Gender Affirming Care: 2008

Thanks to twitter user @Tea94852859 I was alerted to this paper from 2008, on whether or not to block puberty, Here it is : 👇

08sep-cohen-kettenis-jsm2008

Before I covered this paper I had a look at Peggy Cohen-Kettenis to see any interviews she had given. I found her make this statement about “Patient B” who was the inspiration for beginning pubertal suppression in children who presenting with “gender incongruence”. Here’s was Cohen-Kettenis had to say about “Patient B”

You have to look at Michael Biggs work to get a little more detail on “patient B” 👇

It later transpired that patient B was also a Lesbian.

Cohen-Kettenis was described as “brave” by John Money. 👇

John Money was the man responsible for experimenting on the Reimer twins. One of the twins had a botched circumcision which destroyed his penis. Money advised his parents to raise him as a girl and hide this sex from him. Later it was also revealed that the twins were subject to some sexual impropriety at the hands of Money. It was hidden for many years that the experiment failed and the twin realised he was actually male and reverted to living as a man. Tragically, both twins committed suicide.

Cohen-Kettenis also does not dwell on the boy who died during the attempt to fashion a simulacra of female genitalia. This outcome is given in one sentence, in the report on the outcomes of the Dutch Protocol.

Again Michael Biggs sheds more light on the reason why this patient died. He died as a result of complications from surgery, that were a direct consequence of the pubertal suppression.

She proceeds to describe how feminine were the people who had early treatment and mentions Nikki, of Nikki’s Tutorials, who is a make up YouTuber. Nikki is a hugely successful social influencer who recently married another man. So, another homosexual who has been “transed”. We will never know what Nikki’s life could have been or whether he could have lived happily as a gay man.

I was inclined to sympathy for Nikki until someone sent me this information about him representing women at the United Nations.

Nikki did not start puberty suppression till age 14 which, from my research, would suggest he had already reached the age of sexual function. Unlike the kids who have their puberty blocked earlier and, as Marci Bowers, president of WPATH, admitted will be rendered anorgasmic.

You can watch her here

Peggy Cohen Kettenis

The paper: Remember this was in 2008!

Here is the abstract.

Pro-Pubertal suppression

The paper outlines the arguments in favour of pubertal suppression and those against. The pro-arguments focus on avoiding the “torment” of going through the wrong puberty and the passability of those wishing to mimic the opposite sex. She does outline some research suggestive of the idea that there may be a biological cause for “Gender incongruence”. However even she is not confident in the research and concedes that, in the absence of a definitive diagnostic tool, we are reliant on the subjective assessment of the patient, which will likely be mediated through a practitioner of “gender medicine”.

She also admits that all the research shows a shocking percentage of these kids will resolve their gender incongruence, if left alone. It is not highlighted that most of these kids would simply turn out to be gay.

She admits that there are some clinicians who are less than confident about the interventions based on the diagnostic tools available. Here it is described it as “a less than solid foundation” for the medical interventions prescribed.

The arguments pro pubertal suppression centre on the children who have presented with a persistent rejection of their natal sex. The authors describe a myriad of mental health conditions that they argue are not co-morbid with the “gender dysphoria” but are rather caused by the Gender Identity Disturbance. They report parents and patients confirmed there was a relief of suffering once puberty was halted. This, they argue, gave the patients “time to think” a phrase that, some would argue, is undermined by the fact that 98% + continue onto cross sex hormones. Yet, the authors present the opposite argument, the continuance on this path is because the diagnostic criteria applied has a high degree of accuracy.

There is a high premium placed on “passability” as the opposite sex. The emphasis on this seems in part driven by the masculine appearance of the late transitioning males who wish to pass as women. This is less of an issue for females who take testosterone who, at least superficially, more likely to pass as small men.

The other argument is that stopping the development of secondary sexual characteristics removes some unnecessary surgeries. moreover it is argues that there are worse outcomes the later the surgery takes place. Finally the authors contend that not providing this option risks patients seeking illegal means to access the drugs.

The case against: When in doubt abstain?

We now move onto the arguments opposed to these early interventions. These centre around the difficulty of diagnosis and skepticism about the stability of the child’s /adolescent identity. In addition the physical development brought about through puberty may resolve the “gender incongruence” . (In particular relationships my develop that enable acceptance of a homosexual orientation which, bizarrely, is not mentioned).

The high rates of desistance are, to my mind, a particularly compelling argument. 80-95% would be better off if left alone! Again. no mention of how many of these would simply be gay!

Another risk relates to bone density and brain maturation.

The riskier surgery for males deprived of normal penile development.👇. The authors argue that new techniques have been developed to address this issue but note that Jazz Jennings required revisions after his surgery as do many other “transitioners” who have gone public about their surgeries.

This is all an experiment driven by the belief in “gender identity” as an innate facet of the “trans” child. Yet the authors speak of the torment of going through a natural puberty.

The authors describe blocking puberty as reversible but also concede that the impact on brain maturation is unknown. 🤷‍♀️

The authors conclude my claiming that not intervening is more of an ethical dilemma than intervening. We are a long way from ending this practice. Cass Review is out this week but, sadly, I don’t anticipate it saying what needs saying.

You can see the work of Michael Biggs in this YouTube. His work is exemplary.

Michael Biggs

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