Early onset puberty is increasingly prevalent among girls globally according to many scientists and clinicians. In the medical and scientific literature early sexual development is described as a problem for girls and as a frightening prospect for parents. News media and popular environmentalist accounts amplify these figurations, raising powerful concerns about the sexual predation of early developing girls by men and boys and the loss of childhood innocence. In this article the author frames one feminist approach to early (...) class='Hi'>puberty, arguing that feminist theorists should both take scientific work around population changes in sexual development seriously and use their critical skills to unpick and challenge the discourses constituting early development as a matter of concern. The author suggests that contemporary academic and policy debates on the ‘sexualization’ of girls have important resonance for critical explorations of early puberty. These debates currently pay little attention to the physiological aspects of sexual development and could be enriched by so doing. As in the case of ‘sexualization’, issues of class, racialization and agency are central to understanding and challenging normative concerns about girls’ early sexual development. (shrink)

Ethical concerns have been raised about routine practice in paediatric gender clinics. We discuss informed consent and the risk of iatrogenesis in the prescribing of gonadotropin-releasing hormone...

Volume 19, Issue 7, July 2019, Page 68-69.

Gender dysphoria is a persistent distress about one’s assigned gender. Referrals regarding gender dysphoria have recently greatly increased, often of a form that is rapid in onset. The sex ratio ha...

Volume 19, Issue 6, June 2019, Page W3-W4.

This wide-ranging volume presents an in-depth picture of adolescent sexuality and behavior. As perhaps the most vital period in human development, adolescence is a time of complex, often difficult interactions between diverse influences. Here, nineteen scientists representing ten disciplines explore the biological, psychological, and cultural factors involved in the onset of puberty and its associated emotional changes. Patterns of adolescent sexual behavior are viewed in cross-cultural perspective, psychiatric disorders are considered, and trends in adolescent sexual activity, contraception, and pregnancy (...) are described. Key legal and social dilemmas are also explored. This is the third volume in a groundbreaking series from the Kinsey Institute, which has as its aim the study of topics relating to sex, gender, and reproduction that require an interdisciplinary approach. Previous volumes in the series include Homosexuality/Heterosexuality and Masculinity/Femininity. (shrink)

Summary Knowledge is an important but largely neglected variable in sex education research. This study aimed to develop a measure to assess young people's knowledge about puberty and sexual development, and to examine knowledge in relation to age, gender and school. The main results of the study were that knowledge increased more between age 11/12 and 13/14 than between 13/14 and 15/16, girls knew more than boys at every age, and there were few differences in knowledge between the four (...) schools involved in the study. The research has a number of implications for sex education in schools. First, it was found that even by age 15?16 some young people lack information which is essential if they are to avoid unwanted pregnancy. Second, it may be that boys and girls need to be taught separately to enable the different needs of each gender to be addressed. Third, young people know more about some aspects of puberty and sexual development than others, and there are particular times when knowledge develops most rapidly. Giving teachers this information could help them to target areas of particular ignorance. The questionnaire developed to assess knowledge proved to be accurate and reliable, and a measure that is straightforward to score and analyse. As such, it has considerable potential for use in the classroom. (shrink)

The range of hypotheses considered is surprising in that the most arguably plausible one is not included: the invariant principles of language are available for life, while the parameters of variation cannot be set after puberty. This hypothesis provides a better explanation than the author's for both the deep similarities and the vast differences between child “language growth” and adult language acquisition.

