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Cake day: July 4th, 2023

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  • One thing that I would like to make clear is that I was not calling you a concern troll. However, this article is absolutely concern trolling in an attempt to de-legitimize the concept of being trans and the practice of providing gender-affirming treatment for trans children. The problem with all of the arguments made in articles like this is that they can’t explain why giving puberty blockers to trans teens is bad, they just pretend like we don’t know the side effects of these drugs in children. We know the side effects. We’ve been prescribing these drugs to children for decades, and it was never controversial until we started giving it to trans kids. These drugs are safe, with minimal side effects (see previous citation, as well as those at the bottom). The Economist was not concerned about these drugs being given to children with precocious puberty prior to its application to trans children. Publications like The Economist and the NY Times are only wringing their hands about this because the people writing these articles do not want trans kids to get care. Period. Puberty blockers are safe for kids with precocious puberty, but not for trans kids. Cis teen girls get 3,200 cosmetic breast implants and 4,700 breast reduction in the US each year, and The Economist has no editorial position on that . They are, however, very concerned about the 200 gender-affirming top surgeries performed each year. These treatments are fine for cis kids, safe for cis kids, but for some reason we have lots of concerns about how these treatments will affect trans kids. Because certain groups in this country are very focused on finding arguments that will allow them to deny gender-affirming care to trans kids. This seems like a good time to note that while 78% of trans people report wanting hormone therapy (note: this is trans adults, not trans kids), but only 49% get it (source is the 2015 US transgender survey. PDF warning on this link. This is a very interesting document that I would recommend reading in detail). 15% reported wanting puberty blocking medications, but only 1% reported getting them. Keep that in mind when you read these concern troll articles. All this hand-wringing over a tiny percentage of trans people, which is already a tiny percentage of the population. But I suppose it’s worth it if the overall goal is to make sure that 0% of trans kids get gender affirming care

    And, of course, there’s always the question of de-transitioning and people regretting the changes done to their body during the transition process. One thing I would like you to think long and hard about, is the fact that 20% of people who get total knee replacements are dissatisfied with their outcome. 1 in 5 that get knee surgery are unhappy with the results, and that’s a surgery that is generally very successful. Compare that to transitioning (this includes all forms of transition, however only 25% of trans people have any type of gender affirming surgery, source 2015 US transgender survey). Only 8% of trans people report de-transitioning. 62% of them do so temporarily and return to living as trans full time. So less than 4% of trans people de-transition permanently. And the great thing about puberty blockers is that if someone wants to de-transition during the course of taking them, all they have to do is to stop taking them, at which point they will go through puberty

    What bothers me the most about articles like this is that they paint a world of medical and psychological care for trans kids that simply does not exist. The vast, vast majority of them will receive no gender affirming care before the age of 18. Those that do need to receive significant psychological assessment before being put on puberty blockers. For nearly all trans kids, treatment ends here until after they have reached adulthood. Many will continue to be denied care in adulthood. These articles act like trans kids are having their genitals surgically altered before the age of 18, and I simply have not seen any credible assertion that this happens at all. But for some reason, we need to keep asking the question of whether it is safe to treat trans kids over and over again even though it is easy to show that it is both safe and leads to far better outcomes for them (see below)

    Anyway, you wanted articles discussing the effects of puberty blockers on kids. Here they are:

    Here’s an article looking at 84 trans kids on puberty blockers. The only adverse outcome was one person stopping the treatment due to mood swings: https://www.jpeds.com/article/S0022-3476(13)01364-4/fulltext

    Here’s another study looking at 89 kids on puberty blockers. No adverse outcomes noted, and use of puberty blockers in adolescence was associated with a decreased suicide risk: https://publications.aap.org/pediatrics/article/145/2/e20191725/68259/Pubertal-Suppression-for-Transgender-Youth-and?autologincheck=redirected

    Study of 201 trans youth that found that kids using puberty blockers fared better than those that received no treatment and those that received psychological treatment alone: https://academic.oup.com/jsm/article-abstract/12/11/2206/6980064

    Longitudinal study of 55 trans adults that received puberty blockers as kids. Turns out that their well-being is similar to same-age young adults from the general population: https://publications.aap.org/pediatrics/article-abstract/134/4/696/32932/Young-Adult-Psychological-Outcome-After-Puberty

    If you feel that those articles are cherry-picked, here’s a recent literature review: https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/camh.12437?casa_token=0douQYkH2gQAAAAA:_LXV46NipUXSCNWFxYr_dyGbCDEXXpG6wcVXoaTuwyZa57JWjUBoEe85pOSX-44j2a3A1D9YXkmmd48

    Just in case you missed this one earlier, here’s a review of the use of puberty blockers for precocious puberty. It turns out that they are safe and effective and for some reason totally uncontroversial: https://pubmed.ncbi.nlm.nih.gov/19064674/

    We know that these drugs are safe. All of this research took me less than a day to compile. If the author of this article actually wanted to know if these drugs are safe, they would have found all of this information. The reason why they didn’t is because the purpose of that article was to stigmatize providing gender-affirming care to trans kids.