Does prepubertal medical transition impact adult sexual function?

by Brie J

Brie is a public spokesperson for 4thWaveNow. To learn more about her, read her interview, “Born in the Right Body.” 

All audio clips (click to listen) are from the Gender Odyssey conference in Seattle, Washington, August 2017.

Update September 2021: A portion of this article discusses a Facebook post from 2017 that has been altered.(Click for Archived version from August 2019). Unfortunately, several posters on the Transgender Health Facebook page have since deleted comments. In particular, Dr. Johanna Olson-Kennedy deleted her entire Facebook account sometime after May 26 2021, the last date for which we have documentation.)


A few months ago, I watched a YouTube video made by a young non-binary person who couldn’t orgasm. Born female, their natal sex hormones were suppressed in late puberty and testosterone followed. While I knew “puberty blockers” (a gonadotropin-releasing hormone agonist) followed by cross-sex hormones stops future sexual development in males–and sterilize both sexes–I realized I didn’t know anything about how this process affects females and their future ability to experience sexual pleasure.

GnRH agonists suppress 95% of all sex hormone production. For a “vagina-haver,” low levels of estrogen, LH, and FSH can mean vaginal atrophy, or life with a potentially very dry, possibly itchy, thin-walled vagina that is more prone to bacterial infections, bleeding during sexual activity, and urinary incontinence, among other annoying-to-serious health issues. Estrogen keeps mucous membranes healthy and pelvic floor muscles strong.

I read a number of studies that found  “sexual desire, sexual interest and sexual intercourse were totally annulled” during GnRH use in male cancer patients and repeat sex offenders, and that females, sent into “chemical menopause” after being treated with Lupron for endometriosis, experienced even greater decreases in libido, sexual function, and ability to achieve sexual pleasure than women in natural menopause. This could be because during natural menopause, LH and FSH hormones, which are important to emotional well being and sexual desire, surge, but they are also suppressed by GnRH agonists.

I turned to the Facebook group frequented by members of WPATH, hoping to find more information. Surely members of the World Professional Association for Transgender HEALTH would be concerned with protecting young people’s’ abilities to function sexually as mature adults, right?

My search for “orgasm + blockers” turned up six posts. None about what happens to female bodies. The first and most pertinent post is this one (click to read the whole conversation , written by a therapist who has helped “100s of kids transition” and who is also an aunt to two trans teens. In reading her posts, I usually find this therapist to be thoughtful, with sincere concern for teens’ well being, and I was glad she was the one asking (even though it is concerning she’s helped so many kids down this path yet required a “sophisticated” parent to jolt her into thinking about this question):

sexual function piece arlene 1

None of Arlene’s very, very, smart friends were able to give her much of an answer.

sexual function piece arlene 2 responses

Bummer, even the Dutch don’t know. That’s when Arlene is reminded by her fellow WPATH members that dead people can’t have orgasms.

sexual function piece kelley winters

While Arlene defends the value of difficult questions, one of the busiest pediatric gender docs in the country, Johanna Olson-Kennedy who oversees the care of some 900 plus patients at The Center for Transyouth Health and Development at Children’s Hospital Los Angeles, stops by to share a report about infant and toddler masturbation.

She tells readers that she’d “love it” if everyone could “enjoy” an “amazing article” that talks about how “of these 13 orgasming and masturbating infants and children, 5 were misdiagnosed with seizure, and on anti epileptic meds.”

sexual function piece olson saudi 1

She doesn’t bother to post a link to the full text report published online in Annals of Saudi Medicine (but I will), she just uploads a sideways picture of the first page.

sexual function piece olson saudi 2

It’s a sad read about the sex hormone levels in a sample of thirteen babies and toddlers diagnosed with “gratification disorder” (they masturbate. Often) who were seen at pediatric neurology clinics in Jordan. It wouldn’t be worth mentioning here except that Olson-Kennedy references this study again a year later when she talks about the population of natal males who will be forever stuck with “Tanner II genitals” during her presentation for parents: “Puberty Suppression: What, When, and How,” at the 2017 Seattle Gender Odyssey Conference. Audio of the presentation, which is excerpted below into small clips, is available in full here.

It is unclear what this study has to do with protecting sexual function in males denied natal puberty. At the conference, Olson-Kennedy explains that she “went on a journey to find out if prepubertal kids have orgasms.” But how does the study support her own practice of administering blockers and hormones to prepubescent youth? First and foremost, orgasm is never mentioned in this short report focused on masturbation. The subjects were thirteen children between the ages of 4 and 36 months, not “18 months and nine” years old, as she claims. Moreover, only three of the thirteen young ones studied were male, the group of people Arlene is concerned with in her FB post. “What if “we” get it wrong?” Olson-Kennedy asks towards the end of the anecdote, and laughs.  The “Cis Trajectory” is the problem; conceiving un-medicalized bodies as preferable, according to Olson-Kennedy, is the problem (Olson-Kennedy, Gender Odyssey, 8/25/17 8:41-9:50).

Most of us have known or heard of babies and toddlers who like to fiddle with their bits. No one should deny that even the youngest of infants is capable of pleasurable feelings when they touch sensitive parts of their bodies. Even people with immature genitals and lower levels of sex hormones can experience sexual pleasure but are these early childhood experiences comparable to adult ones? Are they ‘good enough’ for a lifetime? Do you think you’d be bitter, as an adult, if as a minor, doctors took away your potential to ever experience full adult sexual pleasure? I would be, yet it appears Olson-Kennedy is suggesting that since very young children masturbate, parents shouldn’t worry about the potential loss of sexual function that results from GnRH agonists used in early puberty and followed by cross-sex hormones.

