Post No.: 0241
Like Post No.: 0138, let’s have another one of our discussions – this time on the subject of gender reassignment.
Erm, okay. This is another extremely tricky subject though, with people holding very strong and opposing views on it.
…Hell, no one can stop us talking about whatever we want, and pity the fools who’d like to try!
Quite right Fluffs!
So I know we both agree that for adults wishing to reassign their own gender – that’s no problem. That’s not what this present debate is about.
But pre/early-pubescent or adolescent children wishing to do so are a different and incredibly tough dilemma when it comes to medical interventions such as hormone therapies. This is because there are cases of those who had regrets for various reasons and have attempted to reverse, or detransition, their gender reassignment when older. If one later changes one’s mind then, beyond a certain point, the consequences of such transitions cannot be completely reversed back to a state as if one had never transitioned at all (at least with foreseeable medical technologies), and one may need to live the rest of one’s life with these consequences. It’s not like getting a tattoo then getting it lasered off if you later don’t like it. (Not that tattoo removal is always successful either.)
Thus wouldn’t it be less risky for children to forego transitioning until they’re older?
Hmm. If any intervention isn’t a medical necessity (i.e. not a healthcare issue, such as to ensure that passing urine is comfortable) then it should be far easier to decide to forego it.
There’s indeed a sense of irreversibility with blocking or replacing hormones during puberty (of all the crucial developmental periods in a person’s life), and the irreversibility of surgery is obvious too, even if the minimum is scars left in sensitive areas (although such surgery isn’t available to people under 18 in most countries).
Yet one must also consider the potential mental and not just the physical aspects of the situation for a child who feels like she/he’s in the wrong body.
Also, it’s more effective to start transition interventions before puberty is complete – before the sexual organs have matured. If this optimal timing for transitioning is missed then hormone therapies become less effective and surgeries that might’ve been avoided may later need to be performed (e.g. a female-to-male transition might not need breast surgery at all if those breasts were prevented from developing in the first place through drugs). Puberty can be postponed via medications – some of which are considered more reversible than others. Once certain gender-specific physical features start to express during puberty, they become more difficult to later change.
Alright, I now concur that it’s more of a psychological and mental health issue, and I agree that this doesn’t mean that it’s not a real, serious or non-trivial issue – far from it. It’s about the wiring of our brains more than the sexual organs we have. Such organs and others secrete hormones, such as oestrogen, that will indeed affect the brain and therefore our thinking to a degree, but ultimately it’s about what our brains think and feel – our brain’s processing and outputs, as it were. All we really are – whether we’re considered ‘neurotypical’ (‘normal’) or ‘disordered’ – is the wiring of our brains and the resultant thoughts and perceptions of ourselves and of the external world. So if a person feels like they’re in the wrong gender body then that’s real to them.
Only the person concerned and those immediately around them can determine whether it’s just ‘a temporary phase’ or something more persistent. Yet we know from psychology research that people can be very poor at knowing what they’ll really still want in the far future (e.g. there are frequent cases within every generation where adolescents have really deeply thought ‘you are my true soul mate’ to their current boy/girlfriend… just to later split up with them(!) Although on the odd occasion they live happily ever after).
Adolescents can be particularly impulsive, they can be impressionable to whatever they find on the web, and can even attempt self-medication via drugs found and bought on the (dark) web. Decisions are often made based on emotions rather than careful risk analyses.
So I guess that’s the dilemma – some children won’t grow up to change their minds but some will and it’s hard to predict who will or won’t despite what they’re currently thinking today. A child doesn’t want to miss the optimum time to physically transition, but if he/she went ahead but later changed his/her mind then re-reassignment is a potential lifetime of mental and physical health problems that were arguably self-inflicted and preventable.
That’s the pickle in a nutshell!
Currently, in the debate between ‘nature and nurture’ regarding whether someone will have a ‘boy’s brain’ or a ‘girl’s brain’, it’s marginally on the side of nurture – not that the genders are born as blank slates and there’s no biological difference between the genders whatsoever, and not that the rest of the body doesn’t matter either, for even the way we move affects how we feel, and post-puberty female and male body frames are, on average, different from each other and so move subtly differently. So if you’re, for instance, a cisgender (a person whose gender identity matches the one they were assigned at birth) male and you started ‘mincing’ your walk to be more effeminate, the feedback effect will mean you’ll likely start to think and behave relatively a bit more ‘effeminately’ too, and vice-versa. (Try it if you’d like!)
Newborn boys’ and girls’ brains don’t seem to neurologically and structurally have any fundamental differences. A brain is neither fundamentally born male nor female. But this could be down to how we define ‘fundamentally different’ (e.g. on average, females have thicker cortices but males have larger brains). An analogy is what is a ‘fundamental difference’ between a cushion and a pillow? This is one reason why there’s currently no firm scientific consensus on this issue.
