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Just a few minutes ago I received an email from the director of a university hospital program that is well-known for its work with the transgendered population - everything from counseling to surgery, and with an important research program as well.

What would be YOUR response to his question?

A number of weeks ago, I received an e-mail message from a parent of a young biological male (I will omit the age, but let's say a number of years before the normal onset of puberty) who is described as transgendered...this youngster appears to be living in a family that is part of what I might call the subculture of "transgender affirming" families. As far as I can tell, this youngster showed very early cross-gender behavior and has, more or less, been living as a girl since preschool, with very clear familial and professional support in so doing.

Apart from considering puberty blocking treatment, this parent asked me about the possibility of a bilateral orchidectomy (castration).

So, here is my therapeutic/ethical question: would anyone recommend castrating this youngster? If so, why? If not, why?

I will be sending him my response within a day or two, at most.

I had to think this out a bit, and this is about the best I can for now. If more occurs to me I will add it later.

To start with this is a tough question to answer with out knowing the individual concerned. I think the age of the person is not the issue at all, other than the fact that it does give cause to question all the life long ramifications which any one considering orchiectomy or transition should be thinking seriously about any way. So there is nothing really different there.

If you take age out of the equation, and I think you should if you want to be fair to the individual, the issue ethically speaking becomes fairly straight forward.

The questions I think are most pertinent here are: Is she emotionally mature enough to make this decision? Does she understand that this is permanent and irreversible procedure? Is this what she wants or is it what she thinks her parents and family want from her?

I think one could not proceed ethically without first answering these questions. I feel the classic advice of "Rush Slowly" applies very well in this case. In the mean time there are other non-surgical alternatives to delay the onset of puberty.

To the question of maturity I say that is in not so much about age in years but life experience, thought they do tend to go hand in hand for most. Suffice it to say that self knowledge and emotional maturity are not a finish line that we cross at some specific geographical time in our lives but rather they are the very terrain that we travel through during our lives. As individuals we all travel that path in our own way and at different rates of speed. I believe that while a person maturity is not something that is easily quantified, it can be generally assessed to a sufficient degree.

The second question is about the permanence and ramifications of the procedure. This is a little more straight forward, but again the idea of permanence may be a bit abstract to some one so young.

The third question I think may be the thorniest and most difficult to determine. It is also the one I think is the most important. I think it is interesting to consider the possibility that growing up in a trans-positive family may have the some of the very same drawbacks as growing up in a trans-negative family. Children do generally want to please their parents and they can be the most convincing of actors. How you will ever be able to know with any certainty is beyond me, but I believe you must know before proceeding.

I would proceed cautiously but with an open mind in any case. The person who really counts and that we must listen to is the girl or boy as the case may. Any one else's wishes are secondary at best.

With more and more families dealing with this at the pre-pubescent stage, I'd think there would be some tentative guidelines for how they proceed.

I would think they'd wait on removing anything, because they'd want as much volume as possible in the future when she has vaginoplasty. Without the testicles, the scrotum and penis will shrink more than if they waited (I think).

Have you thought about posting this question on a TG site like Big Closet? http://bigclosetr.us/topshelf/

I'd think you'd get a better response from TG folks than the Eunuch folks.

Batman

I would suggest that the Doctor give him drugs that will suppress his testosterone, for six months to a year assuming he has hit puberty. Also, he would have to live as a female for that time. Make sure the parents are ok with it, and support it...it is one thing for someone to say the parents are in on it, and another to sit down and discuss it with them with out the boy present.

While it would be better in the long run to snip before puberty and hormones kick in, but that is way to young of an age to make such a choice...especially one that will affect the rest of the life. If he has gone through puberty then he should go to a sperm back and put some away just in case a change of mind occurs at a later date. Perhaps if he spent some time living with some understanding straight men or very butch gay men (a month or two at least) that might help him out. (no offense against effeminate gay/straight men but that would just further confuse the young man.)

There is also the notion of what will the kids at school say? The bullies will have a field day and everyone else will just ignore him.

This is a tough situation. My first thought is would the child be able to make a more informed choice for themselves after the start of puberty and knowing the effects of testosterone to their system? Of course would this be cruel if she did completely identify as female? The child prepuberty identifies as a female but are we sure she will continue to do so after a natural start of puberty?

