Introduction:

The topic of sex reassignment has been very controversial in recent years. This is greatly due to public figures whom identify as transgender and have undergone the surgery such as, Caitlyn Jenner formerly Bruce Jenner and Laverne Cox. But what happens when a child identifies as transgender and wishes to undergo sex-reassignment surgery? In recent years the television network TLC have brought this topic to limelight with the show “I Am Jazz”. This documentary series shows the battles transgender adolescence must undergo, social criticism and medical road blocks to name a few. So, the question arises should they be allowed to transition as a child entering adolescence or be forced to wait until adulthood?

What I know and what I want to know:

The topic of transgender children is not one that we come across very day in our normal life’s. Yes, there are people whom know a transgender individual, but it is most commonly adults, and rarely ever children. For this reason, I feel like my prior knowledge about this topic is not much other than what I know from the documentary series mentioned above. The topic of hormonal treatments during puberty is one of the factors that I am currently somewhat aware of. I am aware that if the hormonal treatments are started too soon into the child’s development it may be a risk factor when later wanting the actual sex re-assignment surgery.

The bases of my research are to better understand the issue of children wanting to undergo this very permanent approach to living as their true selves. I want to know what the pre-operation process is. Do the children have a right over their own body and if they do at what age? What steps must be completed before the surgery can happen? And how does hormone treatment affect their development into adolescents? I believe that by finding answers to my questions I will be able to help individuals of this population whom may not have the answers themselves. Also by increasing my knowledge I’m able to better educate other individuals and decrease the sigma transgender sex- reassignment.

What my research process was and why:

My research journey took me down a couple of different paths. To begin with I wanted to make sure I understood what being transgender is, so I began reading articles about what gender identity disorder (GID) is and how it relates to sex-reassignment. That road took me to statistics on how on GID affects aspects of a transgender adolescent’s life such as suicidal thoughts and cases of bullying. Following that information, I began to research what steps needed to be taken to begin the process of transitioning.

Research came to a road block when I couldn’t find information on how hormone therapy at early stages of puberty affect further development of sexual organs that will be worked on in future surgeries. This was one of my main questions I wanted answered from my research. The question arises from me watching the documentary series that first brought this topic to my attention. This was something I believed would be a deal breaker for someone coinciding letting a child start the process young, which would make or break my argument.

What I learned about my debatable issue in conducting this research:

While conducting my research I learn what are the steps that need to be taken to begin the transition process. Before any individual can have sex-reassignment surgery they must be officially diagnosed with a gender disorder such as GID or gender dysphoria. I found that one may begin the diagnose process as early as age three, however research shows that only 10-20 percent of children diagnosed early in life will carry the diagnose into adulthood (Abel, 2014). To be diagnosed they must meet a series of components. These components include; “the desire to be or the insistence that one is of the other sex”, “persistent discomfort about one’s assigned sex or a sense of inappropriateness in the gender role of that sex”, “the individual must not have a concurrent physical intersex condition”, and “there must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning” (Gibson & Catlin, 2010).

The process of being diagnosed with a gender disorder is not the end of requirements adolescences’ must complete before being approved for surgery. In order to be eligible for the surgery they much reach legal age of the country they live in, for the US that age is eighteen (Gibson,2010). Other requirements include; “had one year of continuous cross-sex hormonal treatment”, “had one year of successful continuous real-life experience in the other gender”, “provide two letters of recommendation by mental health professionals”, and “have the ability to demonstrate knowledge of the cost, required surgeries, lengths of hospitalizations, likely complications, and post-surgical rehabilitation requirements of various surgical approaches” (Gibson, 2010). The last requirement is always the hardest because many medical professionals believe “children are generally unable to provide autronomous, independent informed consent for medical treatments” (Abel, 2014), especially one so permanent.

 Once I knew what needed to be done prior to being eligible for the survey I researched what treatment would be necessary and what actual surgeries would be needed to both transition from female to male (FTM) and male to female (MTF). Gonadotropin- releasing hormones (GnRH) are hormones that are prescribed to suppress the onset of puberty for children (Abel, 2014). This process of suppression prevents many secondary sexual characteristics such as; skeletal changes, permanent deep voice in males, menarche in females, and unwanted phallic growth (Ewards-Leepes & Spack). Early intervention with these hormone blockers can result in a better physical appearance after reassignment surgery. As stated before only 10-20 percent of children carry this diagnoses into adulthood so if a child on the blockers grows into his biological gender and wishes to discontinue treatment these blockers can be stopped, and puberty will resume as normal (Abel, 2014).

If all steps have been taken and surgery is the end goal males and females will have to endure multiple surgeries to make their wishes into reality. First to remove unwanted genitalia and then to reconstruct the opposite genders genitalia. FTM first step is to have top surgery which will result in a mastectomy. For some this is enough to allow them to live a happier life due to the ability to pass as a member of the opposite sex (Gibson, 2010). However, for others that is not enough, they go on to have hysterectomies and salpingo-oophrectomy to remove all reproductive organs before construction of the penis. In order to create a penis, the patient will then have to choose which method of tissue construction they would want a metoidioplasty or phalloplasty (Gibson, 2010). MTF surgery on the other hand involves breast sugary to give the appearance of female breast surgery to either remove the penis entirely or reconstruct it into a vagina (Gibson, 2010).

