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Parents’ Rights In A Gendered World

“Parents of a 17-year-old girl lost custody of their daughter for opposing her wish for transgender medical treatments” reads the headline [1].

In reaching its decision, the court followed usual procedures, having the young person evaluated by professionals who testified [2]  that:

the father’s ongoing refusal to call the child by his (sic) chosen name and the parents’ rejection of the teen’s gender identity have triggered suicidal feelings….  He (sic) has been diagnosed with depression, anxiety disorder, and gender dysphoria, according to court records. 

Removing the child from her parents’ custody, the court concluded, was in her best interest.

The parents’ objection to medical intervention with hormones also stems from consultations with medical professionals, as well as “thousands of hours of research and…observations of [our] own child….”

The conflicting medical testimonies aptly demonstrate that the matter is not settled among medical “experts”; yet, the truth is not impossible to discern.

Medical Practice And Transgenderism

In the short timeframe that gender fluidity has even been considered a possible norm (previously, psychiatric science had concluded that persons who experienced themselves as a gender different than their natal sex were considered to be suffering from a mental illness [3]  in need of healing [4],  which was often successfully treated), the practice of medicine has quickly polarized into two camps: (1) those who conclude that the desires of a person regarding his or her gender are paramount; and (2) those who conclude that one’s gender is based on one’s physiological sex.

The first group is wedded to the philosophy of the World Professional Association for Transgender Health (WPATH) and its standards of care [5]  which advocate for increasingly-early use of hormone suppression and supplementation.  Those who practice in this manner often assert there is no danger in these interventions, yet even they acknowledgement that there is much that is unknown about long-term effects.

While advocating for puberty-blocking hormones as early as 10- to 12-years-old—so that secondary sex characteristics might not emerge and distress the confused child or interfere with later attempts to surgically change his or her genitals—these same doctors caution that estrogen and testosterone, the hormones that are blocked by these medications, also play a role in a child’s neurological development and bone growth.  “The bottom line is we don’t really know [6]  how sex hormones impact any adolescent’s brain development,” states Dr. Lisa Simons, a pediatrician at Lurie Children’s Hospital’s Gender and Sex Development Program.

Furthermore, children who take altering hormones bring about irreversible physical changes ranging from typical adolescent concerns (acne, changes in mood) to potential long-term adverse effects (heart disease, diabetes, blood clots, infertility).  So when children make the decision to start taking hormones, they are really deciding whether they ever want to have biological children.  The parent’s attorney in this case said [2],  “it does not appear that this child is even close to being able to make such a life-altering decision at this time.”

Since it is apparent that the physical risk to these children is not negligible, why is it a risk worth taking?  “To ease the psychological suffering,” advocates often say.  But does it?

In contrast to the WPATH approach, the second group takes genetics and biology as their starting point, and has a different stance on how to ease the psychological suffering of those with gender dysphoria.

All parties stipulate [7]  that persons with gender dysphoria experience far greater psychological distress than others in the overall population; what is debated is the cause of this distress.  Advocates in the first group highlight the need to increase access to affirming mental health care, and the education of parents and schools to reduce risk factors such as bullying and bias.  In short, they assert that if society were more accepting of people in this circumstance the psychopathology would vanish.

The second group challenges that approach, citing, among other evidence, results from a study [8]  which found that even in a society which openly affirms and readily accepts hormone and surgical interventions to change gender identity, the persons studied remained at increased risk of suicide and psychiatric hospitalizations.  Thus, the acceptance, affirmation, and transitioning of one’s gender did not resolve the mental health issues as was hoped.

If the true goal is to alleviate the suffering of those with gender dysphoria, it would be wise to consider the research and treatments that were operative decades ago [9],  where the resolution of childhood gender dysphoria was often successful.  Furthermore, according to the Diagnostic and Statistical Manual of Mental Disorders, “In natal [biological] males, persistence [of gender dysphoria] has ranged from 2.2% to 30%.  In natal females, persistence has ranged from 12% to 50%.”  In other words, most gender confused youth will come to identify with their biological gender if nature is allowed to take its course.

With much of the science still to be settled, and the conclusive research supporting the conclusion that affirming a person’s gender nonconformity is not helpful (and may delay needed help), children need the guidance and direction of parents who are willing to stand firm, with love.  Children experiencing confusion regarding their sex need parents who are willing to be with them lovingly and compassionately through the struggle—even when that love and compassion are resisted—and withstand the cultural pressure to accede to that which much more often than not is a temporary answer to a problem that needs a comprehensive, caring solution.