Transition Therapy for Transgender Teens Drives Divide (2023)

April 23, 2021 -- One step led to another. That is the message from Keira Bell, a 24-year-old British woman who lives daily with the regret of transitioning to male gender in her teens. She received puberty blockers after just a few appointments at a gender clinic, and later injected testosterone. By age 20, she had undergone a double mastectomy.

On Dec. 1, 2020, Bell won a lawsuit against the Gender Identity Development Service of the Tavistock and Portman National Health Service Foundation Trust. Bell claimed doctors should have challenged her more about the decision to transition before starting medical treatment. GIDS is the only institution that treats people under 18 with gender dysphoria as part of England’s national health service.

In short, the High Court ruled that people under age 16 with gender dysphoria — people whose sex at birth is contrary to the gender they identify with — cannot give informed consent for treatment with puberty blockers, drugs that aim to halt normal puberty.

The decision also encouraged docors to seek court approval before treating any gender dysphoric person under age 18 with 'affirmative' medical therapy (ie, puberty blockers and cross-sex hormones, such as testosterone, to transition to male or estrogen to transition to female) if there is any chance that the patient might not fully understand the long-term implications of therapy.

This 36-page High Court ruling has upended the affirmative medical treatment model for adolescents with gender dysphoria in the U.K. The decision is currently being appealed.

Arrested Development: A One-Way Path?

GIDS performed a study that showed no changes in quality of life, psychological function, or degree of gender dysphoria in 44 children who took puberty blockers for up to 3 years The study also showed adverse effects of the treatment: suppression of bone mineral density and growth. And almost 100% of kids taking these agents continued to transition, contradicting GIDS' claims that puberty blockers function as a 'pause' button to give children more time to consider their options. Rather, the findings suggest that the kids were effectively on a one-way path to transitioning medically.

The next step is taking cross-sex hormones, which are associated with several irreversible changes, including deepening of the voice, facial hair, clitoral growth in girls taking testosterone, and possible infertility and sexual dysfunction in both girls and boys. Long-term adverse effects include osteoporosis, blood clots, heart disease, and cancer, among others.

Many will then look to surgeries — as did Keira Bell — particularly the euphemistically termed 'top' surgery, which means a double mastectomy for a female transitioning to male, or breast augmentation for males transitioning to female. In the U.K., such surgeries are reserved for people over 18, but in the U.S., double mastectomies have been performed on children as young as 13 years old.

"I was an unhappy girl who needed help. Instead, I was treated like an experiment," says Bell, telling her story on the website Persuasion. "As I matured, I recognized that gender dysphoria was a symptom of my overall misery, not its cause. Five years after beginning my medical transition to becoming male, I began the process of de-transitioning. The consequences of what happened to me have been profound: possible infertility, loss of my breasts and inability to breastfeed, atrophied genitals, a permanently changed voice, facial hair."

Bell's victory in the U.K. High Court is considered a landmark decision, and along with moves in some other European countries, it signals that the tide may be starting to turn when it comes to how a minor with gender issues can be treated by the medical profession.

A New Kind of Patient

Will Malone, MD, is an assistant professor of endocrinology practicing in Twin Falls, ID, who says there is little evidence to support hormonal interventions for people under 18 with gender dysphoria. In 2020, Malone was one of several doctors and researchers who formed the Society for Evidence-Based Gender Medicine (SEGM), a not-for-profit organization that now has at least 100 physician members.

Malone told Medscape that he first became interested in this issue because he started receiving calls from primary care doctors who said they were seeing teenage girls who were identifying as male, often clustered in groups. "Some girls were very distressed. Some were asking for hormones, some not. The primary care docs wanted to know what to do."

This phenomenon, Malone says, was very different from any gender dysphoria he had learned about in medical school or training, which was primarily in mature adult males who wanted to change sex or was the classical childhood-onset gender dysphoria where young children (mainly boys) reported feeling trapped in the wrong body.