Conclusion:

After concluding my research, I know that children entering adolescence should be allowed to transition. The number of requirements needed for this surgery are intense and if they can get through all of them and still wish to transition they should be allowed to. I believe that if you put that amount of time into it then it’s something you are ready to live with long-term. Why make these children wait longer to live life as their “true selves”?

 

Works Cited:

Abel, Brendan S. “Hormone Treatment of Children and Adolescents with Gender Dysphoria: An Ethical Analysis.” Hastings Center Report, vol. 44, Sep2014 Supplement, pp. S23-S27. EBSCOhost, doi:10.1002/hast.366.

Edwards-Leeper, Laura and Norman P. Spack. “Psychological Evaluation and Medical Treatment of Transgender Youth in an Interdisciplinary “Gender Management Service” (Gems) in a Major Pediatric Center.” Journal of Homosexuality, vol. 59, no. 3, Mar. 2012, pp. 321-336. EBSCOhost, doi:10.1080/00918369.2012.653302

Gibson, Bethany and Anita J. Catlin. “Care of the Child with the Desire to Change Gender — Part I.” Pediatric Nursing, vol. 36, no. 1, Jan/Feb2010, pp. 53-59. EBSCOhost, chaffey.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=48289348&site=ehost-live.

Gibson, Bethany. “Care of the Child with the Desire to Change Genders – Part II: Female-To-Male Transition.” Pediatric Nursing, vol. 36, no. 2, Mar/Apr2010, pp. 112-117. EBSCOhost, chaffey.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=49783261&site=ehost-live

Gibson, Bethany and Anita J. Catlin. “Care of the Child with the Desire to Change Genders – Part III: Male-To-Female Transition.” Pediatric Nursing, vol. 36, no. 5, Sep/Oct2010, pp. 268-272. EBSCOhost, chaffey.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=54408911&site=ehost-live.

Annotated Bibliography:

Abel, Brendan S. “Hormone Treatment of Children and Adolescents with Gender Dysphoria: An Ethical Analysis.” Hastings Center Report, vol. 44, Sep2014 Supplement, pp. S23-S27. EBSCOhost, doi:10.1002/hast.366.

This article talks about gonadotropin-releasing hormones that are given to children before they fully enter puberty as a way to “slow down” the process. This allows children the extra time that may be needed in order to make the decision whether or not fully transitioning is something they truly want without secondary sexual characteristics of their birth given sex. This article is helpful to my paper in the way that it explains want can be done in order to not have secondary sexual characteristics that children may be trying to avoid in puberty.

Edwards-Leeper, Laura and Norman P. Spack. “Psychological Evaluation and Medical Treatment of Transgender Youth in an Interdisciplinary “Gender Management Service” (Gems) in a Major Pediatric Center.” Journal of Homosexuality, vol. 59, no. 3, Mar. 2012, pp. 321-336. EBSCOhost, doi:10.1080/00918369.2012.653302

This article talks about different stage of puberty in children and how the hormone blockers stop certain development stages of puberty.  This article is helpful to my paper because it shows what exactly the hormone blockers do. 

Gibson, Bethany and Anita J. Catlin. “Care of the Child with the Desire to Change Gender — Part I.” Pediatric Nursing, vol. 36, no. 1, Jan/Feb2010, pp. 53-59. EBSCOhost, chaffey.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=48289348&site=ehost-live.

“Care of the Child with the Desire to Change Gender Part I” is the first part of a three-part article that was written for PEDIATRIC NURSING in 2010. This part of the article discussed what is it be transgender with gender identity disorder (GID) as an adolescent whom may be wanting sex re-assignment surgery. This article will be helpful to my research because it states some of the treatments required prior to the actual re-assignment surgery. It also gives an understanding to what it is like for a child to “be trapped in another body” (Gibson & Catlin, 2010) .

Gibson, Bethany. “Care of the Child with the Desire to Change Genders – Part II: Female-To-Male Transition.” Pediatric Nursing, vol. 36, no. 2, Mar/Apr2010, pp. 112-117. EBSCOhost, chaffey.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=49783261&site=ehost-live

“Care of the Child with the Desire to Change Genders – Part II: Female-to-Male Transition” is the second part of the three-part article that was written for PEDIATRIC NURSING in 2010. This article discussed the medical procedures that are involved in the female to male (FTM) sex re-assignment surgery. This article would be helpful in my research because it goes through the process of the surgeries.

Gibson, Bethany and Anita J. Catlin. “Care of the Child with the Desire to Change Genders – Part III: Male-To-Female Transition.” Pediatric Nursing, vol. 36, no. 5, Sep/Oct2010, pp. 268-272. EBSCOhost, chaffey.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=54408911&site=ehost-live.

“Care of the Child with the Desire to Change Genders – Part III: Male-to-Female Transition” is the third part of the three-part article that was written for PEDIATRIC NURSING in 2010. This article discussed the medical procedures that are involved in the male to female (MTF) sex re-assignment surgery. This article would be helpful in my research because it goes through the process of the surgeries.