[barmar]

You can't make simple blanket rules for things like this.

If an 11-year-old suddenly declared that they wanted a sex change, it would certainly be appropriate to question their competence to make such a decision.

But if they've been indicating that they were the wrong sex for the past 8 years, it's much more credible.

[Elianna]

luke warm, on 2011-October-20, 15:34, said:

ideally, that would be the case... if their lesbianism does play a role, *that* would be child abuse... but i suppose they deserve the benefit of the doubt in this

as for 11 being too young, i think we can all agree it's too young for a whole passel of decisions... that this isn't one of them, to most people posting, seems a little surprising to me... heck, i know parents who won't let their 11/12 year old sons play football

Honestly, I don't understand what role you think that their "lesbianism" would play. I don't think that I want to be enlightened, either.

The point is that NOT giving the child puberty-delaying drugs IS making a decision that will affect that child's future, and quite adversely, too, it seems. Giving the child drugs to delay puberty delays the critical time to make a decision.

Hopefully this will give all people involved a few more years to decide on what the correct decision is.

[sasioc]

luke warm, on 2011-October-20, 14:11, said:

is 11 too young for a child to make any potentially life-changing decisions, or just those concerning sexuality?

I think an 11 year old child has the right to be consulted and informed regarding life-changing decisions that will affect them. Their level of input into the final decision should be dictated by the maturity of the child and their ability to understand their options as well as the nature of the decision and how directly it will affect them.

[mike777]

Yes an 11 year old is too young to decide on life changing decisions. The key words being decide and life changing decisions. I would add that often so are their parents.

In fact adults are often too young to decide on life changing decisions but that often does not stop them from making them.

[blackshoe]

You have to draw the line somewhere — and wherever you draw it, then you have to allow people to make mistakes.

In most cases I'd agree 11 is too young — and even in this case I'd want to talk to the kid in person (not that I'm all that great a judge of how mature people are, but if I were going to have an input, that would be part of it). It does strike me though that s/he has been insisting for eight years that s/he's a girl, not a guy, and if that's the case somebody ought to at least be asking why s/he says that so adamantly.

As for how the parents' "lesbianism" might affect things, I've met some pretty vehemently anti-male women, lesbian or otherwise. That kind of attitude might well influence a kid. Not saying it has in this case, of course.

[Elianna]

NOT giving the child puberty-delaying drugs is a life-changing decision. It means that one is deciding that the child will become a man physically, and would have to go through a lot more trauma (both physically and mentally) to change that.

Giving the the child puberty delaying drugs DELAYS the life-changing decision.

Honestly, if this were my child, I do not know how I would feel about SURGERY at age 11. I also would be very upset about all this publicity and invasion of our home life. So I can't say what ultimate decision I would make, but NOT making a decision seems like the best choice.

Quote

As for how the parents' "lesbianism" might affect things, I've met some pretty vehemently anti-male women, lesbian or otherwise. That kind of attitude might well influence a kid. Not saying it has in this case, of course.

I would bet money (and I'm not a gambler) that the percentage of men who have a gender identity/physical gender mismatch who have lesbian parents would not be more than the percentage of men who have lesbian parents in general.

And to be honest, I feel that I've met many more more vehemently anti-female men (both gay and straight) than I've met anti-male women (in fact, I feel that I've met more anti-female women than anti-male women). This may be a generational thing, though.

ETA: I do not know if you actually believe this, but it sounds that you are saying that some women are lesbians because they're anti-male. This may be the wrong thread for a discussion about this, so I'll just say that I hope that this is not a commonly held (misogynistic) belief.

[blackshoe]

The existence or prevalence of anti-female men is irrelevant to this case.

I'm saying that some women, lesbian or otherwise, are anti-male. I say nothing about the reasons for this, it's merely an observation.

[phil_20686]

What I find most interesting about this thread is the largely unquestioned acceptance among posters that one should accept the primacy of feelings/thoughts over the physical aspects to the extent of undergoing major surgery to reconfigure the body `to taste` as it were. It seems to me that this represents a very idealogical position that elevates how one feels about a situation to be the dominant factor in decision making - the concept that it is possible to `feel wrongly` seems to have been lost.

In no particular order here are some thoughts:

(1) It seems to be the dominant progressive/left wing ideology that gender is an essentially cultural construct, which is to say that the interior experience of life is basically independent of gender, and as a logical consequence one should aim to build a truly gender blind society. That is to say one in which there are no gender roles per se. However, this viewpoint seems opposed to the idea of gender reassignment. For the statement "I feel more like a man than a woman" to have meaning, there must be a difference between the interior experience of men and the interior experience of women. Since (extreme) left wing gender politics seems to deny that that statement has any content, it is hard to logically conclude that gender reassignment is ever sensible.*

(2) Following on from the above point, if gender is culturally and socially constructed, then it is certainly mainly environmental rather than genetic, and any trait that is formed primarily environmentally can be changed in the right environment, in which case counselling to attempt to change the childs view on her own gender seems like a better solution.

