Trans Youth and Families Deserve Better Than The Affirming Care “Debate”
In the Washington Post, Megan McArdle pushes vague fearmongering about transgender youth in an example of the poisoned debate that asks endless leading questions when we already know the answers.
Opinion, by Evan Urquhart
A trans girl who loves to sing will permanently lose her voice without a puberty blocker. A trans boy who worries about the expectations for Black men and struggles against an eating disorder decides to put off medical transition. A mom relieved to see her trans son’s mental health improve after medication to stop his period and chest binding now worries that he’s getting skin rashes from not wanting to be without his binder; she wonders if they should consider surgery. A family who fearfully refused to even take their trans daughter to a gender clinic struggles to mend the relationship with a young trans woman who they’ve fully accepted, belatedly.
The first two anecdotes come from a piece in the Boston Globe last week, by a physician who cares for transgender youth. The last two describe families I’ve spoken to in my own reporting. What’s consistent in these stories is that they all describe loving families who navigated the unfamiliar world of gender-affirming healthcare with the hope of doing what was best for their child. Everything else in them is individual, from the age the child first came out as trans to the hopes and fears for treatment to the eventual steps taken. In the two stories from my own reporting one consistent theme was regret, not for the medical steps taken but parents regretting not having fully accepted their trans child from the beginning.
In St. Louis, an inquiry into the Transgender Center following allegations that every single patient had automatically been approved for medical transition found the clinic had only begun puberty blockers or cross sex hormones in about half of their cases. However, the mainstream narrative that youth transition is too easily and lightly started continues to dominate the majority of the coverage of this issue.
Take, for example, an opinion column for the Washington Post by Megan McArdle that published Friday. McArdle doesn’t reference, and may not know, the individual stories of any transgender young person or their family. Instead she writes in response to the release of hundreds of forum posts from WPATH, the professional organization for transgender medicine, amplifying vague fears, repeating buzzwords like “experimental” and making misleading references to gender treatments in Europe.
screenshot from the Washington Post
“Youth gender medicine is increasingly treating puberty as though it were a life-threatening condition like cancer or diabetes, and natal sex organs as though they were potentially dangerous growths,” McArdle writes, without referencing a single example of how or when that’s happened. In truth, we know it hasn’t. Even the stories of people who have detransitioned typically describe transitions undertaken by adults or adolescent transitions that took place after many months of therapy and extensively documented, persistent gender dysphoria. Far from finding effective alternatives, these ideological detransitioners often admit to continuing to struggle with gender dysphoria. The supposed rush to treatment for young trans people is so rare there have been no documented cases of it.
But what does that matter when there’s a widespread panic that it might be happening. The real experiences of trans youth and their families making slow, measured, individualized decisions in consultation with expert doctors are swept away in this feverish imagination about what cis people think might be happening. There might be a wave of masculinizing chest surgeries performed on minors (Reuters found fewer than three hundred per year in a country of more than three hundred million people.) There might be a dramatic increase in the number of people who detransition. (Studies have not shown this, with one of the most recent finding 2 patients out of 548 re-identified with their birth sex after initiating gender transition as a minor.)
Instead of looking at the research or talking to actual families, commentators like McArdle play a shell game where the inappropriate, rushed, or damaging transitions could always be under one of the cups you didn’t point to. It doesn’t matter that they never find the proof, the possibility that someone, somewhere, might be rushed into transition and regret it is sufficient for the “debate” on gender-affirming care to continue.