Thursday 24 January 2019

Canadian Journal recommends doctors prescribe hormone blockers to 'trans kids' as young as 10

The Canadian Medical Association Journal has published a review article urging doctors to prescribe hormone blockers to so-called "trans kids" as young as 10 years old, the National Post reported.
"Medications that suppress puberty — hormone blockers — allow youth time to explore their gender identity and expression without having to worry about ongoing pubertal changes and development of secondary sexual characteristics that may be psychologically disturbing and undesired," the report said.
It recommends hormone blockers be given only once puberty starts — on average, at age 10 1/2 for children born female, and 11 1/2 in those "assigned" male gender at birth.
"Some youth find that their dysphoria abates as puberty starts, making it important to allow initial pubertal changes to occur," the authors write.
The authors suggested following up hormone blockers with cross-sex hormones, also known as gender-affirming hormone therapy, in teens who want to transition from their birth gender to their preferred gender.
For instance, estrogen can be used to help trans girls develop more feminine figures and testosterone can lead to a masculine physique in trans boys.
The authors recommended starting cross sex hormones at age 16, but added "that some youth may benefit from earlier administration of gender-affirming hormones (i.e., between age 13.5 and 16 years)."
"Many youth understandably express the desire to go through puberty in their affirmed gender at similar ages to their peers, which would necessitate starting gender-affirming hormones at even younger ages than these new recommendations," the authors wrote.
The report also stated that gender dysphoria should no longer be treated as pathological.
"Although the consensus in the medical community in the 1960s and 1970s was to view gender variance through a disease model in which associated behaviors, expression and declared identity were deemed pathological and in need of correction, the current approach is an affirming one that does not view gender variance as pathological," the authors wrote.

Are hormone blockers dangerous?

There is a lot of debate among physicians and the medical community as a whole about the safety and ethics of treating trans kids with hormone blockers and cross-sex hormone therapy.
One hormone-blocking drug that's commonly used to suppress estrogen in girls is called Lupron. It belongs to a class of drugs called gonadotrophin hormone-releasing (GnRH) agonists. Lupron was originally approved by the U.S. Food and Drug Administration to treat prostate cancer.
It is now often used "off-label" to treat endometriosis and precocious puberty (or early onset puberty) in girls and boys. The FDA has received at least 24,000 reports of adverse reactions to the drug. Off-label use of a drug is not illegal.
Hormone blockers do more than prevent secondary characteristics during puberty.
"In addition to preventing the development of secondary sex characteristics, GnRH agonists arrest bone growth, decrease bone accretion, prevent the sex-steroid dependent organization and maturation of the adolescent brain, and inhibit fertility by preventing the development of gonadal tissue and mature gametes for the duration of treatment," according to the American College of Pediatricians.
The side effects of Lupron include severe joint pain, osteoporosis, compromised immune systems, and mental health issues such as severe depression and even suicidal ideation.
While some doctors claim the effects of hormone blockers are reversible, Dr. Michael Laidlaw, an endocrinologist, told The Federalist that many side effects are not reversible, including bone density:
There is an exquisitely timed release and change of multiple hormones during normal puberty. Among these are growth hormone and the sex hormones which account for the growth spurt including bone growth and development. It has been shown that puberty blockers interfere with the expected increase in bone density in adolescence such that the bones are not as strong as they would be had normal pubertal development been allowed. This is due to the effect of dropping sex hormone levels to subnormal levels. These lost years of bone development cannot be regained.
Laidlaw added that 80 to 95 percent of the adolescents with gender dysphoria outgrow it naturally.
However, nearly 100 percent of those who are treated with hormone blockers move on to cross-sex hormones and sometimes surgery.

What else?

Specialty gender clinics in Canada have long waiting lists for trans youth who want to transition to their preferred gender, according to the National Post.
The newspaper also noted messy legal battles between divorced parents over who gets to decide the course of hormone treatments for their transgender teen.
Additionally, experts have reported increasing numbers of youth with no known histories of gender identity issues have suddenly identified as transgender.
In another recent study, "Rapid-onset of gender dysphoria in adolescents and young adults: A study of parental reports," published in the U.S. National Library of Medicine by the National Institutes of Health, suggested that peers and social media may be causing a contagion effect.

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