The reality of gender on San Juan Island

As members of the San Juan Island community, we are gratified to see that there is widespread support for transgender and gender non-conforming people here on the island. As noted by Maureen Marinkovich in her article on 5/3, “… our community is very supportive of people, including children, on the path toward [gender] transition.” This support for the LGBTQ+ community has materialized most recently in a lack of interest in and support for her attempt to bring someone here to speak against gender-affirming care for children and young adults.

Marinkovich also claims that “there is no community platform available to discuss gender dysphoria as an experience that is transitory rather than transitive.” While this statement is hard to parse, it indicates a profound lack of familiarity with the LGBTQ+ community and our issues.

The speaker that Marinkovich is bringing to the island is Nicolas Blooms, a self-identified detransitioner, which means that he explored gender transition and ultimately decided that it was not for him. Importantly, Blooms engaged in all of his gender-affirming care as an adult, after the age of 18.

An estimated 0.5% of adults and 1.4% of youth in the United States identify as transgender, according to a 2022 Williams Institute UCLA study. Almost all people who self-identify as transgender are happier after engaging in gender-affirming care, which can range from changing their gender presentation to surgeries. According to the most recent U.S. Trans Survey, which surveyed 92,329 transgender people across all 50 states, 99% of people on gender-affirming hormone therapy report that their life is better or unchanged after beginning hormones, and 99% also report unchanged or improved quality of life after gender-affirming surgeries. A 1% regret rate is extremely low for all types of medical care; for comparison, a 2016 study found that after routine total knee replacements, 6.5% of patients were not satisfied with the outcome. Rates of detransition are so remarkably low as to be statistically insignificant.

Gender-affirming care in children and teenagers is more often social than medical. Social transition may include a new name, hairstyle, and clothing. Medical transition in children follows clearly defined guidelines and policies. For example, hormone therapy can be given to minors only with parental consent – which is true of almost all medical care provided to children. One early medical intervention that can be given to minors is puberty blockers, which pause the onset of adolescence without long-term side effects, and which were initially developed to delay puberty in children who start puberty before the age of 8. Upon reaching the age of majority, with the legal rights of an adult, transgender youth may pursue any and all gender-affirming care that they wish.

In her article of May 3rd, Marinkovich states that Blooms “was supported by his peers” in his gender exploration, and that “the support has caused harm to him and his body.” Gender-affirming care, like the support and care that Bloom received, is the recommended treatment for gender dysphoria, according to the American Medical Association, the Endocrine Society, and the American Academy of Pediatrics. Whether or not it worked for Blooms, the social support and the medical care that he received as an adult are in line with medical guidance, and reflective of a society that values and works to protect LGBTQ+ youth.

Given the overwhelming scientific evidence in support of gender-affirming care, providing statistical context for stories like Blooms’s is critical. Providing support for transgender children and youth is even more critical, as the great majority of them will grow into trans adults who can – and will – flourish in our community.


Owen Ellis and other community members in support of our trans youth

San Juan Island