Posted on 01/18/2019 7:11:10 PM PST by rickmichaels
In many ways, Max is a typical 14-year-old. He eschews soft music in favour of rock and heavy metal, likes to wear hoodies, giggles when hes nervous and has a flair for drawing animals. He can be opinionated and sarcastic one moment, shy and withdrawn the next.
His insecurities, however, run deeper than run-of-the-mill teenaged angst.
I have a male brain that doesnt match up with the body Im in, says the Grade 9, Surrey, B.C., student, who was the female gender at birth.
Its like being trapped in a cage.
Max is now at the centre of a complicated legal fight over who gets to decide the course of treatment for his gender dysphoria. Max and his mom, Sarah, with the support of the gender clinic at B.C. Childrens Hospital, want to proceed with a treatment plan that would involve injecting Max with testosterone a key step, they say, in Maxs desire to transition from a female to a male body.
But Maxs father, Clark, who is separated from Sarah and shares joint custody of Max, believes things are moving too fast and worries about the treatments risks. Why cant Max wait until hes an adult before taking such a big step? What if Max comes to regret his decision, but the changes are irreversible? Doesnt the father get to have a say in the matter at all?
The case raises difficult questions about parental rights, about child autonomy, about how young is too young to make serious medical decisions. The result is a messy ethical and legal tangle, where a number of deeply interested parties all with competing points of view on this issue, and all with the childs best interest in mind are at odds over how to proceed.
The hospital maintains the decision about treatment is ultimately Maxs to make and Maxs alone. That was a staggering notion for the father, which led him to file an application in B.C. provincial court to block the treatment. On Monday a family law judge agreed to adjourn the case for two weeks to allow Sarah time to hire a lawyer; for the time being the hospital cannot carry out any treatments.
None of the family members real names are being used in this story. The Provincial Court Act in B.C. prohibits the identification of any child or party to a family or childrens matter before the court. Sarah and Max had wanted to be identified using their real names. If Im not named, itd be like Im hiding, Max says.
While such legal disputes are rare, experts say family conflicts over proposed treatments and parental consent are likely to increase as more young people are referred to gender clinics across the country.
Clark insists he is not anti-transgender; he bought Max a transgender pride flag last Christmas. He just worries Max is being steered down a path without considering all the options.
I just want to do whats best for Max. And sometimes thats tough love.
Clark added later: I have no animosity towards Sarah on this issue. I think we both believe we are doing the right thing. And I believe we both have Maxs best interest in mind.
***
For as long as he can remember, Max has always preferred hanging around boys. He never played with female gender-stereotypical toys, such as dolls. His family chalked it up to him being a tomboy.
Maxs coming out moment came in Grade 7 when he stumbled across a video on YouTube. Titled Boy, the Danish short film documents the struggles between Emilie, a transgender boy, and his mother. The film opens in a clothing store. The mom picks out a dress for Emilie, but Emilie prefers military-style clothes.
It just kind of clicked right away, Max says.
After watching the film, Max stood in front of the mirror just as Emilie does in the film and cut his hair, which at the time stretched to the middle of his back.
By the time he started Grade 8, Max had undergone a complete overhaul of his identity, Sarah says. School staff were notified that he preferred to be known by his chosen name, not by the female name he was given at birth. Max had also started binding his chest.
While these changes helped, Max says the transformation still felt incomplete.
Even if Im open with who I am, Im still insecure.
There are times, he says, when hell go silent because his voice comes out sounding too effeminate. He often gets distracted by how girlie his hands look.
Sarah says the dysphoria has led Max to try to take his own life and engage in self-harm.
I didnt quite understand transgenderism myself, didnt know if I fully believed in it. But having gone through the experience Ive gone through with my son I fully believe that, yes, it is very possible that transgenderism does exist and there are people wandering around feeling excruciatingly uncomfortable in their own skin.
A clinical psychologist assessed Max about a half-dozen times over a period of several months, beginning in Grade 8. By the end of those sessions, Sarah says the psychologist deemed Max to be a good candidate for testosterone therapy. According to B.C. health guidelines, Max needed to have demonstrated to the psychologist a long-lasting and intense pattern of gender non-conformity or gender dysphoria, among other things.
