Teen Vogue and Heron Greensmith Deny There Are Any Consequences to Minors with Gender Dysphoria who Medically Transition. There Are.

Editorial

Teen Vogue and Heron Greensmith, a female who doesn’t appear to have medically transitioned but goes by they/them pronouns, have published an article mentioning Gender Health Query and several other organizations skeptical about the safety of pediatric medical transition for gender dysphoria. One of the organizations listed is the American College of Pediatricians. It is an anti-same-sex marriage and adoption activism organization, and Gender Health Query does not endorse organizations that do not align with our interests.

All of the other organizations listed are not religiously motivated, anti-LGBT organizations. They include some trans people as ours does. They have evidence to support the claims on their sites and have the same concerns we do for the same evidence-based reasons.

Greensmith states there are no medical reasons for minors not to transition underage:

Among them are the Gender Care Consumer Advocacy Network, ReThink Identity Medicine and Ethics, the Society for Evidence-Based Gender Medicine, Gender Health Query, and the Pediatric and Adolescent Gender Dysphoria Working Group. Looking at these names, one could easily assume there was a strong medical argument against trans-affirming care for youth, or even potentially a discussion worth having. But let me repeat:

There is no valid medical argument against trans-affirming care for youth

Greendsmith fails to include another pro-homosexual/bisexual rights organization site, Transgendertrend, where one can find evidence-based reasons for concern, with some material written by scientists.

While Greensmith mentions our website, there is no mention of our section laying out significant medical consequences to underage transition. We will list them below to counter this irresponsible article allowed by Teen Vogue editors Lindsay Peoples Wagner, Samhita Mukhopadhyay, and Emily Shippee. There is also debate about the quality of the studies Greensmith cites, such as those done by Jack Turban that appear to suffer from confirmation bias and methodological issues (see here, here, and here), a common problem in social science research. All citations can be found in the hyperlinked section.

Significant Consequences Pro-Child-Transition Media Often Avoid Mentioning

1) Permanently destroyed sex organs resulting in a lack of ability to ever have an orgasm-

If a male who wants to be a girl takes hormone blockers as a tween, the youth will always have the penis of a prepubescent child if the child later takes estrogen. This, in of itself, may destroy the youth’s ability to have a fully functioning, adult sex life. If the youth wants a vaginoplasty surgery (they are doing them on minors), they will have to undergo a rectosigmoid vaginoplasty using the colon or one using the peritoneal lining around the stomach. This can create significant order problems later. They also must take skin flaps from the inner thigh leaving considerable scarring. There isn’t enough tissue to do what is called the “gold standard” vaginoplasty, which inverts the penis and scrotum. These other techniques are experimental surgeries.

There are already examples of the vaginoplasty falling apart and needing repair. A trans child reality TV star, has undergone at least four surgeries, describes this ordeal as extremely painful, and will likely go through life not experiencing orgasm even once. In one of the cohorts from a study Heron Greensmith sites (the de Vries/ Steensma cohort from the Netherlands), one of the youths died from the vaginoplasty surgery. Some of these minors making these decisions as tweens will never have sexual feelings in their lives. Many adults decide never to get bottom surgery. It is perfectly rational to question the ethics of destroying such a major choice when doctors transition a tween. And it is shoddy journalism to avoid mentioning this in an article discussing medical risks to under-age youth.

While we understand a dysphoric minor may have a very strong desire to live as the opposite sex and pass better, we believe it is a very sex-negative approach to destroy all ability to fully experience an adult romantic relationship and sexual fulfillment based on a decision the child made before ever having a relationship or even just a crush or sexual desire. The significance of these things is not understood by children. And while it is uncomfortable, this topic must be discussed honestly:

2) Sterility-

The hormone blocker to cross-sex hormone protocol causes sterility. There is a plethora of news articles about trans people who have children or say they want them. There is also a study that shows many trans people want biological children. There was a lawsuit in Sweden regarding trans adults suing because they were sterilized as a requirement for transition, so fertility is important to trans people. A tween or teen will not know how they will feel about children later.

