The Guardian: Joe Biden's gender discrimination order offers hope for young trans athletes - Discussion Thread

[CousinsCowgirl84]

I don’t think the government should be telling an adult (18) what they can do with their body and I don’t think the government should be telling what parents can choose allow their children to do, as long as it’s consistent with whatever trained medical professionals think is better for their health.
 

But calling it genocide is over the top.

[Renegade7]

29 minutes ago, CousinsCowgirl84 said:

I don’t think the government should be telling an adult (18) what they can do with their body and I don’t think the government should be telling what parents can choose allow their children to do, as long as it’s consistent with whatever trained medical professionals think is better for their health.
 

 

Does that include making sure it's safe in the first place, like FDA approving puberty inhibitors for transgender youth?

 

29 minutes ago, CousinsCowgirl84 said:

But calling it genocide is over the top.

 

Totally agree, it doesn't help the discuss at all.  There are a lot of people with reservations on this topic, broadly painting them all with the same bigot brush is wrong.

[TD_washingtonredskins]

On 8/21/2022 at 12:16 PM, TradeTheBeal! said:

 

I have to imagine that's an offensive comparison to anyone who has ties to European Jews from that time period. Both in the scale and the way they are being treated, this comparison is ridiculous. 

[CousinsCowgirl84]

9 minutes ago, Renegade7 said:

 

Does that include making sure it's safe in the first place, like FDA approving puberty inhibitors for transgender youth?

 

of course.

9 minutes ago, Renegade7 said:.

 

[Renegade7]

@CousinsCowgirl84

 

Seems like we agree that government having the final say on if someone should have the procedure or treatment is not the same as making sure it's safe in the first place. Cool cool.

 

I'll be honest, my stance is maybe clouded by what would I do if my child told me they wanted this.  Right now, I would support them best I can up to the point of the physical conversion while they were still a child, and let them make that call themselves as adults (can't stop them anyway).

 

Maybe I'll feel differently 16-18 years from now about what I'd do between 18-25 if they still wanted to do it, right now I'm reading it's expensive AF and typically not covered by insurance, so I wouldn't want them to go into medical bankruptcy jus to do this (lean towards asking then to wait until 25 and ill help pay for it).

 

 

 

 

Edited August 23, 2022 by Renegade7

[tshile]

2 hours ago, The Evil Genius said:

Of course, prohibiting people under 25 medical care to transition can and will create more lifelong mental health disorders for those people under 25. The stress and stigma of being prohibited to transition isn't something to just ignore.

 

Fwiw I generally side with medicine and if the AMA thinks these anti- transition positions are wrong and more harmful to minors, then I believe them. 

I would add the AAP for the youngins, but otherwise, yeah this is where I fall with things. 
 

start with the people formally trained and educated on the subject matter, and move from there. 
 

 

[TradeTheBeal!]

1 hour ago, TD_washingtonredskins said:

I have to imagine that's an offensive comparison to anyone who has ties to European Jews from that time period. Both in the scale and the way they are being treated, this comparison is ridiculous. 

The 1930’s were different than the 1940’s.  But don’t worry superdad, you’ll find yourself in the 40’s soon enough.

[CousinsCowgirl84]

43 minutes ago, Renegade7 said:

@CousinsCowgirl84

 

Seems like we agree that government having the final say on if someone should have the procedure or treatment is not the same as making sure it's safe in the first place. Cool cool.

after you’re an adult you should be able to do what you want with your body, safe or not. I don’t want some wacko parent doing damage to their kid (not specifically regarding this but also vaccines, alternative treatments ect)

43 minutes ago, Renegade7 said:

 

 

 

[Renegade7]

4 minutes ago, CousinsCowgirl84 said:

after you’re an adult you should be able to do what you want with your body, safe or not. I don’t want some wacko parent doing damage to their kid (not specifically regarding this but also vaccines, alternative treatments ect)

 

I see...

 

I also would like clarification from the government, also listening to experts on matter, to help act as an authoritative voice regarding if something is safe or not.  On multiple topics, that'd the FDA's job.

 

I may lose concerning my stance of requiring age 25 before doing any physical sexual conversion treatment or operations.  Open to compromise of 18, I can't support allowing for kids, bridge too far for me right now (but listening).

[tshile]

Just now, Renegade7 said:

 

I may lose concerning my stance of requiring age 25 before doing any physical sexual conversion treatment or operations.  Open to compromise of 18, I can't support allowing for kids, bridge too far for me right now (but listening).

Between the developmental changes as well as mental changes, it’s hard for me to support too. 
 

but. I recognize I have no experience with this. 
 

i have young children. The stories of the people with a 5 year old (or whatever) that was “sure” about this sort of thing… it doesn’t make sense to me. 
 

i, personally, would prefer we find a way to socially accept them (so we tackle the suicide and mental issues aspect) instead of tackling what age surgery/medicine/etc is appropriate….

