Hannah Is a Girl. Doctors Finally Treat Her Like One.

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Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Mon Apr 10, 2017 1:52 am

Came across this in the Sunday New York Times. It is an opinion piece but it describes the new emerging consensus in the medical community on how to treat transgender children. And also where it's going. My own take is, I'm fine with this. If this is what the kids want, what makes them happiest, who am I to gainsay them. What are you going to tell them: "You're a boy goddamn it! Act like one!" On the other hand I suppose one could ask, what if they are really just "going through a phase"? Doesn't this lock in a decision before they are old enough to decide? But apparently in the vast majority of these cases, that isn't what's happening: Transgender kids grow up to be transgender adults. If you are skeptical, read the whole thing, not just the first couple paragraphs.

Hannah Is a Girl. Doctors Finally Treat Her Like One.

NEW HAVEN — Hannah is a 14-year-old girl, clad in leggings and an oversize T-shirt, with long brown hair that she curls around a finger. She was also born a boy.

The government can’t seem to decide whether it should affirm children like Hannah. President Trump jumped from supporting workplace protections for transgender people to ending supportive policies for transgender students in public schools. The Supreme Court waffled on whether or not these kids can use the bathrooms of their identified genders, sending the question back to the Fourth Circuit. Last month, North Carolina repealed a law that forced transgender people to use the bathroom corresponding with the gender on their birth certificates, while strangely prohibiting schools from adopting policies that would let transgender students use the bathroom of their choice.

Politicians could learn something from the doctors who treat these patients. Over the past few years, it has become clear that if we support these children in their transgender identities instead of trying to change them, they thrive instead of struggling with anxiety and depression.

Hannah is using a puberty-blocking implant and getting ready to embark on the path of developing a female body by starting estrogen. Ten years ago most doctors would have called this malpractice. New data has now made it the protocol for thousands of American children.

Being transgender doesn’t affect Hannah much. She is a straight-A student and auditioning for her school’s production of “Annie.” She’s both embarrassed and excited to talk about the two boys who asked her out this year.

“I turned to him and said, ‘You know I’m transgender, right?’ ” she tells me. “He said that he knows I’m transgender and that he also knows I’m pretty and sweet.”

Taking her red cheeks as a sign to change the subject, we switch back to medicine. I feel around her bicep, where a hard rod just beneath her skin releases a drug that turns off the brain cells that would otherwise kick off puberty. The implant has been in place for two years, preventing the process that would have deepened her voice and given her an Adam’s apple. She has been happy with the blocker, but is ready to move on.

“I’m tired of being the only girl in my grade who looks like a little kid,” she says.

She has a point. A review of recent studies suggests we could start cross-sex hormones as early as 14, so that transgender kids don’t suffer the stigma of starting puberty years after their classmates.

As I talk to Hannah, I can’t help thinking how different things would have been just 10 years ago.

Back then, a doctor may have based her treatment on a 2002 manual for the treatment of “gender identity disorder in young boys.” The manual recommends a range of behavioral interventions to force-fit a child into traditional gender roles. They include keeping the child away from typically feminine activities like gymnastics, scheduling more play dates with boys and encouraging “letting go” of the boy by the mother. The hope was that early treatment would “diminish the risk of a continuation of gender identity disorder into adulthood” — in other words, make children stop being transgender. Transgender youth during this time suffered high rates of depression and anxiety. By young adulthood, nearly half had attempted suicide.

Fortunately, most doctors no longer think this way. In 2012, Dr. Diane Ehrensaft from the University of California, San Francisco, proposed “true gender self child therapy,” in which even the youngest children are allowed to explore their gender identity, with all outcomes (transgender or not) being treated as equally desirable.

That’s just what happened with Hannah. At 10, after a yearlong psychological evaluation, she underwent a nonmedical “social transition.” This meant changing her name from Jonah to Hannah, wearing girls’ clothes and using female pronouns. She went from the frustrated boy wearing a yarmulke to the bubbly child wearing a dress and joining the girls’ bunk at summer camp.

At this point, data on the benefits of early social transition is scarce. But this year researchers at the University of Washington published a study based on 63 transgender youth who were allowed to socially transition. They found that their levels of anxiety and depression were just about indistinguishable from their non-transgender peers.

Critics point to flawed studies that suggest that roughly 80 percent of prepubescent children ultimately change their minds about being transgender. Even if this were true, would it have been worth forcing Hannah to live as a boy, putting her at risk for depression and perhaps suicide? Though going back to a boy’s name and boys’ clothes would probably be hard, even a small risk of suicide is scarier.

