Puberty blockers for trans children

Do puberty blockers for trans children work? What would success look like?

Dr Polly Carmichael, director of the GIDS, started a study on PB in trans children in 2011. The Bell judgment reports that a paper was being finalised, but one of the authors had not yet responded to issues raised by the peer-reviewers. A sociologist, Michael Biggs, has published a critique of the study which anti-trans campaigners would find devastating.

Ideally, a critique would have psychological and medical expertise Biggs lacks. He appeared transphobic before he started digging: he reports that three MSc students, whom he mocks as “woke”, told him to educate himself on trans children. He quibbles about the word “study”, preferring to call it an “experiment”, because PB has not been licensed, as if he has never heard of a “drug trial”. He quibbles that “it was not a proper randomized trial”, even though such a trial would not be possible: you notice when you undergo puberty, and people around you notice too. He acknowledges that parents were going abroad for PB when it was not available in the UK. Disingenuously, in one railing against PB in children, he says the sample was too small. However, he has found at least part of the results, from newspaper articles, comments by Dr Carmichael, and from Freedom of Information requests. He says the data show no psychological benefit from PB.

GIDS does not follow up its patients after they turn 18. Well, it’s a young people’s service, and a medical service providing treatment rather than a service studying trans teenagers. Medical intervention (including follow-up) should be for the good of the patient, not primarily to increase knowledge. However, if we are to justify PB, we need success stories.

The Court in Bell heard evidence from a trans man, now 20, who wished that PB were started earlier, as that would have prevented the need for breast surgery.

Biggs comments on the first person to get PB because he was trans, who at 35, Biggs says, was depressed and “could not sustain a romantic relationship”. The report is here. It says “He was functioning well psychologically”, and that “At age 29, he had a serious relationship with a woman, which lasted for 5 years.” Five years is more sustained than some 35 year olds might have managed. It notes bone mineral density was within normal range, yet Biggs chooses to highlight that as a risk of PB.

I found Biggs’ pdf linked from the “Bayswater Support Group”, which pretends to be for parents “looking for the best support for our children”, yet only gives resources opposing transition. It is the same old stuff, from the same old anti-trans campaigners, repackaged yet again with an irrelevant name. It is attached to “Easyfundraising”, which has recorded £7.70 raised and five supporters as of 7 December.

Whether B’s case is a success or failure might depend on who is looking, and what details they choose to emphasise. I have chosen details to make Biggs’ critique look bad. I am trans. Yet his selective quotation of B’s case shows his bias.

What might success look like? Adolescence can be a horrible time, even if you are heterosexual and more or less fit conventional gender stereotypes. Gays and lesbians find it harder. And then there is trans. The comparator for the trans child is not the more or less happy straight or gay twenty-something, now in a relationship and starting a career, but the child of parents like Mrs A who originated the Keira Bell case. Having had their desire to transition uncompromisingly resisted, are children happier? If they were, would we not hear more from them?

Possibly not. They might not want the attention. But- the only one the new/old hate group can point to is Jessie Maynard, who was 16 in 2016, and wrote then that she was happier than she would have been trying to pass as a boy. However she was never assessed by GIDS. Could they not approach her for her thoughts now?

Some detransitioners write blogs, tweet, and campaign. That is brave of them. More are getting together. Soon they may be seeking damages from GIDS.

If everything really is wonderful, might some who transitioned as teenagers come forward now? The bravery would be even greater. They may pass and be living in stealth, and not want to come out as members of a hated and stigmatised group. But without their stories, it may prove impossible for any more teenagers to benefit from the treatment they had.

If someone is trans, there are only bad choices. You can muddle along in the assigned gender. This is painful and uncomfortable. You can transition. It’s a choice of denying your true self, or being your true self and exposing yourself to all the hate and prejudice.

If you transition, you can take hormones and have surgery, and make your body approximate to that of the acquired gender. It’s a problem that too much hope is attached to this. It takes years, and during the process people tend to think that it will sort all their problems, only to find at the end that it has not. We need realistic expectations of what such treatment can achieve. So, again, we need the stories of transitioned people.

That of the actor Elliot Page is not enough. He/they is particularly talented, and has enjoyed success. Compare him to other actors with similar prominence at the time of his announcement. More ordinary teens are unlikely to have similar careers. Still, it’s good for him to come out, as part of a process of normalising trans, and I am glad he feels able to transition.

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