Opinion | The truth about transitioning

The various depictions of how transgender people undergo medical transition in media are woefully inadequate – these are ways that it’s really done.


Tate Hildyard

University of Iowa Hospitals and Clinics are seen on Tuesday, June 23, 2020.

Peyton Downing, Opinions Columnist

During the confirmation hearing for Dr. Rachel Levine, president Joe Biden’s nominee for assistant secretary of health, Sen. Rand Paul, R-Ky., put forward a series of questions regarding transgender health care for youths, specifically asking about “genital mutilation.”

This type of inaccurate description of sexual reassignment surgery only serves to make transgender people seem mentally ill, self-destructive, and as though it is best if any child never has any thoughts about being transgender for fear of being put through genital mutilation.

Politicians and other pundits will routinely generate fear about the dangers of medical transition while disregarding any of the safeguards put in place to protect patients and ensure no harm is done.

Now, it becomes more important than ever to describe how transgender health care functions and operates as misinformation runs rampant.

The best place to start off is sexual reassignment surgery — the “genital mutilation” that Paul seems so very concerned about.

Sexual reassignment surgery actually stands in for a lot of various surgeries that can be done to help alleviate gender dysphoria, ranging from implants to facial feminization. However, the main one everyone talks about — “the surgery” — is bottom surgery.

The long and short of it is that for male to female patients, bottom surgery will most often include what is known as penile inversion, where the organs are quite literally folded into the body and cut and molded in such a way as to resemble a woman’s genitals.

Beyond the surgeries is hormone replacement therapy. This is how so much of what happens to a trans person’s body happens when they are medically transitioning occurs.

It’s important to note that these are not mandatory in any sense for someone to be transgender. It is simply the fact that many opt to do so in order to help alleviate gender dysphoria.

This leads directly into the next issue, which is puberty blockers. These drugs essentially block puberty as the name implies, putting it on a pause until the inhibitors are lifted. Once the block is lifted the body will undergo its normal, natural puberty.

The reason why these are transgender issues is because of the fact that as they halt puberty, it now makes it possible for transgender kids to not experience puberty in a way with which they do not align, and as such will make medically transitioning far easier.

This practice is supported by various medical organizations, such as the American Association of Pediatrics. It is a safe and understood method of ensuring that a transgender child does not undergo the wrong puberty.

As with everything in life and medicine, however, there are side effects. The main one of puberty blockers is that they could cause a slightly decreased bone density.

This is why all of these actions need to be taken with the consultation of medical professionals who understand the issues and the science of how these things function.

The idea that any of this is at all like genital mutilation, a practice of needlessly tearing apart the sexual organs of young children and infants, is a fearmongering tactic meant to alienate transgender people from the common public.

The biggest danger to children is not doctors committing genital mutilation against them — it is politicians needlessly interfering with their lives and preventing them from getting the medical help they need to live healthy and fulfilling lives.

Columns reflect the opinions of the authors and are not necessarily those of the Editorial Board, The Daily Iowan, or other organizations in which the author may be involved.