Imagine, gentle readers, that you are a lesbian, married—of course—to another lesbian.  Would the fact that you are both lesbians have any bearing on your child-rearing abilities and inclinations? Of course it would, particularly if your child was female.  Let’s assume, just for the sake of argument, that you’re not died-in-the-wool lesbian “activists with all that implies.  Wouldn’t you tend to see being lesbian as natural and normal?  Wouldn’t you—if only through your daily example—tend to transmit your lesbian values and behavioral patterns to your daughter, encouraging her to be lesbian as well?  In fact, wouldn’t you expect her to be lesbian, even want her to be lesbian?

Now let’s assume—again, for the sake of argument—that you’re very serious about being lesbians, “gender equality,” “gay rights,” any or all of the catch phrases currently in use.  What more would you want?  What more would you expect?  Now we know.

In a Fox News article titled Controversial Therapy for Pre-Teen Transgender Patient Raises Questions, Perry Chiaramonte raises questions indeed.  You should read the entire article, but the facts are pretty straightforward.

The eleven-year old son of a lesbian couple—according to them–has, since the age of three identified himself as a girl.  At the age of seven “psychiatrists diagnosed a  gender identity disorder,” and a year later “…he [Thomas] began transitioning toTammy.

And what does does “transitioning” mean?

Tommy’s parents, Moreno and Lobel, say they support their child and feel this is the best way for him to find an answer to a question he’s been asking all his life. They say Tommy – whom they now call Tammy – began taking GnRH inhibitors over the summer so that he will remain a prepubescent boy until he turns 14 or 15. They say they want to give him more time to explore the female gender identity that he associates with.

There are a great many issues here, medical, ethical and legal.  I’ll generally avoid the moral component, but please, gentle readers, feel free to add your comments in that area if you wish.

We do, of course, have the medical technology to produce reasonably authentic sex reassignment results.  The body can be surgically altered to produce functional labia and a vagina and breast implants are as common as newspaper.  The correct mixture of hormones necessary are available, but will have to be taken for the lifetime of the patient and will require frequent adjustment as the patient ages.  Such treatment and maintenance regimens are not without substantial risk.

The thornier issue is not only at what point such treatments become ethical, but whether they might not be, particularly at such a young age, the business of the state.  We know, for example, that the human brain does not fully develop until the early 20s.  Adolescent brains, even teenage brains, are still undergoing substantial, often dramatic changes.  On that basis alone, taking affirmative medical steps that will actively interfere with fundamental human development in the furtherance of what might be merely a preference seems unwise at best. Still, perhaps the largest problem is with the psyche.

There is considerable controversy in medicine regarding this and similar issues.  Johns Hopkins professor of psychiatry Dr. Paul McHugh said:

This is child abuse. It’s like performing liposuction on an anorexic child.  It is a disorder of the mind. Not a disorder of the body. Dealing with it in this way is not dealing with the problem that truly exists.  We shouldn’t be mucking around with nature. We can’t assume what the outcome will be.

Fox News senior managing health editor Dr. Manny Alvarez said:

I think that it’s highly inappropriate to be interfering with natural hormonal growth patterns. There are significant potential problems necessary for growth and development.  Potential long-term effects can include other abnormalities of hormones, vascular complications and even potential cancer. I think that if this child – as he finishes his puberty and teenage years – decides to undergo a transgender procedure – then there are proper channels to do so.  But to do it at the age of 11 — to me — could be potentially dangerous to the health of this child.

Fox News Contributor, Psychiatrist Dr. Keith Ablow is also concerned:

Undue influence on the child simply has to be ruled out.  It’s the psychologically correct thing to do, the ethical thing to do and the moral thing to do.  Obviously, when two females adopt a male child, then assert that the child is not actually male, but is, instead, actually a female — like both of them. Everyone in the family should be psychologically evaluated in a comprehensive way before a step like gender reassignment is considered.

Unsurprisingly, the child’s parents and various supporting “activists” frame the issue in terms of the “right” of a parent and child to make gender choices.

Suggesting that parents must have wide latitude in the upbringing of their children is certainly reasonable, but the law is, in many respects, clear, on when the line is crossed between reasonable parental discretion and child neglect or abuse.  Parents generally may not deny their children necessary medical care, nor may they subject them to what amounts to medical experiments ungrounded in medical science.  General abuse and neglect of children is commonly understood, including emotional and/or psychological abuse.

There is a substantial body of evidence indicating that those feeling the need for gender reassignment often have underlying or accompanying psychological problems of such severity that treatment is a necessity.  And as Dr. Ablow suggests, in cases such as these, undue parental influence, even if unintentional or if the parents sincerely believe they are doing their best for their child—as do many religiously motivated parents that withhold life-saving medical treatment—is always a serious concern and should be positively ruled out.

The safest course—for those involved and society at large—would seem to be requiring those who wish to make such drastic decisions to wait at least until they have reached the legal threshold of adulthood, yet even then we now know that brain development has often not reached its final phases.  Fully informed, adult  consent seems a reasonable requirement.

What, gentle readers, do you think?