EDITORIAL

Teen Vogue and Heron Greensmith, a female who doesn’t appear to have medically transitioned but goes by they/them pronouns, have published an article mentioning Gender Health Query and several other organizations skeptical about the safety of pediatric medical transition for gender dysphoria. One of the organizations listed is the American College of Pediatricians. It is an anti-same-sex marriage and adoption activism organization, and Gender Health Query does not endorse organizations that do not align with our interests.

All of the other organizations listed are not religiously motivated, anti-LGBT organizations. They include some trans people as ours does. They have evidence to support the claims on their sites and have the same concerns we do for the same evidence-based reasons.

Greensmith states there are no medical reasons for minors not to transition underage:

Among them are the Gender Care Consumer Advocacy Network, ReThink Identity Medicine and Ethics, the Society for Evidence-Based Gender Medicine, Gender Health Query, and the Pediatric and Adolescent Gender Dysphoria Working Group. Looking at these names, one could easily assume there was a strong medical argument against trans-affirming care for youth, or even potentially a discussion worth having. But let me repeat:
There is no valid medical argument against trans-affirming care for youth

Greendsmith fails to include another pro-homosexual/bisexual rights organization site, Transgendertrend, where one can find evidence-based reasons for concern, with some material written by scientists.

While Greensmith mentions our website, there is no mention of our section laying out significant medical consequences to underage transition. We will list them below to counter this irresponsible article allowed by Teen Vogue editors Lindsay Peoples Wagner, Samhita Mukhopadhyay, and Emily Shippee. There is also debate about the quality of the studies Greensmith cites, such as those done by Jack Turban that appear to suffer from confirmation bias and methodological issues (see here, here, and here), a common problem in social science research. All citations can be found in the hyperlinked section.

SIGNIFICANT CONSEQUENCES PRO-CHILD-TRANSITION MEDIA OFTEN AVOID MENTIONING

1) Permanently destroyed sex organs resulting in a lack of ability to ever have an orgasm-

If a male who wants to be a girl takes hormone blockers as a tween, the youth will always have the penis of a prepubescent child if the child later takes estrogen. This, in of itself, may destroy the youth’s ability to have a fully functioning, adult sex life. If the youth wants a vaginoplasty surgery (they are doing them on minors), they will have to undergo a rectosigmoid vaginoplasty using the colon or one using the peritoneal lining around the stomach. This can create significant order problems later. They also must take skin flaps from the inner thigh leaving considerable scarring. There isn’t enough tissue to do what is called the “gold standard” vaginoplasty, which inverts the penis and scrotum. These other techniques are experimental surgeries.

There are already examples of the vaginoplasty falling apart and needing repair. A trans child reality TV star, has undergone at least four surgeries, describes this ordeal as extremely painful, and will likely go through life not experiencing orgasm even once. In one of the cohorts from a study Heron Greensmith sites (the de Vries/ Steensma cohort from the Netherlands), one of the youths died from the vaginoplasty surgery. Some of these minors making these decisions as tweens will never have sexual feelings in their lives. Many adults decide never to get bottom surgery. It is perfectly rational to question the ethics of destroying such a major choice when doctors transition a tween. And it is shoddy journalism to avoid mentioning this in an article discussing medical risks to under-age youth.

While we understand a dysphoric minor may have a very strong desire to live as the opposite sex and pass better, we believe it is a very sex-negative approach to destroy all ability to fully experience an adult romantic relationship and sexual fulfillment based on a decision the child made before ever having a relationship or even just a crush or sexual desire. The significance of these things is not understood by children. And while it is uncomfortable, this topic must be discussed honestly:

A mother describes the sexual damage caused by medically transitioning her male child starting with puberty blockers

2) Sterility-

The hormone blocker to cross-sex hormone protocol causes sterility. There is a plethora of news articles about trans people who have children or say they want them. There is also a study that shows many trans people want biological children. There was a lawsuit in Sweden regarding trans adults suing because they were sterilized as a requirement for transition, so fertility is important to trans people. A tween or teen will not know how they will feel about children later.

3) A reduction in cognitive function-

A few studies indicate hormone blockers significantly lower IQ test scores. IQ is strongly correlated with career choice and earned income:

Image shows an anecdotal case of a reduction in IQ of 9-10 points in a puberty blocked minor — **Schneider et al.(2017):** “Brain Maturation, Cognition and Voice Pattern in a Gender Dysphoria Case under Pubertal Suppression”

4) A reduction in bone health-

Blockers appear to give a young person the bones of a much older person. Weakening bone density of a young person is worth mentioning:

Graph of reduction in spine tBMD Z-score with GnRHa use for gender dysphoria in minors — Micheal Biggs bone density review paper

5) Gay, Bisexual, and Lesbian Eugenics-

All prior research shows that a very significant number of children with even acute gender dysphoria outgrow it and are very likely to grow up gay or lesbian. This graph is a review of the four most recent and best studies tracking desistance from gender dysphoria. Dr. Ken Zucker created this graphic. The percent of desistance is 67%, a majority:

Graphic showing numbers of DSM diagnosed youth who had persisting versus desisting gender dysphoria — Zucker, Power Point presentation USPATH 2017

