“I doubt that there is any doctor who lightheartedly prescribes a therapy as if it were a cappuccino, without knowing the underlying problems. Triptorelin is an analogue of GnRh, the gonadotropin-releasing hormone. The spotlights had already turned on a few years ago when the extension of the use of this drug, already used in people with precocious puberty to delay it, to subjects with gender dysphoria was approved by the Ministry of Health.The extension had taken place with the favorable opinion of some scientific societies among to which the Italian Society of Pediatric Endocrinology and Diabetology had extended this possibility and with some limitations. The message I feel like sending is that the kids who present these situations have suffering” on their shoulders. And their suffering must be helped, understood, not condemned”. These are the words of Gianni Russo, referent of Pediatric Endocrinology in the Pediatrics Operating Unit of the San Raffaele hospital in Milan.
It is a suffering, he observes, “that must be managed in the best possible way. There are reference centers and it is important that, rather than ignoring a problem, it is addressed. This path does not always lead to a need for therapies and evolution in a different sense compared to chromosomal sex but if these situations exist it is important to take them into account”. The expert’s reflection comes after the Italian Psychoanalytical Society wrote to Health Minister Orazio Schillaci expressing “great concern” about the use of drugs aimed at producing an arrest in pubertal development in boys of both sexes who were diagnosed a gender dysphoria.
But these, Russo points out, “are therapies used since the early 80s, whose effects are known quite well. Triptorelin serves to block the central production of gonadotropins and therefore the stimulation at the gonadal level. Among the indications are also international scientific societies that deal with “gender dysphoria” there is no use in the prepubertal period for these forms. But the use of the drug is recommended in the presence of initial signs of the onset of pubertal development and this because there are actually some boys who in the pre-pubertal period manifest the intention of an adjustment of their own sex to what is their scent in the sense of male rather than female gender, who then have an evolution in a different sense”.
For this reason, the expert clarifies, we prefer to wait for the first signs of development. Russo holds to a premise: “Gender dysphoria has as its characteristic not only the desire to belong to a different gender, but it is accompanied by a great discomfort that negatively interferes with social life. These are the characteristics. In other words , they are not people who wake up in the morning and say: today I want to change gender. They are people who are not feeling well. And, as also happens in the rest of the world, a similar path is started” with the freezing of pubertal development, “in the moment in which there is great discomfort because a gap is created between what one’s perception is and the changes that one’s body begins to have and which clearly differentiate who will develop in a male sense and who will do it in a female sense”.
The goal is “to prevent these physical changes from structuring in such a significant way and exacerbating the discomfort that the person already feels and to allow this person to have some time to better understand their situation and in which direction to evolve. But to have an idea of how this process works, it must be said that psychologists, psychiatrists, psychotherapists, child neuropsychiatrists are the ones who evaluate these situations in the first place, also because they must be clearly distinguished from others.They know what they experience and feel. From a practical point of view, we see that there is a withdrawal from social life: they no longer go to school or go around”, and this suffering “can then be accompanied by thoughts of self-harm or even worse”.
So a journey begins. But, Russo reiterates, “it is important to understand that it is an absolutely reversible therapy and if one decides to suspend it because after six months or a year he has developed a different process together with those who are following him, the hormone production situation returns to the one before “. In percentage terms, he continues, “there are significantly more people who continue a gender reassignment process in a different sense. A much smaller percentage interrupts this process. There are certainly some question marks, but those who deal with these subjects with large cases, such as in the Netherlands, is monitoring them and is seeing that from the point of view of psychophysical well-being these therapies for arresting the progression of sexual characteristics, psychological support, integration, and also support for the family and integration, lead to an evolution that seems to be positive. In general, 100% is rarely achieved, but the job data and what we see tell us that there is a positive effect”.
