Shiloh
Editor, Senior Moderator
Source: https://nationalpost.com/health/can...-transgender-patients-after-u-k-clinic-closed
Canadian specialist urges MDs to 'slow down' in treating transgender patients after U.K. clinic closed
Underpinning debate is a rapid increase in patients presenting as transgender over the last several years, dominated by girls just entering adolescence
Tom Blackwell
Publishing date: Aug 17, 2022 • 4 days ago
Canadian health care faces similar issues around treating transgender teenagers as a controversial British clinic and needs to “slow down” and not move patients so readily to medical transition, says a leading expert in the field.
As the number of youth presenting with gender dysphoria soars and their demographic make-up changes markedly, the health-care system should examine why those trends are happening while taking a thoughtful, “neutral” approach to each young patient, said Dr. Joey Bonifacio.
Gender health-care made headlines recently with Britain’s decision to close the so-called Tavistock clinic for gender issues and replace it with a network of smaller centres. An independent review suggested it was giving short shrift to patients’ non-gender mental health problems, and that evidence was unclear about the long-term effects of puberty-blocker drugs, often the first step in gender transition.
“I do have the same concerns the Tavistock clinic faced,” said Bonifacio, a pediatrician whose practice at Toronto’s St. Michael’s Hospital focuses on gender identity.
“I think it just moves us to ‘Let’s slow down and make sense of what is going on,’ ” he said, though Bonifacio opposes closing down any clinics here. “All of these decisions … concerning social, medical or surgical transitions, these are big decisions and they deserve the time, they deserve the respect that’s needed.”
Article content
He acknowledged that patients already face long wait times, but stressed that doctors and other professionals must thoroughly address any mental-health issues children experience on top of gender dysphoria — the sense of not belonging to one’s birth sex — before beginning gender transition with hormone treatment and, eventually, surgery.
His comments in a recent interview were measured and diplomatic. But they represent a rare case of an expert at the heart of transgender health care in Canada publicly questioning some of its practices.
With sub-specialty training in adolescent and social pediatrics, Bonifacio is a former medical director of the SickKids Hospital gender clinic in Toronto.
Underpinning debate in the U.K. and elsewhere is a rapid increase in patients presenting as transgender over the last several years, dominated by girls just entering adolescence. In the past, gender dysphoria was more likely to appear in younger boys. Statistics are scarce in Canada, but the Trans Youth Can! research project indicates that patient volumes at 10 participating clinics grew from almost none in 2004 to over 1,000 in 2016. About 80 per cent were children born as girls.
Significant numbers of children on the autism spectrum and other neurodivergent patients are also showing up, says Bonifacio. They accounted for about a third of patients at the Tavistock clinic, the U.K. review reported...
Canadian specialist urges MDs to 'slow down' in treating transgender patients after U.K. clinic closed
Underpinning debate is a rapid increase in patients presenting as transgender over the last several years, dominated by girls just entering adolescence
Tom Blackwell
Publishing date: Aug 17, 2022 • 4 days ago
Canadian health care faces similar issues around treating transgender teenagers as a controversial British clinic and needs to “slow down” and not move patients so readily to medical transition, says a leading expert in the field.
As the number of youth presenting with gender dysphoria soars and their demographic make-up changes markedly, the health-care system should examine why those trends are happening while taking a thoughtful, “neutral” approach to each young patient, said Dr. Joey Bonifacio.
Gender health-care made headlines recently with Britain’s decision to close the so-called Tavistock clinic for gender issues and replace it with a network of smaller centres. An independent review suggested it was giving short shrift to patients’ non-gender mental health problems, and that evidence was unclear about the long-term effects of puberty-blocker drugs, often the first step in gender transition.
“I do have the same concerns the Tavistock clinic faced,” said Bonifacio, a pediatrician whose practice at Toronto’s St. Michael’s Hospital focuses on gender identity.
“I think it just moves us to ‘Let’s slow down and make sense of what is going on,’ ” he said, though Bonifacio opposes closing down any clinics here. “All of these decisions … concerning social, medical or surgical transitions, these are big decisions and they deserve the time, they deserve the respect that’s needed.”
Article content
He acknowledged that patients already face long wait times, but stressed that doctors and other professionals must thoroughly address any mental-health issues children experience on top of gender dysphoria — the sense of not belonging to one’s birth sex — before beginning gender transition with hormone treatment and, eventually, surgery.
His comments in a recent interview were measured and diplomatic. But they represent a rare case of an expert at the heart of transgender health care in Canada publicly questioning some of its practices.
With sub-specialty training in adolescent and social pediatrics, Bonifacio is a former medical director of the SickKids Hospital gender clinic in Toronto.
Underpinning debate in the U.K. and elsewhere is a rapid increase in patients presenting as transgender over the last several years, dominated by girls just entering adolescence. In the past, gender dysphoria was more likely to appear in younger boys. Statistics are scarce in Canada, but the Trans Youth Can! research project indicates that patient volumes at 10 participating clinics grew from almost none in 2004 to over 1,000 in 2016. About 80 per cent were children born as girls.
Significant numbers of children on the autism spectrum and other neurodivergent patients are also showing up, says Bonifacio. They accounted for about a third of patients at the Tavistock clinic, the U.K. review reported...