Reply #8: It isn't drugs; it's hormones

[devinkay]

Spironolactone will be used to forestall Katie's puberty. It does this by impeding the body's uptake of andogens. Spiro is a diuretic that just happens to be anti-androgenic. It has been used for several decades to reduce prostate enlargement, to lower blood pressure, and to treat acne. It's most serious side effect is increased potassium levels, which, if monitored, presents a very acceptable level of risk.

Forestalling puberty will give Katie time to mature further before making the final life-altering decision to continue full blown hormone replacement therapy and pursue surgical intervention. If Katie were to change her mind, withdrawing the spiro would simply allow puberty to proceed unchecked.

Katie won't change her mind, though. She knows her gender now as definitely as you knew yours at her age. I knew from my very earliest memories that my male body was a mistake, but nobody back then wanted to hear it. My own parents ridiculed me incessantly for being a sissy, and I grew up struggling to conform to the thing between my legs, all the time knowing full well that I was living a miserable lie and hating myself for it. It's a sign of the times and a testament to Katie's parents' love that she's being given the opportunity to correct a birth defect before it warps her irredeemably.

I was forty before I mustered the courage to face cultural censure and do what I could to get right. If at the age of 8, or 10, or 14 I'd been offered an elixir that would turn my body female but with the caveat that it carried with it a 75% chance of death, I would have taken it in a heartbeat. A life out of sync is really no life at all. I promised myself never to regret my past, but in light of Katie's story I can't help but shed a little tear for what might have been, even as I cheer for the progress we're making in our understanding of gender and its infinite variations.

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