Discussed controversially
Parents of trans children demand a stop to new treatment guidelines
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A new treatment guideline for trans children is met with criticism and resistance even before its official publication, and a parent initiative in particular is raising the alarm. The guidelines call for a departure from the previous approach and make particular use of children’s self-assessments for diagnosis.
The development of new medical treatment guidelines for minors with gender dysphoria – the desire to be a different or alternative gender – is causing a controversial debate. “WELT” reported on the resistance of parents of so-called trans teens in German-speaking countries, who are calling for the immediate suspension of this new treatment guideline in an open letter. The controversy is primarily about the move away from traditional psychotherapeutic approaches in favor of a planned treatment guideline for trans teens that includes early administration of hormones and surgical procedures. The parents sound the alarm.
Healthy young people become “lifelong patients”
The initiative “TransTeens Concern is justified”, led by Anna Weber and David Allison, argues that early and systematic gender-affirmative treatment is ethically questionable and turns healthy young people into “lifelong patients”. In an open letter to the boards and presidiums of medical societies, the parents of “gender uncertain or gender dysphoric adolescents and young adults” criticized the drastic medical and life-changing intervention as unsuitable initial treatment. Instead, they advocate postponing invasive measures until adulthood to ensure an open future. “Welt” quotes the initiators:
“Drastic medical and life-changing interventions should always be the last option and not the first-line treatment as is currently routinely done Germany is the case.”
Concerns about overdiagnosis and suicide risk
The parents’ initiative also warns of increased overdiagnosis and false-positive cases, especially since the legal options for changing gender have been made easier by the new self-determination law and the expansion of new gender-affirming advice centers, internet offerings and clinics for transgender health is being pushed forward. They also criticize the irresponsible exaggeration of the risk of suicide and self-harm in “gender-confused” children and young people, which they consider to be inconsistent with the state of research.
Moving away from “transsexuality,” which is viewed as a psychological disorder
The document has not yet been officially published; it is currently being reviewed by colleagues who can provide feedback. The directive would be a paradigm shift in the treatment of what was once called “transsexuality” and classified as a mental disorder. Today, “gender dysphoria” is no longer viewed as an illness but as a condition. Doctors are of the opinion that appropriate treatment lies less in psychotherapy and rather consists primarily in medical interventions to help those affected.
The new guideline enables a medical diagnosis based on children’s self-assessment. The preamble emphasizes that doctors must respect the wishes of children and young people who feel they belong to a gender other than their birth gender. Therapeutic approaches that aim to steer the sense of gender in a particular direction are considered “unethical.”
Parents’ initiative criticizes UN association
The German treatment guidelines are closely based on the recommendations of the international transgender organization WPATH (World Professional Association for Transgender Health) and the global “Endrocrine Society”. The WPATH recently came under criticism for publishing internal discussions among its members. According to these discussions, teenagers were treated with hormones and may not have been able to understand the implications of their decisions. The WPATH is known for its advocacy of giving puberty blockers to minors – a practice that is increasingly opposed in countries such as the UK, Sweden and Finland due to a lack of evidence. The lifelong consequences of these treatments cannot be estimated and the benefits are doubtful, say opponents. These countries are now increasingly favoring psychosocial support and psychotherapy.
Medical and ethical concerns
The criticism from parents is echoed by some leading physicians. Professor Florian Zepf – the head of the Clinic for Child and Adolescent Psychiatry at Jena University Hospital – and Tobias Banaschewski – Medical Director of the Clinic for Child and Adolescent Psychiatry and Psychotherapy – have also expressed concern about the treatment of healthy minors with gender dysphoria, Banaschewski warns facing a potential “medical scandal.” Zepf himself was a member of the guidelines commission, but left it at the end of 2022 due to professional ethics concerns. Doctors emphasize the lack of clear medical evidence for such treatments. The parents’ initiative also highlighted the lack of evidence in its letter, reports “WELT” and quotes the initiative’s open letter:
“It is unethical to recognize the inadequate quality of the evidence but continue to make strong recommendations for the medical transition of minors without fully understanding the benefits and risks.”
They emphasize that puberty blockers and long-term treatments with cross-sex hormones are “not minor, but life-changing measures.”
Puberty blockade a break “to think”?
The guideline’s status has already had to be downgraded because it is based purely on the approval of the commission members and not on medical evidence, reports “Welt”. Although it is pointed out in many places that there is a lack of evidence for medication and interventions, the administration of puberty blockers, opposite-sex hormones and the amputation of the female breast in minors are still mentioned as options. The parents argue that the WPATH’s justification for giving hormones to minors, that blocking puberty provides a break “for thinking” and is reversible, has often been refuted. The fact that almost all teenagers switch to hormones suggests that they are becoming fixated on the transition path.
From the perspective of the parents’ initiative, it is also inconsistent to no longer classify gender dysphoria as an illness, but still subject young people to hormone treatments:
“Our children have a right to an open future and to physical integrity. Adolescents and young adults need at least freedom of choice in the form of non-invasive treatment alternatives.”
Depending on your perspective and ethical beliefs, you may have different views and beliefs on this topic. Both sides clearly have their supporters, but it should not be ignored that those affected themselves do not have a voice.
Source used: welt.de