In the past few years, the introduction and rapid acceptance of puberty suppression has transformed the clinical treatment of children diagnosed with Gender Identity Disorder. This essay analyzes the narratives used by some advocates of this treatment, particularly the elements of saving children from the looming disaster of puberty and from future abject lives of violence and suicide as transgender adults. It briefly addresses the potential implications of this account for the well being of the children brought under (...) clinical purview. (shrink)

Within bioethics as well as in broader clinical practice, support for transgender and gender‐questioning adolescent access to pubertal suppression has often relied heavily on the desire to prevent risky, self‐destructive, and suicidal behavior. We argue that framing justifications for access to puberty suppression in this way can actually be harmful to both individual patients as well as to the broader trans population. This justification for access to care makes such access precarious, limits its scope, and introduces perverse incentives to (...) the patient population that is being served. We go on to offer an alternative, positive defense of access to puberty‐blocking treatment for transgender youth grounded in the child's right to an open future. We argue that decisions related to pubertal suppression are both importantly weighty and potentially irreversible, and show why this justification is preferable to so‐called “informed consent” approaches. (shrink)

Gender dysphoria is a clinically significant incongruence between expressed gender and assigned gender, with rapidly growing prevalence among children. The UK High Court recently conducted a judicial review regarding the service provision at a youth-focussed gender identity clinic in Tavistock. The high court adjudged it ‘highly unlikely’ that under-13s, and ‘doubtful’ that 14–15 years old, can be competent to consent to puberty blocker therapy for GD. They based their reasoning on the limited evidence regarding efficacy, the likelihood of progressing (...) to cross-sex hormone therapy and the ‘life-changing consequences’ of puberty blockers. In this article, I offer two concurrent arguments to dispute their reasoning. First, I argue that minors can be competent to consent to puberty blockers for GD, because the decision to undergo puberty blocker therapy is no more complex or far-reaching than other medical decisions that we accept a child should be able to make. Second, I argue that—irrespective of competence—such legal restriction for all children fundamentally contradicts the central ethical tenet of child healthcare: best interests. For these two reasons, the high court should not restrict access to puberty blockers for competent GD children. (shrink)

In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical (...) defensibility of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient’s request is substantially autonomous. Although the broadly principlist ethical approach we take can be used to analyse other cases of non-binary adults requesting OPS apart from the case we evaluate, we highlight that the outcome will necessarily depend on the individual’s context and values. However, such clinical provision of OPS should ideally be within the context of a properly designed research study with long-term follow-up and open publication of results. (shrink)

The literature on masculinity lacks thorough and sustained in situ examinations of how diverse boys employ their bodies to construct masculine identities during pubescence. To address this gap, the present article examines how a group of 10 sixth-grade Latino boys, who publicly acknowledged that they were experiencing puberty, employed their bodies at school to construct their masculine identities. The data suggest that among the boys, puberty was a social accomplishment connected to masculine enactments informed by the dominant gendered (...) expectations of peers at school and in their neighborhoods, the hegemonic masculine practices espoused by commercial hip hop rappers, and the dominant gender orders in the U.S and both Dominican and Puerto Rican societies. With physical displays of corporeal strength and tolerance for pain, the boys sought to signal that they were entering adulthood and preparing their bodies for a social world wherein physical confrontations between males were commonplace. The findings contribute to our understanding of how second-generation children who reside in low-income, working-class neighborhoods and have social ties to their nations of origin and their respective cultures construct masculinities in the United States. The article concludes with a call for longitudinal ethnographic studies examining how boys from various social backgrounds construct masculine identities during their pubescent development. (shrink)

The assumption that the onset of puberty is a context-sensitive marker of a reproductive strategy is tested by comparing parental and filial childhood context and somatic development in West and East Germany. Sixty-eight mother-daughter dyads and 35 father-son dyads were taken from two samples of families from Osnabrück in West Germany and Halle in East Germany. According to the observed context discontinuity between the generations in the male dyads, linear regression models show that no indicator of male sexual maturation (...) was influenced significantly by the somatic development of the father. Instead of an inherited timing of maturation, antecedent distal factors like socioeconomic childhood context variables and critical life events lead to an acceleration of male sexual maturation. Finally we test the effect of two different conditions of childhood context continuity on daughter’s age at menarche with maternal age at menarche controlled. Linear regression models show that mother’s age at menarche predicts daughter’s age at menarche only under the condition of contextual continuity between generations, which was the case in the West German sample only. In East Germany, where mother’s age at menarche had no significant effect, the amount of variance explained by childhood context variables was almost the same. These results indicate the context sensitivity of somatic development which seems to follow an evolutionary rationale. (shrink)