My opinion is to let the child start puberty with the support system they have in place. They will surely know if this is too much for the child and can intervene at that point. Having been male and now a eunuch I am glad to know both sides of life.

I know in other parts of the world like Thailand this would be done without question but here, I dont think we as a nation are ready for this. To many red necks, right wing christians, etc. I just dont know, part of me says yes and the other screams no, this is one I am glad I dont have to make.

River

I think the best option here would be to delay puberty, say until about they are 14-16. It would serve two purposes, one it would delay the onset of puberty in the wrong gender, which for most tg can be a horrible experience, aand would give the child time to make sure they are aware of what they are doing is right. I don't think many children under the age of puberty are very aware of their sexuality, so letting them go through puberty of their choice would reaffirm their choice.

There would also be some concerns for the child going through school such as physical-ed classes, but I'm sure the parents and doctors could work out solutions to that.

I am going to assume that this person does indeed have a true identity of female and refer to her using female identifiers throughout my answer.

I have to agree that it is difficult to formulate a certain answer without knowing the girl personally. When it comes to something like transgender transition, what is right for one person is completely subjective.

While regrets among transitioning adults do not seem to be uncommon, especially when the gender conflict first appeared past puberty, it seems that regrets among people who complete transition and first had a serious discomfort with their birth gender at a very early age are extremely rare. If this girl has

JesusA wrote: Tue Dec 11, 2007 2:12 pm been living as a girl since preschool

and showed cross-gender behavior from an even earlier age, I have serious doubts that she would ever regret her decision to transition.

Nonetheless, there are always those rare cases, and the possibility of regret cannot completely be ruled out.

I would want to know who actually came up with the idea of castration? Was it the girl or her parents? If it was her parents, does the girl actually want this? Does she understand what castration is?

I think that we need to be sure the girl understands the irreversible nature of castration, as well as the function of the testicles. Does she understand that without them she will never be able to obtain normal manhood? Does she understand that she will never be able to have biological children?

I also think we need to understand her feelings about her penis. It has been shown that transgender people who express outright hatred for their penises are less likely to have regrets than those who are simply indifferent, and especially those who actually enjoy their penises and associated functions.

I think there is another important factor that we cannot overlook. I have read the stories of many transgender adults, and I have never come across one who would not have given anything to have been able to experience a normal puberty in the gender they identify as. I hesitate to think how this girl would react if she were to one day discover she had the opportunity to experience a female puberty but was turned down because we were afraid she might regret it.

So we have a few different options to look at here, and looking at each one and discussing it with the parents and the girl is best before making a final choice.

Option one is allowing her to experience the start of male puberty, and this is the option that has been traditionally recommend by professionals in the community. From a logical, rational point of view it certainly makes sense. It would give her the opportunity to see how her body would start to develop in her birth sex, and if she finds it distressing, that would only further confirm her female identity. The primary disadvantage here would be the irrversible breaking of her voice, which usually occurs quite early on in male puberty. While male voices can be trained to somewhat resemble female voices, the results are usually less than pleasing.

But from a humane point of view, does it really make as much sense as it seems? If the girl has had a strong female identification since very early childhood and has even lived as a girl since then with no issues, then might we already be certain enough that any degree of male puberty would be unbearable for her? We don't take "ordinary" girls and give them testosterone so they can "see what a male puberty would be like", so why should we do this with her simply because she had the misfortune of being born into a male body?

Option two would be to administer drugs that will block the onset of male puberty. From a logical viewpoint, this is the option that probably makes the most sense. She will prevent the masculinizing effects of a male puberty, and at the same time avoid doing anything irreversible while she confirms her identity as her cognitive reasoning abilities improve with age. It is also a reasonably humane option, because although she is not getting to undergo a female puberty at a normal age, she is still not being forced to endure a male puberty and the irrversible effects it entails.

The disadvantages to this option are the costs involved. I have never heard of Androcur or Spironolactone being administered for the purpose of blocking male puberty, and it is doubtful that they would be effective enough anyway without the co-administration of high does of estrogen. The only drug that seems to be used for this purpose is Lupron. Lupron is by far the most effective method of blocking gonadal hormones, but it is also by far the most expensive. It is probably one of the most expensive drugs in general, and it is certainly far out of the reach of most families. Now if the clinic were willing to provide the Lupron, then obviously cost would not be an issue. But it certainly will not be insurance paying for it, because most insurances refuse coverage outright, and the few that do cover it have a very narrow, well-defined set of conditions they will cover it for (and being transgender is not one of them).

