An Anti-Trans Argument that’s Identical to an Anti-Choice Argument (and why it’s wrong)

Anti-choicers and anti-trans folks make the same argument: having an abortion/taking puberty blockers is too complex a decision for a teen, they say. We can’t let them choose when the stakes are so high, they say. The implication is that we can avoid these high stakes by not allowing abortion / puberty blockers.

But the “no treatment” option anti-choicers demand doesn’t maintain the status quo for a pregnant teen. Letting nature take its course – forcing a teen to go through childbirth – is likely to radically change a teen’s life in ways that can never be reversed.

The “let’s do nothing and wait” option doesn’t maintain the status quo for trans teens, either. In both cases, banning treatment forces the teens to go through permanent changes that may do them great harm.

Banning a treatment – whether it’s puberty blockers or abortion – isn’t putting off deciding until later. It’s the government making the decision right now, without regard for what’s best for the teen.

For teens who may be trans, there is a “putting off deciding” option – and that option is puberty blockers.

And they’re not easy to get! There are already so many barriers to treatment! It can take YEARS between diagnosis and beginning to receive puberty blockers.

If a young teen is pregnant, forcing them to give birth would be horrible and traumatic. And forcing an abortion on them would be horrible and traumatic. It’s a decision that HAS to be made by the teen. In consultation with parents and doctors, sure. But in the end, neither childbirth nor abortion can be justly forced on anyone.

If a young person has gender dysphoria, I hope they get good counsel from parents, from doctors, from loved ones, and from trusted adults who have gone through the same thing. But in the end, it would be unjust and traumatizing to either force them to take puberty blockers, or to force them to go through the wrong sex’s puberty. Like the choice between abortion and childbirth, this decision HAS to be made by the person themselves.

Will some people look back, years later, and think they made the wrong decision?

Yes. It may be rare, but it inevitably happens sometimes.

Just like there are people who got abortions young and grew up and regretted it. That’s sad, but we shouldn’t therefore ban abortion.

If “someday, some small number of patients will regret this treatment” was a reason to ban a treatment, there’d be very little medicine left.

Actually, a bunch of their arguments are the same.

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10 Responses to An Anti-Trans Argument that’s Identical to an Anti-Choice Argument (and why it’s wrong)

  1. 1
    black magic ti says:

    These are not the same arguments at all. First, by not allowing a teenage girl to have an abortion you are altering their lives permanently. By not allowing a teenager to have hormones, you do not permanently alter their lives. a teenager who has been refused hormones can go on later in life and take hormones at more adult age.

    The outcomes are not the same either. by allowing a teenage girl to have an abortion, you do not permanently alter her life. She will still be able to go on to have more children at a time she deems appropriate for herself. Whereas when you do go ahead and give a teenager hormones, and they decide that this transition is not for them, their life is permanently altered. I have had the opportunity to hear from some young people who have detransitioned, and their body is permanently altered.

    And you know what? You might not think that these people who decide they want to detransition don’t really matter, or their numbers are negligible, but they are real people with real lives that need to be counted, included, and considered.

    My argument against giving young people hormones that match the gender they are inside is that we don’t know whether it is safe in the long run for them to take it at such a young age. Everybody’s got sex hormones, it’s just that between the sexes one hormone is more dominant. Men have estrogen, women have testosterone. Our bodies have developed over thousands years to develop in a certain fashion. And I’m not sure we really even have a full grasp on all the effects that sex hormones have on our bodies besides the development of secondary sex characteristics. Basically, I just don’t think all the research is in when it comes to giving hormones to young teenagers. And until all the research is in, it is better to err on the side of caution rather than damaging people and not finding the damage until the body they were born with is of an age for menopause.

    As it is now, science barely understands how woman’s body works as it is. obstetricians are still giving women who’ve just given birth the unnecessary extra stitch, commonly known as the “husband stitch.” These are trained scientists who are trained in the specialty of women’s genitalia and they still believe that by putting in an extra stitch when they are sewing up an episiotomy or a tear from birth that this added stitch will have an effect on the tightness of their vagina. I can assure you, it does not. Do we really want to bestow this kind of scientific misogyny onto our children? because when it comes down to it, scientists still don’t know shit about a woman’s body and that will affect whichever way someone is going hormonally.

    I am by no means saying it is wrong to give young people transition meds. I’m saying we don’t have the science to support it as being a safe choice.