(3) I had quite a few more points but now im exhausted so am going to sleep.



* I realise most people are not very rational.

[helene_t]

blackshoe, on 2011-October-24, 17:06, said:

That kind of attitude might well influence a kid. Not saying it has in this case, of course.

this may sound plausible to some, but in any case it is speculative.
- are lesbians on average more anti-male than other women? I certainly don't think so.
- are these particular parents anti-male? I would have no idea.

anyway, there is no evidence whatsoever that upbringing influences gender identity. the most likely explanation for male gender dysphoria (male-female transsexualism) is lack of exposure to testosteron before birth. I am not saying there is hard scientific evidence for anything, nor that it is particular likely that this complex fenomena can always be explained by a single factor.

even cases of "secondary" transsexulism (i.e. the patient has done serious attempts to accept a male identity and only gives up and decides for sex reassignment as an adult) are attributed to congenital factors by most experts.

I know tons of transsexuals and I have yet to find a single patient that reported that his/her parents wanted a child of the assigned gender rather than the biological gender. They seem all to come from fairly normal families.

Now, when the child is 11, is the chance to keep the doors open for an almost normal female life (the exception being that she will be infertile and that breast/hip growth will be delayed until puperty is induced by giving oestrogenes).

Suppose that the authorities decide to deny any treatment until the child is 18 (or whatever). And that she as 18-years old then opts for hormone treatment so she can have surgery when she is 19. She will still be in a much better position than those patients who strugle for decades with all kind of medical, financial, legal and social obstructions and have surgery at age 40 at which point the maleness of the body is so established that it can never be turned into something that will be unambigously female, neither in the eyes of the patient self or in the eyes of society. Not to mention all the social problems related to adult sex reassignment.

But even so: consider the situation of such an 19-year old newly post-surgery woman who went through a male puperty and only started hormone treatment at age 18. How many cosmetic surgical procedures will be required to make her face, neck, voice cord and breast look/sound reasonably female? What if one of these procedures oopses? And who is going to pay for it? Will she ever be able to accept her own body despite the limitations of what surgery and hormones can do, once puberty has taken place? How many of you guys reading this think they will find her sexually attractive? Will she keep any contact with people who has known her when she was 18 and looked like a guy and therefore might have problems ever seeing her as a woman?

And at that point, will those legislators/juriors/shrinks/whatnot responsible for having made her teenage year a hell and having created a need for all this medical, social and financial mess be able to look her into eyes and tell her that they made the decision that seemed to be in her best interest?

[helene_t]

phil_20686, on 2011-October-24, 18:30, said:

(1) It seems to be the dominant progressive/left wing ideology that gender is an essentially cultural construct, which is to say that the interior experience of life is basically independent of gender, and as a logical consequence one should aim to build a truly gender blind society. That is to say one in which there are no gender roles per se. However, this viewpoint seems opposed to the idea of gender reassignment.

I couldn't care less what biology-denying idiots (left-winged or otherwise) think about this issue. You are right that the logical consequence of biology-denial probably is that SRS is obsolete. But it doesn't matter since biology-denial is largely extinct. I suppose that some of those evil cults who try to "cure" homosexuality might have a cure for gender dysphoria also, based on the premise that psychotherapy can make the patient accept his/her natural sex.

But we live in the 21st century and those of us who have noticed that will also have learned that gender identity is biological. Whether the pre-operative transsexual is as woman trapped in man's body or a man who thinks he is a woman may be a silly semantic issue, what matters is the practical issue that SRS can actually help some of those patients.

[cherdano]

Any surgery is a life-changing decision. A chemotherapy is. Does that mean we shouldn't treat Leukemia?

[mike777]

I think we are using the term life changing a bit too broadly as well as the term child abuse.

In general this used to mean:
1) death
2) divorce
3) moving
4) changing jobs

IN any event medical decisions are very often based on incomplete information and can very often be difficult.

99.99% of time we give parents broad authority along with the expectation that doctors act in an ethical manner.

With difficult decisions parents often rely on family, friends, doctors and their church for advice.

[blackshoe]

helene_t, on 2011-October-24, 18:41, said:

this may sound plausible to some, but in any case it is speculative.

Of course it is. Did I suggest otherwise?

Apparently, since this is not my field of expertise, I'm not entitled to have opinions. So be it. I'm outta here.