Option three would be to perform the castration, and then it could be determined whether to include female hormones at the onset of puberty or wait until later on. From a logical viewpoint, this is the simplest method. We basically eliminate male puberty from occuring without the needed for any expensive, potentially dangerous drugs. From a humane viewpoint it is also the best choice if she does indeed have a female identity, especially if female hormones are included at the onset of normal puberty. But this is also the option that would be the most devastating if the girl changes her mind. Her only option at that point would be to take artificial testosterone, which most of us have found is inferior to natural testosterone. She would also have to deal with whatever irreversible effects of female puberty she has experienced, depending on how far she progressed.

Option four is to require to her to experience a full male puberty and wait until adulthood to make the choice to transition. This option I consider to be the least humane as well as the least logical. Aside from the emotional torment she will have to endure if her identity is truly female, which is highly likely to be the case, there is also the issue of the effects of male puberty. There are three that are most troublesome due to their irreversibility without painful and/or expensive procedures: facial hair, masculinization of bone structure, particularly of the face, and voice. We have already discussed voice elsewhere, but facial hair and a masculine facial structure are for many transgender women the two reasons they will never be accepted as ordinary women. To reverse these is quite expensive in the case of facial structure, and both expensive and painful in the case of facial hair. But if she does not reverse these, then she will likely never be accepted as fully female by most of society. In this case we have failed to allow her to live life as her normal self and forced her to have to deal with the same struggles as any other transgender person, struggles which lead to mental illness, drug abuse, and not uncommonly suicide, when we had the chance to prevent them.

The best way to decide which of these options is the best for everyone involved is to include everyone. The girl, the parents, and the clinician need to make this choice together.

As for my recommendation? Well, my personal recommendation would be to go for it, and also administer female hormones. This is because I find it highly unlikely she will ever regret her decision, and because most transgender adults who have had these feelings from such an early age would have given anything to be castrated before puberty and experience puberty as the gender they identify with.

But in my more "professional" judgement, I am going to have to agree with many others and say that option two is best, the administering of drugs to delay puberty and give her more time to be sure. This option I think is the best balance between being humane and being logical.

At the center of this distressing question is another question. Do we trust the word of our children? Most times it seems the feelings of a child are called into disbelief and then overruled or simply discarded as an example of "she doesn't know enough to tell us her real needs". I believe such an attitude does a disservice to our children. Children may lack experience of the world, but they do not lack experience of themselves. A more pertinent inquiry might be: what is the influence of the adults surrounding the child? The larger hazzard is that the adults are influencing the child's feelings by transfering their wishes for her onto her thoughts. I don't suggest that they are bending her mind for some dishonest purpose, only that adults can have a very persusive, if unconscious, influence on the youngsters that admire them. With the influence of the involved adults accounted for and a responsible party observing, I think we can believe the child when she says "I am not a boy. Help me." --FLO--

As happy as I would be to have mine gone, I do not think ANYONE (Even a parent) has the right to make this decision for another. A child, and he is a child, does not have the maturity nor comprehension skills required to consent to such a drastic and permanent change.

Just yesterday we had an 18 year old pretending to be 26 so he would be taken seriously by the membership here. I often see new young members cautioned by older (wiser?) members to be patient and to wait a few years.

As an aside, I know and have had "relations" with several Trans-men. F2M TG's who would absolutely LOVE to have a dick. But in all three cases they have made a complete outer transition including mastectomy, without modification to their genitals. For all three the reason is the same, they want to enjoy orgasm. And such surgery would most certain limit their capacity to reach climax. All humans have the right to enjoy sex. Lots of M2F TG's keep their dicks so they can enjoy sex. Sure, most WISH they had vaginas, but accept where they are so they can enjoy all the fruits of interpersonal relations.

Sex is a HUGE part of the human condition. And as such only the individual, with an informed and competent knowledge of the matter, should be allowed to control this type of surgery.

JesusA wrote: Tue Dec 11, 2007 2:12 pm Just a few minutes ago I received an email from the director of a university hospital program that is well-known for its work with the transgendered population - everything from counseling to surgery, and with an important research program as well.

