Gender-Affirming Care for Trans Youth Is Neither New nor Experimental
December 2, 2024 11:21 AM Subscribe
Julia Serrano compiles over two decades of academic research on gender affirming care for trans youth and summarizes it into a brief, compelling fifteen minute essay with pages and pages of sources. For those who don't know her, Julia Serrano is a transgender woman, the author of Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity and activist for LGBTQ causes.
Julia Serrano’s essays are really, really great.
posted by GenjiandProust at 12:41 PM on December 2 [3 favorites]
posted by GenjiandProust at 12:41 PM on December 2 [3 favorites]
(also this week, not quite part of this specific topic, but since so much of the discourse around trans youth also involves sports: outsports, which is a lgb(t) outlet that was founded by a desantis-fan republican transphobe published an article that points out blanket sport bans are unsupported by the actual data and links to the actual study in the bmj.)
posted by i used to be someone else at 12:42 PM on December 2 [6 favorites]
posted by i used to be someone else at 12:42 PM on December 2 [6 favorites]
"You can't reason someone out of a position they didn't reason themselves into". I'm glad the author is doing this work, but I'm not sure the overall goal. The sort of folks that are "concerned" about gender affirming care are almost universally not so because they read some pseudo-academic article about the subject, but rather some underlying "feeling" that gender-affirming care is wrong. A long list of citations isn't going to change their view, given such a person likely doesn't trust medical community consensus in the first place.
What can be done instead?
posted by saeculorum at 1:07 PM on December 2 [1 favorite]
What can be done instead?
posted by saeculorum at 1:07 PM on December 2 [1 favorite]
I wonder what marginalized group they'll move on to demonize next
posted by gottabefunky at 1:12 PM on December 2
posted by gottabefunky at 1:12 PM on December 2
What can be done instead?
This is the sort of article that Julia excels at. I don't think she's targeting transphobes who are operating out of pure bigotry and transphobia. She's targeting 'moderate' or 'questioning' (I use those quotes intentionally, since I don't really agree with those labels, but they're in use) folks. Even my otherwise very trans-supportive mom has talked to me about being concerned about various forms of trans health care for minors. She would read references like these that were pointed her way, and she's not alone.
Besides, I think Julia and others in my community need to speak out on the subject as best we can, when we feel safe doing so. It's all we've got.
But yes, there's another group that is perhaps reachable despite their transphobia (that 'underlying feeling' that something is wrong has a name - it's called 'transphobia') that could be spoken to via emotional language and not hard science. I'm not sure of the best way for that - certainly through those they consider sources of ethical guidance? Their community leaders, their sources of news/commentary, their religious leaders. If those people urge compassion and acceptance, they might listen.
posted by Flight Hardware, do not touch at 1:29 PM on December 2 [20 favorites]
This is the sort of article that Julia excels at. I don't think she's targeting transphobes who are operating out of pure bigotry and transphobia. She's targeting 'moderate' or 'questioning' (I use those quotes intentionally, since I don't really agree with those labels, but they're in use) folks. Even my otherwise very trans-supportive mom has talked to me about being concerned about various forms of trans health care for minors. She would read references like these that were pointed her way, and she's not alone.
Besides, I think Julia and others in my community need to speak out on the subject as best we can, when we feel safe doing so. It's all we've got.
But yes, there's another group that is perhaps reachable despite their transphobia (that 'underlying feeling' that something is wrong has a name - it's called 'transphobia') that could be spoken to via emotional language and not hard science. I'm not sure of the best way for that - certainly through those they consider sources of ethical guidance? Their community leaders, their sources of news/commentary, their religious leaders. If those people urge compassion and acceptance, they might listen.
posted by Flight Hardware, do not touch at 1:29 PM on December 2 [20 favorites]
What can be done instead?
I have some success in ridiculing / making fun of cis/heteronormative habits (even surgeries like nose jobs) as "gender affirming care"
Since part of the problem is making trans kids seem weirder by labeling activities with medical terminology, we can do more to 'acculturalize' these ideas. There s lots of things cis people do that are 'gender affirming care', and a lot of it is funny...which is actually important for the, I dunno, majority of people who don't read?
posted by eustatic at 1:36 PM on December 2 [13 favorites]
I have some success in ridiculing / making fun of cis/heteronormative habits (even surgeries like nose jobs) as "gender affirming care"
Since part of the problem is making trans kids seem weirder by labeling activities with medical terminology, we can do more to 'acculturalize' these ideas. There s lots of things cis people do that are 'gender affirming care', and a lot of it is funny...which is actually important for the, I dunno, majority of people who don't read?
