On Children Medically Transitioning

Article By E.S. Wynn

I’m going to come right out and say that I don’t know what the right answer is when it comes to whether or not children should be allowed to medically gender transition. You may create a definite answer for yourself after reading this article, but I am not writing this to create a stance, start an argument or convince anyone to take (or not take) any specific action. I’m writing with an aim to share my personal experiences, my observations, my fears and what I have learned through reading the articles and the viewpoints of others. I want to explore the issue in the hopes that parents who are presented with the choice of whether or not to let their children transition medically can make that decision from a more fully informed place. It’s none of my business what anyone chooses to do with their bodies, and if a child transitions, I am fully in support of it. I am also in support of all individuals who choose not to transition. It really does come down to individual preference either way.

Whenever I wonder if helping children transition medically before puberty is a wise choice or not, I ask myself where the doubt comes from. As far as I can tell, the primary fear is a fear that they're too young to understand dysphoria, to understand gender, sexual characteristics and sexuality. While I think this may be true (to a degree) for some children, I also know that one doesn’t have to know anything at all about sex or gender roles to feel dysphoria. Even before clear distinctions between male and female are laid down in the brain of a child, a child can feel the difference between being one gender on the inside and being a different gender on the outside. I know, and that knowing comes not only from personal experience, but also from the personal experiences of others I know well.

I mentioned in my earlier article “On Dysphoria” [link] that I knew as early as two or three that something was off between my body and my mind. I felt the incongruence, the dysphoria, and I remember it clearly. It was probably one of the first moments that I doubted the godlike wisdom (from a child’s perspective) of my parents and wondered how they could be right when the idea of me being male felt so wrong. It wasn’t that I wanted to be female. I didn’t have any interest in pinks, dresses or Barbie dolls. I wasn’t yearning for a vagina, for a housewife life or a male lover. I was two or three years old. I loved robots, cars, fighter jets, dinosaurs and mud. My favorite colors were sky blue and crimson red, and accordingly my favorite clothes were blue jeans and red shirts (preferably with dinosaurs or robots on them.) Despite all of this, despite the fact that, in many ways, I was a stereotypical young boy, I felt strongly female inside, and the feeling has never gone away. It’s definitely there, and it definitely transcends everything else about who I am. It’s self-image, or for the spiritual, it’s the soul. It’s who I am and who I have always been.

But even looking at my own experiences, even knowing firsthand how strong and how consistent the feelings have been for me, even as far back as my earliest memories, I'm still not so sure what the right answer is. If I had been born in 2017 to well-off, well-educated and very liberal / progressive parents, my feminine side might have been explored and cultivated. I might even have transitioned before puberty. Would I have been happier growing up as a woman? I don't know. Ideally, I wouldn't have the dysphoria (and it is a constant companion,) but I would likely have other concerns and weights chewing at me. (See my article on why I have chosen not to transition here: [link]) Coming to terms with being a sterile woman would likely be chief among the concerns I’d be facing. At least as a male, I have the ability to create a biological family. If I had transitioned surgically, I would have lost that option utterly.

Yet even that way of looking at it precludes the viability of adoption. Who is to say that if I had medically transitioned at the first opportunity that I would not have found enough self-acceptance to be excited about the idea of adoption? Perhaps I would even have found myself preferring the idea of adopting children, celebrating it as a personal choice and pursuing it until I was mother of a whole passel of different kids. My late stepmother was a champion of children who took in dozens of kids and cared for them as if they were her own and because of this, she has become a sort of hero to me. Who is to say that I would not have followed in her footsteps? The thing is that we don’t know. We can only speculate. We can only speculate, and even then, this is all based solely on one individual’s experiences. Chances are that, with the insertion of a major change early in my life, my interests and viewpoints on all manner of things would be different (not necessarily healthier, or better or worse) than they are now.

