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Transgender: when can you know?
Wonder_Hippie
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The point of this thread is to ask the ethical questions that always get bandied about when discussing young people with gender identity disorder. When can they know? When can we reasonably say this person is transgendered, and not just going through a "phase?"
I'm of the camp that believes that children presenting with resolve that they are indeed transgendered are in the best position to know whether or not it's a permanent or passing feeling. I'm making this thread because NPR did the second of a two-part piece on children diagnosed as having GID. I didn't hear yesterday's, but today I was brought to tears as I was driving home from work. It was about a young boy named Armand that, at age 10, was accepted by her parents and family as a female named Violet. The story was very moving, what with the father's family being not only accepting, but encouraging, and proud of the father's decision and acceptance. It was all very heartwarming, but then two examples were brought up afterwards about GID in children and the "treatment" of it.
The first example was some clinic that had treated a handful of GID cases in children for about the past few decades. Apparently, they had required that the children live as their biology dictated, and reported that, after treatment, or rather lack thereof, 80% of the children-come-adults had decided to stick with their biological sex. The second example was some clinic in Europe that was doing research with hormone blockers, and said that 100% of children treated continued life transgendered. It wasn't specified if the children, in addition to receiving hormone blockers to prevent puberty, also received replacement hormone treatment to induce opposite sex puberty.
Now, here's the thing. Hormone blockers apparently carry no risk of infertility. They can be used to delay puberty almost indefinitely, according to one of the researchers interviewed for the program. The researcher stated his own misgivings about early diagnosis, and said that hormone blockers were a great was to delay the final decision. That's pretty nifty. However, replacement hormone treatment in addition to hormone blockers apparently do result in infertility, but the benefits are obvious, in that biological boys will develop as girls, and vise versa.
Now, the question is, when is it safe to say that this individual, this child, is of the maturity level to decide that they are definitely male or female? The father from the piece said something that seems pretty obvious, "when did you decide you were a boy?" If you ask me, there's absolutely no concious decision there for the great majority of transgendered individuals, if for any at all. They just are, as any cisgendered person just is. But the two aforementioned examples result in conflicting data. Naturally, I'd question the first example's treatment course, and would be much more interested in seeing a study about 80% that supposedly chose their biological sex over their previously held transgendered sex. Likewise for the 100% that chose their transgendered identity, but I have this feeling that they're much more adjusted individuals today.
So, how do we approach this? Hormone blockers seem like a really good answer, albeit temporary, to this problem, if it even exists. To me, it seems like the clinic in the first example is little more than an ex-gay kind of organization for GID, but that may be exceedingly harsh. I'm going to look up the broadcast and see if I can't find the names of the clinics, and then hopefully be able to find out about their practices with regards to the children they treat.
Anyways, the unifying, on-topic question: at what age can a child reasonably decide that they are transgendered? Any research about children that are diagnosed accurately as transgendered but later revert to their biological gender would be greatly appreciate.
I'm of the camp that believes that children presenting with resolve that they are indeed transgendered are in the best position to know whether or not it's a permanent or passing feeling. I'm making this thread because NPR did the second of a two-part piece on children diagnosed as having GID. I didn't hear yesterday's, but today I was brought to tears as I was driving home from work. It was about a young boy named Armand that, at age 10, was accepted by her parents and family as a female named Violet. The story was very moving, what with the father's family being not only accepting, but encouraging, and proud of the father's decision and acceptance. It was all very heartwarming, but then two examples were brought up afterwards about GID in children and the "treatment" of it.
The first example was some clinic that had treated a handful of GID cases in children for about the past few decades. Apparently, they had required that the children live as their biology dictated, and reported that, after treatment, or rather lack thereof, 80% of the children-come-adults had decided to stick with their biological sex. The second example was some clinic in Europe that was doing research with hormone blockers, and said that 100% of children treated continued life transgendered. It wasn't specified if the children, in addition to receiving hormone blockers to prevent puberty, also received replacement hormone treatment to induce opposite sex puberty.
Now, here's the thing. Hormone blockers apparently carry no risk of infertility. They can be used to delay puberty almost indefinitely, according to one of the researchers interviewed for the program. The researcher stated his own misgivings about early diagnosis, and said that hormone blockers were a great was to delay the final decision. That's pretty nifty. However, replacement hormone treatment in addition to hormone blockers apparently do result in infertility, but the benefits are obvious, in that biological boys will develop as girls, and vise versa.