What would be YOUR response to his question?

I will be sending him my response within a day or two, at most.

Understanding that the sooner a transgendered person starts on Estrogen and does not have Testosterone "conversion" it makes the question difficult to answer.

I think the age of consent is the primary point. A pre 18 kid can't consent to surgery. Correct? Can / should parents be allowed to alter a kids future? It brings to mind all the kids who had their sex selected for them based on what private parts were more developed then finding out much later that they went the wrong way.

Hate to say it but I would have to say wait. I think its a bit like 18 year olds asking for vasectomy surgery. The Uros are going to be very strongly against anyone that age making a one way decision at such a young age. A pre 18 kid? Its got to be much harder and at least with Vasectomy there are "some" reversals that work.

I remember way back when the dinosaurs roamed the earth... when I was in elementary school, there was a particularly homely girl in one of my classes. She was the target of most of the other girls, as they used to tease her that she looked like a boy. One day, a group of girls jumped her in the girls' bathroom to beat her up. They tore her clothes in the fight. Then, they all ran from the bathroom screaming. A teacher hearing the commotion ran in to find the girl crumpled on the floor. When she picked her up off the floor, she discovered that this girl was in fact a boy. She took the boy to the nurse's office. Later, we found out that the boy's mother and aunt had raised him as a girl, and he had no idea that he was a boy. In those days, They used to take the children into foster care. In high school, I went to a student science convention in Los Angeles, where I ended up meeting several people that I knew in elementary school... including that boy. He was a well adjusted, though nerdy guy who was very interested in girls and looking forward to studying engineering at Cal Tech. It turned out he was not transgendered. He was not gay. He was heterosexual through and through. I asked him what happened, and he told me that the courts had appointed his paternal grand parents as his legal guardians. Like me, he had a high school crush on Los Angeles reporter Tritia Toyota, a rather pretty Japanese-American newscaster who was proof that nerd girls can be quite attractive. That we had in common, a "liking" for asian girls, making us happy that we were studying science at Cal Tech and UCLA. So for me, knowing a boy that was brainwashed to be a girl, I would say that a boy that is several years from the onset of puberty, should be removed from the family for about a year to see if his transgender tendencies are genuine or if they were trained by the parents. Then, if they are genuine, wait until after puberty to see if he changes in the presence of the increased testosterone. If he is still transgendered at 18 years of age, then his transgender-friendly family can pay for the gender re-assignment surgery with the money they saved for the operation.

I have thought about this child for the past day or two.

Honestly, I do believe that even a child can make this sort of decision for him or her self. If the child is interviewed by a competent doctor, and the doc say he or she is in fact transgendered, that should end it right there. If she or he wants to delay puberty, let the child at least have his or her own body. It is after all, HER life. I think surgery should be offered at the best time for the transition process.

There is something about this post that doesn't smell right. Jesus is a well respected poster on this site so I don't think he pulling anything and I assume that he knows his fiend from whom the question came, but does the doctor know the person that posed the question. Recently the trans sites have been buzzing with discussion of the treatment of trans children and the flak from the religious right has been fierce, with accusations of child abuse. The protocols for treating young trans are in a state of flux, but certain outlines have become clear. First is the Hippocratic admonition "Above all do no harm." The age for actual SRS has dropped a bit, 16 or 17 seems the current limit, and it is now acceptable to begin hormone blockers before or with the onset of undesired puberty to prevent unwanted secondary sexual characteristics, the current battle lines seem to be about when to begin cross sex hormones. To perform irreversible surgery long before the child is capable of giving informed consent seems clearly unethical. And while there have been self mutilations by trans children trying to make their bodies conform to their self images, in almost all cases they have been untreated children and tend to attack either their penis or their whole package, not just their testicles. All the young trans people I have talked to in years or running Trans Support Groups have been more interested in getting hormones and developing breasts. This letter to the doctor just doesn't sound right. It sounds more like someone fishing for ammo to attack us. Were the doctor to agree to the surgery, I would expect it to be all over Rush Limbaugh and his ilk..

Transward

It is my understanding that pre pub boys that are castrated never develop an understanding of sex. Almost like the hormones turn the spicket on for life.

Just because people down in Asia would not have a problem castrating any male regardless of age does not make it right!

