October 19, 2011 1:35 pm ET
Weeks after Fox News’ Dr. Keith Ablow was rebuked by the psychiatric community for his comments about Chaz Bono, a cast member on ABC’s Dancing with the Stars, Fox invited the “Medical A-Team” contributor back on air to criticize a same-sex couple’s decision to put their transgender daughter, Tammy, on hormone blockers. During the segment, co-host Martha MacCallum and Ablow repeatedly refused to identify Tammy by her chosen gender and misinformed about the facts surrounding her case.
Herald Sun: “Lesbian Couple Want To Help Boy To Become Girl.” In an October 18 article, the Herald Sun reported:
A LESBIAN couple in California who say their 11-year-old son Tommy 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 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.
Tommy's parents, Pauline Moreno and Debra Lobel, told CNN they support their child and feel this is the best way for him to find an answer to a question he has been asking all his life.
They say Tommy -- whom they now call Tammy -- began taking GnRH inhibitors over the summer to give him more time to explore the female gender identity with which he associates.
Tommy began saying he was a girl when he was three years old, his parents said. 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."
The child's parents also said Tommy threatened to mutilate his genitals when he was seven, 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 the 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. [The Herald Sun of Melbourne, Australia, 10/18/11]
Ablow: “We Have Two Women Raising A Child. He’s Adopted. And He’s Come To Believe That He Too Is Female.” On Fox News’ America’s Newsroom, Ablow claimed:
ABLOW: What’s happening here? We have two women raising a child. He’s adopted. And he’s come to believe that he too is female. That argues for a complete psychological evaluation, not just of the boy, but of his parents as well to see whether psychological forces are at play here to make him say such things. We need to do away with stigma and look at this as scientists and really understand what’s happening -- not make it a cultural debate, but a scientific one.
MacCALLUM: Yeah. [Fox News, America’s Newsroom, 10/18/11]
Medical Association: Same-Sex Parents Do Not Increase The Likelihood Of Children Being LGBT. According to the American Academy of Child & Adolescent Psychiatry, “the leading national professional medical association dedicated to treating and improving the quality of life for children, adolescents, and families affected” by mental, behavioral, or developmental disorders:
Sometimes people are concerned that children being raised by a gay parent will need extra emotional support or face unique social stressors. Current research shows that children with gay and lesbian parents do not differ from children with heterosexual parents in their emotional development or in their relationships with peers and adults. It is important for parents to understand that it is the the quality of the parent/child relationship and not the parent’s sexual orientation that has an effect on a child’s development. Research has shown that in contrast to common beliefs, children of lesbian, gay, or transgender parents:
- Are not more likely to be gay than children with heterosexual parents.
- Are not more likely to be sexually abused.
- Do not show differences in whether they think of themselves as male or female (gender identity).
- Do not show differences in their male and female behaviors (gender role behavior). [American Academy of Child & Adolescent Psychiatry, August 2011]
American Psychological Association Study Found No Link Between Same-Sex Parenting And Children’s Gender Identity. According to the American Psychological Association:
As the social visibility and legal status of lesbian and gay parents has increased, three major concerns about the influence of lesbian and gay parents on children have been often voiced. One is that the children of lesbian and gay parents will experience more difficulties in the area of sexual identity than children of heterosexual parents. For instance, one such concern is that children brought up by lesbian mothers or gay fathers will show disturbances in gender identity and/or in gender role behavior.
A second category of concerns involves aspects of children's personal development other than sexual identity. For example, some observers have expressed fears that children in the custody of gay or lesbian parents would be more vulnerable to mental breakdown, would exhibit more adjustment difficulties and behavior problems, or would be less psychologically healthy than other children.
A third category of concerns is that children of lesbian and gay parents will experience difficulty in social relationships. For example, some observers have expressed concern that children living with lesbian mothers or gay fathers will be stigmatized, teased, or otherwise victimized by peers. Another common fear is that children living with gay or lesbian parents will be more likely to be sexually abused by the parent or by the parent's friends or acquaintances.
Results of social science research have failed to confirm any of these concerns about children of lesbian and gay parents. Research suggests that sexual identities (including gender identity, gender-role behavior, and sexual orientation) develop in much the same ways among children of lesbian mothers as they do among children of heterosexual parents. [American Psychological Association, 7/30/04, citations removed for clarity]
MacCallum Suggested Child Had No Choice About Whether To Undergo Therapy. MacCallum stated:
MacCALLUM: Some of these issues are so complex and people are tormented throughout their lives with feeling -- having these feelings, you know, being born the wrong sex. But, you know, this child is so young, and that’s what has raised all of these concerns about whether or not he has any choice, you know, in this matter.
Tammy Has Reportedly Identified As Female For Eight Years. According to CNN:
One of the first things Thomas Lobel told his parents was that they were wrong.
The 3-year-old had learned sign language because he had apraxia, a speech impediment that hindered his ability to talk. The toddler pointed to himself and signed, "I am a girl."
"Oh look, he's confused," his parents said. Maybe he mixed up the signs for boy and girl. So they signed back. "No, no. Thomas is a boy."
