Girl/Boy Interrupted

transflag

Last week’s San Francisco Weekly carried an absolutely fascinating article by Lauren Smiley about the use of the drug Lupron to interrupt puberty (reversibly) in transgender children. Lupron is used to “pause the child within,” as their advertising slogan goes. Its on-label (FDA-approved) use is to delay puberty in what’s called “precocious puberty,” that is, early-onset.

There are a number of interesting aspects to this very thorough article, not the least of which is that of the emotional damage that can be done to trans kids who are made to wait until the “appropriate time” to begin hormone therapy — that is, when they are “old enough” to consent, as far as the culture is concerned.transsymbol.jpg

For MTFs, that “appropriate time” would usually mean after testosterone has made irreversible changes to the kid’s body, all but guaranteeing she’s going to have a harder time passing in later life. For FTMs, it means losing some potential height gain, which would also be irreversible.

However, exogenous hormones also cause irreversible changes, so the decision being made is — again — irreversible. Lupon apparently allows some wiggle room, in which the development of puberty can be delayed, but not curtailed.

One thing that’s NOT dealt with in the article is whether the delay of puberty with Lupron might affect sexual functioning in later life — and by sexual functioning I mean specifically erotic functioning, which is something a lot of doctors seem to conveniently forget that a lot of trans people are, you know, kinda into, not unlike the rest of us. I was troubled by this omission, but it’s a very long article, and very complicated, so I’m going to cut Smiley some slack here.

I asked her by email whether she’d asked about sexual pleasure in her interviews with physicians. Her reply, after making sure that I would remind anyone that she is not an authority on this, and simply hypothesizing here:

“I didn’t inquire about sexual pleasure but I’m guessing the puberty delaying drugs themselves wouldn’t have an effect on pleasure or orgasms, since they eventually do go onto cross hormones and sex change surgery. So I’m guessing they’d experience sexual pleasure as much as any post-operative transexual. One guy did tell me that by having gone on puberty blocking drugs, the penis stays at a childlike size, and thus provides less material with which a doctor can construct a vagina — I wonder then if there’s less sensitive tissue that would help them to climax. I’m completely out of my element…I focused on the transition period, and no little about the surgeries themselves or the post-op period.”

So there you have it — an open question, and a very important one that shouldn’t get forgotten in considering trans youth. I don’t have time this week to go hunting for the answer, but maybe someone out there already knows.

What do you think about using pharmaceuticals to delay puberty in trans kids? Whether you’re trans, trans-friendly, cisgendered, ungendered, degendered, bigendered, multigendered, or a trans-hostile who thinks everyone who discusses this is going to Hell, please weigh in on this issue. Comment in the comments if you’re outraged, inspired, concerned, or bewildered by trans kids and the biocultural and pharmaceutical options opening up to them.

Transflag and Trans Symbol from Wikipedia.

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