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 apibūdina vaikų socialinį perėjimą prieš brendimą kaip gydymą, skirtą sumažinti genderinį distresą, o ne neutralų ar vien palaikantį žingsnį.
• Jis teigia, kad ankstyvas socialinis perėjimas greičiausiai lems visą gyvenimą trunkantį medicininį gydymą: kryžminės lyties hormonus ir operacijas.
• Jis prognozuoja, kad socialinis perėjimas „drastiškai padidins“ genderinio distreso išlikimo dažnį, palyginti su senesniais vaikų, kurie nekeitė lyties, tyrimais.
• Jis siūlo, kad šis poveikis „galėtų būti apibūdintas kaip jatrogeninis“, t. y. kad išliekantį distresą iš dalies sukelia pats perėjimas.
• Jis ragina gerbti ir suprasti tėvus, turinčius kitokių pažiūrų, kaip geriausiai padėti savo vaikui.
• Straipsnis yra 2020 m. diskusijų serijos Child and Adolescent Mental Health dalis, kurioje taip pat buvo Wren, Minnis, Theodosiou bei Butler ir Hutchinson straipsniai.

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.