posted by eustatic at 1:36 PM on December 2 [13 favorites]
I have some success in ridiculing / making fun of cis/heteronormative habits (even surgeries like nose jobs) as "gender affirming care"
I think that's actually the reasoning behind a fair bit of trans care: these are medications and procedures already available to cis people (breast augmentation, mastectomy, hormone replacement, even vaginoplasty), and therefore must be made available to trans people or risk discrimination. Not sure most people know that though.
posted by Flight Hardware, do not touch at 2:04 PM on December 2 [9 favorites]
I think that's actually the reasoning behind a fair bit of trans care: these are medications and procedures already available to cis people (breast augmentation, mastectomy, hormone replacement, even vaginoplasty), and therefore must be made available to trans people or risk discrimination. Not sure most people know that though.
posted by Flight Hardware, do not touch at 2:04 PM on December 2 [9 favorites]
Not sure most people know that though.
posted by Flight Hardware, do not touch at 2:04 PM
right. and those of us who are oriented toward human rights, who are swayed by or or find solace in articles like this, can often end up being scolds and know it alls in the average conversation--because, by virtue of taking the time to outline 100 years of medical evidence, you will be taking up a lot of space in an average given conversation. I am working on getting info out there concisely in my daily life.
this is also a problem with climate change comms.
so, i would say, in the face of despair, I would try to get funny as a comms strategy. I can't really write jokes , but at least, concision?
I can prepare a short, interventionary statement like "it wasn't called 'mutilation' when [jessica] got a breast reduction to help her back problems; it's only called 'mutilation' when elon musk wants a tax cut'
short statements are good. but i also try to get funnier, in the face of the communications problems...
posted by eustatic at 2:37 PM on December 2 [6 favorites]
posted by Flight Hardware, do not touch at 2:04 PM
right. and those of us who are oriented toward human rights, who are swayed by or or find solace in articles like this, can often end up being scolds and know it alls in the average conversation--because, by virtue of taking the time to outline 100 years of medical evidence, you will be taking up a lot of space in an average given conversation. I am working on getting info out there concisely in my daily life.
this is also a problem with climate change comms.
so, i would say, in the face of despair, I would try to get funny as a comms strategy. I can't really write jokes , but at least, concision?
I can prepare a short, interventionary statement like "it wasn't called 'mutilation' when [jessica] got a breast reduction to help her back problems; it's only called 'mutilation' when elon musk wants a tax cut'
short statements are good. but i also try to get funnier, in the face of the communications problems...
posted by eustatic at 2:37 PM on December 2 [6 favorites]
No one article can ever solve all problems but that doesn't mean it lacks value. Most people actually don't spend much time thinking about trans people unless they know some. That's why these proposed laws claim to be about Protecting The Children because people do respond to that.
Articles like this allow people to say, "oh, the kids are evidently ok? Not my problem," or even more "my child will be ok, I am doing right to support them," and that is a good thing.
posted by emjaybee at 2:43 PM on December 2 [3 favorites]
Articles like this allow people to say, "oh, the kids are evidently ok? Not my problem," or even more "my child will be ok, I am doing right to support them," and that is a good thing.
posted by emjaybee at 2:43 PM on December 2 [3 favorites]
FYI, Julia Serano spells her last name with one R.
posted by dlugoczaj at 2:47 PM on December 2 [3 favorites]
posted by dlugoczaj at 2:47 PM on December 2 [3 favorites]
and on the "general knowledge" front, i found this video interview to be a decent "youtube" style one on gender affirming care, discussed by a specialist, and a non specialist. because the interviewer asks a lot of the questions a confused person would have, i have shared it as an educational video to folks like my relatives who are nurses
and, although it is long, what is interesting the conversation keeps coming back to
"all of these generalizations fall away in the face of taking care of individual patients"
and "there simply wouldn't be gender affirming care if it weren't based on decades of clinical evidence and existing clinical practice"
posted by eustatic at 2:52 PM on December 2 [6 favorites]
and, although it is long, what is interesting the conversation keeps coming back to
"all of these generalizations fall away in the face of taking care of individual patients"
and "there simply wouldn't be gender affirming care if it weren't based on decades of clinical evidence and existing clinical practice"
posted by eustatic at 2:52 PM on December 2 [6 favorites]
I'm glad the author is doing this work, but I'm not sure the overall goal. The sort of folks that are "concerned" about gender affirming care are almost universally not so because they read some pseudo-academic article about the subject, but rather some underlying "feeling" that gender-affirming care is wrong.