Now, the question is, when is it safe to say that this individual, this child, is of the maturity level to decide that they are definitely male or female? The father from the piece said something that seems pretty obvious, "when did you decide you were a boy?" If you ask me, there's absolutely no concious decision there for the great majority of transgendered individuals, if for any at all. They just are, as any cisgendered person just is. But the two aforementioned examples result in conflicting data. Naturally, I'd question the first example's treatment course, and would be much more interested in seeing a study about 80% that supposedly chose their biological sex over their previously held transgendered sex. Likewise for the 100% that chose their transgendered identity, but I have this feeling that they're much more adjusted individuals today.
So, how do we approach this? Hormone blockers seem like a really good answer, albeit temporary, to this problem, if it even exists. To me, it seems like the clinic in the first example is little more than an ex-gay kind of organization for GID, but that may be exceedingly harsh. I'm going to look up the broadcast and see if I can't find the names of the clinics, and then hopefully be able to find out about their practices with regards to the children they treat.
Anyways, the unifying, on-topic question: at what age can a child reasonably decide that they are transgendered? Any research about children that are diagnosed accurately as transgendered but later revert to their biological gender would be greatly appreciate.
Wonder_Hippie on
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I'm not so sure about the age at which hormonal / surgical treatment can be allowed though. None of that should be gotten into lightly. If hormone blockers can delay a decision until a fuller age, that sounds good.
They had been talking about 2 kids, whose names I can't recall, but both were biologically boys.
One had been pretty adamant as early as age 3 that he didn't want his parents correcting people who assumed he was a girl (he had a very feminine appearance, apparently). I presume that this one was eventually accepted by the parents, because when they were quoted / interviewed they used feminine pronouns.
The other had been treated in a clinic in Toronto that tried to "cure" GID, and they described the process of removing all of the child's "girly" toys from the home, and replacing them with "boy" toys... and the child just quit playing with toys altogether, and spent days on end just drawing and coloring. They even took away his pastel-colored crayons. I would have liked to have heard the resolution of that one.
They played a quote by the doctor in Toronto who compared it to having a black child come into the clinic insisting they were white. Basically, he said that the cure is to make the child comfortable in the gender they were born, the same way the black child needs to be made comfortable in not being white.
You really think so? I mean, to me, the purest understanding of the situation would come from a child in their own words. That they don't identify with traditionally [gender] things, and that they prefer to associate themselves with things that are traditionally [another gender]. Of course, transgender is not nearly as simple as that, but do you get what I'm trying to say? Given a name for it, it might cease to be what they just naturally are, and becomes something less personal and individual.
Yeah, I did mention ideally it would come independently from the child. But I don't know whether most / all children would intuitively grasp the concept of being the other gender, rather than just sharing attributes with that gender.
Maybe I am going to be seen as extremely bigoted, but this seems like the way to approach the issue to me.
It's stuff like that that makes me associate those places with ex-gay camps and the like. I mean, what does a kid that wants to be black want to do? Listen to rap, wear baggy clothes, and smoke cigarrilos (/racist hyperbole)? That comparison is horribly flawed. It seems to conflate identity and personality, to me.
Well, yeah, that was kinda my reaction as well. However, having heard at least a part of the broadcast, I figured I'd at least report it so everyone would know what at least some "specialists" are saying.
I think that a slightly more germane question is: at what age is it reasonable to medically treat GID?
The answer to this question depends on how risky and reversible the treatments are.
If hormone blockers carry no particular long-term medical risks (infertility or otherwise) I don't think it's particularly problematic to give them to children prior to puberty as long as we have some form of medically-accepted accurate psychological assessment to ensure that the child would psychologically benefit from it (which I assume we do; but I don't know for sure).
Since hormone replacement therapy is riskier and surgery is essentially irreversible, I have no problem denying these two treatments to anybody under an arbitrary age (much as we currently do with tubal ligations).
That said, since there are plenty of reports of transgendered people knowing from early childhood that they were "different," if a child were to declare that he or she were transgendered (using whatever language they have at their disposal to make that declaration), I'd accept it.
the "no true scotch man" fallacy.
Well, where else would it come from? The idea is not confronted until they themselves present with the desire. I'd reckon the parents that pressure boys with, "are you sure you're a boy?" are few and far between, and of course likewise for girls. It's not questioned that they are cisgendered until the children question it, which would be their independent motivation and decision.
That's kind of where I am on it, but for me and my lack of exhaustive medical knowledge, there's another question. Since the important part is to help a transgendered child develop into a mostly biologically and emotionally consistent adult, is there a maximum developmental point at which hormone replacement can be effective? That's assuming that hormone blockers have been used to delay puberty. I'm working off of conjecture here, because I sincerely don't know, but we'd have to do a careful balancing act between maturity levels and possible medical effectiveness of the treatments.
