Ethical considerations: ”Trans kids”

This paper was published in November 2021. The author is Dr David Schwartz. His credentials are below:

You can access the article here:

Ethics & treatment for Gender Dysphoria

The abstract outlines his view that medicine should be guided by the principle of ”First do no harm” and he makes it clear that current practices, re Gender Dysphoric youth, fall foul of this guiding principle.

The paper opens with some reflections on the media saturation on the theme of “Gender” which has become ubiquitous in the last decade. The author proceeds to define “Gender”, making it clear his view that it is based on a psychological belief rather than a material reality. We are living at a specific cultural moment and claims that ”Gender Identity” is an innate, some claim a ”biological” phenomena are leading to negative consequences for dysphoric youth. Prevailing orthodoxy, he warns, about gender identity disorders is having a negative impact on clinical practice.

The idea that refugees from biological sex are driven by a craving for ”belonging” is a profound observation and chimes with my own observations of my, gender dysphoric, son. 👇

The author makes a clear distinction between sex and gender. Gender exists in the mind. Sex in the body. One of these things is a material reality the other is an entirely subjective belief.

The author had previously been involved in a multi-disciplinary team examining treatment protocols for children and adolescents with Gender Dysphoria. What he found was an enthusiastic embrace of medical responses and scant regard for any psychological approaches to the condition.

After publishing on the topic Schwartz expected to get pushback from trans-activists, what he did not expect was the parents who reached out to him. Through the parents he realised there was a need for an alternative to the medical responses, surgery and hormones, offered as the standard treatment for dysphoric kids.

The author is keen to draw a distinction between adult decisions and those taken on behalf of children or by adolescents.

Schwartz goes on to debunk the idea that blocking puberty is a benign way to provide a period of respite,  for the dysphoric child. We simply do not have sufficient longitudinal data on the impact on health and well-being.  We do know they have negative impacts on bone density and adversely impact fertility. {In fact near 100% of these kids progress to cross-sex hormones and will be sterile. In the U.K we do this to children as young as 10 years old}.

The argument that gender dysphoric children must be protected from a natural puberty has resulted in taking the child at their word and reinforcing their belief by accepting it as a medical truth. Schwartz also laments the lack of research into the psycho-social consequences of remaining pre-pubertal and out of step with your peers.

It is important to name these interventions in plain language. This topic is replete with euphemisms like ”top surgery”, ”Gender affirming care” etc. As the author points out we are removing healthy tissue and organs and rendering, fertile, youth sterile, we are also making them medical patients for life.

The frequency of complications is not measured or reflected in the literature. Much of this is documented on the YouTube accounts of those undergoing this treatment. More recently a YouTuber, Exulansic, has begun to cover this. It is shocking that it is left to individuals, outside of the Gender Industrial Complex, and transitioners themselves to raise issues about the medical complications they suffered. The fatality reported below 👇 was as a result of a necrotised neo-vagina. Those embarking on these procedures deserve better.

The other startling lacunae, in those who promote these medical interventions, is the failure to cover the issue of desistance; i.e. those dysphoric children who re-identify with their birth sex. The research indicate desistance ranges from half to 96%. What is highly significant is that a large proportion turn out to be gay males and Lesbians. The inescapable conclusion is that this is a particularly egregious form of Gay Conversion Therapy. Where desistance is referenced it is, unbelievably, done so only to question whether it is ethical to encourage desistance!

Here Dr Schwartz talks of an exchange he had with a Gender specialist when he pressed her about her role in ”transitioning” children. The arrogance!

The idea that it is not an ideal outcome for children to desist should not be verboten. I have said this before. Nobody should see a life of medical dependence and surgeries on healthy bodies as an optimal outcome.

Gender Identity Ideology is driving medical practice. Don’t drink the kool-aid. Stay angry. This is not good medicine.

Dr Schwartz began to work with gender dysphoric kids in response to parental approaches. Here he outlines some common characteristics in the kids he encountered, professionally. Gender, he found, was a central preoccupation and functioned as “a defence against other, unspoken, dreads”.

The existence of co-morbidities, mental health issues, is something raised repeatedly in surveys off those identifying as ”transgender”. The reckless disregard of competing issues has led to tragically misguided, surgical, interventions. Gender identity issues may serve as a mask for other issues and labelling troubled youth as ”transgender” can be a misdirection. Suicidality may originate in underlying psycopathy and should be explored rather than used to justify a fast track to hormones and surgeries.

The way suicide ideation is presented as a lever to access medical intervention is precisely the opposite of good care. Presented with a suicidal gender dysphoric child/adolescent clinicians should see this as a red flag for irreversible decision making, not, as happens all to often, as a green light.

Conclusion

Clinicians must return to first principles and not jettison the usual rules of safety and care when the word ”Transgender” is uttered.

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