Once transgender youth hit puberty, their gender identity is unlikely to change. At that point, doctors often consider medical interventions. The puberty blocker is the first step. In the unlikely event that a child were to change her mind about being transgender, we could remove the implant, and she would then go through male puberty. The implant has some mild side effects, most notably a decrease in bone density, but that quickly improves after the removal of the implant or the initiation of cross-sex hormones like estrogen or testosterone.

The effects of cross-sex hormones like estrogen are not easily reversible. The hormones can impair fertility, but transgender teens are offered fertility preservation options before that stage, like freezing sperm or eggs. Surgery, which often follows in young adulthood, is also, of course, essentially permanent.

In a Dutch study of 55 transgender people who were given puberty blockers during adolescence, however, none changed their minds and none regretted treatment. All went onto cross-sex hormones around age 16 and later gender-affirming surgery. Psychological functioning improved steadily over the treatment period, and by the end, metrics of happiness and quality of life were on a par with those of the general population. Larger studies are underway in the United States, and early clinical experience agrees with the Dutch results.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby ed » Mon Apr 10, 2017 1:59 am

"treating her like one"

You mean like pap smears?
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Mon Apr 10, 2017 2:31 am

ed wrote:"treating her like one"

You mean like pap smears?


Nice try Ed. :wink:

No, they don't need pap smears, but then neither do most teenage girls. Current recommendation is starting around age 21:

In the United States, Pap smear screening is recommended starting around 21 years of age until the age of 65. However, other countries do not recommend pap testing in non-sexually active women.[1]


In any case, obviously, there are biological facts that make the sorts of treatments needed different.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Doctor X » Mon Apr 10, 2017 9:06 am

Leaving aside the frankly bullshit way of thinking which has yet to die out--that everyone who is not "like me" must be "sick, depraved, and a MFY fan!"--what is left is the uncertainty that remains in that we can never know what another person is feeling and thinking. This is akin to a "she said/he said" rape accusation. If she is correct, cut his balls off. If he is correct, toss her in jail and force her to make me a sandwich.

We do not know.

With a proper cognitive adult--something I pounded into DanishPedophile's head like he wanted to pound 4 year-olds--if they are "wrong" about their choice well, there you go. As an adult, if I get drunk, and get a tattoo of Anax's Waifu beating sparks with a soba noodle on my tight glistening corps-attracting posterior . . . well . . . I made that decision.

The legitimate "fear" is that one will perform irreversible interventions on someone who is not cognitively an adult. If they change their mind?

To which, I note Anax's Waifu observation that Current Data Suggests[Tm.--Ed.] that truly transgendered children stay transgendered. Pretending that is all correct for the moment, then physicians have the opposite "fear" that by waiting they are doing harm: forcing someone to wait years then undergo multiple surgeries to "correct" what should not have happened in the first place. Surgery is a awesome thing if done for the correct reasons on the correct patient. All surgeries have side-effects and risk. Unnecessary surgery is nothing but risk. "Shaving" an "Adam's apple" reads "routine" and "benign" but it is not necessarily so if it could have been avoided in the first place.

The answer?

If I had that I would not be here masturbating to the fourth quarter and overtime of the last Super Bowl while Mila Kunis fights Mila Jovanovichivichvichthingvhich for the honor of cleaning up afterwards. I would be . . . doing something more constructive like . . . wait. . . .

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Abdul Alhazred » Mon Apr 10, 2017 9:13 am

So if a five year old boy says he's a girl, he makes an absolute moral commitment to be castrated at puberty?

"You're a boy goddamn it! Act like one!" ???

How about reassuring him it's a fine thing to grow up to be a man?

That poor kid being led by doctors and parents to a life of misery and degradation.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Mon Apr 10, 2017 10:02 am

Abdul Alhazred wrote:So if a five year old boy says he's a girl, he makes an absolute moral commitment to be castrated at puberty?


No, that's not what the article says, nor what I'm saying. It is at about the age of puberty when they may start with a "puberty blocker". At this point there is nothing irreversible about it. If they stop taking the puberty blocker then they go through normal puberty according to their biological sex. Then, the thinking is, sometime after age 14 they might start in on "cross-sex hormones like estrogen" whose effects are not easily reversible.

How about reassuring him it's a fine thing to grow up to be a man?

That poor kid being led by doctors and parents to a life of misery and degradation.


Or you are imposing your own preferences on the child. Perhaps the "life of misery and degradation" is the one where they try to be a man to please you, when that is not what they really want. The evidence such as there is, doesn't seem to support your approach.

