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Teenage Boy Given Estrogen in Juvenile Hall to Treat Behavioral Disorder

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What happened: While detained at a juvenile hall in Los Angeles, a 16-year-old boy was given estrogen to treat a behavioral health disorder, according to a lawsuit. Estrogen is not currently an established treatment for the boy’s diagnosis.

The teenage boy, who has not been identified, was diagnosed with oppositional defiant disorder (ODD) two days after he was arrested and held at Eastlake Juvenile Hall in June of last year. The doctors’ ODD diagnosis was “correlated with elevated levels of testosterone and delinquency in male youths,” according to the lawsuit filed against doctors Danny Wang and David Oh and the County of Los Angeles.

The boy was prescribed 13 doses of the hormone estrogen “without obtaining voluntary and informed consent” of himself or his parents, according to the filing with the court. The lawsuit described the treatment as “experimental.”

Estrogen is not a treatment for ODD. I can’t be more emphatic about that. You won’t find a reference anywhere that supports the use of estrogen for ODD. — James McGough, a professor of clinical psychiatry at UCLA, Los Angeles Times

Later, the boy developed female breast tissue, and was diagnosed with gynecomastia, “which is the enlarging of his breast tissue, that did not exist prior to taking the estrogen pills.” He also experienced “psychological, emotional, and cognitive symptoms of depression, anxiety, insomnia, inability to concentrate, attention problems, and headaches.”

ODD is a behavioral condition that is mostly diagnosed in childhood and is sometimes diagnosed in patients with attention deficit hyperactivity disorder (ADHD). ODD is normally treated with therapy, and not estrogen, said James McGough, a professor of clinical psychiatry at UCLA.

The Frontlines: Many times, young people who act out are diagnosed with conditions like ODD when in reality, they’re trying to regulate difficult emotional experiences. According to Child Mind Institute, there are many common psychiatric symptoms that are easily misinterpreted in children and teenagers, leading to misdiagnosis and improper treatment.

  • Two of the most common diagnoses in school settings are ODD and ADHD, both of which include symptoms many people consider “acting out.” In children and teenagers, “acting out” behaviors can be signs that a child is having difficulty and needs support
  • With trauma, children and adolescents can experience irritable or aggressive behavior, hypervigilance, problems in concentration, to name a few symptoms, which are similar to ADHD, says the American Counseling Association.
  • In addition, children and adolescents can have traumatic experiences that lead to mental health problems, including post-traumatic stress disorder (PTSD). However, diagnosing PTSD in children is challenging, according to National Institutes of Health.

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A Mighty Voice: Our contributor, Siobhán, shared how her misdiagnosis almost made her lose everything. “Last spring, I entered treatment for the first time since 2006, with a new team of therapist and psychiatrist. I was thoroughly honest with both about my previous bipolar disorder diagnosis 16 years ago; both disagreed, and told me they believed it to be adult attention-deficit/hyperactivity disorder (ADHD).” You can submit your first person story, too.

From Our Community:

BPD or Bipolar? #Bipolar #BorderlinePersonalityDisorder

Other things to know: If they’re not asking the right questions, educators, parents, social workers and even medical professionals can make a misdiagnosis. Here are some other Mighty articles on the impact this can have on people:

What to look for: If you’re concerned about a child’s mental health or suspect they may be having trouble, the Child Mind Institute has compiled a resource on what to look for here.

Header image via AlexLinch/Getty Images

Originally published: July 15, 2020
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