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So, again, for starters: none of that is mutilation, just regular surgery.
Second, right there in the guidelines: this is the section for adolescents. Children is section 7. When your actual source makes the distinction between kids and teenagers, I feel like it's a bit disingenuous to keep calling them "kids"
Third, that's the section on "treatments requested by the patient". It's not putting someone on a path when they are already on that path and merely asking for help.
I don't see how this is different from anyone else trying to get medical treatment for their illness. Would you be horrified to learn that we also let children be treated for cancer and depression? Should there be a minimum age for those, too?
There is nothing "regular" about surgery to remove healthy organs and tissue with the ultimate goal of ameliorating psychic distress. You're welcome to defend this practice, but don't pretend it isn't a major departure from the common practice of surgery as generally understood.
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Unnecessary surgery that removes healthy body parts is mutilation, as are unnecessary hormonal treatments.
When people say "kids" they mean "minors", performing these treatments on even younger children is even worse, but a mastectomy performed on a 16 year old girl is still atrocious.
No one cares, the patient is a minor that doesn't know anything about what they're talking about.
There is no evidence that any illness is involved. The only criteria necessary to get a dysphoria diagnosis is:
Say you're trans
Don't change your mind for a few months
Even those loose criteria aren't always followed.
Cancer has proper diagnostic criteria, so no on that, but if a doctor insisted I have to give drugs to 14 year old for "depression" (or "anxiety" or ADHD) I'd find it absurd.
Probably. Psychology is very unrigorous, and we should not let these kind of doctors make decisions about children, that go against the wishes of parents.
I certainly didn't think it was unnecessary. What makes you the expert here?
That might be believable if there was a huge number of people who regretted these decisions, but people actually seem pretty consistent. I challenge the idea that a 16 year old doesn't have any idea what they want - 16 is young enough to be tried as an adult or apply for emancipation. In most states, two 16 year olds can have sex, get pregnant, and have a child - a massively life changing decision that involves significantly more severe medical risks. We even allow kids to drive! Traffic accidents are one of the top ten leading causes of death, but we trust kids with it.
Are you saying that's all a mistake? We need to keep kids away from any sort of responsibility or freedom until they're a legal adult?
There's plenty of evidence that this intervention results in positive outcomes. You're talking to one of the positive outcomes right now. I'm not sure what else to call it when you do a medical intervention and it fixes a problem?
I think the burden of proof is on the person arguing for the removal of healthy body parts, and the arguments haven't been convincing.
There is a decent amount of people loudly regretting these surgeries, and there are obvious reasons for why others might not want to do it so loudly - the ones that did come out have been rather ruthlessly attacked. I don't know how you determine that people seem consistent, there isn't good long-term data on the outcomes of these interventions, particularly on the new cohort of patients that showed up around 2015.
All of these require extraordinary circumstances that need to be argued in front of a judge. 16 is not enough to vote, not enough to drink a beer, and not enough to sign a contract without the parents' consent, not even enough to get a tattoo. All of these things are far less risky than any part of gender-affirming care, except social transition.
At 16 you're either still going through puberty, or barely out of it. You're still figuring out basic things about your place in the world.
The long-term consequences of pregnancy is precisely why this behavior is discouraged in teenagers. People with my worldview even discourage sex outside of marriage, even if it can be reasonably assured it will not result in pregnancy, and that's regardless of whether we're talking about teenagers or adults.
That said, the big differences is that sex resulting in reproduction is part of the healthy life-cycle of any sexually reproducing species on this planet, not a medical intervention. A better analogy here would be a 16 year old going through IVF, and in that case I'd say it's absurd, and any doctor encouraging it has no business in medicine or psychology.
You need to pass a test proving you're competent, and that you understand the rules of the road, in order to be allowed to drive. The high amount of deaths is a result of the raw number and frequency of people driving, rather than the risk to the person once they make a decision to drive with a car.
No, like you see, I think most of these are bad analogies. These examples also conveniently ignore the far less consequential things we do legally forbid teenagers from doing.
There actually isn't. The evidence for positive outcomes if often inconclusive, where it's positive it's low-confidence. The lack of long-term follow up is endemic in the literature.
People also swear on the effectiveness of homeopathy, crystal healing or reiki, but that is not enough to declare these therapies as effective. There are people who seek out exorcists, and likewise swear that it helped them, but we don't usually take that as evidence of demonic posessions.
When it comes to physical illnesses we have developed a robust protocol to assess effectiveness. The fact that physical ailments are externally verifiable - so we can tell that the patient has it and isn't just imagining things, or is free of it and the treatment actually worked - is of great help. None of that is available for psychological issues, and so the evidence tends be pretty poor. Even for non-political issues like depression you often end up with stuff like "oops, our miracle drug turns out to be no better than placebo".
