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Enabling Puberty Consistent with Age as well as Gender Identity

double standard in delaying puberty for transgender youth

Forum: Trans-Academics
Date: 02/16/2013

Hi people,

On Feb 17, 2013, at 6:27 PM, [removed as requested] wrote:

A colleague is looking for readings that oppose delaying puberty for transgender youth that can be used as a counterpoint to help students see the different perspectives. They are having a hard time finding anything. Does anyone have any ideas that I can pass along?

I haven't seen any publication, but can't there be a criticism of using puberty-blocking hormone from the perspective that transgender youth should have access to the (so-called) "cross-gender" hormones that enable them to experience puberty appropriate for their gender identity at the same time other youth are going through theirs?

That position may seem extreme and untenable, but is more coherent than it appears. To endorse delaying puberty for transgender youth instead of allowing them to go through puberty consistent with their gender identity at the same time as their peers would imply that we cannot, as some believe, "make a definitive diagnosis of gender identity" at that age, because "in this developmental phase gender identity is still fluctuating," as Cohen-Kettenis explains. But if we are to believe that gender identity is "still fluctuating" at that stage, what is the justification for not delaying puberty for *all* children, instead of those considered transgender?

There is a double-standard here: we take for granted that gender identity is solid and fully established when the child's gender identity is consistent with her or his biological sex, and only question its validity or permanence when it is not. There is of course a risk that a transgender youth who receives "cross-gender" hormones would realize that she or he is not transgender and regret it later, but there is also a risk whenever we assume that youth are not transgender because they do not manifest themselves to be transgender before going through puberty. We accept the risk that any youth could go through puberty and later regret it, and yet believe that the risk is too grave when it comes to transgender youth that even the more "progressive," trans-friendly individuals can only advocate for puberty-delaying treatment.

If we were to provide "cross-gender" hormones instead of puberty blockers, many of the medical concerns around bone and muscle mass and skeletal development when delaying puberty would be solved as well.

There are political considerations that might make this proposition untenable, and I personally feel emotional resistance to this idea (I generally don't like aggressive medical interventions--though I cannot justify opposing them simply because I feel uncomfortable), but I cannot find any logical reason that this should not happen. I wonder if there is any published article about this...