(Video) The Science of Being Transgender ft. Gigi Gorgeous

The vast majority of youth now presenting with gender dysphoriaare adolescents who suddenly express revulsion with their sex from birth, and 70% of them were born female. Many of them have anxiety, attention deficit hyperactivity disorder, autism spectrum traits, and depression, Malone explains, which need to be considered.

This newer diagnoses— which has been termed late-, adolescent-, or rapid-onset gender dysphoria — has now been seen in every gender clinic in the western world, and there has been a huge surge in the number of cases. One recent U.S. survey found a 4000% increase since 2006, and there have been similar large increases in Finland, Norway, the Netherlands, Canada, and Australia.

The London GIDS clinic has seen a 30-fold increase in referrals over the past decade – and again they were primarily adolescent girls who said they now identify as boys.. Malone says there is no credible scientific explanation for why there has been such a big swing from predominantly males to predominantly females experiencing gender dysphoria, and around the time of — or just after — puberty onset.

Sabine Hannema, MD, of the Department of Pediatric Endocrinology, Sophia Children's Hospital in Rotterdam, the Netherlands, treats transgender children. She told Medscape that the number of referrals has indeed increased in the last decade, and that the ratio of children she sees has changed, with relatively more trans-boys (assigned female at birth) in recent years.

Stephen Rosenthal, MD, a pediatric endocrinologist at University of California, San Francisco, also treats transgender youth. He said he believes the concept of late-onset is a parental notion. "From our experience in clinical practice, what seems like … rapid-onset from the perspective of the parents — because they are only just hearing about it — might not be [out] of the blue but something the child has lived with for some time — but only revealed during adolescence."

Nevertheless, he acknowledges that there's a lot more that needs to be known.

Is Social Contagion Playing a Role?

There have been numerous reports in the press of clusters of adolescent girls, often in schools, claiming they are now transgender. Many involved in the care of these children are increasingly concerned about the possible role of social contagion in the genesis and propagation of this phenomenon.

Hannema says she is aware of the concern that through exposure to certain media, some children might erroneously believe that their nonspecific emotional or bodily distress is a result of being transgender.

"The implied outcome is that such individuals will then access gender-related medical interventions, and eventually come to regret these once they realize that they are in fact not transgender," Hannema observes. However, she counters that rates of regret have historically been very low.

Joshua Safer, MD, of Mount Sinai Hospital, New York City, is a spokesperson on transgender issues for the Endocrine Society and says the treatment of transgender youth is already conservative.

"We don't do any medical treatment on anybody before puberty. For most of the kids that we're talking about in these mid-teenage years, we're using a very conservative approach, which is puberty blockers…because those are essentially reversible."

"The approach has been used for a long period of time with…precocious puberty, so we do have data from adults who were treated years ago with these regimens. Our confidence about their safety is quite high," he adds.

Yet there is no doubt that more and more people — from the worlds of psychiatry, psychology, and endocrinology, as well as parents of children with gender dysphoria — are increasingly going public with their concerns about how swiftly medical treatment can be administered in some countries, with often minimal psychological counseling beforehand.

Little Research on Those Who Regret Transitioning

Despite the claims of low rates of regret from doctors who treat transgender youth, there is evidence of a growing number of "de-transitioners" — typically twenty-somethings who have had medical interventions and, in many cases, gender-reassignment surgery who now bitterly regret their decision. It is difficult to pinpoint the exact number of those who will come to regret their transition, as there has been no formal research into this, but many argue that this in itself is a strong rationale for pressing the pause button on this practice of "affirmative" medical therapy, particularly in those under 18.

James Caspian is a British psychotherapist experienced in counseling transgender adults. He told Medscape in 2019 that he first became interested in this topic when a gender-reassignment surgeon he knew from Serbia told him he had patients coming back, requesting to have their transition surgery 'reversed.' At first, it was a trickle of patients, but as Caspian explains in a recent podcast, that surgeon has now reported more than 70 'regretting' patients at his one practice alone.

One Reddit subthread for detransitioners currently has more than 17,000 members, and a facility in Sweden, the Lundstrom Gender Clinic, provides trauma therapy for de-transitioners.

Asked about those individuals who may regret transitioning, Safer told Medscape: "It's absolutely true that you can find individuals who regret their choice."

