The Transgender Battle Line: Childhood Psychologists have learned how to treat adults with gender dysphoria, but how about 5-year-olds? By Debra W. Soh
http://www.wsj.com/articles/the-transgender-battle-line-childhood-1451952794
What should parents do if their little boy professes an intense desire to be a girl? Or if their daughter comes home from kindergarten and says she wants to be a boy? In recent years the dominant thinking has changed dramatically regarding children’s gender dysphoria. Previously, parents might hope that it would be a passing phase, as it usually is. But now they are under pressure from gender-identity politics, which asserts that children as young as 5 should be supported in wanting to live as the opposite sex. Any attempts to challenge this approach are deemed intolerant and oppressive.
I myself was a gender-dysphoric child who preferred trucks and Meccano sets to Easy-Bake Ovens. I detested being female and all of its trappings. Yet when I was growing up in the 1980s, the concept of helping children transition to another sex was completely unheard of. My parents allowed me to wear boys’ clothing and shave my head, to live as a girl who otherwise looked and behaved like a boy. I outgrew my dysphoria by my late teens. Looking back, I am grateful for my parents’ support, which helped me work things out.
Since then, research has established best-treatment practices for adolescents and adults with gender dysphoria: full transitioning, which includes treatment with hormones to suppress puberty and help the individual develop breasts or facial hair, as well as gender-reassignment surgery.
But prepubescent children who identify with the opposite sex are another matter entirely. How best to deal with them has become so politicized that sexologists, who presumably would be able to determine the healthiest approach, are extremely reluctant to get involved. They have seen what happens when they deviate from orthodoxy.
In 2003 a sex researcher and psychology professor at Northwestern University named J. Michael Bailey published “The Man Who Would Be Queen,” a book that countered the idea that male-to-female transgenderism is innately tied to gender identity. For some, he said, the attraction is related to a sexual fantasy of being a woman. Dr. Bailey was quickly accused of transphobia and sustained several years of vicious public attacks. The episode left a lasting impression on sexology: Science that doesn’t align with prevailing attitudes can be dangerous.
Witness the recent experience of Kenneth Zucker, a psychologist in Toronto (who has conducted research with Dr. Bailey). A few weeks ago, the city’s Centre for Addiction and Mental Health announced that it would close its Gender Identity Clinic, which Dr. Zucker had led for 35 years. The news came after months of public allegations that Dr. Zucker, an international expert on gender variance in children, had been practicing conversion therapy, which aims to change patients’ sexual orientation.
But he had not been trying to dissuade anyone from being transgender. Instead his therapy facilitated exploration of gender identity. For example, in addition to thinking about transitioning, gender-atypical males could consider being boys who simply liked female-typical things. One doesn’t necessarily need to be a girl to enjoy nail polish or bedtime stories about fairy princesses.
Pointing that out to a gender-dysphoric child isn’t the same as practicing conversion therapy. Trying to turn a gay person straight is unethical, because sexual orientation is immutable. Gender identity, however, is different, in that it is flexible and can change over the course of life. In keeping with that outlook, Dr. Zucker had been following the most up-to-date standards of care published by the World Professional Association for Transgender Health—a document he had co-written.
Of the boys and girls seen in clinics like Dr. Zucker’s, a high percentage—up to 80% in a study of 44 gender-dysphoric boys—grow up to be not transgender, but bisexual, gay or lesbian adults. Thus, helping prepubescent children feel comfortable in their birth sex makes more sense than starting a lifetime of hormonal treatments and surgeries that will in all likelihood turn out to be unnecessary and unwanted.
When children do transition, some regret it. Consider a 2011 study of 25 adolescents who had been gender dysphoric as children, published in the academic journal Clinical Child Psychology and Psychiatry. Two girls who had undergone social transitioning to boys—by taking on male-typical appearances—regretted it and struggled to detransition. One wanted to begin wearing earrings, but said she couldn’t because she “looked like a boy.” The other, hoping for a fresh start with high school, hid childhood photos at home that depicted her time living as a boy. Both feared teasing from their peers.
Such research explains why Dr. Zucker worked with children to explore gender. Then if a child’s dysphoria persisted into adolescence—gender identity becomes more fixed with age, and the start of puberty often determines whether it will desist—Dr. Zucker would recommend transitioning, including puberty-blocking hormonal therapy.
Dr. Zucker was recently awarded $500,000 from the Canadian Institutes of Health Research to conduct an MRI study on the effects of medical transitioning, such as blocking puberty and administering cross-sex hormones, on adolescents’ neurodevelopment. A grant of this size speaks to both his credibility as a scientist and the importance of this research. The halting of this study in the wake of the closure of Dr. Zucker’s clinic means the critical answers he sought will remain unknown.
The most current science has been trumped purely because it is at odds with the dominant political view concerning transgender development. We don’t allow children to vote or get tattoos, yet in the name of progressive thinking we are allowing them to choose serious biomedical interventions with permanent and irreversible results.
The silencing of those who oppose this sends the message to parents that early transitioning is the only valid and ethical approach for a gender-dysphoric child. This message—pushing children to transition at increasingly younger ages so that they will fit neatly into one of two gender categories—is false and unscientific. It is more progressive to offer them the time and the space they need to figure out who they are and what is ultimately best for them.
Ms. Soh is a provost dissertation scholar and doctoral candidate in psychology, specializing in sexual neuroscience, at York University in Toronto.
Comments are closed.