  2. 2
    Ampersand says:

    Black Magic, do you understand that in the vocabulary used by virtually everyone in the field, “taking hormones” (which your comment talks about a lot, even though I don’t mention that at all in my post) and “puberty blockers” (which I talk about in my post, but your comment doesn’t mention) are not the same thing? Do you know what the difference is?

  3. 3
    Jacqueline Onassis Squid says:

    By not allowing a teenager to have hormones, you do not permanently alter their lives. a teenager who has been refused hormones can go on later in life and take hormones at more adult age.

    Do you really think my life wasn’t permanently altered by being unable to transition until I was 52? What a strange thing to believe.

    I second the comment about hormones vs puberty blockers by Amp.

  4. 4
    Ketutar says:

    @black magic ti
    Even though you are right in many points you make, we aren’t talking about “giving young people hormones” or “transition meds”. We are talking about puberty blockers. That is, arresting development.
    No sex hormones changing the body.
    Not letting the puberty start and change the body.
    No breasts growing, no menstruation beginning, no beard growth, voice change, etc. etc.

    This is not permanent or irreversible. It only lasts for as long as the puberty blockers are given. When that stops, the body starts going into puberty and has all the changes it would have had without the puberty blockers.

    And of course people who regret the transition need to be counted, included, and considered, but not at the cost of thousands of people who do not regret. Like my husband.
    We are also not talking about transition, we are talking about puberty blockers. Giving people time to think about it, talk about it, discuss, and consider, before they start doing things that are hard to reverse or even irreversible.

    We are also not just talking about girls. This is not “scientific misogyny”.

    Please respond so that we know you have understood what we say.

  5. 5
    delagar says:

    My kid is trans. Puberty blockers would have saved us years of misery and thousands of dollars, and he would have been so much happier.

    Instead of puberty blockers, he was put on a series of medications for his depression, some of which had very grim side effects, and none of which did much good. He wasn’t depressed. He was trans.

    He started T at age 20, and he’s happier than he was, but he is still forced to live in a body that does not match his gender. (We can’t yet afford surgery, and may never be able to.)

  6. 6
    Corso says:

    From what I understand, and understanding that I’m not an expert, puberty blockers are a relatively healthy way to buy time while the youth figures out what they want to do. Again, my understanding may be flawed, but my understanding is that that’s still not entirely without risk, because puberty is a ticking clock, and blockers might permanently reduce certain aspects of physical development. But when you weigh that against the trauma of a trans kid going through puberty and experiencing body dysphoria… I think that’s a hard decision that people need to make. I’m sure that the youth and their parents have this explained to them.

    I admit to certain hangups though. At the end of the day, it’s not my life, and I’m not going to get in the way of anyone’s happiness, but I do wonder if children are properly equipped to make these decisions, and the fallout from them concerns me. Take the case of Kiera Bell, because it’s relatively recent and has the benefit of being from outside the United States, with all the baggage that has; She went on puberty blockers at 16, hormone therapy at 17, has a double mastectomy at 20, and then sometime between then and now, at 23, she realized that she wasn’t in fact trans, and detransitioned. She successfully sued the hospital and the NHS, the legal argument was that she was too young to consent to the kind of care they gave her. This lead to a lot of therapies being halted for other youths at various stages of transition while the system figures out what to do (read: How to cover their ass).

    That’s a conversation and a tragedy all on it’s own, but I don’t know what to do with the base issue Kiera dealt with: The procedures she went through are permanent, and I don’t know where or how to strike the balance. If she was trans, and she didn’t go through those proceedures, she likely would have had some kind of dysphoria and it would have been harder to treat. As with all trans issues, finding numbers you trust is exceedingly difficult, but it seems like a not-insignificant number of trans youths detransition at some point (the lowest number I found was 10%) and it seems like the older a person gets, the less likely they are to detransition.

    I’d love the opinion of someone who has personal experience, where should the balance be between treating dysphoria and waiting until real consent is possible? At what point is real consent possible?

  7. 7
    JaneDoh says:

    I am not real sure that Kiera Bell’s experience is the best possible counter argument that puberty blockers should not be given to minors because 1) she was much older than most girls who need blockers are and 2) she also got hormone therapy as a minor. Furthermore, the mastectomy that she now regrets was performed when she was an adult who had to seek out and consent to the operation. From what I have read about the case, it sounds like she feels she was pushed into a transition that she didn’t ultimately want by her therapists and doctors, but that is a different issue than whether or not she should have been able to delay her body’s transition into adulthood until she was ready to decide what she needed. Frankly, it sounds like more delay would have been helpful in her case.

