Trends tend to take a while to arrive in Maine as we are in the upper right corner of the chart. And right now, a big trend among conservative politicians is to use state laws and bureaucracies to prosecute and punish transgender children, often by restricting their access to medical care.
I suspect it’s only a matter of time before this craze hits Maine, so I wanted to take this opportunity to talk a bit about what medical care looks like for transgender children. Since transgender Americans make up less than 1% of the population, many people are unaware of their experiences.
First of all, the reason why tackling trans kids is so hyped right now is that Americans are actually overwhelmingly supportive of trans rights: specifically the right for adults to transition, to what they want and generally being left alone about it. It’s because America has a libertarian side. If you were to ask the average trucker in a Midwestern restaurant, “Your friend Joe Schmo feels like a woman born in the wrong body. She wants to change her name to Jane Schmo, undergo hormone therapy, and go shopping in the women’s section of Carhartt. What do you say?” They’ll probably say, “Well, that’s Joe’s business. Uh, I mean Jane’s business.
However, Americans are also prone to moral panics involving children. Do you remember that time in the 1980s when everyone was sure day care centers were full of satanic cults? This stems from the deep human instinct to protect children. It’s a good instinct, but like all strong feelings, it can run amok.
Transgender children do not receive any transition-related medical treatment until around age 11. They don’t need it! Believe me, a girl who was often mistaken for a boy before the age of 12. For young children, it’s all about ‘social’ transition – letting the child wear the clothes they think represent who they are on the inside, allowing them to grow or cut their hair, perhaps under another name. You will notice that this is what most loving and supportive parents tend to do, regardless of their child’s gender identity.
The first medical step in the transition is often the use of “puberty blockers”. These are usually prescribed for children who are experiencing precious puberty (i.e. starting to go through puberty far too soon). What they do for trans kids is give them more time to make sure they are comfortable and confident in their gender identity.
Let’s say you have a child and you thought it was your daughter and at eleven years old he tells you he is your son. You might say “OK, honey – uh, I mean, OK, sport.” But many parents want to make sure their child is really, really sure he’s a boy before going through puberty, because while puberty blockers are reversible, puberty itself involves permanent changes in the human body. As the supportive parent that you are, you might also want to make sure your son doesn’t go through the wrong puberty. Going through puberty sucks for everyone, even if you want the body you gain. I can’t imagine the horror a bad puberty would feel.
If a child’s parents and medical team agree that the child is “insistent, persistent and consistent” in their gender identity, the next step in treatment is hormone replacement therapy, to bring their hormone levels in line with the sex he identifies as, regardless of the reproductive elements they were born with. Transgender girls, like cisgender girls, will grow breasts; transgender boys will have deeper voices and grow those awful little mustaches that teens everywhere are so proud of. It is neither easy nor quick to access hormone replacement therapy. This is mainly because in America it is neither quick nor easy to access any kind of health treatment.
The big worry people tend to have is about surgery. First of all, if someone tells you that children are having genital reassignment surgery, know that they are lying to you. “Bottom surgery” is not part of any current medical guidelines for the treatment of gender dysphoria in children and adolescents. Moreover, American doctors are all terrified of being sued; no surgeon is going to risk being buried in lawsuits or thrown in jail for performing such a controversial operation on a minor.
“Top” surgeries – breast enhancement or removal – are very rare and, like any surgery, are done on a case-by-case basis. Besides the fear of trial, there’s also not much point in doing a procedure like that while the body is still growing, and many teenagers don’t reach their full size and shape. complete only at the age of about 20. are not approved for those under 18 by the FDA. Thousands of breast reduction surgeries are performed on teenage girls every year in America, but not for the purpose of gender transition; they are usually performed to relieve neck and back pain in teenage girls or boys with gynecomastia – overdeveloped breast tissue in cisgender men, usually caused by a genetic or endocrine problem.
When politicians try to outlaw puberty blockers and hormone replacement therapy for transgender youth, they’re trying to force kids through puberty in the wrong body. I hope you keep that in mind whenever this particular moral panic hits Maine.
Victoria Hugo-Vidal is a millennial from Maine. She can be contacted at:
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