What age should t-girls be allowed to take hormone legally in America?

[gugaxamot]

I have been thinking about the above question and I know it is a sensitive issue for many, but I have heard many girls express the wish they they should have been allowed to start transition therapy at a much younger age. Of course, this gets into complicated issues over whether a young person truly has the cognitive capacity to make such decisions. What doe the board think?

[RallyCola]

Are we talking physiologically or psychologically?

There is no medical reason why GnRH cannot be administered to delay the onset of secondary sex characteristics then the teen starts HRT by 13-14 or so. 16 is the preferred age however.

Psychologically you are invoking a much different issue which includes parents and both child and school psychologists that are usually I'll equipped for transition or working with a child who will need to do this.

In short, as early HRT is what is medically best for a child who needs to transition, education and redicing the stigma of transitioning is essential to getting care givers on board.

[GroobySteven]

Good question which I don't have an answer. Morally, as soon as an individual can decide absolutely that they are the transgender without the influence of parents.

[buttslinger]

In the States Elementary School is six years, High School is four years, but Junior High is only two years because that's the explosive time every kid is like a rat being examined in a laboratory after being injected with huge amounts of life altering SEX HORMONES!! YIKES!!!
This is probably the time the question would start to come up, and probably to best time to at least start addressing the situation.

[Nikka]

864317

[Stavros]

I may be wrong but I do not believe that there is a law which covers this issue -rather, there are guidelines for health care professionals and families and I suspect that it is up to the people involved to make a decision. Note, however, that there seems to be a general consensus that hormone therapy is not relevant to the child until they reach puberty which varies in children but could in general be set at say 12 years old. Allow me to refer to an article published in the Archives of Pediatrics and Adolescent Medicine in 2010, linked below, where it states

Allowing transition before the onset of puberty is controversial and should be determined by a close evaluation of the potential risks and benefits in a decision-making process among health care professionals, parents, and children. Before the onset of puberty, no hormonal intervention is necessary

and goes on to refer to
the Dutch protocol that calls for the administration of GnRH analogues starting at age 12 and moving to concomitant administration of cross-gender hormones at age 16, bone density was diminished at the time of GnRH analogue administration but was found to catch up when appropriate cross-gender hormone therapy was started. Height was increased for female to male patients by delaying biologic female puberty and was decreased in male to female patients with the administration of estrogen promoting closure of the growth plates

But note also that there may be issues around health care insurance in the USA which affect the parents of transgender children, and that policies may vary from state to state. It is also possible that while children may not be able to make decisions about their gender status at the age of 5, their parents can if they send them to 'aversion therapy' if the child persistently seeks to dress and behave as the opposite assigned gender.

In the UK the situation has been described as follows:

The Tavistock and Portman NHS Trust says when young children have gender dysphoria they are monitored over time but that it "wouldn't consider it generally helpful to make a formal diagnosis in very young children".
The centre provides counselling and support - with medical intervention not considered until a child approaches puberty.
Hormone blockers may then be prescribed, which delay the physical change of puberty.
A patient can consider taking cross-sex hormones at the age of 16, and surgery after 18, the BBC reports.

The article in the Archive of Pediatrics and Adolescent Medicine is here:
http://archpedi.jamanetwork.com/article.aspx?articleid=384321

The article on the situation in the UK is here:
http://www.mirror.co.uk/news/uk-news/two-britains-youngest-transgender-children-5470887

[ohioguy13]

Saw the Jazz Jennings interview on Dr Oz and that young lady changed my mind on a couple of different fronts. I think its up the person and their parents as to when is right. I believe she will be a great spokesperson for transgender issues now and in the future. She seems to have her head on fairly straight and not just out for fame. So where I might have said 16 before now I think earlier is ok

[BJ4TS]

I equate that with, say, when girls should start wearing bras. When the time is right and not when she reaches a certain age. There shouldn't be a set rule, correct?

[bassman2546]

Why 'in America'? Why not just transgender, period?

[buttslinger]

The last thing the Insurance Companies want is to have psychiatrists insist that if little Bobby doesn't get a million dollars worth of plastic surgery, he/she is going to kill him/herself.
Go OLD SCHOOL and let little Bobby run away to New York when he's 16.