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I'm curious about something. Now I myself am against the view that children with any hint of dysphoria should be immediately placed on blockers and be allowed to transition at very young ages. However, I also recognize that there are specific types of cases involving transgender children in which circumstances are not so simple. A good example is a child who tries to mutilate themselves by cutting off their penis, or a young girl who similarly tries to cut off her breasts? How can we help these children?

At what point is it necessary to truly consider that it IS in the best interest of the child to allow them to transition at a young age, because failing to do so would put the child at risk of self harming themselves. I'm referring to a way less common scenario, but one that still deserves to be addressed. I am not referring to the majority of children.

And no, for those who say the child should be placed into a mental institute, I don't believe that to be a safe and healthy option.

CreatorZaw 4 May 6
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See that’s the tricky thing. Every person matures in a unique way. There is no exact science to know when someone is ready to make that decision. There needs to be a stricter form of “gate keeping” so to speak with therapists. I’m my opinion, it’s them who should be working intensely with these people and try to evaluate what is the right option. It seems that it’s kind of under regulated right now and pretty loose. I just think everyone’s different and they have to make informed and educated decisions, and everyone reaches that point at different times. Obviously that’s not in your young teen years.


I would argue that level of self-harm is NOT helped by transition (especially in a child) and needs help to address issues more serious than GID. Even if I concede such an extreme example MIGHT exist, it's rarity would not, should not, inform general approaches to GID in kids.

I don't believe that it should regulate the general approach. With that being in agreement, what do you do about the outliers? What do you do where therapy does not help and the child is adamant? If a young child tries to commit suicide or tries to get rid of their genitals themselves, is removing transition from the table completely still considered in that child's best interest?

@CreatorZaw Too many variables including WHY the child is acting that way; their environment at home; the people in the child's life. I know a child (not GID) that has been self-harming for the last 6 years of her 15 yr old life - she is spending lots of time in an institution and yet the issues are not being 'solved'. I know her pretty well and have acted, with her mother's knowledge and permission, in ways that I think are beneficial (but which some might question).

My brother was schizophrenic, abused drugs and attempted numerous times to commit suicide. He and I got along very well but I also didn't cut him one ounce of slack or concede an inch of ground - he was responsible for his actions, ALL OF THEM. He died at 43 of a heart-attack. He was clean and on meds at the time.

I would say that the scenario is too extreme to be considered in the greater discussion of the appropriate approach.


This will be controversial but I believe that children showing dysphoria should receive counseling until they are an adult(21) and can properly make this life altering decision. Also, I think hormones/puberty blockers and very harmful as we don't know how they affect a person long term mentally and physically. We should be wary and in only the most dire of situations use them.

NateJ Level 4 May 8, 2020

Maybe a bit controversial, but I think many would still agree with you. I personally think 18 is old enough.


I have a few videos coming up addressing these issues. ><3


I'm not sure anyone under 16-18 should be allowed to transition fully. I am unsure as to where the line should be drawn as a trans-woman myself. I do know there is still time between the ages of 18-25 for a very satisfactory transition due to the fact that our bones and structure have still not fully fused or locked in during that time period. There are cases beyond 25 where the pelvis in MTF women have not fused and actually shift on hormones.

As to young children, puberty blockers seem a bit extreme especially as a first option. Therapy is a must and it needs to be done to look for any issues besides Gender Dysphoria. This is not done to prevent transition in the long run, but to insure there is no other cause and to leave the individual in a mentally healthy place if they pursue transition. I too hold some reservations about puberty blockers, but am unsure on what the proper course is.

As to self harming. I did not self harm, but I definitely had thoughts of mutilation. As soon as I hit puberty, at 12 or 13, I had plans for removing my penis, and dreams of getting rid of my penis. I had all different kinds of dreams and my waking thoughts were a struggle to convince myself that it wasn't going to do what I wanted anyway. Here is the difference, Non-Suicidal Self Injury (NSSI) is a form of self punishment, in the case of someone with gender dysphoria it is a form of self betterment in the individuals eyes. I think they should still be seeing a therapist as what they may try to do will cause more harm than they may understand.