However, he qualifies, "the data do not seem to suggest that the majority of those people say their gender identity is necessarily any different; it's more that they regret the medical treatments for various reasons. Among them, it's the lack of acceptance by society that is their largest reason for regretting their decision."

And he maintains that those who regret their decision are less than 1% of those treated. "I can speak to my specific experience," he says when pressed to cite published research for this figure. "I've taken care of hundreds of transgender people and I have single digit numbers [of those] who have regretted medical treatment, so that's where my number for under 1% [comes from]."

Transgender Adults Are Sounding an Alarm

Many transgender adults are also sounding the alarm because they know the burden of lifelong hormone treatment and the many complications associated with gender-affirming surgeries.

In the U.K., the dialogue has now reached a critical turning point since Keira Bell's victory in court, and mainstream media are now openly covering all sides of the discussion. And although the conversation in the U.S. is markedly different, there are some signals that this may be about to shift.

Last year, Wall Street Journal contributor Abigail Shrier's book Irreversible Damage: Teenage Girls and the Transgender Craze created a furor when it was first published. The Economist listed it as one of its "Books of 2020."

(Video) Growing Up Trans (full documentary) | FRONTLINE

Explaining why she set out to investigate this phenomenon in an article for the Daily Mail, Shrier says she became "haunted" by one question: What's ailing these girls? "Their distress is real, but their self-diagnosis is flawed — more the result of encouragement and suggestion than psychological necessity," she writes.

"Many adolescent girls identifying as transgender don't actually want to become men. They simply want to flee womanhood like a house on fire, their minds fixed on escape, not on any particular destination. They feel alienated from their bodies and the changes brought by puberty: acne, periods and breast development, and uncomfortable attention from men….This is a story Americans need to hear."

Some therapists Shrier interviewed believe that these girls are actually experiencing a type of 'body dysmorphia' not unlike anorexia nervosa, and others are concerned that they are repressed lesbians, and that an internal kind of 'homophobia' is fueling their desire to be male.

Malone, the Idaho endocrinologist, says that Shrier — who interviewed over 200 people, including doctors, psychotherapists, parents, de-transitioners, transgender 'influencers,' and trans adults — has penned "a meticulously researched and much-needed book."

Asked by Medscape what he thinks about Shrier's book, Mount Sinai endocrinologist Safer says it is "entirely based on the perspective of fearful parents worrying that their kids are being brainwashed."

Guidelines Based on One Study

Safer serves on the Standards of Care revision committee for the World Professional Association for Transgender Health. The group’s most recent standards of care issued in 2012, says, "Adolescents may be eligible to begin feminizing/masculinizing hormone therapy, preferably with parental consent. In many countries, 16-year-olds are legal adults for medical decision-making and do not require parental consent." They add: "Hormone therapy should be provided only to those who are legally able to provide informed consent. This includes people who have been declared by a court to be emancipated minors."

Safe is also a co-author of the Endocrine Society's 2017 guidelines for treating youth confused about their gender. These guidelines were formally presented at the annual meeting of the Endocrine Society in March 2018.

(Video) Voice Modification for Transition

Malone was there.

"At this conference, the Endocrine Society — a highly respected organization — rolled out a set of guidelines for kids that essentially said, 'Your job as endocrinologists is to medically affirm [gender dysphoric] adolescents with puberty blockers and cross-sex hormones,'" he tells Medscape.

Malone says he was astounded when he first heard the guidelines, but immediately assumed, "There must have been a massive change in the landscape, some landmark study that I missed somehow. But the evidence simply wasn't there, he says.

Debate Is Most Polarized in the U.S.

The debate about how best to treat transgender minors is probably more polarized in the United States than just about anywhere elsewhere in the world.

Arkansas has just passed a law, due to take effect in July, banning certain types of treatment for transgender youth, which threatens loss of license to any health care professional who provides puberty blockers, cross-sex hormones, or gender-affirming surgery to minors, and opens them up to lawsuits from patients who later regret their procedures. At least 16 other U.S. states are considering similar legislation.

