Medical Student report on day spent in the Adolescent Medicine Clinic on "Gender" Care Day
These kids are mentally suffering on a massive scale. All of them (literally) have multiple mental health problems. All (but 1) of them are white. Most of their parents have no disciplinary principles
This is an exact copy of this thread, which may go missing, and so I’ve archived it here and I’ve pasted it below.
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I'm a medical student, and spent a day in the Adolescent Medicine clinic on Gender Care day. This was to my surprise, but of course, I have a lot of opinions & many questions on this topic. So let's dive into the observations & answers I received from the Providers.... 🧵(1/?)
First 30 minutes in the office: It was by-far the wokest of all environments in my rotations so far. The PA acted as the mask police, scolding me for taking it down to have "too long" of a sip of water. Openly mocked trump & their supporters TO PATIENTS IN THE EXAMINATION ROOM.
To be clear, I am no fan of the orange man [Trump]. But I hate practically everyone in politics, so let's leave it there.
Observation #1: 1st patient was a 13 y.o. female to male transitioner. During the chart review, it was reported that BOTH of their older siblings are also transgender. *Fascinating*, I thought.🤔 I think this finding speaks for itself. Let's move on.
Same patient, during chart review, noted the 1st therapist they saw did NOT think this patient had gender dysphoria They sought out a new therapist who might give them the answer they want to hear. Of course, this new therapist did give them the diagnosis & the coveted "Letter."
They were not interested in school, eating healthy foods (lives off poptarts & pepsi), & blames Mom for their anxiety (despite her bending to this patient's every whim) & openly disrespected her. They don't do any virtual school work because "the teachers suck at teaching."
In this example, I noticed a pattern of chronic victimization. Everything is someone else's fault. There is practically NO accountability for literally anything, including what they choose to put in their bodies for nourishment.
Another observation is that EVERY. SINGLE. Trans patient had multiple mental health comorbidities including:
Depression
Anxiety
ADHD
Autistic Features
Oppositional defiant disorder
And EVERY single one was on an SSRI at least. FEW were regularly seeing a therapist.
All but 1 remained high scoring on the PHQ-9, still reported su!cidality/depression symptoms despite their transition and meds. All of them seemingly enjoyed the control they had over the provider & parents. I thought changing your gender was supposed to fix all of that? 🤨
On to the Provider questions:
Q: What are the age limits for "affirming care?"
Luckily, in my state, they only do puberty blockers at tanner stage 2 WITH parental consent. Cross sex hormones at 16 WITH parental consent. And top surgery at 18.
Q: How do we explain the multiple mental health comorbidities in these pts?
A: We're still not sure if it is causation, or correlation, but still see improvement after social transition. I did not follow up with my observation of persistent high PHQ-9 scores, convo was flowing!
Q: Do we have to have a Gender Dysphoria diagnosis to purse medications?
A: No. We encourage it, but do not require it. But we do require a therapist visit at least once and parental consent.
*Cringes internally*
Q: So if that's the case, how do we know who genuinely is trans, and who is in a phase/influenced by peers?
A: There is a bit of a social component. But that is largely because society is evolving and gender is much more fluid these days.
Fair. But....
Q: It's odd to me how in 2022 we are trying to get away from gender stereotypes, but simultaneously enforcing these stereotypes by suggesting boys who like girl things might actually be a girl.. instead of a BOY who likes dress & dolls.
A: Yes, many of these kids might just be gay
Q: If that's the case, then what might be the repercussions to transition children who might not be trans?
A: Well, what we do here in the under 18's is totally reversible (Lupron).
Q: How many patients have you seen on Lupron, who decide to stop & start puberty at a later age?
A: I have not seen any patients attempt to "detransition" just yet. In fact, we see higher rates of detransitioners among those who transitioned later in life compared to those who did so at a younger age.
Q: Interesting! Is it possible that because these kids have been socially conditioned to align with the other gender that is who they've become now? Because they don't know any other way?
A: It's definitely possible. We don't have the data for that just yet.
What I've learned:
These kids are mentally suffering on a massive scale.
All of them (literally) have multiple mental health problems
Most of their parents have no disciplinary principles and let their kid talk to them disrespectfully
All (but 1) of them were white
There is far too little emphasis on mental health care and support. Medications aren't it. Addressing the family/home life/past traumas IS IT.
I believe a lack of attention to our collective well-being's is why we have all this mess to begin with.
END 🧵
& Yes, I realize it was only ONE day with a handful of patients. I am no expert. I do not know everything Which is why I asked genuine questions to a doc(admin) I trust-who does do this every day. My mind was actively open & willing to be changed. It's called thinking critically
Actual end of this copy of the thread.
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