Do you remember puberty? For some of us it was just yesterday while others it was a lifetime ago. But the confusion, body changes, and craziness of puberty was a massive time for change in our lives. But we were told it was a step in the process of becoming a man or a woman. But what if that direct translation into young boy to young man or young girl to young woman was not what you were meant to do? What if you were transgender and had to go through puberty?
Matt Pasini was sitting in a therapist’s office with his parents just before his 15th birthday, a year after he first came out as trans, when he told them: “I can’t keep living like this.”
Pasini, who grew up in Queens, New York, was grappling with gender dysphoria, which the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V), describes as a feeling of distress caused by identifying as a gender other than the one you were assigned at birth. That distress was getting worse with puberty: people misgendered him in public, he was self-conscious, and every month, his menstrual cycle would cause a mental crisis.
“It became a constant reminder that I was born in the wrong body and I didn’t have any control over that,” Pasini, now 19, told the NewsHour.
Puberty can cause enormous stress for transgender youth, adding to their already-high rates of anxiety and depression. But relief has come for some in the form of puberty blockers. Originally developed to allay early onset puberty, these drugs give transgender youths more time to decide how to move forward in their transition. Lupron and other puberty blockers are rarely covered by insurance for people under 18 — but in New York, that could change as early as December, potentially making a difference for trans youth in the state.
“Relieving gender dysphoria for a lot of these kids is like unleashing them finally into the world, to go be themselves.” — Dr. Andrew Goodman of the Callen-Lorde Community Health Center Along with his parents, therapist and doctor, Pasini, decided after that session that he would start Lupron, one of the most common puberty blockers. Pasini said he noticed a change in how he carried himself, how he interacted with others and how he felt about his body. “I didn’t have as much anxiety in school because of that, and I felt somewhat more comfortable in my body,” he said. “It made me feel a lot more confident. … It made me feel a lot less depressed about myself.” – pbs.org
If it helps individuals to live a better life with more confidence and less depression, it sounds like a great possibility that needs to be considered for all going through this time of painful change. And if it is used for cis children going through the change early, who couldn't it work for transgender children?
Pbs.org elaborates that the treatments for transition-related health care is available in twelve states and Washington, D.C., but it is most often limited to treatment of adults and not minors. Oregon has moved forward to cover adolescents and New York city may decide to do so with three recent court cases, the most recent in October when "the New York State Department of Health filed a proposed rule that would extend its Medicaid coverage to treating gender dysphoria in individuals under 18. The department cannot officially adopt the rule until Dec. 5, after it has considered public comments."
Several doctors who treat trans patients told the PBS NewsHour that Lupron eases some of the distress associated with gender dysphoria in young adults.
“Relieving gender dysphoria for a lot of these kids is like unleashing them finally into the world, to go be themselves,” Dr. Andrew Goodman, associate director of medicine at the Callen-Lorde Community Health Center in New York City, said.
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No large-scale studies have examined the long-term effects of puberty blockers in the treatment of gender dysphoria. A 2010 study by researchers in the Netherlands found that “behavioral and emotional problems and depressive symptoms decreased, while general functioning improved significantly” among 70 people who were treated with puberty blockers between 2000 and 2008.
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Without insurance, each monthly injection of Lupron can cost roughly anywhere from $1100 to $2500. “They’re not really affordable for your average person at all,” Olson-Kennedy said. “People take second [mortgages] out on their homes. They charge their credit cards. They do all kinds of things. It’s absurd … And people who don’t have the resources just don’t do it.”
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In one case, the mother of a 13-year-old transgender girl did not want to wait for the insurance appeal process, Steever said. “Before we could really do all the letters to the insurance company to get them to pay for it … the mom went out and just purchased it and just put it on her credit card. I was floored,” he said.
Other families have purchased the medication from Canada or India because it’s cheaper, Steever said, adding that he does not encourage anyone to buy drugs on the black market.
Taking Lupron can also prevent the costs of surgeries to change secondary sex characteristics, such as top surgery to remove breasts, Goodman said. – pbs.org
Head over to pbs.org for their full story "NY Will Soon Make It Easier For Trans Youths To Delay Puberty."
Here is a short video from PBS to elaborate on the debate "is gender identity hard wired? Do we choose? Is it biological?"
h/t: pbs.org