Brain sex: The jury is still out—but does it matter?

Early this morning, Think Progress (a “progressive” news outlet) posted on Facebook what was meant to be a provocative pull-quote from its latest trans-kid piece by reliable journalist propagandist Zack Ford, “It Takes A Village To Bully A Transgender Kindergartner”:

And what exactly is the “need” of this child? A boy in kindergarten would like to be accepted as “girl”? Well, as a woman, I take offense at any boy who is pretending to share my gender when he quite clearly NEVER can nor ever will. … He is not. He never can be.”

The commenter quoted is, of course, a woman (a bigoted bully, as seen through Ford’s tunnel-vision lens) who questioned the parents’ need to socially transition their 5-year-old child. The child’s transgender status has resulted in a giant kerfuffle as result of the Minnesota school’s dilemma in deciding what to do to accommodate the kindergartner.  Zack Ford paints anyone who questions the wisdom of a 5-year-old boy being assured he is really a girl as an ignorant transphobe, a bigot supported only by right-wing conservative groups.

Zack Ford Facebook
In this post, I’m not going to be writing about the fact that it isn’t just conservatives who question the trans-kid trend (obvious to anyone who reads this blog on a regular basis, or for that matter, the increasing number of blogs by left wing parents, professionals, and feminists. Check out my blogroll). Nor will I be dissecting in detail this “news” article set out as bait on the Think Progress Facebook page to incite the reliable progressive hordes.

Instead, my interest in Ford’s latest bit of Newspeak revolves around the huge number (easily 10-1) of reader comments on that Facebook post, which can be paraphrased as follows:

You stupid bigots! Go read up on the science of gender identity. Gender identity is proven, settled brain science. Little kids KNOW from the time they’re born what sex they are. Plus intersex. No one “chooses” to be transgender, they’re born that way.

 I’ve spent thousands of hours marinating in gender dogma and research studies, both pro- and con-, re: “innate gender identity.” So while it’s no surprise to me to see some people spouting as FACT the totally unproven hypothesis that gender identity is set in stone at birth, what does surprise me is the sheer numbers who have bought what, at best, is a tenuous theory, and who have thereby completely shut down even a modicum of critical thinking.

Of course, who can blame well intentioned progressives? They’re fed bittersweet mouthfuls of Innate Gender Identity gruel every single day not only by the media, but even by the President of the United States, who via his Department of Justice, baldly asserts on line 36 of the complaint against the state of North Carolina:

36. Gender identity is innate and external efforts to change a person’s gender identity can be harmful to a person’s health and well-being.

DOJ complaint

US v. North Carolina

(And it’s not just these few lines. The entire complaint reads like boilerplate trans-activist dogma, and interested readers are urged to take a look at the rest of this document).

This increasingly unchallengeable notion that gender identity, aka “brain sex,” is innate, hard-wired at birth, and thus absolutely unchangeable (despite the efforts of us horrible bigoted parents who are rooting for our kids to commit suicide) means, to the masses who now parrot it like the top graduates of a Maoist Re-Education Camp: Every toddler who claims to be the opposite sex must be agreed with by every adult who comes in contact with the child. Innate gender identity is the ironclad reason why no one is supposed to question the sudden flood of “trans kids” we hear about on a daily basis.

Given the gravity of all this—that little kids are now being ushered aboard a train that will lead inexorably from puberty blockers to cross-sex hormones (with concomitant irreversible changes) in 100% of reported cases–these brain sex/innate gender identity claims can’t just be ignored and dismissed. Not when so many  people—more every day—have swallowed them whole.

Here’s the thing. There is some research that supports a role for biological, genetic, or physiological factors in gender dysphoria. And as much as people on “my side” of this argument (the argument being: should children be “transitioned” to the opposite sex on their own say-so?) would like to simply dismiss any and all evidence for biological aspects of things like gender dysphoria, it’s not that simple.

Shunning entire lines of research because we are made uncomfortable by the findings should not be the way of truth seekers. If opening our minds to their claims changes our position, then so be it. As medical historian and intersex-rights activist Alice Dreger says in her book Galileo’s Middle Finger which chronicles (among other things) the chilling effect of activism on scientific inquiry,

[it is] a rare trait in activists: a belief in evidence even when it challenge[s] our political goals.

Human beings, in general, do not appreciate having their cherished ideas challenged. Political viewpoints tend to be set in stone, with any wavering seen by one’s allies as a dangerous and slippery slope. Evidence contrary to the ideological convictions of either side is taken as an existential threat to the fundamental integrity of the position.

For instance, people (like me) who support a woman’s right to abortion often avoid  acknowledging the fact that a fetus is not just an amorphous mass of cells, but a proto-human being. Conversely, anti-abortion advocates give short shrift to arguments about a pregnant woman’s agency over her body, and the critical importance of a baby coming into the world to a parent who is ready–and can financially afford–to raise the child.

The battle lines dividing those who support the idea that self/parent/activist-identified “trans” kids should be transitioned as young as possible, vs. those who disagree (like me) are drawn across a long-contested and hardened piece of ground: nature vs. nurture. And the opposing combatants are highly reluctant to give even an inch on the matter.

As you’ll see, this post is going to argue not for a détente or concession of territory, but rather, for a willingness of “my side”—the gender critics–to consider the evidence marshaled by our detractors, and then ponder whether it changes your mind. I’m only going to touch on a few areas of research typically used by the trans activist side; if you’re interested, you’ll want to spend some delving time yourself.

Let me cut to the punchline right now: Speaking for myself, weighing the claims (and the research they base it on) of the activists who want to transition children as early as possible has actually strengthened my conviction that medical transition should be an adults-only decision, if made at all. The only thing I can say I might have shifted my opinion on after endless investigation is this: There may be a very small (it’s always been very small) number of people for whom medical intervention is the only way they can live a happy life. I don’t believe we should prohibit these interventions for such people as adults. I still do not believe, weighing up all the evidence, that we should be tampering with the bodies of young people who may very well grow up to be happy without the expensive, drastic, and irreversible meddling of the gender-soaked medical and psychiatric professions. Instead, as I harp on constantly, let’s celebrate and support gender defiance in young people.

