Criticism of puberty blockers is misplaced, says the mother of a trans girl

The mother of a transgender teen says that when her child comes out at age eight, she and her family can “take a deep breath together.”

However, when it came to their daughter, they accepted it immediately, Kylie said.

“As soon as she told us who she was, we just went with it.

“And behind the scenes, we’ve been gathering a lot of information about what would be the best way to keep her safe and healthy.”

The reactions of those around them were “mixed”, some were supportive, some were not.

“We had to educate the people around us, while at the same time learning ourselves.”

At that stage there was no need for medical interventions. Within a few years, however, puberty was looming.

“And at that moment she let us know very clearly that she did not want the changes that were going to happen to her unless she was given something to support her.”

Puberty blockers, which block the physical changes of puberty, are under international scrutiny after a four-year independent study in Britain led by Dr Hilary Cass found “remarkably weak evidence” for their use.

The UK’s National Health Service has banned its routine use for gender-affirming care outside of clinical trials.

According to Pharmac data, 416 young people in New Zealand aged 12 to 17 were prescribed puberty blockers in 2022, up from 48 in 2011, the first year the hormones were used for gender-affirming care in this country.

Rates were more than ten times higher than in England.

Dr. Cass and other child development experts said it was not known whether blockers gave young people time to “consider their options” (as originally intended) – or whether they effectively “locked” them into a medical pathway .

Almost all children who use blockers subsequently progress to a medical transition involving the use of cross-sex hormones.

Puberty blockers at age 10, estrogen treatment at age 14

However, Kylie said blockers gave her family time to think.

“Sexuality and future fertility – those are really big conversations to have at age 10. So the idea with puberty blockers is that you don’t have to have all those conversations at that age. You can wait until your child is a more appropriate age. ” to talk about those things.”

Before her daughter was prescribed puberty blockers at age 10, she had multiple visits to a pediatric endocrinologist, a full medical evaluation including blood tests, a hand X-ray (to assess bone density), and an appointment with a psychologist.

“I’m not surprised that most of them continue because it’s a very rigorous process,” Kylie said.

“They have already gone through rigorous screening to make sure this is something they really want.”

At age 14, her daughter started taking estrogen medications.

Before that, she had to undergo a psychiatric assessment, which meant eight months of visits and tests.

“She is unusually young to be taking HRT. In New Zealand it is not usually given to teenagers under the age of 16, depending on which area you are in.

‘The doctors were willing to make an exception because of the thoroughness of the psychiatric reports and the length of time she had been absent.

“At 14, she had already been socially out for six years, so it wasn’t a decision made overnight.”

‘No parent owes grandchildren’

The teen was offered a fertility preservation option, which meant she had to stop taking puberty blockers and go through puberty far enough to allow the process. But that wasn’t an option she wanted to take.

Kylie said she had no personal grief about it.

“No parent owes grandchildren. When I chose to have children, I did not do so with a plan in mind that they would have to provide me with biological grandchildren.

‘Maybe one day she’ll get older. The fact that they won’t be her biological children doesn’t make them any less her children.’

Family has no regrets

Although there was an increase in the number of young people seeking care, Kylie did not believe there was an increase in the actual number of trans children.

Her eldest child – who is now 24 – came out as non-binary a few years after her daughter.

“You are more likely to seek gender-affirming care if you believe it is available and safe in your community.

“As it has become a little safer to be in your community, it has become more likely for someone to talk to their parents at a younger age.

“I think over the generations we’ll have fewer people in their 30s looking to transition because they’ve been able to make it at a younger age.”

No one in her family regretted it, she said.

“Our daughter is a happy, healthy, normal 17-year-old – she has done extremely well in school, is going to college, she has a great group of friends, she is in a relationship – and is doing everything you would expect of a 17-year-old would expect. birthday to do.

‘We have never been concerned that her intellectual or psychological development has been hampered by her inability to express who she is.

“In fact, our concern would be the harm that would have been done to her by not being able to express who she is, and what she would have to work through as an adult.”

The Department of Health plans to release its own review of the evidence on puberty blockers soon, along with a position statement to provide guidance to doctors.

In addition, Health New Zealand Te Whatu Ora has commissioned the Professional Association for Transgender Healthcare Aotearoa (PATHA) to update its guidelines on gender-affirming care for healthcare professionals, including the use of puberty blockers.