Because it’s a free country, asshole!

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The comments here at Heretic TOC have long been enriched by the hugely informative wisdom of “A”, whose only fault is to have chosen a pseudonym that is absolutely useless as a search term; locating her back-catalogue of contributions is thus a bit of a nightmare. Today, though, she steps into the spotlight with a guest blog you will definitely want to bookmark in your own records if you are interested – as I think we should be – in the difficult decisions faced by children and adolescents who find themselves struggling with gender dysphoria. Following my own explorations of the theme in Trans kids 1: Insistent, consistent, persistent, “A” made an insightful comment from her own perspective as a former “tomboy”. This now appears below in an extended version. “A” describes herself as “a law-abiding but pro-AOC-abolition BL and GL woman who had a tomboyish, but never gender-dysphoric, childhood”. With an academic background in linguistics, including research-level training, she has undertaken varied work around the world. She tries, she says, “to reconcile MAP politics and feminism”.

PERSISTENCE AND DESISTANCE: A TOMBOY’S VIEW

I highly recommend the blog Trans Research. Much of the most up-to-date research is Dutch, as much of the most ‘advanced’ treatment of gender-dysphoric kids is Dutch. Here, for instance, is a Dutch long-term follow-up study of puberty suppression and here‘s another.

According to this Dutch study children should probably not be allowed to transition socially before they are ten. This recommendation is based in part on the experiences of five natal girls who had effectively lived as boys for some years, then during puberty wanted to ‘switch back’ to being girls. All had “significant feelings of shame for their earlier boyish appearance” and some worried about being teased or excluded by classmates over the switch back. Two are quoted about their difficulties with this. While it seems that the girls did in the main manage to switch over to more feminine appearance and behaviour relatively smoothly, one struggled for years, first fearing that she’d be teased if she wore earrings and bracelets like the other girls, and then actually being teased after the move to high school, which she’d hoped would help her “make a fresh start”. The gender-dysphoric boys, however, had not dressed as girls full-time during elementary school and had been perceived by the other children as boys, just different boys. Perhaps if they’d been effectively living as girls, rather than feminine boys, some of them too would have struggled with switching back.

The tomboy makeover is a major trope in our culture. “My little tomboy now wears satin and lace” go the lyrics to Happy Birthday Sweet Sixteen. Tomboys who grow out of it are all over classic girls’ literature: I remember being, at age twelve, quite irked by the ending of Carol Ryrie Brink’s 1936 novel Caddie Woodlawn, in which an eleven-year-old frontier girl who does everything her brothers do finally decides to settle down a bit and learn sewing. In the film Now and Then, a less-than-entirely-successful but quite popular 1995 attempt to make a Stand By Me for girls, a sporty twelve-year-old binds her growing breasts — till she gets attention, and her first kiss, from a cute neighbour boy who likes her basketball skills.

It’s a trope for a reason, and part of that reason is that it has a lot of truth to it. When I was fourteen or fifteen and we were all changing after PE, one of the other girls remarked, apropos of what I can’t remember, that when she was younger she’d wanted to be a boy, and almost every girl in that room said she had, too. An acquaintance working on a neuroscience PhD recommended to me Lise Eliot’s book Pink Brain, Blue Brain and Rebecca Jordan-Young’s book Brain Storm: The Flaws in the Science of Sex Differences, both of which I recommend in turn. Jordan-Young’s book deals extensively with girls with congenital adrenal hyperplasia, or CAH, “a genetic disorder which causes overproduction of androgens from the adrenal glands…[and] is the most common cause of genital ambiguity”. Girls with CAH on average have more masculine interests as children than unaffected girls. In chapter eight of her book, Sex-Typed Interests, Jordan-Young examines this Swedish study of CAH and non-CAH girls ages two through ten.

The CAH girls in the study spent less time playing with ‘girls’ toys’ and more time playing with ‘boys’ toys’ than the control girls. But the other side of the story is that the most popular toys among the control girls, as measured by number of seconds spent playing with a particular toy, were Lincoln Logs and a garage with four cars. Jordan-Young points out that “the normal control girls spent three times as long playing with the garage and toy cars as they did playing with the baby doll. The only ‘girls’ toy’ that was in the ballpark…with these boys’ toys was a pair of Barbie and Ken dolls. (I suspect that Barbie and Ken were riding around in some of these cars.)” At the end of the study, each child was offered one of a car, a doll and a ball to take home, and while no girl from the control group picked the car, control girls were roughly 36% more likely to choose the ball than the doll. Granted, this was in Sweden. But maybe ‘boys’ toys’ are just more fun for many kids, regardless of sex!

