Transyouth: Going From Treating "Very Serious Suicide Attempts" To "Cooperating With Psychosis"

by: Autumn Sandeen

Wed May 28, 2008 at 15:30:00 PM EDT

IDEAS: At what age do you give kids drugs to delay puberty?

SPACK: The puberty-blocking drugs work best at the beginning of the pubital process, typically age 10 to 12 for a girl and 12 to 14 for a boy. Stopping puberty is, in itself, a diagnostic test. If a girl starts to experience breast budding and feels like cutting herself, then she's probably transgendered. If she feels immediate relief on the [puberty-blocking] drugs, that confirms the diagnosis.

IDEAS: So the aim of your treatment is to protect children from harming themselves?

SPACK: Transgendered kids have a high level of suicide attempts. Of the patients who have fled England to see me, three out of the four have made very serious suicide attempts. And I've never seen any patient make [an attempt] after they've started hormonal treatment.

There are no genital surgeries taking place. We're talking about blocking hormones and later giving adolescents hormones -- this is how Dr. Spack addresses this:

IDEAS: At what age should children be allowed to take hormones, like estrogen and testosterone, that will forever change the way their bodies develop?

SPACK: Well, the Dutch would say 16. But I think more flexible guidelines will be coming out. For some kids, 16 might be appropriate. For others {hellip} you lose opportunities if you wait. [One of my patients, a] transgendered girl from the UK, was destined to be a 6-foot-4 male. With treatment, she's going to end up 5-foot-10.

Dr. Spack isn't providing for or arranging for minors to receive genital reassignement surgery as minors.

How the story has been told and emphasized -- from being about the quality of children's lives and suicide prevention to one emphasizing conservative Christian beliefs and theology; from focusing on these children to focusing on the statements of Dr. Paul McHugh -- the John Hopkins professor who advised  the Catholic Church regarding sex abuse and transsexuals -- and whether or not Dr. Norman Spack is a "nutjob", or whether treatments offered to transgender children at Dr. Spack's clinic are "barbaric," "a rejection of the lawfulness of nature," and "cooperating with psychosis."

Although treatment of transsexual youth (or even adults) is not always couched in terms of faith-based, conversion therapy, often it is.

The National Association For Research & Therapy Of Homosexuality's (NARTH's) Dr. Richard P. Fitzgibbons mixes the treatment of transsexual adults with his Catholic faith  -- and the treatment of youth diagnosed with gender identity disorder (GID) -- in his NARTH piece The Desire For A Sex Change:

[After the fold, NARTH, the Liberty Council, and the Catholic Medical Association weigh in, and the tie-in to NARTH's unique diagnosis of Same Sex Attraction Disorder (SSAD) for adolescents and adults.]

Many of those who seek surgical "sex change" suffered from untreated and undiagnosed gender identity disorder (GID) as children. For example, a therapist was consulted by a member of the family of a young woman who had told her parents that she wanted "sex change" surgery after graduating from college. Since childhood, the young woman had shown all the classic symptoms of GID. She had never had female friends, never wore a dress, never used make up, never wore jewelry or dated a boy. She also insisted that her Catholic parents address with a boy's name which they agreed to do.

GID in children is a treatable condition; however, according to Zucker and Bradley, who are experts in the treatment of this disorder in children, parental ambivalence is, in most cases part of the problem with parents ignoring or excusing obvious problems. Zucker and Bradley encourage early intervention, not simply to avoid a later desire for a "sex change" but to prevent the suffering, unhappiness, and isolation that children with GID experience. In the case of this young woman, the therapist recommended treatment of GID to the family member who asked for consultation, but this recommendation was never communicated to the parents. The young woman recently had her breasts removed.

In an article about Dr. Spack's clinic, Fox News quotes Mat Staver, founder and chairman of Liberty Counsel (affiliated with the late Jerry Falwell's Liberty University), with stating that transgender disorder is a mental disorder, not a medical one, and that it should be treated with behavior modification, not hormones or surgery.

"Just as you don't give liposuction to an anorexic, you don't do sexual reassignment surgery on men who think that they are women and vice versa."

In a Philadelphia chapter press release of the Catholic Medical Association on "cross-dressing (in schools) by a child with GID":

In the (Philadelphia Inquirer) article the principal of the school is noted to have written a letter to parents explaining that a transgender child is one whose biological gender does not match his or her gender identity.

This demonstrates a common but serious lack of knowledge of the medical literature related to psychiatric diagnoses in children. These studies show that children with strong transsexual thinking and behaviors, in fact, usually have the diagnosis of a Gender Identity Disorder (GID). GID leads to the desire to dress in clothing of the opposite sex and to be called by a name of the opposite sex. The major textbook on this subject is Gender Identity Disorder, by Zucker and Bradley.

These children have failed to identify and embrace the goodness of their masculinity or femininity for a number of reasons, related particularly to conflicts with peers and parents, primarily with their mothers. As Zucker and Bradley document in their clinical work and research, most children who are treated for GID recover. They come to accept and embrace their birth gender. As this occurs attraction to opposite sex dressing and identity is resolved. Zucker and Bradley encourage early intervention to prevent the suffering of isolation, unhappiness and low self-esteem that children with GID experience and also to avoid a later desire some may have for sex change surgery.

Note that Gender Identity Disorder is described in the DSM IV-TR of the American Psychiatric Association, while there is no diagnosis which specifies a "transgender child."

All of these articles quote Dr. McHugh's opinions regarding the treatment of youth and adult transsexuals, and many of these articles quote Dr. Zucker on how and why parents should arrange for conversion therapy (also called reparative therapy) for their GID diagnosed children. Since GID in Childhood isn't considered just a transsexual youth condition, but is also considered a pre-homosexual condition...

LGB people should also pay attention when organizations like NARTH cite Zucker's work (and to a lesser extent cite McHugh's work) when its contributors write about conversion therapy for LGB adults. NARTH frequently ties GID in Children with their diagnosis of Same Sex Attraction Disorder (SSAD) in adolescents and adults.

The theology and ideology all seem so far away from addressing the suicidal ideation and suicide attempts of transyouth. I guess for me, that's really the frustration of all this is that the moral commentators are commenting from a perspective that they are the voices of moral purity and moral superiority -- it seems to be much more about theology and ideology than about actual needs of actual transyouth.

~~~~~
Related:
* Gender-Variant Children And Transsexuals Will Likely Still Be Disordered In DSM-V
* Pam's House Blend on the National Association For Research & Therapy Of Homosexuality (NARTH)
* Pam's House Blend on Dr. Paul McHugh
* Pam's House Blend on Dr. Kenneth Zucker

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