Just in case it is brainwashing i think that the boy should live with some normal men (that are not effeminate) for a month or two just to get a whiff of a typical male lifestyle or at least some type of big brother situation where they can hang out and just be guys!

I say he because in my mind the child is still male.

If he is of high school age then he might have enough exposure and maturity to go through with it, but boys mature at a later point then girls do. I have seen 20 something boys who where not mature.

It really depends on how mature he is, how intelligent and how much wisdom he has.

DeaconBlues (imported) wrote: Wed Dec 12, 2007 5:09 pm I have thought about this child for the past day or two.

Honestly, I do believe that even a child can make this sort of decision for him or her self. If the child is interviewed by a competent doctor, and the doc say he or she is in fact transgendered, that should end it right there. If she or he wants to delay puberty, let the child at least have his or her own body. It is after all, HER life. I think surgery should be offered at the best time for the transition process.

Well said, DeaconBlues.

My understanding is that in this case we may be talking about someone who might be as young as 10, ie. "

JesusA wrote: Tue Dec 11, 2007 2:12 pm a number of years before the normal onset of puberty

")

I guess that from a mainstream/cautionary standpoint, it would be assumed that it would be better for the youngster to experience the delay of puberty first for several years and witness the possible consequences it might bring along especially in terms of social adjustment etc., then, when he/she is at least 16 and is clearly satisfied with most of the aforementioned effects, and still wants to proceed with the surgery just as strongly, then final surgery (including, if neccessary, complete SRS) ought to be seriously considered. Perhaps the greatest advantage to this approach is the fact that with the aid of modern medicine (and it's arsenal of various puberty suppressing drugs) it is today perfectly possible to undergo pre-pubertal castration/SRS at the age of majority. Such an approach would also be the only currently legally defensible option at this moment in most (if not all) Western countries.

OTOH, disadvantages to the above include, for one, the fact that a lenghty trial with chemical castration is apparently inferior to surgical in several aspects from a standpoint of someone who already made up their mind. First, depending on the drug used, there are a number of adverse side effects which long-term consequences are not yet fully elucidated. GNRH agonists have been suspected in inflicting a lasting disruption of the pituitary gland, and steroid-based anti-androgens such as Androcur have been associated with elevated liver and cancer risks. Second, chemical castration - especially lasting for several years - is rather costly and time-consuming, particularly if such a regimen would have to be combined with a costly hormonal regimen of the opposite sex.

Thus, if there is a way to know with any good measure of certainty (which is a rather moot point, ref. previous posts) that a 10-12-14 year old is fully determined in their motivations and the risk of relapse is judged to be highly negligiable, an early surgical intervention would, in my opinion, clearly be the quickest, healthiest, cheapest and the most convenient alternative. Penectomy is more of an issue in the sense that it may permanently remove the capacity for later sexual functioning, although according to my sources, during SRS, penile nerves are spared and merely relocated and incorporated into the artificial vagina, with most of the sensitive capacity largely left intact.

Nevertheless, I do not think - regardless of motivation and seal of approval from renowned specialists - that any serious attempt at genital modification (such as SRS) can take place legally until at least 16-17 years of age in most Western jurisdictions. And that, I believe, is pretty much the bottom line in the proposed scenario. I am not familiar with the Thai legislation on these matters; if it indeed allows for such surgery at younger ages, I wouldn't be surprised if it might one day become a popular destination for a number of such strong-minded individuals. BTW, I've heard of at least one TS male (US resident), now well in her twenties, who managed to obtain a clandestine orchiectomy by a qualified surgeon at the age of 14 in Mexico. Apparently she was (and still is) very satisfied with the results.

I am going to use an analogy here. It is in no way as serious an issue as the possible castration of a child but please bear with me...

Like most American males, I was circumsized as an infant. I completely and totally wish I had my foreskin back. I feel like I have been denied access to my own body part. Now I understand that most people think that circs are practical and worthwhile, and doctors think they are healthier, BUT I WISH IT NEVER HAPPENED TO ME.