In contrast, parents trying to obtain psychological help for children before proceeding to hormonal treatment can often only find therapists who 'affirm' their child's transgender identity and recommend they start puberty blockers or cross-sex hormones.

Safer told Medscape, however, that except for Arkansas (once the ban is enacted), the standard of care for a child who has gender dysphoria does not differ among states.

"The establishment approach is that the kid would come in and would have a mental health intake and there would be sober conversations. If they are prepubescent, there is no intervention. If they are mid-teenage, then the intervention, if there is an intervention, would be puberty blockers, which are reversible. So, it's very conservative, actually," he says.

Asked about Malone, SEGM, and their concerns about rushed affirmation of transgender youth, Safer says, "This is a relatively small group that has been making the same arguments for a number of years, and they are very much outside the mainstream. It's not that there's a debate within organized medicine, where there are equal numbers of people on both sides. Dr. Malone is outside of those arguments; [he is] not in the mainstream."

Safer also advises against "confusing conservative conclusions from our existing literature with absence of data."

Cognitive Maturity Not Reached Until Age 25

An often-cited claim of proponents of affirmative medical therapy for gender dysphoria is that these kids have high rates of suicidal ideation and restricting their access to hormonal therapies (and surgery) would endanger them.

"The data are that if you are not supportive of the children, that is a source for greater mental health problems," says Safer. "And if you are supportive, the data are that you will have fewer mental health problems, so the strategy is to be supportive, or 'affirming.' That is the standard of care within the medical community."

But there is also little concrete evidence that transitioning improves mental health. And because the concept of late-onset gender dysphoria is relatively new, there are very few studies on this specific patient group.

Doctors Become Skeptical, Develop Ethical Stress

Many who support and practice the affirmative medical treatment of transgender children have accused those who argue against this stance of being "armchair critics," saying that until you have one of these distressed kids "in front of you," you can't begin to understand what will be best for them.

(Video) The Future is Now: Increasing Access to Care for Transgender/Gender Diverse Youth Using Telehealth

However, several doctors who have been treating these children are themselves now starting to express regret.

Angela Sämfjord, MD, child and adolescent psychiatrist at Sahlgrenska University Hospital in Gothenburg, Sweden, started a child and adolescent clinic — the Lundstrom Gender Clinic — in 2016. Two years later, she resigned because of her own fears about the lack of evidence for hormonal and surgical treatments.

She tells Medscape: "There's a lot of tension between some approaches of gender clinics and the trans community. Patients found it hard to accept that they needed to undergo a full mental health assessment before being referred for medical treatment. Parents would say that nobody ever discussed that other issues…might be implicated in the child's dysphoria."

The referred adolescents had many psychiatric symptoms, says Sämfjord, and she realized that gender dysphoria was just one part of a complex problem. She also noticed that the psychiatric symptoms came first, followed by gender dysphoria upon reaching adolescence.

"[I] felt that we could not separate these things. Concentrating only on the gender dysphoria meant we might miss other things," she tells Medscape. Among her patients, 90% had another psychiatric diagnoses in addition to gender dysphoria; 80% had two or more. Depression and anxiety were most common, and 20% had a diagnosis of autism on arrival at the clinic; around 50% had symptoms of autism.

"When I realized the complexity [of these cases]…and that health care professionals are still expected to okay gender-affirming treatment despite the lack of evidence that we currently have, it preyed on my conscience," she told the Trans Train 2 documentary in autumn 2019.

"I wasn't prepared to take the risk, as a doctor, of causing these patients harm. I took the consequences of this and resigned," Sämfjord says.

‘Perfect Storm’ of Inappropriate Transitions

As evidenced by the doctors who were interviewed for the Swedish Trans Train documentaries, some Scandinavian countries have also started to put the topic of gender dysphoria in children — and the best treatment for them — under the microscope.

In 2020, Finland became the first country in the world to issue new guidelines for this group of patients when it concluded that there is a lack of quality evidence to support the use of hormonal interventions in adolescents with gender dysphoria.

This new Finnish guidance supports psychological therapy over treatment with hormones or surgery and suggests different care plans for early-onset vs late-onset childhood gender dysphoria.

