Addressing the anti-trans concern trolls

Two University of Washington researchers, working out of the Social Cognitive Development Lab on what is called the TransYouth Project have tired of the near constant alarm being raised about transgender children being spurred on...even "created" their parents. An example of such alarm resides in a recent op-ed in the Wall Street Journal, The Transgender Battle Line: Childhood.

So Kristine Olson and Lily Durwood have written a response, Are Parents Rushing to Turn Their Boys Into Girls?.

Soh characterizes these transitions as premature and in contradiction with established research, citing studies showing that most children who are gender nonconforming do not grow up to be transgender adults.

Soh's grasping at a 1995 study by Zucker and Bailey that found that within a group of 45 gender nonconforming children, 80 percent were not transgender at follow-up (usually in the high-school years).

These findings are used to argue that social transitions should not be encouraged, because according to the logic, around 80 percent of these children who are identified as gender dysphoric will not ultimately be transgender if left alone or given proper therapy. Here, again, the distinction between transgender children and the rest of the spectrum of gender nonconforming children is critical to acknowledge. The studies that found this 80 percent number (or similar numbers) included a broad range of gender nonconforming children. The authors of this particular study, Zucker and Bradley, wrote that it is actually quite rare for children who are brought to gender clinics to believe themselves to be the other gender. Much more common were children who showed cross-gender behaviors, who may have wished they were the other gender at times but still saw themselves as members of their original gender group. Thus, most of the children who are argued to have grown out of their gender dysphoria never claimed a transgender identity to begin with.

Surprise, surprise. 80% of the children grew out of their gender dysphoria...possibly because only 20% of the children were transgender in the first place.

In addition Zucker and Bailey declared all children who dropped out of the study to automatically be desisters.

Perhaps the clearest evidence that most children in these samples were never transgender to begin with is that, when they were directly asked “are you a boy or a girl” as part of a battery of intake questions, an overwhelming percentage (more than 90 percent) of children in these clinics provided the answer that aligned with their natal sex. Is it so surprising that the majority of boys who in childhood believed themselves to be boys in adulthood believed themselves to be men?

As one research team based in Amsterdam concluded: “[E]xplicitly asking children with GD [gender dysphoria] with which sex they identify seems to be of great value in predicting future outcomes for both boys and girls with GD.” That is, even within samples of gender nonconforming children, the ones who say they are the other gender are the ones who are most likely to say the same thing later in life.

This is not to say that a transgender identity in childhood never desists in adulthood. The truth is that we do not know precisely how many transgender children will grow up to be transgender adults, because no long-term studies have recruited a large number of children who believe that they are members of the opposite sex nor separated the few they have included in past studies from the broader group of gender nonconforming children. Until the start of our project in 2013, we knew of no studies tracking large numbers of children who specifically identified as transgender in early childhood. Thus, while most popular articles on this topic imply that 80 percent of children with transgender identities will not grow up to be transgender adults, we believe it is more accurate to say that we have no good estimate. What little data do exist suggest that many transgender-identified young children do in fact become transgender-identified teens and adults.

Soh points to another study:

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.

Importantly, the study that Soh cites here specifically notes that none of the children in the study actually socially transitioned. That is, while these two female children appeared such that strangers might have mistaken them for boys because of their haircuts, they did not change their pronouns to live as boys. (Actually, they seem to have had experiences that match Soh’s description of her own childhood.) Thus, the degree to which these two children struggled to later assume a more feminine appearance is relevant to the question of whether girls should be allowed to cut their hair short and wear masculine clothing rather than the question of whether girls should be allowed to socially transition to live as boys. From a scientific perspective, we are fortunate that today there are larger numbers of children who have socially transitioned, who can be followed to assess rates of regret and the social or psychological costs (or benefits) of “de-transitioning”—some of the many goals of our ongoing study.

Despite the focus of most of the recent articles on prepubescent children, nearly all of these pieces raise alarm about medical intervention. Our experience is that everyone gets nervous when 5-year-olds are mentioned in the same sentence or paragraph as hormones and surgery—and for good reason. Once again, though, care is needed in interpretation. First, and most critically, the only intervention that is being made with prepubescent transgender children is a social, reversible, non-medical one—allowing a child to change pronouns, hairstyles, clothes, and a first name in everyday life. No one in mainstream medicine (or elsewhere, to our knowledge) is performing surgery on or providing hormones to prepubescent transgender children. Thus, sentences such as Soh’s, “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” are simply irrelevant to the discussion of social transitions and prepubescent children.

Despite the recent alarmist calls about movements to persuade parents to socially transition their children to another gender and worry that doing so sets them up for a lifetime of hormone and surgical treatment, we know of no evidence suggesting that this is an issue. There are no calls to encourage social transitions among children who merely show preferences for objects, clothing, or hairstyles that are associated in our culture with the other gender, nor for children who sometimes wish they were the other gender. Such children are typically quite content to live in the gender assigned to them at birth, especially if they are allowed to express themselves in a safe environment, with family and peer support.

The consideration of social transitions for transgender children is a different discussion entirely. These children, who at first glance might appear similar to other gender nonconforming kids, and who for years were not differentiated within research samples, are actually distinct within the broader group. Transgender children believe themselves to be members of the other gender, and researchers, clinicians, and parents can ascertain this information by getting to know these children, and, once trust is gained, asking them. Many transgender adults recall having had this knowledge as children, and many suffered through years of therapy in which they were told they weren’t who they knew they were. The causal influence of denial of a deeply held identity and the staggeringly high levels of depression, anxiety, and suicidality observed in unsupported transgender young people—punctuated by the suicides of teens like Leelah Alcorn and Skylar Lee—remains untested, though correlational studies indicate that support is related to better outcomes. This new generation of parents of transgender children—who see statistics on these outcomes and have decided to try social transitions to avoid them—are pioneers.

Finally, I note that the title references only male to female transgender children, totally ignoring the female to male cohort. That's probably quite appropriate since much of the current anti-transgender legislation being proposed on the state government level ignores the transgender boys and men as well.

Post-finally, I recall that the institute that spawned the research of Zucker and Bailey, Toronto's Centre for Addiction and Mental Health (CAMH) has closed its Family Gender Identity Clinic after it was found to be practicing reparative therapy.




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