We need to talk about this more, even if it is uncomfortable. Our children have a right to grow into bodies capable of experiencing full sexual pleasure. The organs responsible for fertility are also those responsible for sexual function. Locking people into an adulthood with prepubescent sex organs–or a need for genital surgery–should be a focal point in all conversations about the consequences of denying children natal puberty.

These issues are rarely discussed anywhere, unless you’re lucky enough to catch Olson-Kennedy at a gender conference. Olson-Kennedy “gives prescriptions to people to masturbate” because (as she explains at Gender Odyssey conference in Seattle in August 2017),

Blocking is one tool that’s an awesome tool for a lot of people. And what does that mean? Does that mean that trans feminine, trans girls who get blocked in tanner 2 we are we are making the assumption that all of them are going to have genital surgery. Are we doing that? Because we might be doing that. (Laughs) I’m just saying we might be doing that. And so that actually is worthy of a conversation. Because many trans women do not have genital surgery. Love their genitals, enjoy their genitals, like to use them.

That’s fantastic. We love people who love their bodies and use them and enjoy them. That’s a great human place to be. But we have to ask ourselves if you have Tanner II male genitals are you going to be able to use them, are you going to want to be able to use them? Or we are we just assuming that everybody is now going to have to say “Well I either need to go through puberty to get adult sized genitals or I’m going to have these genitals that I have or I’m getting surgery.” Does that make sense?…If we are judging the success of vaginoplasty by post-surgical orgasm how do we know people are having orgasms prior to surgery if we are blocking them at Tanner II? (Olson-Kennedy, Gender Odyssey, 8/25/17, 8:41-9:50)

In another Facebook post, Olson-Kennedy asks:

sexual function post olson 3

Procuring approval for vaginoplasties at younger ages is important because, only guessing here, her patients aren’t happy to “have NON FUNCTIONING genitals because they had the extraordinary opportunity to avoid “male pubertal maturation.”

sexual function post olson 4

Let’s talk about that. Drugs that are successfully used to chemically castrate sex offenders, which have been shown to lower IQ as much as ten points in children taking them for precocious puberty, are now being prescribed off-label to kids in Tanner II who don’t want to suffer what Winters describes as “irreversible disfiguration from incongruent puberty.” How can adolescents or their parents make an informed decision or a balanced cost-benefit analysis about the potential for permanent sexual dysfunction when the language used to describe the natural process of development equates a body capable of ejaculation and orgasm with one that is disfigured?

We’d be reckless not to think that at least some of the bodies acted on with cross-sex hormones before they have a chance to fully develop will, at some point, seem “disfigured” to the adults who live in them and to those who might want to have sex with them. In a recent study, 958 adults aged 18-81, 87.5% said they wouldn’t consider dating a trans person.

However, even among those willing to date trans persons, a pattern of masculine privileging and transfeminine exclusion appeared, such that participants were disproportionately willing to date trans men, but not trans women, even if doing so was counter to their self-identified sexual and gender identity (e.g., a lesbian dating a trans man but not a trans woman).

How much more difficult will it be for some to find partners and sexual pleasure in their altered bodies? Does Olson-Kennedy talk about these challenges with her patients? In her talk at Seattle Gender Odyssey last year, she says she checks in with some about where they’re looking for dates. Online, she says, it’s easier to disclose and find people interested but “you may be someone’s fetish” (Olson-Kennedy, Gender Odyssey, 8/25/17 1:15:23).

I’m stuck once again, wondering how knowing all this, she still claims that her role is to “Do everything in your human power to get them what they need and deserve” (:29 – 1:14)) when they’re eleven years old and what they want may not be in their long-term best interest?

Oh, and natal females, the group that set me off on this research in the first place? According to Olson-Kennedy, suppressing puberty isn’t all that wonderful for them, either. She explains to parents at Gender Odyssey that not only are emotional lability and significant behavioral changes frequent and serious side effects of blockers (29:15) but another reason these kids are “doing so bad” is because blockers put them in menopause. I appreciate her candor,  “Menopause is bad enough when you’re menopause-age, but when you’re fourteen and you’re having hot flashes, memory problems, insomnia, and you feel like crap, it is really terrible. This is really common” she says, of the current treatment protocol. “What happens when you put a fourteen year old in menopause?” she asks the audience. “You’re shutting down their ovaries,” she answers herself (Olson-Kennedy, Gender Odyssey, 8/25/17, 30:25)

Towards the end of her talk, Olson-Kennedy briefly mentions that pelvic pain is common after 18+ months on testosterone, and that she thinks it comes from “the pelvic floor” not an atrophic uterus. She says genital dysphoria usually sets in two-three years after starting on testosterone, which also negatively impacts the health of female sexual organs, causing vaginal, cervical, and uterine atrophy. I can’t help but wonder how GnRH agonists followed by testosterone, a treatment plan that may produce a double whammy of vaginal and pelvic area discomfort, impacts an already dysphoric teen’s feelings about her body, about her sexuality? The potential for vaginal, cervical, and uterine atrophy needs to become a focus in discussions surrounding youth medical transition, and what that means for the sexual becoming of a vagina-cervix-uterus-haver (perhaps still with the shallow vaginal cavity and thinner vaginal walls of a prepubescent child).

So, why? Why, given all the negatives associated with puberty suppression and early medical transition, aren’t mental health tools like dialectical behavioral therapy, which is successful at helping even suicidal people learn to manage distress and discomfort, offered first?