We thank the commentators for their thoughtful responses to our article.1 Due to space constraints, we will confine our discussion to just three key issues. The first issue relates to the central ethical conundrum for clinicians working with young people like Phoenix: namely, how to respect, value and defer to a person’s own account of their identity and what is needed for their well-being, while staying open to the possibility that such an account may reflect a work in progress. This (...) conundrum thus relates both to what will be beneficial for that person and what constitutes respecting their autonomy, and clinicians must dwell on these questions when deciding what forms of medical intervention to offer. D’Angelo,2 Lemma3 and Wren4 highlight the importance of considering Phoenix as a ‘whole person in context’ 2 prior to initiating treatment or care. In this way, they advocate for a process of ‘therapeutic exploration’,4 which includes taking sufficient time to explore Phoenix’s personhood with them so as to support them in achieving an ‘authentic self-discovery’.2 We agree with these authors that identity development is a complex, life-long process that is influenced by biological, psychosocial and relational aspects, all of which may contribute to an individual’s desire to pursue gender-affirming interventions. To explore the various factors—both conscious and unconscious—that might be motivating Phoenix’s decision to pursue ongoing puberty suppression, D’Angelo,2 Lemma3 and Wren4 describe a comprehensive psychological approach to working with transgender and gender diverse individuals and propose questions to guide such discussions. Consistent with this approach, we stipulated that Phoenix had undergone regular psychological counselling and that the psychologist had judged that ‘Phoenix’s distress is significant and enduring…not a symptom …. (shrink)

Transgender children who are not treated for their condition are at high risk of violence and suicide. As a matter of survival, many are willing to take whatever help is available, even if this is offered by illegal sources, and this often traps them into the juvenile criminal system and exposes them to various threats. Endocrinology offers a revolutionary instrument to help children /adolescents with gender identity disorder: suspension of puberty. Suspension of puberty raises many ethical issues, and (...) experts dissent as to when treatment should be commenced and how children should be followed up. This paper argues that suspension of puberty is not only not unethical: if it is likely to improve the child’s quality of life and even save his or her life, then it is indeed unethical to defer treatment. (shrink)

That a standard of medical care must outline services that benefit the patient is relatively uncontroversial. However, one must determine how the practices outlined in a medical standard of care should benefit the patient. I will argue that practices outlined in a standard of medical care must not detract from the patient’s well-functioning and that clinicians can refuse to provide services that do. This paper, therefore, will advance the following two claims: (1) a standard of medical care must not cause (...) dysfunction, and (2) if a physician is medically rational to not provide some service which fails to meet the above condition (i.e. fails to be a standard of medical care), then she may refuse to do so. I then apply my thesis to the prescription of puberty blockers to children with gender dysphoria. (shrink)

This article considers the claim that gender diverse minors and their families should not be able to consent to hormonal treatment for gender dysphoria. The claim refers particularly to hormonal treatment with so-called ‘blockers’, analogues that suspend temporarily pubertal development. We discuss particularly four reasons why consent may be deemed invalid in these cases: the decision is too complex; the decision-makers are too emotionally involved; the decision-makers are on a ‘conveyor belt’; the possibility of detransitioning. We examine each of these (...) reasons and we show that none of these stand up to scrutiny, and that some are based on a misunderstanding of the nature and purposes of this stage of treatment and of the circumstances in which it is usually prescribed. Moreover, accepting these claims at face value could have serious negative implications, not just for gender diverse youth, but for many other minors and families and in a much broader range of healthcare settings. (shrink)

