Food and Drug Administration (FDA) approval for children’s gender care. Puberty blockers and sex hormones do not have U.S. While the number of gender clinics treating children in the United States has grown from zero to more than 100 in the past 15 years – and waiting lists are long – strong evidence of the efficacy and possible long-term consequences of that treatment remains scant. In all of it, the aim is to support and affirm the child’s gender identity.īut families that go the medical route venture onto uncertain ground, where science has yet to catch up with practice. And, from around the start of adolescence, it can include medical interventions such as puberty blockers, hormones and, in some cases, surgery. It can incorporate therapy or other forms of psychological treatment. It can entail adopting a child’s preferred name and pronouns and letting them dress in alignment with their gender identity – called social transitioning. Gender-affirming care covers a spectrum of interventions. Thousands of families like the Boyers are weighing profound choices in an emerging field of medicine as they pursue what is called gender-affirming care for their children. The United States has seen an explosion in recent years in the number of children who identify as a gender different from what they were designated at birth. “We just keep telling her no, and we’re crushing her. “She’s been asking for how many years now to be a girl?” Danielle said to her husband as they sat talking in their garage that evening. The risk of inaction was even more alarming: Without treatment, the doctor said, Ryace would remain at increased risk of suicide. The effects on her brain development and fertility weren’t well-understood. The doctor at the Akron clinic told Danielle and Ryace that puberty blockers could weaken Ryace’s bones. LONG-AWAITED NEWS: When clinic staff told Ryace Boyer they could help her transition, she told her mother: “This is what I’ve always wanted.” REUTERS/Megan Jelingerīut the initial consultation brought troubling new questions. After years of struggling in isolation to do what they thought was best for Ryace, the Boyers were now getting expert help from people who understood their situation. Afterward, the pair went on a celebratory shopping trip for girl’s clothes. Danielle was relieved. “This is what I’ve always wanted,” Ryace told her mother as they left the hospital. That’s when Danielle sought help at Akron Children’s Hospital and its new gender clinic, where staff told her they could treat Ryace with puberty-blocking drugs and sex hormones to help her transition. When she started middle school, she grew increasingly anxious about what puberty would bring: facial hair, an Adam’s apple, a deeper voice. At school, around town and in family photos, Ryace would remain a boy. At home, Ryace could be a girl, wearing makeup and dresses. But her parents feared for her safety if they let her live openly as a girl in their tightly knit rural community. Ryace (pronounced RYE-us) was assigned male at birth, but by the time she was 4, it was clear to her parents that she identified as a girl. “Do you know kids have tried to kill themselves?” “They were asking us these sad, terrible questions,” she told Steve Boyer as the two sat in their garage that August 2020 evening. Was her then-12-year-old child, Ryace, hearing voices? Was she using illegal drugs? Had she ever been hospitalized for psychiatric treatment? Had she ever harmed herself?ĭanielle was still shaken when she and Ryace arrived home in this small town nestled in a bend of the Ohio River. On the two-hour drive back from the hospital, Danielle Boyer kept replaying the doctor’s questions in her mind.
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