More research needs to be done on hormone therapies meant to address gender incongruence among children

By Kent R. Kroeger (Source:; April 3, 2022)

The need for objective research research cannot be compromised simply because the issue is socially sensitive or politically contentious.

I recently watched a conversation between Joe Rogan and Adam Conover, the comedian host of truTV’s Adam Ruins Everything, about trans-athletes. The conversation was from two years ago, but it remains relevant, even if it was only a semi-cogent conversation between two people marginally qualified to talk about the fairness of allowing trans-women to compete in women’s sporting events.

At one point in the dialogue, Conover justified his acceptance of transwomen competing in women’s athletic competitions by citing his podcast conversation with a transwoman who had served as a U.S. Army helicopter pilot before her gender transition.

“There’s an author named Brynn Tannehill who’s a former military helicopter pilot I just interviewed. She’s one of the people affected by the Trump’s military ban on trans-service people who wrote a fantastic book called “Everything You Ever Wanted to Know about Trans (But Were Afraid to Ask),” Conover told Rogan. “She is now a researcher and went into deep detail about the medical science.”

Subsequent to the Rogan-Conover debate, the University of Pennsylvania’s Lia Thomas, a transgender athlete, winning the 500m freestyle at the NCAA swimming championships arguably offers supporting evidence to those concerned about the fairness of allowing trans-woman to compete in women’s athletics.

After agreeing to disagree on trans-athletes, the Rogan-Conover moved into whether there is enough research to understand the impact of hormonal therapies and transition surgeries on adult and pre-adult individuals.

Writes Tannehill for The Huffington Post:

“Given the level of harm involved when medical care is denied (to trans-persons), and given how unusual regret is, denying medical care to everyone based on the outliers makes no logical or ethical sense. In other words, you would do more harm to more people by denying everyone access than by keeping the system we have in place or even expanding access. Every major medical organization supports access to transition-related care and deems it medically necessary for a reason: The actual peer-reviewed evidence supports it.”

The Rogan-Conover conversation, however, turned much more combative when discussing hormonal therapies and other conversion procedures for gender incongruence among children (‘trans-children’).

Unintentionally, Tannehill’s book highlights how genuinely limited the research has been on the impact of gender-transition, hormonal therapies conducted on pre-pubescent children.

In the absence of definitive research, Rogan and Conover were left with their instinctive feelings and crude understanding of the transgender issue as it relates to children.

But, after all, that is how public opinion forms. People talking about things they don’t fully understand, helping others form opinions based mainly on gut instincts in lieu of anything more substantive. And this is O.K…that is how our social system works.

It isn’t perfect, and it typically doesn’t solve any issue to an acceptable extent. As social scientist Charles Lindblom observed many years ago, our institutions (including the scientific establishment) tend to muddle through, or to borrow a phrase from actor Will Smith’s son Jade Smith in a more contemporary context, “That’s how we do it.”

Unfortunately when it comes to effective public policy, it is usually not defensible just to say ‘that’s how we do it’ and proceed to ‘muddle through.’ At some point, analysts and policymakers must acknowledge their personal biases and intellectual limitations and help us all form more evidence-based opinions.

It’s a tough process, and not always linear in its progress.

Furthermore, it is always necessary to assess the objectivity the research, particularly when the researchers hold known, pre-existing opinions — such as Tannehill’s belief that hormonal trans-therapies are safe and optimal for pre-pubescent children.

Why would anyone reading “Everything You Ever Wanted to Know about Trans (But Were Afraid to Ask)” be surprised on the author’s conclusions? They were most likely determined before one word in the book was written.

In fact, her conclusions are far from conclusive, particularly with respect to children.

But that doesn’t necessarily mean Tannehill’s conclusions are without merit either. It does mean, the existing research doesn’t definitively inform us about the long-term effects of altering natural hormonal processes during pre-pubescent periods. There are early attempts at addressing this issue, but they are just that…early attempts.

“Gender-affirming hormone therapy is considered safe, but is not without risk,” says Julia Cartaya, MD. The benefits include a general improvement in mental health functioning, a decrease in body dissatisfaction and an improved sense of wellbeing, according to Cartaya.

But policymakers need better information than that to make long-term decisions.

The long-term impact of hormonal trans-therapies on pre-pubescent children is a legitimate analytic question that is yet to be fully answered by existing research. Admitting that and doing something about it, sooner rather than later, will be critical to moving society forward on policies related to the trans-community.

  • K.R.K.

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