What to Do When Kids Say They’re Trans - Sasha Ayad returns to The Unspeakable
Dec 19, 2023
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Therapist Sasha Ayad discusses youth gender medicine, why medical protocols have changed in Europe, struggles faced by kids with gender dysphoria, and how parents can support their kids while setting limits.
Informed consent is crucial for young adults over 18, as they may make irreversible decisions without considering potential risks or exploring alternative paths.
The Dutch protocol cannot serve as a comprehensive and accurate determining factor for gender dysphoria in all cases.
Supportive family environments and thorough assessment of underlying issues can significantly impact a young person's well-being and the decisions they make regarding their gender identity.
Deep dives
Gender dysphoria in young people and the role of therapists and clinicians
There is a significant increase in young people announcing trans identities, leading to discussions about the implications of quick access to life-altering interventions. Gender clinics and professionals who support the gender affirming model often prioritize child-led processes, affirming the child's trans identity and pushing for medical interventions. However, concerns have been raised about the lack of thorough assessment of underlying issues, the potential long-term consequences of medical interventions, and the absence of proper informed consent. The cultural and social environments in which these young people exist can significantly influence their path, whether it's an online community or a supportive real-life environment. Informed consent is particularly crucial for young adults over 18, as they may make irreversible decisions without considering potential risks or exploring alternative paths.
The limitations of the Dutch protocol and misinterpretation of research
The Dutch protocol, often used as a reference, involved a small study of children with childhood onset gender dysphoria who underwent puberty blockers and later cross-sex hormones and surgeries. However, the scales used to measure the reduction of gender dysphoria analyzed self-reported preferences based on sex characteristics, leading to questionable results. Moreover, this study does not accurately represent the broader population, as most young people questioning their gender identity during adolescence don't present a history of childhood onset gender dysphoria. The Dutch protocol cannot serve as a comprehensive and accurate determining factor for gender dysphoria in all cases.
Controversy surrounding medical interventions and potential risks
Medical interventions for gender dysphoria, such as puberty blockers, cross-sex hormones, and surgeries, can have long-term consequences. Puberty blockers are often considered a pause button, but the shift to other medical interventions is common, leading to irreversible effects. The number of minors undergoing top surgeries, mastectomies, and genital surgeries is larger than commonly believed. Informed consent becomes a crucial issue as young adults may rush into these procedures without fully understanding the potential risks or alternative approaches. The need for thorough assessment, comprehensive information, and a consideration of mental health and social factors is vital to ensure responsible medical practices in the treatment of gender dysphoria.
Family support and the role of parents
Supportive family environments and thorough assessment of underlying issues can significantly impact a young person's well-being and the decisions they make regarding their gender identity. Parental involvement and maintaining open communication are crucial to provide guidance and understanding for young people questioning their gender. It is essential for parents to consider all aspects of their child's life and mental health rather than solely focusing on affirming their gender identity. Parents who seek proper information, engage in dialogue, and provide a supportive environment can positively influence the path their child takes without rushing into irreversible medical interventions.
The need for balanced and informed discussions
Gender dysphoria and the pathways for those questioning their gender identity are complex and require thorough examination and informed discussions. It is important to acknowledge the limitations of research and clinical approaches, including the influence of cultural and social environments. Balanced conversations that consider potential risks, mental health issues, long-term consequences, and alternative approaches are essential in providing appropriate support for young people facing gender dysphoria. Clear and accurate information should be provided to foster informed decision-making. It is crucial to critically evaluate and improve current practices to ensure ethical and responsible care for individuals questioning their gender identity.
Therapist Sasha Ayad was one of the earliest guests on The Unspeakable. Her interview with Meghan in August of 2020 was revelatory for many listeners and she has become a leading figure in the effort to discuss gender through a non-ideological lens. In this wide-ranging conversation, Sasha shares what she’s learned since then, what kind of data has emerged about youth gender medicine, and why medical protocols in Europe have changed even as the U.S. and Canada hold on to the “affirmative care” model.
Sasha gives some background on how highly theoretical concepts like the “gendered soul” got absorbed into medicine, why kids with gender dysphoria are likely to struggle with multiple mental health issues, and how parents can set limits while also supporting their kids.
**GUEST BIO**
Sasha is a Licensed Professional Counselor who works in private practice with teens, young adults, and families impacted by gender issues. Sasha is a well-known advocate for individualized, least-invasive-first approaches to treating gender dysphoria. She has developed a gentle but effective way of working psychologically with rigid beliefs, identity, and social influence.
