HomeMy WebLinkAbout2023_04_20 AHuenke_Gender affirmative careFrom:Annette Huenke
To:Board of Health; aberry@co.clallam.wa.us
Subject:items for your consideration
Date:Thursday, April 20, 2023 5:29:18 PM
ALERT:BE CAUTIOUS This email originated outside the organization. Do not openattachments or click on links if you are not expecting them.
For the record, Dr. Berry, I said nothing today that could genuinely be considered “dangerous”or “transphobic.” Aside from my brief introduction, I was reading from the “Reconsidering
Informed Consent…” article below (as I told you all was the case). To my mind, the words ofthe authors are cautious, considerate and very much in the interest of anyone considering
‘gender affirming care.’
Annette HuenkePT
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Board of Health members:
These papers are rather recent, perhaps you will find them of interest. (highlight emphasis isnot mine)
Reconsidering Informed Consent for Trans-Identified Children, Adolescents,
and Young Adults
https://www.tandfonline.com/doi/full/10.1080/0092623X.2022.2046221?scroll=top&needAccess=true&role=tab&aria-labelledby=full-article
"In less than a decade, the western world has witnessed an unprecedented rise
in the numbers of children and adolescents seeking gender transition. Despite
the precedent of years of gender-affirmative care, the social, medical and
surgical interventions are still based on very low-quality evidence. The many
risks of these interventions, including medicalizing a temporary adolescent
identity, have come into a clearer focus through an awareness of detransitioners.
The risks of gender-affirmative care are ethically managed through a properly
conducted informed consent process...
Sixty years of experience providing medical and surgical assistance to
transgender-identified persons have seen many changes in who is treated, when
they are treated, and how they are treated. Today, the emphasis has shifted to
the treatment of the unprecedented numbers of youth declaring a trans identity.
As adolescents pursue social, medical, and surgical interventions, health care
providers may experience unease about patients’ cognitive and emotional
capacities to make decisions with life-changing and enduring consequences. An
unrushed informed consent process helps the provider, the parents, and the
patient.
Three issues tend to obscure the salience of informed consent: conspicuous
mental health problems, uncertainty about the minor’s personal capacity to
understand the irreversible nature of the interventions, and parental
disagreement. Physical and psychiatric comorbidities can contribute to the
formation of a new identity, develop as its consequence, or bear no connection
to it. Assessing mental health and the minor’s functionality is one of the reasons
why rapid affirmative care may be dangerous for patients and their families. For
example, when situations involve autism, learning disorders, sexual abuse,
attachment problems, trauma, separation anxiety, previous depressed or
anxious states, neglect, low IQ, past psychotic illness, eating disorders or
parental mental illness, clinicians must choose between ignoring these
potentially causative conditions and comorbidities and providing appropriate
treatment before affirmative care. "
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Detransition-Related Needs and Support: A Cross-Sectional Online Survey
https://www.tandfonline.com/doi/full/10.1080/00918369.2021.1919479?src=recsys
"The aim of the present research was to examine detransitioners’ needs and
support. The four categories of needs (psychological, medical, legal and social)
that were created for sake of clarity in the survey were a simplification of the real
complexity of the experiences made by detransitioners and they have their
limitations. Nonetheless, these categories enabled the current study to uncover
the fact that most detransitioners could benefit from some form of counseling
and in particular when it comes to psychological support on matters such as
gender dysphoria, comorbid conditions, feelings of regret, social/physical
changes and internalized homophobic or sexist prejudices. Medical support was
also found to be needed by many, in order to address concerns related to
stopping/changing hormone therapy, surgery/treatment complications and
access to reversal interventions. Furthermore, the current study has shown that
detransitioners need spaces to hear about other detransition stories and to
exchange with each other.
Unfortunately, the support that detransitioners are receiving in order to fulfill
these needs appears to be very poor at the moment. Participants described
strong difficulties with medical and mental health systems, as well as
experiences of outright rejection from the LGBT+ community. Many respondents
have expressed the wish to find alternative treatments to deal with their gender
dysphoria but reported that it was impossible to talk about it within LGBT+
spaces and in the medical sphere.
These accounts are concerning and they show the urgency to increase
awareness and reduce hostility around the topic of detransition among
healthcare providers and members of the LGBT+ community in order to address
the specific needs of detransitioners.”
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This interview provides history you are most likely unfamiliar with, as well as an overlookedcasualty of this moment in time: what about the parents?
Parental Trauma in a World of Gender Insanity