Malone stresses that in terms of prioritizing psychological assessment, the U.S. (and to a similar extent Canada and Australia) currently trail behind the U.K. and Finland.

But he is thankful that in the U.K. and elsewhere, doctors "are much more skeptical of guidelines [than we are in the U.S.], and this is music to my ears."

"There is far less attention paid to psychological evaluation and treatment in the U.S. compared with the U.K.," says Malone. "There is also a far more aggressive timeline for the provision of puberty blockers and hormones, such that we have created the perfect storm of inappropriate transitions.

"The case of Keira Bell was avoidable. Clinicians should know that if you intervene without good supporting evidence, there is a good chance people will be harmed. As more people come forward, more people will realize…that's what's occurring. The question is, 'What is the burden of harm that has to happen before people start to take notice?' "


What are the risks of transitioning? ›

While transitioning, you'll take hormones to achieve masculine or feminine effects.
Those hormones carry risks:
  • Low or high blood pressure.
  • Blood clots.
  • Stroke.
  • Heart disease.
  • Certain cancers.
  • Fluid loss (dehydration) and electrolyte imbalance.
  • Liver damage.
  • Increased hemoglobin.

At what age is gender dysphoria most common? ›

Transgender Men

Gender dysphoria history: Of the 55 TM patients included in our study, 41 (75%) reported feeling GD for the first time by age 7, and 53 (96%) reported first experiencing GD by age 13 (Table 2). A total of 80% of patients reported that feelings of GD were among their earliest childhood memories.

What age can you start hormone blockers? ›

The protocol always starts with puberty

Puberty blockers are only given to children who have started puberty. For a child who is assigned female at birth, Dr. Cartaya says puberty typically starts between the ages of 8 and 13. For a child who was assigned male at birth, the range is between 9 and 14.

Do puberty blockers cause permanent changes? ›

Puberty blockers do not cause permanent changes to the body. And you can stop taking them at any time. If you decide to stop taking puberty blockers and did not take hormone therapy, your body will go back to the puberty that had already started.

What are the long term effects of transitioning? ›

Transgender women have a higher risk of venous thromboembolism, stroke and meningioma compared to cisgender men and cisgender women. Compared to cisgender men, transgender women have a higher risk of breast cancer and transgender women > 50 years old have a higher risk of fractures.

What are the two types of transitioning? ›

  • When you hear “transition,” you might think about medical transition first. ...
  • Internal transition is about changes in the way you see yourself. ...
  • Social transitioning may include things like:
  • Legal transition is about changing information about your gender in official records or other government documents.

Can gender dysphoria go away after puberty? ›

Gender dysphoria that starts in childhood and worsens with the start of puberty rarely goes away. For children who have gender dysphoria, suppressing puberty might: Improve mental well-being. Reduce depression and anxiety.

What happens if you don't treat gender dysphoria? ›

Although gender dysphoria is not a mental illness, when not addressed, it may lead to worsening mood issues, depression and anxiety, and may further complicate the issues the individuals may be having. Insurance may cover some illnesses associated with gender dysphoria and gender dysphoria care.

Can gender dysphoria be caused by trauma? ›

Gender dysphoria currently exists as a mental health diagnosis, perpetuating stigma as well as pathologizing gender variance. Clinical social workers have preserved a harmful formulation that gender dysphoria is a disorder caused by trauma.

Can you take hormone therapy at 14? ›

We are not currently able to prescribe puberty blockers or gender affirming hormones therapy to youth under 16.

Can puberty cause gender dysphoria? ›

Additionally, while some transgender adolescents have shown gender non-conformity since early childhood, other adolescents might experience gender dysphoria during or after the onset of pubertal physical changes. Some adolescents may have kept their gender incongruence to themselves for a long time.

Do puberty blockers affect the brain? ›

WASHINGTON (TND) — Earlier this month, the U.S. Food and Drug Administration added a warning to gonadotropin-releasing hormone (GnRH) agonists, commonly known as “puberty blockers,” indicating there were serious risks for youth who take them.

