient stops treatment. Production of growth hormones like testosterone and
estrogen also resumes when the patient ends their use of puberty blockers.
Argument
in opposition:
Senior Counsel of the Alliance
Defending Freedom, Matt Sharp, penned a testimony detailing why the use of
puberty blockers by gender questioning and transgender children is dangerous.
Sharp wrote his testimony to the state of Kentucky, imploring the government to
“protect children and parents from being pressured into agreeing to these . . .
‘gender transition’ procedures,” calling puberty blockers and hormone
treatments “harmful” and “experimental” (1). Sharp points to a warning issued
by the FDA that puberty blockers can increase the risk of developing
pseudotumor cerebri, a condition where there is swelling in the brain that
mimics a tumor but has no clear cause (Sharp 3). He also warns that puberty
blockers can lead to underdeveloped reproductive organs and possible
sterilization, stating that there is no known long-term research on the effects
of puberty blockers on these body parts, something which he points out the
Endocrine Society has issued warnings concerning (Sharp 3). Sharp finally
raises concerns over potential mental development impairment of youth given
puberty blockers, quoting the Endocrine Society, “the use of puberty blockers
on children ‘may include . . . unknown effects on brain development’” (3). He
cites a study claiming that of all the children on puberty blockers, over 98%
of them went on to receive hormone transition therapy and 100% of people given cross-sex
hormones follow it by undergoing gender transition surgeries, which Sharp calls
“damaging” and “irreversible” (4). Before he concludes his message, Sharp
points to other countries that have banned or limited puberty blockers for
children, countries such as the United Kingdom, Finland, and even New Zealand.
Sharp concludes his plea saying, “Denying the truth that each and every person
is either male or female hurts . . . children,” and that the youth of today
should be protected by the laws politicians make (5).
Argument in support:
Tekla Taylor and Sinead
Murano-Kinney offer a different perspective in their Advocates for Trans
Equality article “A Lifeline for Trans Youth: Puberty Blockers, Explained.”
According to them, puberty blockers are vitally important to the mental
well-being of trans and non-binary children, because even though it’s scary to
go through puberty normally, “trans youth have specific concerns about how
their bodies might change” (Taylor & Murano-Kinney). These specific
concerns are both mental and physical, with many trans kids not wanting to deal
with the mental anguish that comes with the equally unwanted physical changes
to their body that puberty brings. This mental anguish is described as
“Want[ing] to literally crawl out of [her] skin” by Emma Curtis, a trans woman
from Kentucky who testified in court fighting for trans healthcare (qtd. in Taylor
& Murano-Kinney). Many of the changes bodies go through during puberty are
also either irreversible or incredibly expensive to reverse, changes such as a
deepened voice and the broadening of physical features in trans girls and
women, and the development of breasts and the beginning of ovulation in trans boys
and men. Without access to puberty blockers, the children who are trans now
will be forced to pay thousands of dollars for gender transition that they otherwise
wouldn’t have needed to. Curtis goes on to describe going through male puberty
as a transwoman as “traumatizing” and “heartbreaking” (qtd. in Taylor &
Murano-Kinney). Taylor and Murano-Kinney finish their article by reinforcing
the idea that trans children are still humans and deserve grace and dignity,
and access to the medical care needed. (Taylor & Murano-Kinney).
Argument
in Opposition Breakdown:
Sharp makes a very impassioned argument;
he cares deeply about the welfare of children and doesn’t want them to become
victims of a fad. His argument uses a lot of statistics, but he frequently
doesn’t cite where he’s getting his points from. The most egregious example
would be when he brings up what he calls “a growing movement of
‘detransitioners’” (Sharp 1). He mentions that these detransitioners now oppose
puberty blockers and gender transition procedures for children, but he does not
name any of these ex-transgender people or any groups helmed by them, hurting
his argument for lack of credibility on this point. He brings up statistics
from a study “from the world’s largest gender clinic in the United Kingdom”
without naming it as well (4). Much of his argument comes across as fear
mongering and misrepresenting data, the UK study is the same one where he
pulled “98% of children who were administered puberty blockers went on to
eventually receive cross-sex hormones.” This sounds like a shocking statistic, how
can so many children be convinced of something so harmful to them (4)? However,
even a cursory amount of research into this dilemma reveals that it can take
months to years for trans children to gain access to hormone treatments and
takes many more years on top of that to undergo gender reassignment surgery.
