Last night’s opera was “Satyagraha” by Philip Glass, and I think I’ve already written about it. Libretto in Sanskrit from the Bhagavad Gita, the whole first scene take place within Gandhi’s meditation, the second and third acts depict actual events but none outside of South Africa, so that it’a more abut his formation than it is about who he became, but it also looks backward to Tolstoy and forward to Dr. King. Minimal titles, because what’s being sung is not directly related to the action. To say “It’s not your usual opera” is a gross understatement. Yet I find it oddly moving. Plus every time I see it I get new insights. I may have to break down and get the DVD. In unrelated news, yesterday my favorite browser went down, and when it came back up, it looked different I’m still finding things But, basically, just an annoyance. It shouldn’t be crippling.
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Short Takes –
Former Mueller Deputy Explains Why Indicting Trump Org Matters
Quote – [T]he one point I would make about the press reports of a company being charged — some viewers may think, “Well, what’s the import of that? Who cares? A company can’t go to jail, and that’s not what I’m really interested in.” But just remember, for a company to be found guilty, the government has to prove that at least one individual at the company is criminally liable, so it means more than just a company, Click through for the rest. And if you are interested in reading C&L’s fluff story about Spiderman and the Pope, click here.
The Hill – Kagan rips colleagues in blistering 41-page voting rights dissent
Quote – She cited late conservative Justice Antonin Scalia’s dissent in the 1991 case Chisom v. Roemer in which he opined a supposedly neutral law that limited voter registration to only a few hours a week and thus made it more difficult for Black voters than white voters to register because of life circumstances would result in Black people having “less opportunity to participate in the political process than whites.” Click through to see that she really let them have it. I figured everyone will have seen the indictments by the time this goes up, and voting rights is actually more important at this point.
The 19th – Women in the Biden White House earn 99 cents for every $1 earned by men
Quote – The gender wage gap is typically a “raw” figure that doesn’t adjust for experience, education, title or other factors. It simply looks at median wages. In past administrations, a lack of women in higher-paid positions widened the gap. But in the Biden administration, there is a wider distribution of women across the pay scale, not just in the lowest paid jobs where they have typically been concentrated. About 56 percent of the senior staff in Biden’s White House are women, and about 36 percent come from racially and ethnically diverse communities. Click through for details. Nice to have some good news.
Experts in autocracies have pointed out that it is, unfortunately, easy to slip into normalizing the tyrant, hence it is important to hang on to outrage. These incidents which seem to call for the efforts of the Greek Furies (Erinyes) to come and deal with them will, I hope, help with that. As a reminder, though no one really knows how many there were supposed to be, the three names we have are Alecto, Megaera, and Tisiphone. These roughly translate as “unceasing,” “grudging,” and “vengeful destruction.”
Treanspphibia is probably not something which affects as many people as does racism, or misgyny, or even homophobia. But those whom it does affect are affected more deeply than those affected by any other form of discrimination. It’s probably impossible to truly feel what these people are going through, but surely we can get some idea if we put our minds to it. Although some new legislation under consideration strestches that pretty far. To have your parents criminalized for believing you – to have your doctor criminalized for helping you – that seems to go farther in hate even than the HIV epidemic, and that was pretty bad (and in some ways still is.)
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I’m a pediatrician who cares for transgender kids – here’s what you need to know about social support, puberty blockers and other medical options that improve lives of transgender youth
When Charlie, a 10-year-old boy, came in for his first visit, he didn’t look at me or my colleague. Angry and crying, he insisted to us that he was cisgender – that he was a boy and had been born male.
A few months before Charlie came into our office, he handed a note to his mother with four simple words, “I am a boy.” Up until that point Charlie had been living in the world as female – the sex he was assigned at birth – though that was not how he felt inside. Charlie was suffering from severe gender dysphoria – a sense of distress someone feels when their gender identity doesn’t match up with their assigned gender.
The first thing our team does is make sure our patients and families understand what gender care is. We always begin initial visits in the same way. “Our goal is to support you and your family on this journey, whatever that may look like for you. My name is Mandy and I am one of the doctors at CATCH – the Child and Adolescent Trans/Gender Center for Health program. I use she/her pronouns.” Sharing pronouns helps transgender people feel seen and validated.
