False positives: How many 12-year-olds is it acceptable to mistakenly sterilize?

As anyone who has spent time reading this blog well knows, I am highly skeptical of the existing research which purports to show a static male or female “gender identity” in the brain. Even if there are fundamental differences between typical male and female brains, there are going to be bell-curve outliers; and those outliers are still biologically male or female. Further, to my knowledge, there is no research proving that there is an immutable “gender identity” that is persistent throughout the lifespan, regardless of lived experience and separate/apart from biological sex) . ** (see note, bottom of post)

But for the purposes of this post, let’s just assume that the strident proponents of childhood transition are correct: there is an immutable gender identity, set in stone and impervious to change via life experience. Further, we will assume that, for a small percentage of people who experience gender dysphoria in childhood (no more than  about 20%, the number generally agreed upon even by the most zealous transgender advocates), this gender identity is mistakenly lodged in the skull of the “wrong” body. It follows that there is such a thing as a truly transgender child. These kids really do have a mismatch between brain and body, and the most humane and medically responsible thing that can be done for them is to let them “transition” to the opposite sex, post haste. As young as possible.

Case closed? Not quite.

First, let’s be very clear what we are talking about here, in terms of pediatric medical treatment. The current protocol for children identified as transgender is puberty blockers  (GnRH agonists) administered at the onset of puberty (Tanner Stage 2). The child is then monitored for several years, and if they continue to believe they are the opposite sex, cross-sex hormones are started, so as to prevent natural puberty occurring in the “wrong” gender (i.e., the biological sex of the child). In the case of a natal girl with two x chromosomes and a biologically female body, she will not go through maturation of the ovaries, menstruation, breast development, nor other primary and secondary sexual characteristics. Cross-sex hormones (testosterone for a girl) will cause her to develop more in line with the sexual characteristics of a male: a slightly enlarged clitoris, increased body and facial hair, and an enlarged larynx resulting in a deepened voice. She will thus avoid the assumed trauma of going through the “wrong” puberty, with shrinkage and no maturation of her internal reproductive organs. She will appear more or less as the gender (male) she (now he) identifies with. These changes are permanent. They cannot be undone.

And one of these permanent changes is of special import: In nearly every case, this treatment protocol will result in irreversible sterility. This child will never be able to produce their own biological children. However, the gender experts believe this outcome is worth it and justified for “truly transgender” children. The puberty-blocked girl (who still has the brain of a prepubescent child, not that of a maturing adolescent) agrees that transitioning is far more important than future fertility, and the adults in charge make the monumental decision to destroy the child’s future reproductive capacity.

Fair enough? Maybe, if we continue to assume that there is such a thing as a “truly transgender” person with an immutable, innate gender identity; if we treat this condition as a sort of birth defect that will never change, even later in life; and that the young person in question will be forever miserable to the point of suicide if they do not chemically and surgically alter and thereby sterilize their hated and mistaken body.

The problem is, these gender experts—from the most certain to the most cautious—agree that they don’t reliably know which of these children really will be transgender for life. And what that means is there are going to be some false positives: kids who will mistakenly go through extreme medical and pharmaceutical treatments—not just in childhood and adolescence, but for life, since hormones must constantly be administered to suppress the “wrong” body from reverting to the characteristics normal for the genetic makeup of the person. Some number of these kids will have been misdiagnosed. It’s inevitable. Even the most careful clinician, who believes they have narrowed their treatment cohort to only those children who are most “persistent, consistent, and insistent” cannot prevent this, because the research simply isn’t there to tell clinicians who will or won’t grow up to be truly transgendered.

Let’s agree, for the sake of discussion, that these gender clinicians—and the parents who are authorizing the treatments—truly believe they are doing the right thing. They believe that these puberty-blocked children who continue to insist they are the opposite sex are correct. It’s worth repeating that these children’s brains, and thus their critical thinking, reasoning, judgment, and other aspects of executive function, have also not been allowed to mature; because puberty is about brain development, not just secondary sex characteristics. No matter how careful these clinicians and parents are, they are still going to catch a few wrong fish in the transition net they are casting.

Does this matter? How many misdiagnosed kids are acceptable? How many sterilized children (many of whom might otherwise have grown up to be gay or lesbian adults with a desire for their own biological children) are ok? 100? 50? 20? 2? 1?

Put it this way: If there were any other treatment, for any other disorder, which resulted in sterilizing prepubescent children, and which caused irreversible, permanent changes with as-yet-unknown side effects, you’d better believe that treatment would be limited to only the most extreme cases—and even then, only after extensive clinical trials. These clinical trials would span years of rigorous peer review, with successful completion of many replicated and corroborating studies, involving thousands of subjects. These studies would have to include untreated control groups, and these human trials would have to look at physical and psychological side effects and risks of this extreme and lifelong treatment.