Instead, Olson-Kennedy focuses on getting parents to stifle every protective urge they possess so they’ll sign off on unnecessary and harmful medical interventions for a group of children, at least some of whom sound remarkably like those categorized by Lisa Littman, Susan Bradley, Riittakerttu Kaltiala-Heino, Ray Blanchard, Michael Bailey, Tania Marshall, and 4thWaveNow parents as experiencing ‘rapid onset’ gender dysphoria:

Some present with a prolonged history of gender dysphoria but the absolute hardest are the twelve to fourteen year old trans boys coming out to their parents…they came out like two months ago, and what happens? At nine years old something doesn’t feel right. I’m starting puberty, I’m doing all this work, I’m going online, I found 750,000 YouTube videos “this is me one month on T;” I’m connected to my community; I know I’m trans; I’m twelve years old and I absolutely have to tell my parents and now my parents are here and I’m here [points far away]

And because I’m thirteen you need to get on the ball and this needs to have happened yesterday and because I am here and my parents are here [far away] and the parent desperately wants you, the provider, to close that gap by pushing their kid backwards. But you as a professional know you have to close that gap by pushing them forward and keeping them. You want to keep them because you want them to give consent and be supportive. (Olson-Kennedy, Gender Odyssey, 8/25/17, 48:30-49:50)

I didn’t find all the answers I was looking for because no one has them. There is no medical diagnosis of “wrong” or “incongruent” puberty. Denying a body any stage of sexual development as a first-line of treatment for a non-lethal condition should never be encouraged let alone celebrated. Let’s refocus the discussion on ways to help young people manage their distress that prioritizes their physical and sexual health.

71 thoughts on “Does prepubertal medical transition impact adult sexual function?

  1. Wow! Just wow! How utterly disturbing that Olson-Kennedy can say all that and not have major reservations and concerns about medically transitioning children! great investigating Brie! Thank you!

  2. The “Cis Trajectory” is the problem; conceiving un-medicalized bodies as preferable, according to Olson-Kennedy, is the problem (Olson-Kennedy, Gender Odyssey, 8/25/17 8:41-9:50).

    Oh! Medicine!
    In birth, in death, in puberty
    All this time, I stupidly
    Understood biology
    Was fixed, not ideology.
    The mind is bendable, i thought
    But this thinking seems fraught
    For dr olsen-Kennedy knows
    That Medicine is how it goes!

    (Medicine!)

    *wanders off with Simpsons ‘monorail song’ in head

  3. While I have not done explicit research on the topic of disruption of sexual function, it seems glaringly obvious to me that this will be a casualty for these children who are prevented from ever going through puberty. How COULD sexual function ever approximate “normal” in a person whose genitals were chemically prevented from maturing? Whether or not they have genital surgery, I have a terrible feeling that many of these kids will never be able to have satisfying sex lives. Look at Jazz Jennings, who admitted at age 17 before surgery that they had never had any sexual feelings. Most 17 year olds have had sexual feelings, to say the least. This is a very bad sign.

    • Not only that, but why would a person need to medically construct a vagina if they have no sexual desires? It makes them a sex object for someone else. That is the only purpose a neo-vagina will serve for a person who has no sexual desires. On the outside looking in, doing this to children creates sex objects out of healthy bodies, for those with working parts and fetishes.

  4. Children who wish to block puberty need to be told, and understand the consequences of their actions in terms of sexual fulfilment. Naturally trans enablers don’t want to tell underage ‘clients’ that they will be on possibly dangerous medication for life, will most probably be sterilised, and may not ever reach orgasm. To do so would tarnish the end product they are so happy to push. There needs to be a public service video made which shows graphically what they are getting into and how their life will change. They need to be told that if they wait till after puberty to change they will have many orgasms that will indicate their true sexuality.

    • But CAN children understand what that means? I doubt it. They are children after all.They can’t understand what’s being taken from them becauss they never experienced it.

  5. Forgot to thank you, Brie, for your excellent investigation. The fact that no one seems to have considered that the ability to orgasm is of importance to those whose puberty is being blocked is outrageous. There’s obviously no room in their propaganda machine for the truth.

  6. The “transition or die” narrative is so pervasive, leading to the point where medical practitioners are cavalier (and Olsen is positively cheerful) about their patients’ holistic wellbeing.

  7. Well, I prefer not to interact here much, but I was specifically linked to this post, so I may as well.

    I’m not a prepubertal transitioner, but I am a pubertal one. And yes, I took Lupron for several years. I didn’t experience any meaningful complications from it; I had some hot flushes during the first year, but those dissipated and were never concerning. I’m about as healthy today as I was the day I started. I transitioned earlier in life and development than the person you open the article by talking about, is what I’m saying.

    I’ve never had any reason to complain about my sexual pleasure on T. I’ve never had any kind of issue orgasming — I seem to have a much easier time with all that than the average natal female, even. My sex drive and interest doesn’t seem to be atypical for men in any direction.

    One thing that I suspect gets missed by people who oppose early transition in this context is that many of these young people, including myself, are not going to interact typically with their natal genitals no matter what. Studies on trans people who are GNC in their natal sex and exclusively attracted to it consistently find that the overwhelming majority of these people are genital-avoidant, that is, don’t have sex or masturbate using their natal genitals at all. Pre-op HSTS women are generally exclusive anal bottoms, while pre-op HSTS men have a more complex situation but tend to be either ‘stone butch’ or interact only with their T-enlarged phallus. This is not a situation that is prevented by preventing early transition, because *these people are genital-avoidant in adulthood*. If these children grow into adults with natal-sex-typical bodies, they still aren’t going to have PIV or other kinds of sex that involve interacting with their natal-sex-typical genitals. It doesn’t matter if you’re a ‘vagina-cervix-uterus-haver’ if you’re *never going to have sex or masturbate with those body parts*, regardless of whether you transition at 13 or 33 or never. Ignoring this issues erases the experience of GNC genital-avoidant people, regardless of age or transition status, and assumes people must have a kind of sex they categorically won’t.

