Gender Reassignment: A Good Response to Gender Dysphoria?

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Professor of Paediatrics Dr John Whitehall explains the three-stage medical response to gender dysphoria and the problems associated with this. In this talk, Dr Whitehall describes puberty blocking, cross-sex hormones and sex-change surgery. He also provides a more compassionate solution to children experiencing gender dysphoria.

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In this podcast:
  • 0:41: 1% of children have confusion about their gender: Is this statistic true?
  • 3:03: Numbers of children with gender dysphoria have jumped in recent times: Dr Whitehall’s thoughts.
  • 4:03: What happens to children with gender dysphoria if there is no intervention?
  • 6:52: What is the typical medical response to gender dysphoria today, and what are the problems associated with it?
    • 7:03: Stage 1: Puberty blocking. What are puberty blockers, what do they do, and why are they applied?
    • 11:37: Stage 2: Cross-sex hormones. Structural effect of cross-sex hormones on the brain.
    • 12:58: Stage 3: Irreversible sex-change surgery. What does it actually involve and what are the ongoing issues?
  • 15:29: What is the compassionate response to children experiencing gender dysphoria?
Show Transcript
In 20 minutes, it’s a huge subject. All I can do is really give you some highlight things from the two articles written in Quadrant, one in December and the most recent one in May, and they cover all the stuff. What I’m now is try to give you take-home thoughts about it to summarise and maybe introduce the articles to you. A woman introduced as the advisor to your Archdiocese in Sydney, in the Sunday Telegraph on Sunday was that her views were opposed to mine and she basically said ‘ah yes, children do get this fixed confusion when they’re young and the incidence is 1%’, and she is, apparently, advising the diocese up there how to handle those children in school or 1%.

Where does she get the 1% from, I don’t know personally, but I suspect it is from a survey that came from New Zealand called Youth 12, where they ask 8,000 children, adolescents a number of questions, probably about 200 questions. One of which is ‘Did you ever think that you were a boy in a girl’s body or the other way around?’ Something like 95% of children said ‘no, no we never had that confusion’. About 2.5 said ‘we don’t understand the question’. Another two say, ‘well, we’re not too sure’, and then there was the 1% that’s I believe. Now, extrapolating from that, the Safe Schools programme took that 1%, added the 2.5 and a bit more of the unsure people and they come up with their 4%.

Let’s say it’s 1%. I don’t believe that. I don’t really believe it. Because in preparation for the article, for example, I spoke with 28 of my colleagues, the cumulative experience of 931 years, and they could recall only 12 cases, 10 of which were in children with associated very, very severe mental issues like autism or depression, anxiety, other things like that. The other two were associated with gross prolonged sexual abuse. It used to be in paediatrics that if a girl came and said I’m really a boy, you would think hang on a second, what’s so disagreeable at home with being a girl?

Anyway, that’s 12 in 931 years, that’s almost like one ever 100 years. Now, 150 to 250 have presented to Melbourne in the last year, similar in Sydney. What’s going on? I personally believe that this is an inflated figure. It is a behavioural issue, an infectious behavioural issue, a behavioural trend, which is fanned by a sensationalist media, a noncritical media, and given direction and substance by the websites and the various counselling issues. I think this is a behavioural issue. This is particularly in girls when I analyse who was coming before the courts. Girls now much more commonly presenting than are boys and what better way to get up the nose of your parents by coming home one day and saying I’m no longer a girl you thought, I’m now a boy. Also getting the prominence in the schools and other things. That’s is what I think. You can judge for yourself.

Let’s take those figures 1%. The question is what happens to these children. What happens to them? Using their own figures, if you say it’s 1% are affected by gender dysphoria, then you look up the bible of psychiatry, which is called the Diagnostic and Scientific Manual of Mental Health, DSM 5th Edition a year or two back. It says that the prevalence of this gender dysphoria in adults as recognised by turning up at the gender dysphoria clinics is 0.0003% or 0.0004%, which is 3-4 per 10,000. Your advisor in Sydney is saying it’s 1% and yet they’re saying well hang on a second, when they get to adulthood, it’s only three or four per 10,000.

Isn’t that good news? What does it mean? It means if you do nothing, they’re going to get better at a rate far more than other studies suggest. Because international literature is saying that 85% to 90% or more of these children, if you do nothing but be gentle and kind, all that sort of stuff, you put gentles, confines, constraints around their behaviour, 85% to 90% will revert to their natal sex by the time they have passed through puberty. This is good news. We should be up there reassuring the people.

What can go wrong if we don’t reassure? This is an issue that’s going to get better by itself. How can we mess it up? Well, one way we can mess it up is by going ahead, pandering to, fostering, encouraging the delusion. How do we do that? All this stuff that Elisabeth was talking about. We are then encouraging this child to get further and further away from a position that the child could come gently back to when puberty flows. If in the meantime, the mother has got involved and it’s usually the mother cheerleading the whole business, enmeshed, becomes the poster boy or girl of the school, and of the media and so forth, everyone’s now treating this child as the opposite sex. What sort of confusion is that going to bring when the hormones flow?

Confusion is one thing. Can it get worse? Yes. Because almost inevitably with these children, they get on the pathway of medicalization, which begins with puberty blockers. Have you heard of them? We need to go slightly sideways here. Puberty is an extraordinarily complicated issue, begins somewhere in your head and various neurones get tipped off it’s time to do wonderful things. This is an association with a great development of the brain and hormones from here come to the gonads and then they release secondary sex hormones and cause the gonads to be able to reproduce, and they also affect the way the child thinks. Oestrogen and testosterone are then applied to the head, which has been primed before birth to think in the way of a male or a female.

