As I was writing this essay, I thought it was way too obvious, and that I would not end up publishing it. After all, who doesn’t realize that a healthy body is important in life? This notion is the furthest thing from a novel or controversial concept that I could think of. Yet I am still compelled to publish it, because I am concerned that the most obvious and undisputed ideas are the ones that are being thrown under the bus in the age of faux kindness and pretend activism. Here goes.
Nowadays, it seems that a healthy body is not a priority. There seem to be many over-riding goals that supersede the preservation of our health. For instance, if somebody is stressed or emotionally upset, it’s of supreme importance to sooth the emotional pain, even if that requires treatments that may cause serious effects and side effects, detrimental to physical health.
The most concerning of these “treatments” for emotional distress is related to sex - male or female. It is becoming more and more common, acceptable, and even laudable in today’s society, if someone is uncomfortable with their sex (we call this “gender dysphoria”), to immediately, or as soon as practicable, provide medical interventions to remove the offending sex characteristics, such as breasts, periods, and female voice patterns in biological females, or testicles and penises, flat chests, and body hair in biological males. This applies not just to adults, but also to pubescent teens, starting at Tanner Stage II of puberty (an early stage of puberty, reached by girls around age 11 and by boys around age 12). A large majority of these young people are either on the Autism spectrum, suffer anxiety or other mental health issues, or are homosexual and/or gender non-conforming, making them more vulnerable than the average teen (who is somewhat vulnerable based on age).
For younger children, we do not - because we cannot - engage in any medical interventions. However, we engage in extreme social interventions by assuring children - starting around age 3 or 4, who express dissatisfaction with their biological sex, or who declare that they are actually the opposite sex - that they are “really” the opposite sex. We also make everyone around them agree to keep up the pretense. These children are guided by the adults in their lives to believe that they should never grow up to be the sex they are. Instead, as they approach puberty, perhaps around age 9 or 10, we explain to them that they will soon have medical interventions to assure that they will never appear as the sex they are, but can appear as if they are the opposite sex, the sex we all pretend they are. Thus, while we do not medically intervene in children before Tanner Stage II, we set the scene for the inevitability of those later medical interventions with our words and our actions.
The question I pose is whether a healthy body deserves to be prioritized. Personally, I believe it does. After all, we only have one body for our entire life, and, when it has health problems, they can prevent us from accomplishing everything else in life worth striving for. For example, when treatments for discomfort with biological sex render individuals sterile, as these treatments often (but not always) do, they make it impossible to have biological children. While not everyone wants to have biological children, a large majority of people do want this at some point in their lives, and most individuals who have and raise children find the experience to be one of the most rewarding parts, if not the defining experience, of their lives. Granted, adoption is a wonderful and valuable experience as well, but that does not mean the ability to have biological children is not important or should be sacrificed simply because someone is having difficulty accepting one’s biological sex.
Further, the time-consuming and energy-consuming nature of medical transition itself prioritizes the elimination of emotional distress over a healthy functioning life. This is particularly true when transition is accompanied by medical complications such as infections from surgeries, brittle bones, strokes or heart attacks, cancer, or chronic pain. However, even without those complications, these medical interventions require a certain devotion of time and energy - to schedule, experience and recover from surgeries, or deal with increased doctor’s visits to monitor hormone levels. The mental energy devoted to keeping up the pretense that one is the opposite biological sex also must be noted. Name changes, erasing photos, deciding who can meet who from one’s past, whether one’s family home has “evidence” of one’s biological sex - all takes mental energy and time, and inconveniences the transitioning individual, as well as family members.
But the most important point is that, in prioritizing a desire to reject one’s “problematic” biology, the body is looked upon as something to manipulate at will, with little regard for the obvious potential to harm and weaken it. This seems, to me, a foolish endeavor that ignores the fragile nature of life itself, as well as the benefits of a healthy body. With a healthy body, we can accomplish everything from artistic creations to intellectual pursuits to caring for others. Health challenges will always inhibit our ability to accomplish these pursuits. A shortened life will also negatively impact our ability to accomplish our life goals. Furthermore, simply enjoying a walk in the park, or a nice meal can be severely impaired by the existence of health issues, pain, mobility problems, etc.
An analogy to our treatment of Earth seems appropriate here. Quite clearly, we - people - have often failed to prioritize the health of our planet, instead prioritizing convenience. We want cars, consumption, luxury, profits. Sometimes, this makes us forget what we are destroying. Like our bodies, Earth is resilient, but not without its breaking points. Holes in the Ozone Layer are difficult to repair. Very few people would argue that we should ignore Earth’s health in favor of temporary convenience. We need to strike a balance, and have been failing at that in recent times. Most people agree that this is concerning and that we have to reconsider our lifestyles in order to prioritize the health of our planet. We now bring re-usable bags to stores, recycle old bottles, cans, paper products, and plastic containers. We are questioning things like fracking, and we are trying to use renewable energy instead of depleting the planet of fossil fuels.
Yet the same people who would march with Greta Thunberg to protect our Earth will march to allow, and even encourage, vulnerable teens and vulnerable young adults like Greta Thunberg (who is on the autistic spectrum) to destroy their bodies, removing healthy tissue, filling their bodies with toxic levels of synthetic hormones, simply because they don’t currently feel comfortable with their primary and/or secondary sexual characteristics. For some odd reason, we have decided that the known fact — that children and teens, and particularly those with mental or emotional issues, are fickle, are often uncomfortable with their bodies and their social roles, and will grow and change well into their 20s, if not beyond — somehow does not apply to “gender.”