[helene_t]

blackshoe, on 2011-October-24, 23:22, said:

Of course it is. Did I suggest otherwise?

Apparently, since this is not my field of expertise, I'm not entitled to have opinions. So be it. I'm outta here.

No you didn't suggest otherwise. Fair enough. Sorry if I overreacted.

[kenberg]

barmar, on 2011-October-23, 13:10, said:

You can't make simple blanket rules for things like this.

If an 11-year-old suddenly declared that they wanted a sex change, it would certainly be appropriate to question their competence to make such a decision.

But if they've been indicating that they were the wrong sex for the past 8 years, it's much more credible.

This pretty much reflects my views. I trust most people up to a point and no one completely. Parents have views, sometimes strange views, and psychiatrists often approach matters through a mindset that I am at least a bit wary of. But I am willing to believe the biological mismatch occurs. All I can really say is that I am very glad not to be the one having to make this critical decision. If I were the one who could authorize or forbid the operation, I would want to know the kid, know the parents, study the matter, and get advice from medical and psychological experts of my own choosing. And then I would make the decision. I would not seek out this responsibility.

[Lobowolf]

helene_t, on 2011-October-24, 18:58, said:

biology-denial is largely extinct.

It is?!

[Trinidad]

blackshoe, on 2011-October-24, 17:52, said:

I'm saying that some women, lesbian or otherwise, are anti-male.

In other words: The sexuality of the parents is still a red herring.

Rik

[helene_t]

phil_20686, on 2011-October-24, 18:30, said:

What I find most interesting about this thread is the largely unquestioned acceptance among posters that one should accept the primacy of feelings/thoughts over the physical aspects to the extent of undergoing major surgery to reconfigure the body `to taste` as it were. It seems to me that this represents a very idealogical position that elevates how one feels about a situation to be the dominant factor in decision making - the concept that it is possible to `feel wrongly` seems to have been lost.

Wrong.

Unquestioned acceptance of feelings/thoughts would be "chop the thing off immediately, why didn't they do it when she was 3, she knew it by then?"

Nobody here is taking such a view.

Taking seriously (as opposed to uncritically accepting) the child's wish to keep the doors as open as possible until she has the maturity to make the final decision, is an open-minded position.

FWIW, I think that a large majority of children with early sign of gender dysforia are better served by a don't-worry-just-wait-to-it-fades-away-and-the-child-accepts-its-biological-sex. Adult patients will usually show up at the clinic when all options for coming to terms with the biological sex have been exhausted, but even so it is not unheard of that the patient decides during the initial treatment to halt it and give the biological sex a final chance. I think (but this is a little speculative) that the coaching from gender reassignment specialists can be helpful for those patients, also, since once one have accepted that the lifelong dream of becoming a woman is just a dream and has to be given up, it may be easier to make realistic plans for how to cope with a male gender identity and body.

Saying that SRS is never the right choice is a closed-minded position.

There are plenty of people who oppose SRS on ideological grounds. Even atheists sometime express the moral imperative to accept Nature's choice and don't fiddle with the body. On the other hand, the argument in favor of performing SRS in specific cases based on the patient's desires and psychiatric assessment is largely a medical one. Ideological arguments sometimes come into play in relation to discussions of patient autonomy. In particular, many of these patients are mentally messed up and there is a skisma between the imperative to respect patient autonomy and the imperative to do what is best for the patient. Technically, certain psychiatric conditions are considered contraindications for that reason, but of course it is debatable where to draw the line.

But the position that the patient's interest and/or wishes MUST prevail is just normal medical ethics. This is not to say that society has an obligation to provide all procedures that the patient asks for. As with all medical expenses, we have to get our financial priorities straight. FWIW I think I got too much reimbursements from the Dutch taxpayers. There are several of the procedures they paid for which I think it would be fair for me to pay myself, when comparing to for example people who are traumatized by non-gender-identity-related cosmetic, psychological or sexual issues and often have to pay for surgery or psychotherapy themselves.

[barmar]

helene_t, on 2011-October-26, 03:33, said:

In particular, many of these patients are mentally messed up and there is a skisma between the imperative to respect patient autonomy and the imperative to do what is best for the patient. Technically, certain psychiatric conditions are considered contraindications for that reason, but of course it is debatable where to draw the line.

In some cases, is it possible that they're mentally messed up BECAUSE of the gender dysforia? It must be a stressful life. So rather than trying to treat the mental problems before considering whether to perform reassignment, the reassignment could be part of the treatment.

[kids34]

luke warm, on 2011-October-20, 14:11, said:

in the sense that it plays no part in the decision?


is 11 too young for a child to make any potentially life-changing decisions, or just those concerning sexuality?

If you want to know more you can find some other information here
Child Abuse Facts