Notini et al 1 offer a timely addition in the wake of a significant increase in young people identifying as transgender and gender diverse. The authors focus specifically on the case of 18-year-old Phoenix’s request for ongoing puberty suppression to affirm a non-binary gender identity. A central issue raised by Phoenix’s predicament, and that I suggest we can extend to ethical consideration of requests for other types of medical intervention by binary and non-binary TGD individuals, is whether we should (...) ‘affirm’ the claims made by TGD young people about what promotes their well-being. As a clinician working with TGD young people who have undergone a range of medical interventions to align their bodies with their gender identity, my starting presumption is that it is important to respect what people think will help them: there are some TGD young people for whom, all things considered, medical interventions to affirm gender identity promote their well-being. Well-being has become an important conceptual currency in ethical debates and lies at the core of the authors’ analysis of Phoenix’s case. While the authors do not ground their argument in favour of OPS in a specific theory of well-being, welfarist considerations 2 appear to underpin …. (shrink)

Notini _et al_ 1 offer a timely addition in the wake of a significant increase in young people identifying as transgender and gender diverse. The authors focus specifically on the case of 18-year-old Phoenix’s request for ongoing puberty suppression to affirm a non-binary gender identity. A central issue raised by Phoenix’s predicament, and that I suggest we can extend to ethical consideration of requests for other types of medical intervention by binary and non-binary TGD individuals, is whether we should (...) ‘affirm’ the claims made by TGD young people about what promotes their well-being. As a clinician working with TGD young people who have undergone a range of medical interventions to align their bodies with their gender identity, my starting presumption is that it is important to respect what people think will help them: there are some TGD... (shrink)

This article contributes to current discussions of the origins of modern sexuality by exploring an episode from Book II of Jean-Jacques Rousseau’s Confessions (1782), in the context of eighteenth-century childhood hygiene theory. In this episode, the sixteen-year-old Rousseau is the object of an aggressive sexual advance on the part of another young man, and witnesses this young man’s orgasm. By stressing his unusual immunity to understanding the sexual nature of this encounter, Rousseau places himself outside the cultural argument that moral (...) degradation was bringing on premature puberty (ejaculation, in males) and thus degradation of the human species in eighteenth-century Europe. (shrink)

In this paper, the author addresses the problem of socialisation of children with a history of disabilities and mental retardation by means of visual arts. It is important to look at the very sphere of life of these categories of children. As a rule, these children, for the most part, live in dysfunctional families, which makes it almost impossible to provide them with a form of socialization. This article focuses on the extent to which and how a programme of socialisation (...) of these children can be achieved through the medium of visual arts. At the moment there are works of modern pedagogues who have devoted their scientific researches to this problem, but there are few teachers-artists who deal with this problem. In this article the author devotes his creative attention to this issue and reflects on what means of fine arts and visual literacy can develop and guide in the right direction the socialization of children and young people with disabilities by means of fine arts. A number of scientific works devoted to this problem are seriously reviewed. The author is actively trying to draw the attention of the teaching community to the problem of prevailing social conditions, to reach an educational and cognitive level and, as a consequence, to a better product of the set task of socialization of children with special needs and disabilities in the learning process by means of subject disciplines: drawing, painting, composition, printmaking, etc. (shrink)

Volume 19, Issue 6, June 2019, Page W3-W4.

The current paper synthesizes theory and data from the field of life history (LH) evolution to advance a new developmental theory of variation in human LH strategies. The theory posits that clusters of correlated LH traits (e.g., timing of puberty, age at sexual debut and first birth, parental investment strategies) lie on a slow-to-fast continuum; that harshness (externally caused levels of morbidity-mortality) and unpredictability (spatial-temporal variation in harshness) are the most fundamental environmental influences on the evolution and development of (...) LH strategies; and that these influences depend on population densities and related levels of intraspecific competition and resource scarcity, on age schedules of mortality, on the sensitivity of morbidity-mortality to the organism’s resource-allocation decisions, and on the extent to which environmental fluctuations affect individuals versus populations over short versus long timescales. These interrelated factors operate at evolutionary and developmental levels and should be distinguished because they exert distinctive effects on LH traits and are hierarchically operative in terms of primacy of influence. Although converging lines of evidence support core assumptions of the theory, many questions remain unanswered. This review demonstrates the value of applying a multilevel evolutionary-developmental approach to the analysis of a central feature of human phenotypic variation: LH strategy. (shrink)