However, of course, almost all women are happy to be women. My experience suggests that if you stand in a crowded urban train station at rush hour, say, you’ll be in the presence of at least a couple of women who as girls were hardcore tomboys — to the point of insisting on short haircuts and gender-neutral nicknames, being delighted to be mistaken for boys, frequently wishing to be boys, becoming distressed at puberty and covering up their developing bodies with baggy clothes, etc. — but who are now happy to be women. Some are feminine women; others remain quite androgynous or ‘gender non-conforming’; most are heterosexual, though a disproportionately high number are lesbian or bisexual; and most, it seems, end up in long-term relationships with men and have kids of their own. And many will tell you quite forcefully that as children they would have jumped at the chance to transition, but that they now feel this would have been the wrong choice for them, and are glad they didn’t get to make it.

Social transition is sometimes set in motion alarmingly early these days, with very young kids ‘going stealth’, like this little trans boy (natal female), who transitioned socially at five:

“The week before he starts school, he changes his name to one that sounds more male. The principal and his teachers know his gender status, but to everyone else he’s just one of two hundred little boys showing off to each other on the playground. He worries about his body betraying him, turning him into a woman against his will, and we tell him that doctors can help him with that, if it’s still what he wants when the time comes.”

But if it’s not still what he wants when the time comes, won’t he find it awfully difficult to change back if none of his friends from kindergarten even know he was born a girl? So what does not letting kids transition socially before ten look like? Maybe something like this. The seven-year-old natal girl in question is allowed, as she should be, to present and act as she wishes, but she’s still known by a female name and female pronouns, and “at school, everyone knows she is a girl” though “no one has ever known her to look or act like one, so she gets treated more like a boy”. Her parents are willing and ready to support whichever path she eventually takes, including social and medical transition, but are well aware that that’s far from an inevitable outcome.

The son of blogger Bedford Hope, aka Accepting Dad, walked a similar middle road in middle childhood. He wore long hair and pink skirts and was fine with either set of pronouns as long as you weren’t making fun of him, but he was clear that he was a boy. At thirteen, the age when kids tend to be at their most ruthlessly conformist, he was already deep-voiced and nearly six feet tall, and he went underground with his femininity for a while, to the point of forbidding his parents to mention it. At fifteen, he was out again as a male-bodied person who likes to wear skirts and loves fashion. His parents, too, were willing and ready to support social and medical transition if it came to that, but in the meantime it was watchful waiting. It worked: partly because the parents handled it well, partly because the family lives in a socially-liberal East Coast area of the US, and partly because of the kid himself: he has great social skills and always had a lot of friends both male and female, and he responded robustly to teasing — asked on the playground why a boy would want to wear a dress, he replied “BECAUSE IT’S A FREE COUNTRY, ASSHOLE!”

A shy, awkward, sensitive kid would have required more support in walking the middle road. But then, shy, awkward, sensitive kids require more support with a lot of things. With the best will in the world, though, there are going to be at least a few kids who need to transition socially before ten, who can’t be happy any other way, and I think they should be allowed to. Yes, there’s a risk to that, but there’s also a risk to letting kids play out by themselves or have sex or even try out for the school play.

Another observation from the first study I linked is that, at least in the Netherlands, the age range ten through thirteen is often when kids end up moving towards their eventual path: ‘persisting’ in their wish to transition medically or ‘desisting’ from it. Before this four-year span, outcomes are difficult to predict. After it, kids are much less likely to change their minds, whichever path they’ve picked. But I do wonder if sometimes ‘desistance’ isn’t seized upon too eagerly, if the books aren’t closed prematurely — after all, fourteen is awfully young to know you’re cis ;)! There does seem, according to the Dutch study discussed here, to be a group of ‘persisters-after-interruption ‘: young people who try in adolescence to make it work as cis homosexuals, but who then come back to the clinics in early adulthood requesting transition. I wonder if there isn’t also a group of ‘underground persisters’ whose desires to change sex continue, but are hidden. The blog post from Transparenthood above contains an example of what many people say to the parents of tomboys:

“I had a cousin that was a tomboy. She dressed like a boy and played with the boys until she was fifteen. Then she suddenly blossomed and now she is the most beautiful, fashionable woman you’d ever meet. Don’t worry, she’ll grow out of it.” And if you scroll down, there’s a rather sad comment:

“I became one of those 15 year olds who allegedly ‘blossomed’ into femininity, boyfriends, makeup, and eventually heterosexual marriage (white gown and all) and motherhood…Guess what? That strong cross-gender identification is still there, half a lifetime later…I still think about it every day. I still wonder whether I should have pushed harder to be my true self, even though in the 1960’s there was no support for such thinking and certainly no medical options.”

