South Dakota Legislature Plays Doctor to Transgender Children

[krypton iodine sulfur]

I believe other states may have tabled similar legislation. The short title of the act--"the Vulnerable Child Protection Act"--is disingenuous to say the least.

Roughly, the act would make it a misdemeanour for doctors to provide medical transition to youth under 16. News outlets have focused on 'surgery''; however, it also prohibits the use of cross-sex hormones for transition as well as puberty blockers to delay the onset of puberty greatly reducing the potential for harm.

Admittedly, one of the risks of deal with with youth is a wrong assessment could lead to the incorrect course of action resulting in harm. Medical transition for a youth who is not actually transgender would be bad. Denying or delaying treatment for a youth who is transgender is equally bad. Historically, the latter case is much more likely than the former. This legislation does nothing to invest in improving resources available to children and youths who may be transgender. It simply enforces the prejudices of laypeople. Even the wording of the legislation is at odds with what gender dysphoria is.

https://sdlegislature.gov/Legislati...on=2020&Version=House State Affairs&Bill=1057

26-10-37. Perception of minor's sex--Prohibited practices--Violation as a felony.

Except as provided in § 26-10-38, a medical professional who engages in any of the following practices upon a minor under the age of sixteen, for the purpose of attempting to change or affirm the minor's perception of the minor's sex, if that perception is inconsistent with the minor's sex, is guilty of a Class 1 misdemeanor:

(1) Performing the following surgeries: castration, vasectomy, hysterectomy, oophorectomy, metoidioplasty, orchiectomy, penectomy, phalloplasty, and vaginoplasty;

(2) Performing a mastectomy;

(3) Prescribing, dispensing, administering, or otherwise supplying the following medications:

(a) Puberty-blocking medication to stop normal puberty;

(b) Supraphysiologic doses of testosterone to females; or

(c) Supraphysiologic doses of estrogen to males; or

(4) Removing any otherwise healthy or nondiseased body part or tissue.

 

[repoman]

First, I think that gender "proprioception" to mangle a term may very well be crossed on a fundamental level for many transgenders. But to think that there are no other reasons for a person to think they may be trans is silly and seems like OP agrees.

Can a molested or sexually harassed girl want to be a boy to escape further assaults in the same way some starve themselves or become fat on purpose?

Need some Bayesian statistics. But if radical trans activists pressure doctors and researchers there won't be good data.

Tonight at the Seattle Public Library there was the opposite end of the horseshoe from the old religious right. Meghan Murphy was there speaking. I got off work late so did not see much of a protest, but it was about 200 I heard.

Seems like the radfems hate patriarchy so much and are so biologically essentialist that becoming Terfs sort of follows from it.

Strange bedfellows, Terfs and old school gender role reactionaries.

 

[krypton iodine sulfur]

First, I think that gender "proprioception" to mangle a term may very well be crossed on a fundamental level for many transgenders. But to think that there are no other reasons for a person to think they may be trans is silly and seems like OP agrees.

Many of the issues I am aware of could be largely resolved with better diagnostic criteria for children and youth, and better education for relevant medical professionals (et al).

 

[krypton iodine sulfur]

I guess they're just going hog wild, perhaps hoping now is the time for things to escalate to a more sympathetic Supreme Court?

House Bill 1215

https://sdlegislature.gov/Legislative_Session/Bills/Bill.aspx?Bill=1215&Session=2020

An Act to prohibit the state from endorsing or enforcing certain policies regarding domestic relations.

Be it enacted by the Legislature of the State of South Dakota:

Section 1. That a NEW SECTION be added:

25-11-1. Marriage policies--Prohibitions.

