The real threat to gender-diverse children is the politicization of care issues like puberty blockers and detransition
“I think that we should protect children and their ability to make adult decisions when they’re adults,” Poilievre said.
- “I think that we should protect children and their ability to make adult decisions when they’re adults,” Poilievre said.
- Poilievre is one among many politicians to wade into debates surrounding gender-affirming health care in recent years.
- Alberta Premier Danielle Smith has proposed controversial policies that would affect gender-diverse youth, including prohibiting puberty blockers for children aged 15 and under.
Fertility and gender-affirming medicine
- Two opinion columnists recently wrote about gender-affirming care for minors, making drastically different remarks about the fertility implications of this care.
- Research on fertility outcomes is lackluster to begin with, but outcomes are highly sensitive to whether puberty blockers were taken prior to starting cross-sex hormones and the stage of puberty.
- However, for transgender people who begin cross-sex hormones after undergoing at least some natal puberty, fertility does not seem to be permanently affected.
Puberty blockers
- When puberty blockers were first tested for use with gender dysphoric youth, transgender adults were being coercively sterilized.
- In fact, fertility is not the only issue at stake with puberty blockers.
- A team of Dutch clinicians who were among the first to offer transgender children puberty blockers recently acknowledged that these drugs may not be just a “pause button” to explore identity, as originally intended.
- But there are also major consequences involved in delaying or withholding treatment with puberty blockers, which could hurt transgender girls more than boys.
- Poilievre gives the wrong impression by saying that “we should protect the rights of parents to make their own decision with regards to their children,” because, given the age of the child, parents are typically involved in the decision to start puberty blockers.
Detransition debate
- Detransition also tops the list.
- On one side, opponents of gender-affirming care distort studies to argue detransition has reached epidemic proportions and draw from testimonies of regretful detransitioners as a “cautionary tale against medical transitioning.” Proponents retort by dismissing detransition either by alluding to its “rarity,” using outdated and flawed studies, or by decoupling the experience from regret.
- As a result, the public is exposed to two different sets of “facts,” none of which reflect the heterogeneity that we and others have encountered in researching detransition — different psychological, medical and social motives for detransitioning; a range of emotions including regret, resilience, and satisfaction; expansive patterns of identity discovery and fluidity.
Guidelines, dilemmas and the need for high-quality research
- But that does not mean the science is settled or that the medicine has no room for improvement.
- Gender-affirming care is riddled with ethical dilemmas that have spilled over into an explosive political situation.
- The changing landscape of transgender health care, debates about puberty blockers and detransition are all low-hanging fruit for opportunistic politicians like Poilievre.
- He is a member of the World Professional Association for Transgender Health (WPATH).
- Pablo Expósito-Campos receives funding from the Predoctoral Research Fellowship Program of the Government of the Basque Country, Spain.