Now bump that concept up to the level of TESTICLES. As well meaning and concerned as all of the adults are in the situation, THOSE NUTS BELONG TO THAT KID AND NO ONE ELSE. He loses all possibility of reproduction as well as much of his possible sexual enjoyment. I don't care about religion, or the conservative right. All I care about is that kid's FUNDAMENTAL RIGHT to self determination. If he wants to have SRS when he's a teen, so be it, but as a fully intact prepubescent, there is no reason to modify him in any way.

The thing is, this board is supported by many people who wish they were castrated but cannot find a doctor willing to do the job. This is surely coloring some of the responses in this thread. ie: "If only my parents had the forthought to nut me at 6 years old..." except that kid is not you, he is his own person not yet knowledgeable enough to make such a drastic and permanent decision.

JesusA wrote: Tue Dec 11, 2007 2:12 pm A number of weeks ago, I received an e-mail message from a parent of a young biological male (I will omit the age, but let's say a number of years before the normal onset of puberty) who is described as transgendered...this youngster appears to be living in a family that is part of what I might call the subculture of "transgender affirming" families. As far as I can tell, this youngster showed very early cross-gender behavior and has, more or less, been living as a girl since preschool, with very clear familial and professional support in so doing.

Apart from considering puberty blocking treatment, this parent asked me about the possibility of a bilateral orchidectomy (castration).

So, here is my therapeutic/ethical question: would anyone recommend castrating this youngster? If so, why? If not, why?

Always before, my thoughts on this issue would have been answered with a definite "No". And after much consideration, I have not changed my mind.

Several things about this stand out:

First, the source that Jesus cites as having received this email from is a closed professional list. You cannot look it up, you cannot register there, and you do not post unless you are "in the profession". It is not open to the public, therefore, it is a valid question posed to a group of valid professionals.

Next, the author stated: "

JesusA wrote: Tue Dec 11, 2007 2:12 pm this youngster showed very early cross-gender behavior and has, more or less, been living as a girl since preschool.

"

OK, how early is "very early"? Age 2? Age 3? When language first formed?

Next - "

JesusA wrote: Tue Dec 11, 2007 2:12 pm more or less, been living as a girl.

" Sorry, "more or less" don't get it, pal. This raises SOME doubt on the issue. Now, if said child was resolutely convinced that said child IS a girl, no questions asked, then we could eliminate this. Based on this wording, however, the child is aware of differences between boys and girls and tends to hover between both genders of M and F. Having helped raise 5 boys, I can tell you, there isn't room for waffling here. Mine all identify as MALE, no questions asked. BUT this kid IS asking questions, in the form of "more or less" - you can't do the "more or less" thing. You can't be a girl one day and a boy the next. This needs to be pointed out to the parents and the professional posting the question.

My next issue is with family environment, described as "

JesusA wrote: Tue Dec 11, 2007 2:12 pm what I might call the subculture of "transgender affirming" families.

" My problem with this is how much the openness of the family - which is a GOOD thing, don't get me wrong - has influenced this child's behavior and thinking. I was raised by heterosexual males, when they were around. I knew no gay, trans, or other type-genders when I was a boy. There were men and women. The men were straight. However, this is where a slight glitch comes in - I thought I was straight, sort of went into bi-leanings for a while, then finally settled on asexual with seriously gay leanings. How's that for a ride? Where'd I get that from?

Who knows?

It wasn't from roll models.

However, what has this child gotten from the role models already? How much have they - and HAVE they intentionally - influenced the child to date, in thinking that it is OK for him to be a girl? Were this child to be put in a "typical" male/female parent family and exposed to "boy activities" for say, a period of one year with no talk or acting of transgendering, what would the outcome be? How would the behavior change? Would it?

It's nice to know that a child can be raised in such an open environment on such an issue, but I cannot help but think that this is a heavy influence. The fact that being raised in the presence of heterosexuals didn't assure that I would turn out that way notwithstanding...I cannot use myself as the sole justification. However, the parenting / socialization in such must be considered in this case, I think.

Finally, the issue of castration vs. other options.

Others here have already covered the options, and we've already read about the pros and cons of natural puberty, no puberty (blocked), and puberty of the opposite gender brought on by - in this case - estrogen treatments. We don't need to rehash it. Other than perhaps dependency upon male HRT later in life, should the child have a change of mind, all of these options are reversible.

Castration is NOT.

Now, we do not know the age of this child. We don't know if the child is very intelligent, highly intelligent, average, or a total dumbass. HOWEVER, let's say the child is 6, making a wild guess on clues given. Maybe 7.

