Getting Real About Gender Dysphoria

Medical practitioners have followed the principle of “do no harm” since the Hippocratic Oath was authored around the 4th century B.C. Modern iterations of the oath have added the concept that preventing diseases or injuries is superior to treating or curing them. But today a form of political correctness is causing medical practitioners to administer substances that harm and prevent bodily processes that cure the majority of sufferers of one particular disorder.

The condition that increasingly is being treated contrary to previous practice is gender dysphoria. Gender dysphoria is when a person feels discomfort with the gender traits and associations of his or her biological sex. In extreme cases, such people may feel that they are of the opposite sex to that of their biological body.

As much as 1 percent of the population surveyed in 2012 felt they were “gender variant” to some degree. People suffering this disorder today commonly are called transgender.

There is no known single cause of the disorder. In the largest study of adult transexual identical twins, in only 20 percent of the cases did both twins trans-identify. That indicates a cause other than DNA or prenatal hormones. Recent dramatic increases in the disorder indicate that new social factors are involved in causing this disorder.

Clinical case studies suggest that social reinforcement, parental psychopathology, family dynamics, and social contagion facilitated by mainstream and social media, all contribute to the development and/or persistence of [gender dysphoria] in some vulnerable children. There may be other as yet unrecognized contributing factors as well.

The good news is that the majority of cases of gender dysphoria need no medical treatment to resolve the disorder. They are cured by the natural onset of puberty. The lowest recorded number I have seen anywhere place the number of children who desist, or have the disorder resolved by puberty, is 50 percent. The most common numbers of cases that resolve are 90 percent. As one therapist noted, the body usually gets the final vote.

This raises the question: Why are we using drugs to accommodate and reinforce a psychological disorder that is in conflict with reality and that is unlikely to persist beyond puberty? Note, I am not diminishing how the child feels, nor am I unsympathetic toward the few in whom the disorder persists. The discomfort and anxiety they feel can be severely debilitating. It is neither my place to criticize those adults for whom the symptoms are so great that they feel the necessity to cross dress or have surgery. I will only point out that most adults who have surgery continue to have psychological problems. It is conclusively not a cure.

The public health issue is that treating children with hormones and puberty blocking drugs has zero research showing that it cures anything. There are however many harms and deleterious effects from such treatments. Further, they are administering these drugs without having any blood test or scan that can show objectively that a child is suffering from a disorder. It’s almost like giving chemotherapy to someone who thinks they have cancer.

Puberty is neither a disorder nor a disease. Puberty-blocking drugs cure nothing. They do have negative effects such as lowering bone density and growth. Giving estrogen to boys increases the risks of breast cancer, elevated blood pressure, obesity, cardiovascular disease, and decreased glucose tolerance.

For girls, testosterone can cause increased cardiac disease risk by affecting HDL cholesterol and triglyceride levels, insulin resistance, and numerous other risks to breast and ovarian tissues. Both sexes are likely to have slower or stunted brain development.

Children who receive puberty-blocking drugs followed by hormone treatment with opposite sex hormones will also be permanently sterile. It also appears that children who are given puberty blocking drugs are far more likely to continue pursuing sex change treatment, including sexual reassignment surgery. Thus, we are taking a disorder that had a 90 percent probability of fully resolving, and turning it into a dangerous lifelong medical treatment with both physical and psychiatric risks.

We have no idea what other medical risks or maladies may be caused by this combination of drugs since there have been no long term studies. At this point, it should be noted, the harm to the sufferer is permanent. We have no known drug or procedure that will reverse any of the negative consequences.

There is also a new social and political element to the disorder of gender dysphoria. Today people are promoting something that has been called “rapid onset gender dysphoria.” This has been observed primarily among females where the dysphoria first appears during or after puberty. There were no previous signs of gender dysphoria when they were younger children.

This rapid onset gender dysphoria also appears to manifest among groups of friends or online acquaintances. There is little doubt that this sudden appearance of a previously unobserved phenomenon has social and political causes. It has become fashionable and politically correct to celebrate alternative and nontraditional lifestyles that were previously considered socially deviant. It is also an attitude that is reinforced, if not taught at many universities and public schools.

Many of those that the Right would characterize as social justice warriors maintain a stance that says acceptance and toleration of what were once considered taboo or illegal sex practices and behavior is not enough. We are encouraged instead to promote and celebrate such behavior. The cool kids are doing it.

Defenders of rapid onset gender dysphoria claim that it’s foolish to consider something as troublesome as gender dysphoria could be accepted or absorbed like some hula hoop craze or pet rocks. But I would point out that Tide pods, the cinnamon challenge, and drinking bleach are examples of troublesome trends that have caused illness and death.

Defenders of rapid onset gender dysphoria are also upset about what they feel is a political challenge from those they see as intolerant and hateful towards LGTBQ issues. They think questioning the social aspect of rapid onset gender dysphoria, or suggesting the cause may be some kind of trendy social media linked behavior will produce the idea that all or most gender dysphoria and nontraditional sexual behavior will be called voluntary behavior. Or that there will develop some dichotomy between real or legitimate gender dysphoria and some phony or made up version that can be dismissed.

Gender dysphoria of any kind is real. Those who have it suffer anything from mild discomfort to suicidal depression. It should be taken seriously. But reality also shows that the cause of gender dysphoria is psychological and social, and that current drug treatment and surgery are not a reliable cure.

Indeed, suicide is rooted in psychology. We have also known since the late 19th century through Emile Durkheim and Tomas Masaryk of the social causes of suicide. We have learned how suicide and mass murder can produce imitation and go viral even in the absence of social media. There may be no physical or medical cause, but the victims are still dead.

In a similar way, victims of gender dysphoria are suffering because of psychological problems, and some possibly because of social connections and/or imitation. But their suffering is just as real as a tumor or a broken bone. The problem is that we are treating them with drugs that do not stop their suffering. In addition to not curing the condition, they cause further harm. Some call this child abuse. I cannot disagree.

The bottom line is that the current treatment regimen using puberty blocking drugs and hormone treatment eliminates puberty, the very thing that most often resolves the disorder. Using those methods prevents a cure. You cannot call it malpractice, because assisted suicide and abortion are not malpractice if they are what medical practitioners are authorized to do. But they clearly violate the spirit of the medical oath and the call since the time of Hippocrates to do no harm.

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About Michael Johnson

Michael is a graduate of California State University at Long Beach in political science. He did graduate work in Russian and East European Studies and added a minor in economics. While in school he was the chapter president of Young Americans for Freedom and vice chairman for YAF's California chapter. After a career in financial planning and investment management, he is now a leadership coach and writer. He is currently working on a series of three novels.

Photo: Anne-Marie Miller/Getty Images

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