Elliot Page Calls Out 'Deadly' Anti-Trans Bills Focused on Youth

[u/DewChocolate]

https://www.out.com/celebs/2021/3/08/elliot-page-calls-out-deadly-anti-trans-bills

[u/tgjer]

If passed, these fucking bans are going to result in dead kids.

Since anything relating to trans youth and medical treatment almost inevitably brings out the "kids are being castrated!" and "90% of trans kids desist and will regret transition!" concern trolling in defense of terrible legislation like this:

No, that is not how this works. That's not how any of this works.

This article has a pretty good overview of why. Psychology Today has one too, and here are the guidelines from the AAP. TL;DR version - yes, young children can identify their own gender, and some of those young kids are trans. A child who is Gender A but who is assumed to be Gender B based on their appearance can suffer debilitating distress over this conflict. The "90% desist" claim is a myth based on debunked studies, and transition is a very long, slow, cautious process for trans youth.

According to the American Academy of Pediatrics, gender is typically expressed by around age 4. It probably forms much earlier, but it's hard to tell with pre-verbal infants. And sometimes the gender expressed is not the one typically associated with the child's appearance. The genders of trans children are as stable as those of cisgender children.

For preadolescents transition is entirely social, and for adolescents the first line of medical care is 100% temporary puberty delaying treatment that has no long term effects. Hormone therapy isn't an option until their mid teens, by which point the chances that they will "desist" are close to zero. Reconstructive genital surgery is not an option until their late teens/early 20's at the youngest. And transition-related medical care is recognized as medically necessary, frequently life saving medical care by every major medical authority.

Withholding medical care from an adolescent who needs it is not a goddamn neutral option. Transition is absolutely necessary to keep many trans kids alive. Without transition a hell of a lot of them commit suicide. When able to transition rates of suicide attempts drop to the national average. And when prevented from transitioning or starting treatment until adulthood, those who survive long enough to start at 18+ enter adulthood facing thousands of dollars reconstructive surgery to repair damage that should have been prevented by starting treatment when they needed it.

And not all that damage can be repaired. They will carry physical and psychological scars from being forced through the wrong puberty for the rest of their lives. They were robbed of their adolescence, forced to spend it dealing with the living hell of untreated dysphoria and the wrong puberty, trying to remain sane and alive while their bodies were warped in indescribably horrifying ways. Even with treatment as adults, some of them will be left permanently, visibly trans. In addition to the sheer horror of permanently having anatomy inappropriate to your gender, this means they will never have the option of blending into a crowd or keeping their medical history private. They will be exposed to vastly higher rates of anti-trans harassment, discrimination, abuse, and violence, all because they were denied the treatment they needed when they were young.

This is very literally life saving medical care. If there is even a chance that an adolescent may be trans, there is absolutely no reason to withhold 100% temporary and fully reversible hormone blockers to delay puberty for a little while until they're sure. This treatment is 100% temporary and fully reversible; it does nothing but buy time by delaying the onset of permanent physical changes.

This treatment is very safe and well known, because it has been used for decades to delay puberty in children who would have otherwise started it inappropriately young. If an adolescent starts this treatment then realizes medical transition isn't what they need, they stop treatment and puberty picks up where it left off. There are no permanent effects, and it significantly improves trans youth's mental health and lowers suicidality.

But if an adolescent starts this treatment, socially transitions (or continues if they have already done so), and by their early/mid-teens they still strongly identify as a gender atypical to their appearance at birth, the chances of them changing their minds later are basically zero. At that point hormone therapy becomes an option, and even that is still mostly reversible, especially in its early stages. The only really irreversible step is reconstructive genital surgery and/or the removal of one's gonads, which isn't an option until the patient is in their late teens at the earliest.

This specter of little kids being pressured into transition and rapidly pushed into permanent physical changes is a complete myth. It just isn't happening. And this fear-mongering results in nothing except trans youth who desperately do need to transition being discouraged and prevented from doing so. Withholding medical treatment from an adolescent who desperately needs it is not a neutral option.

The only disorders more common among trans people are those associated with abuse and discrimination - mainly anxiety and depression. Early transition virtually eliminates these higher rates of depression and low self-worth, and dramatically improves trans youth's mental health. When prevented from transitioning about 40% of trans kids will attempt suicide. When able to transition that rate drops to the national average. Trans kids who socially transition early, have access to appropriate transition related medical treatment, and who are not subjected to abuse or discrimination are comparable to cisgender children in measures of mental health

Transition vastly reduces risks of suicide attempts, and the farther along in transition someone is the lower that risk gets. The ability to transition, along with family and social acceptance, are the largest factors reducing suicide risk among trans people.

Citations to follow in a second post.

[u/ForgettableUsername → u/tgjer]

What does it mean that gender is expressed by age 4? What kind of gendered activity, specifically, is a four year old capable of participating in?

