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2014-09-13 Puberty suppression helps transgender youth

posted 13 Sept 2014, 06:09 by Cake Kidd   [ updated 21 Sept 2014, 02:02 ]

Heya everybody,

I still have to get my brain in gear and work through the 29 links and articles I’ve collected over the past few weeks, but I did want to give a quick update on a couple of very relevant studies.

The well-known Dutch research team (this study was done by Annelou L.C. de Vries, Jenifer K. McGuire, Thomas D. Steensma, Eva C.F. Wagenaar, Theo A.H. Doreleijers and Peggy T. Cohen-Kettenis) has just published an article in the journal “Pediatrics”.
Their study assessed 55 transsexuals at various stages during adolescence. The first assessment was made at a mean age of 13.6 years, the last one at 20.7 years, covering more than seven years on average. During this time, patients received puberty blockers, hormone treatment and gender reassignment surgery.

And the result was … “gender dysphoria was alleviated and psychological functioning had steadily improved. Well-being was similar to or better than same-age young adults from the general population. Improvements in psychological functioning were positively correlated with postsurgical subjective well-being.”

The website “2 minute medicine” has a nice write-up about this study, including an interview with Annelou de Vries.

This is the first long-term study evaluating the so-called “Dutch protocol” (i. e. treatment of adolescent youth with puberty blockers at the onset of puberty, followed by hormone treatment and surgery when the diagnosis is stable and the patient is sufficiently mature). It puts the standard medical treatment of transsexuals on an even more soundly scientific footing which is important to ensure that treatments are evidence-based and thus actually work.

Since the scientific evidence has become better and better, some opponents of treatments for transsexuals have withdrawn themselves to the position that surgery might show positive results in the short term, but provides no benefits long-term. Even this position is based on a biased an interpretation of data apparently cherry-picked for the purpose (see my blog entries from 17th August 2014, 5th July 2014 and 25th of June 2014). Some, like Paul McHugh, still believe against all evidence that gender dysphoria is a symptom of a mental illness that can not be improved by the standard treatments of hormones and surgery.

Naturally, for all human conditions that reduce quality of life, it is important to collect evidence on what measures lead to improvement. It’s a moral obligation to study benefits and downsides for all medical treatments, to make sure both the patient and society profits. However, to study the best treatment for transsexuals is of even bigger importance, since a large part of the suffering that transsexuals experience comes from discrimination by others. Public debate and awareness is necessary to educate society about gender dysphoria and to increase the level of tolerance and acceptance. That’s why studies on how to treat transsexualism are doubly beneficial: they ensure effective treatment and can help in the public debate.

Note that the study mentioned above finds that well-being of treated transsexuals was similar to or better than the control group. This adds further evidence that gender dysphoria is caused by the mismatch between gender identity, physical gender and gender role (gender role including acceptance and recognition by society). Since the transsexuals of the study were treated at a young age, they didn’t have the awful experience of going through a puberty changing their body to the wrong gender, and didn’t have to suffer society’s reaction to their misaligned physical gender and gender role. This gives hope that in the future, transsexualism will not be a problem anymore at adult age – just like crossed eyes, cleft lips, flat feet and other conditions, it will be cured in childhood or adolescence.

If you like to read more on the treatment of gender dysphoric adolescents, Kristin Guy has published a master thesis at the California Statue University (2014), which evaluates the experience of parents and their treansgender youth. Its key findings are that social support, acceptance from friends and family and transition are beneficial and increase well-being.

So, that’s me for today … I’ll add the above mentioned articles to the website tomorrow. In other news, Google Chrome does now display fonts better... yay... but I still haven’t solved my fonts problem on Apple’s Safari browser... booo....
Take care and be well!

Oh, maybe one more thought on the people arguing against treatment for transsexuals … decent people have known since Socrates (and probably before) that it is a sign of intelligence to know the extent and limits of one’s knowledge. It’s really easy … if you don’t know much about a subject, don’t make judgements on the matter and don’t hold strong opinions … and do not discriminate and malign people you don’t understand. Remember, in the age of information, ignorance is a choice. If you are unfamiliar with something, that’s fine, but do not let your ignorance harm anything or anybody other than yourself.