Someone who in my view talks a lot of sense about this stuff is one Catherine Tuerk, a nurse, married with grown kids, who started a support group for gender-variant children and their parents after realising that the advice she’d been given to stamp out her son’s childhood femininity — he’s now a gay man — was wrong. Here she describes her 1950s tomboy childhood as her “glory days” and wonders, as I have myself, why some tomboys today don’t have more fun “liking to be boys”.

Here she says what many wouldn’t dare to: “Parents have told me it’s almost easier to tell others ‘My kid was born in the wrong body’ rather than explaining that he might be gay, which is in the back of everyone’s mind. When people think about being gay, they think about sex — and thinking about sex and kids is taboo.”

Indeed: it’s almost an article of faith among many socially-liberal cis people that the little natal boy who loves to dress up as a princess or mermaid isn’t expressing anything to do with a sexual orientation, because prepubescent kids aren’t sexual: (s)he’s expressing his (or her) gender identity, which is entirely separate from sexual orientation and which flows simply and purely from the innocence of children’s unsullied, unsexual hearts. “Why are you thinking about what’s in my six-year-old’s underwear?” is the devastating, unanswerable rejoinder to those who object to trans children using the ‘wrong’ toilets.

Some true believers in gender identity as entirely separate from gender expression and sexual orientation (the ‘Genderbread person‘ is popular now) wonder in all sincerity where the trans girl tomboys and feminine trans boys are. Well, there are probably never going to be many of them, but there may be a few. The Transparenthood blog post above describes a child who may, or may not, be a trans boy but isn’t hyper-masculine, and this post describes a “tomboy trans girl”. I do wonder, though, where we have ended up when a five-year-old who wears dresses every single day and prefers tea-sets to trucks but has lots of physical energy and likes to swordfight with sticks can be described as a tomboy, or a child who likes romantic comedies, small dogs and elaborate hairstyles, who prefers hip-hop dancing to sports and who wrestles with male friends and plays Barbies with female friends is deemed, at the tender age of seven, unmasculine.

Gender roles for kids are in some ways more restrictive than they were when I was coming up. Remember teenage girls in the mid-90s, all baggy jeans and flannel? And Lego, as many have remarked, isn’t for everyone anymore: there’s boy Lego and girl Lego (Lego Friends).

I’ve watched some video footage of child trans activist Avery Jackson, who appeared on the cover of National Geographic. I am not in the least qualified to diagnose Asperger’s, and even people who are cannot of course do so on the basis of a few minutes of video, but the way she talks does remind me a bit of some of the ‘Aspies’ I know. The documentary Kids on the Edge: The Gender Clinic, about trans kids being treated at the Tavistock Clinic in London mentions that about half of the kids seen at the clinic show “autistic traits”. That can, of course, mean many things. It can mean “this child is somewhat socially awkward and quite obsessive but is within the normal range of personality and behaviour and doing fine”. It can mean “this child is really struggling and becoming increasingly unhappy and it’s obvious to everyone that they are on the autism spectrum and desperately in need of the help a diagnosis would bring, but the money-starved public services are dragging their feet on diagnosis, so we have to say ‘traits’ for now”. Then again, it can mean “this child has a lot of symptoms of different conditions that tend, as these neurodevelopmental things do, to co-occur and overlap, and they might get an ASD diagnosis or they might not, but right now we’re focusing on the dyslexia and dyscalculia/the Tourette’s/[etc.], because that’s what’s causing the worst problems”. Trans Research has an Asperger’s/Autism subsection.

The 1997 book FTM: Female-to-Male Transsexuals in Society by Canadian researcher Holly, now Aaron, Devor contains some interesting information on child sexuality. Several of the men interviewed recalled the sexual things they’d done as girls: one started masturbating as a girl of three or four; another’s first partnered sexual experience occurred when he, then she*, was twelve, and involved ‘heavy petting’ with another twelve-year-old girl; a third was having penis-in-vagina sex with adult men beginning when he, then she, was a girl of fourteen. Heartwarmingly, one met his soul mate at school when they were girls of twelve. They were inseparable at once, and at the time of the interview they’d been together ever since — over two decades.

