Transgender surgeries and treatment must begin for even younger kids, say pro-trans doctors

AP Photo/Toby Brusseau

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One of the world’s leading transgender health organizations will be lowering the recommended minimum age for transgender-affirming treatments, including sex hormones and surgeries. 

The World Professional Association for Transgender Health recommended that hormones could be started at age 14, two years lower than the group’s previous advice. The organization has also recommended that some surgeries be available to teenagers as young as 15. 

The group, which provided the Associated Press with a copy of its updated guidance, admitted that there are risks to the invasive and irreversible surgeries, but stated that it is unethical and harmful to withhold early treatment. 

The group, which represents more than 300 doctors, transgender advocates, and social scientists, claims to promote evidence-based standards of care. The new update is based on a review of the supposed scientific evidence on the harms and benefits of transgender-affirming treatments in teenagers who identify as transgender. 

The group defines such teenagers as those whose gender identity does not match the sex they were “assigned” at birth, suggesting that gender and sex are two separate things. The organization insists that studies support early treatment, including surgeries for teenagers, purportedly for positive psychological benefits and to reduce suicidal behavior. 

Dr. Eli Coleman, the organization’s Chairman for Standards of Care and Director of the University of Minnesota Medical School’s human sexuality program, stressed that transgender teens will be able to experience puberty around the same time as normal kids if they start their treatment earlier.  

He said that certain factors would be weighed into allowing a minor to transition, such as parental consent and emotional maturity. 

“Certainly there are adolescents that do not have the emotional or cognitive maturity to make an informed decision,” Coleman stated. “That is why we recommend a careful multidisciplinary assessment.”

The new guidelines, which lower the recommended age for hormone replacement therapy and sex-reassignment surgery, keep the recommended age for puberty blockers, which is between eight to 13 for girls, and two years later for boys. 

As detailed by the group, the update recommends that sex hormone replacement therapy such as estrogen or testosterone should begin at age 14. It is a lifelong treatment and risks include infertility and weight gain, along with strokes for males and high blood pressure for females. 

The update recommends breast removal for girls at age 15. Previous guidance suggested the procedure, which is irreversible, be done around age 17, or at least a year after hormone therapy. 

Finally, the update recommends that most genital surgeries begin at age 17, including the removal of the womb or testicles. 

In December, WPATH released draft guidelines to include a new category of “eunuch” as a protected “gender identity.” According to the guidelines, the Standards of Care recommends medical treatment and services for anyone who self-identifies as a eunuch, including castration and elimination of all masculine physical features, or genital functioning. 

Reduxx reports that the organization collaborated with castration and child abuse fetishists to come up with its guidelines.