The only other thing Max needed was a referral from a family doctor, which his father agreed to obtain.
In August, Sarah and Max attended the B.C. Childrens Hospitals gender clinic, one of the busiest in North America. There they met with a team of people, including a paediatric endocrinologist, a social worker and a nurse, who laid out in plain language what the treatment would entail and all the pros and cons. A three-page informed consent form spelled out the risks of testosterone therapy, including that the treatment in young adolescents is a newer development, and the long-term effects are not fully known.
The form indicated that testosterone use would likely lead to permanent changes such as a lower-pitched voice, facial hair and thicker hair on the arms, legs and torso even if the treatment stopped. Taking testosterone could also lead to elevated risk of heart disease, stroke and diabetes. It is not known, the form says, what the effects of testosterone are on fertility. You may or may not be able to get pregnant in the future.
Despite the risks, Sarah and Max signed the form that day and agreed to proceed with the treatment. After three years, Sarah says she had come to a clear conclusion: Max wasnt going through some phase.
If this is what alleviates my child experiencing this dysphoria, Id rather move forward. If it happens to have side effects down the road, were OK to handle that at least our child would still be alive.
***
Hospital staff were ready to begin injections that same day, Sarah says but she felt it would only be fair to let Clark, who did not attend the meeting, weigh in on the decision.
Clark, whose legal challenge was first reported in the alternative news website The Post Millennial, told the National Post he didnt want to miss work that day and thought the visit to the gender clinic was exploratory. He says he was shocked to hear how quickly things were moving.
I thought it was a long process and nothing drastic was going to really happen, at least without consent, he says.
Clark did not sign the form. He felt the potential medical ramifications were too serious for someone Maxs age to take on.
You dont just jump them into things they cant change back, he says. When shes 18 and she does it, Ill support her 100 per cent. (During his conversations with the Post, Clark referred to Max as his daughter and used female pronouns.)
Clark says a hospital social worker tried to persuade him to come in to talk but he declined; all the information he needed was on that form. He also sent hospital staff a copy of his separation agreement, which includes a stipulation that he and Sarah get to jointly exercise all parental responsibilities including giving, refusing or withdrawing consent to medical, dental and other health-related treatments for the child.
Last month, however, Clark received a letter from the hospital. It stated that under the B.C. Infants Act, as long as a health care provider is satisfied a child understands the nature, consequences, benefits and risks of the proposed treatment and concludes that the treatment is in the childs best interests, the right to consent belongs to the child alone.
Maxs healthcare team has concluded that he possesses sufficient maturity and intelligence to be capable of consenting to his own medical care, notwithstanding the fact that he is only 14 years old. Furthermore, the team agrees that the proposed course of treatment is in his best interests.
The letter goes on to state that while staff always strive to get parents onboard with a proposed course of treatment, under these circumstances we are of the view that it is ultimately up to Max to give or withhold consent to his own medical care; neither you nor his mother can make this decision for him.
At Mondays court hearing, Herb Dunton, the lawyer representing Clark, said they take the position Max cannot be rushed into treatment and no injections should happen until both parents consent, Max turns 18 or the court orders treatment.
Weve got to make sure Max makes the right decision now, Dunton told the court. If they start the treatment the damage is done.
Dunton said the credentials of the professionals recommending hormone treatment need to be evaluated and the recommendations peer-reviewed.
In adjourning the case for two weeks, the judge acknowledged he hadnt encountered a case like this before and did not immediately know whether the provincial law that recognizes Maxs rights to give informed consent trumps family law and the parents joint responsibilities for caring for Max, per their separation agreement.
One legal scholar suggested Clark may face an uphill battle. The (Supreme Court of Canada) has clearly articulated the law on minors capacity to consent, said Karen Busby, a law professor at the University of Manitoba.
Busby was referring to a 2009 decision, AC v Manitoba, that basically said if minors can demonstrate mature and independent judgment and have shown they understand the potential consequences of their decision their views about medical treatments ought to be respected. The top court, however, did allow for some wriggle room, saying, the more serious the nature of the decision and the more severe its potential impact on life or health, the greater the degree of scrutiny required.
