The vanguard has defined the boundaries

Abigail Shrier’s article on the two doctors of transgender medicine who aren’t so sure any more has been getting attention, and in light of the WPATH and USPATH announcement that only doctors should be talking about the subject, the article is helpful. (H/t Sackbut)

For nearly a decade, the vanguard of the transgender-rights movement — doctors, activists, celebrities and transgender influencers  — has defined the boundaries of the new orthodoxy surrounding transgender medical care: What’s true, what’s false, which questions can and cannot be asked. 

They said it was perfectly safe to give children as young as nine puberty blockers and insisted that the effects of those blockers were “fully reversible.” They said that it was the job of medical professionals to help minors to transition. They said it was not their job to question the wisdom of transitioning, and that anyone who did — including parents — was probably transphobic.

And “probably transphobic” generally means also “deserving of swift and ferocious punishment.” This vanguard has done its best to make it impossible to question the wisdom of transitioning, and to treat people who do question it as murderous, sadistic, deliberately cruel, monstrous. This framing that people who question the wisdom of transing are the worst people has not receded or weakened in the slightest.

But that new orthodoxy has gone too far, according to two of the most prominent providers in the field of transgender medicine: Dr. Marci Bowers, a world-renowned vaginoplasty specialist who operated on reality-television star Jazz Jennings; and Erica Anderson, a clinical psychologist at the University of California San Francisco’s Child and Adolescent Gender Clinic. 

In the course of their careers, both have seen thousands of patients. Both are board members of the World Professional Association for Transgender Health (WPATH), the organization that sets the standards worldwide for transgender medical care. And both are transgender women.

Anderson wanted to write about it in the NY Times, but the Times told her it wasn’t interested. Cool cool, it’s just a matter of the futures of thousands of adolescents, so who cares.

On some issues, including their stance on puberty blockers, they raised concerns that appear to question the current health guidelines set by WPATH — which Bowers is slated to lead starting in 2022. 

WPATH, for instance, recommends that for many gender dysphoric and gender non-conforming kids, hormonal puberty suppression begin at the early stages of puberty. WPATH has also insisted since 2012 that puberty blockers are “fully reversible interventions.” 

Anderson and Bowers both have some doubts about that now.

For decades, psychologists treated [gender dysphoria] with “watchful waiting” — that is, a method of psychotherapy that seeks to understand the source of a child’s gender dysphoria, lessen its intensity, and ultimately help a child grow more comfortable in her own body. 

Since nearly seven in 10 children initially diagnosed with gender dysphoria eventually outgrew it — many go on to be lesbian or gay adults — the conventional wisdom held that, with a little patience, most kids would come to accept their bodies. The underlying assumption was children didn’t always know best.

But in the last decade, watchful waiting has been supplanted by “affirmative care,” which assumes children do know what’s best. Affirmative care proponents urge doctors to corroborate their patients’ belief that they are trapped in the wrong body. The family is pressured to help the child transition to a new gender identity — sometimes having been told by doctors or activists that, if they don’t, their child may eventually commit suicide.

No pressure though.

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