 

of course I feel the same way about the sports issue. 
 

seems like bulk of people prefer to just pick a side and entrench themselves there 

[The Evil Genius]

Actress Nicole Maines is probably the best example I am familiar with. She knew she was female as early as 3 and had to wait until post high-school to have the gender confirming surgery, despite legally changing her name much earlier and living as female through most of her school years. 

 

I personally can't imagine what that does to someone psychologically knowing that they have to wait until they're 25.or 18..or whatever to make the change official. 

 

https://www.hollywoodreporter.com/news/general-news/transgender-supergirl-actress-nicole-maines-her-transition-1150522/

 

https://www.washingtonpost.com/sf/national/2015/10/19/becoming-nicole/

Edited August 23, 2022 by The Evil Genius

[bcl05]

The idea that since the use of puberty blockers for trans minors is "off label" and therefore outside the mainstream or "experimental" is absolutely wrong.  Many, many medications were not formally tested in children, because Pharma companies don't want to study kids (for many reasons - it is more complex from a norms/variables standpoint, the dosing changes by age/size are more complex, the consent issues are more complex, etc), so the FDA applications are very commonly for ages 18+.  I prescribe many medications to children that are technically "off label" but are standard of care and have been for many years.  

[tshile]

59 minutes ago, bcl05 said:

The idea that since the use of puberty blockers for trans minors is "off label" and therefore outside the mainstream or "experimental" is absolutely wrong.  Many, many medications were not formally tested in children, because Pharma companies don't want to study kids (for many reasons - it is more complex from a norms/variables standpoint, the dosing changes by age/size are more complex, the consent issues are more complex, etc), so the FDA applications are very commonly for ages 18+.  I prescribe many medications to children that are technically "off label" but are standard of care and have been for many years.  

i understand that, but it doesn’t do much to alleviate my concerns about the appropriateness/safety of doing things at such a young age. 
 

Although, as a quick question, you mention that the pharma companies don’t do it, but I image the doctors working the area have something they’re relying on for guidance based on research (evidenced-based etc)? I would assume as much but wanted to ask

 

(I’ve read your posts - I wouldn’t dream of arguing with you on the subject, don’t want it to come across that I am…)

 

[bcl05]

1 hour ago, tshile said:

 

Although, as a quick question, you mention that the pharma companies don’t do it, but I image the doctors working the area have something they’re relying on for guidance based on research (evidenced-based etc)? I would assume as much but wanted to ask

 

 

 

There are a lot of different ways that these things get established, hard to have a sweeping generalization.  Sometimes, there are randomized controlled trials in children that really establish with good scientific rigor the best practices, even if a medication remains "off label."  Sometimes the disease process in children is similar enough to adults that we can just use more size/age based dosing for the same indications as in adults.  Sometimes, the pathophysiology/mechanism of disease is very different and we need to make bigger jumps in reasoning.  

 

Often there may be practice guidelines, case reports, clinical trials, etc, that can establish best practices that are really a separate process from FDA labeling and approval.  Sometimes we are very sure that the medications we use are the right ones, and sometimes we are just making our best, most educated guess.  

 

Regarding hormone blockers, the idea of waiting til after puberty and some marker of adulthood would be, in my view, a huge disservice to these patients.  The entire point of these treatments is to conform their external bodies to their view of their gender.  The simplest and least damaging way of doing that, in my view, is to block puberty from happening in a discordant way from their identified gender in the first place.  The alternative is doing bigger and more dangerous and more painful and less effective surgeries after discordant puberty, not to mention the psychologic/psychiatric toll of going through a discordant puberty.  The American association of pediatrics and American psychiatric association have both been very clear that we think this the way of doing the least harm for these patients and giving them the best chance at doing well as adults.  It certainly won't be the best option for everyone, and being trans is going to be challenging regardless of how we treat, but every expert I know who cares for these patients feels passionately that we need to be doing more for them as children and adolescents, not less.  I don't personally see many trans patients, but I'm close friends with some MDs who do, and they all feel very strongly about it.  

[tshile]

57 minutes ago, bcl05 said:

Regarding hormone blockers, the idea of waiting til after puberty and some marker of adulthood would be, in my view, a huge disservice to these patients.  The entire point of these treatments is to conform their external bodies to their view of their gender.

That’s about the extent of what I know about it all, this part right here. 
 

my reservations are about the idea of making such a decision at such a young age. 
 

but, I feel/believe my obligation is to what’s best for them. 

the reality is we have a political dynamic where only one party advocates for anything for this group and the other (at best) has no positive ideas. So it’s not like there’s a tough choice to make when voting - only one side even recognizes the people and attempts to give a solution to the problem. So, doesn’t really matter what my reservations are. 

