I'm seeing a lot of misleading headlines today in all newspapers about the Cass report which is recommending trans teens shouldn't be given puberty blockers or hormones, and a huge amount of transphobes online coming out of the woodwork to use this as a reason to argue that no one of any age should be allowed to transition or be openly trans. Quite a grim day to be online.
I'm open minded generally about reports like this and always try to look objectively at the evidence. In this instance it seems that the Cass report is a study conducted with an anti trans bias from the outset.
I've not read it in depth yet but from what I can see it says there's a lack of evidence for the efficacy of trans health care for teens.
In truth, there IS in fact a lot of evidence that trans health care for teens is positive but it turns out the Cass report rejected all of that evidence because they weren't double blind or because the people conducting the studies worked in the field of trans healthcare and so they decided that those people were likely to be biased. There were 103 studies they looked at but they discarded all but 2 of them.
Double blind studies are ones where neither the patient nor the doctor prescribing the medicine know whether they're being given the real medicine or just a placebo. Medical bodies have said it would be unethical to do a double blind study on trans teens taking hormones or puberty blockers.
Apparently a huge amount of the medicine that we and children take is impossible to do such studies on and if scrutinised to the same extent as in the Cass report would have to be banned as well.
From what I'm reading it feels very cleverly constructed and calculated to create a catch 22 scenario where the only evidence they'd accept of the positive outcome of transition is evidence that it's impossible for anyone to create. It feels very weaponised and dangerous, as a trans person. It feels like their eventual aim will be to take away adult trans healthcare too. The kind that has brought so much joy and prosperity to pretty much every trans person I know or have ever met (and there are hundreds of them, in my life at least).
I was a trans teen. A closeted one, back in the 90s, terrified of coming out, with the only other trans people i knew of being the trans women on jerry springer who would be brought on to be mocked and ridiculed. Yet i knew i was trans, and I remember one time, aged around 14, sitting in the courtyard outside the drama studio thinking "i'm lucky puberty hasn't happened yet. If i were to be one of those trans people who transitions, now would be the time to do it". And I didn't. And I'm ok with that, given the time I was living in. I was sooooo far away from having the confidence speak about it. It wasn't until I was 26, in 2010, living in Paris, that I first found the courage to tell anyone. And since then it's been a slow journey of self acceptance and finding strength in community and learning to love and accept who and what I am.
But nowadays there's so much positivity and acceptance towards trans people of all ages and it's so so wonderful when I speak to twenty something trans people who say they came out as a teenager. I well up even writing this, thinking how incredible that is.
Something that's often surprisingly missing from the discourse on puberty blockers and cross sex hormones for teens is the effect of puberty on gender dysphoria, especially in later life. Gender dysphoria is the feeling most trans people struggle with, feeling like their body is the opposite sex to what it's supposed to be. And most of the dysphoric things such as facial hair, height, bone structure, low voice in trans femme people and breasts and hip growth in trans masc people are permanent and the result of going through your original puberty. Every single day of my life I suffer from gender dysphoria related to these characteristics. Sometimes it's mild. Sometimes it's intense. There are medical options you can do and I've done some of them and that's been amazing, but the majority of these changes from puberty are permanent. And when you choose to stop trans teens from transitioning you're condemning them to this fate. for every day of the rest of their hopefully long lives. And something I'm finding out now in my late 30s is that the effects get stronger as you age and get harder to cope with as well. In my 20s I thought I could cope with not medically transitioning but if i'd known then what effects that choice would have later in life i'd definitely have transitioned younger.
Also, unfortunately we live in a society that demonises and discriminates against gender non conformity. Most trans people just want to fit into society and get on with our lives. We don't want to stand out. Most trans people who transition as adults have no chance of fitting in due to the changes to their bodies from puberty, forcing us to face more hostility in our lives if we transition later in life. Transitioning younger prevents this. In an ideal world we could all wait until we're wise enough to know all the answers before making these big decisions but unfortunately that world doesn't and will never exist. We need to tackle things in the world we actually have, and that is one where unfortunately these choices need to be made as teens.
Forcing young trans people to wait or not to transition isn't a neutral act. It's making life changing decisions that will more likely harm them than not. People say it's because they're afraid the teen will regret it. Many studies show regret rates tend to be as low as 1-2% of people. So it is possible but very unlikely. And a risk that the teen in question needs to be given the agency to make themselves.
None of the newspapers ever ask "what if they regret NOT transitioning young." We do. Because we know the answer. The biggest regret among trans people time and time again is not having transitioned sooner.
Medical transition isn't for everyone. It can be a mixed bag. You have to weigh up the pros and the cons and then when you start it it will likely be a whole new experience that you have to assess as you go, figuring out new pros and cons along the way. But for so many of us it's absolutely life changing.
We need to be arming trans kids with knowledge about this. About the future they could be living. About the issues they could face. We need them to know stories of trans people, about the struggles we've had during our lives so that they can make the best decision for themselves and we need to create a more open, positive and inclusive society that allows them the space to flourish and thrive.
We need to allow trans kids to choose whether to take steps with medical transition or not. And puberty blockers are there to give them the time to think more about what decision is right for them. Taking these options away from them will cause a lot of harm.
As trans people we need to weather these storms, carry on spreading truth in the face of widespread misinformation, and stand strong with each other.
And to any friends and allies reading this, please know that most of the mainstream news media has an anti trans bias in this country and please be skeptical of the things you read and hear from them relating to trans people.
This article explains the science side of the studies done better than I can and links at the bottom to an even more in depth report on them:
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