***
The number of referrals to the gender clinic at the B.C. Childrens Hospital rose from seven in 2007 to 80 in 2017. The transgender youth clinic at Torontos Hospital for Sick Children now sees over 200 referrals each year, while the Childrens Hospital of Eastern Ontario saw 180 in the last year.
With an increasing number of referrals to gender clinics, one would expect and we are seeing a proportionate number of families and youth who may have discordant views on their care, says Dr. Joey Bonifacio, an adolescent medicine specialist at St. Michaels Hospital in Toronto.
It is not uncommon for parents to have different views on how to care for their child with gender dysphoria, between them and their child. It is also not uncommon to see disagreement between parents.
B.C. Childrens Hospital said it couldnt comment on the ongoing legal challenge. But it and other clinics in Canada say before any treatment is administered, mental health practitioners will have done an exhaustive screening of the patient.
This includes extensively exploring issues around coexistent autism, family issues, eating disorders and suicidality, B.C. Childrens Hospital said. The adolescent also has to demonstrate a long-lasting and intense pattern of gender nonconformity or gender dysphoria. Once assessed, some choose to start treatment immediately while others discuss other options.
Not all clinics, however, will start right away with hormone therapy. At the Childrens Hospital of Eastern Ontario, Dr. Margaret Lawson says its been her practice to recommend hormone suppression medication sometimes referred to as puberty blockers for six months in youth under 16 and one year for those under 15, before starting them on hormones.
Because the effects of puberty blockers are reversible, this is a more gradual way to transition and helps the patient and parents to be sure of what the youth wants and the parents to be comfortable supporting the start of hormones for their child, Lawson said.
Dr. Brenden Hursh of B.C. Childrens Hospital confirmed in an email there is some variation in practice in this regard at different centres.
We do not require (puberty blockers) in all children below a set age cut-off, but we would certainly use it if we felt there was benefit to the youth, he wrote. Torontos Hospital for Sick Children and the Alberta Childrens Hospital in Calgary say hormone suppression is optional at their clinics, as well.
According to updated guidelines published in 2017 by the international medical organization The Endocrine Society, when it comes to sex hormone treatment, the society recommends adolescents should initially undergo treatment to suppress pubertal development.
Hormone treatment shouldnt begin until the adolescent has sufficient mental capacity to give informed consent, which most adolescents have by age 16 years.
That said, we recognize that there may be compelling reasons to initiate sex hormone treatment prior to the age of 16 years.
Clinics told the Post they strive to obtain consensus among all family members prior to treatment. When conflicts arise, staff do all they can to work with family members to reach an agreement.
Certainly, in some cases, parents and other family members are at different stages of acceptance and support at different times, but these differences usually resolve over time with repeat visits and discussions in clinic, said Dr. Mark Palmert of Torontos Hospital for Sick Children.
When serious conflicts persist, the Canadian Paediatric Society recommends, if circumstances permit, the proposed intervention should be delayed while an attempt at a resolution is made. This could involve referrals for a second medical opinion, consultations with social workers, a bioethicist or bioethics committee.
At the Alberta Childrens Hospital, Dr. Jonathan Darwant says if one parent is adamantly opposed to treatment, they would likely arrange a second assessment by a mental health expert. If that second expert agrees the teenager would benefit from treatment, the next step would be to convene a hospital ethics team to weigh all the points of view.
Delays, however, cant go on forever and Lawson acknowledged there may be times when she starts treatment without the full consensus of family because its in the childs best interests.
A lot of parents are afraid about what this means and the child will have regrets or blame them, Lawson said. But in the long-term, having done this for 14 years, its amazing to see how kids blossom and become comfortable in their own skin. In time, parents come to accept their childs gender identity and realize that their child is the same person they have always loved.
While adolescents dont necessarily have carte blanche decision-making power, it is a time when they begin to make autonomous decisions, Bonifacio said. If the medical team deems the youth capable to make that particular decision then that decision is respected.
Elizabeth Saewyc, a professor at the UBC school of nursing and principal investigator of the first nationwide trans youth survey, said putting off treatment can create long-term distress on the adolescent.
