What’s Your Line in the Sand?

A discussion was going around the other day: “What is your line in the sand that tells you, ‘This is too far.’”

The answer, to me, was very clear. My line in the sand is “medicalization.” If he hadn’t been medicalized so soon life would have slapped enough sense into our son to do—or not do—certain things. Unfortunately for him and for us, he has medicalized.

That people like him will suffer because of these medical interventions as they grow older is almost a certainty, with some experiencing it more intensely than others. If they are on estrogen long-term, by the time they reach their 30s, their bodies will have already started to show signs of strain. As they get older, gradually, and then more precipitously, the probabilities of bad outcomes, including death, will worsen. And if he had surgeries, well, I don’t even want to think about that right now.

Will some of them beat the odds? Sure, that is the nature of probability. However, compared to a fellow parent whose son has not been medicalized, I will have more than three times the odds of seeing my child dead by the time he reaches his 50s, if private US insurance data is any indication. (Check out the Online Appendix: like most “research” in this area, the incriminating details are almost always hidden away in online appendices, if they can be found at all. The table below is created from the data within the online appendix).

Even if he doesn’t, it will be my wife and me who will be taking him to the hospitals and putting him under the care of doctors who probably have no idea of what to do with him. And this will be when we are in our eighties.

And then there’s the social bankruptcy. His identity, even if he beats the physiological odds, requires constant validation, and the market for that is way past its peak. He might still continue to get some validation now in his 20s, when there are enough of his peers who have the time in their hands to participate in his delusion.

But by the time they are in their 30s, most of those peers would have settled down, if they haven’t done so already. They will have risen up the ranks somewhat in their jobs. And so there will be deadlines. And unreasonable supervisors and whiny supervisees. Office parties they can’t get out of. And travel. And reward points. Checking into their 401ks. Mortgages, if they can afford it. ACs that stop working at 2 AM. The joys of DIY home repair. And finally—as Cori Cohn once said memorably in a podcast—children. Diapers. Colic. First words. First fever. First birthday. First steps—edited and posted on Instagram. Swallowed toys. Daycare. Bugs picked up at said daycare.

As his contemporaries juggle with that amorphous entity called life in all its resplendent glory, they soon will not know where their weekend went, let alone the week. And out of all the things they will be juggling, one thing they will quickly learn to jettison is the time they used to allot for our man-child, who will still need constant validation—perhaps even more so—in a world that has moved on.

And the world would have more than moved on. Just like scrubbed pronouns, entire memories of this medical calamity would have been scrubbed out of collective memory, with people like him treated as the unwelcome reminders of our era. It would make so much sense to consider him a freak for insisting, after all the emerging evidence, that “these interventions help,” and increasingly resembling Richard Levine every passing year, minus the uniform and any federally mandated healthcare.

(Richard, we should remind ourselves, had his children before indulging in his inner freak—and was honest enough to confess that he wouldn’t have transitioned earlier because he couldn’t “imagine a life without [his] children.”)

So, what does a person who bet his entire life on that single choice he made in what was practically his childhood do then? They are left with that one last chip: their parents.

And so, in a very selfish way, I draw the line at medicalization.