So let’s start with the obvious. [Note to regular readers: The information in the next couple of paragraphs is well known to you, but please stick with me, because I’m going to cover some research I haven’t formerly written about]. If gender identity is “innate” how come so many gender dysphoric youngsters change their minds?

4thWaveNow is chock-a-block with posts and research studies—as well as personal narratives from formerly trans-identified people who changed their minds, as well as others who experienced and resolved severe gender dysphoria in childhood—supporting the fact that many children outgrow their dysphoria and grow up to be adults happy to have bodies and brains that have not been tampered with by the medical and psychiatric professions. A 2008 meta-study by Korte et al sums it up:

Multiple longitudinal studies provide evidence that gender-atypical behavior in childhood often leads to a homosexual orientation in adulthood, but only in 2.5% to 20% of cases to a persistent gender identity disorder. Even among children who manifest a major degree of discomfort with their own sex, including an aversion to their own genitalia (GID in the strict sense), only a minority go on to an irreversible development of transsexualism.

Because so many trans activists claim that intensity of discomfort with one’s body parts is some irrefutable sign of “true transgender,” or that prior researchers didn’t adequately differentiate between “true trans kids” and the merely “gender nonconforming,” I’m going to emphasize this bit of the above quote:

even among children who manifest a major degree of discomfort with their own sex, including an aversion to their own genitalia.

Even WPATH—World Professional Association for Transgender Health—whose clinician-activists spend a good deal of time promoting younger and younger ages for “transition,” acknowledges on page 12 of its Standards of Care that most trans-identified kids grow out of it:

In most children, gender dysphoria will disappear before, or early in, puberty.

An earlier online version of  the WPATH SOC-7 cited specific numbers—greater than 80%–and included research citations, but this more specific information, oddly enough, has disappeared. But this 2014 study remembers:

…as the World Professional Association for Transgender Health notes in their latest Standards of Care, gender dysphoria in childhood does not inevitably continue into adulthood, and only 6 to 23 percent of boys and 12 to 27 percent of girls treated in gender clinics showed persistence of their gender dysphoria into adulthood.

Ok. So most kids grow out of gender dysphoria. But that fact doesn’t by itself dispense with biological evidence for gender dysphoria, whether or not it persists.

Traditionally, feminists have staked their claim on the “nurture” side of the “gender identity is innate” argument, with little acknowledgement of the findings in biology and neuroscience that hint at any real difference between male and female brain physiology.  And there is plenty of hard science bolstering this nurture-based stance: recent MRI studies have mostly corroborated the view that male/female brains are more alike than different, which leads to the conclusion that sex-role stereotyped behaviors are primarily the result of socialization, as Cordelia Fine laid out in her “Delusions of Gender.”

Nature_versus_Nurture

Trans activists and the clinicians who (let’s face it) follow their lead obviously point to other studies of adult transgender people which support the idea that their brains are hard-wired to be closer to the sex they “identify” with. Some of these studies do offer some evidence for sex differentiation in the brain. But imaging studies of adult brains are pretty much impossible to control, because all adults have had life experiences and social influences (not to mention possible cross-sex hormone treatments in some cases) which, owing to neuroplasticity, will of course have an impact on brain structure.

But even in the (primarily MRI) studies of adult brains that are better executed and controlled, it turns out the fundamental difference in these studied brains is not so much a matter of the subjects’ gender identity but of their sexual preference, as sexologist James Cantor draws attention to in a blog post surveying research studies frequently cited to prove a transsexual brain:

 In Scientific American Mind, journalist Francine Russo takes on a fascinating research question: “Is there something unique about the transgender brain?” she reviews some of the relevant brain research on transsexuals and concludes that transgenderism is indeed a phenomenon of the brain.  Although I agree with Russo that transgenderism is a phenomenon of the brain, I believe Russo over-focused on gender identity, which led her away from the better explanation of the data:

These brain scans don’t reflect gender identity, they reflect sexual orientation.

Cantor’s post, Russo’s Scientific American piece, and the cited research studies are all well worth reading.

There is some other research I find compelling: studies of prenatal hormone levels—specifically, testosterone—and their influence on sex-stereotyped behaviors and other characteristics in children.

A couple of years ago, Brynn Tannehill, a trans activist-journalist, posted a list of what Tannehill obviously considered to be airtight studies,  many of them revolving around prenatal hormones,  in support of innate gender identity . But are they airtight?

First, Tannehill conveniently neglects to mention that many of the cited studies (surprise, surprise) also show a link between prenatal testosterone levels and rate of homosexuality—in other words, hormone levels may have some impact on same-sex attraction.

But, more importantly, it turns out that several of the researchers linked by Tannehill have shown that the impact of hormones on both sexual identity and gender identity, while existing, is small. For example, Melissa Hines, in a 2006 paper, “Prenatal testosterone and gender-related behaviour, looked at several studies and concluded that

 Levels of prenatal testosterone predict levels of sex-typed postnatal childhood play behavior.

 Like what kinds of play behavior?

Research on girls and women with CAH has provided some support for the hypothesized influence of testosterone on human behavioural development. Girls with CAH show increased male-typical play behaviour, including increased preferences for toys that are usually chosen by boys, such as vehicles and weapons, increased preferences for boys as playmates and increased interest in rough-and-tumble play.

 Does this preference for rough-and-tumble, stereotypical “boy” play mean these kids are transgender?

Although there are fewer studies relating prenatal testosterone levels to postnatal sexual orientation and core gender identity, there is also some evidence, particularly from women with CAH or CAIS, that testosterone influences these psychosexual outcomes as well. However, these influences are substantially smaller than those on childhood play behaviour.

 

 

 

 

Prenatal testosterone levels are only a small factor in later sexual orientation and gender identity. What they are more predictive of is –wait for it—preference for non-sex-stereotyped activities! In other words: gender nonconformity (or my preferred term: gender defiance).

So some children play with stereotypically opposite-sex toys, prefer the hairstyles and activities of the opposite sex, and prefer the company of children of the opposite sex. Is it possible these preferences are at least partially “hard-wired” due to the effect of androgens on their brains? Sure. Does it follow that this means they are the opposite sex? Of course not. Nor does it necessarily mean they will grow up to be same-sex attracted, either (as I’m sure many heterosexual women who were tomboys can attest).