I have seen in some circumstances where young people have had health care delayed and denied because everybody wasnt on board. One parent is supportive, and one is not, and nothing happens. That can be a problem, she says. If the clinicians, the psychologists, the endocrinologists, the family doctor, if all of them have done the assessment and have determined that this is medically necessary, then its important to actually pay attention to the expertise.
Saewycs survey found more than one-third of respondents had attempted suicide in the past year and nearly two-thirds reported self-harm.
Experts acknowledge there is a dearth of rigorous, long-range studies of children and adolescents who have undergone hormone therapy.
However, an analysis by Cornell University of 56 peer-reviewed articles from 1991 to 2017 of gender transition in the general population found a robust international consensus that gender transition, including medical treatments such as hormone therapy and surgeries, improves the overall well-being of transgender individuals.
The literature also indicates that greater availability of medical and social support for gender transition contributes to better quality of life for those who identify as transgender.
Maxs father, Clark, says he cant get over the question: What if?
A different question nags at Sarah: I dont want it on my conscience knowing that if this is all it took to alleviate that dysphoria from my child then why didnt we follow through with it?
For Max, the biggest challenge facing him now: Waiting.
The 14 year old does, after 4 years and moving out of the house and paying their own way.
If they are welcome to come home for the holidays is up for the parents to decide.
She wants to be someone, anyone else.
A natural desire but she would be better served if someone put a gag on both her parents.
18, you can get drafted or go full Klinger.
But 21 years is a good age too, honestly I wish there was one definite cut off age, pardon the pun for adulthood.
Pun appreciated and pardoned. I’m sticking with 21.
This tranny crap is 100% the result of liberals making it a cool fad to kids. There is no way middle schools went from having zero of them to over a dozen in just a few years time without it being seen as trendy.
Good, rational explanation
+1
can a 14 year old buy cigarettes, hard liqueur, get married, buy beer, fight in the army? No? Then why the hell should they be allowed to ‘decide’ that they want to mutilate their bodies? IF they are too young to fight, drink, smoke, get married etc- then they are too young to decide that they want to permanently change their gender
Who decides when a 14 y.o. wants to change gender? The child, the hospital, the battling parents?
Probably Liberal Courts.
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Personally, l think the public elementary schools are pumpin the kids heads full of s#!t these days
5 MINUTES ON HOW THE FOUNDERS DEALT WITH JUDICIAL TYRANNY
https://youtu.be/4MSvyk3X3wU
When he or she is 18 years old and not confused by societal pressures. Actually 21 years old would be better.
Oh, for crying out loud, liberals today are so closedminded. You have to play with dolls to be a girl? You have to want to hang out with other girls to be a girl? Otherwise, you must be a boy?
What happened to "a woman can do anything a man can do?"
30-40 years ago, if a girl hung out with boys, as most of my friends and I liked to do (because boys were adventurous and fun), that didn't mean she was a boy on the inside.
Here's what really happened to this poor girl. At a young age, she came across a youtube video that influenced her strongly, just as a book or something else can influence a child strongly:
. . . in Grade 7 when he stumbled across a video on YouTube. Titled Boy, the Danish short film documents the struggles between Emilie, a transgender boy, and his mother. . . . After watching the film, Max stood in front of the mirror just as Emilie does in the film and cut his hair, . . .
Whoever pays the bills, makes the rules.
Parents
When someone is 18 they csn make stupid decisions on their own and pay rent
A minor of any age. Particulay 14. Is an IDIOT SAVANT
parents tell
Kid what to do Period
None of the above. You make the kid grow up to be an adult first.
Sadly, probably not.
Yup. Trans gender people are mentally ill.
You can’t change your DNA.
I will say this, that our liberal overlords utilize a twisted logic to stay at the top of the global dominance hierarchy. Theyve got so many people arguing and wringing their hands over what should be self evident and fundamental truths, that they ensure they may never be challenged.
Its simple divide and conquer. You dont allow people to share common ground so you strip them of their common ground like their sexual identity. They keep power by continuing to subdivide human beings, practicing reductionism on the human psyche.
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