That might be a good way to approach the issue initially. I mean, if your five year old boy comes up one day and says, "I wanna be a girl!" I don't think you should immediately buy him dresses and call him Sheila. I think if you start by gently reinforcing his current gender, you'll probably be able to eventually tell if it's a case of temporary confusion or a fundamental miswiring. If it's the latter, dude needs to be hooked up with some hormone therapy and some silk panties, because genuine transgendered folks aren't going to be happy living as what they perceive as the wrong sex.
My understanding is that this can result in horribly conflicted and emotionally crippled people. As far as examples, I don't think I have to name names.
I'm in this camp. If the person can be treated with therapy to be happy, that seems like the best bet. However, if therapy can't make the person happy and comfortable with their body, then measures that actually alter the make-up of their body (hormones and surgery) seem reasonable.
EDIT: Beat'd by ElJeffe.
Around the age of 3 or 4, kids start to become very curious, seemingly of their own accord, about the differences between boys and girls. They become very interested in categorizing not only themselves but also the people around them on the basis of gender. And this seems to happen cross-culturally; even in cultures with different gender roles than our own.
the "no true scotch man" fallacy.
But doesn't that happen to some extent anyway? On the one hand, I have zero problem with transgenderism or any other body- or identity-altering decisions. In the post-Singularity world of nanotech and cheap gene augmentation, I might be totally tempted to spend a few weeks as a girl, or a dolphin, or a cloud of sentient nano-fog. On the other hand: my trans friend is all about soap operas, beehive hairdos, and this whole John Waters aesthetic that at times almost feels like a parody of femininity. I'm not at all questioning either her decision or the validity of her feelings, but I have to wonder how much socialization plays into this. If the young person that she was had been allowed to enjoy stuff identified as tradtionally feminine without taking any guff for it, might such a wrenching decision have not been necessary?
I think this is difficult to put a number too for several reasons. For starters at a young age, say before age ten it can actually be a faze. But beyond that for those that it is not the transgender community runs a very dramatic gammut from somebody who crossdress as a sexual fetish to someone who views themselves as a woman and anywhere in between. Couple that with the fact that sexuality is very much independent of the gender issues but at same time integral to a persons development in similar ways and you cant say with any certainty when any given person can know for sure. I would say that although it may impede their development as their chosen gender slightly, it is unwise to allow a child to commit to any permanent change until they are 16 or so. I and many of my friends knew pretty well who we were going to be by then, for example I am not Transgendered, but I am at the fetish end of that spectrum, where as a close friend is a female impersonator but is not fully TG, I am hetero and he is Bi and we can both point to a time in our mid teens when we were pretty sure that this was true.
The problem is that while this approach seems common-sensical, it doesn't really work out well in real life.
The principle is good. It's like the old serenity prayer, "Let me be have the courage to change the things I can control, the patience to accept the things I can't control, and the wisdom to know the difference." That principle is the fundamental keystone of emotional health in many situations, so I understand why the natural instinct is to apply it to transgendered people. Since you can't truly be a "real" girl, you might as well accept yourself as a boy... right?
Unfortunately, it doesn't seem to work. Attempts to cure transgendered people of their "transgenderedness" using typical cognitive-behavioral therapeutic techniques tend to fail catastrophically. There's a strong case to be made that many people are simply fundamentally incapable of seeing themselves as the "wrong" gender. You might as well be asking them to believe that they're a tree.
the "no true scotch man" fallacy.
I think that was a peculiarity of your trans friend.
I think some MtFs overcompensate by acting ultra-feminine, but certainly not all. I've known MtF tomboys - biological boys who wore boy clothes and did boy things (like play football or practice tae kwon do) but they did it while sporting long hair and a female name.
the "no true scotch man" fallacy.
Yeah, at age 3 the munchkin finds it very important to identify things as "boy" or "girl" to the point where I have to repeatedly tell her that certain things (plants, inanimate objects that are not designed to simulate an animal form) aren't either one. But it seems quite important to her to know that "Papa" (grandpa) and Daddy are boys and she and Ruth and Mommy are a girls... also which pets and which horses at Papa's house are boys and which are girls.
Of course, she's also fascinated with boobs and nipples (her own as much as anyone else's).
(Yes, Daddy has nipples, but no, he doesn't have boobs... boys don't have boobs. Yes, you have boobs, and when you get older, they'll get bigger.)
just speaking from experience and talking to friends in the community, I havent done any studies or anything. But there is definitley a Cd as fetish community, often tied to the S&M thing. Which is light years from GD and the urge to be a woman. Thats why I am saying there is a definitive spectrum which we all get lumped into, further convoluting the issue at hand.