The state may not enforce, endorse, or favor policies that:

(1) Permit any form of marriage that does not involve a man and a woman;

(2) Appropriate benefits to persons who enter a marriage other than a marriage involving a man and a woman;

(3) Permit counties to issue marriage licenses to persons other than for a marriage involving a man and a woman;

(4) Treat sexual orientation as a suspect class or as a basis of prohibited discrimination;

(5) Recognize a person's belief that that person was born a gender that does not accord with the biological sex of the person as determined by that person's anatomy at birth;

(6) Appropriate tax dollars to pay for sex change operations;

(7) Ban conversion therapy. Under this subdivision, conversion therapy, means a therapeutic practice in which a licensed medical professional, acting under authorized consent, assists a client in the goal or realigning the client's sexual preference to prefer members of the opposite sex who have corresponding reproductive anatomy;

(8) Permit public libraries or public schools in the state to partner with nonsecular organizations to promote, host, sponsor, favor, or endorse drag queen storytime;

(9) Mandate pronoun changes;

(10) Condone or affirm homosexual, transgender, zoophilia, objectophilia, polygamy, or sexual orientation doctrines; and

(11) Permit a person to change the sex on a birth certificate to a sex that does not accord with that person's anatomy at birth.

Section 2. That a NEW SECTION be added:

25-11-2. Rights not affected by chapter.

This chapter does not affect:

(1) Marriages between a man and a woman;

(2) A person's right to set the person's self-asserted, sex-based identity narrative or sexual orientation; and

(3) A person's right to practice secular humanism.

 

[Jarhyn]

The real question is, "Does giving humans self determination over when and which puberty lead to more, or fewer cases of adult body dysphoria"

Because when the choice is "grow tits you don't want and lose months of your life and years of savings getting rid of them, vs taking a pill every day for two years and then taking a weekly injection after that, I choose the pills and then injections.

Because for trans people, this is legislation forcing surgical interventions over the assumption that they change their mind later. It is damning them to a life in a body that is irreversibly ruined for them.

Nobody is giving surgery to kids. Nobody is advocating that and nobody is even discussing it except bad-faith regressives.

Everyone has a puberty, and it's not like we don't know what the effects of BOTH puberties ends up being.

If, as a result of HRT, you develop body features you don't want, there's always the fallback of surgical interventions that trans people already have, and overwhelmingly, those who go on blockers and later HRT, are happy with the result.

All this is is giving some people self determination, and generally more time to plan what they want from puberty. Not allowing it has a greater cost to society in every way.

It's maybe 10% of people who hormonally transition getting surgery to de-transitoon, vs 90% of people who want to transition needing surgical interventions.

This is an absolute no-brainer. This law harms 90% of kids with apparent gender dysphoria to protect maybe 10% of kids, vs letting 10% of kids MAYBE harm themselves to give self-determination to all of them.

 

[Metaphor]

The real question is, "Does giving humans self determination over when and which puberty lead to more, or fewer cases of adult body dysphoria"

Because when the choice is "grow tits you don't want and lose months of your life and years of savings getting rid of them, vs taking a pill every day for two years and then taking a weekly injection after that, I choose the pills and then injections.

Because for trans people, this is legislation forcing surgical interventions over the assumption that they change their mind later. It is damning them to a life in a body that is irreversibly ruined for them.

Nobody is giving surgery to kids. Nobody is advocating that and nobody is even discussing it except bad-faith regressives.

Everyone has a puberty, and it's not like we don't know what the effects of BOTH puberties ends up being.

If, as a result of HRT, you develop body features you don't want, there's always the fallback of surgical interventions that trans people already have, and overwhelmingly, those who go on blockers and later HRT, are happy with the result.

All this is is giving some people self determination, and generally more time to plan what they want from puberty. Not allowing it has a greater cost to society in every way.

It's maybe 10% of people who hormonally transition getting surgery to de-transitoon, vs 90% of people who want to transition needing surgical interventions.

This is an absolute no-brainer. This law harms 90% of kids with apparent gender dysphoria to protect maybe 10% of kids, vs letting 10% of kids MAYBE harm themselves to give self-determination to all of them.

From where did you get these statistics? In particular, how do you know the percentage of people who transition who regret it later (at most 10% according to your post)?

 

[Trausti]

Rapid Onset Gender Dysphoria. Just because a kid goes through an emo stage doesn’t mean society should permit permanent destruction of their bodies. The rate of transgenderism is so minimal that the greater probability is that Johnny is playing with a doll because he’s gay. Remember David Reimer.