Rigorous study, with several phases of clinical trials, is the norm for modern evidence-based medicine, even for life-threatening medical conditions. To take but one contemporary example, there has recently been a successful drug treatment protocol released for the treatment of chronic hepatitis C, which with prior treatments, had a rather dismal cure rate. Despite the promise of the ongoing clinical trials for the new hepatitis C drugs (over 90% cure rate), which took place over many years, the general public was not allowed access to these life-saving drugs. Many people died waiting for the drugs to be approved. If the side effects of these drugs had included sterility—for adult patients—it is highly unlikely the treatments would have been approved by the FDA. Even though the drugs might have saved many lives.

We don’t remove organs and body parts, we don’t give children powerful drugs for any other disorder based on what currently amounts to clinical guesswork. We don’t remove organs or administer chemotherapy because someone might go on to develop cancer later. We don’t prescribe poorly studied, off-label drugs or perform surgery on children to relieve them from psychological distress in any other case apart from “gender dysphoria.” Surgeries and lifelong drug treatment are rightly seen as last resorts, not the first line of treatment for a problem that might turn out to be transient.

The media and trans activists are constantly telling us how important it is to transition children—as young as possible. But what about the kids who might be wrongly diagnosed? Why does no one talk about them? Why is their future happiness not a subject for media exploration? What about the suicide rates of adults who realize with horror later in life that they actually don’t want hormones and surgeries?  That it was all a big mistake? That they don’t want to have to routinely stretch or pump up their artificially constructed sexual organs to keep them in some sort of working order? What about the adults who will mourn the children they were never allowed to bear because of decisions made by parents and doctors decades earlier?

If we care about all children, including the 80-95% of kids who in fact are only “gender nonconforming”;  if only a small number of “truly transgender” children exist, why not allow those few to transition as adults, when they have the cognitive wherewithal to decide for themselves? Why not simply help them cope with their feelings of dysphoria in childhood, instead of stunting their intellectual, emotional, and physical development, and risking the huge mistake of proactively sterilizing even one non-transgender child for life?

Would it really be so terrible for parents to simply let their kids wear what they want, pursue activities they want, heck, “identify” as they want, without the medical piece?

It only takes one person to file a malpractice lawsuit. There is no minimum number for a class action suit, but given the increasing numbers of children undergoing these early transition protocols, the typical 20-50 plaintiffs is not an unlikely number for future adults willing to litigate; a fraction of the people who will wish their parents and doctors had simply allowed them to dress and behave as they wished as children, without making permanent decisions that could not be undone.

So I ask the gender specialists, the parents, the activists, the journalists celebrating the medical transition of children: Granting you for the moment that your fervent belief in immutable, innate gender corresponds to reality, what concern do you have for the children who will be wrongly sterilized, drugged, and surgically altered? Do those children matter to you at all?

Is it acceptable to wrongly sterilize even ONE child?


** Such studies would be difficult to conduct. To come close to proving an innate “gender identity” separate from biological sex, that results in intractable transgenderism, researchers would necessarily have to scan large numbers of identical twins at birth. These twins would then have to be separated and raised in different environments, then be followed into adulthood. (Genetically identical twins are necessary to prove innate brain physiology, and the twins must be raised separately to control for the effects of life experience and influence, which would need to differ to prove that nature trumps nurture). A statistically significant number of those pairs of twins would then have to both be transgender-identified to prove that transgenderism is an essential and innate trait of the human brain.

22 thoughts on “False positives: How many 12-year-olds is it acceptable to mistakenly sterilize?

  1. Regarding your footnote, even if such studies were properly done, and garnered positive correlations, they would not define what transgenderism actually is, and they would not rule out prenatal influences other than genetic ones. Assuming that any such correlations support the idea of “male” and “female” brains, is the hammer going around in search of a nail. It makes more sense to look at the phenomenon as involving persons who are uncomfortable in their bodies, whatever those may be. The efforts to overlay gender are clearly politically and culturally driven.

  2. If this is a naturally occurring phenomena, shouldn’t there be transsexual bonobos or chimpanzees we could study? Or are there and, if so, are there clinical drug trials going on using them? …?

      • Maybe we should start a new group: PEThA. Think it could become hip to defend non-consenting human animals from potentially dangerous testing?

      • Yes. That is the point: biology DOES contain endless variations. Do you feel the need to perform surgery on your dog (at the public’s expense) to make it conform to the sexist social constructs of “appropriate” behavior, or do you actually acknowledge that your dog is fine as he is? Gender IS a social construct, and something is terribly wrong when we feel compelled to “correct” that *variation* to fit an unrealistic construct, to alter biology to conform to what is assuredly an unsuitable idea. Wouldn’t it be better to change the idea to match the reality of our obvious variation?

