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00:00:00 – 00:18:42
The speaker addresses a hometown audience, sharing personal anecdotes and emphasizing the complexity of identity at birth, particularly the differentiation between sex and sexual orientation. They detail the development of gender identity in children, noting that cross-gender behaviors often abate by puberty, but true transgender identity solidifies around ages 10-14. Through various patient stories, including a transgender man and a married couple, they underscore the critical importance of acceptance and support for transgender individuals, highlighting the severe consequences like family rejection and high suicide rates among untreated individuals.
The speaker outlines the comprehensive treatment approach for young adolescents with gender dysphoria, including puberty blockers to delay development, allowing time for gender identity to solidify, and subsequent hormone treatments leading to permanent changes by age 18. Key success stories, such as that of Jackie and Nicole, demonstrate the effectiveness and societal impact of these treatments. The speaker also highlights a pioneering program initiated in 2007 at Boston Children's Hospital, which treats a significant number of local and international patients.
The need for broader anti-discrimination protections in more states, and more affordable treatments, is stressed, alongside a call to declassify certain transgender conditions from the DSM, similar to the removal of homosexuality as a psychiatric disease in 1973. This change is argued to be not only economically feasible but also crucial for reducing suicide rates and promoting societal inclusiveness. The speaker concludes with gratitude and a call to action.
00:00:00
In this segment, the speaker expresses excitement about addressing the hometown audience and shares personal history, including being born in Brookline at the now-closed Allerton maternity hospital. They prompt the audience to reflect on one of the first recognitions of identity at birth, specifically the third word often said, referring to the baby’s sex (“It’s a…boy/girl”). The speaker discusses the complexities faced in determining sex, particularly in situations where physical indications are ambiguous. They emphasize that while the sex is identified based on visible genitals, true identity, including sexual orientation, is not apparent at birth. This leads to the point that sexual orientation cannot be immediately defined, contrasting the straightforward declaration of a baby’s sex.
00:03:00
In this part of the video, the speaker discusses the development of gender identity in children, noting that cross-gender behavior is common and often does not persist into puberty. It is mentioned that true transgender identity typically solidifies around puberty, between ages 10-12 in girls and 12-14 in boys, and is unlikely to change thereafter. The speaker shares a personal experience with a genetically female individual who identified and lived as male, sought help with hormone treatment, and provided the speaker with a valuable education on transgender issues.
00:06:00
In this part of the video, the speaker discusses the experiences of a patient who married a transgender woman and the complexities surrounding gender identity and sexual orientation. The patient humorously explained the difference between sexual orientation and gender identity: “sexual orientation is who you go to bed with, gender identity is who you go to bed as.” The speaker also shares insights from treating around 200 transgender adults, noting the significant sacrifices they endure, such as rejection by family and loss of relationships, often necessary to affirm their true selves. Furthermore, the high suicide rates among untreated transgender individuals are highlighted, emphasizing the critical need for support and acceptance.
00:09:00
In this segment, the speaker discusses the process of treating young adolescents experiencing gender dysphoria, emphasizing the use of puberty blockers to give these children time to solidify their gender identity. They explain that children of different sexes look similar before puberty, but puberty can exacerbate feelings of being in the wrong body. Puberty blockers are used around age 12 to pause development and allow further psychometric testing over several years. By age 16, if the diagnosis is confirmed, they might receive hormones of the opposite sex, leading to permanent physical changes, and by age 18, they become eligible for gender-affirming surgery. The speaker highlights that some surgical results, especially male-to-female, can be remarkably convincing. They emphasize that this approach has become standard care and is supported by Boston Children’s Hospital, as demonstrated through successful patient outcomes.
00:12:00
In this part of the video, the speaker discusses a groundbreaking treatment program initiated in 2007 to help transgender youth, specifically noting its uniqueness in North America despite its Dutch origins. The program, which started in Boston, now treats 160 patients, most of whom are local, with some from as far as England. The speaker shares the story of Jackie, a young transgender girl from England who faced abuse and homeschooling due to her gender identity. The program provided her with innovative hormone treatments that included estrogen at an earlier age to help halt male puberty and ensure appropriate physical development. Jackie’s remarkable transformation and success, including becoming a semifinalist in the Miss England competition, highlights the program’s positive impact.
00:15:00
In this segment of the video, the speaker shares the story of Nicole and her identical twin brother Jonas, highlighting Nicole’s early self-identification as a girl and the family’s supportive response. Nicole underwent a name change at age seven and began pubertal blockade to prevent male puberty changes. Jonas, who matured early, showcases typical male puberty traits, making clear the differences between them due to Nicole’s treatment. The family actively fought against anti-discrimination laws in Maine, with Nicole personally advocating to legislators, which helped block harmful legislation. Despite progress, the speaker notes that anti-discrimination laws are still limited to 17 states, and calls for more affordable drugs for treatments related to gender transition.
00:18:00
In this part of the video, the speaker emphasizes the importance of removing a specific condition from the DSM, comparing it to the historical declassification of homosexuality as a psychiatric disease in 1973. The speaker argues that such a change would not be economically burdensome due to the relative rarity of the condition but highlights the significant risks of inaction, including the potential for increased suicide rates and the broader implications for societal inclusiveness. The segment concludes with the speaker thanking the audience, followed by applause.