Let’s put a finer point on it: while some studies show that prenatal hormone levels could contribute to sex-stereotyped differences in human behaviors and, yes, sense of self, acknowledging these differences doesn’t lead to the conclusion that trans activists reach: If a child is born with a set of proclivities and tendencies more typical of the opposite sex, this means they ARE the opposite sex and medical and chemical alteration of the body is fully justified and should be pursued as soon as possible. 

What else does biological or genetic research show? In an earlier post, I argued that the only way to even begin to prove an innate male or female brain would be to scan a huge number of identical-twin newborns (before they had a chance to have any “nurture” influence—i.e., no social experiences), separate the twins at birth, then compare those brains later when the children grew up, some of whom would no doubt decide to undergo transition to the opposite sex.

For ethical reasons, this sort of research would be pretty much impossible (you can’t forcibly separate twins at birth and raise them separately, and you can’t control how kids are raised by dictating to parents how to raise them, even if you could). But an international team of researchers has looked at twins and the prevalence of gender dysphoria/transsexualism in a meta-analysis published in 2012, “Gender Identity Disorder in Twins: A Review of the Case Report Literature.”  (The full study is behind a paywall.)

Using a combination of their own clinic records and an exhaustive search of the literature, they examined a total or 44 twins of which at least one twin had gender identity disorder (GID)—the diagnostic term at the time, since replaced with “gender dysphoria” (GD). Of these, 23 were identical (monozygotic/MZ). The remainder were fraternal (dizygotic/DZ).

What were their findings?

 Nine (39.1%) of the 23 MZ [identical] female and male twins were found to be concordant for GID. In contrast, none of the 21 DZ [fraternal] twin pairs were concordant for GID.

This was a statistically significant difference, leading to the conclusion that “there is a role for genetic factors in the development of GID.” That difference in rate of gender dysphoria in identical twins matters. But let’s not lose sight of the fact that it was still a minority (39.1%) of identical twins who were both gender dysphoric.

Twin studies
In their discussion of their findings, the authors (like all truth-seeking scientists who submit their work to peer review) acknowledge that reality is nuanced:

The higher concordance for GID in MZ than in DZ twins is consistent with a genetic influence on its genesis although shared and nonshared environmental factors cannot be ruled out. Indeed, from these case reports, very little is known about the “equal environments assumption,” that is, the assumption that MZ twins are not treated more similarly than DZ twins in ways that might affect their gender identity.

In other words—“nature” appears to be a factor, but we can’t rule out nurture. ”Influence” is not causality.

And of even greater interest: In the penultimate paragraph of the discussion, we find this gem:

In the studies on genetics and sexual orientation, a higher concordance for homosexuality has been found in MZ versus vs. DZ twins. Using family methodology, there is also evidence for genetic influences [38]. In the reviewed case studies of twins with GID, from those whose sexual orientation is known, all, with the exception of Green [25], were attracted to their biological sex and nearly 50% of the non-GID twins were also homosexual, reflecting a higher percentage than found in the general population [39]. In all the cases reported to be concordant for GID, there was also concordance for sexual orientation.

Here we have it again. As Cantor noted, as I have noted, as the Dutch pioneers of pediatric transition have noted, this study finds—as nearly every study over decades has found: Whatever the precise contributions of nature v. nurture that leads to gender dysphoria or opposite-sex identification, a huge majority (if not 100%) of the studied individuals exhibit same-sex attraction by adolescence or adulthood.

I’ll hammer it home again: The constantly repeated refrain by trans activists that gender identity has “nothing to do with sexual orientation” is directly refuted in every study, as well as many of the personal accounts by trans-identified people splattered all over the media.


 So, what have we learned from looking at a few studies aiming to tease apart the nature-nurture question about gender dysphoria/opposite-sex identification?

  • there is sparse evidence of an innate male or female brain, and what differences there may be are mitigated and influenced by later life experiences. If anything, brain differences seem to indicate variations in sexual preference, not intrinsic gender identity; and
  • prenatal hormones—specifically, testosterone—have an effect, on….gender nonconforming behaviors in childhood. They have a contributing, but minor, effect on later homosexuality and gender identity; and
  • in general, there is evidence for both biological and non-biological (environmental-social) contributions to the development of gender dysphoria.

For me, it all boils down to this: Nature v. nurture is a false dichotomy. We are all the result of our genetic inheritance, hormonal influences, and how we were brought up and continue to live—which also includes both post-natal physiological influences (e.g., the various chemicals we imbibe in our hyper-industrialized world in addition to drugs and hormones we deliberately take in), as well as what we learn and experience over the course of our lifetimes.

In the end, the squabbling over nature v. nurture is a non-issue. What matters is protecting kids from the—however well intentioned—meddling of adults in children’s bodily and psychological integrity.  Whatever the relative contributions of nature and nurture to a child’s sense of self and ultimate decisions, adults should protect children from undergoing interventions that close off future possibilities.

Proponents of medical transition for children are not champions of gender nonconformity. If they were, as I’ve said many times, they would be celebrating it in children and instead of agreeing with the magical thinking of a child that this means they are “born in the wrong body,” they’d be helping these kids realize they are wonderful and unique examples of their natal sex. A healthy, fully functioning body attached to a brain is an integrated whole with that brain. It is an existential reality, no more “wrong” than the body of a person who demonstrates more sex-stereotyped typicality. By promoting the view that research evidence pointing to certain sex-stereotyped behaviors as having a biological component (however small) means kids’ bodies can be “wrong,” they are using science to limit the possibilities for children.

Puberty blockers, cross sex hormones, and surgeries for children and young people permanently limit their options. Options like: sexual experiences in an unaltered, non-surgically-tinkered-with body. Options like: Figuring out your sexual orientation, especially if you’re gay or lesbian and won’t, on average, come to terms with that fully until early adulthood. Options like: Being a role model for other kids that boys and girls can be and do or be anything, regardless of whether they fit into sex-stereotyped-typical behaviors and appearances.

Yes, a person who later decides to “transition,” who undergoes hormone treatments or surgeries after puberty may not “pass” as well as a someone who had natural puberty curtailed (and was incidentally permanently sterilized in the process). But the Cult of Passing as the opposite sex should be challenged—especially since those same trans activists who worry so much about “passing” (in perhaps their most obvious self-undermining argument) want us to also believe (for instance) that a “penis can be female.” To play Devil’s Advocate with the trans activists, if a boy’s penis can be female, you have no business promoting medical transition for anyone’s child.