Things get even worse when body image issues are involved. An anorexic is going to report satisfaction from losing weight, but we tend to not accept that as a valid reason for going along with their decision.
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What if the parents are wrong?
Not much.
Even in cases involving rigorous medicine, where we can be near-certain that a doctor is correct and the parents are wrong, informed consent and parental authority are recognized as necessary. Psychology is nowhere near that level of rigor and certainty, so I don't know on what grounds you wish to overrule parental authority or ignore the lack of informed consent from the child.
On the grounds that a child or adolescent is not the property of their parents, because they are a human being, and a human being cannot be the property of another human being (Grant v. Lee, 1865).
I never said that they are, so I don't see how that implies a psychologist should get to overrule them.
Generally we allow people to refuse treatment, even if that will have negative consequences for them. We also generally recognize children lack the maturity to make long-term decisions, so we grant the power to make medical decisions about them to their parents (or whoever has custody of them). Even with adults, if someone is unconscious, it's their next of kin that generally make medical decisions for them, not the doctors. None of that implies owning another person as property.
Also how consistent are you with "rightness" overruling parental authority. If the evidence for pediatric transgender care is determined to be very poor, are you ok with a blanket ban on transgender care, even if the child, parents, and a bunch their doctor agree that it's right?
When an adult refuses medical care for themselves, the negative consequences fall on the person making the decision. When an adult refuses medical care for a child, the adult does not experience those consequences.
And there are many examples of that going wrong, usually from parents who think of their children as their property and refuse to distinguish between 'my child's long-term interest/coherent extrapolated volition' and 'my personal preferences/non-universal ideology'.
Because the next of kin is expected to make the decision based on 'what the patient would decide if conscious' and not 'what the next of kin wants'.
Not directly, but usually parents go through suffering of their own when something bad happens to their children.
Sure, but I don't think that's enough to have doctors override the decisions of the parents outside of extreme circumstances.
The bit about personal non-universal ideology is interesting. How is your idea on who should decide the child's treatment not based on your non-universal ideology?
And we give it to parents because we expect them to make the decision the child would have, if they were mature.
So in a case like this, if the parents managed to convince the child that this treatment will help, would you say the state has no right to intervene?
I disagree. For one, it's an impossible standard to go by, because I don't know if we can agree on what's "right" between the 2 of us, let alone between a country of millions of people. But to the point, personally I'd say they have that authority by default, and you need a strong positive argument if you want to take it away.
I kind of see it as both. To the extend positive evidence exists it's low-confidence, and for many metrics it's just inconclusive / not enough to form any opinion. As to the harm, the problem here is that the intervention itself is inherently harmful - surgeries remove healthy body parts, hormones have many side effects, etc. The rationale here is that the benefits of addressing "dysphoria" are balance out the downsides, but I think that's the claim that needs to be justified, rather than skepticism of it.
It might not be a mirror image, but if we're going by "they are usually right" I feel confident in my arguments that such treatment should be denied - children don't know what the hell they're talking about, normie parents mostly trust authority figures like doctors, but some doctors I can only describe as completely ideologically captured (they explicitly say dysphoria is not necessary to transition, and that transition is about expressing yourself authentically rather than treating any ailment) or certifiably insane (one go to example of mine was involved in the Satanic Panic back in the 90's, and now writes / gives talks about "gender angels" and hands out blockers to non-verbal autists), and the most prominent world-wide association of gender-care specialists has been caught red-handed hiding evidence that doesn't go their way.
I personally feel very strongly that treatment under these circumstances is wrong, but I don't know if I have the authority to step in here and tell people what treatment is right for their child. But since we're not living in the libertarian utopia where parents decide for themselves, I see no reason why I shouldn't lobby that my values are implemented.
That's not the same thing.
But often they don't make the same decision their child would have if mature. Many parents attempt to override their child's decisions even after their child is mature.
No, I think that clears the higher bar.
On the other hand, if a child, upon finding out that meat is made out of dead animals, desires to adopt a plant-only diet, and their parents approve, I would not override their decision, even though many non-Adventist-influenced experts doubt that it is wise.
They said the same thing about kings once....
As above, so below.
But they aren't deciding for themselves! They are deciding for another person! In the purest form of libertarianism, the child would decide everything for themselves.
I am not advocating for pure libertarianism, but that is what I mean by 'your children aren't your property.' The base state isn't parents having absolute power over their children, it's them having no authority whatsoever. All power accorded to parents is a creation of society.
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