At What Age Should Minors Who Identify as Trans Have Access to Trans-Medicine?

Parnaz Daghighi, Kali Davie, Samantha De La Rosa, Suzanne Ford, Andrew Lawendy, Leo Bannister, PhD
The University of Texas at San Antonio, San Antonio, TX 78249
Objectives Physiological/ Developmental Considerations
To explain our stance on the ethics of allowing individuals younger than the age of 18 to Effects of Transitioning
undergo trans medical treatments and procedures for the purpose of gender
reassignment. .
Benefits Risks
Background ➢ Adjusting to physical
➢ Able to enjoy their
Gender reassignment surgery is the process by and psychological
sexual life in the changes can be
which an individual chooses to change their future.
gender by altering their sexual and other difficult.
➢ Don’t have the ➢
physical characteristics. This can be achieved Possible post-
mental stress of surgery
through hormone therapies and reassignment being in the wrong
surgery in order to resemble the gender they complications.
body. ➢ The patient who is
identify with psychologically. Gender ➢ Psychological
reassignment is commonly used to treat gender undergoing gender
happiness for reassignment will be
dysphoria, also known to be a condition in which patient, when they
someone has a conflict with their biological unable to reproduce.
have found the right
gender and the gender they identify with. When doctor. (3)

this procedure is planned to change the life of a ➢ Insufficient research

young individual this can have a profound effect
on them. Since medical advancements have
allowed us to now alter our bodies to satisfy our
internal identity, this has become popular among
those who suffer from gender dysphoria in our
society. In turn, it has become a controversial
topic.
Age of Autonomy
In medicine, the Age of Autonomy is considered to be the age in which a patient is given
the right to make their own medical decisions independently without the need of parental
consent.
❯❯ 70-90% of children who experience gender dysphoria resolve their identity crisis by
the time they reach the second stage of puberty, roughly around the age of 16.
❯❯ The State sets regulations regarding the sanctioned Age of Autonomy.
❯❯ The determinants of sexual orientation are not well known and it is believed to be
due to a combination of genetics, hormones, and environmental factors.
❯❯ Sexual orientation is not a choice made by the individual and it has nothing to do
with parenting style, sexual abuse, or other adverse life traumas or events.
❯❯ Gender identity is usually set by age 3 or 4 years.
❯❯ Sexual orientation is set around the age of 9 or 10 years.
❯❯ Youth Risk Behavior Survey data from Minnesota and Vermont found that about 1%
of 9th graders (Age 14) identify as gay or lesbian, 10% are unsure and 89% straight. (1)
❯❯ Contradictory to popular culture  the study shows that individuals  who come out as
transgender experience an increase  in the chances of committing suicide anywhere
between 7% to 17% depending on the number of individuals that were told.(2)
➢ Less anxiety, gender - The frontal cortex is the cerebral area of the brain that is
about the effects of
dysphoria, and principally responsible for our cognitive and decision making
delaying puberty.
depression levels abilities. As the image above reflects, this area of the brain is not
➢ May be at higher risk
than before. fully developed until the age of 20.
for diseases such as
➢ Lowers self - Research proves that younger individuals are more likely than
breast cancer, heart
manipulation. adults to engage in risky behaviors, this has been contributed to
disease, or diabetes
➢ Construction of parts lack of experience and maturity, lack of a fully developed frontal
in the future.(4)
is easier in youth. (3) lobe, and inability to fully analyze the situation in terms of cost and
benefit.
- Brain mass and synapse strength also increases with age. (6)
Academic Learning
Important biopsychosocial of hormone therapy: Conclusion
- Genetics, the age that you start therapy, and one’s overall state of health determine
Our group recommends that any hormonal or surgical intervention to
the outcome of hormone therapy.
alter the sex or gender of an individual should commence at or after
- Changes include physical changes, emotional state changes, sexual changes, and
the age of 18 for the following reasons:
reproductive system changes.
- Precedence for age of autonomy, impacts on growth and
- Psychotherapy highly recommended due to emotional changes.
development, risky decision making, and lack of evidence that
- Becoming irreversibly sterile from hormone therapy must be acknowledged.
transitioning positively affects the life course.
- Full changes associated with puberty make take years to fully develop.
- Can affect liver functions, cholesterol, and cause diabetes. References
- Mental health issues and safety are of major concern with LGBT youth, such as (1) Ceglie D.D. Care for Gender-Dysphoric Children. In: Kreukels B., Steensma T., de Vries A.
depression, eating disorders, and may be victims of perpetrators of dating violence as (eds) Gender Dysphoria and Disorders of Sex Development. Focus on Sexuality Research.
well. This is a very important point because data has shown that LGBT individuals are
Springer, Boston, MA (2014).
(2) Hass, Ann P. “Suicide Attempts Among Transgender and Gender Non-Conforming Adults.”
often in sexual relationships with older adults in contrast to other youth of the same Williams Institute, America Foundation for Suicide Prevention , 5 Feb. 2014. 
age. (5)
(3) Medhalt. Sex Change Surgery Guide: Pros Cons, Side Effects, Scars and AfterCare
(4) Boghani, P. When Transgender Kids Transition, Medical Risks are Both Known and
Unknown. (2015).
(5) Deutsch, Maddie. Information on Estrogen Hormone Therapy. UCSF
All of the above pose concern for individuals who are younger than 18 years Transgender Care, San Francisco, CA: The Regents of the University of
        California (2015).
old, as adolescence is a time of mental and physical growth on its own that (6) Petanjek, Z. et al. Extraordinary neoteny of synaptic spines in the human
furthermore, affect  the social aspects of life. (5)        prefrontal cortex. Proc. Natl. Acad. Sci. USA 108, 13281–13286 (2011).