... until your power rations run out ...
Well, her reaction may very well be an ecstatic embrace of the female lifestyle after, as you suggest, being denied access to it. Little boys that play with feminine toys aren't necessarily transgendered. It really comes down to whether or not the person insists that they're another gender, not just behaviors. I personally know a male-to-female transgendered teen that describes herself as a tomboy, but yet still identifies as definitely female. She unfortunately didn't have access to hormonal treatment, and puberty really fucked with her.
There's just so much to it. It's such a deep and academically sastisfying subject. For me, at least.
Not actually too different from my trans friend, who is having a hells of a hard time getting the hormones whilst living in a tiny Northwestern town in the ass-end of nowhere. She eventually had to settle for basically buying them illegally off the loading dock of the Planned Parenthood at midnight.
When adults with GID are given hormone therapy and encouraged to live as their 'inner' gender, they usually do much, much better. Sometimes they even see partial or complete remission of the comorbid mood and behavioral disorders that you mention.
The only question here is whether this also applies to adolescents. It probably does but there isn't enough data to know for sure yet.
I understand why this is counter-intuitive. "I am a girl," when spoken by a boy, especially when that boy has a history of other psychiatric disorders, has all the qualities of a delusion. It sounds a little like somebody saying, "I am Jesus" or a drug-user saying "I can quit any time I want," doesn't it? But experience shows that when you treat that person as a girl, in the vast majority of cases, they get healthier. When your theory doesn't fit the evidence, it's time to find a new theory. There's just a lot we don't know about how gender is oriented in the brain yet.
the "no true scotch man" fallacy.
Not ignorant, I would say its true that many people with actual GD have a rough young life, as anyone who doesnt present as "normal" in a high school atmosphere does, and this can make it difficult for someone to come through it well adjusted. I would say the instance of depresion for example would be on par with that of some one who is openly gay as a teen, or stands out in some other way that is not viewed in a postive light by the majority. Again I have no numbers but it seems very reasonable that it would take a strong person not get upset if you arent met with acceptance in your formative years.
The needle exchanges in San Francisco carry intramuscular syringes specifically for TG/TSs who have to buy their hormones on the grey market.
the "no true scotch man" fallacy.
Tell that to a slew of European languages. :P
I keep saying she should think about moving to the coasts, but even KC was too big for her. The buildings made her dizzy.
I always found this difficult to wrap my head around.
What I believe is that there is no one fix solution to children who exhibit transgender traits.
I believe in both transitioning and curing therapy. In some cases, like all of the cases shown in NPR, I believe transitioning to the opposite sex would've been better.
I really disagree with the 1st doctor in the 1st part of the NPR show that prescribed taking away all the things the kid loved. I have a fear the child will grow into an adult who's never secure about his own gender identity.
However, I also believe there are times when the transgender issue might've been brought up by the environment they lived in. For example, the parent/guardian might've wanted a boy/girl, so perhaps they've always rewarded the opposite sex reaction more positively.
I think the doctors also talked about cases where the child's confusion lies more with the parents' expectations rather than the child's own wants.
Most of all though, from the cases shown in NPR, it seems rather than the psychologists or the parents themselves, it's the child itself who knows who he/she is much better than anyone else.
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Not 100% certainly but there is signifigant overlap. They both involve geneticially determined physical characteristics that cannot be changed given current technology (and some that can).
I cant really see how you could know what your gender actually is before puberty though. Society and biology really kick in then, so you may feel one way before and another way after.
but they're listening to every word I say
Because the concept of gender is even more ingrained than any other ideology.
Husband/wife, he/she, male/female, man/woman. Regardless of what we want to say, people will prefer to see their genders defined.
Perhaps in the future, there will be a new revolution of the way we think about gender where genders aren't as important, but for now where human reproduction is still the product of male and female - gender will still be an issue.
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Interestingly, none of the kids who were given the choice at age 10-12 or so chose to go back to their biological gender at adulthood. To me, that's pretty indicative that this wasn't just a "phase" and that those kids were honestly transgendered.
I'm pretty convinced that gender identity and gender roles may be linked, but they are certainly NOT the same thing. As a parent of a 3-year-old, we've been pretty careful to not push her into any gender role stereotypes. Yet, she knows she's a girl like Mommy. If I told her that she couldn't like dinosaurs or play with a football because she's a girl, I really don't think that would make a difference in her belief that she's a girl.