But the toddler shook his head. "I am a girl," he signed back emphatically.
Regardless of the fact he was physically male, Thomas has always maintained that he is a girl. When teased at school about being quiet and liking dolls, Thomas would repeat his simple response, "I am a girl."
Thomas, now 11, goes by the name of Tammy, wears dresses to school and lives as a girl. [CNN, 9/27/11]
Parents Deny Coercing Child Into Changing Gender. From CNN:
After seeing therapists and psychiatrists, the mental health specialists confirmed what Thomas had been saying all along. At age 7, he had gender identity disorder.
The diagnosis was hard for [Pauline] Moreno and [Debra] Lobel to accept.
"The fact that she's transgender gives her a harder road ahead, an absolute harder road," Moreno said.
They have been accused of terrible parenting by friends, family and others, that "we're pushing her to do this. I'm a lesbian. My partner is a lesbian. That suddenly falls into the fold: 'Oh, you want her to be part of the lifestyle you guys live,' " Moreno said.
But that couldn't be further from the truth, they said. People don't understand how a hurting child can break a parent's heart.
"No parent wants to be in this situation," said Lisa Kenney, managing director of Gender Spectrum, a conference for families of gender nonconforming children. "Nobody had a child and imagined this was what would happen."
Transgender kids do not come from lax parenting where adults "roll over" to their kids' whims, said [Dr. Johanna] Olson, who treats transgender children.
"The parents are tortured by it," she said. "These are not easy decisions. Parents go through a long process going through this."
Moreno and Lobel allowed their child pick his own clothes at age 8. Thomas chose girl's clothing and also picked four bras. Then, Thomas wanted to change his name to Tammy and use a female pronoun. This is called social transitioning and can include new hairstyles, wardrobe. Aside from mental health therapy, this stage involves no medical interventions. Social transitioning is completely reversible, said Olson, a gender identity specialist.
Every step of the way, her parents told Tammy, "If at any time you want to go back to your boy's clothes, you can go back to Thomas. It's OK." Tammy has declined every time. [CNN, 9/27/11]
Ablow: “It’s Very Tough To Reverse Course” Following Hormone Blockers. During the discussion, Ablow asserted that the child’s hormone treatments would be “tough to reverse.” From the broadcast:
MacCALLUM: Is this any form of irresponsible, at the very least, parenting that could be legislated in any way?
ABLOW: Well, here’s the thing. It’s very tough -- and I agree with the other guest. It’s very tough to reverse course. And this has been written about. There are people who undergo these transformations, they may regret it later. But when you’re a boy, who, at three, is taken at his word, signing to his adoptive female parents, “I am a girl, too,” and you then are dressed as a girl and then you get hormone injections, it’s tough to reverse course even though they say “well, we’ll stop the estrogen when he’s 15 so he can decide.” Well, maybe. [Fox News, America’s Newsroom, 10/18/11]
Endocrine Society: Hormone Blockers Are Reversible. According to the Endocrine Society, “the world’s oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology,” the effect of GnRH analogs, the hormone blockers Tammy is reportedly taking, is reversible:
An advantage of using GnRH analogs is the reversibility of the intervention. If, after extensive exploring of his/her reassignment wish, the applicant no longer desires sex reassignment, pubertal suppression can be discontinued. Spontaneous pubertal development will resume immediately. [Endocrine Society Guidelines, September 2009, via Journal of Clinical Endocrinology & Metabolism, citations removed for clarity]
Hormone Blockers Give Transgender Children Time To Decide If They Want To Transition. In May 2008, NPR reported on a family with a transgender daughter:
Robert and Danielle soon came to find out about a new, highly controversial, treatment for preteen kids with gender identity issues. The treatment allows kids to postpone puberty and avoid developing the physical attributes of the sex they were born with.
The treatment has been offered in the United States only for around four years. Essentially, kids who meet the criteria for gender identity disorder are given monthly injections of a medication that blocks their bodies from releasing sex hormones. This means that while the children continue to grow taller, for the three or four years they are on the medication, they are kept from maturing sexually.
But not everyone believes that it is possible to know with this level of certainty that a child is transgender. There are two views in this debate.
Polly Carmichael, a British psychologist who works at the Portman Clinic in London, which has a unit specifically dedicated to gender identity, says the identity of most children this age is in constant flux.
"You can have a child who is presenting with absolute certainty, but it may be that at a later point they will decide that is not in fact what they want and their feelings may indeed change," Carmichael says.
This makes deciding on treatment very difficult, because there is one very serious side effect to the second part of the treatment.
Taking testosterone or estrogen immediately after blocking puberty will make a teenage patient sterile.
[Norman] Spack, the endocrinologist at Children's Hospital in Boston, says that because the gonads do not mature before they are exposed to the hormones of the opposite sex, the gonads become too damaged to produce either viable eggs or viable sperm.
"This is one of the most controversial aspects of this. At what age can a young person fully understand the implications of doing something that will make fertility for them, by today's technology, virtually impossible?" he says.
