In an interview with the Daily Caller News FoundationDr. Susan Bradley, a Canadian psychiatrist and a pioneer in the treatment of gender dysphoria in children, spoke out against the popular model of affirming children's transgender identities and treating them with puberty-blocking drugs, a practice she had taken part in in the past.
Bradley had opened a paediatric clinic in 1975 for children suffering from gender dysphoriaa deep sense of unease concerning one's body and one's biological sex, in which he offered a psychological therapy-oriented approach; most patients stopped feeling transgender over time, Bradley told DCNF.
Around 2005, the clinic started prescribing puberty-blocking drugs to children affected by gender dysphoria as a way to alleviate their suffering, a model that has since been widely adopted by the medical establishment worldwideincluding the United States.
Bradley, who is now in his eighties, expressed regret that the clinic was involved in the administration of puberty-blocking drugs to treat gender dysphoria, which she now believes can cementing that sense of confusion that children might otherwise overcome. He also expressed concern about the side effects of such drugs.
'We were wrong' he stated. "They are not as irreversible as we have always believed and have long-term effects on children's growth and development that include infertility and a good number of bone growth problems."
Since most children suffering from gender dysphoria, before the widespread implementation of an approach aimed at affirming the gender to which children feel they belong, they overcame it and ended up accepting their own body and genderaccording to the New York Times, Many doctors have expressed concern that puberty-blocking drugs end up making children's temporary gender dysphoria permanent, consolidating their feeling of belonging to the opposite sex.
These drugs also prevent the increase in bone density that normally occurs during puberty, with some patients suffering from lifelong bone problems.
The FDA also identified six cases where there was a 'plausible' link between GnRH antagonist drugs and a condition called pseudotumor cerebri, which is caused by high fluid pressure in the brain.
Bradley told DCNF that his opinion on puberty-blocking drugs has evolved over time.
"We thought they were relatively safe and endocrinologists said their effects were reversible and that we did not need to worry. Underneath I felt that I was sceptical and felt that maybe we were making things worse and not helping them.
And I think it has been confirmed that when these children start taking these drugs at any age, almost everyone ends up wanting to switch to hormone therapy'. stated Bradley.
Bradley opened the Clarke Institute of Toronto's Child Youth and Family Gender Identity Clinic (GIC) in 1975, and later became head of the department of child psychiatry at the Hospital for Sick Children and head of child psychiatry at the University of Toronto.
"The opinion of a specialist like Dr Bradley has the enormous potential to influence this debate because she is what Cass Sustein called 'an amazing validator"told DCNF. John Burgo, psychotherapist and deputy director of Genspect. "It's human nature to reject even reasonable arguments and credible evidence if they come from someone who is easily identified as belonging to the other side, if they come from 'them' such as Republicans or famous 'transphobes'. But Dr Bradley is a pioneer in her field and is not politically aligned".
"She does not argue that puberty-blocking drugs are never the right choice. Instead, she invites us to have a cautious exploratory approach to gender-related discomfort based on its decades of experience,' Burgo said.
"When a professional who was expected to be aligned on one side (that of an affirmative model of gender dysphoria) utters a complex opinion and invites caution, this can help the audience not to take sides against her or to polarise and reject her opinions, but can open their minds to alternative viewpoints.
Surprising validators like Dr. Bradley can soften conflicts and promote dialogue even more than well-balanced presentations showing the arguments of both sides can.
Bradley believes that the transition is useful for some adults and says that some patients consider it the best thing they have ever done for themselves, but that the parameters of its success, including patient satisfaction, are complicated.
One of his patients had made a transition from woman to man, had married a woman who was a childhood friend of his and seemed happy and satisfied, but later underwent a very expensive phalloplasty operation. Despite appearing 'very masculine', the patient was never really satisfied and was perpetually seeking further physical improvement, according to Bradley.
Another patient Bradley had worked with had transitioned from male to female, but eventually told psychiatrists that he was no longer trans and was in a relationship with another man. This triggered Bradley the doubt that the transition for some patients was just a search for a way to be accepted.
"It made me realise that what we are actually talking about is their need to be accepted; in the end we all need someone to love us," said Bradley. "And it's very complicated. There are people for whom it works. But there are many people who end up feeling that they have not really solved their problems concerning who and what they are... the crux of the matter is the fact that these decisions were made when these children were too young to really know how they were going to handle this. And that is not fair.
Bradley chaired the subcommittee on gender dysphoria for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official manual of the American Psychiatric Association, which is used to classify and diagnose mental disorders.
He led eight other physicians in determining the diagnostic guidelines for gender identity disorders.
He also produced research, with other clinical doctors, showing that 87.7% of the boys who came to their clinic for gender identity problems ended up 'giving up', that is, they stopped believing they were actually girls and came to terms with their sex.
Bradley now believes that most child patients who identify as transgender are actually on the autistic spectrum or suffer from borderline personality disorder, which she believes should be classified as part of the autistic spectrum.
Autistic adolescents are particularly prone to obsessive thoughts, prone to having problems with their physical appearance and find it hard to change their minds once they are convinced that something is true, all of which make them more vulnerable to the risk of being convinced that they are of the opposite sex and having to seek medical assistance by, for example, taking puberty-blocking drugs or hormones.
"You have to put yourself in the shoes of a 12- or 13-year-old who thinks 'This is my way of becoming normal'," said Bradley. "These children are not doing well with today's affirmative approach. I don't know if there is a child who could do well, given thehe ability of a 10, 12 or even 14 or 15 year old child to understand the complexity of the choice he is making concerning his sexual function and his long-term life. It doesn't make any sense."
The GCI was closed after Bradley's retirement in 2007 under intense pressure from transgender activists who believed that the clinic, which did not automatically affirm the gender identity of children or their status as transgender persons, was transphobic.
Scepticism concerning puberty-blocking drugs has grown in recent years, following high-profile scandals involving paediatric gender dysphoria treatment clinics that prescribed these drugs to stop healthy puberty in children as young as 10 years old following psychological screenings deemed inadequate.
Stella O'Malley, psychotherapist and founder of Genspect, an organisation critical of gender transitions during childhood, expressed her concerns regarding this type of intervention in an earlier interview with DCNF.
"Blocking the sexual development of children is a highly authoritarian intervention. Children are asexual and cannot understand the impact of impaired sexual functioning,' he said. "We have been about 10 years in this large-scale experiment and we already have reports of problems with cognitive development, bone mineral density and fertility. All the latest evidence shows that drugs that block puberty are neither safe nor reversible'.
Proponents of medicalised gender transition in children claim that these drugs can alleviate the discomfort that young people with gender dysphoria may experience due to puberty and may reduce the need for surgery or hormonal treatment later in life as they prevent the development of certain traits associated with their biological sex, such as a deep voice in a male patient.
"The anxiety disappears," he told the New York Times Dr Norman Spack, a leader in the push for the use of drugs that block puberty in patients with gender dysphoria. "You can see those boys being so relieved."
The Centre for Addiction and Mental Health, formerly the Clarke Institute of Toronto, did not respond to requests for comment from the Daily Caller News Foundation.
Translation by Chiara G.
Original article here.
