Minneapolis
Raising kids is the ultimate hands-on project. If your teenaged son tells you he plans to text while driving, for example, your job is to set him straight on the facts and consequences—to help him face reality.
But in Minnesota in 2017, there’s one exception: If your boy declares he thinks he’s a girl, powerful social forces dictate that you must raise no objections, swallow hard, and get ready to enthusiastically support his “gender transition.”
Today, a youth transgender craze is sweeping the nation, and the elites here in my state are fully on board. The Minnesota Department of Education, the State High School League, and Gov. Mark Dayton heartily embrace it. The Minneapolis and St. Paul public schools have policies allowing students to use the bathrooms, locker rooms, and showers of the opposite sex. Meanwhile, a Twin Cities organization called “Transforming Families” announced last year that its youngest transgender support group—for kids ages 4 through 8—has about 25 members.
Affirmation of “gender transitions” by young people is the new litmus test of enlightened, progressive thinking. But it has a dark underside: chemical and surgical experimentation on children, with unknown consequences that may haunt those young people and our society for decades.
A few years ago, there were only a handful of pediatric “gender clinics” in the country. Today, there are at least 40. What’s happened? Activists have successfully reframed as a civil rights issue a condition previously viewed as a disorder. To express skepticism about a child’s self-diagnosis as transgender is now to risk being branded a hateful bigot. Medical professionals who do so may face career-ending persecution.
This newly dominant civil rights narrative obscures both the scientific facts and medical risks that young people will face if they go down the “gender transition” road. Here’s the fundamental problem: The claim that a human being can change his or her sex is “starkly, nakedly false,” according to Dr. Paul McHugh, who served for 26 years as psychiatrist-in-chief at Johns Hopkins Hospital in Baltimore.
Every cell in the human body identifies individuals as either male or female, with males having an XY and females an XX chromosome. Transgender advocates like to claim that “gender” is “assigned at birth.” In fact, sex is an anatomical reality “assigned” when a baby is in the womb.
Young people who are clinically impaired because they feel significant incongruence with their biological sex suffer from a condition known as “gender dysphoria.” Increasingly, children who suffer from gender dysphoria “come to their ideas about their sex” through psychosocial “conflicts over the prospects, expectations, and roles that they sense are attached to their given sex—and presume that sex reassignment will ease or resolve them,” says McHugh. For example, a boy whose father has abandoned him or a girl who has seen females abused may come to believe that life would be better as a member of the opposite sex.
Until recently, the standard treatment for pediatric gender dysphoria was “watchful waiting” and family talk therapy focused on issues that might underlie patients’ misperception of reality. This made sense, because the vast majority of young people outgrow this condition by the end of adolescence.
But in 2007, Dr. Norman Spack of Boston Children’s Hospital introduced to the United States a radical new treatment protocol that originated in the Netherlands. Its premise—rooted in ideology, not science—was that young people who are unhappy with their sexed bodies should be affirmed in their desire to live as the opposite sex.
Children who choose “gender transition” begin a process that renders them dependent on the medical system for life. They are given puberty blockers at around age 12 and cross-sex hormones—estrogen for boys and testosterone for girls—at age 16 or so.
Cross-sex hormones increase superficial resemblance to the opposite sex by stimulating the development of secondary sex characteristics, such as facial hair in females and breast tissue in males. Many of the changes that result cease if hormone use ends, but some—such as changes in facial and body hair and balding in women—never go away.
An increasing number of young people go on to “sex reassignment” surgery. This can include amputation of healthy body parts—including double mastectomies for girls as young as 16, and removing or creating “penises” and “vaginas.”
The medical risks of hormone-related treatment are significant. For example, puberty blockers stunt growth during use and may also decrease bone density. Girls who use testosterone may develop severe acne and have trouble with mood swings, anger, and aggression.
One of the most serious risks is lifelong infertility. Permanent sterility is likely when puberty blockers in early adolescence are followed by cross-sex hormones, according to “Growing Pains: Problems with Puberty Suppression in Treating Gender Dysphoria,” a report by McHugh and two other physicians, Paul Hruz and Lawrence Mayer, that appeared in the spring 2017 New Atlantis. Pediatric gender clinics like the one at Seattle Children’s Hospital caution postpubertal adolescents to consider freezing their eggs or sperm before hormone use, if they may someday want a biological child.
The effects over time of hormone use on children’s development are unknown. In addition, young people who take these hormones will need lifelong monitoring for dangerous side effects, including cancer, liver damage, diabetes, stroke, and heart attack. For example, a consent form used by Fenway Health, an LGBT medical facility in Boston, warns that “the long term effects” of testosterone use by females have “not been scientifically studied and are impossible to predict.”
Today, doctors hesitate to give estrogen treatments to postmenopausal women or testosterone to young male athletes because of documented dangers. Nevertheless, some physicians now dispense powerful cross-sex hormones to young people because they wish to resemble the opposite sex. In our state, the University of Minnesota’s Program in Human Sexuality provides hormone treatment to “gender creative” adolescents and surgical referrals for “young adults.”
In short: The use of sex-reassignment treatments in children amounts to a massive, uncontrolled experiment. Vulnerable children are being encouraged by activists to make irreversible, life-changing decisions at an age when many states bar them from getting a tattoo or using a tanning bed.
The last few years have seen a dramatic increase in the number of young people complaining of gender dysphoria. Britain’s Gender Identity Development Service, to cite one striking example, reports a 2,000 percent increase of referrals of children under 18 between 2009-10 and 2016-17.
Two major factors appear to be driving the dramatic increase in gender dysphoria in young people. Influential adults in medical, educational, and media settings are encouraging troubled children to attribute their personal problems to being transgender. At the same time, gender transition has become a kind of fashion statement in social media.
In Minnesota, as elsewhere around the United States, state education officials are fueling the explosion. Here, the Department of Education is pushing a “transgender toolkit” and urging K-12 schools to adopt the policies it recommends, insinuating that schools that don’t could face legal problems.
The toolkit states that “transgender and gender nonconforming students” should be treated as the gender they identify with, in terms of bathroom and locker room use, participation on athletic teams, overnight accommodations during school trips, pronoun use, dress codes, and school records. It goes on to assert that a “family’s acceptance . . . of their child’s gender identity is strongly associated with positive mental health,” and implies—chillingly—that if parents are judged to be insufficiently supportive, “the school support team should follow their protocol for reporting child neglect or harm.”
As a result of ideological strongarming like this, it is increasingly difficult for children to find the help they need to address the mental health problems that may underlie their gender confusion. Activists have succeeded in portraying the evaluation of alternative explanations as questioning a child’s “true identity.” As one therapist has put it, in no other field is the self-diagnosis of a 10-year-old to be taken seriously.
The costs of our extraordinary experiment in juvenile “sex reassignment” will become increasingly evident. Some young people are already attempting to “de-transition” from life-altering medical treatments they now regret. In the end, however, it may take a raft of lawsuits over damaging side effects like lifelong infertility to prompt rethinking of the children’s gender identity crusade now underway.
Katherine Kersten is a senior policy fellow at the Center of the American Experiment in Minneapolis.
