Trans Kids, Puberty Blockers, and Gender Affirming Care

Journalism

VICE News spoke to 10 researchers who weren’t aware their work was being used for Florida's anti-trans agenda—and said it’s being misrepresented.

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The anti-trans lobby is using bad science to attack vulnerable young people

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Gender-affirming care is medically necessary, evidence-based care that uses a multidisciplinary approach to help a person transition from their assigned gender -- the one the person was designated at birth -- to their affirmed gender -- the gender by which one wants to be known.

health, What is gender-affirming care? - CNNArchivedRead

Videos

Politics

“It’s certainly not just us as parents making random decisions for our child, deciding, hey I’m going to do this. Everything is really thoughtful, intentional.”

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Misinformation about a spa in Los Angeles was amplified by anti-trans and far-right groups across the globe, leading to abuse of trans women in LA

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Activists are beating back Republicans’ virulent attacks on trans rights. But the battle is costing the trans community.

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A new wave of legislation seeks to enshrine an evangelical understanding of the gender binary and exclude transness from the public sphere.

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In states across the US, conservatives are pushing to ban gender-affirming healthcare and limit trans kids’ access to sports teams

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The Tavistock gender identity unit is preparing to appeal against a court decision that resulted in it being unable to prescribe puberty-blockers to people under 16. The Observer writer offers a heartfelt defence of the right of young people to choose this treatment

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The ACLU's Chase Strangio reflects on what he's learned fighting transgender discrimination in the legal arena, especially attacks on trans youth.

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Fifteen states have enacted or are currently considering laws that would restrict medical treatments to more than 58,000 transgender youth.

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Dr Sandra Duffy comments on the English High Court ruling on children's access to puberty blockers, the subject of today's case summary. The High Court this week handed down its judgment in the case of Bell v Tavistock NHS Trust, which case concerned a judicial review of the practice of the Tavistoc

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Science

'We should haven’t to prove that we’re really a certain gender in order to be treated like a person'

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Though often discussed as a discrete event, puberty comprises one segment of a larger developmental continuum and is notable for rapid transformation …

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Entering puberty at a relatively young age is often thought to be associated with negative outcomes, such as poorer cardiovascular and psychosocial he…

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Adolescence: Vulnerable Period for Stress-Induced Prefrontal Cortical Function? Introduction to Part IV

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057016/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/

https://www.scientificamerican.com/article/anti-trans-laws-will-have-a-chilling-effect-on-medicine/

Buying time or arresting development?

We welcome the opportunity to comment on the concerns raised on the use of the hypothalamic blocker, the gonadotropin-releasing hormone (GnRH) analogue, to pause pubertal development in young people who have been assessed as having gender dysphoria and to extend the information presented in our recent review.1 It is important in the first instance to note that transgender identities have been documented across many different societies and historical time. Nowadays, more and more people are challenging the rigid articulation of sex and gender prescribed by many cultures and voicing an incongruity with their biological sex. Internationally, a meta-analytical study reported the prevalence of ‘transsexualism’ was 4.6 in 100 000 individuals: 6.8 for transwomen and 2.6 for transmen; time analysis found an increase in reported prevalence over the last 50 years.2 We may not understand exactly why this happens, but evidence from twin studies and brain differences, although tentative, suggests at least in part a biological component to gender diversity. To account for a strongly felt, unwilled, human capability like gender dysphoria, we probably need multiple-level explanations where the social and the biological intersect.One of the principal impressions in meeting young transpeople is the frequent intense distress caused by the body they experience as …

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As a traditionally underserved population that faces numerous health disparities, youth who identify as transgender and gender diverse (TGD) and their families are increasingly presenting to pediatric providers for education, care, and referrals. The need for more formal training, standardized treatment, and research on safety and medical outcomes often leaves providers feeling ill equipped to support and care for patients that identify as TGD and families. In this policy statement, we review relevant concepts and challenges and provide suggestions for pediatric providers that are focused on promoting the health and positive development of youth that identify as TGD while eliminating discrimination and stigma.

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Chen, D., et al. (2020) Evaluate Neurodevelopmental Effects of Pubertal Suppression in Transgender Youth. Transgender Health.

A new, unsubstantiated label is being given to transgender youth that suggests they falsely believe they are transgender due to social influence, trauma, and experiences of sexual objectification.