 

[Jarhyn]

The real question is, "Does giving humans self determination over when and which puberty lead to more, or fewer cases of adult body dysphoria"

Because when the choice is "grow tits you don't want and lose months of your life and years of savings getting rid of them, vs taking a pill every day for two years and then taking a weekly injection after that, I choose the pills and then injections.

Because for trans people, this is legislation forcing surgical interventions over the assumption that they change their mind later. It is damning them to a life in a body that is irreversibly ruined for them.

Nobody is giving surgery to kids. Nobody is advocating that and nobody is even discussing it except bad-faith regressives.

Everyone has a puberty, and it's not like we don't know what the effects of BOTH puberties ends up being.

If, as a result of HRT, you develop body features you don't want, there's always the fallback of surgical interventions that trans people already have, and overwhelmingly, those who go on blockers and later HRT, are happy with the result.

All this is is giving some people self determination, and generally more time to plan what they want from puberty. Not allowing it has a greater cost to society in every way.

It's maybe 10% of people who hormonally transition getting surgery to de-transitoon, vs 90% of people who want to transition needing surgical interventions.

This is an absolute no-brainer. This law harms 90% of kids with apparent gender dysphoria to protect maybe 10% of kids, vs letting 10% of kids MAYBE harm themselves to give self-determination to all of them.

From where did you get these statistics? In particular, how do you know the percentage of people who transition who regret it later (at most 10% according to your post)?

https://www.researchgate.net/public...en_1960-2010_Prevalence_Incidence_and_Regrets

The reality is that I highballed it by an order of magnitude. In reality, it's more like 2%, with other studies indicating it's as low as .4%.

I highballed it so that you would look even sillier for trying to deny that there's a net benefit for allowing transition.

 

[Jarhyn]

Rapid Onset Gender Dysphoria. Just because a kid goes through an emo stage doesn’t mean society should permit permanent destruction of their bodies. The rate of transgenderism is so minimal that the greater probability is that Johnny is playing with a doll because he’s gay. Remember David Reimer.

Then it sure is a good thing that blockers give two to four whole years to evaluate and make a decision before permanent body changes happen!

 

[Metaphor]

https://www.researchgate.net/public...en_1960-2010_Prevalence_Incidence_and_Regrets

The reality is that I highballed it by an order of magnitude. In reality, it's more like 2%, with other studies indicating it's as low as .4%.

I highballed it so that you would look even sillier for trying to deny that there's a net benefit for allowing transition.

You did no such thing. You plucked a number from whole cloth.

I can't get the full text of that study, so I can't look at the methodology, but what percentage of the survey data were of people who had procedures performed when they were children under 18?

 

[Jarhyn]

https://www.researchgate.net/public...en_1960-2010_Prevalence_Incidence_and_Regrets

The reality is that I highballed it by an order of magnitude. In reality, it's more like 2%, with other studies indicating it's as low as .4%.

I highballed it so that you would look even sillier for trying to deny that there's a net benefit for allowing transition.

You did no such thing. You plucked a number from whole cloth.

I can't get the full text of that study, so I can't look at the methodology, but what percentage of the survey data were of people who had procedures performed when they were children under 18?

I can't say for certain, but likely 0%. Because no doctor advocates for surgery on <18 year olds. The point of blocking and later HRT is to make surgical interventions that MIGHT be offered to <18 year olds not necessary in the first place. A quick Google search shows that of all interventions .9% are genital reconstructions. This means that HRT can in fact reduce surgical interventions by 99% in terms of confirmation surgeries, with somewhere around 3% of current numbers of surgical interventions being performed.

Allowing blockers and later HRT to replace rather than re-engage a puberty of a trans person would thus cut total surgical interventions by 97%

 

[krypton iodine sulfur]

Rapid Onset Gender Dysphoria.

'ROGD' was initially based on parents reporting their perceptions of their children. This would not meet the recommended diagnostic criteria for a gender dysphoria diagnosis in youth.