 

🤷‍♂️ 

[TD_washingtonredskins]

2 hours ago, TradeTheBeal! said:

The 1930’s were different than the 1940’s.  But don’t worry superdad, you’ll find yourself in the 40’s soon enough.

 

I understand that, TTB. I appreciate the snark but it's still a ****ty comparison. For one, you're talking about less than half of 1% of the population. Secondly, nothing is being taken away or stripped from those people. There is simply a large contingent of the population that doesn't want to re-do decades of societal rules to bend to that small percentage. 

 

And, for those about to say "yeah, for now...just wait" I truly do not see a day where they are forced into camps or anything like that and I don't think you do either. Not being able to choose your locker room, sex, or dressing room isn't persecution. It's not being given special privileges. So, I stand by the statement that it's an insulting and offensive comparison...1930s or 1940s. 

[Cooked Crack]

 

[bearrock]

Why would a blanket rule based on arbitrary age be a better approach than individualized decisions that involves parental and medical input?  If the choices are blanket ban based on age vs an unequivocal right of minors to make decisions regarding transition, it may be difficult.  But that's a false dichotomy. 

 

Much better approach would be mandatory medical consultation combined with parental consent that may be affirmed or overriden in clear cases where parents are acting contrary to the child's best interest.  I can also see merit in an argument where mental health professionals may be too willing to conclude gender dysphoria without considering alternate explanations and/or procedures that is not permanent.  But a blanket ban based on age?  Maybe it might be justifiable in a society where everyone works like hell towards a gender-blind society.  (A big maybe at that)  I don't think that's the US right now.

[Larry]

Just observing, our society currently has age-based bans for many activities. Activities that are considerably less life-altering than removal and disposal of the reproductive system. 
 

And I can point that out, without agreeing with the people who are simply trying to ban the icky people they don't think society should allow to exist. 

[bearrock]

49 minutes ago, Larry said:

Just observing, our society currently has age-based bans for many activities. Activities that are considerably less life-altering than removal and disposal of the reproductive system. 

 

First, just because ban based on age alone have been implemented in other areas doesn't mean those are necessarily correct decisions.  Second, do any of those age banned activities involve denying appropriate medical treatment?  What age based ban without exception has the potential to cause active harm while the person waits for the age ban to expire?  

[Larry]

Pointing out, it's an elective medical procedure. The term "cosmetic" might fit, too. 
 

Should there be a right to piercings or tattoos?  
 

----

 

And again. I'm not trying to pain an equivalence between those. 
 

One thing I'm constantly reminding myself of. Show me somebody who wants to have his **** cut off, and I will absolutely not dismiss it as a casual thing. Nor assume that said person has not put a lot of thought into it. 
 

It's not something that somebody just decides to do, for giggles. 
 

Just saying that I can also see the argument that someone who cannot get a credit card or a piercing, because society has decided that people of that age cannot be considered competent to make a binding consent, can't consent to gender reassignment, either. 

[The Evil Genius]

So no piercings or tattoos until you're 25 then?

 

Cool. 

[bcl05]

I don't think that trans people would consider gender-affirming care "elective" or "cosmetic."  There is extremely clear evidence of the significant burdens of untreated gender dysphoria, including an extremely scary suicide rate.  These symptoms, including depression and suicidality, are dramatically improved with gender-affirming care.  Some would (convincingly, to me), consider this medical care life-saving.  Comparing it with tattoos and piercing seems callous and ignores the experiences of trans people.  

Edited August 26, 2022 by bcl05

[bearrock]

2 hours ago, Larry said:

Just saying that I can also see the argument that someone who cannot get a credit card or a piercing, because society has decided that people of that age cannot be considered competent to make a binding consent, can't consent to gender reassignment, either. 

 

Again, therein lies the false binary choice.  It's not blanket ban vs whatever the minor decides.  You can bring in medical experts, parents, court system, any number of societal actors who are handed the responsibility of making big, life altering decisions on a day to day basis.  By issuing a blanket ban on transitioning based solely on age, the law would be forbidding transitioning even in cases where any self respecting experts, parents, and judges would agree that the minor's best interest is served by allowing the procedure.

[CousinsCowgirl84]

12 minutes ago, bearrock said:

 

Again, therein lies the false binary choice.  It's not blanket ban vs whatever the minor decides.  You can bring in medical experts, parents, court system, any number of societal actors who are handed the responsibility of making big, life altering decisions on a day to day basis.  By issuing a blanket ban on transitioning based solely on age, the law would be forbidding transitioning even in cases where any self respecting experts, parents, and judges would agree that the minor's best interest is served by allowing the procedure.

These things have costs though, vs Larry’s simplified (if suboptimal) age limit. Who do you think should be responsible for those costs? The court system is already over taxed…

Edited August 26, 2022 by CousinsCowgirl84