Another thought to consider is the potential for rebellion on the part of the child. If I had medically transitioned as a child, or even gone on puberty blockers, I wonder if I would have been completely happy with my life and the course I had chosen to set for myself. It seems to me that transitioning medically could either strengthen the bond between parents and child (as an ordeal that unifies the family as they go through it) or stress it (if the child has doubts later and blames the parents for letting them do something they eventually come to see as self-destructive.) Helping a child transition before puberty could set them up for a lot of pain if they change their mind about it as a teenager or an adult. What if, one day, a given hypothetical transsexual minor decided that he/she wanted to be a different sex than the one they had transitioned to? What if they stopped taking their medications and started using any surgeries or social discomforts against their parents like weapons? There are so many little variables, so many what-ifs, and in reality, no real hard lines. Even this could be seen as just fearful mental masturbation with no facts except “teenagers tend to be rebellious” behind it. As I have said before in previous articles, it is perfectly normal to be transgender and not be transsexual, or intending to transition to a different sex. Perhaps if a child expresses consistent dysphoria, the cure could be as simple as offering them the ability to express themselves however they like. Perhaps they could be allowed to transition in every way except medically, and then be given the option to transition medically once they reach a specific age, whether it be as young as twelve or as old as eighteen. In effect, we’re already there. Children are not whisked off for surgery the instant they begin playing with the “wrong” toys, even children of the most liberal and progressive parents. There are years of therapy, there is a great deal of gatekeeping (for better or worse) and hormones are only administered (at the earliest) when a child reaches puberty. When you consider the fact that we have the ability to delay puberty for years, there is definitely room for doubt on the part of the child. There is time for the child to decide what they want to be when they grow up.

Another fact to consider is that this question is not new. There are plenty of transgender individuals out there right now who have transitioned medically as children, and some who medically transitioned as adults wish that they’d had the opportunity to do so as children. There’s also research that indicates that starting hormone therapy at or just before puberty (whether natural or delayed with puberty blockers) prevents or encourages certain physical sex characteristics (facial hair, breast tissue growth, voice deepening, etc.) and makes it easier for a trans kid to pass, to be accepted and to focus more on growing up than on fighting dysphoria. It could be said that puberty is a type of hormone therapy provided by a person’s own physical body, and by striking before it does, a more neutral body can be pushed in a direction more in line with the mind of the individual.

I want to offer two additional ideas in closing. The first is that if a child is suicidal and/or threatening self-mutilation because of gender dysphoria, then I think that is a clear sign that something definitely needs to be done to take the child’s needs into account. Children do not threaten such things as a gambit for control. They see and consider taking drastic action because they see a problem, a very serious problem, and the only course of action in that case is to take them seriously. Talk to your child. Make sure they are informed about all of their options. Help them consider the benefits and downsides of every decision, and encourage them to search themselves for the answer to what is right. Most of all, listen to your child. Help them, talk with them, understand their perspective, seek out professionals and work with them, but most of all trust your child and follow their lead. If your child is suicidal and the cause is gender dysphoria, neglecting or ignoring that cause could lead you to not having a child at all, and I don’t have to tell you how painful or serious a proposition that is. No one wants to lose a child to suicide, especially when it is easily preventable.

The second consideration I’d like to offer is that I believe there may be too much emphasis on medical transitioning, that transitioning and living as a given gender doesn’t have to be so complete or so defined. Of course, individual preference is individual preference. I have read the first-hand accounts of people who fought hard for complete transition before turning 18 and I applaud them for the courage and hope that their stories become lessons that make it easier for others to get the therapy they know that they need, regardless of how young they are. What I am saying is that all of the options should be understood, and perhaps explored. I say this not out of fear that someone young might make a “mistake,” but out of the opinion that passing should not be so important. Seeking medical transition to feel more in tune with one’s body is absolutely necessary in some cases, but if the reasoning for seeking a complete sex change is based primarily in fear of the opinions and judgments others level at an individual for their inability to pass (or for any other physical trait, like height or weight) then I think a decision to surgically alter one’s body deserves some thought first. Judgments can be worn down and changed if people are willing to be themselves completely (whatever that means to a given individual.) It just takes time, and a willingness to embrace individuality, to fight the toxic standards of a society that oppresses us only to the degree that we allow it to.


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