U.K. court reins in gallop toward transgender treatment

MEGAN BASHAM, HOST: It’s Thursday, the 14th of January, 2021. 

Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Megan Basham.

MYRNA BROWN, HOST: And I’m Myrna Brown. First up: gender dysphoria.

Before we go any further, this is a story that might not be appropriate for younger listeners. So if you’ve got the kids around, you might want to hit pause and come back later.

BASHAM: Last month, Great Britain’s highest court handed down a ruling that limits access to puberty blockers for minors. The decision put the brakes on the headlong rush to treat gender dysphoria as a physical problem, rather than a mental and emotional one. Child advocates hailed it as a victory for vulnerable teens who need protection, sometimes from themselves.

WORLD’s Anna Johansen Brown reports.

ANNA JOHANSEN BROWN, REPORTER: When Keira Bell was 16, she wanted to be a boy. She struggled with depression, anxiety, suicidal thoughts. She thought she’d been born in the wrong body, so she went to London’s Tavistock Centre. It runs the country’s only gender identity development clinic. There she got puberty blockers. Then cross-sex hormones like testosterone. Then a double mastectomy—all so she could live as a man.

Here she is in a 2020 interview with the BBC.

BELL: Years ago, when I went to the clinic, it felt like it was saving me from suicidal ideation, and just depression in general. And at the time, I felt like it relieved all those mental health conditions I was struggling alongside gender dysphoria…

But her mental health struggles persisted, and Bell began to regret making such radical, life-changing decisions as a teen. She wanted to be a girl again.

Eventually, Bell sued the gender clinic, saying she was rushed into treatment without enough counseling and therapy. She says no one challenged her ideas or offered a different way of thinking.

BELL: I should have been told to wait, and not affirmed in my gender identity I was claiming to have…

In December, Bell won her case. The U.K.’s highest court ruled that minors under the age of 16 should not be given puberty blockers without a court order. The ruling emphasized the “experimental nature” of the drugs: The lack of evidence showing they help improve mental health, or that they’re even safe and without serious side effects.

Dr. Andre Van Mol is a family practitioner in California. He says the court is exactly right.

VAN MOL: Well, it’s hardly a hormonally neutral thing you’re doing to the person. The consequences of treatment are highly complex and potentially lifelong and life changing in the most fundamental way imaginable.

Puberty blockers are just what they sound like. As long as the patient gets regular injections, the drugs stop puberty from happening. Advocates say it’s a pause button that allows children extra time to decide what gender they really want to be. They insist the effects are fully reversible.

But Dr. Van Mol points out that’s not a sure thing. After all, during puberty, there’s a lot going on: Major changes in organs and musculature.

VAN MOL: Puberty is the time of the greatest increase in bone density a person has in their life. So if you block that, that’s a problem. You’re asking for premature osteopenia and osteoporosis.

The brain also develops rapidly during puberty.

VAN MOL: Hindering of brain development milestones, you know, can you get those back later? We don’t know. 

Dr. Van Mol says it just isn’t possible for a young person to make an informed choice on something like this because they cannot grasp the scope and implications of the decision.

Ryan Anderson is a senior research fellow at the Heritage Foundation.

ANDERSON: When you think about the things that are really, really meaningful to adults, when it comes to family life and their fertility and their ability to have children and to nurse children that to kids aren’t even on the radar screen, right?

Parents are in an especially tough spot.

LARUE: My name is Gigi LaRue. And I am using a pseudonym. I work with Our Duty, USA, which is a group of parents whose children have become convinced that they’re born in the wrong body.

LaRue uses a pseudonym to protect her young daughter, who struggles with gender dysphoria. 

LARUE: She sort of got the idea from someone else. And, you know, it made sense to her because she feels uncomfortable. But it’s a very alluring concept to believe that any discomfort you have in your body can be fixed with surgery and drugs.

LaRue says she’s one of the most liberal people on the planet. But she doesn’t think kids should be making gender decisions so young.

LARUE: And little kids are, who still believe in the tooth fairy and Santa Claus, are grasping these ideas and applying them to themselves. And being encouraged by parents and the community to be, you know, be your authentic self, instead of being allowed to explore tutus and, you know, dolls as a boy, they’re being told that they’re really a girl, or vice versa.

Without getting to the root problems, puberty blockers and hormones and surgery won’t fix anything.

LARUE: A lot of them detransition. There’s a lot of kids who have changed their minds. Because they weren’t ready and it didn’t solve it. And they did make a decision too early. And so I think that that’s trying to sort of be hush hush because nobody wants to admit that this doesn’t always work.

Instead of rushing to intervention and changing the body, Dr. Van Mol recommends trying to understand why children feel this way.

VAN MOL: You’re going to find underlying issues both in the child and the family. And those can be addressed, you know, interventions can happen to help those which will also improve the situation.

Gigi LaRue wants more people to speak up.

LARUE: It’s really difficult to find somebody who will even talk about it with you, because everyone’s afraid. We’re not allowed to talk about it, we’re not allowed to publicly disagree with it, because you’re immediately labeled as phobic or somehow anti, which is not the case, I just don’t believe children should be medicalized.

She doesn’t agree with conservatives on much of anything. But she says advocates for puberty blockers are practicing bad medicine. And that should unite people on both sides of the aisle.

Reporting for WORLD, I’m Anna Johansen Brown.


WORLD Radio transcripts are created on a rush deadline. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of WORLD Radio programming is the audio record.

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