"People in favor of this approach argue that suppressing puberty will give the children and their clinicians more time to decide whether medical transition is right for them. In reality, however, almost all children who start taking puberty blockers for their gender issues will continue onto cross-sex hormones at a later date."
This is the most solid point you make here, I think: the idea that puberty blockers are a way to buy time to make a decision seems to be a convenient fiction, used to placate people who don't want to see minors transitioning, whether because they oppose transition in general or because they don't think minors are qualified to make such decisions about their own health.
In reality, someone who chooses to go on puberty blockers is someone who has already made up their mind to transition, and the role puberty blockers actually serve is to avoid the unwanted effects of natal puberty until they're allowed to start cross-sex hormones. You could call it harm reduction, but I think it makes more sense to call it preventive treatment: an adolescent who's denied puberty blockers will go on to become an adult who has to live with some unwanted bodily changes forever, and who can only correct other changes with surgery that's much riskier and more expensive than blockers.
"Puberty happens before kids are mature enough to truly grasp the implications of their decision to transition."
First, this is overstated - there's very little evidence that minors are actually unable to grasp the implications of their decisions. That's mostly an unquestioned assumption used to override decisions that adults don't like. And we acknowledge that in other cases where we decide that the minor's long-term health interests outweigh the child-rearing interests of the adults around them: for example, minors are often able to give legal consent for decisions about their own reproductive health, mental health, or addiction treatment at a younger age than other medical decisions.
Second, it goes both ways - the effects of _not_ going on puberty blockers are every bit as serious, permanent, and life-changing as the effects of going on them, if not more so. A bias toward inaction is just a bias toward one set of consequences rather than the other. If it were truly the case that minors were incapable of making these decisions, then the proper response would be to take the decision out of minors' hands completely and let the adults around them decide whether or not they go through natal puberty, rather than only second-guessing them when they want to avoid it.
"There are two aspects of juvenile transsexualism, however, that I feel confident enough about to say something here. One is the need to curtail the use of puberty blocker monotherapy because being hormonally sexless wreaks havoc on the human body."
The age of puberty varies between individuals; some people are "early bloomers" and others are "late bloomers". To the extent that puberty blocker monotherapy is used to shift the onset of puberty within the typical range, what reason is there to believe that it "wreaks havoc" beyond what we already consider normal?
"Puberty Blockers Solidify Commitment to Medical Transition"
This bold assertion in a heading doesn't seem to be supported by the text that follows. You're making a claim about causality, but simply observing that minors who go on puberty blockers for gender dysphoria usually continue onto cross-sex hormones does _not_ tell us anything about causality.
By analogy, we might observe that the vast majority of people who take ibuprofen several days in a row for a toothache continue on to get a root canal, but it'd be a mistake to conclude that ibuprofen solidifies the commitment to get a root canal. Having a toothache is what leads to both the ibuprofen and the root canal; people choose the ibuprofen first because it's more accessible, or less of a commitment, but most of them will need a root canal anyway, because people generally aren't wrong about having a toothache, and ibuprofen doesn't address the underlying issue.
"Social Transition Increases Commitment to the Cross-Gender Path"
Exactly the same problem here. Your conclusion that "Both interventions greatly increase the odds of staying on the transsexual path" doesn't follow from observations like "whether male children dressed or socially presented as girls strongly predicted whether they persisted in the desire to transition": you've overlooked the likelihood that the male children who dress as girls despite social expectations were just more gender dysphoric in the first place.
"However, I believe some kids stand to benefit from youth medical transition. I don’t know the proportion or how to reliably identify them, but some surely exist."
What do you think of Kay Brown's conclusion (https://sillyolme.wordpress.com/2011/02/28/age-of-innocence/) that "the developmental process, what ever it is, for desistors, is finished by age 14. If a gender atypical 14 year old is still gender dysphoric and wishes to begin hormones and transition, we can be reasonably certain that he or she will not change his/her mind later. Thus, based on the evidence, we can safely begin such interventions."
Maybe starting some therapy does increase the likelihood of going further. It’s what we would expect if social transition and not having the wrong puberty worked. And expecting people who’ve received a treatment that works to not continue along the treatment path is silly.
I do think you underestimate the benefits of early transition for male-attracted mtf patients. It’s difficult enough to nab a good husband as a cis woman these days — and losing years to post-puberty transition and being masculinised by testosterone doesn’t help.
As finding a husband was never in the cards for your group, timing of transition doesn’t really matter — the outcome is the same. Husband and kids were never a part of the scenario no matter how early the transition.
I wouldn't say timing of transition doesn't matter for female-attracted MTFs. Being masculinized by testosterone still has consequences for their ability to attract partners, their ability to fit in socially, their satisfaction with transition outcomes, and the lengths to which they need to go to achieve those outcomes.
Women care less about looks than men. So good character gets you everywhere, whereas with men, once you’re older, you’re shown pretty well what you were valued for.
