Note: This post is centered around an NBC Dateline broadcast in 2012 which featured the transition of a 9-year-old child from male to female, encouraged and facilitated by medical professionals. My intent in writing this post is not to in any way blame or criticize any child, but to shine the spotlight on the choices made by adults who are responsible for the welfare of children. A link to the Dateline episode can be found later in this post, along with transcript excerpts.

Only one medical professional in the story voiced a word of caution, Dr. Margaret Moon of the Johns Hopkins Berman Institute of Bioethics. Why aren’t we hearing from Dr. Moon, and others like her, anymore?

Update: Here is just one example, out of Australia, demonstrating how the docile Western media hawks the dominant trans message without even a hint of doubt. The article, dated May 21, 2015, featuring one of the burgeoning number of young women who want to medically transition to men, trumpets the urgent message that waiting lists for government-funded hormones and surgery for children ages 5-18 is a horrible injustice:

The waiting list for a transgender support service at the Royal Children’s Hospital has blown out beyond a year, prompting calls for urgent action to help vulnerable children. Surging demand has increased pressure on the hospital’s gender dysphoria service in recent years, with young people now forced to wait up to 14 months for a first appointment. The service works with transgender children, adolescents and their families. The term transgender broadly applies to people whose gender identity is at odds with their biological sex. The unit sees young people between 5 and 18 years old. Transgender Victoria executive director Sally Goldner said being told to wait for services could be devastating for children. “The services available need to be expanded urgently,” she said. Ms Goldner said being forced to wait for the help they needed was particularly problematic for children about to reach puberty. http://www.theage.com.au/victoria/surge-in-demand-sees-one-year-waits-for-childrens-transgender-clinic-20150521-gh61rj

(Because, obviously, puberty is a tragedy for these kids. They need to be on blockers followed immediately by cross-sex hormones, rendering them permanently sterile.)

With the bandwagon packed full of MDs and psychotherapists cheering on the transitioning of children and adolescents (and duly praised on a near daily basis by the fawning mainstream media), only a few professionals counsel caution. We so desperately need their voices to counter the deafening unison chorus of “Puberty blockers are good! Early transition is best!” “Infertility? Who cares?”

The proponents of childhood transition have a big podium, a PowerPoint presentation at the ready, and easy answers to such monumental, life-altering questions as: Should an 11-year-old, whose judgment, ability to weigh consequences, impulse control, and self awareness will not be developed for a decade or more, be entrusted to make the decision to be sterile for the rest of their lives? On what basis?

Just how big is the podium owned and operated by the pediatric transition gang? Well, here’s one example: People like Jenn Burleton, executive director of TransActive Gender Center in Portland (featured in two of my other posts on breast binding, and in a recent post on GenderTrender), are participating in pediatric Grand Rounds at hospitals. Grand Rounds are important events; they typically involve many doctors and other providers, and are considered major learning opportunities. Here is a clip of Burleton presenting at Legacy Emanuel Hospital in Portland, Oregon as part of monthly Grand Rounds in April 2011.

[Hat tip: GenderTrender who first posted this video]

What does Burleton (who has no medical background) have to say at the Grand Rounds podium? Among other things, Burleton says (twice) that most of the kids TransActive “serves” are under age 10. Burleton also reports, quite breezily, that when asked, these kids say they are happy with the “tradeoff” between starting cross-sex hormones immediately after puberty blockers, versus having their own biological children in the future. They choose infertility. And Burleton claims these youngsters “understand” what this means.

Is anyone in the medical profession raising questions about this practice? One MD who has sounded a warning in the not-distant past is Dr. Margaret Moon, a pediatrician and bioethicist at Johns Hopkins Berman Institute of Bioethics. Dr. Moon was interviewed by NBC Dateline in July 2012 as part of the program “Living a Transgender Childhood,” about a young boy named Joey Romero who was diagnosed with gender dysphoria and began his transition to “Josie” at the age of 9, with the help of Dr. Johanna Olson, a gender specialist at the Children’s Hospital of Los Angeles. As Dr. Olson’s bio page says, she is considered a “national expert” on giving puberty blockers and cross-sex hormones to pubescent children. You might even call her a trailblazer, since, counter to recommended clinical guidelines, she sometimes takes kids straight from blockers to cross-sex hormones at age 13 or younger, which permanently sterilizes them; ova and sperm cannot develop in a person who has never experienced the puberty natural to their biological sex.

As documented on the Dateline episode, Olson promises Joey/Josie and his mother, Vanessa, that he won’t have to wait until age 16 to receive cross-sex hormones, which up until recently, was the youngest an adolescent could be to qualify for this treatment.

Predictably, NBC Dateline gave plenty of airtime to Dr. Olson, and very little to Dr. Moon. To her credit, Hoda Kotb, the journalist reporting the story, did attempt to push back at times during the broadcast, but Dr. Olson quickly shut her up (as so many others have been similarly gagged) by playing the suicide card.