    • I’m glad to hear you’re doing well, Trent. I don’t think it is possible to assume that: “It doesn’t matter if you’re a ‘vagina-cervix-uterus-haver’ if you’re *never going to have sex or masturbate with those body parts*, regardless of whether you transition at 13 or 33 or never.”

      I’ve spoken to people who were incredibly dysphoric at 12-16 but then had the intensity abate. They now find pleasure in their bodies (usually after working with an excellent therapist, finding more ways to be physical in their bodies, and once puberty is mostly passed).

      Being “genital-avoidant” may only be a brief stage in a long life. It is impossible to know for certain how any 11 years old will feel ten years later.

      Did you listen to all the audio in the article? Olson-Kennedy has helped more kids medically transition than anyone at this point and she also finds many who come to “love their bodies” – I think you’re possibly accepting life-long predictions based on inflamed youthful perceptions.

      Best of luck to you. Thanks for commenting

      • I do understand the arguments you make and why you make them. I also know the context of your daughter and most ‘ROGD’ kids is not the same thing as HSTS narratives, regardless of transition or age at it (though there are exceptions). Some cross-section of people who transition early in life will lack genital avoidance, and these people have a different set of issues to me or, say, Jazz Jennings.

        Yes, I’m familiar with Olson-Kennedy’s work. I’d like to reiterate that people transitioning in childhood and adolescence in the 2010s are not monolithic, as I suspect you personally know. I’m also pointing out that when avoidance *does* exist, as it does in a substantial portion of this demo and the people in it that so happen to benefit the most from early transition, studies in adults — and all the literature on desistance has shown, over and over again, that adolescents (on this etiological spectrum) are far closer to adults than children in terms of their relationship to sex and gender, from as early as age 10-13 — shows it’s lifecourse-persistent and has nothing to do with one’s body configuration at the end of puberty.

        I’m also familiar with the narratives of detransitioners who transitioned in (virtually always late) adolescence on an intimate level, in that one woman who spent some time as a spokesperson for the detrans movement was a personal friend of mine and I’ve been in proximity to much of the unofficial research being done on the demographic. I strongly suspect there are many things being missed in detransitioner narratives that intertwine with this topic and several others. A friend is in the process of looking into this further and getting about the answers both of us expected.

        I’d also like to reiterate you’re focusing on one portion of the comment. I’ve known other early transitioners, including people without genital avoidance and people who transitioned significantly earlier than me, who have generally normal sexual pleasure. I can’t think of anyone I’ve met in that sample, and it’s a decently sized one, who has problems relating to the actual process of medical transition itself. I understand some people face these issues and sympathize with them, but it doesn’t look from my anecdata like there’s anything concerning.

    • It can take A DECADE until the side effects of Lupron appear. It’s not candy or a magic pill. It has consequences and iif you are still healthy in 5+ years you are very lucky.

      https://khn.org/news/women-fear-drug-they-used-to-halt-puberty-led-to-health-problems/

      But that’s just Lupron. Testosterone is another can of worms and your female body got too much of it on purpose. Again, if you never suffer any problems besides infertility (which I doubt because let’s be honest, it’s a dangerous drug for female bodies) consider yourself lucky.

      You are young and might feel invincible. But neither Lupron nor testosterone are without consequences.

      • “I’ve known other early transitioners, including people without genital avoidance and people who transitioned significantly earlier than me, who have generally normal sexual pleasure.”

        This is not true. Natal males who never went through puberty and therefore never matured sexually AND are on drugs that reduce libido, lead to genital athropy and sexual dysfunction (grnh agonists / hormones). CAN’T experience the same sexual feelings as a normal adult male. When even adults who went trough puberty experience sexual dysfunction etc. then men with tanner stage 2 bodies and no sexual maturation will be even worse off.

        Are you talking about natal females who overdose on testosterone which increases the libido as a side effect? Females have it better in this regard although an increased libido can lead to higher risk of getting stds.

  8. thank you. it has been on my mind for a long time. does non-binary now mean asexual, also?. seems that WPATH, being a patriarchal organisation, has left the females behind on this one. the lesbians disrupting Pride London have this one right. this is an erasure of females. an erasure of lesbianism. an erasure of sexuality. what a prudish society we have become!

  9. This is sterilization plain and simple. The entire transgender trend is simply Eugenecism with a progressive face. Disgraceful.

  10. There is an attempted murder trial just starting in Sydney au, where I’m from. The attacker, Evie Amati, a transgender male to female, tried to kill three people with an axe. ‘Her’ acts were filmed on CCTV. ‘Her’ lawyer in his opening address is claiming gender transition and hormone medication as major contributors to her actions. This trial will be very interesting as things such as the difficulty of dilating a fake vagina have already been mentioned. It might be a good source of reference for those looking to transition as it will most certainly show the ugly, real life side of transitioning.

    • Margaret, I hope the news media in Australia will refer to Evie as a male. He is a male presenting as a female.
      The stats on crimes committed by MTFs is skewing crime stats, making it appear as an uptick in violent crimes perpetrated by biological women.