Just because a kid goes through an emo stage doesn’t mean society should permit permanent destruction of their bodies. The rate of transgenderism is so minimal that the greater probability is that Johnny is playing with a doll because he’s gay.

Also does not satisfy recommended diagnostic criteria.

Remember David Reimer.

David Reimer wasn't diagnosed as having gender dysphoria or gender incongruence of childhood (or equivalent terminology of the times). Strangely enough, this legislation does much less to prevent cases like Reimer's.

 

[Metaphor]

I can't say for certain, but likely 0%. Because no doctor advocates for surgery on <18 year olds.

You ought tell that to the doctors that perform double mastectomies on girls as young as 14, then.

The point of blocking and later HRT is to make surgical interventions that MIGHT be offered to <18 year olds not necessary in the first place. A quick Google search shows that of all interventions .9% are genital reconstructions. This means that HRT can in fact reduce surgical interventions by 99% in terms of confirmation surgeries, with somewhere around 3% of current numbers of surgical interventions being performed.

Allowing blockers and later HRT to replace rather than re-engage a puberty of a trans person would thus cut total surgical interventions by 97%

Um, no. You haven't thought about this.

Let's say a boy is given puberty blockers until he is 16. He will have the genitals the size of a pre-pubescent boy. Now, at 16, he will either want to transition surgically, or he won't want to. The puberty blockers won't prevent the need to have genital surgery if he wants to transition surgically.

 

[Metaphor]

I can't say for certain, but likely 0%.

Let me clarify my meaning. This study that you claim shows a 'regret' rate of 4%: is that 'regret' rate based on people who began to medically and surgically transition after reaching 18 years of age?

Since the study starts in 1960 and ends in 2010, long before childhood trans diagnoses exploded in incidence, I'd say almost none of the data speaks to the statistics about people who begin medical transition as children.

 

[Jarhyn]

I can't say for certain, but likely 0%. Because no doctor advocates for surgery on <18 year olds.

You ought tell that to the doctors that perform double mastectomies on girls as young as 14, then.

With blockers and HRT, no mastectomy will be necessary. I don't believe double mastectomy should ever be done on a child, because I don't agree with stupid policies like of the OP which make them the only alternative to having breasts. And if someone changes their mind later they can stop blockers at the age of 16 and let their breasts grow out.

The point of blocking and later HRT is to make surgical interventions that MIGHT be offered to <18 year olds not necessary in the first place. A quick Google search shows that of all interventions .9% are genital reconstructions. This means that HRT can in fact reduce surgical interventions by 99% in terms of confirmation surgeries, with somewhere around 3% of current numbers of surgical interventions being performed.

Allowing blockers and later HRT to replace rather than re-engage a puberty of a trans person would thus cut total surgical interventions by 97%

Um, no. You haven't thought about this.

Let's say a boy is given puberty blockers until he is 16. He will have the genitals the size of a pre-pubescent boy. Now, at 16, he will either want to transition surgically, or he won't want to. The puberty blockers won't prevent the need to have genital surgery if he wants to transition surgically.

First, as said previously, there are vanishingly few people who actually get GRS, even at or after the age of 18: >1%. Surgical transition is unlikely and likely unnecessary for their outlook.

Second, no doctor is going to perform that surgery on someone under the age of 18.

Third, if they choose not to transition they stop taking blockers, no surgical repair necessary. Back to your regularly scheduled male (or female) puberty

Blockers from the age of 12 to 16 are THE way to afford a child in consideration of HRT to have time to think it through, settle on a course, and not have to deal with unwanted permanent changes to their anatomy. Denying this as a course WILL result in 97% more surgical interventions.

You seem under the impression that GRS is common. It is not. Granted, quite a few more MtF seek GRS, but few can afford it, few want something as difficult and imperfect as is offered with current technology, and still, few want it at all.

 

[Loren Pechtel]

Rapid Onset Gender Dysphoria. Just because a kid goes through an emo stage doesn’t mean society should permit permanent destruction of their bodies. The rate of transgenderism is so minimal that the greater probability is that Johnny is playing with a doll because he’s gay. Remember David Reimer.

