A picture is worth the many thousands of words I’ve spilled on this blog.
Dr. Kenneth Zucker, who runs the gender identity clinic at the Clarke Institute in Toronto, Canada, and Dr. Susan Bradley, one of its founders, have been vilified as “transphobic” by trans activists because of their caution in prescribing extreme drug and surgery treatments to minors. In fact, the clinic is currently under “6-month review,” Zucker has been forbidden to speak to the news media, and the Canadian legislature is considering a bill that would outlaw the work of the clinic–even though Zucker and colleagues do prescribe puberty blockers and cross-sex hormones to “a significant minority” of their pediatric patients.
Update: The Globe&Mail story was sent by a reader who pointed me to a critical discussion about these doctors here. Apparently Zucker and Bradley subscribe to more conventional views about gender and sex role conformity than I’m comfortable with, yet they seem to be some of the only medical professionals who are questioning the rush to pediatric transition. Where are the gender-critical, non-homophobic doctors and therapists who are providing an alternate view? Tell us about them in the comments, please.
It is a measure of how lopsided the transgender discussion has become that these professionals–who have decades of experience with “gender nonconforming” children–are hounded by trans activists simply for presenting a nuanced view. These doctors’ only crime is in encouraging a child to simply consider living life without injecting powerful drugs and cutting off healthy body parts. For this, Zucker and Bradley are treated as personas non gratas who could one day be prosecuted as criminals for merely suggesting that it might be better to love one’s biological body than to permanently alter it; that preserving his or her future reproductive capacity might be a worthwhile goal for an 11-year-old; that other psychological conditions and trauma might play a role in the etiology of gender dysphoria.
This piece in Canada’s Globe and Mail (May 8, 2015) is an extremely important and unusual article. The balanced view taken by the story’s author, Margaret Wente, should be the journalistic norm, not the exception. Some excerpts:
“Some of these kids are quite significantly ill,” says Dr. Bradley. “They often have serious family problems and anxiety disorders. Or they’ve had serious trauma. A girl I saw had been raped, and after that she decided she was going to be a male. If you didn’t pay attention to the trauma you’re not doing that kid a service.” …
“The trans lobby has got us on the run,” Dr Bradley sighs.
These days, that eminently reasonable view is being challenged by people who believe that children’s sexual confusion should automatically be taken at face value. The clinic that Dr. Bradley helped to found – which does, in fact, support gender transition for a sizable minority of its patients – is being pilloried as transphobic. …
Dr. Bradley cautions that transition is a radical step – involving surgery and a lifetime regime of hormone therapy – and that the road, under the best of circumstances, is rocky. “The child is going to find himself in a really difficult situation…”
These days the media are overflowing with heartwarming stories about happy transgender kids and their happy families. But hundreds of kids have resolved their issue without changing genders. Their families are appalled by the attacks on Dr. Zucker …
“My family’s experience with Dr. Zucker has been incredibly misrepresented,” another mother told me. Her daughter was five when they took her to the gender clinic, and strongly identified as a boy. She once asked if God makes mistakes, “because I should have had a penis.” She too was an extremely high-anxiety child. Dr. Zucker advised them that the immediate task was not to remake her into a boy, but to build her confidence and self-esteem. He asked them to dress her in gender-neutral (not boys’) clothing, and to encourage her to play with other girls.
“It took us months to find a therapist who wouldn’t try to make it all about being transgender,” says the mom. “We just wanted to give her space.” Today, at 8, their daughter is a happy kid who wears her hair long, says she likes being a girl, and still prefers gender-neutral clothes. “I don’t know what’s going to happen with her in the next few years,” the mother says. “But because of Dr. Zucker she will love herself.” …
Under pressure to be politically correct, we have allowed a small but noisy bunch of activists to undermine a caring and first-rate institution, and to turn the problems of emotionally troubled children into an ideological battleground. It’s time to stop, before we do more harm.
Someone recently took me to task for daring to criticize PFLAG for abandoning parents of young lesbians, and for daring to suggest that parental or clinician homophobia might play a role in the increasing number of kids and teens who are medically “transitioning.” This first-person piece in the Advocate, written by the mother of a young lesbian who decided to “transition,” is a good case in point. Mom wonders “what she did wrong” to make her child turn out gay. She feels intense shame at even the word “lesbian.” But when her daughter decides she is actually a guy, not gay, mom’s main worry is that her straight son will have a hard time finding someone to partner with.
