This is big news. Children who have been diagnosed as “transgender,” who are currently being experimented on with hormones and surgeries, will finally be studied in (one hopes) a systematic way at several clinics across the U.S. over a 5 year period.
The good news? Someone will actually be collecting data and publishing research studies on these kids. The bad? The children are still the same guinea pigs, being treated experimentally with outcomes still to be determined.
The studies will run for 5 years, which will be enough time to yield some important information. But the real litmus test is what life will be like for these children when they grow up to be adults. The younger children will still be adolescents when the studies end. One can only hope that the NIH will fund further longitudinal studies to follow these people–some of whom will be permanently sterilized–well into their lives as adults.
The study – which will begin enrollment in fall 2015–will include 280 transgender youth with gender dysphoria–those who are persistently distressed by the incongruity between their gender of identity and the gender they were assigned at birth. Participants will be those who seek medical intervention to align their physical bodies with their gender identity and alleviate gender dysphoria and its associated negative effects, including anxiety, depression and substance abuse.
The study will include youth from two age groups: younger children in early puberty, who will receive hormone blockers, called GnRH agonists, used to suspend the process of puberty – preventing the development of undesired secondary sex characteristics; and older adolescents, who will begin use of masculinizing or feminizing cross-sex hormones that allow them to go through the ‘right’ puberty – consistent with their gender of identification.
For the cohort in the earliest stages of puberty, the study will evaluate the impact of treatment on mental health, psychological well-being, physiologic parameters and bone health, and will document the safety of hormone blockers. In the older group, the study will document the safety of administering cross-sex hormones for phenotypic gender transition, as well as evaluate its impact on mental health, psychological well-being, and certain metabolic/physiological parameters.
Who will be conducting this NIH-funded research? The doctors who have made the biggest names for themselves in the new frontier of pediatric transgender “treatment”:
The multicenter study will be located at four academic medical centers with dedicated transgender youth clinics. The co-investigators and their institutions include:
Johanna Olson, MD, Children’s Hospital Los Angeles and the Keck School of Medicine of the University of Southern California
Stephen Rosenthal, MD, UCSF Benioff Children’s Hospital San Francisco
Robert Garofalo, MD, MPH, Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine
Norman Spack, MD, Boston Children’s Hospital and Harvard Medical School
These doctors have a lot at stake to prove that their experimental treatments will produce positive longterm outcomes for these kids–over the lifespan. Can and will they design studies that will truly be unbiased and well controlled? Will they end the studies and treatments early if negative outcomes start piling up? Will they be motivated to apply for more funding after 5 years, or will they declare 16-year-olds who began transitioning at 11 successes and cease following them? Will they look closely at how natal males and females differ in their response to hormones and surgeries?
Time will tell. For the children’s sake, we can only hope these doctors will use the NIH research money ethically and wisely.
But given how much these doctors have already invested in administering hormones to kids and publicly touting the unmitigated good of “transition” and “trans kids,” it’s hard to see how they can approach this research without bias. If long-term evidence ultimately shows more harm than good resulting from this, they will be seen as providers who hurt innocent children–a much bigger stigma than harming adults.