I think the question here is: to what extent should a decision of this magnitude be based on a 12-year-old's feelings?
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Do Extreme Interventions for Trans Youths Save Lives?
- Thread starter icehorse
- Start date
The OP is focused on castration which only applies to males. It does not apply to females.
Some of the references you provide are not from medical science.
You note "chemical castration" by which I assume you mean puberty blockers. By mentioning an easily reversible intervention but then focusing on gender affirming surgery you conflate the two of them.
You also ignore a good standard of care which is not to just jump to castration but to follow a process of therapy. So from my perspective you are arguing against a straw man not against the accepted standard of practice.
Gender-affirming care, as defined by the World Health Organization, encompasses a range of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity” when it conflicts with the gender they were assigned at birth. The interventions help transgender people align various aspects of their lives — emotional, interpersonal, and biological — with their gender identity. As noted by the American Psychiatric Association (APA), that identity can run anywhere along a continuum that includes man, woman, a combination of those, neither of those, and fluid.
The interventions fall along a continuum as well, from counseling to changes in social expression to medications (such as hormone therapy). For children in particular, the timing of the interventions is based on several factors, including cognitive and physical development as well as parental consent. Surgery, including to reduce a person’s Adam’s Apple, or to align their chest or genitalia with their gender identity, is rarely provided to people under 18.
“The goal is not treatment, but to listen to the child and build understanding — to create an environment of safety in which emotions, questions, and concerns can be explored,” says Rafferty, lead author of a policy statement from the American Academy of Pediatrics (AAP) on gender-affirming care.
What is gender-affirming care? Your questions answered
As states move to restrict certain treatments for transgender youth, experts explain the many types of care, the need for them, and their impact.www.aamc.org
Yep, this. The thread is a stark misrepresentation of both medical consensus and supporters thereof, for the reasons you outlined. As such, I don't see it as productive or warranting engagement beyond clarification/refutation of the inaccurate and incendiary rephrasing (e.g., "castration") of the positions of people who, as with any other major medical issue, support listening to thorough, careful professional evaluation when it comes to provision of gender-affirming care (whose guidelines already recommend against irreversible procedures for minors).
metis
aged ecumenical anthropologist
It's not, as the parents and the doctor must be involved.
So the 12-year-old's feelings aren't considered at all?
In that case, what exactly is the decision based on?
metis
aged ecumenical anthropologist
I didn't say nor imply that.
It's something that must be talked about not only within the family but also with the medical community. In most cases, if something needs to be done, usually hormone suppressants are used until the teen gets older.
Yes you did, whether you meant to or not.
I said:
You said:
The rest of that post is apparently meant to explain why /how it's not, but in the context of the question I asked it doesn't accomplish that.
It explains how the decision is made, not what it's based on.
Again, this only explains how the decision is made, not what it's based on.
metis
aged ecumenical anthropologist
When someone is going through puberty, their sexual drive begins to kick in, and sometimes the hormones that generally empower that drive are different from what the genitals seemingly would indicate. However, at 12 it is unlikely that most doctors would be willing to prescribe even hormone suppressants let alone an operation.
A few comments to my multiple worthy opponents:
1 - Please keep in mind the idea of factual claims. It could be that you don't agree with the source of a claim. But that's not a sufficient argument. For example, I hate trump with every fiber of my being. But once in a blue moon, when he was president, he would say a true, useful thing. So much as you might hate the source, you must be able to focus on the claim.
2 - As I said, this thread is a CONTINUATION of previous, long threads. I attempted to summarize those threads here, but summaries - by definition - lose some amount of detail.
3 - Ask yourselves if you accept everything the medical community does without question. Are you happy with prescription drug prices? Do you think that profiteering often occurs? Do you agree that the nutrition guidance the medical community supports is largely influenced by special interest groups? Do you wonder why countries like Japan have almost no incidence of hip or knee replacement surgeries? Are you aware that the standard western high-carb diet plays havoc with blood sugar levels?
Given all these questions (and many more like them), and given the huge money associated with trans health care, why on this particular topic are you willing to buy the party line published by WPATH.
World Professional Association for Transgender Health - Wikipedia
1 - Please keep in mind the idea of factual claims. It could be that you don't agree with the source of a claim. But that's not a sufficient argument. For example, I hate trump with every fiber of my being. But once in a blue moon, when he was president, he would say a true, useful thing. So much as you might hate the source, you must be able to focus on the claim.
2 - As I said, this thread is a CONTINUATION of previous, long threads. I attempted to summarize those threads here, but summaries - by definition - lose some amount of detail.