    I had my adult body shape and height at age 14, so if I were trans, I would have needed puberty blockers at 11 or 12 to pause the development of my body. The average age for girls to begin menstruating is 12-13, and girls who have not started by 16 are considered to have delayed puberty, so Kiera Bell is an edge case – we are mostly talking about much younger kids who need blockers until they are old enough to make a more permanent decision about their bodies (one that they will likely have to live with for the rest of their lives).

    I don’t think we should ignore detransitioners. We should definitely try to see what (if anything) they have in common so we can better help people who present with gender dysphoria to make the best possible choices for themselves to alleviate their dysphoria. But their existence doesn’t mean we should make trans kids suffer as their bodies change in ways that cause pain and trauma when it is preventable and reversible if they do happen to decide transition is not for them.

  8. 8
    Corso says:

    @7 Hey Jane

    I generally agree, I’m just trying to build my own understanding. I mentioned Kiera Bell because she was somewhat topical, but maybe someone who had a more typical experience with puberty blockers would have been better. That said, Kiera was older than the average person to take puberty blockers, so when determining whether or not someone is developed/mature/able to consent, I don’t think a younger person would be more developed/mature/able to consent than Kiera.

    I don’t want to step too hard here, because there’s a lot of lived experience in the room, but brain development continues into our late 20’s. I think we need to be really careful when making decisions that will effect the rest of our lives, and like I said before: I’m not going to get in the way of anyone’s happiness. Making these kind of decisions is not going to be easy, and I’m not going to pretend that I know better than anyone making those decisions. I’d just like to understand better than I do now.

  9. 9
    Grace Annam says:

    Corso:

    Again, my understanding may be flawed, but my understanding is that that’s still not entirely without risk, because puberty is a ticking clock, and blockers might permanently reduce certain aspects of physical development.

    This is a reasonable hypothesis to frame, but I am given to understand that it turns out not the case. My understanding is that when you stop the blockers, puberty comes roaring back and catches up.

    Puberty blockers have not been formally approved for trans care. In fact, NO medications of any sort have been formally approved for transgender care; all transgender care is “off-label”. That said, all medications used in transgender care have been studied and approved for other medical purposes, so it’s not like this is unknown territory. I certainly have no objection to studying them MORE, but long before anyone thought to use them for children who might be transgender, they were used and studied on cisgender children to treat precocious puberty, among other things.

    I’m sure that the youth and their parents have this explained to them.

    They do.

    Take the case of Kiera Bell, because it’s relatively recent and has the benefit of being from outside the United States, with all the baggage that has…

    You may not be aware that Bell is located in the United Kingdom, and that medical treatment for trans people through the NHS has never been as “good” as it is in the United States (for those in the states able to access care at all; I’m generalizing). Also, attitudes toward trans people in the UK have taken a dramatic dive, in recent years, far beyond what they have done even in the last four years in the United States.

    https://threadreaderapp.com/thread/1347457964320452608.html

    Note that the case of Keira Bell has been pushed aggressively in the press and given far more column inches of print and minutes of video than the cases of many hundreds of other adults who turned out to be trans who navigated through the NHS. If we’re going to give it more weight than any other single case, that should be on the basis of a compelling argument for why her story matters more than someone else’s.

    This is important because, in this ongoing societal argument, detransitioners command headlines which trans people can’t dream of. There are a large number of adults, now, who transitioned as children or teens. They seldom get interviewed, despite the fact that they outnumber detransitioners significantly. It gives an impression of parity which doesn’t exist.

    She went on puberty blockers at 16, hormone therapy at 17, has a double mastectomy at 20, and then sometime between then and now, at 23, she realized that she wasn’t in fact trans, and detransitioned. She successfully sued…

    There were a lot of problems with that legal process, and the result was a very flawed decision. It sets a bad legal precedent.

    But the biggest problem with referencing Bell’s case in a discussion of medical care for children is that she elected to undergo chest reconstruction as an adult. She had been old enough, for at least a year, to vote, to enlist in the military, and to purchase and consume alcohol. She could get tattoos. She could access whatever kind of elective surgery she could pay for.

    I’d love the opinion of someone who has personal experience, where should the balance be between treating dysphoria and waiting until real consent is possible? At what point is real consent possible?

    I have one person’s personal experience, and a little time. I may not have time to reply further, so this may be what you get from me.

    When informed consent is possible depends on the human. That’s why you have therapists and doctors involved, and a system. There’s no such thing as a foolproof system. The UK system is underfunded, outdated, slow, and clunky… and now it’s been hamstrung. Remember that we’re not talking about cross-hormone therapy, in that decision; we’re talking about just blocking puberty, the absolute minimal intervention.

