Summary

In a short debate piece, Kenneth Zucker, a psychologist who led the Toronto CAMH child gender clinic until 2015, argues that socially transitioning a young child (new name, pronouns, presentation) is not a neutral act but a form of treatment. Older follow-up studies found that most children with gender distress who did not transition no longer had it after puberty. So he predicts that early social transition will make it much more likely the distress lasts, often leading to lifelong hormones and surgery. He suggests this could be called iatrogenic, meaning caused by the treatment itself. He asks doctors to respect families' differing views. It is an informed expert opinion and a key statement of the view that social transition is a treatment, but it offers no new data.

Key findings

• Zuckerは、思春期前の子どもの社会的トランジションを、中立的な、あるいは単に支える行為ではなく、性別への苦痛を減らすことを意図した治療と説明しています。
• 早期の社会的トランジションは、異性ホルモンと手術という生涯にわたる医学的治療につながる可能性が高いと主張しています。
• トランジションしなかった子どもの古い研究と比べて、社会的トランジションが性別への苦痛が続く頻度を「劇的に増やす」と予測しています。
• この効果は「医原性と特徴づけられるかもしれない」と示唆しており、これは、続く苦痛の一部がトランジションそのものによって引き起こされることを意味します。
• 子どもを最もよく助ける方法について異なる見解を持つ親への、敬意と理解を求めています。
• この論文は、Child and Adolescent Mental Healthの2020年の議論シリーズの一部で、Wren、Minnis、Theodosiou、ButlerとHutchinsonによる論文も含まれていました。

Abstract

A gender social transition in prepubertal children is a form of psychosocial treatment that aims to reduce gender dysphoria, but with the likely consequence of subsequent (lifelong) biomedical treatments as well (gender-affirming hormonal treatment and surgery). Gender social transition of prepubertal children will increase dramatically the rate of gender dysphoria persistence when compared to follow-up studies of children with gender dysphoria who did not receive this type of psychosocial intervention and, oddly enough, might be characterized as iatrogenic. Parents who bring their children for clinical care hold different philosophical views on what is the best way to help reduce the gender dysphoria, which require both respect and understanding.

Conclusion

Social transition of prepubertal children should be understood as a psychosocial treatment with likely downstream biomedical consequences; it will probably increase persistence of gender dysphoria relative to earlier follow-up studies and might be characterised as iatrogenic. Parents hold differing philosophical views about how best to reduce their child's gender dysphoria, and these require both respect and understanding.