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Adolescents with gender dysphoria (GD) may be treated with gonadotropin releasing hormone analogs (GnRHa) to suppress puberty and, thus, the developme…

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Gender affirmation is multidisciplinary treatment. Gender-dysphoric/gender-incongruent persons seek and/or are referred to endocrinologists to develop the physi

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Introduction: Gender dysphoria (GD) (DMS-5) is a condition marked by increasing psychological suffering that accompanies the incongruence between one's experienced or expressed gender and one's assigned gender. Manifestation of GD can be seen early on during childhood and adolescence. During this period, the development of undesirable sexual characteristics marks an acute suffering of being opposite to the sex of birth. Pubertal suppression with gonadotropin releasing hormone analogs (GnRHa) has been proposed for these individuals as a reversible treatment for postponing the pubertal development and attenuating psychological suffering. Recently, increased interest has been observed on the impact of this treatment on brain maturation, cognition and psychological performance.Objectives: The aim of this clinical report is to review the effects of puberty suppression on the brain white matter (WM) during adolescence. WM Fractional anisotropy, voice and cognitive functions were assessed before and during the treatment. MRI scans were acquired before, and after 22 and 28 months of hormonal suppression.Methods: We performed a longitudinal evaluation of a pubertal transgender girl undergoing hormonal treatment with GnRH analog. Three longitudinal magnetic resonance imaging (MRI) scans were performed for diffusion tensor imaging (DTI), regarding Fractional Anisotropy (FA) for regions of interest analysis. In parallel, voice samples for acoustic analysis as well as executive functio...

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Background In adolescents with severe and persistent gender dysphoria (GD), gonadotropin releasing hormone analogues (GnRHa) are used from early/middle puberty with the aim of delaying irreversible and unwanted pubertal body changes. Evidence of outcomes of pubertal suppression in GD is limited.Methods We undertook an uncontrolled prospective observational study of GnRHa as monotherapy in 44 12-15 year olds with persistent and severe GD. Prespecified analyses were limited to key outcomes: bone mineral content (BMC) and bone mineral density (BMD); Child Behaviour CheckList (CBCL) total t-score; Youth Self-Report (YSR) total t-score; CBCL and YSR self-harm indices; at 12, 24 and 36 months. Semistructured interviews were conducted on GnRHa.Results 44 patients had data at 12 months follow-up, 24 at 24 months and 14 at 36 months. All had normal karyotype and endocrinology consistent with birth-registered sex. All achieved suppression of gonadotropins by 6 months. At the end of the study one ceased GnRHa and 43 (98%) elected to start cross-sex hormones.There was no change from baseline in spine BMD at 12 months nor in hip BMD at 24 and 36 months, but at 24 months lumbar spine BMC and BMD were higher than at baseline (BMC +6.0 (95% CI: 4.0, 7.9); BMD +0.05 (0.03, 0.07)). There were no changes from baseline to 12 or 24 months in CBCL or YSR total t-scores or for CBCL or YSR self-harm indices, nor for CBCL total t-score or self-harm index at 36 months. Most participants reported positive or a mixture of positive and negative life changes on GnRHa. Anticipated adverse events were common.Conclusions Overall patient experience of changes on GnRHa treatment was positive. We identified no changes in psychological function. Changes in BMD were consistent with suppression of growth. Larger and longer-term prospective studies using a range of designs are needed to more fully quantify the benefits and harms of pubertal suppression in GD.### Competing Interest StatementPC is Director of the Gender Identity Development Service at the Tavistock and Portman NHS Trust. All authors state they have no competing interests. No funding was obtained for this work.### Funding StatementNo funding obtained for this work### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethical approval for the study was obtained from the National Research Ethics Service (NRES: reference 10/H0713/79) in February 2011. Study consent allowed the use of routinely collected clinical data (medical and psychological) as part of clinical treatment for the study. Study procedures including consent were reviewed by the UK Health Research Authority.All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAppropriate anonymised data will be placed on public access after publication

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Consensus Parameter: Research Methodologies to Evaluate Neurodevelopmental Effects of Pubertal Suppression in Transgender Youth

Gender Affirming Care Decreasing Suicide

Anti-trans bills send a clear, harmful message to trans youth that they are not welcome in society, furthering feelings of isolation and rejection.

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Executive Summary

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When transgender youths have access to a puberty blocker, their chances of suicide and mental health problems in the immediate term and down the road decline significantly, a new study finds.

health, Puberty blockers can be 'life-saving' drugs for trans teens, study shows - CNNReadArchived

This cross-sectional survey study examines the association of childhood and lifetime recalled exposure of gender identity conversion efforts by both secular and religious professionals with adverse mental health outcomes in adulthood within the previous year and during their lifetime.

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Impacts of Strong Parental Support for Trans Youth

Perspectives of Transgender Youth on Parental Support

Useful Additional References

In recent years, trans people and issues have become hypervisible in the media. While many outlets have published some thoughtful, accurate stories, too much of that coverage has failed their audie…

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@reubsjw: So, a lot of people are giving some pretty uninformed takes about puberty blockers based on the pretty uninformed take about puberty blockers contained in the Cass Review interim report. As someone who stud...…

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Trans women are women. This is not up for debate – so don’t try to.

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This site memorialises trans people who have passed away, as a supporting resource for the Trans Day of Remembrance (TDoR).

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Image stating 'Trans Lives are not a Debate'

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