We have always been open about allowing the boys here to make their own decisions on what to wear, haircuts, etc., but nothing any more permanent than having pierced ears. The worst case - a bad haircut that ended in a buzz and pierced ears left to heal over. When one of them was 9, he kept his head shaved with a razor for a year. He liked it. We let him. But hair grows back. Testicles do not.

It is my opinion that a child of this CANNOT, under ANY circumstances, understand all of the issues that WE KNOW comes with castration. WE know what will happen, because we are rational adults. It is not the end of the world to us when we don't get our way - but to a child, THAT is. How many screaming-mimi fits have you all seen in public by kids up to, say, age 12, even?! Think about it. The rationality is NOT there. It's a fact.

The answer, in my opinion, is still NO.

This child, or any child, is not able to comprehend the ramifications of castration.

I would make one and only one concession in this case or one like it - if the child is intelligent, and can display understanding of the effects of surgery, then surgery of any kind - up to GRS or just castration - would NOT take place for any reason until the age of 16 at the MINIMUM.

In closing, I am bothered that a parent brought this up to a professional.

I am bothered by the said environment that MIGHT be encouraging it.

I am also bothered by the "more or less" attitude of being a full-time girl.

I am bothered by the age of "girl onset", so to speak - just before preschool?

How would I deal with it, then?

Treat the little XY as a full-time girl. Period. End of story, hardass conformity.

No boy haircuts. No boy clothes. No boy toys. No boy activities.

The child lives full time as a girl, no exceptions, no excuses.

See how long it lasts.

Commitment to the cause there is a MUST.

There can be NO waffling on the issue of gender.

Now, like I said, if the child can do it as a girl until age 16, +/-1 if very intelligent, then she gets my blessing. I'm even for the lupron approach to avoid male puberty.

But at the first big setback or backslide into the "I'm a boy!" mindset, then the party is over. He's a boy. Surgery before then is NOT an option.

So far this is one of the most interesting coversations we have ever had on the boards. --FLO--

There have been so many thoughtful response to jesus' post. Naturally as individuals are all coming at this from different points of view, and so even though we are looking at the same thing, we all see it a different way.

One of the things I would like to bring to this discussion is the idea that the old binary gender paradigm plainly is false. I know this because I don't fit well in the "M" or the "F" box. I'm really some where in between M & F and there are people here in the EA who are in the "E" box which is not to be found any where in between F or M. So even at this point we can see that gender can not be described accurately using binary opposites. Perhaps a triangular arrangement might be more appropriate?

If only we could leave said discussion here, we could get away with only the two dimensions x and y ( or even XXY or even XYY or XXYY or XXX also known as triplo-X ) but even that would still leave sexuality out of the picture, and we all know sexuality is all about F*(c)#ing, so the two dimensional model is well... you get the idea. So now you need to add a third dimension... Zz DOH!

Well perhaps a cube then... Ah yes, then we could describe every one's sex and gender using the Cartesian coordinate system. René Descartes would probably be very happy with that arrangement, and after a ten thousand years of cataloging every living person's sex and gender he would only be able to tell us that.... ( drum roll please ) gender and sexuality combine to form a very complex and amorphous matrix that defies simple descriptions.

One may as well ask "What shape is the air?" It's a simple question any child might ask a parent, and you might be inclined to answer that the air is the shape of the room you are in, but then you have to start making exceptions for all the objects in the room. Things get very complicated very quickly defeating any simple geometric shape that comes to mind, and the world doesn't stop at your doorstep either. So as soon as you step outside into the real world you are lost. Suddenly air is round like the planet... minus a few small details like the Rocky Mountains of course. What is the point here? Air is what ever shape it needs to be, regardless of what shape you might like to think it is, and so it is with gender and sexuality.

Having said all that I expect the old gender paradigm to remain in popular usage for a long time to come. After all it is well worn and comfortable like an old pair of blue jeans. I also expect to catch plenty of grief for busting out all the seems, cutting off the legs and wearing those jeans like a pair of Daisy Dukes!!! LOL

I read an article about a clinic in Denmark recently that is treating young transexuals. They are doing it in the form of experiment. So far they have had about 35 patients. Treatment begins with puberty supression drugs when child has first signs of puberty. Logic behind it is to avoid excessive masculinisation. It is impossible or very expensive to undo some masculinisation after puberty. Boy normally changes his identity to girl living fulltime girl. And when he turn 16, he can decide what he really want to do. Either to continue with normal male puberty or have SRS surgery and continue with female puberty. So far no patient has changed their minds when reaching age 16.

