CW: Potential transphobia, medical treatment
With all the legislation currently targeting the transgender community and especially transgender youth, we need to acknowledge that there is something similar happening to disabled children — and people seem to be perfectly fine with it.
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TRANSCRIPT OF “FOREVER YOUNG”
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MALE VO [00:03]
This is Bad Attitudes.
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Hello friends and strangers! Welcome to another episode of Bad Attitudes: An Uninspiring Podcast about Disability. I’m your host, Laura.
Absolutely not me pissing off people on social media. Just kidding. Absolutely me.
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As always, I want to remind you that disability is not a monolith. My experience as a disabled person is going to be different from the experiences of other disabled people. I am one voice for the disabled community but I am not the only voice.
The topic of today’s episode is not something I considered talking about so soon — or possibly ever. It simply didn’t occur to me to make an episode about it, but it has suddenly become relevant.
As I’m sure you’re aware, a lot of legislation targeting the transgender community is making the rounds in the US. Some of this legislation specifically targets transgender children, preventing them from being prescribed puberty blockers, with legislators deeming the treatment “abusive.” On an Instagram post about the fact that Idaho is working on a bill that would send doctors to prison for LIFE for prescribing puberty blockers, I made an off-handed comment that these same conservative legislators would be okay with giving puberty blockers to disabled kids to make them quote “easier to care for.”
I didn’t think much about this comment because, let’s be real, when you think you’ve reached the limit of how society will treat disabled people, it’s just the tip of the iceberg, so I expected people to basically take it at face value or ignore it all together. But one user couldn’t do that and replied, quote, “I don’t think that ever happens. Don’t weaponize disability, especially when your statement is false.”
Well, bless your heart.
I’m inclined to give them the benefit of the doubt because, according to their Instagram profile, they’re 17, and I, too, was secure in my convictions at 17. But, then again…you’re 17 in 2022. You literally grew up plugged into the Internet like Neo was to the Matrix and you couldn’t be bothered to do ONE Google search?
A single Google search for “disabled children puberty blockers” turns up no less than 5 related search results on the first page. Unsurprisingly, these results are interspersed with articles about puberty blockers and gender dysphoria.
Using puberty blocking treatment on disabled children is part of something known as the “Ashley treatment,” so-called after the first child on whom the treatment was performed. In 2004, Ashley X underwent growth attenuation, which uses high doses of estrogen to advance the closure of her bone plates and prevent her from growing taller. She also underwent a hysterectomy, breast bud removal to prevent development, and an appendectomy.
Ashley is considered severely disabled and was born with a static encephalopathy. She requires constant care, a feeding tube, and is unable to raise her head, sit up, or talk. Her parents made the decision to seek out these treatment options because she began to show signs of puberty at the age of six and a half, and they began to consider the ramifications on her long-term care. (Puberty at such an early age is common among children with a variety of severe brain damage.) Her parents’ and doctors’ reasoning for this treatment SEEMS sound. Her appendix was removed because Ashley would be unable to vocalize symptoms of appendicitis. A hysterectomy prevents menstruation and associated painful cramps, so she doesn’t have to experience that discomfort, but also so caregivers don’t have to be concerned about menstruation when dealing with a diaper-wearing patient. And her smaller stature will make it easier for her parents to care for her physically as she, and they, get older.
Other potential benefits include low to no-risk of breast cancer. Pregnancy is a non-starter. Of course, in order to get pregnant, Ashley would have to be sexually abused by a caregiver, and her lack of secondary sexual characteristics (ie, breasts), makes it less likely that she will be sexually abused by a future caregiver. Hopefully. Honestly, there’s no guarantee, and the likelihood of sexual abuse — especially at the hands of caregivers — is a reality all disabled people and the people who love them should be aware of.
I’m not here to judge Ashley’s parents — or any other parents — for making the decision to provide their daughter with this treatment. But you’ve got to admit it feels kind of…icky. The type of child to whom the treatment is applied is currently quite narrow, but how long until it broadens? And how broad will it become? How long until we slip back into the abyss of forced sterilization?