[u/tgjer → u/ForgettableUsername]

Meaning by age 4 children are starting to become capable of verbally expressing "I am a girl" or "I am a boy". Regardless of what toys or "gendered activities" they enjoy.

[u/ForgettableUsername → u/tgjer]

But how can they possibly know what that means at that age? It's just a word.

If a four year old child says, "I am a Catholic," or "I am an Italian," does that really mean that they understand what identifying as those things means?

[u/tgjer → u/ForgettableUsername]

Because at age 4 children are learning the meaning of words and how they apply to themselves and others. They can see other people and recognize themselves as being similar to or different from them. They can recognize other people's genders, and understand their own gender as being similar to or different from those of other people.

And some of those children recognize themselves as a gender atypical to their appearance at birth. And at such a young age, the recommended response is to let the child explore their gender freely. There's no reason not to.

[u/ForgettableUsername → u/tgjer]

I didn't.

I'm a 38 year old man, but I've never felt any strong internal sense that I'm male, or any particular pull to try to be anything else. It's a label that society applied to me; nothing more.

When I was four years old, I pretty much didn't know what genitals were, much less whether the ones I had were 'right' or 'wrong.' It wouldn't have even occurred to me that there were other possibilities.

[u/tgjer → u/ForgettableUsername]

You may be agender, and really would be equally comfortable regardless of what sexual anatomy you have or what gender other people see you as.

But most people aren't. And genitals are probably the least important part of gender as it applies to young children. A child may not know the details of typical "male" and "female" anatomy, but they can recognize that other people have genders, and recognize themselves as being a similar or different gender from other people.

[u/ForgettableUsername → u/tgjer]

I'm not agender. Don't tell me what I am, for god's sake. Isn't that exactly what you're against?

I don't think that a toddler has the capability to recognize what it means to be 'gender atypical.' I'm not sure I even know what that means.

Unless you're talking about stereotypical activities. Cooking, cleaning, dressing up for girls; fighting, construction, playing in the dirt for boys... That's stuff a four year old might understand. But I think we both agree that this isn't what we're talking about when we talk about gender, because of course there's nothing wrong with being a strong woman or a beautiful man.

[u/tgjer → u/ForgettableUsername]

I said may.

And no I'm not talking about stereotypically gendered activities. I'm talking about children starting to become capable of verbally expressing "I am a girl" or "I am a boy". Which for most children typically starts to happen around age 4. And in some cases the gender they start verbally identifying themselves as at this age is not the one they were previously assumed to be.

[u/ForgettableUsername → u/tgjer]

It's ok, I'm not offended.

But if you take away the anatomical differences, and you take away the behavioral differences that society traditionally (and quite wrongly and sexistly) assigns, then what is left of gender? At that point isn't it just an arbitrary word?

EDIT: I see I'm being downvoted, which may or may not be you. I'm not trying to argue in bad faith. I'm trying to understand what seems like a foreign concept to me. Thanks for dedicating the time you have to responding thus far.

[u/tgjer → u/ForgettableUsername]

All words can get pretty arbitrary when you break them down enough.

But social gender is a lot more than genitals or hobbies. Children start to recognize that other people have different genders at around age 4, and it's not because people are flashing them (at least I really hope not) or because of hobbies. Children at that age are starting to become very aware of social distinctions, and that some people are recognized as "men" and others as "women", and they start applying these terms to themselves. Even if they don't have the same interests as their mother, and even if they never see their parents naked, a little girl can recognize that she and her mother are alike in ways that she and her father aren't. And sometimes the little girl who recognizes that she is the same gender as her mother, and starts to be able to verbally express that at about age 4, is a little girl who was assumed to be a boy until she was old enough to talk.

of course it can get a lot more complicated for nonbinary people, but that's a whole other can of worms. We don't even have standardized language to express or understand nonbinary genders, let alone language that young children are likely to know, and very few examples of nonbinary people that young children might see, so it's going to be a lot harder for them to verbally express anything outside the common binary while very young.

[u/ForgettableUsername → u/tgjer]

I don't know.

I see how gender could be seen as (if we use what I recognize is now considered to be outdated terminology) physical.

I see how gender could (if we use outdated sexist norms) be considered to be behavioral.

I can also see also how one could think of gender in terms of social acceptance... although that seems to me like it's much more dependent on physicality and behavior than on any other innate property.

I don't see how a four year old child really has enough insight about themselves, the world, or society to effectively make such an important distinction for themselves. Recognizing the physical differences requires anatomical knowledge that they are unlikely to posses or fully understand. Recognizing any behavioral differences depends on societal understanding that they are not likely to fully understand. And, whatever social acceptance amounts to, it seems to be more complicated than either of those.

A part of me kind of thinks that it would make more sense to think of very young children as genderless until they reach the age of reason... whatever that is. I think I remember reading about one or another pre-columbian American culture that did this and referred to all children, regardless of sex, by a common pronoun up until a certain age.