Puberty blocking is not a benign intervention. While I’ll grant that, if stopped in time, GnRh agonists are “reversible” (as in, they will not prevent natural puberty), the psychological and neurological effects of delaying natural puberty cannot be seen by any thinking person as “fully reversible.” Neither is social transition “fully reversible,” for that matter. You can’t “reverse” a childhood spent cementing the idea that biological sex can be changed by a society bent on denying the existential reality of sexual dimorphism. You can’t “reverse” a message, repeated over and over to a child by trusted adults that there is something fundamentally wrong with his or her body that must be corrected.

Regarding nature-v-nurture?  Here’s what I’d say to my fellow kid transition critics:  Don’t dismiss the stuff from the “nature” side because you’ve pre-decided that any science supporting an innate contribution to gender dysphoria is a priori bunk and it’s all nurture/socialization.

In my opinion, taking seriously the dogma of the other side, examining it closely, and then coming to well-thought-out, nuanced conclusions is a much stronger place to operate from than dismissing out of hand any kernel of truth “they” might be obsessing over. That’s not truth seeking; that’s just being close-minded in service of an impenetrable ideology.

Nature-nurture—it’s both. Just like our thought-generating brains are indivisible from the bodies they’re a part of.

Your thoughts?

Groundbreaking study: Kids mean what they say

The clinic advised that Rudy should start to make his own choices and, specifically, recommended that he was allowed to pick an item of clothing. ‘He chose a Disney princess nightie and skipped around the house in it, laughing,’ recalls Kathryn. Towards the end of Year 1 at school, Rudy started wearing girls’ clothes at home. ‘Of course, he chose to dress as a girl. I watched him at the disco, chatting to girls, wearing a pink glittery dress. That was a turning point.’ Back home, Rudy chose a girl’s school uniform for the new term and asked to be called Ruby.

–Parenting a transgender child: The day my four-year-old son told me he was a girl

 


When Ana was five years old, her mother Cathy organised a birthday party with one rather unusual condition: No girly presents, please. ‘I felt awful doing it, but I knew Ana would be devastated if anything pink or fluffy turned up.’

‘I knew when I was growing up,’ says Alfie now, ‘that I didn’t want to do the things that girls did. I was the sort of kid who ran around and got dirty. … People thought me being a tomboy was a phase, but I knew I wouldn’t change. I didn’t want to wear girl clothes. I hated the way they fitted to me. … I was told I would change and get interested in make-up, but I could never see it happening.’ The paediatrician then brought up the topic of gender transition. So in the car on the way home, I said to mum: ‘I think I’m transgender.’

–My child had a boy’s brain in a girl’s body


Trans activists and gender specialists don’t have much in the way of well controlled, peer-reviewed research to support their core assumption that “gender identity” is innate and immutable. Some of the latest brain science shows little difference between male and female brains. But leaving that aside, what is the scientific basis for believing there is an innate “gender identity,” baked in at birth, that would justify turning young people into sterilized, permanent medical patients as adults?

Recently, in the activist blogosphere, the transgender press, and on the WPATH Facebook page, there have been excited proclamations that data to prove “true identity” has emerged in the form of a paper published a few months ago in the journal Psychological Science. The study of 32 “transgender” children and the same number of non-trans controls, entitled “Gender Cognition in Transgender Children,” [abstract; full study here] was conducted by University of Washington assistant professor of psychology and director of its TransYouth Project  Kristina Olson (not to be confused with LA Children’s Hospital gender specialist Johanna Olson), along with transgender activist Aidan Key and Stony Brook University assistant professor of psychology Nicholas Eaton.

I’m going to start with the punch line and work backwards from there: The study demonstrates only that 32 socially transitioned children (that is, kids who are being “supported” by their families and “gender specialists” in being referred to by an opposite sex name, pronouns, and presumably, though the authors don’t tell us, sporting opposite-sex-stereotyped clothing and hairstyles), really, truly do prefer the playmates, hairstyles, and clothing more typical of the opposite sex. Further, these “transgender children” really and truly do prefer and “identify with” the same playmates and physical attributes as the control group of “cisgender” children (yes, the study authors use that term) of the opposite sex.

Who were the “transgender children” recruited for the study?

To be included in the current study, children had to be 5 to 12 years old and live in all contexts as the gender expression “opposite” of their natal sex. These requirements resulted in the exclusion of 4 additional gender-nonconforming participants

And the control group?

Thirty-two control participants (20 female, 12 male; mean age = 9 years) … matched to the transgender participants were recruited through the first author’s research lab from a database of families interested in participating in developmental psychology research studies. They were required to have no significant history of gender nonconformity.

[Note: A group of “cisgender” siblings of the “transgender” children were also part of the study, but time and space in this article do not allow a full analysis of their responses, which were similar to but not the same as the non-familial “cisgender” control group.]

What do the authors mean by “gender nonconforming” or “no significant history of gender nonconformity”? This is never defined, although we can guess that the “transgender” children dress, play, and appear differently from generally recognized gender stereotypes. But the control group? Do the authors mean these children entirely conformed to stereotypes—i.e., the girls all wore dresses, played with dolls, and had long hair, while the boys played with trucks, had short hair and wore rough-and-tumble   trousers?

Olson et al don’t tell us. And what about the four excluded “gender nonconforming” subjects, who apparently did not “live in all contexts” as “opposite” to their natal sex? Did these children occasionally indulge in sex-stereotyped play and behaviors, so they weren’t “trans” enough?

The study stimuli consisted of questions coupled with pictures of boys and girls, “matched for approximate age and attractiveness.” (And what does “attractiveness” mean? There is an even bigger question vis-à-vis these pictures, which I will get to in a few moments).

Olson and colleagues tested the children in 3 areas:

  • Gender preference (for play/friendship)
  • Object preference (associating a nonsense word with a picture of a boy or girl,  saying this was the name of a toy or food that the pictured child was using)
  • Gender identity (whether the child feels they are a boy or girl)

Each of these three variables were addressed via explicit (i.e., responses to direct questions)  and implicit measures.