Increasingly, transgender minors are seeking medical care such as puberty-suppressing or gender-affirming hormone therapies. Yet, whether these interventions should be performed at all is highly controversial. Some healthcare practitioners oppose irreversible interventions, considering it their duty to protect children from harm. Others view minors, like adults, as transgender individuals who must be protected from discrimination. The underlying ethical question is presented as a problem of priority. Is it primarily relevant that minors are involved? Or should decision makers focus on (...) the fact that they treat transgender individuals? The paper explores the relevance for medical practice. We provide results of an interview study with German healthcare professionals. We discuss the general question whether prioritization among different group memberships of the same person is ethically defensible. We conclude that priority conflicts between group memberships of the same person can be deceptive and should be addressed by an intersectional approach. Eventually, we discuss practical implications. (shrink)

Adolescence signifies a transition from the use of prereproductive to reproductive strategies in the life history of Homo sapiens. Insofar as human generations overlap, events at adolescence, surrounding the onset of puberty, offer a unique glimpse into human adaptation from the point of view of the changing strategies of both parents and offspring. The timing of puberty is an important life history trait that varies between species, but also between and within the sexes in human beings. The onset (...) of puberty marks the beginning of the reproductive life, is affected by previous experience, and serves as a trigger for behavioral change. Surbey (1988, 1990) reported relationships between father absence, heightened levels of childhood stress, and early menarche and considered them within the context of human evolutionary history. Subsequently, similar findings have been reported in a number of human populations and have been interpreted from several evolutionary perspectives. This article discusses the extent to which these and related findings regarding alterations in the timing of human puberty reflect evolved parental or offspring strategies. It entails a consideration of the applicability of the concepts of phenotypic plasticity, nonadaptive genetic variation, and conditional and alternative reproductive strategies in describing the interwoven nature of strategies employed by parent and child in the transition at adolescence. (shrink)

The decision of the High Court in Bell v Tavistock has excited considerable discussion about lawful consent for puberty-blocking drug treatment for children with gender dysphoria. The present paper draws attention to a wider question that surfaces through this case: is informed decision-making an adequate practical tool for seeking and obtaining patients’ consent for medical treatment? Informed decision-making engages the premises of the rational choice theory: that people will have well-crystallised health goals; and, if they are provided with sufficient (...) information about medical treatments, then they will be able to choose the treatment that satisfies their goals. Whilst appealing, the informed decision-making paradigm is assailed by various fallacies, which apply not only to children but also to adults. In Bell v Tavistock, the High Court seems to have recognised such fallacies, and it rejected informed decision-making as an adequate tool for consent from children with gender dysphoria. Similar considerations apply to adults in various situations. Thus, Bell v Tavistock can be seen as an attempt to refine the views on the consent that were expressed by the Supreme Court in Montgomery. It can be inferred that the Supreme Court did recognise the limitations of informed decision-making, but it did not develop this point. Further work is required to formulate an adequate model of decision-making, and Bell v Tavistock serves as a useful reminder to rethink informed decision-making as the device for consent. (shrink)