"People in favor of this approach argue that suppressing puberty will give the children and their clinicians more time to decide whether medical transition is right for them. In reality, however, almost all children who start taking puberty blockers for their gender issues will continue onto cross-sex hormones at a later date."
This is the most solid point you make here, I think: the idea that puberty blockers are a way to buy time to make a decision seems to be a convenient fiction, used to placate people who don't want to see minors transitioning, whether because they oppose transition in general or because they don't think minors are qualified to make such decisions about their own health.
In reality, someone who chooses to go on puberty blockers is someone who has already made up their mind to transition, and the role puberty blockers actually serve is to avoid the unwanted effects of natal puberty until they're allowed to start cross-sex hormones. You could call it harm reduction, but I think it makes more sense to call it preventive treatment: an adolescent who's denied puberty blockers will go on to become an adult who has to live with some unwanted bodily changes forever, and who can only correct other changes with surgery that's much riskier and more expensive than blockers.
"Puberty happens before kids are mature enough to truly grasp the implications of their decision to transition."
First, this is overstated - there's very little evidence that minors are actually unable to grasp the implications of their decisions. That's mostly an unquestioned assumption used to override decisions that adults don't like. And we acknowledge that in other cases where we decide that the minor's long-term health interests outweigh the child-rearing interests of the adults around them: for example, minors are often able to give legal consent for decisions about their own reproductive health, mental health, or addiction treatment at a younger age than other medical decisions.
Second, it goes both ways - the effects of _not_ going on puberty blockers are every bit as serious, permanent, and life-changing as the effects of going on them, if not more so. A bias toward inaction is just a bias toward one set of consequences rather than the other. If it were truly the case that minors were incapable of making these decisions, then the proper response would be to take the decision out of minors' hands completely and let the adults around them decide whether or not they go through natal puberty, rather than only second-guessing them when they want to avoid it.
"There are two aspects of juvenile transsexualism, however, that I feel confident enough about to say something here. One is the need to curtail the use of puberty blocker monotherapy because being hormonally sexless wreaks havoc on the human body."
The age of puberty varies between individuals; some people are "early bloomers" and others are "late bloomers". To the extent that puberty blocker monotherapy is used to shift the onset of puberty within the typical range, what reason is there to believe that it "wreaks havoc" beyond what we already consider normal?
"Puberty Blockers Solidify Commitment to Medical Transition"
This bold assertion in a heading doesn't seem to be supported by the text that follows. You're making a claim about causality, but simply observing that minors who go on puberty blockers for gender dysphoria usually continue onto cross-sex hormones does _not_ tell us anything about causality.
By analogy, we might observe that the vast majority of people who take ibuprofen several days in a row for a toothache continue on to get a root canal, but it'd be a mistake to conclude that ibuprofen solidifies the commitment to get a root canal. Having a toothache is what leads to both the ibuprofen and the root canal; people choose the ibuprofen first because it's more accessible, or less of a commitment, but most of them will need a root canal anyway, because people generally aren't wrong about having a toothache, and ibuprofen doesn't address the underlying issue.
"Social Transition Increases Commitment to the Cross-Gender Path"
Exactly the same problem here. Your conclusion that "Both interventions greatly increase the odds of staying on the transsexual path" doesn't follow from observations like "whether male children dressed or socially presented as girls strongly predicted whether they persisted in the desire to transition": you've overlooked the likelihood that the male children who dress as girls despite social expectations were just more gender dysphoric in the first place.
"However, I believe some kids stand to benefit from youth medical transition. I don’t know the proportion or how to reliably identify them, but some surely exist."
What do you think of Kay Brown's conclusion (https://sillyolme.wordpress.com/2011/02/28/age-of-innocence/) that "the developmental process, what ever it is, for desistors, is finished by age 14. If a gender atypical 14 year old is still gender dysphoric and wishes to begin hormones and transition, we can be reasonably certain that he or she will not change his/her mind later. Thus, based on the evidence, we can safely begin such interventions."
Maybe starting some therapy does increase the likelihood of going further. It’s what we would expect if social transition and not having the wrong puberty worked. And expecting people who’ve received a treatment that works to not continue along the treatment path is silly.
I do think you underestimate the benefits of early transition for male-attracted mtf patients. It’s difficult enough to nab a good husband as a cis woman these days — and losing years to post-puberty transition and being masculinised by testosterone doesn’t help.
As finding a husband was never in the cards for your group, timing of transition doesn’t really matter — the outcome is the same. Husband and kids were never a part of the scenario no matter how early the transition.
I wouldn't say timing of transition doesn't matter for female-attracted MTFs. Being masculinized by testosterone still has consequences for their ability to attract partners, their ability to fit in socially, their satisfaction with transition outcomes, and the lengths to which they need to go to achieve those outcomes.
Women care less about looks than men. So good character gets you everywhere, whereas with men, once you’re older, you’re shown pretty well what you were valued for.