FIRST, DO NO HARM

The Biggest Problem in Kids’ Transgender Surgery

"First do no harm" is a popular saying that derives from the Latin phrase, "primum non nocere" or "primum nil nocere." The term is particularly popular amongst those involved in the field of healthcare, medicine, or bioethics, and among popular accounts of the medical field, since it is a basic principle taught in healthcare-providing classes.

The takeaway point of "first do no harm" is that, in certain cases, it may be better to do nothing rather than intervening and potentially causing more harm than good. 

The Doctors’ Failure

While not part of the Hippocratic Oath, what doctors learn in school is that it is better to act with care and consideration, outside of an emergency situation.  The TV show “House” notwithstanding, the better part of valor is to take time with each patient to understand the whole patient and the full set of concerns they have.  More art than science, listening is a huge part of diagnosis.

 ”In the Hippocratic Oath, the physician pledges to prescribe only beneficial treatments, according to his/her abilities and judgment; to refrain from causing harm or hurt.”  Thus, when faced with a child who thinks, (or has been convinced to think), that their emotional struggles mean they should change their sex, a prudent doctor would begin with psychological counseling in order to see if a non-invasive solution might yield beneficial results.  Most of us remember feeling out-of-sorts and even, truly awful at various points in childhood and adolescence.  And yet, with time, maturity and the settling down of the hormone surges, most kids find their path and go on to live good lives as the sex they were born to.

Yet, parents who would hesitate to let their young child get a tattoo or pierce their ears seem readily convinced that drugs and surgery are a good first approach to solving their child’s problem. I get it; parents want their kids to be happy, but the reality is that happiness is transient.  As we age, we strive for contentment, but the period of rapid growth doesn’t allow for much of that.  Still, unless a parent can find a doctor willing to make permanent changes to a child, other options will be explored.  Because of that, (parents can’t get the hormones, nor can they operate on their own child).  I blame doctors for falling into the transgender trap.

No one has been able to explain the vast number of children thinking they were born in the wrong body. Transgender rates have been fairly constant and VERY low over the years.  And children should experiment and find what they love to do and who they are over the years.  I believe that doctors who lead with sex change surgery for children without exploring other options are committing malpractice.  They are, at least, violating their oaths.

I doubt we would call a gay person someone trapped in the wrong body.  How many of these kids would normally try out gay interests and either realize that they are truly attracted to someone of their same sex or discover that this period was simply a try-out?  They do little or no harm to their adolescent selves, (as long as it is safe sex), experimenting with their sexual desires.  Being attracted to a person who is the same sex is not the same as needing to change your sex.

The hormones required to halt puberty and support a sex change cause permanent damage to developing bodies.  And the surgery renders many sterile and all women undergoing a full change will lose the ability to nurse.  Is that really a decision a child can make?  And why do doctors comply with these desires?  Is that how they would react to other conditions a child might report?  Shouldn’t their reasoning be explored.

The literature is full of stories of girls copying each other in pregnancy or suicide pacts.  Isn’t that more likely?  And how many boys who really hate sports and prefer more mental challenges have been pressured to “act like a boy?”  That alone could cause someone to think they were somehow “wrong.”

I remember all the woes of childhood, where someone with red hair or curly hair hated their hair, while others (me) lamented my stick-straight hair.  I knew boys who liked to play chess instead of football, girls who were better athletes than many boys and myriad other variations on the stereotypical boy or girl.  As adults, we don’t judge others so harshly.  Why then do we assume that a child who is unhappy in their body for a time, is actually desiring to be the opposite sex?

The Lesbian and Gay Community’s Contribution

Being attracted to your same sex, (or to both sexes,) is simply sexual attraction.  Many people, if pressed, would admit to having feelings outside of heterosexual practice.  That’s fine.  But why did this community, having won all the rights and freedoms they were always entitled to, (but didn’t get), want to stand up for sex changers?  Aligning with childhood transexual surgery is a bad idea; just as the same group is supporting transexual men who wish to participate in women’s sports.  If you want to call yourself bisexual or describe yourself as binary, (or whatever the term is now), go ahead.  We’re all different.  It’s just that changing sex as a kid is a far different story than changing it when fully an adult.   

The vast majority of lesbians and gay men are happy in their bodies and enjoy their sexual freedom without thinking there’s anything wrong with them.  Sexual desire is not the same as sexual transformation and comes with few risks now.

In time, as many children discover that they have made a big mistake, and a decision they should never have been allowed to take, we will see a smaller number of people undergoing surgery and taking harmful drugs.  Let’s move to that day as soon as possible, before more kids are harmed.