Excerpt from "Sex-changing treatment for kids: It's on the rise," cnsnews.com, by Lindsay Tanner. February 20, 2012--A small but growing number of teens and even younger children who think they were born the wrong sex are getting support from parents and from doctors who give them sex-changing treatments, according to reports in the medical journal Pediatrics.
"Offering sex-changing treatment to kids younger than 18 raises ethical concerns, and their parents' motives need to be closely examined," said Dr. Margaret Moon, a member of the American Academy of Pediatrics' bioethics committee. It's harmful "to have an irreversible treatment too early," Moon said. Doctors who provide the treatment say withholding it would be more harmful.
H. Patrick Stern, M.D. Professor of Pediatrics Chief, Section of Developmental/Behavioral ETSU Pediatrics: "Whether they are boys or girls, all children have some qualities of masculine and feminine behavior, with some displaying more evident behaviors of the opposite sex. Animal research demonstrates that animals castrated at birth and given physiological amounts of the hormone of the opposite sex will develop behaviors and physical characteristics of the opposite sex."Our culture promotes immediate, self-centered gratification regardless of the risk to the individual, other people and society. Children should not be given authority to make decisions because they want something; adults should make decisions based on the best interest of the child. Interventions targeted to help children accept their God-given sexual identities can cure what has been identified as a disorder and can teach children that applying biblical principles to manage stress can promote spiritual growth. Physicians sometimes think that they are wiser than God. God does not make mistakes."
Negative Health Consequences of Same Sex Sexual Behavior
I am still prayerfully trying to figure out my viewpoints on many of these issues. The questions I raise are ones I am debating internally, which can be a very uncomfortable battle.
ReplyDeleteWhy is external gender assignment regarded with such finality and believed to be so determined by God that it cannot be altered?
I'm an M1, and the more I've learned about genetics, the less convinced I am that God specifically decided people's psyches match their external genitalia. What really "unconvinced" me was learning of the presence of XX males, Klinefelter's, and Androgen insensitivity disorders, to name a few. Genetically, these people are one sex, but externally and psychologically they are another. What would that be like, to be a male, married to a woman and trying to have a conceive, only to find out that you are genetically a woman? Does that make you less of a man? What would it be like as a woman to find out you have androgen insensitivity disorder, and if you had functional androgen receptors during development you would be a male? The fact that development of biological sex can be disrupted by many processes and is clearly determined by biological factors makes me skeptical that God would never allow a person to develop with this disconnect between mind and body.
I agree that God does not make mistakes, and He is sovereign in His wisdom. But that doesn't prevent us from using medical treatments in a plethora of disorders and diseases. God has given us many insights into medicine that He graciously allows us to use to save and improve lives.
I struggle with the idea of providing hormonal supplementation to children to make them accept their biological sex since in other situations (to prevent further development of their biological sexuality) it is condoned. Is that a double standard? However, I do think that all other options should be extensively exhausted - especially psychotherapy to help the child accept their biological sex - before considering the alternative.
I am unversed in what the risks of using hormones to promote/prevent physical changes in patients are (is it not similar to the risks of hormonal birth control?) and I understand that a gender reassignment surgery will never create normal functioning genitals. Asking the patients who have had these procedures may lend some insight into our thinking. Are they happy? Are they healthy? Are any of them followers of the Lord? Can these two things - gender reassignment and following the Lord - coexist? It seems (though this is coming from a one-sided report) that adolescents that go through gender reassignment have many fewer psychological disorders, and that changing genders can end their depression and suicidal thoughts relating to their gender identity disorder. Is there data that conclusively shows this, or the opposite?
These are very difficult issues we face as physicians in our society. I think the most important thing is that as believers we are allowed to refuse to participate in treatments such as these, especially if we are not at peace with the Lord about it.
Thank you for writing on such relevant and difficult topics. I greatly respect your insights and take them to heart.
The previous comment was far more well-considered than the "expert opinion" provided by the CMDA writer - and exceptionally gracious in its criticism. "God does not make mistakes" is now an argument against medical intervention for a particular problem? Does Dr. Stern believe the world today is as God made it?
ReplyDeleteI, too, am a bit put off by the comment that "God does not make mistakes" as justification for Dr. Stern's position. We live in a fallen world where I see many congenital defects monthly. Those anomalies are not God's mistakes, they are deviations from His intentions that are the result (globally, not specifically) of sin. Why is it so hard to accept that gender-identify issues could also be the effects of our fallen state? We don't hesitate to fix an esophageal atresia or a congenital heart defect; perhaps we should not shut the door on the subject of this article too soon; perhaps we should be trying to develop the science to be accurate in identifying the problem so that, if needed, the person can be helped. No easy answers here, but no quick conclusions either.
ReplyDeleteLife is not simple – God did not design it that way. Gary Thomas wrote in his book Sacred Marriage “God never promises to remove all our trials this side of heaven – quite the contrary! – but He does promise that there is meaning in each one. Our character is being perfected, our faith is being built, and our ‘heavenly reward’ is being increased.” Although every parent would love to remove all stress from their child’s life, we know that is not possible. Parents should not create needless stress for their children. One of the key roles that parents have is to teach their child the skills to manage stress. From a spiritual standpoint, stress is an opportunity to grow.
ReplyDeleteGender identity disorder is a disorder. As physicians, we attempt to eliminate a disorder and return a person to a state of health. Children I have cared for have not had any identifiable genetic or metabolic disorder with a gender identity disorder. They were functional sexually. I am not aware that there is any substantial evidence based research related to this disorder other than small anecdotal reports as was referenced in The Point. Although I have never prescribed hormones for my patients with this disorder, if I had to make a judgment, I would propose the use of the hormone which promoted the biological gender identity of the child. Children who have identified genetic disorders, such as XXY males, present different clinical questions than those without one. Those children may not be technically male or female genetically. They are much more complicated and clinical decision making may be different.
The most important role of a parent is not to ensure the physical or emotional wellbeing of their child, but to assist their child to have eternal salvation with God. A hospital administrator, John Melton, wrote in his Monday Letter, “We are not human beings going through a temporary spiritual experience. We are spiritual beings going through a temporary human experience.” The most important role we have as physicians is also to promote the spiritual wellbeing of our patients. We use our skills, which includes counseling, medication and surgery, to achieve this goal. Frederick Robbins, MD, a pediatrician who received the Nobel Prize for his work in developing the polio vaccine, emphasized the guiding principles of care as primum non nocere (first do no harm). Who would argue that restoring the God given biological identity with normal sexual function in a child who has a gender identity disorder is not better than changing a child’s biological identity without normal sexual function?
God obviously allows very complicated problems to be experienced by children. God sent his only son to suffer and die in the passion and crucifixion so that we have the opportunity for eternal salvation. Whether one believes that God planned for all humans to suffer too or simply allows it, we must help our children grow spiritually as parents and physicians when faced with life’s stressors as they journey through this temporary human experience.