Finally, two more articles I like, and recommend: S/He and What’s So Bad About a Boy Who Wants to Wear a Dress?

*Sorry about all this he-then-she stuff, trans readers. I know it isn’t the most up-to-date or respectful terminology but it’s what Devor uses in the book.

 

Trans kids 1: Insistent, consistent, persistent

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This is the first part of a two-parter on transgender youth. Heretic TOC’s tentative conclusions on trans kids’ rights and well-being, including the right to puberty blocking, will be deferred until part two. By all means send comments straight away, but it would not make sense to judge my opinions until you know what they are. As for the conclusions being “tentative”, I think that as an outsider parachuting myself into this difficult issue for the first time, that’s the way they should be. My view is offered with due humility and I welcome reasoned dissent, not least from one or two people here whose knowledge goes far beyond my own.    

 

What is best for transgender youth? Noisy militants demand the “right” of even little children to adopt the gender of their choice, so that every Stephen can become a Stephanie, start wearing dresses, long-hair and makeup, use the girls’ toilets at school and require everyone to call her “she”.

And every tomboy Stephanie, it is asserted, should be free to do the opposite. Thus the path may be cleared, or so it is hoped, for a smooth transition at adolescence and beyond to a more complete reversal, if so desired, of young people’s originally assigned sex, through hormone treatments and surgery.

Heretic TOC has always keenly advocated children’s rights, so cheerleading for the right of youth with gender dysphoria to change their gender may seem an obvious choice. What is definitely a no-brainer is that we should favour policies and practices aimed at securing their dignity and well-being – aims which should include promoting both a happy childhood and long-term flourishing in adult life.

These welfare aims are not necessarily best advanced, however, simply through declaring and implementing a child’s right to transition. This is because, unlike children’s sexual expression and self-determination, gender transition involves setting out on a path that becomes increasingly harder to reverse as time passes; and irreversible changes of a profound nature, especially sex reassignment surgery (SRS), are sometimes profoundly regretted.

ng-trans-cover-pic

On its Facebook page, the American Family Association posted about this magazine cover: “BE WARNED PARENTS AND GRANDPARENTS!!! National Geographic shakes a fist at God and biblical authority on their radical mission to advocate gender confusion…” The nine-year-old trans girl in the picture, Avery Jackson, and her parents, Debi and Tom, have received an outpouring of public support following the appearance of this very high-profile publicity, but also lots of internet trolling.

This is not to say there should be no early start to transition. Some children make their feelings very clear, very early. From as soon as they learn in infancy about the traditional dress codes and gender roles, they will begin telling their parents they have been assigned to the wrong gender. They just know, from as early as age two or three, that they are really a girl not a boy, or vice versa. In the mantra of therapists approved of by the trans community, if these children are “insistent, consistent and persistent” in such beliefs, then it makes sense to start treating them as belonging to their chosen gender, with a first name and clothes, etc., to match, perhaps just at home to begin with and later at school.

There is nothing irreversible about these symbolic changes, and for that reason there can be no strong reason for making a child’s life miserable by sternly ruling them out. But there are hazards, even at this stage. “Being” a girl instead of a boy, or a boy instead of a girl, may be relatively easy if your mum and dad are relaxed about it and they are the only ones to know; and so will changing back again if so desired. At this stage, there is no commitment beyond the level of any other “let’s pretend” game.

It is much more of a commitment to go to school with a new name and gender though. And a vastly bigger commitment if – as is increasingly happening now that transgender is suddenly such a fashionably high-profile phenomenon – your life as a trans child is featured on a TV reality show such as I Am Jazz, or if your photo is featured on the front cover of National Geographic magazine, as happened to nine-year-old Avery Jackson last month. Once things have reached this stage changing course could be as psychologically tough as getting to the altar with the dreadful sinking feeling that your betrothed is not going to be Mr or Mrs Right after all, but you are already caught in a trap.

The psychiatrist Richard Green, a pioneer in the field of transsexuality since the 1960s, expressed a dim view of transgender children being exposed to the full glare of the media when I heard him speak in London last month on the development of transsexual surgery for adults from its beginnings in the 1930s.

“I’m not convinced that going on TV to announce your child is dysphoric is the best way to ensure their development,” he said. “It might even be considered child abuse. Better if it’s under the radar: allow the child to go to a new school. You test the water. Being on the cover of National Geographic is not necessarily in that kid’s best interests.”