What age is best for puberty blockers? ›

The longer blockers are used past the typical start of puberty — generally age 14, at the latest — the greater the possible risk. When blockers are initiated in the early stages of puberty, Dr. Rosenthal typically suggests that his patients stop using them by age 14.

Do puberty blockers delay mental development? ›

Puberty blockers delay the start of puberty, including development of secondary sex characteristics. Surprisingly, even though puberty blockers are widely used to help transgender adolescents go through gender transition, their impact on brain function during this critical stage of brain development is largely unknown.

Do puberty blockers stop pubic hair growth? ›

No, puberty blockers will not stop pubic or armpit hair from growing or improve acne. Puberty blockers only make a difference for the puberty changes that make you look “female” or “male”. For example, in bodies with ovaries, breast size may get smaller if they have already started to develop.

Why is transition in life difficult? ›

Life transitions are challenging because they force us to let go of the familiar and face the future with a feeling of vulnerability. Most life transitions begin with a string of losses: The loss of a role. The loss of a person.

How many years does transitioning take? ›

Transitioning is a process that can take anywhere between several months and several years. Some people, especially non-binary or genderqueer people, may spend their whole life transitioning and may redefine and re-interpret their gender as time passes.

How many people change their mind after transitioning? ›

The study found that 2.5 percent of the group had reverted to identifying as the gender they were assigned at birth.

What are the 4 phases of transition? ›

The stages are shock, anger, acceptance and commitment. People's initial reaction to the change will likely be shock or denial as they refuse to accept that change is happening. Once the reality sinks in and people accept the change is happening, they tend to react negatively.

What are the five stages of transition? ›

The Five Stages of Founder Transitions
  • Stage 1: Pre-Announcement (Denial) ...
  • Stage 2: The Announcement (Anger) ...
  • Stage 3: The Search (Bargaining) ...
  • Stage 4: The Transition (Depression) ...
  • Stage 5: The Future (Acceptance) ...
  • Final Thought.
19 Aug 2020

What are the 5 examples of transitions? ›

Transitional devices
  • Of addition. Examples: also, besides, furthermore, moreover, etc. ...
  • Of contrast. Examples: however, still, nevertheless, conversely, nonetheless, instead, etc. ...
  • Of comparison. Examples: similarly, likewise. ...
  • Of result. Examples: therefore, hence, thus, consequently, etc. ...
  • Of time. Examples:
3 Aug 2022

How do you get over gender dysphoria without surgery? ›

Other ways to ease gender dysphoria might include use of:
  1. Peer support groups.
  2. Voice and communication therapy to develop vocal characteristics matching your experienced or expressed gender.
  3. Hair removal or transplantation.
  4. Genital tucking.
  5. Breast binding.
  6. Breast padding.
  7. Packing.
26 Feb 2022

What do I do if my daughter wants to be a boy? ›

Support Your Daughter's Gender Style

Some children are more masculine or feminine in style, so be respectful of who your daughter is and do not try to change her. I encourage you and your husband to support her clothing choices, hairstyle, and even her gestures and mannerisms.

Can gender dysphoria be overcome? ›

For some people, treatment may just involve acceptance and affirmation or confirmation of their identity. For others, it may involve bigger changes, such as changes to their voice, hormone treatment or surgery. Read more about treatments for gender dysphoria.

What is the prognosis for gender dysphoria? ›

Outlook (Prognosis)

Different treatments can relieve symptoms of gender dysphoria. However, reactions from others to the person's transition including social and legal difficulties during the transitioning process can continue to create problems with work, family, religious, and social life.

Can you misdiagnose gender dysphoria? ›

There is no medical test for gender dysphoria and there are cases where sufferers have been misdiagnosed and subsequently “detransition”.

What is an Autogynephile? ›

Autogynephilia is defined as a male's propensity to be sexually aroused by the thought of himself as a female. It is the paraphilia that is theorized to underlie transvestism and some forms of male-to-female (MtF) transsexualism.

Can social anxiety cause gender dysphoria? ›

found that while gender dysphoria was significantly related to social anxiety disorder, only one variable related to minority stress, perceived violence at school, was significantly related to the disorder.

