中文导读

近年来，利用“青春期阻滞剂”阻止身体发育成熟在儿童变性治疗中呈抬头之势。这一药物通常和跨性别荷尔蒙疗法一起应用于有性别认同障碍的人群，但若在青春期早期使用，会带来不孕不育等不可逆后果。再者，在青春期也很难判别儿童究竟是跨性别者、同性恋或异性恋。为了最大程度地保护孩子们的利益，是否禁止使用青春期阻滞剂，这是政策制定者面临的一大难题。

Drugs offered to transgender children need to be used more cautiously

Arising number of girls wish to be boys and boys wish to be girls and a rising number of them are taking drugs to block puberty. In Britain cases of children being treated for gender dysphoria by the National Health Service remain rare, but in the past decade they have climbed at a rate of 50% year on year (see chart). In America the number of gender clinics treating children has increased from just one in 2007 to perhaps 50 today.

This has bothered lawmakers. In America several states want to ban giving puberty-blocking drugs to children. In Britain the high court is considering the judicial review of a clinic which complainants believe has been handing out puberty blockers too freely.

The use of such drugs raises thorny questions about who decides what can happen to a child’s body and why. Put aside the culture wars, if you can. This debate should be settled in the interests of the child. Yet those can be very hard to discern.

Puberty blockers prevent adolescents from developing secondary sexual characteristics like breasts or a beard. They almost always set off a cascade of interventions that involve “cross-sex” hormones and later may also include gender-reassignment surgery. The main purpose of puberty blockers is to bring comfort to people with gender dysphoria, by sparing them the experience of, say, becoming more like a woman if they are a girl who wishes to be a boy. They also make most future surgery less severe.

However, the combination of puberty blockers and cross-sex hormones also leads to irreversible changes which, if they start early in puberty, include sterility. About a dozen studies of gender-dysphoric children who did not take puberty blockers have found that most of them, if supported by counselling, are happy with their sex once they emerge from puberty. The share often cited is 85% and many of them turn out to be gay. One sign that something is wrong is that more people are “detransitioning”—re-identifying with their biological sex. Most of them are girls who wanted to be boys when they were in their teens. If they took puberty blockers and then cross-sex hormones early they would be sterile for life, even if they did not have hysterectomies.

As of now, there is no way to distinguish the 15% or so of children who will transition successfully from the 85% who might have been happy with the gender of their birth if they had received counselling alone. Some claim that withholding puberty blockers adds to the burden on vulnerable children with gender-dysphoria and may lead to higher rates of suicide.

Choosing whom to treat is a judgment of Solomon. The decision to intervene is made harder by a reckless disregard for data. The academic studies purporting to show the higher suicide risk among trans children are unconvincing. Clinics do not publish enough studies on the effects of various treatments on their patients. Too little research compares children who have had treatment with those who have not. The field needs a better understanding of the long-term effects of puberty blockers and cross-sex hormones. Every child who is treated should be enrolled in a long-term follow-up study.

This should be with their informed consent. But so should the treatment itself. Today children and parents are not always fully informed about the potentially grave consequences of starting on puberty blockers. Their effects are often described as largely reversible—and the effects of cross-sex hormones that are almost always taken with them are not.

To ban puberty blockers in all circumstances would be unjustified. Not only would it be harsh on some children, but it would also leave the issue permanently obscured for lack of new research. However, today’s rush into treatment smacks of a fad. Many adolescents feel unhappy with the way they were made. Transitioning will be solace for some. But for others it will be a dreadful mistake.

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Feb 1st 2020 | Leaders | 654 words

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每日一学

2020/02/08

最后一段第三句话“However, today’s rush into treatment smacks of a fad.”中的 smack of 如何理解？

其实这里主要用到了 smack of sth 这个表达，这一短语表示“有…味道；带有…意味”，英英释义为 to seem to contain or involve a particular unpleasant quality, e.g. Her behaviour smacks of hypocrisy. 她的行为有点虚伪。而名词 fad 的意思是“一时的风尚；短暂的狂热(something that people are interested in for only a short period of time)”。原文这句话的意思是：然而，如今草率的治疗决定有点像是一时的狂热。

（查看本文更多讲解，请点击下方参与阅读训练营，词汇量需过八千方可报名，词汇量低于八千请移步☞词汇训练营）

声明：

本文全文摘选自The Economist(1st Feb 2020)，仅供个人学习交流使用。欢迎转发至朋友圈。

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