I agree. The high-profile route is a sign not of children being legitimately insistent, consistent and persistent, but rather of militant activism by adults who have shown themselves all too willing to use ruthlessly dishonest tactics. Think of the aggressive noisiness we hear all the time from “victims” of “historic child sexual abuse”: the pushiest ones tell the most sensational yarns and grab the most media and political attention. In this post-truth era, few seem to care whether their stories – with lurid “Satanic abuse” and improbable conspiracy theories based on “recovered memories”, or outright lying – have any basis in reality.

It’s the same, unfortunately, with some trans activists. On BBC’s Newsnight last month, for instance, an activist called Shon Faye made swingeing allegations against Dr Ken Zucker, one of the world’s most eminent clinicians in the transgender field. He falsely claimed that Zucker’s peers, in a  review of his clinical practices, found he had a habit of taking unnecessary photos of his young patients “in various states of undress” and he was “asking them very lurid sexual questions”. Zucker’s long-time colleague Ray Blanchard, also on the programme, intervened to say the allegations were untrue. The presenter stopped Faye from going any further, but by then the damage had been done. The allegations appeared to have been an attempt to recycle an earlier one. A former client, now an adult, claimed Zucker asked him to remove his shirt in front of other clinicians present, laughed when he complied, and then referred to him as a “hairy little vermin”. The accusation was subsequently retracted by the accuser. The resurrected form of the accusation on Newsnight was potentially even more damaging; its vagueness hinted at the possibility of a sexual motive on Zucker’s part – and we need no persuading as to how destructive that can be.

What is certainly true, as H-TOC has reported previously, is that there has been a long-term campaign against Zucker, who is seen by some as a monster who practised a brutal form of “conversion therapy” in which he tried to make kids’ gender identity “normal”, otherwise known in the terminology as cisgender. All this agitation led to a highly critical external review last year of Zucker’s work at his clinic, Toronto’s Centre for Addiction and Mental Health (CAMH), as a result of which he was sacked. Investigative journalist Jesse Singal wrote an in-depth series of articles about this, and concluded:

…the truth about Zucker and his clinic is a lot more complicated. Many of the claims activists have made about him are false or seriously overblown, and the “external review” that led to his firing… was absolutely riddled with errors and falsehoods. CAMH itself quickly decided it couldn’t stand by the review it had commissioned; after we reported that the single most damning allegation in the review was completely false, CAMH yanked the document off its website entirely, replacing it with a toned down “summary.” Zucker has since sued CAMH for releasing what he and his lawyer claim was a defamatory report, and that suit is ongoing.

Zucker had a great chance to put the record straight last month in a BBC 2 documentary called Transgender kids: Who knows best?, and to a significant degree he succeeded – despite a vigorous censorship bid in the shape of a the petition aimed at stopping the show going out, and Shon Faye’s libellous trashing of Zucker, broadcast as part of a Newsnight preview of the show. The programme as a whole was generally well-received by mainstream reviewers, who judged it “cautious”, “well worked out”, “even-handed” and “sophisticated”.

Crucially, it considered the controversial and all-important question of what gender dysphoria actually is. There are those, including clinicians and activists, who believe it always reveals a key aspect of an individual’s innermost, stable identity, by showing there is mismatch between their gender identity and their assigned gender, as traditionally determined by their visible genitalia at birth. Thus until they transition they will never feel at ease with who they are. Arguably, they feel a bit like a gay person before liberation or a Kind one now – forced to hide and deny a fundamental aspect of themselves, and hating the idea that the medical profession wants to wish them out of existence through a “cure”.

Zucker does not deny the importance of the fundamental identity question, but as a clinician he is also aware that people are very complicated and that any particular case may actually be driven by other factors. “Taking any behaviour in isolation when thinking about gender dysphoria is not the way that I think about it,” he says. You also need to know about the child’s family and life history. He gave the example of a girl whose mother had been murdered when she was four. The child wanted to be a boy, he said, in the belief that a boy would have been better able to protect her mother and look after himself too.

It sounded very plausible, but I note that Mike Bailey, one of the top research scientists in the field, is sceptical. Addressing him on Sexnet, Bailey said:

Ken, this mantra that there are many ways to gender dysphoria is possibly true, but it is also possibly false. That your clinical team comes up with various formulations about family dynamics that make sense to the team and that the child gets better when problematic dynamics are treated are not very convincing to me as evidence. (I think a plausible alternative is that the passage of time and a shared commitment to helping the child desist are the active ingredients.) Clinical formulations of this general type (family dynamics) have virtually no evidence supporting them.

