Ironically, the best way to leave detransition as a valid option is to give kids puberty blockers prior to puberty. If you want breasts later, better to have never grown them so they can be grown via hormones than to have had surgery. Which means earlier care and more aggressive use of puberty blockers.
I do appreciate you noting that care for trans girls should be examined on a separate track, since masculinization IS largely irreversible and forcing girls to grow beards and have their voices drop is a direct and long term harm, regardless of whether the care givers can pretend innocence by insisting that they did no harm; the harm was 'natural'.
I would note as an aside that Scandinavia has pretty bad transition care in general, (plus scandals around breaches of medical privacy in service to anti trans researchers and really invasive sexual questioning directed at minors) so pointing to them as ‘socially liberal’ comes across as a bit of a bait and switch.
I hope your call is heeded, because as you say , and as has already happened in some US states , “ the sooner Canadian clinicians acknowledge and address these legitimate clinical concerns about GAMC in adolescents with gender dysphoria, the less likely it is that legislators will impose ill-considered policy changes driven more by politics than evidence”.
All the potential harms you list seem like pure guesswork to me. It doesn't really concern me that rates of GAC have increased, it's likely a consequence of improved information and access. I really don't understand the concerns your raising, all your sources point to minimal downsides and immense upsides to prescribing testosterone to teenage trans boys. On the other hand restricting access to GAC for trans youth would likely cause immense harm, as has happened everywhere this has been implemented.
I'm also not sure I agree that early intervention matters less for trans masculine people. It's true trans fems face more irreversible changes like voice dropping, facial/body hair, etc that can be prevented with early puberty blockers/HRT use but it ignores that a major component of male and female puberty is changes in bone structure. Estrogen driven puberty leads to pelvic widening and early bone fusing, and this happens much earlier than in testosterone driven puberty. What this means is that a trans girl in her late teens may still benefit from HRT widening her pelvis while stunting other bone growth, a trans boys skeleton is basically locked in at that point. Given how many trans masculine people feel dysphoria towards being short, having wide pelvises, narrow shoulders, feminine faces, etc this seems like a very relevant consideration.
Ironically, the best way to leave detransition as a valid option is to give kids puberty blockers prior to puberty. If you want breasts later, better to have never grown them so they can be grown via hormones than to have had surgery. Which means earlier care and more aggressive use of puberty blockers.
I do appreciate you noting that care for trans girls should be examined on a separate track, since masculinization IS largely irreversible and forcing girls to grow beards and have their voices drop is a direct and long term harm, regardless of whether the care givers can pretend innocence by insisting that they did no harm; the harm was 'natural'.
I would note as an aside that Scandinavia has pretty bad transition care in general, (plus scandals around breaches of medical privacy in service to anti trans researchers and really invasive sexual questioning directed at minors) so pointing to them as ‘socially liberal’ comes across as a bit of a bait and switch.
Hello Sanity, long time no see !
I hope your call is heeded, because as you say , and as has already happened in some US states , “ the sooner Canadian clinicians acknowledge and address these legitimate clinical concerns about GAMC in adolescents with gender dysphoria, the less likely it is that legislators will impose ill-considered policy changes driven more by politics than evidence”.
All the potential harms you list seem like pure guesswork to me. It doesn't really concern me that rates of GAC have increased, it's likely a consequence of improved information and access. I really don't understand the concerns your raising, all your sources point to minimal downsides and immense upsides to prescribing testosterone to teenage trans boys. On the other hand restricting access to GAC for trans youth would likely cause immense harm, as has happened everywhere this has been implemented.
I'm also not sure I agree that early intervention matters less for trans masculine people. It's true trans fems face more irreversible changes like voice dropping, facial/body hair, etc that can be prevented with early puberty blockers/HRT use but it ignores that a major component of male and female puberty is changes in bone structure. Estrogen driven puberty leads to pelvic widening and early bone fusing, and this happens much earlier than in testosterone driven puberty. What this means is that a trans girl in her late teens may still benefit from HRT widening her pelvis while stunting other bone growth, a trans boys skeleton is basically locked in at that point. Given how many trans masculine people feel dysphoria towards being short, having wide pelvises, narrow shoulders, feminine faces, etc this seems like a very relevant consideration.