3) A reduction in cognitive function-

A few studies indicate hormone blockers significantly lower IQ test scores. IQ is strongly correlated with career choice and earned income:

Schneider et al.(2017): “Brain Maturation, Cognition and Voice Pattern in a Gender Dysphoria Case under Pubertal Suppression”

4) A reduction in bone health-

Blockers appear to give a young person the bones of a much older person. Weakening bone density of a young person is worth mentioning:

Micheal Biggs bone density review paper

5) Gay, Bisexual, and Lesbian Eugenics-

All prior research shows that a very significant number of children with even acute gender dysphoria outgrow it and are very likely to grow up gay or lesbian. This graph is a review of the four most recent and best studies tracking desistance from gender dysphoria. Dr. Ken Zucker created this graphic. The percent of desistance is 67%, a majority:

Zucker, Power Point presentation USPATH 2017

Greensmith mentions Dr. Ken Zucker derisively in this piece but fails to mention that Dr. Zucker believes that children who would grow up gay or lesbian are at risk of having their bodies permanently medically altered prematurely. Any risk of permanently altering physical appearance with cross-sex hormones of potentially LGB youth is a serious ethical concern, especially for people who care about the health and diversity of expression of LGB populations. This is why Zucker took a more cautious approach, the protection of likely gay, bisexual, and lesbian youth from harm. Other gender dysphoria experts like Dr. Korte, Dr. Steensma, and Tavistock clinicians have mentioned this as a concern. Heron mentions conversion therapy laws. We are starting to see that transitioning minors is conversion therapy for some youth, particularly lesbian youth struggling with puberty. This is LGB eugenics. It’s already happening:

The London Times

And eugenics is the correct word as these protocols have the potential to sterilize, destroy sexuality, and permanently change the youth's features and voice. There are now too many stories of mostly young lesbian and bisexual women who transitioned as minors and have regrets. There are so many, the days of plausible deniability one doesn't know are over. It is callous of Heron Greensmith to fail to even mention them considering these are mostly lesbian and bisexual young women. Greensmith may want to consider if cheerleading tomboy teenagers (likely to be same-sex attracted) in their body dysmorphia and female inferiority complex is healthy for them in the long-term because it isn't. It's harming some of them.  Lesbian and bisexual youth who struggle with gender dysphoria but are better served by being allowed to just grow up without medical damages matter too. Some heterosexuals males and females also may have regrets.

6) Evidence of serious negative long-term side-effects from using Lupron, a hormone blocker-

Many women are suing due to side-effects from Lupron, a common gender clinic hormone blocker, that doctors gave them for precocious puberty or endometriosis:

As with many drugs, side effects have long been a problem. More than 20,000 adverse-event reports have been filed with the FDA in the last decade. Women have reported to the FDA hundreds of cases of insomnia, depression, joint pain and more than 100 cases of blurred vision. About 900 reports cite side effects that children below age 13 have suffered, mostly within months of taking Lupron. Those reports frequently note injection-site pain but also include dozens of cases of bone problems, such as pain or disorders, and the inability to walk.

And from Righting Injustice:

Last month, the FDA required the safety labels of GnRH agonists to be updated to include new psychiatric side effects causing emotional lability such as crying, irritability, impatient, anger and aggression. The labels were also updated with a warning that use of the drugs were linked to convulsions, particularly in patients with a history of seizures, epilepsy, cerebrovascular disorders, central nervous system anomalies or tumors, and in patients taking drugs that can increase the risk of convulsions, such as bupropion and SSRIs.

Other side effects are deteriorating jaw joints, degenerative disks, growth of preexisting tumors, deteriorating vision, exacerbation of asthma, osteopenia, memory loss, hair loss, and fibromyalgia. In adult men, some of the labeled risks of Lupron are heart attacks, strokes, and sudden death.

7) The large increase in trans-identified females looks like other body dysmorphia social contagions of which there are many in history-

Please see this section and view the graphs showing soaring numbers of female teens identifying as trans. It is not responsible to fail to question this. We would appreciate it if Teen Vogue would write a story on the massive increases of female teens identifying as trans with what appears to be a spike in transition regret by female young people:

8) A list of just a few of medical the consequences trans youth will have to deal with as adults-

• Vaginal atrophy in FtMs that causes severe pain during sex

• Increase risk of heart attack and stroke

• Liver problems

• Need for repeat vaginoplasty surgeries if they collapse

• Unknown cancer risks from underage transition 

9) The validity of the argument about the benefits of hormone blockers is debatable-

The hormone blocker study done by the Tavistock clinic in Britain has shown blockers may worsen mental health.

