Tag Archives: Transgender

Politics & Current Affairs

Why Puberty Blockers Are Essential Healthcare Tools

Let’s talk about puberty blockers, an essential element of safe and successful gender-affirming care for transgender youth. Social media, politicians, and news outlets have shared a great deal of misleading information about what these drugs do, how they work, and whether they’re dangerous or reversible. This has even led some U.S. cities and regions to enact legislation against their use. Tragically, some localities have even established punitive measures against trans children and the parents who allow them this life-improving and sometimes even life-sustaining care. So let’s take a look at what they really are, how they really work, and why they’re such important mental and physical health tools for many trans kids. 

Puberty-blocking drugs don’t stop puberty for all time; they just stop it for right now. Their results are reversible. If kids stop using them, puberty resumes. There is no evidence that puberty blockers affect future fertility, though taking estrogen or testosterone with them may impact the ability to have children later.

Puberty blockers were approved by the FDA in 1993. According to Cedars Sinai Medical Centers, they’re considered very safe by the medical community. They may possibly affect height (they may delay growth-plate closure, which can lead to taller adult height), and may slightly lower bone density for some. But so far, research shows the effects to be minimal. Doctors and hospitals are required to provide detailed information about risks and downsides to children and their families before providing them with these medications. People with severe gender dysphoria (i.e., who feel their genders to be different that the one assigned to them at birth) usually feel that living in a body that feels more like them is worth being a little taller, or worth taking bone-strengthening minerals and drugs to avoid osteoporosis later in life.

When children feel strongly that their genders don’t match the ones assigned to them at birth, going through puberty can feel crushing and tragic—a permanent sign to the world to treat them as someone they know they’re not. According to the Mayo Clinic, puberty blocking drugs keep kids from going through major changes (some irreversible) like the development of breasts, body hair, and male genitalia; deepening of the voice; and menstruation.

To get rid of those signs, many people go through painful, expensive, and difficult surgery later. But there are certain things that happen to the body at puberty that may not be reversible even with surgery. Those who undergo surgery later often experience complications, pain, great expense, and all the risks that come with surgery and anesthesia. Yet they still don’t have physical outcomes as successful as they might have if given puberty blockers at the first signs of puberty.

Many trans children who go through puberty and see their bodies undergoing distressing, permanent changes suffer severe depression and other negative mental health challenges, according to the National Institutes of Health. Some engage in self-harm such as cutting, substance abuse, or suicide. If given access to puberty blockers, they can delay or stop many of those changes, buying them time until they’re adults and can decide legally how they want to present and identify themselves. Puberty blockers have been shown to significantly reduce depression and suicidality in trans children.

Puberty blockers have led to improved mental health, better social interactions with other kids, and sometimes avoidance of future gender-confirmation surgeries.

The physician information portal HCPLive (which is part of the MJH Life Sciences publishing company) writes, “Investigators said that previous data showed gender-affirming hormones (GAH), puberty blockers (PBs), and gender-affirming surgeries have been found to be independently associated with reduced depression, anxiety and additional adverse mental health outcomes. Puberty blockers administered during puberty can actually reduce suicide risk in this population. A decreased lifetime incidence of suicidal ideation was also found among adults who received access to puberty blockers during adolescence.”

In short, puberty blockers improve and even save lives. They don’t poison children, or take away their choices later. These drugs give children the freedom to delay major health and life choices until adulthood. They align physical and psychological health, and let children feel more like themselves. Providing them to children whose lives could be immeasurably improved—even saved—by them makes them an essential element of pediatric healthcare.

History, Politics & Current Affairs

Let Me Not to the Marriage of True Minds Admit Impediments

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Laura Pride

Let me not to the marriage of true minds
Admit impediments. Love is not love
Which alters when it alteration finds,
Or bends with the remover to remove:
O no; it is an ever-fixed mark,
That looks on tempests, and is never shaken;
It is the star to every wandering bark,
Whose worth’s unknown, although his height be taken.

—from Sonnet 116 by William Shakespeare

All year long, I’ve anxiously and hopefully awaited the Supreme Court’s decision on the question of marriage equality, wondering every day for months whether they would do the just and proper thing by all LGBTQ citizens of the United States at last. This week, as the nation awaited the decision with bated breath, I hoped that the answer would come on Friday, June 26, since that was my late mother’s birthday, and I could think of no greater honor to her memory than to have a landmark civil rights decision giving millions of people financial, emotional, legal and medical protection be announced on her natal day. On Friday, my dream came true.

