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Arkansas has taken a drastic step by becoming the first state to prohibit gender-affirming care for transgender youth, following the Arkansas General Assembly’s decision to override Governor Asa Hutchinson’s veto. This new legislation poses severe consequences for any physician who administers puberty blockers, cross-hormone therapy, or gender-affirming surgeries to minors. At least 17 other states are considering similar measures. These laws punish doctors for fulfilling their medical responsibilities and discriminate against transgender youth for simply being themselves. They are rooted in misconceptions, fear, and religious beliefs rather than the scientific evidence that supports the well-being of transgender children. Moreover, these restrictions can negatively impact cisgender children who also seek similar care.
When addressing the misinformation surrounding anti-transgender legislation, it’s crucial to clarify the facts about puberty blockers, as these medications are often the first step sought by younger transgender individuals who wish to pursue medical transition. It’s important to emphasize “choose” and “their” — no child is forced into being transgender. In reality, many transgender youth lack the support they need from adults who can advocate for them. Often, parents are more likely to coerce their children into suppressing their true selves than to embrace their gender identity.
Contrary to prevalent myths, no transgender child is undergoing irreversible surgical alterations. Responsible parents of transgender kids do not demand procedures that their children have not consented to. There are indeed instances of non-consensual surgeries performed on children to fit societal gender norms, but it is not a practice related to the care of transgender youth.
What Are Puberty Blockers?
Puberty blockers are medications designed to halt the production of hormones like testosterone and estrogen, preventing the physical changes associated with puberty. For children assigned female at birth, these blockers can stop the development of breasts and menstruation. Certain aspects of puberty, like body odor and acne, may still occur since they are not solely regulated by these hormones.
There are primarily two types of puberty blockers:
- Histrelin acetate, which is implanted under the skin of the arm and lasts about a year before replacement.
- Leuprolide acetate, an injectable form that requires administration every 1 to 4 months, depending on the specific preparation.
It typically takes one to two months for these blockers to take effect, and they are usually administered for a duration of two to three years. Essentially, puberty blockers act as a pause button; once they are discontinued, puberty will resume from the point it was halted. If a transgender child later transitions to cross-hormone therapy, their body will undergo puberty in alignment with their gender identity.
Who Needs Puberty Blockers?
Puberty manifests in phases, with children typically beginning this process between the ages of 9 and 11. Physicians often utilize Tanner stages to assess a child’s development visually. Tanner stage 2 is generally the optimal time for introducing puberty blockers, as it marks the onset of sex characteristic changes that may not align with a transgender child’s gender identity. Identifying this through blood work, breast bud formation, and other physical signs can help parents and guardians determine the right timing.
For transgender youth, accessing puberty blockers is crucial for their mental health and allows them to express their gender identity authentically. By preventing unwanted physical changes, these medications can reduce the necessity for future medical procedures. For example, a transgender male who experiences female puberty may require surgery later to address discomfort caused by breast development.
Puberty blockers are also utilized for children with precocious puberty, which occurs when secondary sexual characteristics develop too early. For such children, blockers can help delay puberty until a more appropriate age.
Both cisgender and transgender children can benefit from the use of puberty blockers.
Are Puberty Blockers Safe?
Yes, puberty blockers are considered safe and their effects are reversible. Fertility is not adversely affected by their use. Possible side effects may include pain at the injection site, headaches, fatigue, weight changes, mood swings, or irregular periods in those who experience menstruation.
What Are the Risks vs. Rewards?
Denying access to puberty blockers poses greater risks than providing this essential treatment. Children with untreated precocious puberty may face serious behavioral and emotional challenges, including increased susceptibility to substance abuse, social isolation, and self-image issues. These concerns are similarly relevant for transgender youth. The advantages of administering puberty blockers significantly outweigh the associated risks, leading to improved mental health and reduced rates of depression, anxiety, and suicidal thoughts.
While politicians may believe they are acting in the best interest of children by restricting access to puberty blockers, they are, in fact, infringing on the rights of supportive parents, knowledgeable therapists, and informed medical professionals. They must recognize that their actions stem from ignorance, fear, and transphobia rather than genuine concern for children’s welfare.
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Summary
Puberty blockers are essential medications for transgender youth, allowing them to pause unwanted physical changes during puberty and affirm their gender identity. They are safe, reversible, and critical for mental health. Recent legislation targeting these treatments threatens the well-being of both transgender and cisgender children, emphasizing the need for informed support from parents and medical professionals.
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