What’s the difference between explicit and implicit measures? In psychology research, it has been posited that “implicit” measures

 may resist self-presentational forces that can mask personally or socially undesirable evaluative associations

In other words, implicit measures are meant to get at how someone really thinks and feels, whereas a reliance strictly on explicit “self reporting” might be tainted by what a subject thinks someone wants to hear (or other motives).

So, for the “gender preference” part of the Olson et al study, the explicit measure was to ask the child, “who would you rather be friends with?” when shown a pair of pictures of a boy and girl. The implicit measure was to show the children pictures of a boy and girl and ask to label them “good” or “bad.”  (The underlying premise here is that most pre-pubescent kids prefer their own “gender” as playmates).

For gender identity, the implicit measure consisted of asking the research subjects to label pictures of boys and girls as “me” or “not me.” The explicit corollary was

telling them that people have outsides (their physical body) and insides (their feelings, thoughts, and mind). They were told that some people feel like they are boys on the outside, and some feel like they are girls  on the outside, and that those people might feel the same way or different on the inside. They were told some people feel, for example, like a boy on the outside and inside, and that others feel like a boy on the outside but a girl on the inside. Further, they were told that some people feel like both or neither, or that their feelings change over time.

Children were asked whether, on the inside, they felt like a boy, a girl, neither, or both; whether their gender identity changed over time; or whether they did not know.

For “object preferences” the authors didn’t assess preference for actual objects, but only whether the research subjects chose the same preferences as pictured  boys or girls. They were

shown pairs of photographs of children and told that each one had a preferred toy or food. The names of these items were in fact novel words (e.g., “This is Amanda and she likes to play flerp. This is Andrew and he likes to play babber.”). Our interest here was whether children would use the gender of the person endorsing the item to inform their own preferences.

It’s difficult to see how this adds any more information than asking kids what sex playmates they prefer. If a child who “identifies” as a boy sees a picture of a boy playing “babber,” that child would likely prefer to do what the pictured boy is doing.

Be that as it may, what exactly did Olson et al set out to prove with these probes?

… if these children are not confused, delayed, or pretending, and in fact their expressed gender represents their true identity, we would expect them to respond   similarly to gender-matched control participants not only on self-report measures, but also on implicit ones.

We reasoned that if children are confused by the particular questions posed to them….[or] if they are merely self-reporting the “wrong” gender identity… or even if they are just oppositionally reacting to the question of their gender identity— …these children should show one of two patterns of confusion. First, they could be truly confused, as indicated by random responding and no systematic  response across measures and participants. Alternatively, they could implicitly identify as their natal sex (because they actually understand gender and are merely self reporting this “incorrect” gender).

And the results of the study? Surprise—the socially transitioned “transgender” children did indeed respond similarly to the “cisgender” control group.

But what does this actually demonstrate?

First, let’s consider the stimuli, consisting of pictures of age-matched boys and girls. What would distinguish a picture of a prepubescent boy from a picture of a prepubescent girl,  apart from clothing and hair styles? Not much.

Prior to puberty and the influence of estrogen or testosterone, school-aged kids look much the same. So unless the pictured boys and girls had identical haircuts and clothing, the 32 “transgender” children labeling a boy or girl picture as “me” or “not me” would have been identifying with a boy or girl based on stereotyped dress and appearance—haircuts, clothing, and the like. How could it be otherwise?

Put another way, if the pictures of the boys and girls did all have the same haircut and clothes, irrespective of biological sex, would the research subjects have been able to identify the sex of the child they identified with? Likely not.

Now, to the question of whether these kids were confused, delayed, or pretending, the authors did show that these kids are not likely to be knowingly pretending to be the opposite sex, nor are they “confused” i.e., they just don’t know what they think or feel. But why is this of much significance?  What would be the motivation for these children to “merely” self report the “incorrect” gender, or to “oppositionally react”? The fact that these kids are sincere in their convictions is reported by Olson et al as an important finding, but does anyone, including critics of pediatric transition like myself, doubt that dysphoric or trans-identified kids really mean their gender nonconformity?

Further,  deliberately “pretending” in order to deceive is not the same as conflating fantasy or desire with objective reality–an aspect of normal childhood development which activists, gender specialists, and researchers like these seem never to have heard of. Just because a child  sincerely sees him or herself as the opposite sex does not make it true.  Child psychologists have known for decades that children’s firmly held beliefs do not always comport with reality.

 Research indicates that children begin to learn the difference between fantasy and reality between the ages of 3 and 5 (University of Texas, 2006).  However, in various contexts, situations, or individual circumstances, children may still have difficulty discerning the difference between fantasy and reality as old as age 8 or 9, and even through age 11 or 12. For some children this tendency may be stronger than with others.

The authors seem not to have thought of the most obvious conclusion: That these kids DO believe they are the opposite sex but that doesn’t make it so—especially since even the implicit measures the authors seem to think are so meaningful are nothing more than identification with gender-stereotyped activities and appearances which they happen to prefer.

By demonstrating that the “transgender” children aren’t just being obstinate or dishonest, Olson et al seem to believe that their study indicates (in their words) “true identity” in the children they have labeled “transgender.”

But what is “true identity?” Is it the elusive Holy Grail of inborn, unchangeable gender, something no one has come remotely close to proving, yet is the unquestioned assumption from which all the current medical and psychological and legal decisions about “transgender children” have flowed in the last few years?

That the authors even use the term “true identity,” which they themselves admit is unproven, is all we need to show the study is fatally tainted by confirmation bias.

 Confirmation bias, as the term is typically used in the psychological literature, connotes the seeking or interpreting of evidence in ways that are partial to existing beliefs, expectations, or a hypothesis in hand.

–Confirmation Bias: A Ubiquitous Phenomenon in Many Guises, by Raymond S. Nickerson,  Tufts University

It’s quite clear that the authors’ “hypothesis in hand” is that there is such a thing as “true identity.” Further, they interpret the evidence that “transgender” children feel as strongly about their identity and gender nonconformity as “cisgender” children do as somehow confirming this hypothesis. Even though they themselves in their Notes section  of the study assert:

  1. We avoid using common colloquial phrases such as “born as a boy” because they suggest that transgender identities are not innate (an unresolved scientific question) and are thus offensive to some individuals.

