Many countries are increasingly shaming transgender medical care for adolescents and children. This is known as child abuse, and it is subject to criminal prohibition. However, it is approved by the major medical associations and has been in existence in the United States for over a decade.
According to a survey published in the British Psych Bulletin, many clinics still use treatment programs from Amsterdam 30 years ago. According to the review, the number of young people being referred to gender clinics in the US, UK and Canada has increased tenfold since 2005.
Both the World Professional Association for Transgender Health and the Endocrine Association are experts in the treatment and prevention of hormone-related conditions. Here’s what you can expect.
Blockers for adolescents
Children who doubt the sexuality of their parents are often referred for treatment at special clinics that can confirm their gender. Such treatment usually begins with a psychological assessment to determine if the children have a “gender dysphoria,” or distress caused when a gender identity does not match the gender assigned to the person.
First, medication is given to children who meet the clinical guidelines. This temporarily stops puberty. This treatment is only for young people with gender dysphoria diagnosed after they have had counseling with their parents and adult caregivers.
It is not possible to start the drug in young people until they have shown early signs of puberty (enlargement of breasts, testicles). This usually happens between the ages of 8 and 13 for girls, and one to two years later for boys.
GnRH agonists block the brain’s release of key hormones that are involved in sexual puberty. They are used to treat premature puberty. It is a rare medical condition in which premature puberty can occur.
The drug can be administered as injections once a month or as an arm transplant lasting up to a year. The drugs’ effects can be reversed. Sexual development and puberty are restored as soon as they are stopped.
Some children continue to take the medication for years. They may have a side effect that causes a decrease of bone density. This reverses once the medication is stopped.
Children can experience adolescence without the use of adolescence inhibitors. They can identify as the opposite sex, or begin treatment to adapt their bodies to their gender identity.
If you choose to go with the second option, the guidelines state that the next step is to use manufactured estrogen and testosterone – hormones which encourage sexual development during adolescence. There are skin patches and pills that contain estrogen. The weekly injections of testosterone are a common part of the testosterone treatment.
These should be started when the children are able to make informed medical decisions. This usually occurs around 16 years of age, and parental consent is often required, according to Dr. Gina Squire (co-director of Seattle Children’s Hospital’s Gender Clinic).
Many transgender people take hormones throughout their lives, even though some changes may not disappear if they stop taking the drug.
The most common side effects of testosterone in girls who are influenced by boys is permanent voice loss, facial hair, and the bulge like an apple. Dr. Stephanie Roberts, a Boston Children’s Hospital expert on gender management, stated that this can often happen to girls who change to boys. Roberts says it is almost always permanent.
An investigation into the long-term effects of hormones on transgender adults found that there are potential health risks, including blood clots or changes in cholesterol.
Teens are less likely to undergo sex reassignment therapy than hormone therapy. However, most centers are reluctant about giving exact numbers.
According to guidelines, such surgery should be reserved for people over 18 years old. According to the World Transgender Health Association, breast surgery is acceptable for anyone under 18 who has been taking testosterone for at most one year. The Endocrine Association states that there isn’t enough evidence for recommending a particular age limit.
Some teens and children resort to self-mutilation in an attempt to alter their anatomy, according to studies. Studies have also shown that transgender adults and young people are more likely to suffer from depression, stress, and suicidal behaviors if they’re forced to live with the species they were born to.
Opponents to transgender youth medical treatment claim there is no evidence of alleged benefits. They cite long studies that show that most children who are not treated have lost their transgender identity by the time they reach their teens. Opponents often cite a study that included many children wrongly diagnosed with gender dysphoria, but lacking data.
Doctors state that children are correctly diagnosed. Transgender identity usually lasts until adulthood and is not easily lost. Guidelines state that treatment should not start before puberty.
Studies have shown that treatment can increase children’s happiness, as well as reducing suicidal and depression. It is ethically questionable to conduct the most powerful kind of research, which involves a study in which some children are treated and others not. Studies on the treatment effects of long-term treatments are ongoing.
Follow @LindseyTanner AP Lindsey Tanner, Medical Writer
Howard Hughes Medical Institute’s Department of Science Education supports the Associated Press’s Department of Health and Science. All content is the sole responsibility of the Associated Press.