Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A physician is worried about gender transition in pediatrics

Julia W. Mason, MD
Conditions
October 7, 2019
3K Shares
Share
Tweet
Share

My first transgender patient was a teenager who said although he was born female, he’d protested his gender from the time he could talk. He told a story of being asked, “Well, if you are a boy, where is your penis?” and he pointed to his umbilicus (which was an “outie”). OK, no problem, we have a gender clinic I can refer you to.

When he came back and asked for help with the testosterone injections, we did that gratis (he had Medicaid, and it didn’t cover us injecting his testosterone.) That young person has been on testosterone long enough to have an unwanted side effect — stress incontinence. I prescribed topical estrogen, saying, “You have the urethra of a 70-year-old woman at this point.”

My second transgender patient came in with their mother, explicitly looking for a referral to the gender clinic. Also female at birth, but not as convincing, to me. However, mom was on board, and they had made up their minds, so I gave the referral. That one went on testosterone during their senior year in high school and got “top surgery” (a double mastectomy) during the summer before college.

They now hang out with a whole crew of trans-boys at college, joking about how they all have the same voice. (A female voice deepened by testosterone seems to end up sounding similar to other FTM voices most of the time.)

My third transgender patient was only 12, and the parents were split on what should happen. The dad was sort of like, “OK, I’ve got a son now — neat.” The mom was horrified. They brought their daughter to a gender therapist, and this therapist gave a gender dysphoria diagnosis within the first five minutes of the first session with the patient. The therapist gave a referral to the gender clinic, and “puberty blockers” were recommended. This didn’t happen. The mother had been doing some research into the side effects of puberty blockers, like Lupron, and this information changed dad’s mind.

The child has made a social transition (like multiple students at their school), but medical treatment is being put off for a few years. However, this kid recently told me that their FTM friend who moved to Los Angeles is being started on testosterone soon, age 13 in eighth grade.

My fourth transgender patient came in with her mom and little brother. She has a diagnosis of ASD but is high functioning. She is homeschooled and spends a lot of time online. I got her mom and brother out of the room and asked her what her goals were: did she want a beard? Oh no, she didn’t want a beard. Did she want a deeper voice? Yes, she would like a deeper voice. Also, she’d very much like to be taller. After I explained that medicine couldn’t make her taller (she was Tanner 4) and testosterone causes beardiness and acne in most, she decided she’d be happy with just working with a speech therapist to change her voice.

I’ve learned that if I refer a patient to the gender clinic, they are going to get the maximalist treatment. They’re not going to get any help figuring out if they really need the full medical/surgical transition. I am now wary of referring to the gender clinic. I’ve learned that there are hundreds, probably thousands of “detransitioners.” Many of them can be found at Reddit/detrans, which got up to 5,000 members in just 22 months.

I’m worried about the rapidly rising numbers of children being diagnosed as transgender and being treated with hormone blockers, cross-gender hormones, and surgery.

Julia W. Mason is a pediatrician.

Image credit: Shutterstock.com

Prev

A simple way to add empathy to primary care

October 7, 2019 Kevin 1
…
Next

What to know about C. auris, the deadly fungus affecting our sickest patients

October 7, 2019 Kevin 0
…

Tagged as: Pediatrics, Primary Care

Post navigation

< Previous Post
A simple way to add empathy to primary care
Next Post >
What to know about C. auris, the deadly fungus affecting our sickest patients

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • Close the gender pay gap in medicine

    Linda Girgis, MD
  • The black physician’s burden

    Naomi Tweyo Nkinsi
  • Why this physician supports Medicare for all

    Thad Salmon, MD

More in Conditions

  • 5 things to know about weight from a bariatric surgeon

    Maria Iliakova, MD
  • Physician autonomy and patient interactions in corporate health care

    Michele Luckenbaugh
  • Vague criteria can lead to misdiagnosis and prison

    L. Joseph Parker, MD
  • U.S. maternal mortality crisis: a deep dive

    Alan Lindemann, MD
  • Contemporary weight loss: Unveiling the quest for elusive elixir

    Osmund Agbo, MD
  • Why patients write: stress relief, self-care, and sharing experiences

    R. Lynn Barnett
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • Balancing motherhood and medicine [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Misunderstandings about opioid use disorder

      Amy Baxter, MD | Conditions
  • Recent Posts

    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • 5 things to know about weight from a bariatric surgeon

      Maria Iliakova, MD | Conditions
    • Out-of-office infusions in oncology care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of business knowledge for medical professionals

      Curtis G. Graham, MD | Physician
    • Using the language of art to create work-life balance

      Sarah Samaan, MD | Physician
    • Levamisole is good for your dog, but bad for your cocaine

      Robert Killeen, MD | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 23 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • COVID Drug and New Mutations; Costco Offers $29 Care; Trump Unmasked Over Bronzer
  • Long COVID Rare in U.S. Kids, Has Affected 7% of Adults
  • Vascular Conditions Offer No Clarity on Pollution-Dementia Link
  • FDA Staff Voice Serious Concerns About Investigational ALS Cell Therapy
  • Primary Prevention Benefits of Lowering LDL Also Apply to the Elderly

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • I’m tired of being a distracted doctor

      Shiv Rao, MD | Tech
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • Balancing motherhood and medicine [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Misunderstandings about opioid use disorder

      Amy Baxter, MD | Conditions
  • Recent Posts

    • Navigating adulthood in the digital age

      Eleanor Menzin, MD | Physician
    • 5 things to know about weight from a bariatric surgeon

      Maria Iliakova, MD | Conditions
    • Out-of-office infusions in oncology care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of business knowledge for medical professionals

      Curtis G. Graham, MD | Physician
    • Using the language of art to create work-life balance

      Sarah Samaan, MD | Physician
    • Levamisole is good for your dog, but bad for your cocaine

      Robert Killeen, MD | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A physician is worried about gender transition in pediatrics
23 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...