 On the one hand, because they don’t want to be “offensive” to “some individuals” (and I think we can guess who they are), Olson et al don’t want to “suggest” that gender isn’t innate (and in fact present their study as evidence that their “transgender” research subjects have a “true identity,”). But at the same time, the authors explicitly acknowledge that the question of “innate” gender identity is an “unresolved scientific question.”

But while being careful not to offend “some” people, they don’t have any trouble splattering the term “cisgender” throughout this article,  despite the fact that some other individuals find “cis,” well—offensive. Certainly Olson et al aren’t living in such a bubble that they are unaware that the label “cisgender” is repugnant to many of us who the transgender community apply it to.

And in point 2 in the Notes, we have a further indication that the authors’ work is riddled with confirmation bias:

2. We use the term “opposite” for clarity but acknowledge that gender is not binary.

They “acknowledge” that gender is not binary. But as with “innate  gender identity,” who has proven that “gender is not binary?”  No one. This jargon comes straight from the trans activist lexicon.

In peer-reviewed research, investigators always indicate the limitations and possible flaws in their study.  The weaknesses I’ve pointed out in this post are not even marginally addressed by the authors. What limitations do Olson et al concede?

 All of the participants tested here identified and lived life as one gender at the time of assessment, choosing names consistent with that gender and preferring those pronouns as well. Future studies along the spectrum of childhood transgender experiences will be needed to clarify how generalizable these findings are to children who have different degrees of identified gender expression or to those with different life experiences.

Apparently what’s next is seeing whether their study measures can also be used to prove the “true” identities of “gender fluid,” “genderqueer,” and “nonbinary” children. I wonder what exclusion criteria they’ll have in future studies? Hopefully they will be more precise in their definitions of what constitutes gender (non)conformity in their next paper.

In their summary, Olson et al reiterate their key finding that these kids really mean it when they say they prefer the lifestyle of the opposite sex:

In summary, our findings refute the assumption that transgender children are simply confused by the questions at hand, delayed, pretending, or being oppositional. Instead, transgender children show responses that look largely indistinguishable from those of cisgender children, who match transgender children’s gender expression on both more- and less-controllable measures. Further, and addressing the broader concern about transgender individuals’ mere existence raised at the outset of this article,the data reported here should serve as evidence that transgender children do indeed exist and that their identity is a deeply held one.

“Do indeed exist.” Of course children who believe they are, or want to be, the opposite sex “exist.” And of course such children are going to exhibit preferences for the appearances and activities of the opposite sex, in a “deeply held” way. But it doesn’t follow that those children are somehow innately the opposite sex.

All Olson and colleagues have demonstrated is that some children really, really, really want to be the opposite sex; even to the point of saying they are the opposite sex. They want to look and dress like the opposite sex—a girl, for instance, might want a short haircut and to wear comfortable boys’ clothes. They like playing with children of the opposite sex. And they like doing things that the opposite sex likes to do. In other words, these kids are don’t conform to the more typical behaviors of their birth sex. But does it then follow that they should be encouraged and conditioned to believe they are the opposite sex, leading them in the near future to puberty blockers and on to sterilization and surgeries?

If the stakes were not so incredibly high, a study like this could simply be filed away under “strongly held beliefs and desires of gender nonconforming children.” But given the fact that so many activists and gender specialists are in the business of promoting medical transition, this study should instead be filed under “confirmation bias rationalizes non-evidence-based medical experimentation on vulnerable children.” What Olson et al have not proven is innate gender identity. All they have shown is that these kids really mean it when they say they are or want to be the opposite sex.

This study, instead of being promoted as a rationale for pediatric transition, should carry no more weight than any of the thousands of media articles trumpeting the unsubstantiated yet continuously promoted idea that children who refuse to conform to gender stereotypes—yes, who really mean it when they say they want to look and play and dress like the opposite sex—are “transgender.” Like the ones quoted at the beginning of this article. Or the thousands of others that have been published in the last few years. Like this one:

Tom charges about in a Batman costume, brandishing a sword. …Tom loves dressing up. “Normally as a superhero,” Cassie [his mom] says.

“Batman and Superman,” Tom adds. “And Wolverine!” He also likes to play cowboys or policemen with his best friend, Charlie. “Sometimes we arrest people. Remember when we did it yesterday to the dog?” He grins. “He wasn’t putting the ball down.” He shows me his bedroom. There’s his treasured Playmobil pirate ship, his Marvel poster featuring Ironman, Captain America and the Hulk, and his pencil case shaped like a football boot.

When Cassie took three-year-old Tom to the barber for the first time, she wept. “That was the final thing. If I let him get his hair cut short, that was me accepting he is a boy.” The hairdresser was bemused. “I was crying and I had this little boy with me who had hair down to his arse. She asked him: ‘Has your mummy never let you get your hair cut?’ And he loved it, because she thought he was a boy with long hair.” After that, Tom never got mistaken for a girl, and became much happier.

Transgender children: ‘This is who he is – I have to respect that’

 

Parents, keep listening to your gut—not the gender therapist

A few months ago, my teenage daughter stopped trying to “pass” as male. She dropped the self-defined-as-male uniform (emphasis on SELF), the stereotyped swagger and the fake-deepened voice and —moved on. Her fervent desire to be seen and treated as a boy (as opposed to a gender-atypical girl) faded away, just as other formerly unshakable ideas and urges had in the past. And our relationship has never been better.

Although I’ve allowed myself to exhale, just a little, she will remain at risk, because every sector of society—the media, the government, the schools, medicine and psychology–is now saturated with the message that if you’re a “gender nonconforming” girl–one who prefers the clothing, activities, and hairstyle more typical of the opposite sex– you just might actually be a boy.

What did I, and the other adults who love her, do? It hasn’t been easy. In fact, for a time it was a living hell, a purgatory of slammed doors, stony silence, yelling matches, and mostly—waiting.

There was no magic answer. We rode it out. I learned something about keeping my mouth shut. About saying my piece and then leaving it be.  About living with uncertainty.  We didn’t cater to demands for instant gratification.  We paid for and encouraged activities that would get her out into nature and off the Internet. Mostly, we waited.