    Elsewhere, there are functioning systems which permit cross-hormone therapy at 16, which have a satisfaction rate above 90%, a satisfaction rate medical providers in many other specialties can only fantasize about. Denmark, for one.

    Puberty blockers should be prescribed after a medical exam to ensure that there are no contraindications, and after the kid says they want them. Then you’ve got time (several years, if the process was started soon enough) to let the kid go through a therapeutic process which will enable everyone involved to decide what’s best for the kid. Currently, the default is that the kid is cis, and unless everyone (therapist, doctor, parent or parents, the kid) agrees otherwise, there is no cross-hormone therapy, and no surgery. That’s already the default.

    In most places there is even still a process in place for people 18 years old and older, despite the fact that we let 18-year-olds make their own decisions on other hazardous topics (enlisting). And those systems apply no matter how old you are. An adult in their forties still has to get a therapist to sign off, for cross-hormone therapy.

    (A few people work with an informed consent model. Essentially, you put the risks and benefits in front of the adult and let them make their decision. To my knowledge, no one, anywhere, is using informed consent for people under 18.)

    At some level of restriction, eventually, we have to start to ask whether the point of a system is to make sure than only the correct people are going through it, or to prevent as many people as possible from going through it. The former is consistent with affirming, careful medical care. The latter is not; if your objective is to prevent as many people as possible from going through a process, then it’s clear that you believe that transition is inherently a bad thing, to be avoided at all costs.

    And that’s exactly how transition has been approached by medical professionals, everywhere, until very recently: a thing to be prevented except in the most extreme cases.

    Which is why trans people old enough to remember those days don’t have a lot of patience for the notion that we should be more careful.

    I hope this information and context helps.

    Grace

  10. 10
    Corso says:

    Hey Grace,

    Thanks for taking the time. I think I understand better, but I’m still not sure what should happen going forward.

    You may not be aware that Bell is located in the United Kingdom, and that medical treatment for trans people through the NHS has never been as “good” as it is in the United States (for those in the states able to access care at all; I’m generalizing). Also, attitudes toward trans people in the UK have taken a dramatic dive, in recent years, far beyond what they have done even in the last four years in the United States.

    I wasn’t aware. I kind of assumed that America was as bad as a first world democracy got on social issues, probably because being within 100 miles of the US border, and having lived here for the last decade, I get a *lot* of American news. I try to keep up with the goings on over the pond, but it’s a losing battle…. I was proud at the time to have a UK example, but it looks like it came with baggage.

    What has me hung up is that the governments tend to be really, really, really bad at dealing with nuance, and sexuality seems like a thing that is extremely nuanced, but we, society, expect the government to provide a framework within which to operate. Which is a perfect recipe for a system with all kinds of absurdities.

    I asked when real consent is possible, and I think it’s a good question. You pointed out that when Kiera received her mastectomy, she was an adult, and could vote, drink, or get a tattoo, all of which is true. More, the age of sexual consent in the UK is 16, which matches their age of (I kid you not) enlistment, but they can’t drive until they’re 17, and they can’t smoke or drink until they’re 18. At what age is a youth able to make informed decisions that will effect them for the rest of their life? I agree with you completely: Your mileage will vary. I know some very mature children, and I know some adults I wouldn’t trust with a fork and a power outlet. Any age is arbitrary, but the government has to pick a number. (Or do they?)

    What do you do with that? I don’t know if a 16 year old is mature enough to make life altering decisions. Some are, but the ones that aren’t don’t magically become more mature on their 18th birthday. But whether or not every youth of 16 is mature enough to make life altering decisions, the bar’s already been set, hasn’t it? Again…. The answer won’t be perfect, but we need some kind of framework; Is the right thing to do to believe the youth, give them puberty blockers until they’re 18 (16?) (x?) or their puberty asserts to give them the most time possible to ponder the question, and then start them on hormones if they still want them? If someone decides afterwards to detransition, give them what care we can, but point out that they made a decision, and decisions have consequences?

    It seems rough, but I don’t know what the alternative is, what happened in the UK makes no sense; If Bell is deemed too young to consent, then that should be clear. If she can consent, she shouldn’t have grounds to sue. Healthcare providers need some kind of idea of how to operate without the Doom of Damocles’ Lawsuits hanging over them. They shouldn’t be legally liable for providing perfectly legitimate care to symptoms as described.

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