Spack, however, is quick to point out that there is no risk of infertility from the hormone-blocking treatment alone. Infertility only comes when the hormone-blocking treatment is paired with Stage 2, the use of opposite-sex hormones. And so, Spack says, hormone blockers should really be seen simply as a treatment that gives families more time to think about what to do.
"It's a lot different to be talking to a 14-, 15-, 16-year-old about the implications of this than a 10- to 12-year-old," he says. "And so it buys you time ... without the tremendous fear of their body getting out of control." [National Public Radio, 5/8/08]
Ablow: “We Need Guidelines Here For How To Behave Toward Those Young Kids Particularly Who Are At Risk To Be Misinterpreted.” Ablow further stated:
ABLOW: It’s time for the President’s Commission on Bioethical Concerns, just as with stem cells, to get involved here, summon the best minds from around the world to look at this issue, because the theory that people are born into the wrong bodies needs to be looked at scientifically. We need guidelines here for how to behave toward those young kids particularly who are at risk to be misinterpreted. [Fox News, America’s Newsroom, 10/18/11]
Endocrine Society Has Several Guidelines For Diagnosing Gender Identity Disorder. From the Endocrine Society’s “Clinical Practice Guideline” for the treatment of transsexual persons:
1.1 We recommend that the diagnosis of gender identity disorder (GID) be made by a mental health professional (MHP). For children and adolescents, the MHP should also have training in child and adolescent developmental psychopathology.
1.2 Given the high rate of remission of GID after the onset of puberty, we recommend against a complete social role change and hormone treatment in prepubertal children with GID.
Because GID may be accompanied with psychological or psychiatric problems, it is necessary that the clinician making the GID diagnosis be able 1) to make a distinction between GID and conditions that have similar features; 2) to diagnose accurately psychiatric conditions; and 3) to undertake appropriate treatment thereof. Therefore, the SOC [Standards of Care] guidelines of the WPATH [World Professional Association of Transgender Health] recommend that the diagnosis be made by a MHP. For children and adolescents, the MHP should also have training in child and adolescent developmental psychopathology. [The Endocrine Society, September 2009, via Journal of Clinical Endocrinology & Metabolism, citations removed for clarity]
Endocrine Society Recommends Transgender Youth Hormone Blockers For Most Children As They Change Their Minds As Teenagers. From the Endocrine Society guidelines:
Transsexual persons seeking to develop the physical characteristics of the desired gender require a safe, effective hormone regimen that will 1) suppress endogenous hormone secretion determined by the person’s genetic/biologic sex and 2) maintain sex hormone levels within the normal range for the person’s desired gender. A mental health professional (MHP) must recommend endocrine treatment and participate in ongoing care throughout the endocrine transition and decision for surgical sex reassignment.
The endocrinologist must confirm the diagnostic criteria the MHP used to make these recommendations. Because a diagnosis of transsexualism in a prepubertal child cannot be made with certainty, we do not recommend endocrine treatment of prepubertal children. We recommend treating transsexual adolescents (Tanner stage 2) by suppressing puberty with GnRH analogues until age 16 years old, after which cross-sex hormones may be given.
Given the high rate of remission of GID after the onset of puberty, we recommend against a complete social role change and hormone treatment in prepubertal children with GID.
In most children with GID, the GID does not persist into adolescence. The percentages differ between studies, probably dependent upon which version of the DSM was used in childhood, ages of children, and perhaps culture factors. However, the large majority (75–80%) of prepubertal children with a diagnosis of GID in childhood do not turn out to be transsexual in adolescence. … Clinical experience suggests that GID can be reliably assessed only after the first signs of puberty.
This recommendation, however, does not imply that children should be entirely denied to show cross-gender behaviors or should be punished for exhibiting such behaviors. [The Endocrine Society, September 2009, via Journal of Clinical Endocrinology & Metabolism, citations removed for clarity]
Center Of Excellence For Transgender Health Supports The Use Of Hormone Blockers For Transgender Youth. The Center of Excellence for Transgender Health, whose mission “is to increase access to comprehensive, effective, and affirming health care services for trans and gender-variant communities,” states:
Pubertal suppression would be appropriate (with parental/guardian informed consent) for those patients who have had a persistent and consistent cross sex identity from childhood who are entering puberty and have reached Tanner Stage 2. Occasionally, there may be patients who desire halting their pubertal trajectory who are further along in their development. For these patients, GnRH analogues may be useful, but it is important to note that side effects are more common when a person already has circulating adult levels of sex hormones. [Center of Excellence for Transgender Health, accessed 10/18/11]
Ablow Has A History Of Engaging In Pseudoscience. Ablow has a history of engaging in pop-psychology, relying on pseudoscience in order to promote conservative talking points. [Equality Matters, 9/26/11]
Ablow Has A History Of Attacking LGBT People. Ablow’s previous attacks against the transgender community have provoked condemnation from a number of prominent medical experts, including the president of the American Psychiatric Association. [Media Matters, 9/16/11]
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