Is Gender Affirming Care Safe? An easy 123
A man from Albania asked me to cut through the noise. Here are the answers.
I was recently contacted by a man from Albania who wanted to understand the medical reality of what it means to be transgender. He wanted to cut through the noise, the myths, and the misinformation. He asked some important questions, and they deserve clear answers.
What is gender identity?
The world mostly categorises gender as male or female, and most people do fit into one of those two categories. When you are born, a doctor looks at your body and makes the best guess, and that is what goes on your birth certificate. If that guess matches how you come to see yourself, that is fine, you are cisgender. If it does not match, there was a mistake. You were marked male, but you actually come to realise you are female, or vice versa, and that means you are transgender.
How do you know if someone is transgender?
That is easy. You ask them. That is it. You cannot tell by looking. You cannot tell from a chromosome blood test or a brain scan. Gender identity is a deeply personal sense of self, and the only person who truly knows is the person themselves.
Is the treatment dangerous?
Some transgender people choose to take hormones so that their body develops in ways that match their gender. A trans man might take testosterone, a trans woman might take oestrogen, and all we are doing is replacing one hormone with the other, the same hormones that half the human population already has. Ironically, this is one of the safest treatments we know.
There is a lot of public debate about puberty blockers, but medically, the evidence is clear. We have been using them in children since the eighties. The American Medical Association, the American Academy of Pediatrics, and the Endocrine Society all agree that gender affirming care is safe, effective, and medically necessary.
Can you turn someone transgender?
No, you cannot. You cannot make someone male and you cannot make someone female. You cannot indoctrinate a child into being transgender, and you cannot force a transgender child not to be. You might be able to make them pretend, but who they are does not change. Gender identity is not determined by chromosomes. Chromosomes just dictate which body parts you have and which hormones you produce. Who you are is something much, much deeper. It is in your heart, your brain, and your sense of self.
Are research studies experimental?
Medical research is not experimental, it is essential. We follow patients over time so that we understand the long-term outcomes as well as the short-term outcomes of treatments. The studies being proposed in the UK are not testing whether puberty blockers are safe. We already know they are. They are observational studies following children and young people over years. They are not an experiment. It is just good medicine.
The reality we face
Trans people exist. They always have. And right now they are facing real difficulties with acceptance and inclusion, not because of who they are, but because of how the world is responding to them.
In the UK, gender reassignment is a protected characteristic under the Equality Act, and now we need to make sure that those protections are reality. Understanding gender diversity is not complicated. It just starts with listening, with listening to the facts more than the fear, and with recognising that trans people, including trans young people, deserve the same dignity, the same healthcare, and the same support as everyone else.
Over to you
If this helped clarify things for you, please share it with someone who might need to hear it. And if you have questions of your own, I am always here to listen.