A leading transgender health group has lowered the recommended minimum age for children to get transitioning medical help, saying hormone therapy can start at 14 and some surgeries at 15.
The World Professional Association for Transgender Health has said it is changing its advice on when adolescents should be able to seek treatment because it is unethical and harmful to withhold early treatment.
The shifting advice comes as many experts – including a former member of the group’s board – fear irreversible treatments are already being given to children who would otherwise outgrow their gender questioning.
The updated advice – due out later this year – suggests starting lifelong hormone treatments from the age of 14. Long-term risks can include infertility and weight gain, as well as strokes in trans women and high blood pressure in trans men, the guidelines warn.
Trans boys should then be eligible for breast removal at age 15, about two years younger than previous recommendations.
Genital surgeries – including removal of the uterus and testicles – should be allowed to start at age 17, the group said, a year earlier than its previous recommendations.
Puberty blockers could be considered in the early stages of puberty, between ages 8 and 13 for girls and usually two years later for boys.
Blockers can weaken bones, and starting them too young in children assigned males at birth could impair sexual function in adulthood, although long-term evidence is lacking, experts agree.
Dr Eli Coleman, chairman of the group’s standards of care, insisted that emotional maturity, parental consent, long-standing sexual discomfort and careful psychological assessment were essential before taking such life-changing measures. life.
“There are definitely teenagers who don’t have the emotional or cognitive maturity to make an informed decision,” Coleman said.
“That’s why we recommend a careful multidisciplinary assessment.”
But the trend of helping teens make the transition has already sparked dissent within the group.
Transgender psychologist Erica Anderson, 71, resigned as a board member last year after raising concerns about the “sloppy” treatment given to children without adequate guidance.
She has since warned that the titmouse has “gone too far”, warning that many are making life-changing decisions because it’s “trendy” and on social media.
Anderson, who is still a member of the group, said she supports the updated guidelines, as long as clinics stick to recommendations for comprehensive assessments before treatment.
But she warned that she had heard dozens of families say it hadn’t happened.
“They tell me horror stories. They tell me: ‘Our child had 20 minutes with the doctor’” before being offered hormones, she says. “Parents leave with their hair on fire.”
Anderson said she has heard recent estimates suggesting the rate in children is as high as 1 in 5 – which she strongly disputes. That number likely reflects children who question sex and aren’t good candidates for lifelong medical treatment or permanent physical changes, she said.
Still, Anderson said she condemns politicians who want to punish parents for allowing their children to receive transgender treatment and those who say treatment should be banned for those under 18.
“It’s just absolutely cruel,” she said.
With post wires