12: Gender-Affirming Care for Children and Adolescents

What you’re about to hear is a powerful and sustained disagreement with the current discourse on youth gender medicine and the more extreme voices who tend to dominate the public conversation. 

Gender-affirming care, as defined by the World Health Organization, includes social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity” when it conflicts with their gender assigned at birth.

How long should physicians and clinicians observe a child before they decide to treat them for gender dysphoria?

When (if ever) should a child socially transition, begin hormones, and/or undergo surgery for their gender?

Dr. Erica Anderson is an internationally recognized clinical psychologist and academic, specializing in Gender, Sexuality, and Identity. She served on the medical staff of the Youth Gender Clinic at the UCSF Benioff Children’s Hospital and on the board of the World Professional Association for Transgender Health (WPATH).

Dr. Jack Drescher is a Clinical Professor of Psychiatry at Columbia University and a Distinguished Life Fellow of the American Psychiatric Association (APA). In 2022, Dr. Drescher was a member of the APA’s DSM-5 Workgroup on Sexual and Gender Identity Disorders – responsible for revising the definition of what is now referred to as “gender dysphoria.” An openly gay psychiatrist, Dr. Drescher has also served on the World Health Organization’s workgroup revising sexual and gender diagnoses.

Show Notes

• Defining gender [04:16]
• Shift in patients at pediatric gender clinics [11:20]
• The Canadian approach [16:33]
• Treatment options [20:11]
• Determining if a child will benefit from transition [27:04]
• Increase in cases [29:19]
• Risks and benefits of treatment [35:01]
• Level of caution for when to use medicines [42:46]
• Canadian vs Dutch approach [46:58]
• Question of rapid medicalization [49:14]
• Difficulty of the conversation [54:44]
• Comparison with gay marriage [57:24]

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