Week 9 Assigned Reading (Age Of Uncertainty) Flashcards
What is the main concern outlined in the article with regard to the use of puberty blockers and ongoing/evolving gender dysphoria? Linking back to the lecture, critically evaluate whether this concern is valid or not (or if we simply don’t know).
- Rapid increase in hormone use to suppress puberty in children expressing discomfort with biological sex
- Widening of grounds for accessing these hormones
- Uncertainty about long-term benefits and harms
- Concern about children’s capacity to consent to intervention
- Lack of sufficient psychological assessment before prescription
“My colleagues are seeing in their clinics young people who have changed their minds about wanting to transition away from their biological sex and who also have serious mental health problems that have been left unaddressed.”
What are the critical statistics mentioned in the article with regards to “growing out” of gender dysphoria?
75-95% of children grow out of gender dysphoria over puberty
_____-____% of children grow out of gender dysphoria over puberty
75-95%
What statistic was offered with regards to “transition regret” as reported in the Dutch study cited in the article?
Less than 1% of the highly selected group in the Dutch study regretted transition
______% of the highly selected group in the Dutch study regretted transition
Less than 1%
What was the critical statistic offered by the author as a potential confound when assessing the Dutch study’s conclusion?
Fewer than 10% of people in the Dutch study had received puberty blockers
Fewer than ___% of people in the Dutch study had received puberty blockers
10%
Most participants in the Dutch study received puberty blockers after _____
2000
Average time lapse for those who had regrets was ___ years
10
“Since earlier studies show that ___-___% grow out of gender dysphoria over the time of puberty, it looks like we are in unknown territory in prescribing puberty blockers to this wider group of children.”
75-95%
What is the concern about the prescription of puberty blockers in general in Aotearoa-NZ as a means of treating gender dysphoria? Why should these medications require additional checks on them?
- Puberty blockers are not approved for use in gender dysphoria by Medsafe
- Extra precautions are required for unapproved medicines
- NZ guidelines don’t mention extra information requirements for unapproved use
- Lack of monitoring and safeguards in place
- Ministry of Health has not commissioned a review despite uncertainties
“I was surprised to discover that puberty blocking hormones are not approved for use for gender dysphoria - not by Medsafe here, nor by the US Food and Drug Administration, nor the European Medicines Agency.”
Puberty blockers are ____________ for use in gender dysphoria by Medsafe
not approved
Puberty blockers are not approved for use in _________ _________ by Medsafe
gender dysphoria
Detail the case of Keira Bell (UK) mentioned in the article.
- Started questioning gender identity at 14
- Given puberty blockers at 16, followed by cross-sex hormones
- Had double mastectomy at 21
- Started having regrets after surgery
“I started to realise that the vision I had as a teenager of becoming male was strictly a fantasy … Transition was a very temporary superficial fix for a very complex identity issue.”
Detail the case of “Rachel” (NZ) mentioned in the article.
- Longed to be male from age 10
- Put on puberty blockers at 14, testosterone at 15
- Had double mastectomy at 16, full hysterectomy at 18
- Started regretting decisions at 19
“Transgender ideology stopped making sense to me and I thought, ‘Wow, with time and with the right support, I could have lived perfectly happily as a masculine lesbian woman’.”
Keira Bell (UK):
- Started questioning gender identity at __
- Given puberty blockers at __, followed by cross-sex hormones
- Had double mastectomy at __
- Started having regrets ____________
Keira Bell (UK):
- Started questioning gender identity at 14
- Given puberty blockers at 16, followed by cross-sex hormones
- Had double mastectomy at 21
- Started having regrets after surgery
Keira Bell (UK):
- Started questioning ______ ______ at 14
- Given _______ ______ at 16, followed by _______ ________
- Had _______ _______ at 21
- Started having regrets after _________
Keira Bell (UK):
- Started questioning gender identity at 14
- Given puberty blockers at 16, followed by cross-sex hormones
- Had double mastectomy at 21
- Started having regrets after surgery
“Rachel” (NZ):
- Longed to be male from age __
- Put on puberty blockers at __, testosterone at __
- Had double mastectomy at __, full hysterectomy at __
- Started regretting decisions at __
“Rachel” (NZ):
- Longed to be male from age 10
- Put on puberty blockers at 14, testosterone at 15
- Had double mastectomy at 16, full hysterectomy at 18
- Started regretting decisions at 19
“Rachel” (NZ):
- Longed to be ______ from age 10
- Put on _______ ______ at 14, _________ at 15
- Had _______ ________ at 16, full __________ at 18
- Started ________ _______ at 19
“Rachel” (NZ):
- Longed to be male from age 10
- Put on puberty blockers at 14, testosterone at 15
- Had double mastectomy at 16, full hysterectomy at 18
- Started regretting decisions at 19
Many countries are adopting a stricter stance on the prescription of puberty blockers to young people. Build an argument in favour of this stance.
- Lack of long-term studies on effects of puberty blockers
- Potential for regret and irreversible changes
- Concern about children’s ability to provide informed consent
- Need for more comprehensive psychological assessment
- Importance of exploring alternative treatments
Many countries are adopting a stricter stance on the prescription of puberty blockers to young people. What can be done to ensure trans youth get access to the medical support they require in order to live happily?
- Implement comprehensive psychological support and assessment
- Develop evidence-based guidelines for treatment
- Conduct long-term studies on outcomes of various interventions
- Provide alternative support options for gender-questioning youth
- Ensure access to mental health services and support groups
Many countries are adopting a stricter stance on the prescription of puberty blockers to young people. Build an argument against this stance. What can be done to ensure cases such as the two mentioned above are avoided?
- Puberty blockers can provide crucial relief for transgender youth experiencing severe distress
- Delaying treatment may increase mental health risks for gender-dysphoric youth
- Blockers are described as a reversible intervention, allowing time for decision-making
- Strict limitations could lead to increased rates of self-harm or suicide among trans youth
- Individual assessment is more appropriate than blanket restrictions
Many countries are adopting a stricter stance on the prescription of puberty blockers to young people. What can be done to ensure cases such as the two mentioned in the article are avoided?
- Implement comprehensive, ongoing psychological support throughout the process
- Develop standardised, evidence-based protocols for assessment and treatment
- Conduct long-term follow-up studies to better understand outcomes
- Provide thorough education to patients and families about all potential risks and benefits
- Ensure a multidisciplinary approach involving mental health professionals, endocrinologists, and other specialists
According to the Dutch study cited in the article, less than ______% of their highly selected group regretted transition.
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