What you're missing is that they aren't going to do anything that's not reversible without a long time of living as the other gender.

 

[Jarhyn]

Rapid Onset Gender Dysphoria. Just because a kid goes through an emo stage doesn’t mean society should permit permanent destruction of their bodies. The rate of transgenderism is so minimal that the greater probability is that Johnny is playing with a doll because he’s gay. Remember David Reimer.

What you're missing is that they aren't going to do anything that's not reversible without a long time of living as the other gender.

Exactly. And 2-4 years on blockers, from ages 12-14 are not just reversible, there's nothing TO reverse. It's a pause, not an advancement in any directions. And if you get on the HRT train after blockers, around the age of 16, no surgical interventions are necessary (assuming you are in the 99% without the money, or will to complete that surgery). You get everything you want, with no surgical interventions.

 

[krypton iodine sulfur]

Rapid Onset Gender Dysphoria. Just because a kid goes through an emo stage doesn’t mean society should permit permanent destruction of their bodies. The rate of transgenderism is so minimal that the greater probability is that Johnny is playing with a doll because he’s gay. Remember David Reimer.

What you're missing is that they aren't going to do anything that's not reversible without a long time of living as the other gender.

Exactly. And 2-4 years on blockers, from ages 12-14 are not just reversible, there's nothing TO reverse. It's a pause, not an advancement in any directions. And if you get on the HRT train after blockers, around the age of 16, no surgical interventions are necessary (assuming you are in the 99% without the money, or will to complete that surgery). You get everything you want, with no surgical interventions.

From a cis-normative mindset, many default to the assumption that non-intervention is avoiding making a potentially wrong choice. People trapped in that paradigm can only get as far as 'What if they transition and the decision is wrong?"

For the rest of us, we understand the ultimate goal should be to prevent individuals going through a puberty which is misaligned with their gender identity, regardless of whether the individual may be transgender or cisgender.

Personally, I hope for increasingly better assessments allowing for more accurate diagnoses at younger ages.

 

[Metaphor]

Second, no doctor is going to perform that surgery on someone under the age of 18.

That's optimistic. Doctors have already done it. But more to the point, doctors already advocate mutilating the genitals of baby boys for no reason at all. Millions of boys have had their penises mutilated for no reason at all. And you think doctors won't perform genital surgery on children? They do it on babies right now for no reason at all.

Third, if they choose not to transition they stop taking blockers, no surgical repair necessary. Back to your regularly scheduled male (or female) puberty

You appear to believe that puberty blockers are harmless. There have been no long-term outcome studies on puberty blockers so the idea that they are harmless is not evidenced.

But they certainly don't have no consequences. Having a later-than-average puberty results in people being taller than they otherwise would have been. That's not obviously a positive or negative but it's not "nothing".

Blockers from the age of 12 to 16 are THE way to afford a child in consideration of HRT to have time to think it through, settle on a course, and not have to deal with unwanted permanent changes to their anatomy. Denying this as a course WILL result in 97% more surgical interventions.

I'm sorry you simply don't understand the maths involved. You really don't.

You also seem to believe the only thing I'm concerned about is the irreversibility of surgery. You've completely glossed over whether puberty blockers have harmful long-term outcomes.

 

[krypton iodine sulfur]

Millions of boys have had their penises mutilated for no reason at all. And you think doctors won't perform genital surgery on children? They do it on babies right now for no reason at all.

While I am opposed to the practice of circumcision for minors, it is not analogous to gender affirming surgeries for transgender people. The decisions are predicated on different criteria. Perhaps the closest analogue is surgical gender assignment for intersex (something I am also opposed to absent some pressing health concern).

You appear to believe that puberty blockers are harmless. There have been no long-term outcome studies on puberty blockers so the idea that they are harmless is not evidenced.

I don't know if any in-depth studies exist, but leuprorelin has been used for various reasons such that we have seen long term outcomes. It isn't the only medication used to this effect--it's just the only one I can think of immediately. I would agree we can't say there are no risks or potentially negative effects. They have to be weighed against the risk of doing nothing.