The Gender Creative Child by Diane Ehrensaft

In contrast, it took massive doses of estrogen to feminize anatomic males. They looked so virilized that, when clothed, only someone with knowledge of their history would guess their anatomic birth sex. The patients emerged much the way they do now: bearded, with a male build, although often short for a male, and in need of mastectomy to flatten the chest.

Even patients who had undergone full puberty could cease menstruating with normal male replacement doses of testosterone. The cross-sex hormonal protocols used for those patients transitioning from female to male were identical to those used for genetic males born without testes or with low levels of testosterone. No psychological tests were performed, no blockers given to suppress the hormones from the ovaries or testes. We only treated adolescents over the age of sixteen (post-puberty) who had been referred by highly experienced therapists, of whom there were few who worked closely with gender-nonconforming young people. Treatment was simplistic and insufficient then, especially for patients transitioning from male to female.

Although the patient had been born anatomically female and had reached full female puberty, he went through college as a male with the support of his three male non-trans roommates, who kept his secret. In 1985, WHEN I ran an adolescent medicine practice, a colleague asked me to provide testosterone treatment for a recent college graduate, my first transgender patient. To my beloved parents, Edith Ehrensaft and Morris Ehrensaft, ninety-six and ninety-eight years old, and still going strong Foreword PATHWAYS FOR NURTURING AND SUPPORTING CHILDREN WHO LIVE OUTSIDE GENDER BOXES

The Gender Creative Child by Diane Ehrensaft