There is a problem, that person is not able to experience male puberty before making decision.

but the results are much more satisfying in many aspects.

I even saw pictures of one young boy turning into a beautiful young woman on the net. Latest picture was taken when she was 22 or 23. It was impossible to tell that she was born as a boy. She looked really great.

Unfortunately I can not find these pages right now. But if I find, I'll post them here.

Jema,

You raise an interesting point in the discussion of a multitude of possible genders.

However, whether it be MtF or MtE or MtO (other) in this case of an XY-child not CURRENTLY and fully identifying as "male" - and "pretty much" identifying as "female" - the same arguments and questions must still apply for something as radical and irreversible as castration surgery - not to mention total GRS - the answer at this age must still be NO.

Now, all questions of surgery aside, were this my kid, I'd be prone to let the little darling do what makes him/her happy - short of surgery. If the kid wanted to delay puberty, fine. If the kid wants to go through female puberty, fine. But that decision at a later date. If the kid wanted to stay on lupron to avoid it altogether until the age of 16, fine.

If the sweater is pink for 6 days a week and blue on Saturday, fine. If he wants a gray sweater, that's fine too. But like I said, we're not going to try and convince the local vet to do anything radical! Not at such an age.

For the record, we've got a boy on the Godson's baseball team that - at first glance - looks like a very pretty girl. He's very effeminate. But he's also a wicked good baseball player. With fashion at that age, it's sometimes hard to tell, but I've bought enough clothes to know that some of his came from the girls' section.

Is there a gender issue there?

I don't know.

I've read that coming out as wanting to be the opposite gender, and as well as donning that roll in ALL occasions can be a good thing for the child. When it's no longer taboo to wear a skirt, and everyone adapts to it, then the issue sometimes resolves itself and might even go away.

But for the age suggested, I still have to say "keep him away from sharp objects".

I would say no to the individual in question at this point. There are a multitude of reason that could fill dozens of pages. I will simply defer to Paulo's writings on this subject.

T.

Paolo,

In my original post I favored going with suppressing puberty with drugs until three questions could answered with certainty.

jemagirl (imported) wrote: Tue Dec 11, 2007 4:09 pm The questions I think are most pertinent here are: Is she emotionally mature enough to make this decision? Does she understand that this is permanent and irreversible procedure? Is this what she wants or is it what she thinks her parents and family want from her?

I think one could not proceed ethically without first answering these questions. I feel the classic advice of "Rush Slowly" applies very well in this case. In the mean time there are other non-surgical alternatives to delay the onset of puberty.

However I did leave the door slightly ajar. If the all the questions can be answered with a high degree of certainty which I think is very doubtful. then her age should not be a factor at that point.

I agree with that most children are not emotionally mature enough to understand the consequences of castration. In any case since there are other less permanent options starting with surgery doesn't make much sense.

In my other post I wanted to raise the concept of multi dimensional genders because so often people of mixed gender do not get the help they/we need. When one expresses aspects of female and male so young it is often seen as gender ambivalence or confusion, when in fact that may not be the case.

Somehow, at least for me, this seems to fit into the "intersex" dilemma, where some girls with extra large clitoris's have them cut off when they are young or some boys with micro phalluses have their testicles removed and eventually have a vagina made for them. It's not quite the same, but the "intersexed" people who had no choice in the matter grow up angry because they had no say in the matter. Many of the intersexed people who went through these operations have poor sex lives from all that I've read and some boys who were castrated and turned into girls, eventually went back to being boys, though castrated.

What I'm saying is that the parents and the doctor are in a dilemma. What if the boy is wrong about wanting to be a girl? Who will take the blame? A child who does not understand all the ramifications of gender? Personally, a child should not be able to make a decision about elective surgery. That's what I think, but I know it's important to do the surgery before puberty. Someone will need to make a decision, but if I was the surgeon, I wouldn't do it. To many ethical questions and he might go to jail for endangering the life of a child if something bad happens. Hash