Much of the false concern over trans kids (and trans healthcare in general) is founded in ignorance, outrage, and moral panic. The process for any gender affirming care is often gatekept. In many parts of the US, for instance, we have to prove our transness, receive letters from providers to have insurance cover things (if they’ll cover it at all), and see a therapist and psychiatrist for at least a year before any first steps. Sometimes that’s even contingent upon presenting as our identified gender in public for a certain amount of time before receiving any medical care, which basically means appeasing someone else in their perception of how they think you should present a particular gender, which can be pretty goddamn backwards and wacky.
All gender affirming care is entered into by the patient with a very full knowledge of the side effects of medical transition. The extra steps are largely about making access more difficult to achieve through insurance so you give up, theoretically costing your insurance company less. (Though that’s debatable, considering that preventative care can cost less than hospitalization or thousands of hours of therapy in the long-run.)
In some places, like California where I thankfully live, trans healthcare is largely based on informed consent. But even then, providers often refuse to diagnose us or prescribe HRT. My fiancé once had an endocrinologist under new insurance refuse to prescribe his HRT despite the fact that he had already been taking testosterone for two years before switching to this provider. He just needed the doctor to transfer the prescription over from his previous insurance and providers and they refused, forcing him to seek care outside of the county he resided in at the time.
Once you do find someone willing to provide gender-affirming care, informed consent is the process in more progressive cities and states. We have to watch videos, read about side effects, and present our knowledge to our providers before sometimes going on waitlists to get our medication. I was lucky to be receive my prescription the same day that I requested it, but staffing shortages even in LGBTQIA+ specific healthcare frequently results in waiting weeks or even months to receive your prescription. Insurance authorizations can also stall things if your paperwork is missing something or if they just feel like being difficult and denying your first request to see if you’re willing to go through an appeal process.
The point is, nobody gets on puberty blockers or HRT without knowing the intended and potential side effects. As a community, we are inundated with information before we ultimately choose whether or not to transition medically. Nobody accidentally ends up on puberty blockers - it is a well thought out course of action weighed against the risks of not undergoing such care.
All trans people weigh the risks of gender affirming medical care, which includes trans children/teens and their families. Puberty blockers merely grant a child time to figure out what to do next, which can be much safer than just letting a kid go through a puberty incongruent with their gender identity. That is why I reinforce the real issue in my essay on puberty blockers several times throughout the piece. What’s at stake is quite serious and shouldn’t be impacted by bigots with a keyboard. Ultimately, the question is whether a parent would rather their trans kid stall puberty before undergoing permanent irreversible changes to their body, or if they’d rather risk their kid going through a puberty that results in a dysphoria-induced suicide.
It’s not *always* that dire, but it frequently is. Often enough that access should be considered a human right, particularly when juxtaposed against the extremely small number of people who begin gender-affirming care and later choose to detransition for a reason *other than social ostracization.*
The side effects of puberty blockers are far more manageable than burying a child or forever caring for one who attempted suicide and lived through it with brain damage. The side effects are even more manageable than just living with and enduring gender dysphoria. If our concern is that a child or teen has an underdeveloped brain, we must also consider that the stress, anxiety, and depression that gender dysphoria can cause also impacts a developing brain. Young people exposed to extreme amounts of stress hormones will often experience adverse side effects for the rest of their life if the cause of the elevated distress isn’t treated shortly after the emergence of such symptoms. We are talking about lifelong treatment resistant depression and anxiety, as well as a possible future emergence of C/PTSD. We must think about the long term effects of medication in the same way that we must think about and consider the side effects of not seeking treatment.
In most cases, random strangers don’t have the best interests of you or your children in mind when critiquing the medical care you receive. Just as I wouldn’t be likely to listen to someone who opposes blood transfusions, kidney dialysis, or chemotherapy in favor of prayer, I’m not going to listen to someone who learned about the side effects of gender affirming healthcare from someone on Reddit or WebMD. Someone else’s concern for my health is irrelevant. Someone else’s concern for a child’s parent and doctor-approved medical intervention is also irrelevant.
The only relevant opinions and concerns are that of the patient (self or child), informed parents, and qualified medical professionals. And in some cases, refusal to put a child on life-saving treatment should, in fact, be considered child abuse. A strongly held belief is not a good enough reason to let a child die when healthcare could intervene and save their life.