I drew a clear line in the sand: There would be no money to pay for a gender therapist, testosterone, or a binder. If she wanted to pursue those things at the age of medical majority, that would be her choice—and it would be on her dime. At the same time, I let her know that her clothing and hairstyle choices were hers to make. Further: I purchased the “men’s” clothing (including underwear), paid for the haircuts, supported all the other stuff she wanted to do or wear that is more “male typical.” Not always successfully, I tried to calmly and sparingly convey the message that however she dressed, whatever interests she pursued, she was a female—perhaps an unusual one, but a young woman nevertheless, who might someday become a role model to show other girls just how amazing and truly “gender-expansive” a woman can be.

Like many who read this blog, I phoned gender therapists during the weeks after her announcement that she was trans. Without even meeting my child in the flesh, all four of these therapists talked to me like this trans thing was a done deal. I wrote about one of those conversations here. One very friendly therapist, an FTM whose website stressed commitment to “informed consent,” assured me that there was no need for my daughter to first experience a sexual or romantic relationship before deciding whether she was trans. “Most of the young people just skip that step now,” the therapist said.

Skip that step? I thought back to my own adolescence. I didn’t even begin to have a clear idea of who I was, as a sexual being, until after I’d had more than one relationship. It took years for me to come to know my body’s nuances and intricacies, its capacity for pleasure, how I might feel in relation to another. [Update: for lesbian youth in particular, this process can be a long one, on average not complete until one’s early 20s]

This same therapist signed my kid up for a “trans teen” support group scheduled for the following week—again, without ever having met her. “There’s nothing you or I can do about your daughter being trans,” said another therapist… on the phone, without having met my kid. Yet another therapist refused to talk to me at all; insisted she’d have to have a private appointment with my kid first.

Contrary to the myth promulgated by the transition promoters, at least in the United States, there is no slow and careful assessment of these kids who profess to be trans. The trend is to kick out the gatekeepers, and  move towards a simple model of “informed consent”: If you say you’re trans, you are–no matter how young and no matter when you “realized” you were trans.

All these therapists seemed well meaning enough. They believed they were doing the correct thing. But with each conversation, I felt more and more uneasy. My gut feeling that something wasn’t right led me to research, to question…to put the brakes on. And the more I read, and thought, and understood, the more determined I became to find an alternative. I started this blog out of sheer desperation. I needed to find someone, anyone, who understood what I was going through. I needed other parents to talk to—badly.

My kid never did go to a gender therapist. Never did sit in a room full of “trans teens.” If she had, I feel certain she’d be sporting a beard right now.

When I first started blogging, I got a lot of hate mail. In every anonymous drive-by comment, the hater referred to my “son” who would grow up to hate my guts. “He” would surely commit suicide, and more than one of them wished me a lifetime of misery when that inevitably happened. Even the mildest posts resulted in hostile reblogs from strangers who had not the slightest idea of my family’s situation.

At first, these anonymous barbs stung, but it didn’t take long for me to realize that I could rely on my inner parental compass. Because, see, I know my daughter. I knew, when she suddenly began spouting the gender-policed jargon planted in her head by Tumblr trans activists, that this wasn’t who she really was. This was a girl who, all through childhood, was never “gender conforming” but who was secure in herself because I’d made sure she knew, via my words and my example, that girls could be and do anything.

Most of all, I knew she needed me—not to blindly “support” and give in to her every demand, but to simply BE THERE, even as a limit; a steady place she could push and rail against. It was scary, and painful, being on the receiving end of teen outrage.  Because a teenager does have the right to make some of their own decisions. Later adolescence is a time of individuation, dawning adulthood. Haranguing or lecturing not only gets you nowhere, it isn’t fair. Negotiation is probably the most important parenting skill when it comes to high-school-aged youth. And no parent gets it right all the time. (Paradoxically, part of being a halfway decent parent is knowing how imperfect you are at the job.) But one thing became more and more clear to me:  my child did not need a parent who would collaborate in sending her down a road to being a permanent medical patient. In fact, she needed protection from the very same people who were sending me hate mail on Tumblr.

Not so long ago, child and adolescent psychologists—people who actually study the development of young human beings—were frequently cited and quoted. These experts, as well as every other rational adult, were well aware that kids shift identities: try this one on, shed it like a snake skin, try on another. Younger kids go through a long and wonderful period of make believe and magical thinking. They are actually convinced they ARE the identity they try on. And adolescents are renowned for trying on hairstyles, belief systems, clothing styles—only to discard them after a few weeks, months, or maybe even years.

In contrast to today’s social-media-fueled paradigm, when a kid’s announcement that they are the opposite sex is taken at face value by seemingly everyone around them, it was previously understood that adults were largely responsible for the inculcation of gender stereotypes into children’s minds. Children aren’t born hating their sexed bodies. They only grow to reject themselves when someone they look up to promotes the idea that their likes and dislikes in clothing, toys, activities, or other pursuits are seen as incongruent with their natal sex.

 A child’s burgeoning sense of self, or self-concept, is a result of the multitude of ideas, attitudes, behaviors, and beliefs that he or she is exposed to. The information that surrounds the child and which the child internalizes comes to the child within the family arena through parent-child interactions, role modeling, reinforcement for desired behaviors, and parental approval or disapproval (Santrock, 1994). As children move into the larger world of friends and school, many of their ideas and beliefs are reinforced by those around them. A further reinforcement of acceptable and appropriate behavior is shown to children through the media, in particular, television. Through all these socialization agents, children learn gender stereotyped behavior. As children develop, these gender stereotypes become firmly entrenched beliefs and thus, are a part of the child’s self-concept.

… Often, parents give subtle messages regarding gender and what is acceptable for each gender – messages that are internalized by the developing child (Arliss, 1991). Sex role stereotypes are well established in early childhood. Messages about what is appropriate based on gender are so strong that even when children are exposed to different attitudes and experiences, they will revert to stereotyped choices (Haslett, Geis, & Carter, 1992).

We have people like this: the mother of a six-year-old girl who has “transitioned” to male, writing storybooks to indoctrinate kindergartners. To suggest to them that they, too, might really be the opposite sex:

“Can the doctor have made a mistake? Was I supposed to have been born a boy? Am I the only kid in the world like this?”

Deep down, Jo Hirst had been anticipating these questions. And she knew she had to get the answers right.

It was bedtime, and her six-year-old was curled up on her lap. Assigned female at birth, from 18 months of age Hirst’s son* had never wanted to wear female clothing and always played with boys.

