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Controversial Therapy for Pre-Teen Transgender Patient Raises Questions

A lesbian couple in California who say their 11-year-old son Tommy who wants to be a girl named Tammy are giving their child hormone blockers that delay the onset of puberty -- so that he can have more time that he can have more time to decide if he wants to change his gender.

The couple’s supporters say the Hormone Blocking Therapy has only minor side effects and is appropriate for a child who is unsure of his gender. "This is definitely a changing landscape for transgender youth," said Joel Baum, director of education and training for Gender Spectrum, a California-based non-profit group. "This is about giving kids and their families the opportunity to make the right decision."

But critics of the treatment say 11-year-olds are not old enough to make life-altering decisions about changing their gender, and parents should not be encouraging them. They say it’s too soon to tell what the side effects of the treatments may be, and they say Tommy’s parents, Pauline Moreno and Debra Lobel, are irresponsible for seeking them and allowing them to be administered.

"This is child abuse. It's like performing liposuction on an anorexic child," said Dr. Paul McHugh, professor of psychiatry at Johns Hopkins University.

"It is a disorder of the mind. Not a disorder of the body. Dealing with it in this way is not dealing with the problem that truly exists.

“We shouldn't be mucking around with nature. We can’t assume what the outcome will be," McHugh said.

Dr. Manny Alvarez, senior managing health editor of FoxNews.com, said the hormone blockers also may pose a medical risk. "I think that it’s highly inappropriate to be interfering with natural hormonal growth patterns,” Alvarez said. “There are significant potential problems necessary for growth and development.

"Potential long-term effects can include other abnormalities of hormones, vascular complications and even potential cancer. I think that if this child – as he finishes his puberty and teenage years – decides to undergo a transgender procedure – then there are proper channels to do so.

“But to do it at the age of 11 -- to me -- could be potentially dangerous to the health of this child," he said.

Tommy's parents, Moreno and Lobel, say they support their child and feel this is the best way for him to find an answer to a question he’s been asking all his life. They say Tommy – whom they now call Tammy – began taking GnRH inhibitors over the summer so that he will remain a prepubescent boy until he turns 14 or 15. They say they want to give him more time to explore the female gender identity that he associates with.

Thomas began saying he was a girl when he was 3 years old, his parents said in an interview with the Daily Mail. He was learning sign language due to a speech impediment, and one of the first things he told his mothers was, “I am a girl.” They say they thought he was confused or mistaken, and signed back, 'No. No. Thomas is a boy."

But Thomas insisted, they said. He shook his head “no” and repeated what he had signed.
They said Thomas threatened to mutilate his genitals when he was 7, and psychiatrists diagnosed a gender identity disorder.

One year later, he began transitioning to Tammy.

After much deliberation with family and therapists, the child began taking hormone blockers a few months ago. The medication, which must be changed once a year, was implanted in the boy’s upper left arm.

Tommy will continue this treatment until he turns 14 or 15, at which point he will be taken off the blockers and pursue the gender he feels is the right one. He will then either start his puberty cycle as a boy – or begin making the full transition to a girl.

"There's an increase of children who are telling their parents that they are a different gender. We're trying to understand why there's an increase," said Diane Ehrensaft, a developmental and clinical psychologist and author of the book, "Gender-Born. Gender-Made," who says the trend may be due to a more open society.

But while chemicals are giving children like Tommy more time to decide which side of the fence they belong on, some critics say that some children who question their identity at a very young age might change their mind when they start adolescence.

"Most transgender patients will say that they knew at 6 years old. But what we don't know is how many others had those thoughts and feelings that went away once they hit puberty," said Dr. Jeffrey Spiegel, a professor at Boston University and a plastic surgeon who specializes in facial feminization operations for transgender men.

"While it may be a good therapy for those who've committed to transgender, it may not be good for those who might have changed their mind once they hit puberty and beyond."

Walt Heyer, whose book "Paper Genders" details his own experience transitioning from a man to a woman and back again, agreed. "The blockers should NOT be introduced to a child," Heyer said. "If they are going to make a transition, they should wait to do so when they reach 18 to 20 years old. When you start the therapy at that age you are not dealing with the fact that the mind is not fully developed."

Heyer also cited a Dutch study that said 61 percent of individuals who desire a gender change are found to have secondary psychiatric disorders, such as depression or dissociative disorder, which he suffered from.

Other critics asked whether Tommy’s same-sex parents may be unknowingly influencing his questions about his gender.

“Undue influence on the child simply has to be ruled out,” said psychiatrist Keith Ablow, a Fox News contributor. “It's the psychologically correct thing to do, the ethical thing to do and the moral thing to do."

"Obviously, when two females adopt a male child, then assert that the child is not actually male, but is, instead, actually a female -- like both of them. Everyone in the family should be psychologically evaluated in a comprehensive way before a step like gender reassignment is considered,” said Ablow.

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