[Georgelemental]

Puberty is an incredibly complicated process, involving innumerable intertwined signaling pathways, gene expression changes, physical and mental changes, etc. We are only beginning to understand it all; to think we can just "pause" it like an MP3 player is the height of hubris. These experimental treatments have many potential negative side effects, including osteoporosis and infertility. Teenagers who feel insecure about their bodies (which is totally normal at that age) are being pressured and induced into potentially destroying their future at an age where they are not mentally mature to make these permanent life-altering decisions. Many will sorely regret it, some will even take their own lives. A tragedy in the making

[stubybubs]

Everything in the body is complicated. The history of medicine is rife with unintended consequences. Many body altering surgeries are entirely useless and dangerous. Over 40% of antibiotic prescriptions are off-label and fully 75% of all prescriptions in pediatric populations are off-label, all of those prescriptions being administered by definition at a time of great growth and change in the body.

And yet it's only this that people are talking about. It's bad faith. If you really want to shut this particular thing down for the reasons you've given then you would shut down most of medicine, and virtually all care for pediatric populations.

Edit: yes I am a doctor

[jfengel]

Indeed. We value evidence-based medicine, especially when it comes to rejecting interventions that have been demonstrated not to work. As has been said, the name for "alternative medicine that actually works" is "medicine".

But a surprising amount of "medicine" is less well evidenced than we'd like it to be. That's not the same as demonstrably-false, but nowhere near the rock-solid gold-standard of testing. But we don't stop using it, because suffering patients can't wait while we straighten out the epistemological mess.

The best one to make a decision is a doctor, who has both the education required to understand the state of the art, and the details of the patient in front of them. They can combine that with their experience to make the best decision possible. It won't always be perfect, but it's got more likelihood than people guessing about what they think medicine is about.

[theprincess]

And yet, Lupron has been used since the 1970's to treat precocious puberty and every single ban on using it for gender affirming care still allows it to be administered for that purpose. Medical associations also approve its use, in both cases.

When the people against it are only against it for one group of people, and doctors by and large disagree with them, it makes me suspicious that their motives are not based in concern for health and instead are based on personal feelings that are being projected onto an external cause.

[somedude895]

> only against it for one group of people

People aren't against any group of people, they're against administering a damaging and potentially life-ruining treatment to perfectly healthy children.

[theprincess]

Children with gender dysphoria are not "perfectly healthy."

They have a serious problem. The level of hubris in assuming that all these heterosexual parents, many of them conservative, would just up and decide to "trans" their kids is outstanding.

Whatever makes people trans is immutable. Every possible way has been tried to "fix" them, by making them happy as their assigned sex. All the attempts just led to broken people, many of whom killed themselves.

The gall to just insert yourself into the lives of these kids and their families, without understanding their struggles or knowing them, and trying to take away the one proven path to them having a happy successful life is really something to behold.

[TRiG_Ireland]

You're perfectly happy to give it to cis kids, but not to trans ones. Why?

[pritambaral]

> ... are being pressured and induced into ...

Citation needed.

[glimshe]

Agreed. We've created societal structures and cultural norms that have survived thousands of years to deal with teenagers, which have existed and behaved like teenagers since the dawn of humankind. Our civilization exists because of the systems that we put in place, good or bad, and they allowed us to not only survive, but also thrive. Our thriving included getting rid of many bad ideas and norms along the way.

Whenever we want to experiment with radical changes in our systems, we need to be very careful. New radical approaches lack the test of time, and should be introduced carefully when there is potential for widespread negative impact.

Today we're saying that a large number of teenagers actually would be better off with a permanent change in gender. This extraordinary claim, which goes against biology and our established cultural norms, could be true but we have to recognize it as extraordinary and approach with extreme care. Maybe one day we'll figure out how many teenagers actually would benefit from this, but right now it's clear to me that we're just going all-in on an untested paradigm with great potential for irreversible pain and suffering.

[anaisbetts]

For the record people that transition, AT ALL AGES, overwhelmingly stay that way and do not regret their decision.

* Here is the [*APA's policy statement*](http://www.apa.org/about/policy/transgender.aspx) on the necessity and efficacy of transition as the appropriate treatment for gender dysphoria. More from the APA [*here*](http://www.apa.org/pi/lgbt/programs/transgender/?tab=1)

* Here is an [*AMA resolution*](http://www.tgender.net/taw/ama_resolutions.pdf) on the efficacy and necessity of transition as appropriate treatment for gender dysphoria, and call for an end to insurance companies categorically excluding transition-related care from coverage

* A policy statement from the [*American College of Physicians*](http://annals.org/aim/article/2292051/lesbian-gay-bisexual-t...)

* [*Here*](https://assets2.hrc.org/files/documents/SupportingCaringforT...) are the American Academy of Pediatrics guidelines

* [*Here*](https://www.aafp.org/dam/AAFP/documents/events/alf_ncsc/Educ...) is a resolution from the American Academy of Family Physicians

* [*Here*](https://www.socialworkers.org/assets/secured/documents/da/da...) is one from the National Association of Social Workers

---- *Citations on the transition's dramatic reduction of suicide risk while improving mental health and quality of life, with trans people able to transition young and spared abuse and discrimination having mental health and suicide risk on par with the general public:*

* [*Bauer, et al., 2015*](http://bmcpublichealth.biomedcentral.com/articles/10.1186/s1...): Transition vastly reduces risks of suicide attempts, and the farther along in transition someone is the lower that risk gets

* [*Moody, et al., 2013*](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722435/): The ability to transition, along with family and social acceptance, are the largest factors reducing suicide risk among trans people