What can go wrong if we stop it? That’s what they do, allegedly, to give the child more time to think through the options for the future, as if any child with normal or artificially postponed puberty could possibly contemplate procreative things 10, 20 years down the track. We’re keeping this child in a prepubertal infantile state with the argument that they’ll be able to think more clearly. That’s one thing. In all the court cases repeated as a mantra, is this statement that the blockers are safe and their effects are entirely reversible. All you’re doing is slowing up puberty.

There’s work throughout the world shows that that’s not true. Work I’m quoting, it’s not my work, it’s all there in the literature. Work from Glasgow and Norway, for example, in sheep, shows that if you block their puberty with the blockers, you interfere with the development of the limbic system, which is deep in your head, and that correlates, compares, evaluates sensations and emotions and gives rise to executive function. That area in the sheep is demonstrably, predictably increased in size, hypertrophied, not a normal thing. When they cleverly looked at the expression of the genes that comprise these cells, something like over 100 of the genes were upregulated and 200 were downregulated. This is a molecular evidence that this vital part of the head in the sheep was interfered with. No surprise then that when they put the sheep through the maze, he forgot where he was and got anxious.

How do you tell the sheep gets anxious? I didn’t know that but I now know that the pass water when they shouldn’t, I suppose it’s embarrassing, I’m not sure, pass water, go to the toilet, bleat and stuff, move around and anxious. They can tell that these sheep then, their memories were interfered with and their behaviour was altered, after a certain period of time.

Are there any human correlates? Yes. If you treat a man with prostate cancer, for example, or a woman with certain gynaecological things you block, the production of the oestrogens or the testosterone, it’s been shown they don’t think as clearly. Now it’s not as easy to demonstrate because if you’ve got prostate cancer, your mind’s on other things, your mind is now devolving, unfortunately, with age and you’ve got the effect of all the treatment, but there’s this definite strong suggestion that yes, people don’t think as clearly as they ought to after only six months’ treatment. At a time when the brain is devolving. Children who are started on blockers are done so at a time of enormous change, growth differentiation, communication, tremendous change in puberty, and that then is being blocked and they’re on the blockers not for just six months, but some for years. It’s nonsense to say that the effects of blockers are safe and entirely reversible. The laboratory evidence, the other evidence disagrees.

What happens next? That can be called stage one therapy, stage two therapy is if you block this child now, there’s no signs of puberty and then you give cross-sex hormones to evoke the ersatz external characteristics of the opposite sex. You imagine, they get breasts where there weren’t and they get hair when there wasn’t all that sort of stuff. Does that affect the head? In none of the court cases is there any mention, and I’ve read them all, in none of the court cases is there any mention to the structural effect of the cross-sex hormones on the brain. Measuring the effect of those cross-sex hormones on male transvestites reveals that the grey matter shrinks at a rate 10 times that of normal ageing after only six months’ treatment. These children, who will go to be blocked for years, are then going to be on the cross-sex hormones for the rest of their life. Does it get worse? Yes.

If you get to stage three, then you have irreversible surgery. Now the international advice – nobody takes much notice of it – is that no irreversible surgery should be done under the age of 18, but in the last few years, five years have had bilateral mastectomies. 15 years, 16 years, and 17 years old, in this process of transitioning. There’s no evidence that they can see and I think this would be an illegal process if the full sexual reassignment surgery was done in Australia but not all that difficult to do overseas, and the gender dysphoria people are arguing that it should be done here under Medicare. What does it involve?

Easy to say. Sexual reassignment surgery must be something having your appendix out or maybe your tonsils, or whatever. People don’t understand the monumental, massive attempt this is to artificially the external genitalia of the opposite sex after having castrated the person in the process. Castration is inevitable to this either with the cross-sex hormones or as part of this monumental effect to create the external ersatz characteristics.

Is this a once-only business? No. If you create a hole in somewhere, a stoma or whatever, its natural tendency is to close. If you create an artificial vagina, its tendency will be to close. How could you possibly ensure continence, for example, and how can you possibly ensure function in any of this system? It means that once the child gets onto that process and goes all the way through like this, the child is then stuck on medical attention for the complications, general complications of the hormones, tendency to have thrombosis, hypertension, diabetes, all this sort of stuff, as well as maintaining the surgical apparatus, which was artificially constructed. That is the end result.

Where does that end result begin? It begins in pandering to this delusion in the school. I know we’re Christians and there are many biblical injunctions that our heart is to go out to suffering children and we’re to care and we’re compassionate, that’s fine. We are. Are we being compassionate when we foster a delusion that’s going to lead to this? Do we then, for example, in a child with anorexia nervosa, we be compassionate, fine. Do we then set up in the school special mirrors that will make the kid look fatter or little gymnasia where they can come and lose weight, or special toilet for them, where they can without embarrassment go and vomit up all the food they’ve just eaten or toilet to go defecate by themselves to having taken spoonfuls of Adderall to try and lose weight? We don’t provide special attention for them like that?

Very lovingly, we try to bring them back from their delusion. This is the issue. I think we’re being conned at the school level that we should be compassionate or our compassion is involved or compassion is involved in sustaining and fostering this delusion when, in fact, that’s where the child gets on a process to which there is hardly any end. It’s all in the books.

This talk was part of a presentation by the Australian Christian Lobby in Hobart, Tasmania.

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