Comment by antiufo | Hacker News Reader

Comment by antiufo | Hacker News Reader

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Trans woman here, both 1) access to HRT for minors and 2) HRT without medical/parental gatekeeping are widely supported positions in the trans community (which I also endorse).

Rationale for 1. It's widely supported by the medical community and by scientific studies, and helps improve the quality of life of people with gender dysphoria.

Rationale for 2. Gatekeeping traditionally consist in telling a psychiatrist anecdotal personal stories about your gender expressions and behaviors. Some psychiatrist hold sexist attitudes, and can prolong your gatekeeping or refuse treatment if you don't tell them a nice tradwife story (always known, only attracted to boys (if MtF) or girls (if FtM), always played with [gendered toy]).

This even has the opposite effect of not wanting to talk with them about genuine doubts, since they can deny you HRT if they don't like your adherence to sex stereotypes.

In the end the trans person themself is more qualified to know whether they would like their bodies to be more masculine or feminine.

(EDIT: added rationales)

Anyone (anyone regardless of anything) who said they believed giving any medicine to a child without parental consent, even implying subterfuge, to me is extremely dangerous and I would pull my child out of any activity/school/club if there was someone there with those views in a responsible role of the children.

For that reason I think attitudes like this do more harm for the trans community than good. If I knew a trans person with these views I would do everything possible to avoid any contact with them and my children.

Abortion is another example where minors are allowed to make decisions by themselves. Which is particularly important when you have politically heated topics like these, where the medical literature and your average parent often hold very different views.

Yes, a medical abortion approved and administered by medical professionals.

I don't think the medical literature suggests taking homemade drugs from strangers on the internet.

When the political reality of the place where you live influences that, I definitely support gray-market solutions. Just like https://abort.lol/ exists for abortion.

You and people like you truly have no idea how much harm you are causing, do you? It is utterly irresponsible to encourage anyone, but a child more than anything, to take this type of medication without medical supervision. Consequences can be extraordinarily dire.

I will refrain from name-calling, but I have never been as angry or disgusted by anyone else on this site.

Edit: I want to make it clear that the dire consequences I'm talking about are NOT feminization/masculinization, nor even common complications of either such as infertility.

Taking uncontrolled doses of hormones, at irregular times, without any kind of tracking of the quantitative effects (blood tests to determine effective levels), especially for someone undergoing puberty, can easily lead to hormone overdoses that can seriously harm pretty much any organ in the body - including at the very least the heart, kidneys and liver. Testosterone and estrogen have many many effects in the body outside of determining sexual characteristics.

Your original post is now flagged/dead (seems hard to justify), so I'll respond here:

How do you make a judgment that some 12 yo kid is more at risk from having to wait for HRT approval due to not being able to find a sympathetic medical professional, vs the risk from being highly suggestible, unable to sensibly judge that HRT is the right solution and consequently causing permanent change to their bodies (including possible loss of fertility, and a number of other side-effects around blood clotting etc.) as they progress through puberty?

Many, many public schools in the US gave out COVID shots without parental consent. It also seems that several of them are encouraging kids to transition and hide it from their parents - a school in Alaska was recently sued for this.

In the UK vaccinations are not mandatory. However, medical professionals can force treatment (or refuse treatment) based on the medical needs of the child. I don't have a problem with this as some parents kill their child from neglect. I am also not a doctor.

I can't really comment on the US. But thank you for the insight...

Also, if you are in the UK, you should note that "public schools" in the US are government-run schools. Our equivalent of your "public schools" are called "private schools" (EDIT: they are called "private schools" in the US only).

I think the solution of having the doctor manage this kind of thing is a lot better than what happens in the US.

In the UK we would also call a public school a private school. Our free schools could be any number of things: a state school (secondary or primary), a college (usually 16-18 but a secondary (11-16) can also be a college), 6th form (16-18 only), grammar school (you have to pass exams to get into), high school (an americanism used in some places in the UK), academy (a secondary school with a different funding model from the government). All very confusing! I think the safest bet is to just call the free schools "secondary school" and the private schools private or public schools.

> I think the solution of having the doctor manage this kind of thing is a lot better than what happens in the US.

I think it is difficult as in the US medical care is mostly privatised.

You cannot sue a doctor in the UK, you would sue the trust (a collection of hospitals in a geographical area). So if a doctor needs to force treatment on a child and the parents refused it would go to a board who would approve or deny it. All children (and adults) will receive treatment for free, so there is also no gotchas about who is going to pay.

> HRT without medical/parental gatekeeping are widely supported positions in the trans community

It's a widely supported position of the trans community that minors should have access to home-made HRT without any quality control or regulation?

Because honestly, I feel like if you're taking hormone replacement therapy you want some kind of guarantee of quality.

This was the first time I heard about "homemade" HRT. But proper HRT can be easily bought on online pharmacies. An index of them is available for example at https://diyhrt.wiki/ or https://hrt.cafe/

For some trans people, the alternative is no gender-affirming care at all, which tends to lead to bad health outcomes (e.g., suicide).

To be trans is to live on the edge of the law and on the very cutting edge of biopunk medical science. A lot of shit is off-off-off-label, where there are no guarantees of quality, but something is better than nothing which is what you'd get if it were up to your parents and doctors.

The alternative is the come to terms with one's sexuality, just like everybody else. In other words, in most relevant cases here, to come out as a gay man.

"Can you just not be confusing and ignore what you want to do with your life? That would mean the world to me."

This is what you said.

Well, you're just wrong then, and the behavior you are encouraging is literally illegal in most of the world.

And beyond legality, kids self-administering HRT with neither parental nor medical supervision is a truly scary thought. It is certain to leave most with significant health issues, that no amount of good will will help them solve.

What is supported by medical literature and law/bureaucracy are not necessarily aligned. Abortion also faces this problem.

Ideally yes you would want a GP to prescribe you HRT. But if in the place where you currently live this is not possible without years of gatekeeping, or parents have veto power, gray-market solutions are the next best possible alternative.

I very much doubt you'll find any piece of medical literature supporting the idea that it is better for a child to self-medicate on complex drugs like HRT then it is to wait until they are legally able to ignore their idiotic parents and move out to a state that actually cares about their well-being and happiness. Not to mention, HRT is not at all recommended for children, puberty blockers are.

I fully support the right of children to receive puberty blockers to help them achieve a smooth transition when they are old enough to fully understand the consequences. I bemoan states and parents that seek to harm trans children by refusing them access to this type of treatment, and others. But slef-medicating as a child is in absolutely no way an acceptable replacement. Being a non-passing trans adult, as bad as it is, is likely to be much much better than the harms you expose yourself to by accidentally overdosing on hormones as a child.

What is the difference between "medical gatekeeping" and requiring a prescription? Because over-the-counter hormone therapy (regardless of the intent or reasoning behind it) seems like an all around bad idea.

Nothing bad per se in requiring a prescription. What I'm talking about is the multiple psychologist/psychiatrist sessions where they get to decide whether you are allowed to start HRT mostly based on your adherence to sex stereotypes.

I also read a lot of the kiwifarms thread after this latest news, and it seems like there are a lot of trans people on that thread, so at least a slice of the trans community disagrees. This may be a popular position among trans activists and the Twitter crowd, though.

Your post, even with its edits, is gross. However, I must thank you for providing your words so that I may show my own two children about the dangers of belief systems such as yours.

Go for it. As a trans person who grew up with abusive parents who beat me instead of helping me with my gender identity, I wish I'd known of a way to start hrt sooner so I don't have to suffer now as a non-passing trans person.

But as they say, the cruelty is the point.

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