Aug 012011

I spent this weekend at the Gender Spectrum Family Conference and Professional’s Conference. Gender Spectrum is an organization in the San Francisco Bay Area (Berkeley) which helps families with transgender or gender non-conforming children. I really enjoyed my time, both attending workshops and chatting with families and professionals, so I thought I’d share a bit of what I learned and experienced. My mind is still swimming with new knowledge and perspectives, so please excuse the scattered-ness. I am not going to go through Trans 101 or Transition 101 here – I’ll be covering that in another post fairly shortly.

Some quick things I learned:

  • In California, gender identity is a protected class.
  • The most common intersex condition is congenital adrenal hyperplasia. If unrecognized, this can lead to death very quickly in newborns. Females with CAH end up producing too much testosterone as fetuses. This alters aspects of their physical sex, but not their gender – nearly all of them identify as women.
  • Some physicians have had luck suppressing testosterone in their pre-op trans women patients by just using estrogen and progesterone with no androgen blocker. The work will be presented at this year’s WPATH meeting and is slated for publication. I will cover it more thoroughly when it does get published.
  • Some professionals are thinking that the ratio of MtF:FtM is actually closer to 1:1. The numbers I’d previously heard varied, but with more MtF in Western countries and more FtM in Japan.

GnRH analogues were discussed a lot. These are so-called “hormone blockers” that can delay puberty. They’re considered safe to use, and have been used for children with very early (“precocious”) puberty for a while. GnRH analogues can also “buy” valuable time for trans children, delaying puberty to allow for decision-making, resource finding or family-convincing. For trans boys, it means they have more time to grow (the hormonal changes in puberty for both sexes stop height growth – this is why women are shorter than men). Unfortunately, they are also rather expensive.

There are trans children now who have the opportunity to go through hormone treatment instead of their natal puberty. That is, for a trans girl, instead of going through male puberty, she can be put on estrogen and progesterone so she goes through puberty just like any other girl her age. I am really excited about this. This reduces the painful and expensive procedures they might have had to go through otherwise, and helps them truly be in the right body for them. There’s only one medical conundrum… if they want to change their genitals then surgery is still the best option. Surgery for trans men is getting better all the time (Yay!). For trans women, though, not going through their natal puberty presents a potential problem. One of the things that happens in male puberty is that the penis gets bigger. The penis then gets used in surgery to create a vagina. The bigger the penis, potentially the deeper the vagina. Now, other tissue can be used instead (skin grafts from places like the forearm, thigh, or tummy), but they’re not as sensitive. I do believe that people are working on a solution to this, though. We’ll see what they come up with.

The consensus at the conference was that transgenderism is a biological condition. I was impressed with the strength of the evidence I heard. I want to look at the original articles before I discuss it in detail. Stay tuned, though – I definitely will be posting about it!

Part of the joy of the conference was getting to hear about children exploring their gender with support from parents or others. That was awesome. Most of the stories I’ve heard have been from people who transitioned as adults, where they had to fight every step along the way alone. There’s still a struggle in these families, but it’s wonderful to see how they support each other.

I also have a long list of new local resources to check out. I’ll add those as I parse through them.

All in all, it was a great experience. I’m really glad I went. 🙂