[Lest anyone unfamiliar with my blog think I don’t care about teen suicide, I have written about it here, and frequently on Tumblr. The blog http://www.transgenderreality.com has also documented the “transition or die” narrative that has gone viral on social media, influencing many young people to threaten self harm if they aren’t allow to medically transition immediately]

There were a few follow-up stories in the mainstream press briefly mentioning Dr. Moon immediately after the NBC show aired, but in the nearly three years since then, no reporter seems to have bothered to ask her to say more about any continuing concerns she might have regarding the gathering tidal wave of childhood transition. In the old days, when journalists were watchdogs, this would have been considered professionally shoddy. After all, an expanding and controversial medical trend deserves to be treated with some balance in the press, but it appears that this duty has been largely handed off to bloggers in the 21st century.

I suspect that Dr. Moon, like psychiatrist Dr. Paul McHugh, who founded the Johns Hopkins sex reassignment clinic, then subsequently shut it down in 1979, is likely being ignored because trans activists have successfully branded her as “transphobic.” Dr. Moon had the audacity to apply her clinical judgment as a pediatrician, and her sense of basic morality as a bioethicist, to try to slow down the careening-out-of-control pediatric transition bandwagon. McHugh wrote an Op-Ed in the Wall Street Journal in June 2014, explaining that the sex resassignment clinic was shut down at Hopkins because he and his colleagues realized that those seeking the treatment suffered from mental disorders that were not alleviated by the surgeries and hormones. For this, McHugh is persona-non-grata in the transgender world.

The Hopkins Bioethics institute helpfully posted clips from the Dateline episode featuring the few instances Dr. Moon is shown expressing her very reasonable concerns about the sterilization of children. They also published their media contact information. But in the intervening 3 years, I haven’t been able to find a single news story quoting Dr. Moon.

The NBC Dateline clips on the Hopkins page are here:

http://bioethicsbulletin.org/archive/jhu-bioethicist-margaret-moon-on-dateline-nbc

In her brief cameo appearances, Dr. Moon says drugs that delay puberty, as Hoda Kotb reports, “may be helpful in some extreme cases. But that second step—giving opposite sex hormones is alarming.”

Dr. Moon: Any change you make that’s irreversible is harder to justify when a child is young…We have lots of very well intentioned people looking at the same data and coming away with very different ideas.

Kotb: Is this an overdiagnosis issue?

Dr. Moon: Potentially. Yes, potentially an overdiagnosis issue.

What does Dr. Moon think now, 3 years later? Has overdiagnosis gone from potential to reality?

The segment showing Olson interviewing 9-year-old Joey/Josie is eerie.

“I just want to get surgery right now,” the child says.

Olson : Let’s say you could wake up and have whatever you wanted on your body. No penis. You want a vagina and breasts…I made you giggle! Would that be a yes? Yeah. I hear ya.

Yes, Joey/Josie did giggle. The child nodded slightly at the leading question. A 9-year-old giggles (like many would) when an adult talks about genitals. And the producers at NBC Dateline thought that was the defining, newsworthy moment between doctor and pediatric patient?

But at that first visit, Olson didn’t prescribe the blockers. Joey/Josie was too young. Not because Dr. Olson thought the child wasn’t transgender. Not because Dr. Olson thought a child that young might not be certain. It’s just that little Joey/Josie was nowhere near starting puberty (so there was nothing to block yet). Says Mom: “When she realizes she’s not going to walk out the door with breasts, she’s going to be really disappointed.”

In a one of her brief appearances, Dr. Moon brings up the decades-old evidence that trans activists and their media acolytes seem not to have heard of–despite the fact that even the World Professional Organization for Transgender Health (WPATH) itself acknowledges this evidence in its latest Standards of Care on page 11.

Kotb: The few studies that do exist suggest young kids with gender identity problems often grow out of them.

Dr. Moon: Those kids who start as children, who say, I’m in the wrong body, end up by the time they’re in middle adolescence actually fairly comfortable with their own gender.

At one point, we see Kotb gamely using her common sense: “To me, it seems ridiculous to have a child at 12, 13, 14 deciding whether they want to have biological children when they’re 20, 30, or 40.”

Then Olson goes there, delivering the coup-de-grace: Sterility or death! “Well, they make the decision to kill themselves at 12 and 13. That’s a pretty powerful decision. We take an oath: Do no harm. If doing nothing is doing harm, we have to do something.”

Here we have an authority figure–a doctor–saying that the only “something” you can do to prevent a dysphoric 12-year-old from committing suicide is to sentence them to lifelong drugs, surgeries….and sterility.

In Clip 2 on the Hopkins page, the NBC producers and editors introduce a note of tension.

Kotb: Had Vanessa’s unwavering support of Josie’s transition pushed her too far, too fast?

Mom/Vanessa: The thought of her making such a huge decision in her life, all based on what she thought I wanted, that would be…that would be traumatic for me.

Traumatic for you? How about for Joey/Josie, who might realize at age 30 that he actually wanted to be a dad, after all, but was permanently sterilized by the adults who diagnosed him as a child?

