“Withholding puberty blockers with the hopes of preventing children from ever transitioning is fanciful child abuse…”

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In the sane world, Dr. Maura Priest is an assistant professor of philosophy at Arizona State University. At the American Journal of Bioethics Priest argues:

… transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval … Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. … Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.

In the irrational world, Michael K. Laidlaw, Michelle Cretella and Kevin Donovan have written an open peer commentary in regards to Maura Priest’s paper. Laidlaw is a trans obsessed Catholic warrior. Cretella is executive director of the hate group, American College of Pediatricians. Dr. Kevin Donovan is a highly respected medical ethicist at Georgetown University. I had more respect for Donovan before he chose bad company.

According to these three: “watchful waiting with support for gender-dysphoric children and adolescents up to the age of 16 years is the current standard of care worldwide, not gender affirmative therapy”.

Children and adolescents have neither the cognitive nor the emotional maturity to comprehend the consequences of receiving a treatment for which the end result is sterility and organs devoid of sexual pleasure function. To argue that all children who are self-declared as transgendered will be harmed psychologically and physically without puberty blocking treatments is false; the greatest number will be seen to not require this at all.

The Laidlaw group is being disingenuous if not outright dishonest. More importantly, they are dangerous. Dr. Priest correctly posited that gender-affirming therapy “is the established standard of care.” It is supported by the American Academy of Pediatrics and others. The Laidlaw group counters with the “standard of care worldwide.” Worldwide includes Russia, China, the Muslim world and so on. They are being intellectually dishonest.

What they are basically saying is to treat adolescents only with talk therapy because most of them will grow out of gender dysphoria and puberty blockers have undesirable side effects. None of the three actually treat these children or have applicable training and experience. They are agents of the Catholic Church in contrast to being medical advocates for an evidence-based standard of care.

For convenience they are also omitting a trained clinician from the diagnostic process. Children may not have the cognition or maturity to fully appreciate gender-affirming care. That is why a highly trained psychiatrist or pediatrician is so essential. His or her job is to help guide the adolescent and parents based on their best professional judgment.

Part of what the Laidlaw group are saying is correct. Most children do, in fact, grow out of gender dysphoria. However, those are not the children who are being provided with puberty blockers. Children who receive puberty blockers are generally those who have already made a social transition because they are the children with the most acute suffering. The Laidlaw crew would have people believe that the kids transition because of the puberty blockers. The adolescents who do grow out of gender dysphoria are not those in the most severe distress.

Gender dysphoric children are at significant risk for self-harm. Addressing the potential for suicide should be a clinicians first priority. Denying puberty blockers means that these children will develop anatomical features consistent with natal sex. Trans boys will grown breasts while trans girls will develop male adam’s apples.

I cannot speak for Dr. Donovan but I can reasonably assert that the goal of Laidlaw and Cretella is to prevent people from ever transitioning in order to support the teachings of the Catholic Church. Clinicians should not be guided by superstition. Not when the very lives of children are at risk.

When adolescents, through lack of care, acquire gender-antagonistic traits their suffering increases dramatically. This added and unnecessary misery increases the potential for self-harm. (That is just common sense.) Moreover, when they eventually transition, their presentation will be less consistent with their gender and more consistent with their natal sex. This creates lifelong misery.

In conclusion:

  1. The gender-affirming care model is the standard of care in this country and;
  2. Children have an absolute right to receive medical treatment consistent with the established standard of care.

In other words, withholding puberty blockers with the hopes of preventing children from ever transitioning is fanciful child abuse which is not based on the best available science. Fanciful because it would have no effect on which children eventually transition. It is wishful thinking powered by zealous religious beliefs. It has no place in the exam room.

Kids with gender dysphoria have enough problems without adding religious prejudice to their dilemma.

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By David Cary Hart

Retired CEO. Formerly a W.E. Deming-trained quality-management consultant. Now just a cranky Jewish queer. Gay cis. He/Him/His.