Too Young to Decide
We can all agree that children should not be able to change their sex.

Dr. Norman Spack of Children’s Hospital in Boston


Charles C. W. Cooke

When children look to adults to give them guidance, adults often fall short of their charge; but few fall as short as Dr. Norman Spack of Children’s Hospital in Boston. According to a scattering of reports that have consistently struggled to gain attention when pitted against more important topics — the Oscars, for example — there has been a dramatic rise in the number of incidents in which children are given treatment that is designed to halt their development as males or females and, ultimately, completely change the sex of their birth. Spack is the procedure’s champion. He rejects the traditional notion that children who are confused about their gender are suffering from what psychiatrists term “gender-identity disorder” — which varies in severity from normal growing pains to fully-fledged disorders — and believes instead that they have innate differences in their brains that render them, literally, of the wrong sex.

Such “transgendered” children, argues Spack, need “correcting” before it is too late. And this is done, he explained in the Boston Globe in 2009, with “puberty-blocking drugs” that “work best at the beginning of the pubital process, typically age 10 to 12 for a girl and 12 to 14 for a boy.” The results are remarkable. One patient was a “girl from the UK,” who “was destined to be a 6-foot-4 male. With treatment, she’s going to end up 5-foot-10.” Spack’s ideas are growing in popularity. “If you open the doors, these are the kids who come,” he claims.

Well no, actually, they don’t. “These kids” are brought to Spack’s Huxleyesque “Gender Management Service Clinic” — and other such institutions across the country — by their parents; their futures are discussed primarily between their parents and a doctor; and crucially, the decision is made by their parents, who then sign off on treatment that is undertaken by an (adult) doctor. No child in the history of the United States has ever walked into a doctor’s office and organized his or her own sex-change therapy, much less prescribed themselves and administered the requisite drugs. But even were a child to “walk through the door” entirely of his own volition, would that constitute an excuse? A child might also pick up a loaded handgun or avail himself of the liquor cabinet or elect to rub lipstick into the carpet, but we would not consider such agency to be sufficient warrant to cease all parental and societal oversight.

Spack, however, clearly sees no moral problem with indulging troubled children’s every desire. When questioned about the potential drawbacks of his scheme, his only concession to the Boston Globe was “the issue of fertility.” He adumbrated: “When young people halt their puberty before their bodies have developed, and then take cross-hormones for a few years, they’ll probably be infertile. You have to explain to the patients that if they go ahead, they may not be able to have children. When you’re talking to a 12-year-old, that’s a heavy-duty conversation. Does a kid that age really think about fertility?” One can only conclude that, in Dr. Spack’s worldview, children of “that age” are unlikely to “think about fertility,” but are nonetheless capable of making irreversible decisions that will affect them until their dying day.

Children, of course, are incapable of making either kind of decision, or of fully grasping the gravity of what is being suggested. It is thus that we maintain laws that prohibit the young from voting, driving, buying whiskey, and starting a family — even when these tasks are within their physical abilities. It would be made blindingly obvious just how ridiculous are suggestions to the contrary if it were reported that twelve-year-old children were undergoing vasectomies or electing to be sterilized. (Or, perhaps, changing their skin color.) If such cases came to light, the condemnation would be swift, with all sections of the country calling for the heads of the parents, doctors, and, ultimately, Congress — all of which institutions, one might note, are filled by adults. In our society it is with adults that the buck stops.

Dr. Margaret Moon, a member of the bioethics committee at the American Academy of Pediatrics and a teacher at the Johns Hopkins Berman Institute of Bioethics, is horrified by the trend. She contends that it is devastating for children “to have an irreversible treatment too early.” She is concerned that, in addition to abdicating their responsibilities, adults involved in children’s sex-change treatment often have questionable motives. Parents, she notes, are much too quick to try and medicate their children’s natural confusion and curiosity, or clutch at straws out of shame at having a different — and possibly homosexual — child.

There is a legitimate debate about the degree to which our society’s adults should use medicine to change their gender, but not one that obtains in this case. What the likes of Dr. Spack are doing has nothing to do with sex or individual rights, and everything to do with the welfare of children and our duty to protect them before they cross the threshold into adulthood and make life’s major decisions for themselves. Unlike so much these days, this is an issue that transcends the standard political divide; Dr. Spack can cloak his sickening procedures with as many euphemisms as he likes, but the only two words that we should hear are “child abuse.”

— Charles C. W. Cooke is an editorial associate at National Review.