generalspeaking

Monday, January 21, 2019

Male Mind, Female Body : Remedy?

Still from short film BOY

"I just want to do what's best for Max. And sometimes that's tough love."
"I have no animosity toward Sarah on this issue. I think we both believe we are doing the right thing. And I believe we both have Max's best interest in mind."
"I thought it was a long process and nothing drastic was going to really happen, at least without consent."
"You don't just jump them into things they can't change back. When she's 18 and she does it, I'll support her 100 percent."
"What if?"
Clark, father of daughter/son (identities withheld)

"I have a male brain that doesn't match up with the body I'm in. It's like being trapped in a cage."
"It just kind of clicked right away [after watching YouTube video "Boy" while in Grade 7]."
"Even if I'm open with who I am, I'm still insecure."
Max, 14, Grade 9, Surrey, British Columbia

"I didn't quite understand transgenderism myself, didn't know if I fully believed in it. But having gone through the experience, I've gone through with my son I fully believe that yes, it is very possible that transgenderism does exist and there are people wandering around feeling excruciatingly uncomfortable in their own skin."
"If this [testosterone injections] is what alleviates my child experiencing this dysphoria, I'd rather move forward. ... If it happens to have side effects down the road, we're OK to handle that -- at least our child would still be alive."
"I don't want it on my conscience knowing that if this is all it took to alleviate that dysphoria from my child then why didn't we follow through with it?
Sarah, Max's mother

"Max's health care team has concluded that he possesses sufficient maturity and intelligence to be capable of consenting to his own medical care, notwithstanding the fact that he is only 14 years old. Furthermore, the team agrees that the proposed course of treatment is in his best interests."
"Under these circumstances we are of the view that it is ultimately up to Max to give or withhold consent to is own medical care; neither you nor his mother can make this decision for him."
Letter to Clark, Max's father, from B.C. Children's Hospital

"I have seen in some circumstances ,,, where young people have had health care delayed and denied because everybody wasn't on board. One parent is supportive, and one is not, and nothing happens. That can be a problem. If the clinicians, the psychologists, the endocrinologists, the family doctor, if all of them have done the assessment and have determined that this is medically necessary, then it's important to actually pay attention to the expertise."
Elizabeth Aaewye, professor, UBC school of nursing

Some enterprising researcher who may have doubts about the new open and accepting attitude of medical professionals toward accepting a child's confident assertion that they are not in fact, a girl despite having been born female, or a boy, identified as such at birth -- but in reality a member of the opposite sex yearning to be recognized as such and anxious to be given medical treatment to make the physical transformation to match their psychological belief -- should begin interviewing women of all ages to ask whether such gender-identification confusion ever resonated with them.

It would, without doubt, be recognized that a good proportion of girls in their early years fantasized being a boy, imagining how much freedom it would confer upon them to do things that boys do so effortlessly and so physically well coordinated, in rebellion against the cultural confines they struggle against as girls. The same would be true for many boys who resent the expectation that they will do
manly things and behave in a manner that fails to suit their personalities, imagining that pressure would be relieved if they were girls instead.

Children are suggestible, hugely so, and their imaginations can run rampant into fanciful territory. We are a species never quite satisfied with who and what we are, seeking to portray ourselves differently to reflect what we would prefer, and at the same time we are attention-seekers, wanting to stand out in the crowd, generally to be admired, even if it takes a leap at non-conformity in rebellion to do so; we see ourselves as individualists so often, entitled to insist on having things our way. Who is it that can claim with complete confidence that children are not in fact gender-confused psychologically and briefly as part of maturation?

The general scientific, medical consensus seems now to have succumbed to the confidence in belief of a biological mismatch between ego/personality and birth presentation in gender. This is not now seen as a type of brief psychosis, but rather a biological error in need of intervention by medical science to remediate an error that nature produced. And if this doesn't represent a confusion of medical arrogance and layman effort to salve an emotional conundrum afflicting a steadily increasing group of people for whom transgenderism has become an escape from their reality in life, what else is it?

Max, all of 14, born a girl, feels she is a boy and insists she must live out her life as a male. Her/his mind is settled on self as male and all that is now wanting is to convince her father just as he was successful in convincing his mother, and undergoing treatment to transform his voice, his physique and confer upon him the male characteristics that she so fervently wishes to acquire. All the medical personnel consulted agree with that candidacy, as does mother Sarah, but father Clark is the holdout. The parents are separated, with joint custody and a provision in the custody agreement that both must agree on any issues of substance.

Clark and Sarah must jointly exercise "all parental responsibilities" inclusive of "giving, refusing or withdrawing consent to medical, dental and other health-related treatments for the child", reads their legal document. Despite which the B.C. Children's Hospital invokes the B.C. Infants Act to insist that as long as a health care provider is satisfied a child understands the nature, consequences, benefits and risks of the proposed treatment and concludes that the treatment is in the child's best interests the right to consent "belongs to the child alone".

Max was assessed a half dozen times over a period of several months starting in Grade 8, by a clinical psychologist. When those sessions ended, the psychologist considered Max a good candidate for testosterone therapy, for Max demonstrated to the psychologist a "long-lasting and intense pattern of gender non-conformity or gender dysphoria" among other issues related to the matter at hand. Sarah and Max went to the B.C. Children's Hospital's gender clinic, reputed to be one of the busiest in North America.

They met with a medical team that included a paediatric endocrinologist, a social worker and a nurse. All described the treatment that Max would undergo. On a three-page "informal consent form", the risks of testosterone therapy were laid out. The "treatment in young adolescents is a newer development, the long-term effects of which are not fully known". Testosterone use would lead to permanent changes; a lower-pitched voice, facial hair and thicker hair on arms, legs and torso, that would prevail even should treatment be stopped.

Testosterone treatment could lead as well to an elevated risk of heart disease, stroke and diabetes. "It is not known", according to the consent form, what the effects of testosterone are on fertility. "You may or may not be able to get pregnant in the future". Max, said his mother, was definitely not undergoing some "phase". Staff at the hospital were prepared to initiate injections that very day, but Sarah felt it incumbent upon her to advise Max's father who was shocked at the swiftness of the conclusion.

He refused his assent on the basis of the information on the form. A court hearing has ensued. Clark's lawyer speaking for his client advised they take the position that Max not be rushed into treatment, that no injections should commence until such time as both parents agree to consent, or Max turns 18, or the court orders treatment to proceed. The judge, in hearing the details felt he had never encountered a case quite like this before in his career.

He was not aware whether provincial law recognizing Max's rights to give informed consent trumps family law and the parents' joint responsibilities in care of their child as per their separation agreement.