What makes you suspect that the parents and doctors are choosing this for the child instead of allowing her to choose it for herself?
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby ed » Mon Apr 10, 2017 11:08 am

so not objectively a girl then. Good, thats settled. Perhaps we have some trendy feel good alternate reality goiny on. Thats fine as long as we all know whats what.

Or is it that upon observing another vhuman you have no right to make an assumption about that persons gender? Is using a masculine or feminine pronoun a microagression? Is it evidence of hate if you use such pronouns without permission? It it like a gendered variation of vous and tu?

Remember that feelings only get more hurt, not less.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Rob Lister » Mon Apr 10, 2017 11:24 am

The child seems to want this. The mother and father seem to be on board. It appears to be legal. So ... whatever. But if I were the doctor I'd be concerned about a malpractice suit in the coming decade.

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby ed » Mon Apr 10, 2017 11:29 am

Rob Lister wrote:The child seems to want this. The mother and father seem to be on board. It appears to be legal. So ... whatever. But if I were the doctor I'd be concerned about a malpractice suit in the coming decade.



The potential for abuse is vast. The courts must represent the childs interests
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Abdul Alhazred » Mon Apr 10, 2017 12:49 pm

The New York Times -- Therefore, even if they are being "honest" they are getting all sorts of important details wrong, and to the extent anything technical is involved the reporter doesn't understand the story.

Therefore, I back off (though my general opinion on the subject is provisionally unchanged).

I took the story at face value and went from there. That was wrong.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Mon Apr 10, 2017 12:55 pm

Fwiw, the author of the article isn't a reporter. The Times sometimes publishes contributions from outside people.

Jack Turban is a research fellow at Yale School of Medicine, where he lectures on the treatment of transgender and gender-nonconforming youth.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Abdul Alhazred » Mon Apr 10, 2017 4:35 pm

Anaxagoras wrote:Fwiw, the author of the article isn't a reporter. The Times sometimes publishes contributions from outside people.

Jack Turban is a research fellow at Yale School of Medicine, where he lectures on the treatment of transgender and gender-nonconforming youth.


Emphasis added.

In other words, an interested party pushing an agenda.

I do not hesitate to compare him with Doctor Mengele.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Mon Apr 10, 2017 11:41 pm

:godwin: :godwin: :godwin:
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Doctor X » Tue Apr 11, 2017 6:32 am

Let us be clear, this treatment is not without consequences. You basically alter the natural development of the human body based on how the person feels. In writing that sentence I in no fashion seek to diminish these conditions to some fancy or "feelings." It is clear that the brain and the body does not agree--which is not surprising. The brain does not know how the body is wired.

I think I mentioned in a similar argument with a friend who leans so far conservative Cruz is a Hippy some time ago that he tried to default to "genetics." "What your chromosomes say!"

I then enlightened him on an actress he surely abused himself to in the past who is chromosome-wise a male. Due to a--long story short--mutation in the Androgen Receptor [!--Ed.] she defaulted as we all do to female without developing the internal plumbing.

What is "she?"

All her life she considered herself female and--despite some fantasies involving, say, Michelle Pfeiffer dressed as Catwoman with Salma Hayek pouring mole sauce on them [Get on with it!--Ed.]--has not considered herself attracted to women, herself masculine, or any of that. She only discovered her condition when by about 18 years old she never menstruated.

And we can go on and on.

I would like, Anax-君, [だめよ!--Ed.] to cast aside the prejudice that wishes to pretend these conditions are "mental illness," "a phase," "fag!!" or whathaveyou because they do not want to accept them as simply another version of humanity in all of its wonder and weirdness.

Again, if an adult decides to do something that ultimately proves "stupid," well . . . there you go. The real biological problem is that if the child is correct regarding his gender identity then delaying this treatment is a harm. There is no simple answer, and to paraphrase a Persian saying a colleague would make in such situations: "You try to do good and bugger* an orphan."

Sex is also a biological fact which Mother Nature--that Bitch!--can sometimes cloud. "Sex" becomes an issue medically. Women have conditions and risks which are not the same as men. This crosses with race--black people have certain risks and other races have other risks, blah, blah, blah. One of the challenges of Modern Evidences--Thanks--Based Medicines [Stop that!--Ed.] is to sort out what happens.

Not to get personal, but you may be aware of some interesting changes in risk factors between those who live in Japan and those who live in, say, Des Moines. The "classic" has been a rarity of bowel cancer in Japan but a higher risk of stomach cancer--see 生きる. THAT risk seems to be more environmental/food in that Japanese who move to Des Moines tend to approach the USA!USA!USA! bowel and stomach risks.

