The doctors defying the FDA by prescribing transgender kids with puberty-supressing drugs to help change their lives



An increasing number of children are realising they are transgender, and are actively seeking care at clinics around America.



Because of their age, parents and doctors are having to make tough emotional and medical decisions, prescribing medication that halts puberty.



However this has led to fierce debate among medical experts - despite the willing parents, and doctors, who want to give transgender children a normal upbringing while protecting them from harm and embarrassment.

Tough decisions: Amber stopped going by her given name, Aaron, when she was 10; at 11, she started medication to keep her from going through puberty

While the medication is approved by the Food and Drug Administration for children who start puberty prematurely, it is currently unapproved for transgender adolescents.



Only a small number of clinics in America serve transgender children, and it was only a few years ago that doctors began treating them with puberty-blocking drugs.

Many doctors who support the drug believe that the medication gives children time to explore their gender identity before taking hormone pills - effects of which are irreversible.



There are two American organisations studying gender issues that recommend the drugs' use in certain transgender cases, but many doctors remain divided on whether to prescribe the controversial puberty-halting medication.

By suppressing the production of sex hormones, the drugs make it easier to pass as the opposite gender, and if the youngsters stop taking the medication, they will go through puberty.

Supporters of the drug say it can prevent feelings of overwhelming devastation when a transgender girl grows facial hair or her voice drops, and when a transgender boy develops breasts or begins menstruating.

Amber, a feminine 12-year-old who loves Hello Kitty, pink skirts and makeup, was born a boy - a secret that led to all her baby pictures being tucked away as though her childhood never happened.

She stopped going by her given name, Aaron, why she was 10, and began dressing as a girl; then when she turned 11, her parents gave permission for doctors to administer medication to keep her from going through puberty.

Amber's mother, Michelle, said after reading the research about how common depression, anxiety and even suicide are among transgender adults, she believes that letting her take the medication and live as she wants is the only real choice.



She told the Los Angeles Times : 'We are confident this is her authentic self.'

Michelle and her husband Jamie, whose last name was withheld at Amber's request, described the last few years as a 'roller coaster of emotions', from guilt for not recognising years earlier that their daughter was transgender, to grief over losing Aaron and worries about Amber's future.



It was only when Aaron was nine, after years of house-bound anxiety over his gender, that a friend suggested to Michelle he might be transgender.



She and Jamie did research, met with a therapist and watched a television show about transgender kids.

'Once I realized what was going on, it was a huge relief to know there was something we could do to help her. I just wanted her to be comfortable who she was,' she said.



' Puberty in the right body is hard enough, puberty in the wrong body is really hard'

Jamie said he found the change, and giving up his expectations for a father-son relationship, difficult, but he knew that Amber was much more confident and happy.



He said: 'As uncomfortable as it is for a father to see his son dressing as a girl, I knew we were heading in the right direction.'



And while Jamie is supportive of Amber taking the medication, the father still has his doubts.

He said: 'This is some pretty serious territory. As a parent, you are always second-guessing yourself.'

Jo Olson, Amber's doctor and the medical director of the transgender clinic at Children's Hospital Los Angeles, said the drugs can reduce depression and anxiety, while also eliminating the need for some future surgeries.



She said: ' Puberty in the right body is hard enough, puberty in the wrong body is really hard.'

A 2007 survey conducted by Dr Joseph Kosciw of the Gay, Lesbian and Straight Education Network found that over 85per cent of transgender students had suffered verbal harassment.

Nearly half, 49.5per cent, reported physical harassment and 34.1per cent reported being physically assaulted.



Other doctors, however, have expressed caution over the drugs based on a lack of research.



Walter Meyer, an endocrinologist and psychiatrist in Texas who works with transgender patients, said not all children who identify with the opposite gender end up as transgender adults, and giving medication to adolescents may be going too far.



Dr Olson acknowledged that many doctors are currently making clinical decisions based on instincts and observations rather than research, but she said she prescribes the drugs only to adolescents who are in counseling, and have been persistent about their gender identity.

Michelle and Jamie said a monthly support network has helped them discuss their feelings, while also enabling them to trade information about schools, doctors and medications.



'Being in the group has reinforced our thought process and the choices we are being forced to make,' Michelle said.



Amber's father said the puberty suppressors act as a temporary expedient to 'make sure everybody is 100per cent on board with the way it's going.'



However Amber , who as the toddler Aaron was exceptionally young when he first made his gender preferences clear, insists she never wants to be male.