There are two fundamental differences between giving puberty blockers to trans kids and performing the Ashley treatment on disabled kids.
One, puberty blockers are REVERSIBLE. It is a temporary stop-gap in the treatment of transgender youth. They will not be on puberty blockers forever. But you can’t put a uterus back in a woman’s abdomen.
Secondly, and more importantly to my mind, trans kids get to have INPUT on their treatment. These kids are given puberty blockers because they have expressed to their parents and their healthcare providers that they are transgender, and going through puberty would exacerbate their gender dysphoria. Children undergoing the Ashley treatment don’t have that luxury. They are unable to communicate with their caregivers, or, more accurately, their caregivers are unable to understand them.
There is SO much science still doesn’t understand about the way the human brain works. So, her doctors may say that Ashley is at an infant level of communication and self-care, but what do those of us outside her head REALLY know about what she thinks or feels?
Like I said, I’m not judging Ashley’s parents. They had to make a decision based on the information available to them, and I am certain it wasn’t an easy decision. But, we have to acknowledge that IF this treatment becomes more prevalent, it could create numerous problematic situations for disabled people.
My whole point with this episode was to show the incongruity of how disabled children are treated versus how “normal” children are treated. Arguably, transgender children are not “normal,” but from the perspective of the legislators attempting to pass these laws, they are normal children UNTIL they are given puberty blockers or other treatments for gender dysphoria. But it is not a far stretch to imagine that these same legislators would find the Ashley treatment to be perfectly acceptable, or that it would be okay to go even farther by applying similar treatments to quote “less” disabled children.
Again, puberty blockers are a TEMPORARY solution given to treat children who are dealing with gender dysphoria. Gender dysphoria is dangerous and can often lead to children taking their own lives. Puberty blockers could potentially prevent death in a gender dysphoric child. Puberty blockers give these children and their caregivers an opportunity to determine the next best steps for a child who is transgender.
What does the Ashley treatment prevent? As mentioned before, it could POSSIBLY prevent breast cancer by removing the breast buds, and it could POSSIBLY prevent cancers of the female reproductive organs by performing a full hysterectomy. If the child tested positive for the breast cancer gene, then it makes sense to remove the breast buds from a severely disabled child. Preventing the possibility of painful and invasive medical treatment — like that for cancer — in a child who is going to be dependent on invasive medical care for the entirety of her life makes sense.
But even Ashley’s parents admitted that those were side benefits. The primary reasons for the Ashley treatment were to make her care easier. Ashley could still develop some type of cancer. She could develop any number of unknown illnesses regardless of the preventative nature of the treatment.
Naturally, there is concern around the side effects of puberty blockers, mostly related to bone density and potential infertility. Most of these side effects are mitigated by the fact that puberty blockers are TEMPORARY, meant to give transgender children and their parents an opportunity to consider their next options, NOT to be taken long-term.
Do I believe transgender children should have access to puberty blockers? Yes. I feel like you can’t have a stronger argument in favor of something than “it might stop a child from taking their own life.” Do I believe parents should be able to dictate that their disabled child undergo something like the Ashley treatment? That’s far more complicated.
As mentioned, it’s a treatment that has the potential to put disabled children and adults in precarious situations. I’m not saying this will happen, but there is certainly the potential to bring back forced sterilization of disabled people. There is also the very real possibility it could lead to unnecessary medical treatment of disabled people.
Puberty blockers and the Ashley treatment are NOT the same thing but it would be irresponsible of legislators to call one child abuse and not the other. And I have no trouble imagining that the conservative legislators who want to halt treating gender dysphoria in general would be more than willing to overlook disabled children receiving similar treatment.
Bills currently before legislative bodies across the United States are far more abusive than puberty blockers could ever be.
Obviously, I am not an expert on transgender healthcare (or even disabled healthcare) so please be gentle with me, but if you have any feedback, I am always open to it.
Thanks for listening and I’ll talk to you in the next one.
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