What about other "things?" In cases where you have a dominant gene causing a problem, well, it will affect children no matter whom you mate. But in others does, say, your daughter bear your cardiovascular risks being a Round-Eyed Devil Couch Potato Eating Cheezy-Poofs[Tm--Ed.], Her Mom! [Stop it!--Ed.]'s risks being a Japanese woman . . . or your risks being a man . . . or . . . well, either way do not let her smoke, eat lard, and listen to Country Music!

More seriously, just [Dragging from his fundament.--Ed.] making this up, do daughters only carry the maternal risks for breast cancer? Buuuuutttt, mens gets breast cancer too--very rare but, when it happens, very fucking deadly.

Anyways, these are the sort of issues that drive researchers nuts trying to figure out risks. In many cases, "fuck do we know!" is the current answer.

Nevertheless, sorting all of this crap out can run into actual socio-political problems. Do Japanese have a higher level of myopia or is that just a sad racist stereotype? The huge problem is that Those With an Agenda [Racists.--Ed.] will try to turn such into quality judgements. You might be amused that one political faction tried to prevent Hirohito's marriage to . . . to . . . Mrs. Hirohito claiming she was color blind. She was not, ironically as far as anyone can tell. She liked to paint in color.

Avoiding work let us bring this back to the example I cited: does said actress experience the risk factors of a man or a woman? The answer: "fucking depends!" or more technically "fuck if we know!" So does she have Her Mom's breast cancer risks? Does she have more of Her Dad's cardiovascular risks?

This is all a mess and there a no very good answers that will cover all cases and leave orphans sleeping peacefully at night.

The article suggests a study where something like 50 people studied all agreed that treatment and the like helped them. Yay. Critics will cite studies of those who undergo gender reassignment that do not have such a high--100%!--satisfaction. I imagine you can identify the problem with comparing both populations. The bottom line is [ZZzzzZZZzz--Ed.] even if physicians and parents do their best for the sake of the child rather than some Agenda--whatever it is--they may still "bugger an orphan" despite everything. It is a risk we take being humans.

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Abdul Alhazred » Tue Apr 11, 2017 8:53 am

Anaxagoras wrote::godwin: :godwin: :godwin:


Castrating little boys to make a political point.

And maybe also for teh LULz.

Not just Nazi -- Mengele.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Tue Apr 11, 2017 8:59 am

Sure Abdul, anyone who doesn't see it your way is obviously motivated by pure evil.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Abdul Alhazred » Tue Apr 11, 2017 12:33 pm

Anaxagoras wrote:Sure Abdul, anyone who doesn't see it your way is obviously motivated by pure evil.


We're not talking about a mere difference of opinion.

We're talking about a man who castrates little boys for a living and writes a puff piece in the NYT to promote himself.

There's a lot of pure evil out there.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Tue Apr 11, 2017 11:15 pm

Abdul Alhazred wrote:
Anaxagoras wrote:Sure Abdul, anyone who doesn't see it your way is obviously motivated by pure evil.


We're not talking about a mere difference of opinion.

We're talking about a man who castrates little boys for a living and writes a puff piece in the NYT to promote himself.

There's a lot of pure evil out there.


Abdul, you are reacting to this emotionally instead of dispassionately weighing the pros and cons. And you are trying to win the debate by Godwinning the whole thing with your Mengele comparisons. I really don't have any horse in this fight, I'm just trying to see the issue clearly. Now, the doctor may be wrong about all this but I don't think he has evil intentions.

Yeah, I don't know what a person other than myself is truly thinking, and we can't ever be 100% sure that what they think they want now is what they will also want in the future. But ask trans people, adults themselves what they think about it. I'm trying to see it from their perspective here. I seem to remember you once posted some videos from Zinnia Jones here. What do you think she would say about it?
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Doctor X » Wed Apr 12, 2017 3:20 am

Perhaps I missed it, but where does the doctor castrate minors or advocates that procedure?

I am a bit busy [Watching Red Sox pornography.--Ed.] so perhaps my Google-Fu proved ineffective. . . .

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Postby Anaxagoras » Wed Apr 12, 2017 4:15 am

Doctor X wrote:Perhaps I missed it, but where does the doctor castrate minors or advocates that procedure?

I am a bit busy [Watching Red Sox pornography.--Ed.] so perhaps my Google-Fu proved ineffective. . . .

--J.D.


I think that Abdul's position is that giving the hormones is equivalent to chemical castration. I personally don't know enough to say. Does it lead to impotence and/or sterility perhaps? Actual gender reassignment surgery is not being suggested though, until they are an adult.
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