We believe that this was a very irresponsible article designed to hide the risk of this to the health of all gender dysphoric children regardless of how stable their trans-identity is. We support the promotion of coping skills, and the importance of brain development and physical health to support these youths for the long-term, not extreme medical fixes youth are led to believe will be a panacea. This article is especially insensitive to the concerns of the growing numbers of gay, lesbian, and bisexual people who are upset about what appears to be substantial increases in stories of transition regret among youth in their early twenties who are mostly lesbian or bisexual women. Transition regret among young females would be a good topic for a Teen Vogue article. The stories of regret are very easy to find at a time of massive increases in trans-identified youth.

Heron Greensmith needs to make the morally and intellectually honest argument. That argument is that false positives, resulting in permanently altered bodies of cognitively immature tweens/teens, resulting in sterilization and other health issues, are worth trans-positive healthcare in hopes more good than harm will be done. That argument is that it is a good thing for an 11-year-old, with no concept of sexuality or desire for children, to permanently destroy their sex organs in order to have a more feminine face, because looks and access to extreme plastic surgery to relieve distress are more important than coping skills and long-term physical health. Instead, Greensmith engages in ideological, black and white, biased, and cherry-picking discourse. This is bad journalism. And as an opinion piece be clear, Greensmith doesn’t represent the opinions of all LGBT people. We recommend that Teen Vogue find someone willing to engage with all of the facts around permanently altering minors. While we are a medical watchdog organization, and harm is our emphasis, we lay out a more unbiased picture, including arguments Greensmith makes, about the ethics of pediatric transition in “17) MORAL DILEMMAS.”

-Justine Kreher

References can be found in links at the end of these sections:

1) DO CHILDREN & TEENS WITH SERIOUS GENDER DYSPHORIA EVER DESIST FROM THE DYSPHORIA?

2) CONSEQUENCES & PERMANENT SIDE-EFFECTS THAT RESULT FROM THE USE OF HORMONE BLOCKERS

11) WHY ARE SO MANY FEMALES COMING OUT AS TRANS/NON-BINARY?

Here is a list of references for our Topics section.

Thanks to The Australian and Bernard Lane for Publishing Our Comments About the Affirmative Model

News Commentary

Bernard Lane has been writing articles about transgender issues for The Australian. Those articles can be found listed under his BIO.

Lane included GHQ statements for an article about conversion therapy laws and how these will be used to immediately affirm the significant increases in trans-identified youth:

“Health chiefs can’t ignore ‘global epidemic’ of transgender teens”

Here is the quoted GHQ commentary:

Justine Kreher, from a new US-based LGBT group Gender Health Query worried about overdiagnosis of gender dysphoria and medicalisation of minors, said most LGBT people were not aware of the risks.

“The evidence is strong that early social transition (living as the opposite sex) and use of hormone blockers will lead to the over-medicalisation — or “conversion” — of LGB minors who would have outgrown gender dysphoria with maturation,” she said.

“It’s already happening as known cases are mounting. The question is, how high will the percentage be?”

Gender Health Query’s international board includes trans adult Miranda Yardley and lesbian feminist philosopher Holly Lawford-Smith from the University of Melbourne.

Ms Kreher, also a board member, said LGBT lobbies and progressive media refused to discuss “the reality that for many gender-nonconforming youths, or even adults, there isn’t a clear line between gay and trans”.

“Trans people argue transition as a minor is a human right (but troubled) LGB people would argue the right to mature and accept oneself, without being medically defaced by the psychology and medical profession, is a human right.”

Ms Kreher said activist promotion of medicalised gender change had been “extremely effective in inducing suicide terror in the public”.

“People should take suicide risk seriously, but it is also exaggerated and employed to manipulate people to not care about serious risks to minors who may (grow out of gender dysphoria) with time,” she said.

“These risks include sterilisation, loss of sexual function, impacts on bone and circulatory health, and a reduction in IQ if they take hormone blockers.”

The article included commentary from mental health professionals expressing similar concerns:

The internationally recognised sex researcher, Ray Blanchard, joined online debate about the Queensland bill, tweeting: “Conversion therapy laws are Trojan Horses, ostensibly about banning attempts to change sexual orientation in adults, actually about banning therapy to help gender-dysphoric children and youth become comfortable with their anatomic sex”.

