Astral Codex Ten Podcast feed 2024年07月17日
[ACC Entry] Should Transgender Children Transition?
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儿童变性是一个备受争议的话题,专家意见存在分歧。一些专家主张支持儿童的性别认同,认为父母有责任帮助孩子完成变性过程,包括社会、医疗和手术。而另一些专家则主张采用治疗方法,认为孩子太小,无法理解性别,父母应该帮助孩子纠正错误的行为。两种观点都基于对儿童心理健康的担忧,但最终如何选择取决于父母的个人信念和对孩子的理解。

👧 **支持变性:** 支持者认为儿童的性别认同是真实的,父母有责任帮助孩子完成变性过程。他们认为,阻止孩子变性会导致心理健康问题,甚至自杀风险。他们建议采取“性别肯定”方法,包括社会变性、青春期阻滞剂、跨性别激素和手术等。支持者认为,这种方法可以帮助孩子获得幸福和健康的生活。 **支持者观点的依据:** * 研究表明,对于确诊为性别认同障碍的儿童,接受变性治疗可以显著改善心理健康状况。 * 许多变性人表示,他们早年就意识到自己的性别认同与出生性别不符,而接受变性治疗让他们能够过上符合自己身份的生活。 * 变性治疗的安全性已被广泛研究,且对儿童的副作用很小。

👨‍⚕️ **治疗方法:** 反对者认为儿童太小,无法理解性别,父母应该帮助孩子纠正错误的行为。他们认为,许多孩子只是在探索性别,而并非真正的性别认同障碍。他们建议采取治疗方法,帮助孩子解决心理问题,并接受自己的生理性别。反对者认为,过早地进行变性治疗可能会对孩子造成负面影响,并导致他们成年后后悔。 **反对者观点的依据:** * 研究表明,一些儿童在青春期之前会放弃自己的性别认同,不再认为自己与出生性别不同。 * 治疗方法可以帮助孩子解决心理问题,例如焦虑、抑郁和自尊心低等。 * 过早地进行变性治疗可能会对孩子的身体和心理健康造成负面影响。

⚖️ **争议焦点:** 关于儿童变性,专家意见存在分歧,主要集中在以下几个方面: * 儿童是否能够理解性别,并做出明智的决定? * 变性治疗对儿童的心理健康是否有积极影响? * 治疗方法是否能够帮助孩子接受自己的生理性别? * 父母如何才能在尊重孩子意愿的同时,保护孩子的安全和福祉?

[This is an entry to the Adversarial Collaboration Contest by flame7926 and a_reader.]

[Content note: suicide, depression, transphobia, self-harm]

Transgender childhood transition is a hotly debated topic, with extensive media coverage devoted to it in recent years. (pro: BBCThe Lancet and The New York Times ; contra: The Cut, New Statesman and The Globe and Mail).We see plenty of stories of transgender children (or gender dysphoric children and gender nonconforming children), both in the media and in the blogosphere. As early as 2 or 3, defying the expectations of their family, those children show a persistent and insistent preference for many things associated with the other sex: little boys want long hair and love dresses, Barbie dolls, Disney princesses and mermaids; little girls, instead, dislike stereotypically feminine activities and prefer rough and tumble play, refuse to wear dresses and insist to have their hair shorter and shorter.

Sometimes, from the very beginning, the toddler corrects the parents: “I’m a boy /girl!”, but more frequently cross-gender behavior is more prevalent. This is only sometimes followed with the child expressing preferences that would be termed gender dysphoria. The child (born and currently living as a as one sex) says to their parents something like “God made a mistake” or “something went wrong in Mommy’s tummy” because he should have been a girl, not a boy (or the other way around). The worried parents search information on the internet and seek out the advice of an expert. There, they usually find one or both of these contradicting opinions:

Gender-affirming approach

Listen to your child – he/she knows best his/her gender. Let your child be his/her true self. It’s your responsibility as a parent to support your child in all stages of his/her transition: social transition now, puberty blockers at the beginning of puberty, cross-sex hormones in adolescence, surgery at 18. To oppose it is child abuse. Transphobia costs lives: 41% of transgenders attempt suicide. Do you prefer a happy daughter or a dead son?

Or:

Therapeutic approach

Your child is just confused. He/she is too young to understand gender and to take such important decision. 80% of gender nonconforming children desist. You, as a parent, have the responsibility to correct his/her wrong behavior. If you tolerate it, gender dysphoria will be reinforced by repetition and persist to adulthood. To encourage your child’s delusion is child abuse. Transgenders individuals face lifelong struggle and often suffer from poor mental health: 41% of transgenders attempt suicide. Do you really want that for your son, when he could instead come to accept the body he was born with?

The first approach is promoted by transgender activists, the second by the conservative media, but both are supported by some experts. The “Gender-affirming approach” is supported by the Dutch team from the Gender Clinic at VU Medical Centre, Amsterdam, who elaborated the typical transition treatment for minors, with puberty blockers at 12 and cross-sex hormones at 16, and, in the US, by Kristina Olson and others from the TransYouth Project. The “Therapeutic approach” is supported by Kenneth Zucker and his team from the Gender Identity Service at Centre for Addiction and Mental Health, Toronto, and, in the US, by Paul McHugh at Johns Hopkins University School of Medicine. There are also experts such as Debra Soh, once a gender nonconforming girl herself, that advise parents to wait and see until adolescence, because in many cases gender dysphoria desists spontaneously, without intervention.

Who to believe when the experts disagree? Let’s see the evidence.

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儿童变性 性别认同 专家意见
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