05 Apr Old Enough
By Tonya Cox
I have a delightful 3-year-old granddaughter named Ellie. She is a girl that knows her own mind and is highly intelligent with an emotional awareness and vocabulary that rivals children many years older. She knows what she wants and often seeks to dictate those desires to her parents. Nevertheless, she does not always get her way. Her parents know that sometimes what she wants is not in her best interest. Developmentally speaking a three year old’s reasoning is only one-sided. Ellie can only understand a problem from the one side she sees as she is unable to see the whole picture or the long-term consequences of her choices. Notwithstanding this developmental fact the Endocrine Society, the largest global organization for endocrinologists, released new guidelines in the treatment of transgender children that for the first time encourages children as young as age 3 begin a social transition by changing their name and wardrobe to match their “identified gender.” These are the first new guidelines released since 2009 and are expected to greatly influence pediatricians around the world.
Proponents of these new guidelines, like Dr. Steve Rosenthal, an endocrinologist and head of the Child and Adolescent Gender Center at UCSF Children’s Hospital, feels that allowing children at younger ages to receive the available medical interventions limits the amount of expensive and complicated surgeries later on in their life so a gender transformation goes more smoothly. He said, “we have worked … to optimize care, both on the mental health side and medical care,” and that, “I personally feel it would be malpractice to withhold…treatment.” He is not only a proponent of the new guidelines but on the panel that recommended them.
Opponents of these new guidelines, like Dr. Eric Vilain, a pediatrician and geneticist who heads the Medical Genetics division at UCLA, feels that it is “putting a lot on the shoulders of these children,” and “putting them on a path that will have a lot of medical and surgical consequences. A path that we don’t fully know the outcome.” Dr. Vilain is also concerned that too many doctors are willing to recommend social transitioning for children. He points out it is much harder to discard an adopted belief about gender when a social transition takes place so early in a child’s life. The new guidelines specify that children must have “sufficient mental capacity to give informed consent.” Yet who is determining, and how are we determining, that “sufficient mental capacity?”
The former guidelines prohibited medical interventions before the age of 16. Now pre-pubescent children can receive hormone treatments to stop the onset of puberty. This treatment is discontinued by age 14 to prevent serious side effects like a weakening of the bones. At this time a child must make a definitive decision to allow the natural onset of puberty or continue with gender transitioning and receive medical treatments like hormones the rest of his or her life. Some doctors and psychologists are concerned that these controversial guidelines will encourage kids to change their gender and promote unnecessary transitions. In fact the American College of Pediatricians reports that 80 to 95% of children who question their gender before puberty actually identify with their birth gender after puberty. Conversely, 100% of children who begin social transitions and medical interventions before puberty inevitably identify as transgender. This suggests that the treatment itself is creative in nature. The American College of Pediatricians, the Association of American Physicians and Surgeons, the Christian Medical Association, and the Catholic Medical Association representing over 20,000 physicians and health professionals proclaim these practices as “misguided and dangerous.”
A danger that was ”inconceivable” a generation ago is now promoted and accepted as normal. Children’s books like “I am Jazz” detailing the story of a boy transitioning to a girl are on our schools’ list of recommended literature and is read in classrooms. The things our children are exposed to today are influencing them towards making life altering decisions at a young age.
We know children are very susceptible to societal influences. For example, one study found something as simple as a food commercial not only altered a child’s food choices but actually changed their brain activity! Neuroscientists agree that the pre-frontal cortex, or reasoning part of the brain, is not fully developed until age 25. This leaves kids and young adults more susceptible to peer pressure and making impulsive decisions. The things our children are exposed to today are influencing them towards life altering decisions. These reasons, among many others, is why children have parents. They need parents to teach them, guide them, and protect them from societal influences, peer pressures, and impulsive decisions that may have long lasting and life changing affects. But in today’s world even parental rights are threatened. More and more schools, courts, and legislators are taking away parental rights. This weakens parents‘ ability to care for their children and destabilizes families.
An estimated 1.4 million adults and 150,000 teens in the U.S. identify as transgender while the numbers for children are not yet known. This issue of gender transformation is a sensitive issue. Its prominence is incited by societal trends and “experts” who disregard the facts. Children need the guidance of their parents, just like my 3-year-old grand-daughter Ellie. All Americans must support and protect parental rights. Parents have an obligation to protect their children from these societal trends, and especially from sanctioning their children to socially and medically alter their gender before they can understand the enduring consequences of that choice.