60 Minutes failed to focus. It introduced content that had no relevance to its intended subject.
I did not watch 60 Minutes on Sunday but a couple of readers alerted me to the content. A transcript of the coverage of transgender medicine is here.
The segment was titled:
State bills would curtail health care for transgender youth
Lesley Stahl reports on the spate of legislation being introduced in states that would limit care for transgender youth.
It was supposed to be about unconscionable legislation that will adversely affect children. Instead, they aired a debate on the appropriateness of gender-affirming care.
For some reason a producer at 60 Minutes decided that the report should include desisters. These are adults who transitioned as adults and desisted as adults. That has no relevance to gender incongruent children:
“For political advantage — appealing to the Trump base — politicians are putting the lives of children at risk.”
- Prepubescent children receive no medications whatsoever. They transition through hair and attire.
- After adolescents enter puberty they might receive puberty blockers. According to the Endocrine Society — the acknowledged experts — puberty blockers are fully reversible.
Usually between ages 14 and 16, patients still look prepubertal compared with the maturity of their peers. Although the delay can be psychologically challenging for the patients who may desire to look like their preferred genders, the slowdown gives them an opportunity to reconsider the transition. GnRH analogues are reversible. Cessation of them usually results in patients restarting their genetically intended puberty within six months.
- Only in their later teen years might adolescents receive cross-sex hormones. Typically, this requires the approval of:
- A behavioral health specialist; possibly two.
- An endocrinologist who will administer the medication.
In contrast, young adults might not be as careful in choosing a provider as the parents of child in distress. One of the desisters even mentioned that her provider did not follow WPATH guidelines. Parents will be naturally reluctant to approve medications and that’s a good thing.
Parents also get second opinions. Young adults might not get second opinions because they are predisposed to believing that transitioning will solve all of their problems. An adult visiting an endocrinologist might receive hormones without the necessary psychiatric evaluation.
Furthermore, one of the desisters had surgery. Children are not candidates for surgery.
“What happened to the parental rights that are a fetish for the religious set?”
The other problem that 60 Minutes introduced is the question of a representative sample. The show tried, but failed, to stress that desisters are a minuscule portion of the gender-diverse community.
There are about 1.4 million transgender persons in the United States. Three people who might have been ill-served by their doctors is not a representative sample. It is actually quite meaningless.
Are there mistakes? Sure. Are there desisters? Of course. However, gender-affirming care saves lives. That is particularly true in regards to gender incongruent children.
If people would utilize the services of a teaching hospital they would be more likely to receive the care they require. The reason for that is two-fold. First, people will be treated by a team of clinicians rather than an individual doctor.
Secondly, many teaching hospitals — perhaps most — have what Mt. Sinai in New York calls its Center for Transgender Medicine and Surgery. Every person providing care from that center has training specific to transgender medicine.
These programs are not limited to more progressive locals. For example, there is the Trans Health Program at University of Utah Health. Even in Alabama, one can find quality LGBTQ care. Mississippi? You bet.
60 Minutes had the potential to provide a valuable segment. State legislators — none of whom are transgender medical specialists — are irresponsibly trying to pass laws restricting trans care for children. This is the care that constitutes the clinical practice standard of the American Academy of Pediatrics.
For political advantage — appealing to the Trump base — politicians are putting the lives of children at risk. What happened to the parental rights that are a fetish for the religious set?