And:

Dr Parry pointed out that many children grew out of gender dysphoria, becoming “more comfortable with birth gender or a same-sex orientation”. Clinicians say this is a reason to be cautious about medical interventions.

Psychologist Dianna Kenny, who treats gender dysphoric youth, told the committee that trans activists “vehemently denied the role of social contagion in the spread of gender dysphoria in young people because it flies in the face of their flawed ideology that children are the experts regarding their own gender identity”.

Dr Kenny, a specialist in developmental psychology and a former professor at Sydney University, said beliefs and attitudes were especially contagious in centralised social networks.

“This network is highly centralised with only one voice — the trans activist lobby — being heard above the desperate cries of terrified parents and horrified academics, doctors, psychologists and psychotherapists.”

She said this social contagion was affecting not just children and adolescents but also medical practitioners, legislators and educators.

The article confirms this is mainly affecting young females:

There were at least 216 patients on controversial puberty blocker drugs (up 108-fold over six years).

The clinic refuses to reveal birth sex data but 94 per cent of the 84 under-18s on opposite-sex hormones were taking testosterone, meaning they were born female.

Thanks to the paper and author for airing our concerns.

References

Lane, B. (2020, February 11) “Health chiefs can’t ignore ‘global epidemic’ of transgender teens.” The Australian. Retrieved from https://www.theaustralian.com.au/nation/health-chiefs-cant-ignore-global-epidemic-of-transgender-teens/news-story/5849a55ba47884befdc9eb72d25d32d7

New Study Linking Conversion Therapy to Depression in Trans Adults & Criticism

News

Affirmative model advocate Jack Turban released a study linking suicide risk to childhood conversion therapy.

“Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults:”

Findings In a cross-sectional study of 27 715 US transgender adults, recalled exposure to gender identity conversion efforts was significantly associated with increased odds of severe psychological distress during the previous month and lifetime suicide attempts compared with transgender adults who had discussed gender identity with a professional but who were not exposed to conversion efforts. For transgender adults who recalled gender identity conversion efforts before age 10 years, exposure was significantly associated with an increase in the lifetime odds of suicide attempts.

The study was also criticized for having poor methodology by health professionals/scientists:

Misinterpretation of the findings of this study may limit safe, ethical treatment options for gender-questioning and gender-diverse people:

Prof Richard Byng, PhD, University of Plymouth, UK
William J Malone, MD St. Luke’s Endocrinology and Diabetes Clinic, Twin Falls, ID.
Prof David Curtis, PhD, Queen Mary University of London, UK

The study by Turban and colleagues reports that previous exposure to “gender identity conversion efforts (GICE)” is associated with suicidality among transgender-identifying adults. While the large sample size is a strength, the authors underplay the serious methodological weaknesses, particularly the likely confounding effects of co-existing mental health problems. They then take this association and in the abstract and conclusion seek to imply causation. Hence, the findings could mislead frontline clinicians and public policymakers alike.

The key limitation is that the study did not control for comorbid psychiatric illness, the greatest single predictor of suicidality. While mental health conditions are acknowledged as confounders, they are declared unlikely based on the spurious idea that this would require internalized transphobia. Rather, it seems likely that professionals encountering persons with gender dysphoria (GD) and significant mental health problems were more likely to engage in conversations about the merits of transition, which may later be recalled as a conversion effort. Thus, the association found is arguably more likely due to reverse causation.

Another limitation is that the study data are from a convenience sample of current transgender-identifying individuals, rather than all persons with a history of GD. The sample is highly unlikely to have captured individuals exposed to GICE who subsequently adopted a gender identity concordant with their biological sex. Thus, these data cannot be generalized to individuals as they present with GD.

Prepubertal-onset GD has a high rate of remission, while desistance of GD among those in adolescence with recent onset GD, the increasingly dominant presentation, is as yet unknown. We oppose coercive or unwanted deliberate attempts to change an individual’s gender identity and propose that a range of neutrally framed, supportive therapies and consultative approaches, which are neither affirmation nor conversion, be evaluated in randomized controlled trials. Outcomes of noninvasive treatments should be compared to those of “gender-affirmative models of care,” entailing hormonal and surgical interventions which are associated with increased heart disease, impairments in bone density, infertility, and high rates of suicide over the long term.

