Just a few years ago, children who felt trapped in the wrong body faced a lifetime of hiding who they were. Not many, if any, doctors were willing to give kids any hormone replacement or medical interventions to help them lead normal lives. There also weren’t many studies on the physical effects of doing so.
According to reports in the medical journal Pediatrics, children and teens who feel they were born the wrong gender are getting more help. Not only are parents being more supportive in recent years, but the medical community is implementing more programs to help these children live happy and normal lives.
Dr. Norman Spack, the author of one of three reports published in today’s journal, and director of one of the nation’s first gender identity medical clinics at Children’s Hospital Boston, strongly feels that these kids need and deserve treatment:
If you open the doors, these are the kids who come. They’re out there. They’re in your practices. Switching gender roles and occasionally pretending to be the opposite sex is common in young children. But these kids are different. They feel certain they were born with the wrong bodies.
While many of these kids are diagnosed with “gender identity disorder”, which is a psychiatric diagnosis, many doctors disagree since new research suggests these kids “may have brain differences more similar to the opposite sex”. Dr. Spack said that according to some estimates, 1 in 10,000 children have the condition.
The treatment is not without its skeptics. Many doctors still feel it is a tricky situation to treat children who have yet to hit puberty with hormonal therapy. Some also feel that kids may be unsure of their longterm feelings and treating too early may cause harm. Yet doctors who perform the medical treatment claim that not treating the child at all can be way more devastating, and result in self mutilation, depression and suicide.
The Endocrine Society does endorse transgender hormone treatment but not before before puberty begins. Only at that point, do they recommend puberty-blocking drugs until age 16, followed by lifelong sex-changing hormones with monitoring for potential health risks. They also advise mental health professionals to be involved in the process. Complete gender-reassignment surgery can only be performed on teens aged 18 and older.
Yet doctors who are skilled in hormonal therapy feel that making the kids wait can do more harm than good. There are drugs approved for delaying puberty in children who start maturing too soon. Furthermore, the drugs’ effects are reversible. Spack maintains that they caused no complications in his patients. “The idea is to give these children time to mature emotionally and make sure they want to proceed with a permanent sex change.”
Dr. Jo Olson, medical director of a transgender clinic at Children’s Hospital Los Angeles, who is currently treating an 8-year-old for gender identification issues says the journal findings should help encourage more pediatricians to offer sex changing treatment:
“It would be so nice to move this out of the world of mental health, and into the medical world.”
What do you think? Should medical intervention in the form of hormonal treatment occur before puberty? Should this be a mental health issue or a medical issue? Both?
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