We then ask patients and families to share their gender journey so we can better understand where they are coming from and where they hope to go. Charlie’s story is one we often hear. A kid may not think much about gender until puberty but begins to experience worsening gender dysphoria when their body starts changing in what feels like the wrong way.
Support and acceptance from family has a huge impact on a transgender person’s mental health. AP Photo/Lynne Sladky
In addition to being accepted at home, young people often want to live in the world in their identified gender. This could include changing their name and pronouns and coming out to friends and family. It can also include using public spaces like schools and bathrooms, participating on single-gender sports teams and dressing or doing other things like binding breasts or tucking back male genitalia to present more in line with their gender identity. Though more research needs to be done, studies show that youth who socially transition have rates of depression similar to cisgender peers.
However, most young people also need to make physical changes to their bodies as well to feel truly comfortable.
Medical options for transgender youth can include hormone blockers or hormone therapy as a first step. AP Photo/Lynne Sladky
Gender-affirming medical interventions
When I first met Charlie, he had already socially transitioned but was still experiencing dysphoria. Charlie, like many people, wanted his physical body to match his gender identity, and this can be achieved only through medical interventions – namely, puberty blockers, hormonal medications or surgery.
For patients like Charlie who have started experiencing early female or male puberty, hormone blockers are typically the first option. These medications work like a pause button on the physical changes caused by puberty. They are well studied, safe and completely reversible. If a person stops taking hormone blockers, their body will resume going through puberty as it would have. Blockers give people time to further explore gender and to develop social supports. Studies demonstrate that hormone blockers reduce depression, anxiety and risk of suicide among transgender youth.
Once a person has started or completed puberty, taking prescribed hormones can help people match their bodies with their gender identities. One of my patients, Zoe, is an 18-year-old transgender woman who has already completed male puberty. She is taking estrogen and a medication to block the effects of testosterone. Together, these will help Zoe’s body develop breasts, reduce hair growth and have an overall more female shape.
The health risks from taking hormones are incredibly small – not significantly different, in fact, than the risks a cisgender person faces from the hormones in their body. Some prescribed hormone effects are partially reversible, but others are more permanent, like voice deepening and growth of facial hair or breasts. Hormones can also impact fertility, so I always make sure that my patients and their families understand the process thoroughly.
The most permanent medical options available are gender-affirming surgeries. These operations can include changes to genitals, chest or breasts and facial structure. Surgeries are not easily reversible, so my colleagues and I always make sure that patients fully understand this decision. Some people think gender-affirming surgeries go too far and that minors are too young to make such a big decision. But based on available research and my own experience, patients who get these surgeries experience improvements in their quality of life through a reduction in dysphoria. I have been told by patients that gender-affirming surgery “literally saved my life. I was free [from dysphoria].”
In March 2021, nearly five years after our first visit, Charlie walked into my exam room. When we first met, he was struggling with his gender, anxiety and depression. This time, he immediately started talking about playing hockey, hanging out with friends and making the honor roll. He has been on hormone blockers for five years and testosterone for almost a year. With the help of a supportive family and a gender-competent therapist, Charlie is now thriving.
Being transgender is not something that goes away. It is something my patients live with for their entire lives. Our multidisciplinary care team continues to see patients like Charlie on a regular basis, often following them into young adulthood.
While more research is always needed, a gender-affirmative approach and evidence-based medicine allows young transgender people to live in the world as their authentic selves. This improves quality of life and saves lives, as one of our transgender patients said about his experience receiving gender-affirming care. “I honestly don’t think I would be here had I not been allowed to transition at that point. I’m not always 100%. But I have hope. I am happy to see tomorrow and I know I will achieve my dreams.”
Mandy Coles, Clinical Associate Professor of Pediatrics and co-director of the Child and Adolescent Trans/Gender Center for Health, Boston University
================================================================ Alecto, Megaera, and Tisiphone, one phrase struck me in this: “assigned at birth.” Specifically the word “assigned.” Could this help ore people to realize that external physical details really aren’t enough to determine for certain what gender a person’s soul is? By itself, maybe not … but as one tool in our learning, perhaps it can help.