In some small-scale societies, a sexual division of labor is common. For subadult hunter-gatherers, the onset of this division dates to middle childhood and the start of puberty; however, there is apparently no physiological explanation for this timing. The present study uses an experimental approach to evaluate possible energetic differences by sex in gathering-related activities. The energetic cost of gathering-related activities was measured in a sample of 42 subjects of both sexes aged between 8 and 14 years. Body mass (...) and other anthropometric variables were also recorded. Our results show that the energetic differences in the simulated gathering activities depend only on body mass. Both sexes expend a similar amount of energy during locomotion activities related to gathering. Discarding the energetic factor, the sexual division of tasks may be explained as an adaptation to acquire the skills needed to undertake the complex activities required during adulthood as early as possible. Carrying out gathering activities during childhood and adolescence could be favored by the growth and development cycles of Homo sapiens. Moreover, if most of the energetic costs of gathering activities depend on body mass, the delayed growth in humans relative to other primates allows subadults to practice these tasks for longer periods, and to become better at performing them. In fact, this strategy could enable them to acquire adults’ complex skills at a low energetic cost that can be easily subsidized by other members of the group. (shrink)

The author introduces us to the mythology, system of thought and social practices of the Inuit in an attempt to discover their conception of social sex (or gender). Unlike the binary conception that predominates among westerners, the Inuit have a tripartite system in which some individuals, men or women, straddle the social frontier between the sexes/genders. This third social sex, which is prominent in mythology and among the great mythical figures, is also found at the heart of shamanistic mediations, as (...) well as in many families, where the identity of dead relatives is transmitted to the 'newborn', regardless of their sex. When the sex is different, the children are cross-dressed till puberty, after which time they have to take on the gender corresponding to their sex, but a number of these young people used to become shamans and so continued to assume the mediations of the third social sex. This construction occurs without any reference to sexual orientation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:116 Feminist Studies 41, no. 1. © 2015 by Olumide Popoola Olumide Popoola Fishing for Naija To choose. To find a way in which one can tell everything. Not just the he and she. But much more of it, all. Gestures. Opening and closing. To do both is saying quite loudly: no not now, not here, not you. John opened the door and stepped out of the car. Uncle (...) T was shifting from one of his loafers to the other, white handkerchief in hand, wiping his shiny forehead. He pulled on the other door so Karl could come out too. Karl didn’t. The bungalow door opened. Ó could hear the excitement in John’s voice. It was all relief and shit. Greetings were exchanged. Words passed back and forth. Uncle T laughed. Happy, it seemed. John laughed too. A joke. Apparently. Karl remained in the taxi. “I think you will need some privacy. We will be back in one hour.” John hugged è. Karl finally stood in the cemented driveway. “I believe we have some catching up to do.” Stepping away from the entrance the father entered the room, leaving the door wide open, turned his head, scrutinized è, two deep lines furrowing the forehead, eyes a good stare in them. They were the opposite to Karl’s, no deflection whatsoever, no putting things at bay, first, Note In this excerpt from a novel, the gender neutral Yoruba pronouns “o” and “e” have been used to replaced the English ones. Please note that the correct Yoruba character for the pronoun “e” has a grave accent and a dot underneath. Because that character is not available, it has been represented by the character è instead. Olumide Popoola 117 then processing in small bits, nothing at all, no fucking warmth as far as Karl was concerned, but all getting into you, straight away. “Carla.” The odds we bet on, the strands we hold, the time we spare, and all falls, or betrays that itch, that place we want to find where belonging meets the now, the here, the us. It was musty inside. No one had bothered to open the windows when the electricity cut off in the morning. “Sit down. What do you want? Water, soft drink?” “I’m fine,” Karl replied. The thank you was stuck in è throat. The eyes. Like whoa, all over the top. Demanding. “This is not what I’ve been expecting.” It was funny like that. This is not when I was expecting you, Karl thought. “What do you think of our country so far?” “I love it. Really.” Ó could see è father’s legs, ashy feet in leather sandals with a large flap covering the top of the foot, a small ring for the big toe. They were obviously different. Very different. Uncle T and him. No moisturisation on this front. At all. The father didn’t seem to believe in Uncle T’s shea butter products. At least not for the feet. The seat cushion shifted. The father leaned back, arms crossed over his head, touching the wall, eyes looking straight ahead. Very delaying tactic. For emphasis. For drama. As if rehearsed. But then again he’d had two weeks since Karl’s arrival in Nigeria. Two weeks of leaving everyone in limbo, just so he could now come with effing heavy artillery. “I was expecting a daughter.” And the manner of closing is always more defined, more punctuated than the question opened. It hangs on the hinges, only for effect. body ['badi] n pl bodies the entire physical structure of a human being adjective versatile 118 Olumide Popoola A mosquito was buzzing around, making the silence between their words like a spotlight. You couldn’t not look. Karl followed it with è eyes. “I always knew. As long as I can think. Mum always lets me be myself. As long as I do nothing wrong. Nothing real bad, I mean. Be polite. I want her to be proud of me. When puberty started I just said I wouldn’t pretend to be a girl no more. She understood. She knew. I had never been one.” It was hot, no fan or air-conditioning to separate the time from the... (shrink)