I’m a straight woman who has already been afforded all the benefits of legal marriage more than once. I have never had to worry that a partner would be excluded from my hospital room, disallowed from taking custody of our child in an emergency, denied inheritance rights or social security or medical benefits, or publicly humiliated, shunned and mocked for calling himself my partner without benefit of marriage. I have lived a privileged life because I happened to be born with the prevailing sexual orientation during a time and in a place in which I could choose my partner of my own volition without being abused, threatened or punished for my orientation or my choices. But while I am heterosexual, I also cherish a number of gay, lesbian, bisexual and trans friends and family members, and my life would be pale and hollow without them. Since childhood, many, at times most, of my nearest and dearest have been and continue to be homosexual or bisexual men and women. They always will be. To watch them be denied basic honor, dignity, respect and rights because of their orientation has sickened and disturbed me since I was a girl, and I have been a devoted ally to my darling LGBTQ loved ones (and to all the millions of LGBTQ strangers out there) for decades.

I cried with joy and relief early on Friday morning when I read the news minutes after the decision was announced, and I look forward to shedding more tears of joy at the weddings and anniversaries of my friends for decades to come. The world is so much brighter, fairer and more hopeful each time we extend justice and equality to those who have been denied it. We are so lucky to be alive to witness this beautiful day.

History, Politics & Current Affairs

What Makes a Woman “Feminine”?

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Vanity Fair

Caitlyn Jenner‘s photos were published in Vanity Fair earlier this week, as we all know by now. She looks beautiful in them, and I wish her only happiness in her life as the woman she has always felt herself to be.

Since she seems to have taken charge of all aspects of publicizing her transition from Bruce to Caitlyn, we must assume that Ms. Jenner had the final say regarding which of the photos taken by top celebrity portraitist Annie Leibovitz she wanted to have featured on the Vanity Fair cover. Of all the photos from that spread, the one on the cover shows Ms. Jenner in the most vulnerable possible state: sitting in white underwear with arms pinned behind her and her strong, beautiful legs awkwardly pressed together. All the others show her looking more in-charge and comfortable with herself, not to mention in prettier clothes. For example, here she is relaxing:

Sofa

Here she is about to drive her $180,000 sports car:

Red Dress

In each of these images, she shows herself to be in command of the moment and of herself. In one, she looks away from the camera as if unaware and unconcerned about its gaze; in the other she wears sunglasses and a body-conscious red dress, and she exudes power and control. Compare these to the cover image in which her wrists and ankles could be bound for all we know; they’re certainly pulled tightly back and out of the way, and she looks directly at the camera, unsmiling and very aware that she is being appraised by the viewer in her half-naked state.

After a lifetime of being lauded for physical strength and power, which were so often conflated with her appearing to many to be the epitome of manly attractiveness, it is understandable, but I think a bit disturbing, that she and Vanity Fair should see the opposite—a physical position of seeming powerlessness—as the apotheosis of feminine beauty. While it is true that stripping away clothes could also be taken as a symbol of stripping away what she felt were the public lies about her private self, both she and photographer Annie Leibovitz knew full well that by portraying her without clothes or visible hands or feet they were also using visual shorthand to get across the idea of her vulnerability as part and parcel of her newly-public femininity.

She is in fabulous physical condition, as one would expect a disciplined gold-medal-winning Olympic decathlete to be, and one can understand that she might want to show that off—it must feel great to show the world that she can look so conventionally attractive as a woman. And, of course, Vanity Fair wants to sex up the cover as much as possible to sell more issues. But I wonder: did Ms. Jenner or Vanity Fair think that placing her in as vulnerable a state as possible was a necessary part of making her look most feminine?

If people think that what makes Ms. Jenner appear to be “feminine” is the fact that her near nudity and constrained pose leave her looking vulnerable and fragile, that saddens me, since in that case the choice is clearly not about glamour (which can be strong and empowering) per se; it is instead about playing up weakness as a womanly trait. Caitlyn Jenner is plenty glamorous in all the photos, so the choice must have involved what she and Vanity Fair think makes her look most like a woman, and that appears to be weakness, vulnerability and the impression of greater sexual availability (i.e., fewer clothes, direct gaze, body seated rather than standing and legs and arms out of the way). I’m concerned about underlying sexist and disempowering messages about femininity and beauty that could be sent to the world by this photo spread when the most fragile and powerless-looking of all photos taken becomes the image chosen to symbolize feminine beauty out of all the beautiful, powerful images available.

I am not denigrating Caitlyn’s choice to transition from male to female, nor her desire to share her story and her first photos of herself in a beautiful and powerful way. I support and applaud her in this. I am merely questioning what this episode in popular culture tells us about how we may conflate powerlessness and vulnerability with ideals of female beauty.