      • ‘Submission’ does not make something ‘female’. That is a sexist stereotype.

        Red tail hawks have a larger female that keeps the males hunting and guarding the nest.

        These pigs are on an island and were interbred for centurys and kept by humans. They are a genetic mess. I bet they do not live as long as other wild boars, and most likely[like every other interbred animal] have a slew of other genetic problems and do not have a full lifespan even with the help and care of humans. Island animals that lack genetic variance normally die out. The genetic problems insure their extinction. These pigs are being kept by humans as a food source, so I am sure they are hanging on and slaughtered when they begin to develop problems. Pigs being interbred are a genetic mess, with science behind it.- but it doesn’t mean normal Xy men with social problems are turning into XX women.

        Look up interbreeding animals, they have weak immune systems and short lifespans, weak heart anomalies, and in some cases- extra limbs, missing eyes, etc. They attempted to do this for years in agriculture to save money, but sick animals that die off through interbreeding are not a good long term survival plan.

        Just because men focus on one desired trait they base their fetish on, with genetic anomalies do not prove men magically can become women or it is a good idea for everyone to interbreed..

        These are not magical third sex pigs. They are dying out and would have died out much sooner without people.

  3. “We don’t remove organs or administer chemotherapy because someone might go on to develop cancer later.”

    Well, some women with the breast cancer gene (like Angelina Jolie) do have preventive double mastectomies. But a) it’s still controversial, b) there actually is a gene that gives these women a very significant chance of developing and dying from breast cancer, c) it’s a rare procedure, and d) these are fully grown, adult women making the difficult decision to permanently alter their physical bodies.

    • I believe that’s a form of breast cancer that is so aggressive (and deadly) that it cannot realistically be screened for with mammograms. If I had tons of money and a whole crew of kids and that gene, I’d have it done too. But that really doesn’t have anything to do with body dysphorias or gender issues.

      • It is a useful reverse analogy in a way. Women with that gene have proactive mastectomies because there is a high likelihood they will get breast cancer. The proactive sterilization of gender nonconforming girls is backwards, since the vast majority of them would grow up to be lesbian adults if left alone. So blockers+hormones is placing that majority at risk, by only catering to the small number of girls who actually would be perfectly ok, as adults, with having their fertility destroyed at puberty. And to reemphasize again–even the gender docs themselves say there is no data confirming who will actually grow up to be “transgender”. And even those people might be unhappy in adulthood when they can’t reproduce! We don’t know. It’s a huge experiment, and the results will take decades to be revealed.

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  5. Would the author agree that suicide is a fairly permanent form of sterilization?

    From a recent study on suicide rates of transgender individuals, which actually investigated the factors that contributed to said elevated suicide rates:
    http://www.torontosun.com/2015/06/08/suicide-rate-much-higher-for-transgender-canadians-study
    “There was a link between suicide and how far along a trans person was in changing their body to the desired state — the closer to completion, the fewer attempted suicides.”

    Would this blog author seek to comfort parents attending the funeral of a transgender teenage boy who’d taken his life with, “Well, what’s important is that his uterus was fully functional, right up to end.”?

    For a feminist website, I’m astounded at the fixation here – a cynical reader might infer that to this author (and commentators), the baby-making ability of those born with female bodies trumps the value of their actually living healthy, happy lives.
    “The answer is no sterilized children are acceptable.”
    Um, why? Because… who cares about the health or happiness of someone born with a female body? Because there is no aspect of their life worth considering, beyond their ability to serve society as a baby-making factory?

    • You raise several points here worth addressing. First though, you entirely missed the key point of the post you responded to, which was how to address the danger of false positives when treating children with “gender dysphoria.” Even if I grant that there is such a thing as “truly transgender” children who would kill themselves if not given puberty blockers + cross-sex hormones, what are these doctors doing to prevent false positives? And there will be many, given that upwards of 80% of kids grow out of dysphoria.

      Second, there is no “fixation” with baby-making in this post. You seem to think that my questioning the wisdom of sterilizing 12-year olds (PARTICULARLY ones who won’t grow up to still ID as “trans”) is equivalent to consigning all girls/women to a role as baby machines. It’s an outlandish claim, completely unsupported by anything in the post (or any of my other posts, for that matter). I just don’t think adults have the right to permanently sterilize children who really have no idea how monumental that decision is, unless there is no other way to address the child’s distress. And it has NOT been proven, by a longshot, that gender dysphoric kids must undergo hormone treatment to alleviate their unhappiness.

