editorial
Cross-sex hormone treatment for transgender children shouldn’t be an option
Published Thursday, 01-Nov-2007 in issue 1036
The stories of parents of transgender children are well-documented thanks, largely, to a 2006 report in The Village Voice that profiled the nation’s youngest transgender girl.
The stories that followed delved deeper into the lives of transgender children and their families – the turmoil and triumphs, the love, acceptance and support, and the fear, heartache and confusion.
Incredulous readers have empathized with families of transgender kids, whose lives have been documented by major media outlets coast to coast.
Certainly, we were stunned and inspired by the courage of these children and their families. We were, however, concerned about one treatment some doctors have prescribed for children as young as 12 years old.
A story in the Oct. 18 issue of the Gay & Lesbian Times reported on a treatment using hormone “blockers” such as Lupron Depot. Lupron Depot and other blockers have been used for decades to delay the early onset of puberty, known as precocious puberty. Now, the drug is also being used to block puberty in transgender children, which allows the child and family time to decide whether the child will fully transition into the opposite sex.
The side effects of the drug are minimal and completely reversible – but they cost a pretty penny, between $500 and $700 per month.
The cost is too much for some families – so they are forced to explore alternatives. One alternative, the treatment we find alarming, is cross-sex hormone treatment, or hormone therapy, which, according to an article in SF Weekly, has been prescribed for some transgender children as young as 12.
In transgender adults, cross-hormone therapy can result in infertility and higher risks for cardiovascular disease, liver disease, diabetes, certain types of cancer and depression. The International Journal of Transgenderism says certain hormones are “less ideal.”
Although the cross-sex hormones are more affordable ($25 - $70 per month) than the Lupron Depot, the effects are irreversible, and can do permanent damage.
For adolescents, cross-hormone therapy requires the consent of a parent or legal guardian, a person who fully understands the ramifications of the treatment. A 12-year-old is not fully capable of understanding the impact infertility, depression or cancer may have on his or her adult life.
Further, according to the article in SF Weekly, a doctor in London was quoted saying that “treatment itself could affect a patient’s gender identity, since adolescence is a key time for brain development and a possible time for a change in perceived gender.”
As a result of a child’s inability to consent, parents are forced to weigh the potential harm of allowing the child to take the cross-sex hormones against the risk of letting the child develop into his or her biological sex – certainly an overwhelming and difficult decision to make.
We understand parents’ fears of letting their transgender children develop physically into their biological sexes – children could face violence or intolerance or be prone to depression or suicide.
But, the dangers of the cross-sex hormone therapy outweigh these risks.
Cross-sex hormone therapy, as a treatment for children under 17, should not be allowed.
Although cross-sex hormones help transgender children develop into their true gender, and help them pass through adolescence, the effects later in life could be devastating. Since 12-year-olds don’t have the capacity to understand battling cancer, infertility or depression later in life while juggling the responsibilities of adulthood, the responsibility lies with the parent to explain to the child why the treatment should be postponed.
The other factors parents worry about – violence, depression, and suicide – are very legitimate concerns, but, they can be addressed by increasing support and resources for transgender children in the family and in the GLBT community.
Children can battle depression and confusion with counseling and support from parents. The dialogue between parent and child should be steady. Many parents of transgender children put the child through counseling, a good way for the child to express the complex feelings that accompany being a transgender youth.
Further, GLBT organizations need to develop resources, safe spaces, for these children to learn and grow in tolerant environments.
The stories we’ve read are, at times, heart wrenching, and, in a perfect world, there would be a safe, affordable treatment for transgender children – but until that treatment is available, parents and doctors should not rely on a treatment that will harm the child in the long run.
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