What does have strong evidence going for it, though, is a connection between gender nonconformity and autism spectrum disorder (ASD), which can definitely be a profound mental health issue at the severe end of the spectrum. According to paediatric neuropsychologist John Strang, children and adolescents on the autism spectrum are seven times more likely than other young people to be gender nonconforming. And, conversely, children and adolescents at gender clinics are six to 15 times more likely than other young people to have ASD. Zucker has himself pointed out this connection; pro-trans activists play it down.

James/Jasmine, are you reading this? Our brilliant, geeky, teenage male-to-female transgender contributor here at Heretic TOC a couple of years ago also identified as autistic, but at the mild end of the spectrum, such that she felt it was not a mental health problem but a valid and positive aspect of her identity. If you see this, Jasmine, we’d love to hear your reaction!

Even more convincing evidence on Zucker’s side came in the programme from “Lou”, who was born female and had a double mastectomy as part of transitioning to a man. Now she feels “freakish” and regrets it deeply. She says it is a decision that “haunts” her and she feels her gender dysphoria should have been treated as a mental health issue. The identity that now feels truest to her is as a cisgender lesbian.

And yet when she was a girl entering puberty she was desperate to be a boy. Distressed by her unwanted periods, she attempted suicide. She was told by the trans community she really had no choice: it was transition or die. She did not think he had a mental health problem.

Also on Who Knows Best? was trans therapist Hershel Russell, who is based in Toronto, like Zucker, and was one of the people who helped get him sacked. Russell  tried to talk Lou’s case away as a rare exception. But even one exception is enough to prove that matters are not as simple as the more gung-ho activists would have us believe. They also have a problem with the widely-touted claim (albeit the figures are disputed) that around 80% of children and adolescents diagnosed with gender dysphoria do not in the end go through with transition: they desist, sticking with their sex as assigned at birth.

In the Q&A session following his talk on transsexual surgery, I asked Richard Green about the reasons for this desistance. I was particularly interested to know whether he thought the persistors were mainly people with a potentially diagnosable gender-related biological condition underpinning their gender dysphoria, whereas perhaps the desistors had become transgender for socially-motivated reasons.

He favoured a biological explanation for persistence, especially when it was really insistent and consistent. As for those who desist, he said a lot of them become gay or lesbian. And nobody knows better than Green, who wrote a classic book on the subject, that gender non-conforming boys tend to be homosexual later on. It appears to me that gender dysphoria and sexual orientation probably have a connected common origin. Given the present scientific consensus that sexual orientation has pre-natal biological origins, it also seems a good bet that gender dysphoria is triggered further back in an individual’s development than any social influences.

For yet another Toronto angle on all this I can thank Peace, who has guest-blogged and commented here. Transitioning from female to male, Peace has chosen not to guest-blog about his personal journey, but responded instead to my request for general information, thoughts and resources on the subject. One such resource I found particularly helpful was Families in TRANSition: A Resource Guide for Parents of Trans Youth, published by Central Toronto Youth Services.

What struck me most from this publication was its calmly reasonable tone – a million miles, one might think, from the militant, angry activism that sees Ken Zucker libelled and branded a monster. Bizarrely, however, one of those pleasant, sensible contributors turns out to be none other than Hershel Russell, one of Zucker’s most strident critics. He confesses he worries a bit about parents who seem immediately very accepting of their child’s wish to transition. Zucker himself could have written that!

A point I feel Peace would particularly agree with is this:

Trans people often describe puberty, the point at which their bodies begin to change and visibly betray their inner experience, as traumatizing – “nature’s cruel trick” – and a time of true despair. It is a time when feelings of depression or thoughts of suicide may emerge or worsen.

But the guide makes clear that being transgender is not always about heading towards radical anatomical change:

Some youth are clear that their survival depends on fully transitioning from one gender to another. Other youth find that they only need to change one aspect of their bodies, or need no medical interventions at all but rather wish to express their unique gender identity through clothing and behaviour. Whatever the case, these needs come from inside the child and, for better or worse, are unlikely to be changed by pressure or persuasion.

 

The next part of this two-part blog will go deeper into the question of what being transgender really means. It will introduce the scientific basis for a striking claim: that there is such a thing as an intersex brain. It will also discuss transgender choices in relation to wider cultural issues.  

 

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