Gender dysphoria (GD) is marked by an incongruence between a person’s biological sex at birth, and their felt gender (or gender identity). There is continuing debate regarding the benefits and drawbacks of physiological treatment of GD in children, a pathway, beginning with endocrine treatment to suppress puberty. Currently, the main alternative to physiological treatment consists of the so-called “wait-and-see” approach, which often includes counseling or other psychotherapeutic treatment. In this paper, we argue in favor of a “third pathway” for (...) the diagnosis and treatment of GD in youths. To make our case, we draw on a recent development in bioethics: the phenomenological approach. Scholars such as Slatman and Svenaeus have argued that the extent to which the body can (or should be) manipulated or reconstructed through medical intervention is not only determined by consideration of ethical frameworks and social and legal norms. Rather, we must also take account of patients’ personal experience of their body, the personal and social values associated with it, and their understanding of its situation in their life: their narrative identities. We apply this phenomenological approach to medicine and nursing to the diagnosis and treatment of GD in youth. In particular, we discuss Zahavi and Martiny’s conception of the phenomenological interview, in order to show that narrative techniques can assist in the process of gender identification and in the treatment of youth presenting with GD. We focus on two case studies that highlight the relevance of a narrative-based interview in relations between patients, HCPs, and family, to expose the influence of social ideologies on how young people presenting with GD experience their bodies and gender. (shrink)

Erginleme töreni, belli bir yaşa gelince herhangi bir gruba veya topluma katılması için kişiye uygulanan ritüelleri ifade eder. Uygulanma yöntemleri değişse de bu tören, ilkel veya gelişmiş neredeyse her toplumda görülür. Amaç, bireylerin topluma eğitsel, dinsel veya mitsel anlamda alışmalarını sağlamaktır. Yazısız toplumlarda bu törenler, dinsel içerikle yüklüdür. İlkellerde erginleme töreni, genç kız ya da erkeklerin çocukluktan kurtulup kabilenin yetişkin bireyi kabul edildiği ergenlikte gerçekleşir. Bu tür törenlerde gençler bazı zorlu testlere tabii tutulur. Topluma kabulü hak etmek için sınanmak zorunludur. (...) Bazı ilkel kabilelerde erginleme, kişinin koruyucu ruhla ilişkiye girmek için birtakım sınanmalardan geçmesi şeklindedir. Bunu başaran genç, kabile tarafından isim alarak üyelik ve aidiyet kazanır. İleri toplumların dinsel geleneğinde erginleme törenleri ise sembolik niteliktedir. İlkellerin bedensel acı çekme biçimindeki kabul törenleri, gelişmiş toplumlarda manevi hazır oluş şeklindedir. Hinduların Upanayana, Yahudilerin Bar/Bat Mitzva ve Hristiyanların vaftiz ritüelleri tipik üyeliğe kabul törenlerini ifade eder. Çalışma önemli bir toplumsal ritüel olan erginleme töreninin ilkel ve bazı gelişmiş toplumların dinsel geleneğinde nasıl gerçekleştiğini ele almıştır. (shrink)