Does plastic cause gender dysphoria? ›

Recent evidence indicates that thalates from plastic and polychlorinated biphenyls (PCBs) are one of many factors predicting gender dysphoria, particularly in the case of male-to-female transgenders.

How long does it take to transition from female to male? ›

Guidelines recommend people spend 12 months on hormone therapy before they get genital reassignment surgery (GRS). This operation involves recreating a person's genitals to that of the opposite sex. Removal of the gonads may be done as well.

How old do you have to be to transition genders? ›

—Most genital surgeries starting at age 17, including womb and testicle removal, a year earlier than previous guidance. The Endocrine Society, another group that offers guidance on transgender treatment, generally recommends starting a year or two later, although it recently moved to start updating its own guidelines.

Can hormones cause gender dysphoria? ›

However, recent studies point toward a biological basis involving endocrine, neurobiological and genetic factors. For instance, an increased prevalence of gender dysphoria was observed among people who experienced atypical prenatal androgen exposure in utero, such as females with congenital adrenal hyperplasia (8–15).

What are the early signs of gender dysphoria? ›

Gender dysphoria symptoms
  • distress.
  • anxiety.
  • depression.
  • negative self-image.
  • strong dislike of your sexual anatomy.
  • strong preference for the toys and activities associated with the other gender (in children)

How do schools deal with gender dysphoria? ›

The first thing you do is breathe, calm yourself, and just take it one step at a time. Just your calm and understanding presence will go a long way in making them feel safe. Next, try to connect them to others like them. They need their people, their group, in order to feel welcomed.

How can gender dysphoria affect mental health? ›

Anxiety, depression, self-harm, eating disorders, substance misuse and other problems can occur. People who have gender dysphoria also often experience discrimination, resulting in stress.

How does gender dysphoria affect the brain? ›

A recent study investigated the volume of grey matter in individuals with GD and found that they had a smaller volume in the left posterior superior hemisphere of the cerebellum compared to male controls and a smaller volume of the right inferior orbitofrontal cortex compared to female controls.

Did the FDA issue a warning about puberty blockers? ›

lawmakers support findings. MONTGOMERY, Ala. (WSFA) - New findings from the Food and Drug Administration show a link between common puberty blocker hormones and serious risks for youth who take them.

What drug is used for puberty blocking? ›

The most common medication for this process is gonadotropin-releasing hormone (GnRH) analogues. These drugs suppress your child's sex hormones (testosterone and estrogen) during puberty. The most common puberty blockers include: Goserelin (Zoladex)

How much do puberty blockers cost with insurance? ›

The cost of puberty blockers is approximately $1,200 per month for injections and can range from $4,500 to $18,000 for an implant.

Are there any downsides to puberty blockers? ›

Puberty blockers are considered to be very safe overall. We are not sure if puberty blockers have negative side effects on bone development and height. Research so far shows that the effects are minimal.

Can a 15 year old get puberty blockers? ›

Transgender children are not offered puberty blockers or hormone treatments until they reach puberty. Medical guidelines generally do not recommend genital gender-affirming surgeries before a child reaches age 18.

Does puberty mess with your mind? ›

However, researchers have discovered that puberty not only changes your body, but also your brain. This is because puberty involves changes in hormones that also attach to your brain cells and change how the brain learns and grows. These changes are useful because they help shape the brain for new forms of learning.

Do puberty blockers reduce breast size? ›

Being on this medication will cause some breast reduction in those assigned female at birth.

What damage do puberty blockers do? ›

Delayed growth plate closure, leading to slightly taller adult height. Less development of genital tissue, which may limit options for gender affirming surgery (bottom surgery) later in life. Other possible long-term side effects that are not yet known.

Can you take puberty blockers at 13? ›

Puberty blockers are only given to children who have started puberty. For a child who is assigned female at birth, Dr. Cartaya says puberty typically starts between the ages of 8 and 13. For a child who was assigned male at birth, the range is between 9 and 14.

