Stories about: endocrinology

Norman Spack: Saving transgender lives

SpackNorman_06In traditional Navaho culture, individuals with the physical or behavioral features of both genders are considered “two-spirited” and often arbitrate in marriage disputes because they’re trusted to see both sides of the story. In the broader American culture, though, identifying with a gender different from the one assigned at birth—what we call transgender—is not fully understood or accepted.

That’s changing—slowly. Recent cultural developments—including the rise of transgender characters in TV shows such as “Orange is the New Black” and “Transparent” and the high-profile transitions of celebrities like Bruce Jenner, who is being interviewed by Diane Sawyer on ABC’s 20/20—have brought about a heightened interest and awareness of the transgender population and their journey towards acceptance.

That journey can be especially challenging for transgender teens and young adults, a population with a startlingly high rate of suicide attempts and mental health struggles. We sat down to learn more about transgender youth and adults from one of the leaders in the field, endocrinologist Norman P. Spack, MD, co-director (with Urologist-in-Chief David A. Diamond, MD) of the Gender Management Service (GeMS) program at Boston Children’s Hospital—the first of its kind in the nation.

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Does early maturity make for a mean girl?

Many parents of pubescent and pre-pubescent girls encounter troubling behaviors among their daughters between the ages of 10 and 13. The apple of your eye may begin to talk back to you, choose questionable friends or dabble in mean girl behavior. It is worrisome. But a study published in the January issue of Pediatrics that linked early puberty in girls with relationships with more deviant peers, susceptibility to negative peer pressure and higher levels of delinquent and aggressive behaviors may sound an unnecessary alarm.

Previous studies have suggested a link between early puberty and behavioral and emotional problems in girls, but the researchers’ recommendations—specifically limiting association with deviant peers for early maturing girls—should apply to all adolescents, says Diane Stafford, MD, attending physician in endocrinology at Boston Children’s Hospital.

This recent study in Pediatrics of 2,607 girls and their parents focused on interviews at ages 11, 13 and 16 years. Girls and their parents were questioned about age of menarche (first period), best friend’s deviant behaviors like alcohol or drug use, delinquency and aggression.

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