References
1. Turban J, et al. Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults. JAMA Psychiatry. 2019:1. doi:10.1001/jamapsychiatry.2019.2285
2. Franklin J, et al. Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychol Bull. 2017;143(2):187-232. doi:10.1037/bul0000084
3. Steensma T, et al. Factors Associated With Desistence and Persistence of Childhood Gender Dysphoria: A Quantitative Follow-Up Study. Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(6):582-590. doi:10.1016/j.jaac.2013.03.016
4. Dhejne C, et al. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. PLoS ONE. 2011;6(2):e16885. doi:10.1371/journal.pone.0016885”

References:

Turban J.L., Beckwith N., Reisner S.L., Keuroghlian A.S. (2019). Association Between Recalled Exposure to Gender Identity Conversion Efforts and Psychological Distress and Suicide Attempts Among Transgender Adults. JAMA Psychiatry(11), 1-9. doi:10.1001/jamapsychiatry.2019.2285

New Study on LGBT Youth & Mental Health released by the Trevor Project

News Commentary

 A new study on LGBT youth and mental health has been released by the Trevor Project, a U.S. based LGBT youth advocacy group. 

In this survey there are as many trans-identified youth as gay and lesbian youth or bisexual youth. This is unprecedented in earlier suites on the LGBT population.

This study shows that both trans youth and LGB youth report high rates of suicide ideation and attempts, as well as discrimination. The rates are higher for trans youth.

Youth who report having people try to change their sexual orientation or gender identity report worse mental health. GHQ does not support rejecting trans youth or diminishing their gender dysphoria issues. We support a mental health model and worldview that doesn’t consider inappropriately transitioned minors and young adults as morally acceptable collateral damage.

It is very important to protect LGBT youth from bullying and physical violence. This is not the only study that shows an association with poorer mental health and suicide risk and bullying.

There are some aspects of this study that have a negative impact on the quality of it:

 1) It is gathered on social media websites so it is a survey study, not population based. These may yield questionable results.

 2) This study as published online has a major shortcoming in that it does not break down biological sex, not by gay or lesbian, and not by trans-identified biological females relative to males.

2 studies reveal that having a biological sex of female verses male may be what is actually driving the highest suicide risk rates rather than “cis” versus trans. The recent Toomey 2018 study in the US and a Stonewall UK study are reviewed here pointing out that reality.

Recent data is showing large increases in numbers of females who identify as trans, as well as large increases in females with serious mental health problems. Biological sex is a very relevant factor in this research. Scientists should display this information clearly in studies and take it into consideration when analyzing data. It is actually an odd oversite that it is not included in the Trevor Project Study and other recent LGBT studies.

3) The study does not break down the mental health of gay, lesbian, and bisexual youth or of trans versus non-binary-identified youth. These are different populations. For example, many studies show bisexuals have worse mental health problems than gays or lesbians. They may have as many mental health problems as trans people do. Not isolating this population was a missed opportunity to communicate with the public what these young people are experiencing. It’s one of several negative side effects arising from constantly lumping all “LGBT” people together. These populations all show differing profile averages in mental health, physical health, and income. 

4) There are multiple questionable identities like “demi-boy” and “ace-spectrum” lumped in with LGBT youth which appear to reflect online Tumblr youth culture rather than clear data collection.

A previous blog post about two females who obtained nippleless double mastectomies raises the topic about whether or not minors will receive sugeries for non-traditional medical transitions. These are for identities such as agender, nullo, or neutrois, which are identities where the person wishes to be no gender or sexless and may remove nipples, the whole penis, or have the vagina sewn up and clitoris removed. These identities technically fall under non-binary identities which are being medicalized in children under the age of eighteen. Here in the list of the Trevor Project identities is “Neutrois.

Update 06/24/19: A recent news article “Almost 2 percent of high schoolers say they are transgender” about a CDC study shows it has similar results to the Trevor Project survey. It demonstrates drastic increases in numbers of trans-identified teens, and that they have much higher suicide risks rates

We do not have open comments on the Gender Health Query website. But that doesn’t mean we aren’t interested in what you have to say. If you have a comment, blog post idea, or any other feedback, we would be interested if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences. Please contact us.