The Advocate, first published in 1967, was originally the flagship publication for the gay and lesbian community. Back in the day, a mother admitting openly to homophobic feelings in the pages of this journal might have been challenged. Perhaps we would have seen her coming to terms with those feelings, before overcoming them and embracing her daughter’s lesbianism. It’s unlikely that the Advocate of the 1960s or 1970s would have published an Op-Ed celebrating a lesbian turning into a straight man.
What about the fact that mom only turned to PFLAG after the child came out as trans; could her lack of support for her daughter’s lesbianism have had any impact at all on her child’s desire to become male?
But this is 2015, not the dawn of the gay/lesbian liberation movement. Transition stories–particularly of young people–are gobbled up like candy. The reporters at the Advocate obviously didn’t think the mom’s discomfort with lesbianism was worth looking into. In fact, I haven’t seen a single journalist in any media outlet raise the question of why, perhaps, this or that lesbian in the latest trans confessional story couldn’t just stay a lesbian and skip the hormones and double mastectomies.
While this particular piece is an Op-Ed and not a news story, the unfortunate thing is that celebratory feature and news stories about lesbians “transitioning” to male are no different, and no more balanced, than first-person accounts like this one.
“…when my daughter came out as a lesbian, that same voice echoed in my head, reminding me of the honor of our family name. This elder had long ago passed away, but his words lived on.
For months, that voice drove me into the closet. I couldn’t say the word “lesbian”; in fact, it made me cringe. Publicly I walked around feeling dishonest, carrying a secret I wasn’t ready to share, and privately I cried as I searched to learn what I had done wrong to cause my child to be gay. I was lost, I was alone, I had no idea how to support my child, and so I quietly criticized myself for my failure as a mother; I was ashamed.
When my daughter revealed to me that she wasn’t a lesbian but was actually a transgender male, even more fear and sadness entered my life, mostly for my new son’s happiness and well-being: How would my new son find someone to love him and a society to accept him?
I turned to PFLAG, a national organization that brings support, education, and advocacy opportunities to parents, family members, and friends of people who are LGBTQ. PFLAG helped me tremendously as I looked for information, worked to raise my awareness, and discovered new ways to support my child.”
Yesterday on Tumblr, I posted a piece critical of PFLAG, the organization that used to advocate for lesbian, gay, and bisexual people and their parents. Like most formerly LGB groups, they have now been absorbed into the media and activist lobby for the transgender community.
One commenter took me to task, assuring me that there is plenty of support for lesbian and gay youth and their parents, and that it is fit and proper that those support organizations expand their mission to include trans and “genderqueer” advocacy.
But while support and visibility for “vanilla” lesbian youth and their parents has withered away, there is a large network of US organizations which have sprung up in support of (among other things) the medical transition of children and adolescents. In fact, there are so many of these pro-trans organizations that I could write a post a day on each one, and still not be finished in 2 months. And that’s without even touching the groups in other countries.
One such US organization is GenderSpectrum in the San Francisco Bay Area. I found no mention on their extensive website of the very real possibility that some of the kids who don’t fit gender stereotypes might actually turn out to be gay, lesbian, or bisexual (despite plenty of evidence that many LGB adults start out as gender nonconforming youth). No, in GenderSpectrum’s lingo, these kids are “gender expansive;” and paradoxically, but entirely consistent with the current Orwellian genderist reality we live in today, this means they need to eventually squeeze–not expand–their healthy bodies into breast binders and doctors’ examination rooms.
Here are some excerpts from the medical part of the GenderSpectrum website, wherein they counsel medical providers how to move their young “gender expansive” patients along the road to transition:
An important first step is the manner in which the provider creates space for the young person to talk about their gender. Sometimes a child’s gender-expansiveness will be obvious. Either the family has shared with you their observations/concerns about their child’s gender, or the child’s gender diversity is perceptible. In these situations, it is important to be affirming of the child’s presentation. For instance, if a child comes into the exam room in clothing stereotypically consistent with the “other” sex, show interest. Questions or comments such as “where do you get cool shoes like that?” “I love the color of that dress,” or “how do you keep your baseball hat’s bill so straight?” will demonstrate openness on your part that can help the patient relax and feel more secure.
