In the Affirmative

What's the Measure of a (Cis) Man?

My child began gender-affirming care at three years old.

That’s the first time we went to see an endocrinologist, a doctor who practically became part of the family over the next decade.

I’d felt like something was different for months before I made the appointment. At our first visit, blood was drawn, x-rays were ordered, and a full physical exam was performed. After looking at all the results and talking with my pre-schooler, the doctor mentioned hormones we could consider giving. I was reluctant to start anything too invasive (or painful) so young, so we agreed to just watch and wait, keeping an eye on physical and emotional health to guide our decisions.

Everyone around me knew we’d taken this step, and no one, regardless of political or religious leaning, voiced the slightest objection.

That’s because my child was assigned male at birth, and whatever I chose to do to make him grow into the socially expected body of a cisgender man was considered okay.

So when he began dropping off the growth charts in his third year, eventually settling below the 2nd percentile line at the bottom, no one questioned medical intervention that would help him get to an expected adult height over 5’3”. There’s nothing dangerous or unhealthy about being that height. If my daughter had the same projection, there wouldn’t have been any discussion about it. But it’s more than two standard deviations from average for American cisgender men, and those lower ends of the bell curve are where the most social judgement rings out.

People knew, instinctively, that it would be hard to live a life outside society’s traditionally defined (and inherently bodyist/ableist) gender presentation. They knew my child might suffer if his outside didn’t match what his inside expected. More often than not, I was the one saying, “We’re just going to wait and see,” while other folks recommended more aggressive interventions.

As he got older, his own voice was added to the conversation. We talked about this recently (while I was asking his permission to write about it), and he said, as a young adolescent, he desperately wanted to take something, anything, to kick his pituitary gland into gear and look the way that felt truer to him. He was deeply anxious and self-conscious about how the world perceived him, no matter how often I told him that every body is a good body.

If we had gone that route, the pharmaceutical options on offer would have been a lot like the tested, approved, overwhelmingly safe medications that trans kids take to stay fully aligned, mind, body, and soul.

But in his case, blood tests and bone age scans showed that his body hadn’t skipped a growth stage but was just taking a bit longer than typical to start it. Eventually that engine revved up on its own and he was growing two inches every two months rather than every twelve, but the wait was an enormous struggle for him.

Despite my suddenly astronomical whole-milk bill, I was relieved that we wouldn’t have to debate taking syringes full of growth hormones in a cooler whenever we went on vacation. I was even more relieved that he felt his body and brain connecting in a way it hadn’t before. I could feel him make peace with his reflection.

But if that hadn’t happened naturally, I had so many other possibilities to get him there safely, with no input from my representatives. I could have given my son hormones to change his growth pattern toward a more traditional view of manhood and no one would have given a damn. In fact, I would have been largely supported, because avoiding bullying is considered preventative care.

Alternately, if he was hitting growth milestones much faster than usual and careening into puberty too soon, we could have slowed that down, too. Not because it would affect his physical health, but because it could negatively impact his mental and emotional wellbeing.

But if I’d gone to the same trusted doctor and given him hormones (or hormone blockers) to affirm a gender other than the one he was visually assigned at birth with no analysis of his gene structure or brain activity, a majority of state governments would stand in the way.

I’m not qualified to say what gender is, and probably neither are you. Honestly, that mysteriousness and ambiguity is what makes it such a great maypole for a moral panic. But I am a parent, and that makes me pretty qualified to get sniffy at people who want to hurt kids – and even worse, use bad faith and disinformation to do it.

I’m so tired of hearing politicians talk about protecting kids from permanent decisions. Read a book, y’all. Puberty blockers aren’t permanent. Puberty is. So is suicide.

I didn’t have the data at the time my child was struggling, but it turns out there’s actually research showing an inverse relationship between men’s height and the risk of death by suicide. But those numbers are nowhere near the risk for trans kids who aren’t supported by adults.

We live in a country where cisgender minors can get elective nose jobs, breast reductions, acne medications (with massive known side effects), and growth hormones, not to mention permanent procedures they’re too young to consent to (DO NOT GET SIDETRACKED BY CIRCUMCISION, BROWN), but social support and medications that give trans kids a better chance of survival are kept out of reach.

The optimist in me believes conservative lawmakers just don’t know the societal risk vs. reward of healthcare oppression. The much louder pessimist thinks they just don’t care if trans kids die because it’s the most unlikely group of their future voters in the country.

But I didn’t write this to change their minds. I don’t have enough money for that. I wrote this for anyone who has heard politicians say “They can just wait until they’re adults” and thought, okay, maybe that makes some sense.

Respectfully, no. Some things can’t wait. That’s why we saw a doctor every six months, to make sure we didn’t miss a critical window of care. I had so many choices on the table to help and support my kid through a long, tough stage of his development, one that was deeply tied to his identity and future. If you wouldn’t dream of taking those options away from us, why would you create a nightmare for anyone else?