Everybody, male or female, has both estrogen and testosterone in their bodies. The amounts of those hormones just differ. However, for transgender children, their bodies start producing too much of the "wrong" hormone when they hit puberty -- causing them to physically develop the sex characteristics associated with their biological gender instead of their psychological gender. There is a way to stop this, however. If you're the parent of a transgendered child, this is what you should know about what is sometimes called the "Dutch Protocol."
What is the Dutch Protocol?
Instead of allowing transgender children to develop the sexual markers of the wrong gender when they hit puberty and then using hormone replacement therapy to try to erase those markers later, the Dutch Protocol (also called the Dutch Model) uses synthetic "puberty blockers" called gonadotropin-releasing hormone analogues (GnRH), to halt puberty altogether.
This procedure prevents biologically male children from developing things like larger genitals and a noticeable Adam's apple and facial hair. It prevents biologically female children from developing things like breasts and rounded hips.
Why is it used?
Not having those secondary sex characteristics develop at all can offer transgendered children a huge advantage should they decide to opt for gender-reassignment surgery at age 18. They won't have some of the body issues they might otherwise encounter if they are allowed to go through normal puberty. Once breasts develop, they have to be dealt with in order to for a female-to-male transgendered teen or young adult to physically transition genders. A male-to-female transgendered teen may not ever be able to erase some of the physical characteristics of a biological male once those develop, like broad shoulders or a square chin.
Transgendered children using this method also don't have to contend with going through a secondary puberty. When hormone replacement therapy is introduced after a child has already gone through the puberty associated with his or her biological gender, he or she has to go through that difficult transition all over again in the process of "switching" the testosterone/estrogen balance to that which reflects his or her gender identity.
When is it done?
Children who were used in the study that developed the Dutch Protocol began the puberty-blocking hormone therapy at an average age of 14. However, there's no exact age to start. Therapy to halt puberty should begin as soon as the child begins to show signs that he or she is entering puberty according to Stage 2 of the Tanner scale of physical development. That can often be as early as age 8 or 9 for biological females and age 9 or 10 for biological males.
Once the child has reached the point where gender reassignment can begin, he or she would be given the normal course of hormone-replacement therapy designed to initiate the cross-gender transition. That will allow the child to go through a puberty that's more normal for his or her psychological gender prior to any surgical interventions.
For more information about hormone replacement therapy, visit http://www.centraliowaobgyn.com or a similar website.
Share16 December 2015
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