I challenge anyone to find me a single account of a “transgender child” which does NOT resort to talking about toys, hairstyle, clothing, or play stereotypes to justify the diagnosis of “trans” in a young child.

Our kids are being cheated of the opportunity, the breathing space, to simply explore who they are without a gaggle of adults jumping in to interfere with the process by “validating” their frequently transient identities. Kids are being encouraged to freeze their sense of self in a moment in time, during the period of life when everything is in flux. And even though key researchers have said over and over again that most gender dysphoric kids “desist” and grow up to be gay or lesbian; even though the latest research denies any such thing as a “male” or “female” brain, parents are encouraged to socially transition their kids, put them on “puberty blockers,” and refer to them by “preferred pronouns.”

For very young children, this cementing of the child’s identity in a period when they most need the freedom to simply play and explore—to “make believe”—is essentially stunting the child’s development.

Young children go through a stage where it is difficult for them to distinguish reality from fantasy.  Among many other things, it’s why we have ratings on films. A young child can’t understand that the monster onscreen is not real.

Research indicates that children begin to learn the difference between fantasy and reality between the ages of 3 and 5 (University of Texas, 2006).  However, in various contexts, situations, or individual circumstances, children may still have difficulty discerning the difference between fantasy and reality as old as age 8 or 9, and even through age 11 or 12. For some children this tendency may be stronger than with others.

Just exactly what is motivating doctors and psychologists to jettison decades of research and clinical practice in favor of a completely unsubstantiated and unproven hypothesis of “transgender from birth”? The glib answer is: suicide. But if a gender nonconforming youth expresses the desire to self harm, encouraging that youth to further dissociate from their whole selves (because the body and mind, contrary to the bleating of trans activists, are not separate units, but a whole) is not a responsible way to support mental health.  As this commenter said in a recent post on GenderTrender:

 Wow. Conservatives aren’t the only ones who suck at science. Brain sex? Seriously? If you’re allegedly born in the wrong body, why doesn’t your brain count as part of the “wrong body”? Your brain is telling the truth but the rest of your body is a liar? Wtf? This shit is as sensible as scientology.

And when it comes to teens,

 Teens often pick up on cues and assimilate ideas presented in movies/films viewed in the movie theater and other sources, (online sources for watching movies now eclipse movie theater viewings or film DVD rentals for teens), and while teens already understand the difference between fantasy and reality, they may still absorb or become attached to ideas that are powerfully presented in films but that have no basis in reality, the teen not having enough experience or knowledge to sort propaganda from fact, fiction from reality. Films, television programs, music and statements from celebrities can [and do] become a part of the thinking and emotional/psychological makeup of teens and children.

This used to be a “duh” thing. Are teens influenced by what they imbibe, what’s in fashion, what celebrities (like Jazz Jennings and Caitlyn Jenner and Laverne Cox) are doing,  what their peers are saying and doing? Might socially isolated teens be even more swayed by what they see on social media, while they sit for hours, alone in their rooms?

Facebook depression,” defined as emotional disturbance that develops when preteens and teens spend a great deal of time on social media sites, is now a very real malady. Recent studies have shown that comparisons are the main cause of Facebook depression; the study showed that down-comparison (comparing with inferiors) was just as likely to cause depression as up-comparison (comparing with people better than oneself).

…Other risks of extensive social networking among youth are loss of privacy, sharing too much information, and disconnect from reality.

My daughter, like so many others I’ve now heard about, emerged from months of self-imposed social isolation and YouTube/Reddit binges, to announce, out of the blue, that she was transgender. And simply for questioning this, for refusing to hop aboard the train, I’ve been labeled a “child abuser” of my “son”? Until the last few years, parents who recognized that teens go through phases weren’t considered abusive. They were considered well informed.

Not so long ago, parents and helping professionals neither interfered with nor bolstered a particular identity that a kid was trying on. Everyone understood this was an important part of growing up: to allow our young to experiment, to see what worked and what didn’t. It’s called the development of a self. It takes years. It’s not even complete at 21. The self doesn’t emerge, fully formed and immutable at birth. It develops in response to experience, to love, and to adversity.

Given my own daughter’s desistence from the idea that she is or was ever “transgender,” I feel even more strongly that parents are right to resist the push by every sector of society to identify “gender dysphoric” minors as “trans.” Yes, some of these young people may go on to identify as the opposite sex; some will seek medical transition. But what the current atmosphere has done is rob them of the crucial time they need to figure it all out. Medical transition was once a rare, adult-only decision. I’m in favor of a return to that more reasonable approach to the matter.

So you bet I’m going to keep doing what I can to support parents who want to at least delay an adolescent’s decision to permanently alter body and mind with hormones and surgeries. You bet I’m going to try to save my own kid from what amounts to a cult that won’t let you leave if you change your mind, without serious social consequences. You bet I’m going to continue to protect my daughter and others like her from a lifetime of difficulty, from the rapacious medical industry that is profiting from the regressive resurgence and marketing of gender stereotypes.

You can also bet that I’m going to continue shedding light on the frankly insane practice of labeling very young children as transgender, conditioning them as preschoolers to believe their own bodies are somehow wrong and alien, that they must undergo teasing and torment from other children, that they must wear prosthetics to amplify or hide their own genitalia to be accepted as they are. Or just as bad: That the entire world must be browbeaten into redefining  biological reality such that “some girls have penises” and “some boys have vaginas.”

And this work is not just about protecting kids. It’s also about supporting family members and friends who are deeply affected by the transgender narrative.  Extremist trans activists, the media, the doctors and psychiatrists–none of them talk about the terrible damage done to the family system, to the fabric of close relationships, when a child “transitions.”  All the activists have to say is that the skeptical parents and loved ones are “transphobes.” No one talks about the fact that the majority of these dysphoric kids would grow up to be gay or lesbian adults if not interfered with;  adults with healthy, intact bodies, not dependent on drugs and carved up by surgeons’ knives.

So we have to keep talking about it. We have to keep the lights on in our corner of the Internet, even if only to document this strange medical and cultural fad for future historians.

Thanks to everyone who is traveling this road with me. While I know we often feel swamped and hopeless, we have each other for strength and courage. And for now, that will have to be enough.