  11. I expect that doing this research would be extremely upsetting, not to say gruesome, but I’m wondering whether anyone has ever looked at female survivors of FGM and whether any of them are ever capable of sexual response? I know that the whole POINT of performing FGM is to ensure that women will be sexually incapacitated, so I’m guessing the answer is probably no, but this seems to be the most closely analogous group for purposes of study.

  12. Wow! Thanks for bringing up the issues in this post. That was one hell of a nonsensical discussion. When a baby is born it cannot see clearly. Imagine injecting a drug into the corneas of blue-eyed babies so that those babies never fully focus on the world. Why would anyone do this? Now imagine the world has been convinced that blue-eyed babies are likely to be suicidal so this is necessary. Imagine the industries that could develop around this predicament. There would be therapy for families and children, special schools, special learning tools, special means of transportation. These blue-eyed blind babies would be so special. They would be treated with kid gloves for their entire lives. Some brown-eyed children would become jealous and want to be like them. Others might decide (or their families might decide) as they got older that they would rather have complete vision. Now an entire industry could pop up to decide which cohort of these children would benefit from this. Another sector could focus on research to restore their mutilated vision.
    It is impossible to reason with insanity. If it was not so sad that young lives are dispensable in this equation, I would be laughing much harder.

  13. Someone pointed out above that early transitioners aren’t a monolith. That’s true. Not everyone will experience debilitating experiences upon transitioning. It’s also true that not one single person can know ahead of time, which people will or will not experience negative side effects. People invested in transitioning, those that transition included, aren’t always willing to share the downsides to using hrt.

    As a parent of a young teen that desperately wanted to transition, she didn’t run across any information in her own searches of adverse effects short or long term. One of the reasons she started questioning the need to transition, is because I shared them. I had to do the research for her because I’m the parent and that’s what parents do for their kids in ALL medical things.

    If there’s a 50/50 chance that my child will experience negative outcomes from transitioning, shouldn’t I weight the pros and cons pretty heavily? No matter the tipping point on that scale, I need to know the potential for harm on something with irreversible side effects. Maybe it’s one child out of 100 that experiences harm. Should I ignore that as statistically improbable?

    As parents, looking to protect our children from long term harm, we simply don’t have the answers to those questions. I refuse to make my child a test subject to a social experiment. Just looking at the side effects of Lupron should be enough to give any parent pause. Those side effects are well known and documented by watch dog sites.

    Forget for a moment whether a young person experiences sexual pleasure as a young person. Maybe the side effects of transitioning aren’t enough to cause issues with sexual pleasure in the now. What about 20 yrs from now? Bodies change with time and it’s extremely short sighted to only look at now. There are zero long term studies of this and the outcomes of what that looks like for a 40 yr old who transitioned at age 17. Zero.

    The only place I’ve seen information in that regard is among people sharing their stories. It’s a giant mixed bag and mostly from people who didn’t transition so young.

    That would be a big fat “no thanks” not interested in doing that to my child and her whole and perfect and beautiful body that she was born with. If she wants to play around with that later in life, so be it. It’s her body afterall. While I’m her care taker and protector, I will look out for long term impacts. It’s what parents do and those that can’t see long term, aren’t doing their children any favors.

    • >>> Forget for a moment whether a young person experiences sexual pleasure as a young person. Maybe the side effects of transitioning aren’t enough to cause issues with sexual pleasure in the now. What about 20 yrs from now? Bodies change with time and it’s extremely short sighted to only look at now.<<<

      This made me think of how I've heard so many times that many women tend to experience the most sexual pleasure when they get older, into their 30's and beyond even. I know in my personal case this was absolutely true.

  14. This is horrifying. To be implementing this intervention without knowing the side effects on something so basic as sexual functioning — I can’t even imagine what these people are thinking. I want to underscore something else that popped out at me in this article: that teenage girls on Lupron have increased mood lability. Mood lability in normal teenagers, girls especially, is a problem. Mood lability also increases suicidal tendencies, which is the rationale for early transition in the first place!

  15. Jazz Jennings is a sad example. Forever stuck at tanner stage 2, no libido, non functioning genitals and ironically he told his grandma that he can get so many orgasms after srs and Marci Bowers told him to figure out to orgasm. An adult tells a castrated boy to figure out how to experience sexual pleasure although the ability to experience it has bern taken from him.

    But if genitals are already dysfunctional – destroying them does NOTHING. How stupid are the adults around him?? how can parents and surgeons be so blind?

    Jazz thinks he got an actual vagina, that he doesn’t have to dilate in high school and that he finally can experience orgasms because the adults in his life ignored reality and his biological sex.

    This will NOT end well. When he realizes that he is still dead down there although adults told him the opposite over and over he will spiral into depression even further.

    It’s not just Jazz it’s thousands of gender nonconforming boys. But neither surgeons nor trans actvists care and most parents seem to just go with it instead of asking questions and think critical.

    • But I don’t think you will ever hear that Jazz doesn’t feel anything but happy, happy, happy with the surgery. Too much is riding on his livelihood and saving face for everyone enabling him. Plus, will he even know what he is missing, when he hasn’t ever experienced an orgasm?

  16. I respect Trent’s feelings, but “anecdata” should not be good enough for anyone when we are talking about powerful drugs with serious, life-determining effects. And if what we are doing may be some version of chemically castrating our kids to the point where a significant number of them won’t experience sexual pleasure later in life, I would think we’d want some actual research on that, rather than plowing ahead with these interventions. I would point out, for what it’s worth, that there are societies where they purposely impair pre-adolescent girls’ ability to achieve sexual pleasure and orgasms in adulthood. When they do it, we call it female genital mutilation and consider it a grotesque affront to human rights. Yet here we are, potentially turning our “trans” kids into a version of the same thing—sexualized objects for someone else’s pleasure, yet potentially unable to feel any themselves, with both kids and parents pushed in the direction of the most radical, medicalized interventions rather than being encouraged, at least as a first line, to work out their conflicts around their healthy, natural bodies.