These children are, more likely than not, adults by the time they go through
with these procedures and thus, in theory, should have the wisdom and
wherewithal to understand the ramifications to their bodies. Sharp’s whole
argument hinges on reframing several facts to stoke the fires of outrage in
people who do not have a clear understanding of how puberty blockers and gender
transitions work. It sounds bad, but if you scratch the surface, it all falls
apart.
Argument
in Support Breakdown:
Together, Taylor and Murano-Kinney
present a well-thought out and detailed argument. From the start of their
article where they state plainly that “puberty can be a tough time for anyone,”
connecting with the audience by reminding them of their own struggles during
adolescence (Taylor & Murano-Kinney). Throughout their article, the duo
uses very expressive language and do not shy away from exclamation points for
some of the statements they find more exciting. They also quote trans experts,
such as Curtis mentioned earlier and one Beck Witt Major, a transman from
Arkansas. Adding first-hand accounts and testimonies from actual trans people
who have struggled to receive the affirming care they needed makes the article
much more credible (Taylor & Murano-Kinney). The two also increase their
credibility by linking to several different medical organizations such as the
American Academy of Pediatrics and the American Medical Association. There is
also a third link to the American Psychiatric Association, but the specific webpage
linked has been taken down since the publication of Taylor and Murano-Kinney’s
article (Taylor & Murano-Kinney). In all, Taylor and Murano-Kinney present
a well-thought out and researched argument that intends to increase
understanding and educate.
Similarities
and Differences:
Even in a debate with sides so
diametrically opposed as these, it is still possible to find common ground
between them. In fact, both sides care deeply about the wellbeing and welfare
of children. Unfortunately, that is where the similarities end. Differences on
the other hand, the sides of this debate have those in spades. Trying to
inhabit the viewpoint of Sharp, it seems that he is of the opinion that children
are too young and immature to understand what being transgender is and likens
transness more to mental illness that needs to be cured and removed than
something to be understood. It’s clear he wants what he thinks is best for children
but is too willful to hear and understand arguments from the opposing viewpoint.
Taylor and Murano-Kinney prefer the process of listening to trans people and
hearing their stories. The two then convey that message to their audience,
hoping to find common ground with people who want the best for children. In the
end Sharp is trying to convince his readers his point of view is correct, while
Taylor and Murano-Kinney are trying to convince their audience to listen to
trans voices and support them.
Synthesis:
So, do puberty blockers negatively
impact the mental health of minors? Based on the sources explored here, I
conclude the answer is no, and in fact puberty blockers seem more beneficial
for improving mental health in some cases, such as precocious puberty and
gender transitioning. In the debate surrounding puberty blockers, both sides do
have some good points. It would be reckless and essentially medical malpractice
to allow children access to puberty blockers all willy-nilly. Complications
will come up such as the decrease in bone density Sharp mentioned, as well as
the potential for improperly developed sexual organs in case the trans
individual would want to have children at some point in the future. However,
it’s also irresponsible to prevent access to puberty blockers for trans and
gender questioning children, tantamount to abuse in some cases. Forcing a trans
child to go through the puberty of their birth assigned gender puts them
through unwanted stress and can lead to depression and even suicide in extreme
cases. So then, what do we do? We compromise: a good middle ground I see
between the two sides would be on a case-by-case basis. Each gender questioning
child who wants puberty blockers will, along with their parents or guardians,
be evaluated by psychiatrists, pediatricians, and endocrinologists who will
make sure the child understands the risks associated with such medication and
can monitor them in case of side effects. With this process to get puberty
blockers and hormone replacement therapy, it will prevent children who want to
get on puberty blockers as if it were a fad or phase and allow for personalized
care for each child who is approved to undergo such procedures.
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