Interview: Evaluating The Use of Hormone Blockers In Children Under 16
Following a court case regarding Kiera Bell and hormone blockers a massive shift has occurred regarding the use of puberty blockers in children under 16 years. There has been considerable coverage of the people who agree with the decision and adults who are not directly affected by the ruling, but there has been little coverage of the effects on the teenagers who were almost ready to be seen by Tavistock Gender Identity Clinic after a long and mentally painful wait.
Liam, a 14-year-old trans male has known that he was not born in the body that matched his mind since he was 7 years old. He has told me that he always knew that he was different, but it was only through age that he knew why. As puberty hit and he was developing in areas that were feminine it set in stone his hatred towards his body.
“I knew by all the things adding up. Hating my chest. Crying when I had to have a shower and see my body. Always wanting to hide myself and never ever wanting to wear the feminine clothes.”
“It was a scary thing. And difficult to manage all the changes at first but I gradually got used to it. Periods. Larger chest than I wanted. And the pain from binding.”
More recently, Liam’s hips have grown and taken the shape of an adult woman. He explains to me that because this development happened instead of being blocked while he became sure of his future form, he will never have a male figure now.
As Liam further developed, he became extremely dysphoric and would attempt to scratch his established breasts off. He began self-harming and as he further advanced, he became suicidal. 46% of people who are trans have thought about taking their lives each year, with 12% trying.
As Liam sought support for his feelings he became involved with a lot of services, all with waiting lists, all trying to help him make sure that he was informed about the pros and the cons of transitioning, that it was something that he had to do, all needing informed consent.
Liam felt that school was so desperate to look supportive that they jumped on the opportunity to prove it. He felt that one day he was accepted by others and then the next he was either ‘the trans kid’ or an opportunity for teachers to prove their acceptance. Liam said that he had put off telling anyone because he was afraid of losing friends and family, that people would see him differently and because of the way that the school handled it, that is exactly what happened. Liam knew that regardless of the way he was treated he could not pretend to be female anymore despite the pain of losing friends.
“When I first came out, friends became a day by day thing. Now I have a new set of friends and they are good, supportive friends. The people I spend time with now are accepting people.”
On the request of Liam’s mum, he was referred to Child and Adolescent Mental Health Services (CAMHS) to support his mental health and ensure that he was considering his options fully before doing anything that could not be undone. Liam explained that he was only seen after long waits and pressure from people who were concerned about him.
Following several trips to Accident and Emergency due to suicidal intentions, he was offered workers who would get him to open his feelings and then go off ill for months, leaving him alone with his pain.
Liam felt extremely let down and lost faith in CAMHS to help him be safe. With sessions being six weeks apart, Liam lost all confidence in them.
Having come out of counselling through CAMHS he now sees a charity therapist who listens to him. This therapist is concerned that his mood will not improve until he can stop fighting the changes to his body. That despite all coping strategies in place, Liam is incongruent to himself constantly while in the wrong body.
Prior to ‘coming out’ Liam tried hard to fit in however due to his masculine mannerisms he would get shouted at for being in the female toilets. This was when he was still attempting to fit in as a female. When Liam began to live socially as a male, he faced confrontation for being too female. Either way, he could not avoid being perceived as different.
“Being jumped in the park and in social groups many times, even in open spaces, in front of hundreds of people. Some of my friends have been beaten so badly that they have had seizures and ambulances have had to be called. It is always dangerous leaving the house. My depression and anxiety vary a lot but mainly come from worries of if someone found out if they would beat me up.”
I asked Liam why the police were not stopping this and he said that
“They don’t do much to stop hate crime towards the LGBT’s, when we do report it we get told that it will get worse if they get involved”
Asked about what he felt about the recent decision regarding the use of hormone blockers in children he said;
“The new ruling has changed quite a lot. It shows anyone who's transgender isn’t seen as a person anymore. If I wasn’t trans then I could consent to all treatments but because I am trans I can’t? It has taken away the strength and hope of just a year and I'll be there. Just this long and I'll be who I want to be. One of the things keeping me going. Now there are even more boxes to tick and a court, who has never spent any time with me decides whether I am allowed to be happy. I have already had to wait so long that the changes to my body can’t be undone.
“If I could say anything to those people making the decisions, it would be that we are still human. We should have the right to be who we want to be without the worry of having to wait till a certain age, when everyone who knows me knowing it’s what I need. Since when has someone’s happiness and life been discarded and left to the 0.1%”.
I asked Liam to explain how he is coping now that he knows he will need to wait longer
“I could say to myself it’s not long now, but I can’t. I knew by the time I finished university I could start a new life as the new me. Now someone I don’t know will decide that. I never had a happy childhood because everyone wanted me in girls’ clothes, doing girl things. I want to be an adult as who I am. Not still transitioning. I have started self-harming again; my dysphoria has worsened and I am in pain from binding. My ribs hurt but its better than knowing there are the wrong things there. When shark week comes I cry knowing I still have years of them but there is something that can make it all stop out there that works and the 0.1% who aren’t even trans have decided I can’t make the decision to have it. Even if they won’t let me have the testosterone for years, they could at least stop me getting more feminine.”
Liam has faced daily struggles throughout his life to try and fit in. He has been able to give informed consent to being put on birth control tablets to try and reduce his menstrual flow which have side effects and risks. He has been able to give informed consent to access support groups, therapy, can attend the GP on his own and is believed to have the capacity to decide almost every other area of his life but he has had this consent taken away from him. There are 5717 people on the waiting list who will also have to wait and potentially be hurting as much as Liam.
He explained to me that he knows that there may be risks, which have not been proven yet, but the risk to himself if he is unable to block the female development is much greater. He stressed that he would happily take the risk if it meant his quality of life would improve.
Asked if Liam would like to leave us with any thoughts, he said
“Being trans is not a choice. It is painful every day to try and be accepted as the person you are. No one would willingly choose this pain. There are so many assessments, so many waiting lists, so long to wait. This is a lot of time to stop and think and know you are doing the right thing. Why add more waiting?”
Written by Janine S White
As someone who does not like to fit into expectations, I like to support society to be more accepting and understanding of differences. If I can make just one person more aware of the pain that can be caused by inequality and think first, then I have succeeded.