I don’t shy away from hard conversations – I almost wrote “controversial” because they’re the kinds of conversations that spark big reactions from a lot of people. But there’s no controversy about human rights, so I refuse to tap dance around the discussions that affect anyone’s rights to freedom, bodily autonomy, and existence.
I had one such conversation the other day about puberty blockers for transgender kids/teens – the slash is on purpose, because the time when puberty blockers are prescribed is right on the cusp of puberty, right at the moment the sex hormones begin to kick in. The person I was talking to felt very strongly that puberty blockers should not be prescribed until a person was 18 and had the legal right to decide for themselves, because “puberty blockers cause infertility” they said.
I had an instant reaction to that statement, a feeling that it wasn’t correct, or at a minimum, wasn’t the whole picture, but I didn’t have the facts at my disposal, hadn’t done enough specific research to speak with authority, and it wasn’t the right circumstance to pull out my phone to search, so I said, “I don’t know enough about that subject yet to speak intelligently on it, but I’ll do some research and get back to you.”
And then I did the research, checking my sources very carefully. It’s not what this post is about, but if you’re interested, puberty blockers are used to arrest the onset of puberty, basically putting the physical changes that come with the teen increase of the sex hormones on hold. They have been used medically to treat “precocious puberty” or early onset puberty since the 1980s, and were FDA approved in 1993. Puberty blockers are not prescribed until the first signs of puberty, and are typically discontinued within 1-2 years, at which time puberty will restart. Possible effects of longer-term use can include issues with bone density or development and fertility, depending on when the medicine is started.
The prescription of puberty blockers for transgender youth usually only happens when there’s a lasting pattern of gender nonconforming or gender dysphoria, a worsening of gender dysphoria at the onset of puberty, when psychological, medical, and social problems that could interfere are treated, and when there’s informed consent – the ability to understand the treatment and consent to having it. Benefits of puberty blocker use in transgender and gender nonconforming youth include:
Improving mental well-being, Easing depression and anxiety, improving social interactions with others, lowering the need for future surgeries, and easing thoughts or actions of self-harm.
The physical results of puberty blockers are not permanent, and puberty begins again when the blockers are stopped, so the conversation about blockers causing infertility isn’t accurate at all, and at worst, is a gross misrepresentation of a long-term use risk.
Often, the idea of puberty blockers is collapsed with the prescribing of hormone replacement therapy for transgender and gender nonconforming youth. They are not the same thing. Puberty blockers stop the onset of the sex-at-birth hormones, HRT replaces those hormones with the ones that best represent the person’s gender. The HRT drugs can lead to diminished fertility, and are therefore prescribed only with extensive counseling about the long-term effects, along with options for fertility preservation, etc.
Collapsing one thing with another is something we, as human beings, are very good at. An unfortunate majority of people have collapsed sex and gender, especially in our schools and libraries when the discussion turns to books written about gay and transgender characters. How someone identifies and/or how they present their identity has nothing to do with who they’re attracted to or who they love, and yet people are still calling books with gay parents, or about trans or nonbinary characters “inappropriate” and sexual, while heterosexual parents are portrayed in kids’ books with impunity. And just in case it feels “so last year” to worry about book bans, PEN America has documented more than 4,000 instances of book bans in the first half of the 2023-24 school year, more than the entire previous year, most of which feature LGBTQ+ and Black authors and characters.
I did speak up the other day when, during a discussion about media stereotypes about transgender people and how they inform our biases (think Klinger from M*A*S*H and how he was hoping to be diagnosed as “crazy” for dressing as a woman), someone brought up drag queens, with the implication that drag queens represented the transgender community. I disagreed, stating that drag queens and kings are first and foremost performers and entertainers. Their sexual preferences and genders are not related to, or prerequisites for performing in drag, and in fact most of the transgender and gender nonconforming people I’ve encountered are the opposite of drag performers, much preferring to quietly get on with their lives without drawing attention to their presentation.
I am committed to speaking up, to showing up, and to sharing the things that I believe will help make the world a more inclusive, more generous, more caring place. I’ve learned to step back from conversations I’m uncertain about until I can learn what I need to know to have intelligent and thoughtful discussions that might actually impact someone’s thinking – and then having those conversations. I also speak up immediately about things I do know so as not to allow misinformation or disinformation to stand. Pointing out that drag performers should not be collapsed with transgender people may not seem important in the stand for inclusion and human rights, but accuracy matters. Information matters. Speaking up about the truth in the face of exaggeration and lies matters.
I will be bringing up the puberty blockers conversation the next time I see my friend, and I will present the information I’ve learned, and the sources (Mayo Clinic and medical journals) I researched. There’s so much in life that most people don’t even think about until someone – a friend, a family member, a community member – changes it from a concept “out there” to something personal. And when there’s a person attached, a person with hopes and dreams and fears and goals and laughter and tears, the idea of human rights and bodily autonomy isn’t negotiable. It isn’t up for discussion, and it isn’t subject to someone else’s ideas of “appropriate.” The only hard conversations, when someone’s humanity is on the line, are the ones we don’t have.
An impressive display of clarity and intellectual rigour. More proof, if it were needed, that scientific research does not conflict, rather it complements, the empathy with which you overflow.
I wish I could love this twice! Thank you for your eloquence and willingness to fight the fights that need fighting :) 💓💓