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Wednesday, June 10, 2009

More about blockers

The one thing I have learned being a parent for the past 12+ years is that you never know with certainty that you are doing the right thing. From diaper cream to university, its a never ending array of choices. The choice to start your child on 'blockers' is another one in the long list, where you don't know with certainly you're right. But, as I tell parents every day, you have to trust your instincts.

The best guide you will ever have is your child. Listen to your child. They will tell you what they need, and what works for them. Even babies are able to do this if you listen carefully.

Over the past 9 months Anneke has been taking blockers, many of her friends have begun to grow breasts and start their periods. Soon her 'difference' will be obvious. We'll cross that bridge when we get there.

The following is some more info about blockers as a 'controversial' therapy for trans-gendered children.

The treatment will begin with what is known as a “hormone blocker,” a drug that will postpone the physical changes of adolescence. Some doctors are using hormone blockers to buy time for transgender youth, so they can decide whether they are certain they want to transition. If not, the doctor stops the blocker and the child matures as he or she otherwise would have. If, however, the youth wishes to transition, the doctor stops the blocker and begins “cross-sex hormone” treatments.

Debate about the medical and ethical ramifications of postponing adolescence is fervent. Opponents question how anyone under the age of consent can make a decision about their gender, and point to potential side effects of treatment. Advocates say that the treatment spares kids the pain of developing features they don’t identify with, saves much of the cost of altering those features through surgery, and reduces the risk of suicide and self-mutilation.
Recently, debate in the medical community has shifted toward a “harm prevention” model, says Dr. Norman Spack, senior endocrinologist and co-founder/co-director of gender management services at Children’s Hospital Boston. Just two years ago, Dr. Spack says, The Endocrine Society refused to host a symposium of the world’s most renowned transgender specialists. Now, the society has asked them to create recommended standards of practice for treatment, which they will publish in about a year and a half.
Further, last February, Dr. Spack and Children’s Hospital Boston, opened the first major clinic in the country to treat transgender children, and they are working closely with European physicians at the forefront of the field.
Physicians at the Amsterdam Gender Clinic, for example, had, by last February, treated about 60 patients by blocking puberty in children who “met strict requirements.” A 2007 article describes the physicians’ work and the criteria the children must meet: “Their Gender Identity Disorder had existed since an early age; they were otherwise psychologically stable; and [they] had a supportive family.” The article reports that the adolescents were “between the ages of 12 and 16 … half of whom were referred early enough to start shortly after the onset of puberty. For those who had reached the middle stages of puberty, the drug could slightly reverse and stop any further development.”
A tough decision
Whether to treat transgender children is a difficult decision to make. Not only must parents and doctors decide whether the child’s feelings are going to last and consider types of treatment and when to begin, parents must also bear the cost of treatment and the fact that they may be met with lack of family support or, at the very least, incomprehension from friends and family.
“[People] don’t understand why we as parents are doing this,” says Daniel’s mother, Stephanie Grant,* who’s written a “booklet” about her experiences titled The Agony of Nurturing the Spirit. “It’s not just because of the suicide rate. It’s one thing to have general reassignment surgery that costs $30,000 to $40,000. But testosterone is such a wicked hormone. … [Transgender] adults spend hundreds of dollars and hours getting rid of hair, muscle tissue, having one’s face removed because testosterone causes changes in jaw structure etc. To save our children from the many hours of surgery, we have an opportunity to help future adult transgenders to just need [genital] reassignment surgery, because what they go through is unbelievable. [But,] people don’t understand why we can’t wait.”

As parents Ben and I have made our share of bad decisions. Blockers for Anneke is not one of them.

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