3 - Ask yourselves if you accept everything the medical community does without question. Are you happy with prescription drug prices? Do you think that profiteering often occurs? Do you agree that the nutrition guidance the medical community supports is largely influenced by special interest groups? Do you wonder why countries like Japan have almost no incidence of hip or knee replacement surgeries? Are you aware that the standard western high-carb diet plays havoc with blood sugar levels?
Given all these questions (and many more like them), and given the huge money associated with trans health care, why on this particular topic are you willing to buy the party line published by WPATH.
World Professional Association for Transgender Health - Wikipedia
Koldo
Outstanding Member
What magnitude? I am talking about puberty blockers. What do you suggest if not basing it on a 12 years old feelings?
metis
aged ecumenical anthropologist
Who's the "you" addressed to?
You know, I largely agree with much of your concerns but I really don't see why you keep going on about WPATH. It's a medical association. It was founded by medical doctors and sexologists. It's not much different from the professional org that oversees the creation of the DSM. There's organizations like this for every specialized field.
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I know, and admittedly I don't know a lot about the topic, but (and correct me if I'm wrong) it seems that their purpose is to suppress or 'skip' puberty all together, and if that's what it is it's a big deal.
If a 12-year-old decides to forego puberty, it's not like the 25 year old he or she is going to turn into can change their mind later.
I didn't say it shouldn't be based on the 12 year olds feelings at all, I was asking 'to what extent'?
Most 12-year-olds don't even know what classes they want to take in college, or even high school, and what we're talking about is a little more involved than say, changing your major.
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I appreciate your thoughtful question!
In an earlier thread I brought up the field of ecological psychology. I'm a science guy. But science has run up against some questions that the typical scientific approach cannot answer. For the most part, science takes a slice and dice, isolate the variables and test one variable at a time sort of approach. For many domains, this works quite well.
But ecological psychology (eco-p) - to summarize - says that you cannot isolate a patient from their environment and hope to get good answers. So an eco-p professional would ask something like this:
We see a huge increase in suicides and suicidal thoughts across ALL teens (trans and otherwise). We see a 2,000% increase in teens identifying as transgender. We know that puberty is a confusing and traumatic period for most teens. We see that the environment teens exists in includes such unhealthy factors as:
- poor diets
- poor air and water quality
- constant bombardment by social media and other forms of powerful propaganda
- the very real threat of environmental disaster
- the rise of post-truth, alternate facts proponents
- obviously poor journalism
- prevalent addiction to smart phones
And on and on.
Given the overall unhealhy environment that teens are awash in, doesn't it behoove us to step back and look at the whole system to see if less invasive interventions are possible?
No doubt that some teens who identify as trans will continue to do so throughout their lives. But without an eco-p approach, we do not know how many times we could avoid chemical castration or surgery and achieve positive healthcare results.
I appreciate your thoughtfulness.
Have you read the wikipedia summary of WPATH carefully? It is a mixed bag.
That's true of many of these organizations, honestly. The American Psychiatric Association has done questionable and even corrupt things, too.
Koldo
Outstanding Member
It delays puberty.
The idea here is that the puberty blockers gives everyone more time.
Koldo
Outstanding Member
What do you suggest? And how could this suggestion preclude taking puberty blockers?
I agree!
My oversimplified, general rule is that all organizations are advocacies
That's not necessarily a bad thing, but it should be acknowledged.
To be quite honest, that sounds more like an American concern (not saying it’s only an American thing, obviously. That happens everywhere.)
The rest of the world doesn’t really question medical associations to such a degree because….well our medicine is largely bought by our government. In my country of Australiastan all medicine usually has to prove to be cost effective before the government even bothers. Private companies might but ehhh
So we don’t really have this cultural “overhanging profit margin affecting results” kind of thing to really worry about.
Not saying our drugs are cheap, probably cheaper than the US, generally speaking, though.
All this verbose crap to basically say, no organisation is without fault. No one will claim otherwise. (Well, I certainly hope so.)
This includes medical associations. But there is still a vast difference between citing a medical community and a news blog with a clear political agenda. Just for example.
One is made up of qualified professionals, who yes are all still fallible and can make mistakes. But still have enough expertise to have their opinion be taken more seriously about their topic of study. The other is a layman often using their own topic of expertise (journalism) to manipulate and even misconstrue actual medical data to fulfil their own goal/s.
Do not allow for the (clearly awful) profitability of US drug companies and their lobbies to allow you to become too cynical towards medical organisations. They’re not all bad
I see. I thought you were trying to say that WPATH is a political activist organization like HRC or GLAAD, so I was just trying to be clear that it isn't.I agree!
My oversimplified, general rule is that all organizations are advocacies
That's not necessarily a bad thing, but it should be acknowledged.