    • Elizabeth & worriedmom, I see the parallel between FGM and what is happening to children given these experimental treatments.
      I don’t know how the women who had FGM forced on them at age nine would feel about this comparison.
      Look for the #FGM. There are many women out there discussing this very personal mutilation and violence.

  17. An earlier study reported this, although it is not clear if these young people had been on blockers:

    “The majority of the group (57%) had no partner at the time of the interview or had never had one; 36% had a stable relationship with a partner. One FM (7%) was having casual relationships with several girlfriends. Of the subjects who at the time of the interview had a sexual partner, 71% expressed satisfaction with their sex life, 14% expressed a neutral view, and 14% were dissatisfied. Several FMs mentioned that they found it difficult to live without a penis,
    especially at moments when they did not know their potential sexual partner very well. Autosexual behavior was not very frequent. Fifty percent of the subjects masturbated less than once a month or never, 43% more than once a month. MFs generally reported a decrease in frequency, while FMs reported no change or an increase in frequency. Of the 13 subjects who
    were sexually active, 77% regularly achieved orgasm”

    https://www.ncbi.nlm.nih.gov/pubmed/9031580

    • The study was done ONE year after surgery. But according to other bigger studies the mortality rate increases over time.

      Where are the long term studies of adults who had the surgery as a teen? They already exist.

  18. As that was published in 1997, safe to assume these folks passed through all stages of puberty. GnRH agonists were first used to suppress puberty in gender variant kids in Holland in the mid-late 90s but only in those older than 16……just pulled the full text (293):

    —If applicants meet the above requirements, they are allowed to proceed to the second diagnostic phase, even if they are younger than 18 years of age (but they must be older than 16). If they are diagnosed transsexuals but do not meet the additional criteria, the second diagnostic phase is postponed.

    The second phase implies the start of the real life test, supported by a (partial) hormone treatment
    (Cohen-Kerrenis, 1994). In Holland adolescents are referred for hormonal treatment (and surgery) to members of the Free University Hospital Gender Team, which is responsible for the treatment of 95% of the Dutch adult patients. Partial hormone treatment blocks the action of sex steroids in a reversible way: the male-to-female bodies do not masculinize any further, and the female-to-male patients stop menstruating and sometimes experience a weakening of breast tissue (Gooren and Delemarre-van de Waal, 1996). Full hormone treatment is not reversible and masculinizes the female body or feminizes the male body. It is given before the age of 18 only when the patient has
    responded favorably to the partial hormone treatment.—

    https://drive.google.com/file/d/1X0Gzyd66RmWF4F7YhwHNVhpYQqZDd6p_/view?usp=sharing

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  20. This just sounds like a quiet kind of genocide where our kids bit by bit are turned into receptacles & robots. Chemically castrating people isn’t freedom or actualization, it’s madness. Shrinking otherwise normal genitalia for a most likely temporary teen age impulse while causing horrible mood problems as teens or younger, scars bodies and creates trauma. I get that a number of teens are suicidal for many reasons but the answer isn’t hormones & surgery. It is helping them know things take time…including becoming comfortable & embodied within oneself. There’s no way to rush that.

    Having been on Lupron for Endo I can attest to how awful it is. My wife believes it’s why I immediately after stopping it I became chronically ill from new autoimmune diseases that effect me today. I can’t think of why any healthy person would volunteer to be on hormones.

    One has to ask – why do these professionals seek to cut into, render sexless, and castrate the generations to come? With a society that has been long dependent on German chemical medicine, coupled with selling plastic surgery as enlightenment, how can we not ask what the deeper thing is here. These kids are being used & abused but for what end? After trans gender what’s next? Transracialism is emerging. Then what?

  21. This is not at all surprising after all we know that these are the same hormones used to achieve chemical castration. From my perspective as one who believes the majority of kids sent down the road to transition are working out how to relate to differences stemming from their homosexuality it is such a tragic irony that here are these young people able to identify as the opposite sex work brutal surgical changes to their anatomy all in order to negotiate a way for them to be accepted by themselves their families and their peers given a same sex attraction only to have that attraction deadened and frustrated. I think Olsen who is smart enough to know what is going on is leaning on that to further lessen the chance of kids recognizing what it is that is propelling this for them and likewise her push for earlier surgical intervention issues the chance to transition kids before they are likely to name and express an identity relative to their sexual desires hell before they are old enough to have the cognitive development needed to achieve a mature sense of Gender constancy.

    • It occurs to me this is exactly what may happen with these kids…in other words, it will be impossible for them to know what they’re missing because there is no chance they will ever experience it. It’s as if a person were born blind, and would never be able to conceive of what having sight might have been like, even though people describe it. The notion that one might be a sexual being will be forever a mystery – so I’m actually not sure whether the children will come to resent or mourn the loss, or not. It won’t be like having at one time been able to experience sexual function and losing it, it will be like never having had it at all.

      Not that that isn’t profoundly sad, as well, but it would impact, perhaps, the feelings a grown person might have about it. Perhaps that is what the clinicians are counting on?

      • We know that intersex people who suffer from genital surgeries in childhood mourn the loss of sexual function. They never experienced a normal sexuality either.