Additionally, altering one’s hormone levels doesn’t just change one’s body but affects one’s mind too, and this is a possible major reason why most transgender people who don’t reassign are happy they didn’t, and why most who do reassign are happy they did (excluding the social effects of stigma and therefore the mental health risk of e.g. depression, for both groups). For example, artificially boost a child’s testosterone levels and that child might prefer to be male simply because of the effects of their greater testosterone levels as a result of their hormone therapy? Another reason could be adaptation and eventually getting used to whatever body we’re perceptually stuck with.
There’s still a strong argument that our ideas of gender and sexuality, regarding the brain, are largely learnt or culturally and environmentally shaped by the world the brain inhabits, rather than innate. And we live in a highly-gendered world (e.g. pink for girls, blue for boys). This can in some cases create harmful stereotypes and self-fulfilling prophecies (e.g. women aren’t supposed to be engineers, men aren’t supposed to cry).
There seems to be a large genetic component to sexuality but it isn’t 100% genetic – there exist identical twins with different sexualities. This might be due to slightly different environmental conditions inside the womb (perhaps one twin received slightly more testosterone than the other) and/or events outside of the womb?
Non-binary gender fluidity and gender switching also exists in wild nature (e.g. some fish, such as the kobudai) – although this is not to say that what ‘is’ in other parts of nature means what ‘ought’ to be for humans too.
It’s also noteworthy that people’s desire to reassign their gender is independent to their sexual orientation – they may transition to become technically heterosexual or homosexual. But being transgender or having gender dysphoria is highly correlated with having a homosexual sexuality, although we don’t currently have information on whether having a homosexual sexuality is highly correlated with having greater transgender or gender dysphoria thoughts i.e. most As are also Bs, but it’s unsure whether most Bs are also As. It’s like most rabbits are furry things, but most furry things aren’t necessarily rabbits. And correlation doesn’t necessarily mean causation either.
Transitioning (or detransitioning) is not a single event and you’re done – it can involve not only the medical and/or surgical transition (which are not just one-off events themselves e.g. a lifetime of drugs, follow-up surgeries) but changing one’s social identity and legal identity too. The process is not as easy, fast or smooth as many may think and so should not be seen as a ‘quick fix’.
Most first socially transition (i.e. come out to their family, friends and others about their gender dysphoria first) before committing to any interventions to change their gender externally. But if their family isn’t supportive then it can be a very difficult time.
Of course every individual case should be taken on an individual basis, but with the current weight of arguments (which could later change), I’d say parents should firstly be accepting of their child and even teach or encourage them to play with whatever they want, wear whatever they want (although we can’t stop parents buying ‘girls clothes’ for girls and ‘boys clothes’ for boys) and mostly be happy to remain in their current skin whatever their outward gender appearance and birth gender.
But if a child still continues to wish to transition then let and support them, but maybe encourage them to delay the decision… until what age though is debateable! Adolescence disputably ends at about age 25 but people develop at different rates. Well people don’t legally need parental consent after 18 anyway (depending on the country).
It’s an incredibly difficult quandary because no one has a crystal ball for how a person’s life – even one’s own life – will turn out. There are cases of people who are glad they had transitioned or had held it off, or to even had detransitioned without regrets. But there are evidential cases of regret on all sides too – those who changed who wished they didn’t, and those who didn’t who wished they did sooner.
Yet because any attempted reversal of the effects of hormone therapies and/or surgeries aren’t always successful or possible without undertaking even greater health risks, such as the ever-present corresponding risks of side-effects and/or complications – I agree that gender reassignment has got to be a last rather than early resort.
Whilst a person can switch sexualities back-and-forth easily (some adolescents and young adults experiment with different sexuality phases and then eventually settle into what they find feels right) – hormonal and surgical changes are very hard, if not impossible, to switch back (e.g. one might need to get replacement parts rather than one’s original parts back).
After puberty, some might accept themselves as the gender they were born as, or just socially and legally transition without therapy (i.e. they’ll just dress to the gender they want to be). Some satisfactorily transition when much older (after they’re 30); although for many it’s not easy living in a body they’re not happy with for so long, and it might also hurt any partner they get/got into a relationship with during this time when they spring the surprise onto them that they now want to transition genders.
We acknowledge that this is a massively tough topic. The long-term mental and physical impacts, and bigger-picture societal impacts, of all this are still currently unknown, being researched and deliberated.
…We still have some more things to discuss on this topic of gender and reassignment, particularly regarding social factors, but I think we should continue it another time.
Good call because I need to hop onto the kitty litter!