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

• 주커는 사춘기 전 아동의 사회적 전환을 성별 불쾌감을 줄이려는 치료로 설명하며, 중립적이거나 순전히 지지적인 단계가 아니라고 합니다.
• 그는 이른 사회적 전환이 평생의 의학적 치료, 즉 반대 성 호르몬과 수술로 이어질 가능성이 높다고 주장합니다.
• 그는 사회적 전환이 전환하지 않은 아동에 대한 이전 연구와 비교해 성별 불쾌감이 지속되는 빈도를 ‘극적으로 늘릴’ 것으로 예측합니다.
• 그는 이 효과가 ‘의인성으로 특징지어질 수 있다’고 시사하는데, 지속되는 고통이 부분적으로 전환 자체로 인해 생겼다는 뜻입니다.
• 그는 자녀를 돕는 가장 좋은 방법에 대해 다른 견해를 가진 부모들에 대한 존중과 이해를 요청합니다.
• 이 글은 Wren, Minnis, Theodosiou, 그리고 Butler와 Hutchinson의 글도 포함한 Child and Adolescent Mental Health의 2020년 토론 시리즈의 일부입니다.

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.