As to suicide in transgender individuals I think this stems from all sides. Living in a world where you feel trapped and with no control, causes depression. Many transgender people feel that they can never have the right body, add to that an unsupportive environment or family, and you compound that depression. Then take these highly depressed individuals, who many already questioning their sanity, and tell them they are mentally ill or crazy. This drives them to feel hopeless, and when you remove hope or a future you create a perfect environment for suicide.

Now I have looked into studies about suicide after full transition and here are my critiques. The initial study that is cited showed no difference and included the entirety of those studied. A strange thing happens in that study when you look at the younger transitioners though. While the older transitioners were unable to assimilate into society or feel supported, the younger transitioners were supported and accepted. This means that if you take the data from the younger transitioners all the numbers fell back to only slightly higher than normal for the general populace.

So what of NSSI or suicide studies since? Most of these have showed a much greater risk factor. However most of these studies do not look into many other factors that could be causing this. One factor could be the constant social feed transgender people get that they will be attacked for being themselves. Another factor is fed to them by transactivists that if they don't transition immediately or get on hormones that they are either being prevented transition for no good reason or that this is why transgender people commit suicide. It is a world of negatives being fed to transgender people.

These studies have striped a complex issue down to a Psychological result. We need studies that take into account Biological, Psychological, and Social data to determine with any accuracy what the real cause of increased suicidal and NSSI rates are. While it is important transition is not just thrown out as a catch all, I also do not think we should throw transitions out all together either. We need to maintain therapy (which I feel is undervalued in all our lives) and ensure positive outcomes for those who transition and those who do not.

This argument is a huge debate in the transgender community itself as those of us who want a safe path, and tend to be self ascribed transsexuals, are being drowned out by affirmative advocates who aren't listening to our concerns. We are labeled as gatekeepers (transmed, truscum) because we want precautions taken. We fear the back lash mass detransitions from kids pushed through will cause all of us. It is already stating in Europe and what sucks is if the doctors/psychologists had listened to our concerns it might not have.

I apologize for the huge post but as a Trans-woman this is very important to me. I want safe transitions, but this is not it. I also think this is causing so much harm because it fuels the narrative that we are all just crazy. If you look into those of us not spouting the trans advocate narrative you will find most of us to be very sane and stable people.

It is a huge debate, because for the most part we don't know how this plays out long term. However, when it comes to children with severe dysphoria, I really don't know myself. (I also think there is an argument to make for 16 y/os to be allowed to make the decision in certain circumstances)

I transitioned in the late 80s/early 90s and the debate over RLT was primary then too. I think transition (RLT) IS necessary, as is therapy. There are LOTS of things going on and there needs to be a period to shake them out and build some type of stable life before GRS.

I can give you some anecdotal info: those that went through RLT (via SOC at the time) and did NOT have other issues (mental health) were stable healthy adults post. Those that tried to subvert the system and hide other issues, seldom succeeded. The two that I knew that were able to go around the system and get surgery overseas both committed suicide within 6 months post....

I've been accused of being a gate-keeper for 30 years. I have NO power to grant or withhold anything from someone else, never have, so the accusation is sour-grapes (at a minimum). People WANT affirmations - I believe I can be a little more objective.

BTW, the first therapist I saw said I made a poor candidate and would not recommend me for any therapy or programs leading to SRS. His reasoning? I had not had sexual relationships with men. I found a better therapist a year later and now, 30+ yrs later, still going strong and happy.

@tracycoyle Sadly I see that happening now as well. I tried in the late 90's to come out and the psychologist I was evaluated by told me I would be miserable the rest of my life and didn't even mention options to fix it. That left me hopeless living in Iowa suffering for 20 years with severe depression. I would have loved to rush my transition when I finally did come out, but I understand it is a process for a reason. I don't regret the time I have had to take, and I will continue to work on myself to maintain my stability. I am really sorry that our supposed community won't listen to people like you, or those of us concerned about consequences.


A child who self-harms is mentally ill. Self-harm is an attempt to justify the pain they feel. ANY health provider tells you different doesn't have the kid's health as the priority. Even those in "mental institutions". If such a child doesn't have a solid advocate, the system will take advantage - it is policy not people driven and policy is created by lawyers and administrators.
Doctors and hospitals are like police. It is a service of last resort. They don't work for you.

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