I think there are people whom this data is important to, both in- and outside of the community. We need these things to be good for ourselves, for internal arguments, for newer trans people, etc. And we need it for its stated goal because there are absolutely contexts where these things are important, because anti-transness is also operating in the worlds of journalism and academics which they mostly has to play by those rules. (At least in the US, I think less so in the UK where it seems the transphobic elite consensus is powerful.) Personally I think that trans people and allies who will go into those spaces to engage that way are rare and valuable. Not sufficient, but necessary. I can't do it personally, my brain isn't good enough.
At the risk of being ra-ra or cringe or something: I think campaigns are waged on multiple fronts, and I generally think you need them all. We need slogans and we need citations. IDK what the right strategy is but I'm 1000% certain it doesn't involve giving up, feeling helpless, etc.
posted by fleacircus at 3:14 PM on December 2 [9 favorites]
I think there are people whom this data is important to, both in- and outside of the community. We need these things to be good for ourselves, for internal arguments, for newer trans people, etc. And we need it for its stated goal because there are absolutely contexts where these things are important, because anti-transness is also operating in the worlds of journalism and academics which they mostly has to play by those rules. (At least in the US, I think less so in the UK where it seems the transphobic elite consensus is powerful.) Personally I think that trans people and allies who will go into those spaces to engage that way are rare and valuable. Not sufficient, but necessary. I can't do it personally, my brain isn't good enough.
At the risk of being ra-ra or cringe or something: I think campaigns are waged on multiple fronts, and I generally think you need them all. We need slogans and we need citations. IDK what the right strategy is but I'm 1000% certain it doesn't involve giving up, feeling helpless, etc.
posted by fleacircus at 3:14 PM on December 2 [9 favorites]
breast augmentation, mastectomy, hormone replacement, even vaginoplasty
Don't forget the other way too, and I'm not up on terms, but penis/testicle (re)construction etc. I notice this only because a lot of discussions about trans people by cis people seem to focus on trans women but as someone with trans men loved ones it sticks out to me no shade
posted by tiny frying pan at 3:45 PM on December 2 [7 favorites]
Don't forget the other way too, and I'm not up on terms, but penis/testicle (re)construction etc. I notice this only because a lot of discussions about trans people by cis people seem to focus on trans women but as someone with trans men loved ones it sticks out to me no shade
posted by tiny frying pan at 3:45 PM on December 2 [7 favorites]
that 'underlying feeling' that something is wrong has a name - it's called 'transphobia'
imho the specific belief system is that transition is bad, or at the very least it's better to be cis than trans. which is of course just transphobia but I think it kind of helps to spell it out, at least for me.
no wonder such people aren't easily swayed by evidence that gender-affirming care works: they see any sort of transition to be essentially a kind of failure
posted by BungaDunga at 4:38 PM on December 2 [6 favorites]
imho the specific belief system is that transition is bad, or at the very least it's better to be cis than trans. which is of course just transphobia but I think it kind of helps to spell it out, at least for me.
no wonder such people aren't easily swayed by evidence that gender-affirming care works: they see any sort of transition to be essentially a kind of failure
posted by BungaDunga at 4:38 PM on December 2 [6 favorites]
Nothing is going to sway those people though. It may as well be a religious belief for them. But there's a large middle of people misinformed by media like the NYT and WaPo... this information is for them.
My nesting partner's parents are a good example. Well meaning liberals who had all kinds of difficulty when he came out and started transitioning. They're much better now about things but the NYT definitely does not help as a trusted news source that consistently gets it wrong and muddies the waters.
posted by kokaku at 6:23 PM on December 2 [6 favorites]
My nesting partner's parents are a good example. Well meaning liberals who had all kinds of difficulty when he came out and started transitioning. They're much better now about things but the NYT definitely does not help as a trusted news source that consistently gets it wrong and muddies the waters.
posted by kokaku at 6:23 PM on December 2 [6 favorites]
I have some success in ridiculing / making fun of cis/heteronormative habits (even surgeries like nose jobs) as "gender affirming care"
I love this! I would say that gender affirming care also includes erection drugs, penis cosmetic surgery, testicle reconstruction, and testosterone and anabolic steroid treatment. And fertility treatment (which I say as someone who has used assisted reproduction).
posted by medusa at 6:24 PM on December 2 [5 favorites]
I love this! I would say that gender affirming care also includes erection drugs, penis cosmetic surgery, testicle reconstruction, and testosterone and anabolic steroid treatment. And fertility treatment (which I say as someone who has used assisted reproduction).
posted by medusa at 6:24 PM on December 2 [5 favorites]
but penis/testicle (re)construction etc
100%, very good point. I included mastectomy because the trans masc guys I know are focused on their chest dysphoria, but penis reconstruction is a very real and increasingly frequent option, from what I've heard.
And yes, the focus has been on trans women. Ugh, both because we take a lot of heat, and because it means trans guys are far too invisible (but really good about defending us, from what I've seen).
it's better to be cis than trans.
