lem0ngirl15
I personally encourage you to speak some sense into other professionals in your field that you are noticing that something is not right here. But Im a bit off put by how your answer to detrans people is more médicalisation.
Drwillpowers
Well, I have been. But unfortunately, that has basically just done nothing but get me ostracized.
As an example, I was in a online group for transgender clinicians, and I mentioned the jazz Jennings case.
For my MTF patients, I developed a very low dose topical testosterone that can be used to restore genital function. They can maintain genital function despite being on feminizing hormone therapy and if someone wants to go about bottom surgery, having normally developed and non-atrophic tissue is very important.
It's not like this has never been done before, a similar treatment is used to treat micropenis, or boys with noonan syndrome.
I suggested that perhaps my colleagues consider this option for their patients, because allowing these kids to never undergo normal genital development is a bad idea both if they continue on hormone therapy or if they don't.
For my kids on blockers, I do this. Because I don't want them to not undergo normal genital development and have dysfunctional sexual activity in their adulthood.
I was immediately ostracized and told "trans genitals are normal genitals" and banned from the group for talking about experimenting on children.
I think you can see the irony here. These are treatments that are already done to cisgender children to help them develop into normal adults. Suggesting that we could do such a thing to transgender children was met with literal hostility and my immediate banning from the group.
I have been trying to communicate my concerns to my colleagues, but no one wants to hear them.
I don't mean to be triggering to anyone in this group by talking about how some patients do benefit from this therapy, because clearly everyone here did not. And I understand that completely and I by no means am encouraging people to transition. Quite the opposite, I try and actually correct any possible thing that I can find before HRT and consider transition the last resort for people who have not started HRT.
My answer to detrans people is more medicalization, simply because without it, many of you will not actually get back to where you began.
We have tattoo removal machines for a reason. People get tattoos, they make mistakes, they decide they don't want them, and so we have the ability to remove them. I don't really think of this as any ethically different than that. If someone ultimately decides the transition isn't for them, and it is not helping them, and maybe even hurting them, It is literally my duty as a physician to try and do everything I can to help that person. Not medicalizing that problem is denying the fact that there is a problem. That they have a medical issue that went unaddressed.
In addition, getting to the bottom of why they felt the transition was the right thing for them in the first place is absolutely essential, because many of these people have a lot of different reasons why they seek transition that still need treatment.
When I see young women who have undergone transition because they were victims of sexual violence, and they don't want to be women anymore, simply stopping the hormone therapy isn't enough for them. They need treatment of the underlying problem, which is the psychological wound that caused them to feel that way in the first place. Denying that they need that treatment, or acting like that is medicalization I think is foolish. The same goes for not helping someone refeminize their body or remasculinize their body if that's what they desire. I think pushing anyone to do anything with their body is wrong, and I'm not ever going to do that on this subreddit. I'm the very rare physician who is against compulsory vaccination. I think people have the right to control their own bodies. They get to choose what goes into them. But abandoning people, who made a bad call or got some bad advice from a medical provider and accidentally transitioned to their own devices seems if anything more cruel than transitioning them in the first place. We have a duty to try and undo the damage that we did, and then help these people heal from whatever brought them to us in the first place.