The Daily Caller Paints Discussion of the Risks and Benefits of Trans Treatment as a Scandal
Doctors serving the trans community are damned if they do, damned if they don’t as the normal process of weighing the risks and benefits of a procedure are twisted by the far right.
If you’re concerned about the negative impacts of puberty blockers and also hewing closely to the medical evidence (an admittedly small Venn-diagram slice), chances are you’re incredibly worried about the bone density of transgender youth. Like, really, really concerned that a side-effect that can be treated with calcium supplements and regular checkups is part of the risk-benefit calculus when doctors, parents, and the young patient consider the option of delaying puberty for a trans kid. Really!
Of course, as more evidence has come in we’ve learned that there don’t seem to be any lingering issues with bone density for transmascs, cutting in half this apparently alarming problem that’s been weighing on the minds of the nation’s most concerned trolls. Still, there are shorter-term concerns for both transmasculine and transfeminine youth, as well as the possibility transmasc youth who desist or detransition may not get the full benefit of testosterone to short up their bone health. Any good specialist in gender-affirming care for youth would surely discuss bone health with others in the field, and carefully go over it with the patients during the process of informed consent.
This process of discussing the risks and benefits of treatment is what makes gender-affirming care medical care, alongside the process of updating and improving treatments as medical evidence comes in. For the far-right Daily Caller, however, a doctor discussing gender-affirming care as medical care is SCANDALOUS.
screenshot from the Daily Caller
That’s right (or, actually, wrong) Puberty Blockers aren’t as ‘reversible’ as advertised… because they may impact bone health. This article breathlessly describes an educational video by a gender-affirming care specialist, Dr. Daniel Metzger, entitled Foundations in Gender Affirming Hormone Therapy: Adults and Adolescents,” where Metzger trains clinicians on the important risks professionals ought to be discussing with patients and their families, including bone density concerns (which could lead to osteoporosis late in life if preventive measures aren’t taken), fertility concerns, and the somewhat niche concern that trans girls who arrest puberty early can present a challenge for genital surgeons, who typically construct a vagina out of the patient’s penis skin.
It’s important that the doctors and parents of trans youth fully understand these risks! Metzger is engaging in the sort of necessary training that allows doctors to understand and communicate with young patients and their families, a very normal part of helping doctors learn about a field. However, because trans people are involved, the mundane is made to sound extraordinary… and ominous. Even though every medical treatment comes with tradeoffs, risks, and side-effects (and the thoroughness with which trans patients in particular are made aware of every single risk may help explain why regret rates for gender-affirming surgeries are so spectacularly, unusually low), the Daily Caller wants readers to believe there’s something sinister going on with this quite mild list of side-effects and potential concerns.
Opponents of gender-affirming care pull this trick over and over again. By stating the ordinary in an alarmist tone, they rely on readers baseline suspicion and prejudice against the trans community to stop them from asking common sense questions like “How many medications carry a risk to bone density? How are bone density risks managed in other contexts? Is this considered a mild or a severe type of risk?” This is the ordinary way we’d judge a medical treatment, by comparing it to other treatments, but with trans healthcare the process breaks down. When a reader comes in convinced that there can be no possible benefit to a trans person getting the appropriate healthcare, any risk, no matter how small, can be presented by propagandists in an alarmist way.
Trans healthcare is medical care. It should be judged by the same standards as other care, subject to the same laws, and treated in the same way. In this, as in many other articles from the anti-trans right, the everyday operations of medical providers are made to sound extreme in a bizarre removal of context that relies on prejudice to work.