I really do think this is a far too common belief. Ironic, since a lot of us have trans pride to the point where we think we are kinda better. Certainly freed from the gender binary. Marginalized groups get to do that, I think, at least in the short term. I know I would have a very hard time fully trusting a cis partner, given what mine did to me.
posted by Flight Hardware, do not touch at 6:26 PM on December 2 [4 favorites]
100%, very good point. I included mastectomy because the trans masc guys I know are focused on their chest dysphoria, but penis reconstruction is a very real and increasingly frequent option, from what I've heard.
And yes, the focus has been on trans women. Ugh, both because we take a lot of heat, and because it means trans guys are far too invisible (but really good about defending us, from what I've seen).
it's better to be cis than trans.
I really do think this is a far too common belief. Ironic, since a lot of us have trans pride to the point where we think we are kinda better. Certainly freed from the gender binary. Marginalized groups get to do that, I think, at least in the short term. I know I would have a very hard time fully trusting a cis partner, given what mine did to me.
posted by Flight Hardware, do not touch at 6:26 PM on December 2 [4 favorites]
gender affirming care
Every cis woman who's ever plucked a chin hair has engaged in gender affirming care. There is a powerful anti-sleeping sickness medicine (!) that cis women used to pay nearly into the three figures a month for just to slow down unwanted facial hair growth (then it went out of patent and it got messy).
That said, multiple fronts is right.
posted by praemunire at 6:40 PM on December 2 [8 favorites]
Every cis woman who's ever plucked a chin hair has engaged in gender affirming care. There is a powerful anti-sleeping sickness medicine (!) that cis women used to pay nearly into the three figures a month for just to slow down unwanted facial hair growth (then it went out of patent and it got messy).
That said, multiple fronts is right.
posted by praemunire at 6:40 PM on December 2 [8 favorites]
Articles like this aren't only for people who disagree with the premise of the article.
There are so many other people it exists for, including trans people and the people who love us, who need to live in a world where not everything we read is an attack against us, or a sly insinuating invalidation, or an earnest but ignorant "help me understand".
It can be lonely and isolating to be trans, and you can start doubting yourself, or losing faith that you have any kind of community.
This information needs to be shared and accessible and common knowledge.
posted by Zumbador at 2:16 AM on December 3 [9 favorites]
There are so many other people it exists for, including trans people and the people who love us, who need to live in a world where not everything we read is an attack against us, or a sly insinuating invalidation, or an earnest but ignorant "help me understand".
It can be lonely and isolating to be trans, and you can start doubting yourself, or losing faith that you have any kind of community.
This information needs to be shared and accessible and common knowledge.
posted by Zumbador at 2:16 AM on December 3 [9 favorites]
I wonder what marginalized group they'll move on to demonize next
As a trans person I gotta say, I’d don’t like this framing.
It feels like our ‘allies’ don’t actually care what happens to us and have given us up as a lost cause, and are instead just looking for when the torrent of shit will touch other people (who are by implication more important).
It’s a sentiment that comes up every time persecution of trans people is mentioned and it sucks.
posted by june_dodecahedron at 2:57 AM on December 3 [4 favorites]
As a trans person I gotta say, I’d don’t like this framing.
It feels like our ‘allies’ don’t actually care what happens to us and have given us up as a lost cause, and are instead just looking for when the torrent of shit will touch other people (who are by implication more important).
It’s a sentiment that comes up every time persecution of trans people is mentioned and it sucks.
posted by june_dodecahedron at 2:57 AM on December 3 [4 favorites]
I (a trans person) use that framing sometimes because people are often lousy with empathy and future thinking. They don't get concerned unless it affects them or maybe a group closer to them. The number of well off tech gays I've come across who just don't see the bigger picture is sad, and they already have skin in the game whether they realize it or not.
Would I rather people cared about us for our inherent humanity, sure. Different approaches for different people.
posted by kokaku at 3:37 AM on December 3 [3 favorites]
Would I rather people cared about us for our inherent humanity, sure. Different approaches for different people.
posted by kokaku at 3:37 AM on December 3 [3 favorites]
Yeah that's fair kokaku. It's an is/ought problem.
posted by june_dodecahedron at 3:43 AM on December 3 [2 favorites]
posted by june_dodecahedron at 3:43 AM on December 3 [2 favorites]
I'm going to be using a bunch of the points from this article to make a submission on the New Zealand Ministry of Health's 'call for feedback' on restricting access to puberty blockers, which they publicized about as well as you'd expect. Very timely, SansPoint, thank you!
posted by ngaiotonga at 12:34 AM on December 4
posted by ngaiotonga at 12:34 AM on December 4
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