The inclusion of girls and women in sport at all levels depends on single sex categories for most sports from puberty onwards, because of the biological differences between the sexes. Most sport is, by definition, competitive; involving invasion games, teams, leagues, races, competitions and sometimes rankings, from foundation to excellence. Girls and women are underrepresented, particularly in traditional sport, as recognised by the UK Sports Councils and most governing bodies of sport. This paper uses feminist philosophy: Lister on androcentric (...) citizenship, and Fraser on justice as balance, framing, recognition, representation and redistribution. It investigates the impact on the inclusion of girls and women, of eligibility policies adopting ‘self-identification of gender’ guidelines for the inclusion of transgender people in sport, at participation rather than elite levels. It explores fairness and equality as incorporated in law in the 2010 Equality Act in Britain, and contributes to ‘equality evidence’ available to the UK Sports Councils and GBS. These bodies are charged with developing fair and inclusive evidence-based eligibility criteria, in sports participation settings, for both girls and women, and transgender people. (shrink)

The inclusion of girls and women in sport at all levels depends on single sex categories for most sports from puberty onwards, because of the biological differences between the sexes. Most sport is, by definition, competitive; involving invasion games, teams, leagues, races, competitions and sometimes rankings, from foundation to excellence. Girls and women are underrepresented, particularly in traditional sport, as recognised by the UK Sports Councils and most governing bodies of sport. This paper uses feminist philosophy: Lister on androcentric (...) citizenship, and Fraser on justice as balance, framing, recognition, representation and redistribution. It investigates the impact on the inclusion of girls and women, of eligibility policies adopting ‘self-identification of gender’ guidelines for the inclusion of transgender people in sport, at participation rather than elite levels. It explores fairness and equality as incorporated in law in the 2010 Equality Act in Britain, and contributes to ‘equality evidence’ available to the UK Sports Councils and GBS. These bodies are charged with developing fair and inclusive evidence-based eligibility criteria, in sports participation settings, for both girls and women, and transgender people. (shrink)

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers.1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we outline (...) the potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner.1 First, the authors’ note OPS will almost certainly result in reduced bone density.1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about implications during adolescence and young adulthood when peak bone accrual occurs.2 Further, the authors propose ongoing monitoring with bone density scans, but no clear guidelines for clinicians if bone density becomes critically low—so we ask, at what point would a potential fracture risk outweigh the proposed benefits …. (shrink)

We applaud Notini and colleagues for highlighting the clinical and ethical complexities of a case in which a non-binary individual desires indefinite treatment with puberty blockers. 1 While we agree discontinuing treatment may cause psychological distress, we believe there are potential physical and neurocognitive harms caused by prolonged treatment that have been underestimated given the limited research conducted to date. Specifically, the impact of permanent pubertal suppression on the brain and decision-making capacity should be considered. In this context, we (...) outline the potential risks of ongoing pubertal suppression on bone and cardiovascular health, sexual and reproductive function, and brain development—all noted in the article but perhaps in an overly simplistic manner. 1 First, the authors’ note OPS will almost certainly result in reduced bone density. 1 Although we agree the absolute fracture risk is low in studies among older adults, there is less clarity about... (shrink)

Previous research indicates positive effects of a person’s attractiveness on evaluations of opposite-sex persons, but less positive or even negative effects of attractiveness on same-sex evaluations. These biases are consistent with social motives linked to mate search and intrasexual rivalry. In line with the hypothesis that such motives should not become operative until after puberty, 6- to 12-year-old participants (i.e., children) displayed no evidence for biased social evaluations based on other people’s attractiveness. In contrast, 13- to 19-year-old participants (i.e., (...) adolescents) displayed positive and negative attractiveness biases toward opposite- and same-sex targets, respectively. Moreover, these biases increased with the age—and thus the reproductive relevance—of the targets being evaluated. Findings corroborate the relevance of mating-related motives for social judgment and illustrate how such biases can grow during human development. At a broader conceptual level, this research demonstrates the utility of investigating proximate social judgment processes through the lens of adaptationist thinking. (shrink)