We take teenage emotional discomfort and elevate it to a level of importance that it has never seen before. We are literally cutting off body parts and chemically altering these young people’s appearance simply to assuage discomfort with their sexed bodies. We as a society are simply shrugging our shoulders at the consequences these treatments have on these young healthy bodies, including bone density issues, increased chance of stroke or heart attack, increased risk of cancer, infections from experimental surgeries, and sterility and sexual dysfunction - and those are the known detriments. We don’t even know what other problems we are courting with these experimental treatments, - but apparently, we don’t care.
It is worth noting that these medical interventions are not only an assault on the healthy bodies of the young vulnerable individuals expressing distress over their sex. These treatments are also a diversion of our limited medical resources from those who truly need intervention - those suffering actual medical ailments, like cancer or the loss of a limb - to those who are simply having an emotional reaction to the difficulties of life. Apparently, it is common for health care providers to fudge the reasons for these medical interventions (categorizing the provision of synthetic cross-sex hormones as “medication management,” for example) in order to get insurance to cover the treatments. The more insurance companies have to pay out for these interventions, the more difficult it is for those with actual medical ailments to receive the treatments they need to be healthy or as close to healthy as they can be with whatever ailments they have. Why this type of insurance fraud is considered acceptable is beyond me. I assume it’s because these medical providers believe these interventions are “life-saving,” even though there is not one shred of evidence that this is true (a subject for another essay).
As usual, I would ask the reader what I am missing here. Is there any reason we should not protect the health of young bodies, but should instead immediately satisfy the emotional urge to be seen as the opposite sex? Is our health really something to be sacrificed in exchange for the quelling of anxiety over our sexed bodies? Does this make any sense at all?
I will end this by paraphrasing my mother, who died after a long battle with Parkinson’s Disease. She would often say to me: “If only I could just feel normal, without pain and discomfort, my life would be so wonderful.” If only we could all appreciate this sentiment, and be thankful for a healthy body, life would be so wonderful.
I know this is an older post, but I just saw it. I definitely agree with your points insofar as I think there needs to be a lot more space for time and consideration and a slow process built into gender transition in general and especially for minors and young people, particularly those with other mental health challenges.
Here's where I struggle with this idea myself: at some point, if a person is tormented by mental ills, a healthy body is irrelevant because they can't use and enjoy it, and in some cases their mental illness will destroy it-completely, in cases of suicide, but also partially through substance use, inactivity, eating issues of all kinds, and so on. Having worked in health care for years, I've see that serious mental problems can be just as debilitating as physical problems. I've also noticed that there is a tendency among those who aren't the patient to look at mental problems with sort of a "just get over it and move on" type of attitude that generally isn't extended to physical issues, even those that have a behavioral (issues that worsen with inactivity) or psychological (such as pain of any type and especially chronic pain) component. (Please don't jump on me! I'm NOT saying pain is in people's heads, at all! But there is significant proof that pain of any kind is absolutely influenced by psychological aspects, which is why certain types of psychotherapy are among the primary modes of treatment for severe and-or chronic pain). My observation-including in myself-has been that people who aren't dealing with a given mental issue often have great difficulty empathising with those who are, and often believe that the person has control over their mental state more than they really do.
So, it seems to become a slippery slope. I can see, to an extent at least, how some mental health professionals advocate so much for patient self report being the primary means of diagnosis. Because, that's really the best tool they have for any mental illness, even things like schizophrenia. (There are certainly cases where people fake symptoms of psychosis for various reasons, usually secondary gain, but I don't think too many people would argue that we should thoroughly investigate or interrogate someone claiming to hear voices commanding them to hurt someone before treating them.) Certainly there ARE cases where patients will deny such symptoms yet are still obviously disabled. But when patients report any symptoms, it's quite difficult to "disprove" it, not to mention severely damaging for the majority who actually do have the symptoms they report.
The reason this relates to what your saying (brevity is not my strong suit and I'm so sorry) is that medical treatment for any mental illness causes physical side effects, many of them serious. Antidepressants are known to cause increased suicide risk at the start of treatment, especially in young people. However, once that was publicized widely and prescriptions dropped for young people, the suicide rate in that demographic actually increased, possibly because people who needed the treatment weren't getting it. ECT can cause permanent and significant memory loss, including of things like one's wedding day or the birth of one's child. It also can bring someone out of a catatonic state, in which they can't interact with anyone including their spouse or child. It's difficult to balance these risks and easy to say "well, if he wanted to snap out of it, he could!" because we can't SEE any cause that is preventing the person from improving. Antipsychotics cause tremendous weight gain and all the problems that go with it-cardiac, metabolic, orthopedic and so on. They also can cause permanent abnormal facial movements that persist even if the med is stopped. Again, it's very easy for people who love the patient to think "well, he just needs to understand that the voices aren't real! Then he won't need to suffer all those physical effects!" But the voices ARE real, to the patient. And they're often much more disabling than the physical problems. (I do think part of the reason for that is that we generally have a much better approach to management of chronic physical illness than chronic psychiatric illness, but that's a different topic).
So it's difficult for me to balance my own sense that many people with gender issues, especially those who are young and whose issues are relatively recent, could use more time and introspection before jumping into any physical modifications, with my observation that for whatever reason many people with mental difficulties of all kinds simply seem to be unable to overcome them without some form of medical intervention. Along with the observation that the patient is typically the best source of information about what is going on with them, physically but especially mentally. I haven't yet figured out how to reconcile all that.
Thanks for letting me share my thoughts.
There really needs to be more research done on the health effects of gender "care," especially on chronic pain. The population seeking these treatments has higher rates of trauma and emotional distress, which are huge risk factors for chronic pain. I would not be surprised if the majority end up in chronic pain after hormones/surgery. That is something patients needs to be warned about (informed consent!!), and parents need to be aware of before they start down this path. Even if we believe the lie that the treatments will solve emotional problems in the long term, if it's a trade off of chronic physical pain is it really worth it?