Because what they wear is a key indicator of whether they will eventually need weekly testosterone injections and double mastectomies.
But it is also quite common to see no evidence of a young patient’s identification. Perhaps the child or teen lives in a context where it has been made clear that this topic is off-limits. They may feel great shame about their gender, or not even have the words to describe what they are feeling. Thus, the provider needs to open the door for this information to emerge. In taking the patient’s history, consider ways you might elicit information about a child’s emerging gender. Ask open-ended questions about the young person’s toys, activities, styles of dress, and friends. Specifically asking whether the child has questions about gender also establishes a setting where it is clear that gender diversity is ok.
Didn’t we already put this to rest in the 1970s and 1980s, during the Second Wave of feminism? Do we really need to be instructing medical practitioners that it’s ok for girls not to behave and dress like stereotypical-circa-1940 girly-girls? But of course, this isn’t really about accepting and supporting a “gender expansive” child. No, just supporting and encouraging a kid to dress and act the way they want to isn’t sufficient anymore:
In some cases, a pre-adolescent or teen patient (and perhaps their parents) may have a clear sense about the medical pathway they hope to travel. The well informed pre-adolescent sees a straight line from using pubertal suppressants to taking cross-sex hormones to undergoing gender affirmation surgery. The teen that has come to recognize their transgender identity recently is immediately ready for hormones. Further, they may have a strong notion about when this will all begin: NOW!
Ok, at least the author of this advice column gets it that pre-adolescents and teens have poor impulse control and the need for instant gratification. And we also see acknowledgment that some teens “recently recognize” they are trans (any mention of the trans trend on YouTube and Tumblr? Nah.)
But, careful, good doctor! You don’t want to dash the hopes of Jodi-call-me-Joe in her baseball cap and boy’s-definitely-not-pink Nikes:
However, for any number of reasons, your professional judgment might well be that it is not time to begin moving down this road. This reality, however medically sound, can be devastating for the child or teen that sees changing their body as the most important aspect of affirming their gender identity. For a young person experiencing significant body dysphoria, the impact is especially intense, and can have significant mental health repercussions. It may well be that the patient and caregivers came into the appointment assuming that the entire process will be a battle, and the fact that they are being told “not yet” may be perceived as affirmation that you will be a gatekeeper standing in their way.
“Gatekeeper” is now the pejorative term for a medical professional who doesn’t immediately agree that the “well informed pre-adolescent” (an oxymoron if there ever was one) knows exactly what they’re doing–including consigning themselves to lifelong infertility.
But have no fear, gatekeeper. GenderSpectrum will teach you how to gently tap the brake for an over-eager child, while assuring them that the gas pedal will be pushed to the floorboards in due time:
Consequently, it is important for the patient to get some sort of “yes” in the process. Maybe this is an explanation about the steps and processes for medical intervention, with a firm follow-up appointment to determine the patient’s readiness. Perhaps it is putting written materials in their hands, or discussing with them what being ready means and what they can look for in the meantime. You may wish to refer them to resources for how they can achieve the desired effects in more cosmetic ways until medical interventions are appropriate.
Because “getting to yes” and encouraging a kid to get on the road to lifelong cross-sex hormone treatment and plastic surgeries is the ultimate destination, sooner or later. Why help them feel comfortable in their own skin? That is so 1980.
A Finnish study, published in April of 2015 in the journal Child and Adolescent Psychiatry and Mental Health, is one of several that are beginning to document the upsurge in teen girls wanting to “transition.” This study focuses on the high level of comorbid mental health issues that occur along with gender dysphoria.
The number of referrals exceeded expectations in light of epidemiological knowledge. Natal girls were markedly overrepresented among applicants. Severe psychopathology preceding onset of gender dysphoria was common. Autism spectrum problems were very common.
So why does this matter? Well, maybe, just maybe, those other issues need to be addressed. And could they even be the cause of the dysphoria?
In the majority of the applicants, gender dysphoria presented in the context of wider identity confusion, severe psychopathology and considerable challenges in the adolescent development. At this point it is not possible to predict how gender dysphoria in this group will develop: will gender dysphoria in these adolescents cease with the resolution of wider developmental problems, or perhaps consolidate later into transsexual identity, with the completion of the developmental tasks of adolescence.