Greensmith mentions Dr. Ken Zucker derisively in this piece but fails to mention that Dr. Zucker believes that children who would grow up gay or lesbian are at risk of having their bodies permanently medically altered prematurely. Any risk of permanently altering physical appearance with cross-sex hormones of potentially LGB youth is a serious ethical concern, especially for people who care about the health and diversity of expression of LGB populations. This is why Zucker took a more cautious approach, the protection of likely gay, bisexual, and lesbian youth from harm. Other gender dysphoria experts like Dr. Korte, Dr. Steensma, and Tavistock clinicians have mentioned this as a concern. Heron mentions conversion therapy laws. We are starting to see that transitioning minors is conversion therapy for some youth, particularly lesbian youth struggling with puberty. This is LGB eugenics. It’s already happening:

Sexologist James Cantor predicts social transition will increase gender dysphoria persistence in pre-gay children

London Times headline image - It feels like conversion therapy for gay children, say clinicians — The London Times

One of several examples of transition regret

And eugenics is the correct word as these protocols have the potential to sterilize, destroy sexuality, and permanently change the youth's features and voice. There are now too many stories of mostly young lesbian and bisexual women who transitioned as minors and have regrets. There are so many, the days of plausible deniability one doesn't know are over. It is callous of Heron Greensmith to fail to even mention them considering these are mostly lesbian and bisexual young women. Greensmith may want to consider if cheerleading tomboy teenagers (likely to be same-sex attracted) in their body dysmorphia and female inferiority complex is healthy for them in the long-term because it isn't. It's harming some of them. Lesbian and bisexual youth who struggle with gender dysphoria but are better served by being allowed to just grow up without medical damages matter too. Some heterosexuals males and females also may have regrets.

6) Evidence of serious negative long-term side-effects from using Lupron, a hormone blocker-

Many women are suing due to side-effects from Lupron, a common gender clinic hormone blocker, that doctors gave them for precocious puberty or endometriosis:

As with many drugs, side effects have long been a problem. More than 20,000 adverse-event reports have been filed with the FDA in the last decade. Women have reported to the FDA hundreds of cases of insomnia, depression, joint pain and more than 100 cases of blurred vision. About 900 reports cite side effects that children below age 13 have suffered, mostly within months of taking Lupron. Those reports frequently note injection-site pain but also include dozens of cases of bone problems, such as pain or disorders, and the inability to walk.

And from Righting Injustice:

Last month, the FDA required the safety labels of GnRH agonists to be updated to include new psychiatric side effects causing emotional lability such as crying, irritability, impatient, anger and aggression. The labels were also updated with a warning that use of the drugs were linked to convulsions, particularly in patients with a history of seizures, epilepsy, cerebrovascular disorders, central nervous system anomalies or tumors, and in patients taking drugs that can increase the risk of convulsions, such as bupropion and SSRIs.

Other side effects are deteriorating jaw joints, degenerative disks, growth of preexisting tumors, deteriorating vision, exacerbation of asthma, osteopenia, memory loss, hair loss, and fibromyalgia. In adult men, some of the labeled risks of Lupron are heart attacks, strokes, and sudden death.

7) The large increase in trans-identified females looks like other body dysmorphia social contagions of which there are many in history-

Please see this section and view the graphs showing soaring numbers of female teens identifying as trans. It is not responsible to fail to question this. We would appreciate it if Teen Vogue would write a story on the massive increases of female teens identifying as trans with what appears to be a spike in transition regret by female young people:

Graphs- Increasing representation of female in gender dysphoria clinics

8) A list of just a few of medical the consequences trans youth will have to deal with as adults-

Vaginal atrophy in FtMs that causes severe pain during sex
Increase risk of heart attack and stroke
Liver problems
Need for repeat vaginoplasty surgeries if they collapse
Unknown cancer risks from underage transition

9) The validity of the argument about the benefits of hormone blockers is debatable-

The hormone blocker study done by the Tavistock clinic in Britain has shown blockers may worsen mental health.

We believe that this was a very irresponsible article designed to hide the risk of this to the health of all gender dysphoric children regardless of how stable their trans-identity is. We support the promotion of coping skills, and the importance of brain development and physical health to support these youths for the long-term, not extreme medical fixes youth are led to believe will be a panacea. This article is especially insensitive to the concerns of the growing numbers of gay, lesbian, and bisexual people who are upset about what appears to be substantial increases in stories of transition regret among youth in their early twenties who are mostly lesbian or bisexual women. Transition regret among young females would be a good topic for a Teen Vogue article. The stories of regret are very easy to find at a time of massive increases in trans-identified youth.

Heron Greensmith needs to make the morally and intellectually honest argument. That argument is that false positives, resulting in permanently altered bodies of cognitively immature tweens/teens, resulting in sterilization and other health issues, are worth trans-positive healthcare in hopes more good than harm will be done. That argument is that it is a good thing for an 11-year-old, with no concept of sexuality or desire for children, to permanently destroy their sex organs in order to have a more feminine face, because looks and access to extreme plastic surgery to relieve distress are more important than coping skills and long-term physical health. Instead, Greensmith engages in ideological, black and white, biased, and cherry-picking discourse. This is bad journalism. And as an opinion piece be clear, Greensmith doesn’t represent the opinions of all LGBT people. We recommend that Teen Vogue find someone willing to engage with all of the facts around permanently altering minors. While we are a medical watchdog organization, and harm is our emphasis, we lay out a more unbiased picture, including arguments Greensmith makes, about the ethics of pediatric transition in “17) MORAL DILEMMAS.”

-Justine Deterling Kreher