* [*Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment*](http://pediatrics.aappublications.org/content/early/2014/09/...). A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, ... cross-sex hormones and gender reassignment surgery, provides trans youth the opportunity to develop into well-functioning young adults. All showed significant improvement in their psychological health, and they had notably lower rates of internalizing psychopathology than previously reported among trans children living as their natal sex. *Well-being was similar to or better than same-age young adults from the general population.*

* The only disorders more common among trans people are those associated with abuse and discrimination - mainly anxiety and depression. Early transition [*virtually eliminates these higher rates of depression and low self-worth*](http://www.jaacap.com/article/S0890-8567%2816%2931941-4/full...), and [*dramatically improves trans youth's mental health*](https://archive.thinkprogress.org/allowing-transgender-youth...). *Trans kids who socially transition early and not subjected to abuse are comparable to cisgender children in measures of mental health.*

* [*Dr. Ryan Gorton*](https://www.ncbi.nlm.nih.gov/pubmed/3219066): “In a cross-sectional study of 141 transgender patients, Kuiper and Cohen-Kittenis found that after medical intervention and treatments, suicide fell from 19% to 0% in transgender men and from 24% to 6% in transgender women”

* [*Murad, et al., 2010*](https://www.ncbi.nlm.nih.gov/pubmed/19473181): "Significant decrease in suicidality post-treatment. The average reduction was from 30 percent pretreatment to 8 percent post treatment.

* [*De Cuypere, et al., 2006*](http://www.sciencedirect.com/science/article/pii/S1158136006...): Rate of suicide attempts dropped from 29.3 percent to 5.1 percent after receiving medical treatment among Dutch patients treated from 1986-2001.

* [*UK study - McNeil, et al., 2012*](https://www.scottishtrans.org/wp-content/uploads/2013/03/tra...): "Suicidal ideation and actual attempts reduced after transition, with 63% thinking about or attempting suicide more before they transitioned and only 3% thinking about or attempting suicide more post-transition.

* [*Smith Y, 2005*](https://www.ncbi.nlm.nih.gov/pubmed/15842032): Participants improved on 13 out of 14 mental health measures after treatment

* [*Lawrence, 2003*](http://link.springer.com/article/10.1023/A:1024086814364): Surveyed post-op trans folk: "Participants reported overwhelmingly that they were happy with their SRS results and that SRS had greatly improved the quality of their lives

* [*Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study*](https://sci-hub.se/https://doi.org/10.1176/appi.ajp.2019.190...) - "*Conclusions:* "... the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them."

There are a [*lot*](http://www.ncbi.nlm.nih.gov/pubmed/24344788) of [*studies*](http://link.springer.com/article/10.1007%2Fs10508-009-9551-1) showing that [*transition*](https://mayoclinic.pure.elsevier.com/en/publications/hormona...) [*improves*](https://www.hindawi.com/journals/tswj/2014/960745/) [*mental health*](http://europepmc.org/abstract/med/25690443) and [*quality of life*](http://link.springer.com/article/10.1007/s10508-014-0453-5) while [*reducing dysphoria*](https://www.researchgate.net/publication/23553588_Long-term_...).

Not to mention [*this 2010 meta-analysis*](http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2265.2009....) of 28 different studies, which found that transition is extremely effective at reducing dysphoria and improving quality of life.

More stuff:

https://www.nbcnews.com/feature/nbc-out/media-s-detransition...

https://publications.aap.org/pediatrics/article/doi/10.1542/...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/

https://www.jsm.jsexmed.org/article/S1743-6095(18)30057-2/fu...

https://transequality.org/sites/default/files/docs/usts/USTS...

https://www.researchgate.net/publication/262734734_An_Analys...

https://epath.eu/wp-content/uploads/2019/04/Boof-of-abstract...

https://psychiatry.org/news-room/news-releases/study-finds-l...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/

https://www.gendergp.com/exploring-detransition-with-dr-jack...

https://journals.sagepub.com/doi/full/10.1177/00380261209346...

https://www.cambridge.org/core/journals/psychological-medici...

https://adc.bmj.com/content/107/11/1018

https://doi.org/10.1210/clinem/dgac251

https://www.jsm.jsexmed.org/article/S1743-6095(18)30057-2/fu...

[peanutcrisis]

I'd strongly recommend anyone interested in this topic to find sources outside of the US. The foundation of these studies are largely dubious, consistent with the kind of replication crisis you see in the medical field. Throw activism into the mix and these sources are now biased towards certain outcomes.

For those who lean left, I strongly recommend reading up on Hannah Barnes' book, "Time to Think". The UK and the EU have deemed "gender-affirming care" experimental with US holding out. This should definitely give some pause.

[anaisbetts]

> EU have deemed "gender-affirming care" experimental

This is a lie that Gender Critical people keep repeating, it is simply untrue. The EU continues to treat transgender children according to the same scientifically studied standards of care that they have in the past

[peanutcrisis]

For those reading, comments are an unreliable proxy for politicised topics such as this. As such, if you want to be certain about what your beliefs are (as opposed to blindly inheriting the opinions held by your bubble), always go to the original sources.

For those who wish to validate the claims of my original comment and that of the person replying me, you can check out sources outside of the US, especially Sweden and the UK (i.e. The Cass Report, Hannah Barnes of the BBC), and comments by progenitors of Evidence-Based Medicine (EBM).

A good place to start is an investigative feature published in the British Medical Journal (BMJ): https://www.bmj.com/content/380/bmj.p382

[xk_id]

There is research being promoted by the other side of the debate too... Unfortunately, once a scientific issue becomes politicised, it’s hard to know who can be trusted.