        Or look at Jazz Jennings. One reason he had this surgery is to get orgasms (that’s what he told his grandma). Of course destroying already stunted genitals doesn’t magically give chemically castrated males a libido but Jazz knew he was missing something.

        Others may not be sad or angry but I guess most of boys like Jazz are aware that other people experience something they can’t.

        It would be interesting to know how they deal with this issue but there aren’t any studies or personal experiences on the internet.

      • >> We know that intersex people who suffer from genital surgeries in childhood mourn the loss of sexual function. They never experienced a normal sexuality either. <<

        It makes me wonder if intersex people who suffered from genital surgeries in childhood, get together and share their mourning, and thus increase the prevalence and awareness of having lost something? When it comes to transgender, they get together and mourn their suffering of a different kind.

  22. Thank you for your blog post. I do not agree with most of the comments, however i appreciate seeing and taking time to understand both sides. The most important thing to me as a parent is to support my child with love and understanding. Doing your own research as a parent is always expected however, it needs to go beyond the internet. Speaking to paediatric endocrinologists seems key.

    Also thank you to Trent for sharing his story and experiences. Having the other voice heard it vital so discussions don’t become a closed loop.

    I also appreciated the link to the Kaiser article. It didn’t seem to include any data on gender variant kids who were taking hormone replacement therapy. This is the population that as parents with gender variant kids are interested in.

    Once again, thank you Trent for being brave and commenting here.

    Finally, please use the pronouns that a person has asked you to. To use the wrong pronouns on purpose, is emotional abuse.

    • You were doing fine until your last sentence. Abusive? Really? The only pronouns people use when they are talking to directly to each other are “you“ and “I“. That’s gender-neutral. If you are actually saying it’s “emotionally abusive“ when referring to someone in the third person (which only occurs when you are talking to someone else ABOUT another person), you probably need to think about the definition of abuse a little more carefully.

      • Interesting article. It must be a hard line to walk as a parent – to not invalidate your child’s feelings but also ensure they are doing the right thing for them.
        That article sort of brushed aside the factor of parental rejection because the attempted suicide rate among trans people with accepting parents is still 33% – but fails to state the rate found by the study among those who were rejected, 57%. If you’re going to show the data, show all of it. Then people can draw their own conclusions instead of what you feed them.
        I agree that we need a more holistic method to supporting trans kids. This comes not just at a parental level, supporting them in their gender exploration and possible transition, but also by de-stigmatizing the experience of people who identify outside the cisbinary. Then, maybe, the attempted rate of even those with parental support would not be so high.
        For instance, one could use a persons preferred pronouns COUGH COUGH like come on COUGH COUGH

      • The problem with these studies is that “rejection” is not clearly defined. There are a large number of parents who support and love their kids, support their gender nonconformity, but don’t agree that their child is actually the opposite sex. “Support” comes in many flavors. Trans activists who terrorize parents with “suicide or transition” and quote sloppy studies should be calling for a control group of loving families who never reject their kids, but don’t buy the idea that sex is mutable. COUGH COUGH

    • Yes parents need to do research and speak to medical staff. I would encourage you to also consider the value similar to what the recommendations made by intersex advocates call for when considering any treatment plan is to consider who are the adults these children would grow up to be and what do they say. And that is where the voice of gay and lesbian people whose childhoods are marked by the same characteristic experiences as today’s transgender kids from anxiety that we would grow up and take on unwanted secondary sex characteristics to being sick from refusing to use the toilet all day every day to hating if our genitals are noticed and increasing isolation and depression in younger years.

  23. I hope all of this coughing is not contagious.
    Ellie, many parents find that the new identities their children are assuming do not make sense at all.
    If a trans-identifying teen could take a poll of their entire family and long-time friends, how many people would believe the new identity made sense, reflected the inner person? None?
    These identities come from social media & peers= not authentic.
    People insisting on a new gender identity also insist on external validation of their identity. No other identity insists on the external validation of the identity via language and basically forcing people to profess untruths that they do not believe.

    • I believe most trans cannot control what they are doing. It is like a compulsion or obsession. It is an inner battle. They need outside help and healing. Think of a drug addict or alcoholic. Same thing. They have an unquenchable desire or obsession with getting the next drink or next high. They can’t control it. Many are in denial. Many fight this inward battle. We don’t affirm what drug addicts are doing. We get them help to recover. Unfortunate sometimes is many do not want help. So do we affirm them and let them continue to drink or shoot up?

      • The most unfortunate thing to me is I so want to get my daughter “help” for what may possibly be a result of an early trauma that we’re both aware of. But if I take her to a therapist, she’ll say she’s trans and then it could all be over. The therapist will affirm, have her on “T” and we now have possibly just fast-tracked everything before really looking into other possibilities. The cards seem stacked for sure.

  24. We do not “need more holistic methods to support trans kids.” We need to come together as a society for the good of humankind and STOP CREATING TRANS KIDS. For those minuscule numbers that do have true gender dysphoria that cannot be relieved through psychotherapy, perhaps transition in time is the answer. In due time when they are well into adulthood with fully developed brains and enough life experience, good medical care will tell. Accepting alternative pronouns puts money in the pockets of the creators of the great trans kid myth. This is what they want. For those young people caught up in this myth, sadly they are being used and played for fools. When your own kid is one of those fools to no fault of their own, you cannot agree nor should you be expected to agree. The creators of the myth can take their suicide lies and spin them whichever way they wish, a myth is still a myth.