The researchers conclude:
Adolescents seeking sex reassignment represent a variety of developmental pathways differentiated by the timing of onset of gender dysphoria, psychopathology and developmental difficulties. It is important to be aware of the different groups, or developmental pathways, in gender dysphoric adolescents in order to be able to find appropriate treatment options. In the presence of severe psychopathology and developmental difficulties, medical [sex reassignment] treatments may not be currently advisable. Treatment guidelines need to be reviewed to appreciate the complex situations.
Medical “transition” is seen as the magic bullet. But here’s a thought: What if the other, very common, comorbid disorders are actually the cause of the body dissociation that is now celebrated and promoted as “gender identity”? Why do we rush to hack up healthy young bodies and dose them with powerful hormones, rather than addressing the brain that erroneously thinks it should be attached to a different physical form? Why has it become taboo to pose the obvious hypothesis: Maybe we have it exactly backwards. It’s the brain that is mistaken–not the body.
Questions like these should not be controversial. They should not generate a whole new avalanche of hate mail in my Tumblr inbox. Questions like these should spur thinking, caring people–people who claim to care about suicidal and troubled teens–to investigate deeper; to put the brakes on the headlong rush to drugs and surgery as THE solution to a complex intersection of mental health issues.
Trans activists, take heed.
We have reached a very strange point in modern Western societies. Throughout human history, kids and teens have been seen as needing parental guidance as they wend their way through childhood and adolescence. As a society, we do still give lip service to this once uncontroversial concept. Modern neuroscience even tells us that judgment, impulse control, and foresight is not fully developed in young brains until well into the 20s. This brings into question the idea that even a 21-year-old has the wherewithal to make adult decisions. Graduated driver license programs, an increase in the legal drinking age to 21 (formerly 18 in some US states), and other societal changes have been enacted in recognition of the fact that childhood and adolescent brain development is a much slower process than we previously thought–particularly when it comes to awareness of future consequences and sound judgment.
But among activists, medical providers, and in the mainstream narrative around pediatric transgenderism, even toddlers are seen as wiser than their parents. Every day, the mainstream media posts another story of childhood or adolescent transition, with no critical voices, no questions raised. Parental concerns are condescendingly dismissed as “transphobic” at worst, at best out-of-touch.
So many doubting parents have been cowed into submission, called “child abusers,” even receiving death threats for daring to question the wisdom of our offspring. Complete strangers on the Internet are imbued with more authority than loving parents on this issue. Concerned parents who have legitimate reasons for questioning hormones and surgeries for their minor children are being lumped in the same category as blatant child abusers. The effect has been a public silencing of critical parental voices, except in small back corners of the Internet.
It’s time for parents who have done their homework on this issue to speak up. Please join me here. Add your voice. Anyone reading this who knows of a parent who might have something to say, please let them know they have a platform here. Anonymity is respected, although anyone who wants to speak publicly and openly is welcome too. Please note: If you comment on a post, your comments will be published publicly with the user name you have chosen on WordPress.
As a start, I am highlighting (with her permission) a comment made recently on one of my posts. There are so many more like her.
I have finally found someone like-minded in you! I completely agree with what you write. My daughter, who is 17, told me last year that she was now my son. Since I suspected that she might be a lesbian, it wasn’t too much of a shock. However, when I began researching this subject I was extremely concerned with the medical intervention that takes place with these children. Then when I went to a meeting for parents with transgender children, I was shocked about how all of these parents were jumping on the bandwagon of drugs and surgery without questioning. They even complain about wait times for surgeries! I make it a point to question everything in these meetings and I know that they are just annoyed with me. The only reason I go now is to bring up questions, so that the new parents who attend can see that there is another side. Unfortunately, here in Canada, children as young as 16 can make medical decision for themselves and parents are not allowed to intervene (and surgeries are free). Hormones still have to be paid for, so that is a relief to know that my daughter won’t have the money for that.
Anyway, it’s been a difficult road for us. I drew the line on any medical intervention while she’s living in the house (except, of course, she can present as any way that she wants and I will call her by her chosen name). When I told the parents group that they were all shocked.
I wish I could meet people in my area who are in the same situation. It’s very difficult doing this alone.