Another cameo of Dr. Moon:

Kotb: Dr. Moon, who opposes opposite sex hormone treatment for children Josie’s age says most 9 and 10 year olds are not mature enough to participate in life-altering medical decisions.

Dr. Moon: They’re not sure of who they are. And they can’t really offer their parent that sort of reassurance.

A voice of reason. How did we get to the point where a young child must reassure his parents that he really, really, really isn’t going to change his mind later? Ever?

Kotb: Even Dr. Olson says there is no exact science that can determine who is truly transgender.

Olson: What’s missing in the data right now is: these exact characteristics mean for sure this person is going to be a trans adolescent and adult. We don’t have that data.

That should be the show stopper—right there. We don’t have the data. We STILL don’t, three years later. We do have data (which NO ONE on the show discussed) that most “gender nonconforming” kids outgrow their dysphoria and grow up to be gay or lesbian, happy in the only bodies they will ever have. But that doesn’t seem to matter here.

What does seem to matter is that Joey as a 3 year old had tantrums and trouble sleeping. The doctors and journalists find it significant that Joey seemed to prefer his sister’s toys and clothes—a younger sister who was adopted into the family. “If we’d go into the store,” Mom says, “Joey would head over to the little girl’s section.” No one—the journalist, mom–brings up the possibility that some of Joey’s behaviors could be attributed to feeling upset or threatened when a younger, female sibling appears and takes some of the attention away. Any family with more than one child is aware of this dynamic. But it’s not even touched upon here.

Joey’s pediatrician was on the bandwagon from the get-go:

Kotb: The doctor noticed the way 6-year-old Joey was playing with his toy.

Mom: Joey lifted his shirt and started breast feeding the doll, and the doctor said, “I think your child may have gender identity disorder.” And I was like, what? And the doctor said, you know, like transgender.

”[I had to rewind the video at this point to listen again. Could a doctor really have said this about a little child playing make-believe-Mommy at age 6?]

Kotb: Vanessa learned more about the condition from online support groups. So she decided to try something radical: Buy her child a new girl wardrobe.

[Where have we heard this before? The child had a “condition.” And confirmation of that “condition” came from Internet “experts” and chat groups. ]

Mom: Joey started saying, “You can’t say he anymore, you have to say she.” So we had to correct our pronouns.

[They had to “correct” their pronouns.]

But Dateline caught a moment of doubt. This segment must be watched, if nothing else, to see the expressions on the child’s face during this conversation between mother and 10-year-old child.

Kotb: Estrogen treatment is irreversible and will make Josie sterile, but Josie and her mother never doubted it was the right thing. Until an unexpected conversation happened.

Mom: On the inside, are you a boy or a girl?

Joey/Josie: Maybe I’m a boy inside, and a girl outside.”

Mom: If you wanted to grow up to be a man, you could. Would you tell me?

Joey/Josie: Sometimes I think I’m a boy, sort of, but I wanna be a girl….would you let me be a boy?

Mom: Of course. I love you no matter what..Sometimes I think you’re afraid to tell me what you really want.,

[Mom is hanging on every word Joey/Josie says, expecting the child, age 10, to be able to predict his future thoughts and feelings; to understand and decide in advance who he will be, whether he should give up the chance to reproduce as an adult; what it means to choose to be subjected to lifelong medical and surgical interventions ]

Mom: I’m just kind of surprised by the answers you’re giving me.

We see Joey/Josie and Dr. Olson meet again, when the child is 11. The first signs of puberty are evident, we learn, from the doctor’s exam.: “You are in the perfect place to start on blockers.” Olson promises to give Joey/Josie estrogen in 2 years. “Around 13,” Olson says. “But you’re not gonna have to wait until you’re 16 to start. You know that. “

Mom: A lot of times it strikes me that if this had happened 20 years ago, I wouldn’t have been able to give her blockers. She would have had to go through male puberty. That terrifies me. I don’t know that she would have survived male puberty.

Again with the only options being death vs. the terrible fate of accepting one’s own body. Maybe 20 years ago, Joey would have been encouraged to be himself and just grow up, without an implant in his arm dispensing pituitary-freezing, off-label drugs. Allowed to just be a kid and see what happened, without diagnoses and medical intervention. Just a thought.

The Dateline episode ends with Joey/Josie reading aloud from his vision of a future as a woman: “As an adult, my hair will be very long, blonde, wavy, and super pretty. I’m going to marry a boy. I want to be a mommy. I’m going to be very beautiful.”

And there we have it. Lots of gorgeous blonde hair.

I would like to highlight the other therapists, scientists, and doctors who dare–or have dared in the recent past—to question the headlong rush to the transitioning of gender nonconforming children and teens. Since mainstream journalists seem intent on ignoring these questioning professionals, let’s give them some more exposure here. Suggestions, anyone? Please tell us about them in the comments to this post.

Meanwhile:

Paging Dr. Margaret Moon. Dr. Moon, are you out there? Urgent page for Dr. Moon: We have an emergency.