      Your concern about suicide, is, of course valid (although the fact that you resort to bludgeoning me with the questionable “transition-or-die” meme is not helpful). http://transgenderreality.com/2015/03/04/when-suicide-is-presented-as-the-logical-alternative/
      I did read the study you linked to (of a group of 433 trans-identified Canadians) and as you say, one of the findings was that the rates of attempted suicide were lower in people who were further along in their transition. Other factors, such as parental support, were also critical factors. However, like most studies, this one did not look at self harm or suicidal thinking over a long time period. Medical transition, from accounts I have read, does provide relief to some people, especially in the early years, but there are no controlled studies to indicate that (a.) less extreme treatments and ACCEPTANCE for gender nonconformity wouldn’t also lower suicidality rates or (b.) trans-identified people remain happy with their choice to medically transition later in life. In addition, the US survey study most often cited by the media to push the unsubstantiated claim that medical transition is the ONLY treatment for gender dysphoria is riddled with methodological flaws.
      http://4thwavenow.com/2015/08/03/the-41-trans-suicide-rate-a-tale-of-flawed-data-and-lazy-journalists/

      The jury is still out on all of this—ESPECIALLY for children. Until the jury comes back with conclusive evidence, I will remain an informed critic of the medical transition of children.

    • And-you do realize that these children are being sterilized for displaying stereotypical traits and given a chemical castration drug? For their behaviour? Children like to pretend. The UN considered any group of healthy children being sterilized as a human rights violation.

      If a boy likes a dress, he must be a girl.
      If a girl has an interest in math, she must really be a boy.
      You don’t see a problem with that?

      Is’t that holding up sexual stereotypes as true – you have only reversed the stereotype, and conforming to them to choose the other extreme like a punishment, by permanently damaging sex organs with drugs and surgery??

      This is anti-gay conversion therapy that sterilizes/punishes any child that displays anything that might be considered behaving ‘gay’, and tells them that they are this way, because they were born wrong and they need to cut parts of themselves away. This is a type of mental and sexual abuse where children are groomed to reject their own bodies, taught to hate themselves and lied to by manipulative homophobic people that would rather have a son then a gay daughter. The root of some of this is homophobia. Some of the trans children in the media / in public are questioned as to what their sexual orientation is: like a child is going to know/- if you are blocking puberty they don’t reach that stage!! This sexualization of children is pretty pedophilic and exploitative. It sexualizes underage children using a bad excuse. It looks like soft porn for pedophiles. TLCs latest abused child series..lets see, Honey boo boo, the 19andcounting house of molesting, and now Jaz is the next abused child being featured.

      Not all is rooted in homophobia, -there is one family with a very public trans child that most women from mom-boards already know has some sort of munchausen by-proxy. Each one of her children, is a project that has something that needs fixing medically. Her other younger child, no longer the center of her focus, may be damaged already from unnecessary aggressive medical treatments.

      I guess you never heard of the monster study? Children follow what the adults cultivate, https://en.wikipedia.org/wiki/Monster_Study

      Oh, by the way, People that are depressed and mentally ill commit suicide. Suicidal people are capable of violent acts. They no longer value their lives, and rarely at that point, any one elses’ life. Saying someone is suicidal can also mean they are capable of murder-suicide, and may take people with them when they kill themselves. Mentally ill men are not women. This makes these guys wanting access to women more dangerous. It is being used as a conversation stopper, but it doesn’t help you case.

  6. thanks for your work. I’m filled with dread, thinking of these children and teens caught in the clutches of the frenzied trans trend, of how recklessly we are risking their physical and mental health, their lives and futures with both delusional thinking and frankenscience–and of the backlash that is to come. And there will be a backlash. It will be driven by the fierce rage and unspeakable pain of those wantonly broken by this experimentation initiated upon them when they were too young to know well enough for themselves; when they should have been able to count on parents, health professionals and the law to protect, support and guide them with wisdom.

    • Yes, and in so many words, even the most gung-ho gender docs admit they don’t know how many of these kids will be happy, down the road, with what was done to them. I frankly don’t know how they sleep at night.

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  8. This is natural selection at work, weeding out the gullible. In the end, class action lawsuits will bring an end to these child sterilizations, but the time is not ripe for that yet. Right now is the ‘harm’ phase.

  9. Pingback: Just another ho-hum day in trans-kid news: Stanford to open specialty clinic for “trans” kids, Washington Post and BBC tout transition narrative | 4thWaveNow

  10. Pingback: “We don’t remove organs and body parts, we don’t give children powerful drugs for any other disorder based on what currently amounts to clinical guesswork…Why not simply help them cope with their feelings of dysphoria in childhood, instead

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