  25. Beyond mad. Yes!! We need to stop creating transkids!! I’m so sick and tired of professionals not admitting that their is undeniably a social contagion going on. My kids friend group now has yet another girl on hormones. This girl is bipolar , attempted suicide several times and is on a shitload of psychiatric meds. Because she is over 18 all she had to do was access an informed consent clinic and voila! Now on testosterone! Although I am truly horrified and saddened to what professionals are creating with children I feel like the over 18s are probably the most vulnerable to this contagion. It all happens so fast. No time for reflection or decent therapy for pre existing mental health issues or trauma. This needs to be exposed and critically looked at by our society. I have told every single professional my child has been to about how many friends in the group are on hormones. Some saw it as progress . Some were very concerned but are too afraid to adress the elephant in the room. Bottom line is my kid isn’t getting any kind of truly therapeutic help that will truly help make informed decisions.

  26. Has anyone been following the very interesting series The Economist has been running on Transgender issues? It addresses the misogyny in women getting punched when they raise questions about certain transgender ideologies or simply try to initiate critical conversations, which apparently is much more frequent in the UK than it is in the U.S. https://www.economist.com/transgender [This is the general link] And then James Kirkup wrote a piece about how men can write about transgender issues without receiving death and rape threats, but when women do, factions of trans women avow violence and acts of physical abuse on them to exact revenge, using the domestic abuse/rape culture she asked for it or she deserves it kind of justifications. ” Here is the link to Kirkup’s piece but the whole series seems much more willing to openly discuss issues that are basically silenced here, for the most part, in the U.S. Worth a look — https://www.economist.com/open-future/2018/07/06/i-am-neither-trans-nor-a-woman.-can-i-write-about-the-issues-they-face

  27. Thank you. As always, I’m awed by your ability to make cogent arguments against this madness. I find myself slipping ever more toward incoherent, black depression when reading the likes of Olson-Kennedy.

    One quick observation, re your question about why DBT isn’t offered to kids with ROGD. My kid didn’t have ROGD when she walked into a DBT therapist’s office for help with an unrelated issue. But when she walked out, she did. And we’d never have known, had it not been for an errant text message. Affirmed behind our backs. When we looked for alternate therapists, they were generally the same dismal lot. I have no faith that the answer lies there, sad to say.

    But enough about me.

    The more important observation is this: parental concern at the prospect of one’s child being genitally mutilated is not rare or sophisticated. I should hope it’s universal, kneejerk, gut instinct, any-idiot material.

    • “The more important observation is this: parental concern at the prospect of one’s child being genitally mutilated is not rare or sophisticated. I should hope it’s universal, kneejerk, gut instinct, any-idiot material.”

      Sadly it’s not universal at all.

      If it was universal then no parents would have chosen circumcision for their baby sons and no parents would have chosen “circumcision” for their preteen daughters.

  28. PS: Does anyone else think it’s weird that no one ever simply asks adults whether they had orgasms as kids? Might be a bit more straightaway, and less child-rapey, than the creepy, Kinsey-esque Jordanian study. But maybe that’s just me.

  29. I would be happy to share my own experience here. I am a transmasculine person living in a long-term marriage with a man. I did not accept that I was transgender until I was in my mid thirties. As a teenager and adult I tried to masturbate, but it was at best unfulfilling and at worst traumatic. I was distressed by sex with my husband. It was not until I was seriously considering that I might be transgender that I managed to achieve any kind of pleasure from masturbation. This was in the context of trying to imagine that I had a penis, which rather than being a fetish seemed to make sense of my body. I am now taking testosterone and am able to have regular orgasms. I am a deeply conservative Christian and certainly not comfortable with the idea of ‘informed consent’ rapid transition for very young people, for example. But like another commenter (Trent) above, I would like to highlight the difficult relationship that many transgender people have with their genitals. My experiences started well before any conscious awareness that I might be transgender.

    • If you dont mind me asking, were you perhaps molested as a child? Because what you are describing is consistent with sexual abuse. A lot of women who were abused have this exact same issue. I’m sad that you resorted to testosterone , which can have lasting negative affects on a female

      Also I am a Christian myself and I’m really not trying to offend you but I fail to see how believing any kind of trans identity is possible can be compatible with Christianity, (unless you are talking about the liberal branches)

      • Only just saw this reply. As far as I know I was never molested as a child. I wondered as a teenager whether I could have been, because things I read told me that issues I was experiencing were experienced by people who had been sexually abused. However I have no memory or evidence of having been abused. As far your comment about identity goes, I suppose it depends on definition. I am not offended at all. My faith in Jesus is the most important thing in my life. I am not planning on any social transition and do not identify as male. I am simply trying to find the most appropriate way of dealing with the unsettling experience of having my brain expect my body to be male.

    • Thank you for your willingness to share this. Very helpful to have perspectives of individuals on the trans spectrum in this conversation.

  30. “In a recent study, 958 adults aged 18-81, 87.5% said they wouldn’t consider dating a trans person.”

    Actually, if you look at that study, you see that the result grossly overrepresents the number of people who would consider dating a trans person. The study participants are 36.6% non-heterosexual and 2% trans or non-binary. The study shows that LGBs are more willing to consider dating a transgender than a heterosexual person is. It also shows that trans people are far more likely than any other group to consider dating a trans person. The survey sample overrepresent LGBs by about 10X and overrepresents trans people by about 7X. Therefore, the 12.5% willing to date a trans person does not reflect reality. If the responses are weighted to reflect the real world percentages for heterosexuals, LGBs and Ts in the population, the result is something in the neighborhood of 3% willing to consider dating a transgender person, not 12.5%. (Also, it is worth noting that that 3% – the people “willing to consider dating” a trans person is greater than the % of people who would actually decide to date a trans person and then follow through on that decision. )

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