How long does transitioning usually take? ›

Transitioning is a process that can take anywhere between several months and several years. Some people, especially non-binary or genderqueer people, may spend their whole life transitioning and may redefine and re-interpret their gender as time passes.

Is transitioning difficult? ›

Transitions are hard for everybody,” says David Anderson, PhD, a clinical psychologist at the Child Mind Institute. “One of the reasons why transitions may be hard is that we're often transitioning from a preferred activity – something we like doing – to something that we need to do.”

How do you cope with a partner who is transitioning? ›

If your partner is up for talking, remain respectful, curious, and honest. Try not to avoid the hard questions, but also make sure each person feels up for answering. Boundaries can change at any time, and it is okay to take a break to think, then come back together to finish a discussion.

Can a female change to male naturally? ›

No. It's not natural. U have a psychiatric problem of gender identity disorder and this may lead to depression. A female can't become a male and vice versa.

How long does transition from female to male take? ›

Take your time, transitioning can take a long time. On average it takes 2-3 years.

How much does female to male transition cost? ›

Breaking Down the Costs

Bottom surgery, or changing the genitalia, costs an estimated $25,600 for male-to-female patients and about $24,900 for female-to-male, according to The Philadelphia Center for Transgender Surgery.

Why do children struggle with transition? ›

Kids resist change for different reasons. Some crave order, routine, and control so changing things, especially when they have no control, leads to resistance. Other kids fear the unknown. Then there are children who simply don't want to stop doing what feels rewarding to them to do something else.

Why do some people struggle with transitions? ›

The main reason is that we are often transitioning from something we enjoy to something we need to do. While young and old experience transitions, it is the adults who determine when and where transitions occur. The inability to control their own routines is what causes angst for kids during transitions.

Does transition cause anxiety? ›

One side effect of transition is anxiety. Anxiety manifests itself through nervous behaviors such as eating too much or too little, watching too much television, playing games, fidgeting, procrastination, tension, pacing back and forth, worry, uneasiness and fear.

What are the stages of transitioning? ›

Transition, on the other hand, is internal: it's what happens in people's minds when facing and experiencing change. You can use the model to understand how people feel as you guide them through change. It has three distinct stages: Ending, Losing, and Letting Go.

Do you need counseling before transitioning? ›

According to the commentary, the World Professional Association for Transgender Health (WPATH) advises mental health screenings and recommends psychotherapy before any body modifications are made.

How long do you have to be on hormones before transitioning? ›

The speed at which changes occur depends on various factors. These include the dose and your body's response. For most people, it takes 18 to 24 months to achieve the full effect.

Do couples stay together after transition? ›

Sometimes the couple will need to decide whether they will remain together. However, many couples do remain together after one partner transitions. Familiar dynamics in the relationship often change or are altered.


1. The Confusion of the Trans Movement: the ethics of the trans gender debate.
(Jamie Baillie)
2. Gender Identity Development and Medical Options for Transgender Youth | UCLAMDChat
(UCLA Health)
3. Transforming Gender (Transgender Documentary) | Real Stories
(Real Stories)
4. I Emailed My Doctor 133 Times: The Crisis In the British Healthcare System
(Philosophy Tube)
5. WHAT IS IT LIKE TO BE TRANS? - Trans Talks: Part 1
(King of the Aces)
6. Y'all Means All: Having Trans* Inclusive Conversations
(Duke University School of Law)
Top Articles
Latest Posts
Article information

Author: Wyatt Volkman LLD

Last Updated: 12/31/2022

Views: 6175

Rating: 4.6 / 5 (46 voted)

Reviews: 85% of readers found this page helpful

Author information

Name: Wyatt Volkman LLD

Birthday: 1992-02-16

Address: Suite 851 78549 Lubowitz Well, Wardside, TX 98080-8615

Phone: +67618977178100

Job: Manufacturing Director

Hobby: Running, Mountaineering, Inline skating, Writing, Baton twirling, Computer programming, Stone skipping

Introduction: My name is Wyatt Volkman LLD, I am a handsome, rich, comfortable, lively, zealous, graceful, gifted person who loves writing and wants to share my knowledge and understanding with you.